European Urology Open Science最新文献

{"title":"Copyright page","authors":"","doi":"10.1016/S2666-1683(25)00068-0","DOIUrl":"10.1016/S2666-1683(25)00068-0","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"72 ","pages":"Page I"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunotherapy in metastatic renal cell carcinoma: Insights from a Dutch nationwide cohort","authors":"Hilin Yildirim ,&nbsp;Anke Richters ,&nbsp;Adriaan D. Bins ,&nbsp;Arnoud W. Postema ,&nbsp;Maureen J.B. Aarts ,&nbsp;Martijn G.H. van Oijen ,&nbsp;Patricia J. Zondervan ,&nbsp;Katja K.H. Aben","doi":"10.1016/j.euros.2025.01.008","DOIUrl":"10.1016/j.euros.2025.01.008","url":null,"abstract":"<div><div>Targeted therapy with tyrosine kinase inhibitors (TKIs) was the standard of care for metastatic renal cell carcinoma (mRCC) until recently, when new first-line combinations with immuno-oncology (IO) agents were approved. We evaluated IO uptake in both first-line and later-line treatment in routine clinical practice in the Netherlands. Patients diagnosed with synchronous mRCC between 2018 and 2022 were identified from the population-based Netherlands Cancer Registry (<em>n</em> = 2621). The median age was 70 yr and 58% of patients had clear-cell RCC. Overall, 55% received at least one line of systemic therapy, 7% underwent cytoreductive nephrectomy without systemic therapy, and the remaining 37% received best supportive care. In the systemic treatment cohort, first-line TKI use decreased from 94% in 2018 to 21% in 2022, while IO use increased from 6% to 79%. Data from 2019–2020 show that 32% and 10% of patients received any second-line and third-line therapy, respectively. The 3-yr overall survival rate for patients with synchronous mRCC increased from 20% (95% confidence interval [CI] 16–23%) in 2018 to 28% in 2021 (95% CI 24–33%). Our analysis shows that IO approvals for mRCC since 2019 have led to an immediate and large increase in IO use to approximately 80% of patients who receive systemic treatment.</div></div><div><h3>Patient summary</h3><div>Since 2019, systemic treatments for metastatic kidney cancer have shifted from drugs targeting selected proteins to immunotherapy. Our results show trends over time for more favorable characteristics among patients receiving systemic treatment and improvements in survival.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"72 ","pages":"Pages 42-45"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrarenal Pressure Monitoring During Ureteroscopy: A Delphi Panel Consensus","authors":"Bhaskar Somani ,&nbsp;Niall Davis ,&nbsp;Esteban Emiliani ,&nbsp;Mehmet Ilker Göcke ,&nbsp;Helene Jung ,&nbsp;Etienne Xavier Keller ,&nbsp;Arkadiusz Miernik ,&nbsp;Silvia Proietti ,&nbsp;Ben Turney ,&nbsp;Oliver Wiseman ,&nbsp;Antonia Bosworth Smith ,&nbsp;Marco Caterino ,&nbsp;Rhodri Saunders ,&nbsp;Mohammed Boulmani ,&nbsp;Olivier Traxer","doi":"10.1016/j.euros.2025.01.005","DOIUrl":"10.1016/j.euros.2025.01.005","url":null,"abstract":"<div><h3>Background and objective</h3><div>Elevated intrarenal pressure (IRP) may increase the risk of complications in patients undergoing ureteroscopy. As there is limited clarity on a threshold value for high IRP, how to manage high IRP, or which patients are at greater risk of complications due to high IRP, we used the Delphi methodology to understand expert opinion in this area.</div></div><div><h3>Methods</h3><div>The Delphi process comprised two online surveys and an in-person meeting. During the in-person meeting, areas of disagreement and consensus were explored. Consensus statements were developed and voted on to determine the level of consensus. The study was granted a waiver by HML IRB Research and Ethics (reference number 2193).</div></div><div><h3>Key findings and limitations</h3><div>The pan-European panel started with 12 and ended with 11 experienced endourologists. Eleven consensus statements were developed. The statements cover topics such as the definition of high IRP, complications linked to high IRP, and patient risk factors for these complications. After anonymous voting, consensus was achieved for all the statements. Two had a strong level and nine had a moderate level of agreement. There was no consensus on an IRP threshold, although the majority would be concerned for patient safety at a pressure above 61–80 cm H₂O.</div></div><div><h3>Conclusions and clinical implications</h3><div>Any IRP above normal physiological levels should be considered high. High IRP during ureteroscopy is a concern for patient safety. It is important to understand links between high IRP, patient characteristics, and complications. We call for additional research to better understand these risks and to inform refinements to clinical practice.</div></div><div><h3>Patient summary</h3><div>A group of experts were asked their opinion on pressure within the kidney (intrarenal pressure, IRP) during a procedure called ureteroscopy (URS), when a narrow telescope is passed through the bladder and into the tube connected to the kidney. Statements that the panel agreed on were developed. These statements show that there is a concern about high IRP during URS as it may be linked to a higher risk of complications for the patient. More research is needed to better understand high IRP and its link to patient outcomes.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"73 ","pages":"Pages 43-50"},"PeriodicalIF":3.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, Management, and Prevention of Gynecomastia and Breast Pain in Patients with Prostate Cancer Undergoing Antiandrogen Therapy: A Systematic Review and Meta-analysis of Randomized Controlled Trials","authors":"Ichiro Tsuboi ,&nbsp;Robert J. Schulz ,&nbsp;Ekaterina Laukhtina ,&nbsp;Koichiro Wada ,&nbsp;Pierre I. Karakiewicz ,&nbsp;Motoo Araki ,&nbsp;Shahrokh F. Shariat","doi":"10.1016/j.euros.2025.01.001","DOIUrl":"10.1016/j.euros.2025.01.001","url":null,"abstract":"<div><h3>Background and objective</h3><div>In patients with prostate cancer treated with antiandrogen monotherapy, gynecomastia and breast pain are relatively common. In the setting of androgen receptor pathway inhibitors (ARPIs), the incidence of these adverse events (AEs) remains unclear. In addition, the effect of prophylactic treatment on gynecomastia remains uncertain. We aimed to evaluate the incidence of gynecomastia and breast pain in prostate cancer patients treated with ARPIs compared with androgen deprivation therapy (ADT) and the effect of prophylactic treatment for these AEs due to antiandrogen therapy.</div></div><div><h3>Methods</h3><div>In June 2024, we queried four databases—PubMed, Scopus, Web of Science, and Embase—for randomized controlled trials (RCTs) investigating prostate cancer treatments involving antiandrogen therapy. The endpoints of interest were the incidence of these AEs due to ARPIs and the effect of prophylactic treatment for these.</div></div><div><h3>Key findings and limitations</h3><div>Eighteen RCTs, comprising 5036 patients, were included in the systematic review and meta-analysis. ARPIs included enzalutamide, darolutamide, and apalutamide. The results indicated that patients who received ARPI monotherapy had a significantly higher incidence of gynecomastia than those who received ADT monotherapy (risk ratio [RR]: 5.19, 95% confidence interval [CI]: 3.58–7.51, <em>p</em> &lt; 0.001). There was no significant difference in the incidence of gynecomastia between ARPI plus ADT therapy and ADT monotherapy (RR: 1.27, 95% CI: 0.84–1.93, <em>p</em> = 0.2). Prophylactic tamoxifen or radiotherapy reduced significantly the incidence of gynecomastia and breast pain caused by bicalutamide monotherapy.</div></div><div><h3>Conclusions and clinical implications</h3><div>We found that ARPI monotherapy increases the incidence of these AEs significantly compared with ADT. In contrast, ARPI plus ADT therapy did not result in a higher incidence of AEs. The use of either tamoxifen or radiotherapy was effective in reducing the incidence of these AEs due to bicalutamide monotherapy. These prophylactic treatments could reduce the incidence of AEs due to ARPI monotherapy. However, further studies are needed to clarify their efficacy.</div></div><div><h3>Patient summary</h3><div>Although androgen deprivation therapy (ADT) improves overall survival in patients with prostate cancer, it is associated with several complications. Androgen receptor pathway inhibitor (ARPI) monotherapy has emerged as a promising strategy for improving oncological outcomes in these patients. However, ARPI monotherapy increases gynecomastia and breast pain in prostate cancer patients compared with ADT, while ARPI plus ADT did not result in a higher incidence of adverse events.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"73 ","pages":"Pages 31-42"},"PeriodicalIF":3.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Subtyping for Predicting Pathological Upstaging and Survival Outcomes in Clinically Organ-confined Bladder Cancer Patients Undergoing Radical Cystectomy","authors":"Joep J. de Jong ,&nbsp;James A. Proudfoot ,&nbsp;Siamak Daneshmand ,&nbsp;Robert S. Svatek ,&nbsp;Vikram Narayan ,&nbsp;Elai Davicioni ,&nbsp;Shreyas Joshi ,&nbsp;Aaron Dahmen ,&nbsp;Roger Li ,&nbsp;Brant A. Inman ,&nbsp;Paras Shah ,&nbsp;Iftach Chaplin ,&nbsp;Jonathan Wright ,&nbsp;Ewan A. Gibb ,&nbsp;Yair Lotan","doi":"10.1016/j.euros.2024.12.009","DOIUrl":"10.1016/j.euros.2024.12.009","url":null,"abstract":"<div><h3>Background and objective</h3><div>Many patients with bladder cancer are understaged. Previous work revealed that molecular subtyping using Decipher Bladder improves clinical staging. This multicenter validation study evaluated Decipher Bladder for upstaging in patients who underwent radical cystectomy (RC) without neoadjuvant therapy.</div></div><div><h3>Methods</h3><div>The Decipher Bladder genomic subtyping classifier (GSC; Veracyte, San Diego, CA, USA) was performed on bladder tumor specimens from patients with high-grade, clinically organ-confined (cTa-T2N0M0) urothelial carcinoma who subsequently underwent RC without neoadjuvant chemotherapy. The primary endpoint was pathological upstaging to non–organ-confined (NOC) disease (pT3+ and/or N+) at RC. The secondary endpoints included overall survival (OS) and pathological upstaging to MIBC+ disease (pT2+ and/or N+) at RC within clinically non–muscle-invasive bladder cancer (cNMIBC) cases.</div></div><div><h3>Key findings and limitations</h3><div>A total of 226 patients (134 cNMIBC [cTa/Tis/T1] and 92 cT2) were analyzed from eight participating institutions. Upstaging to NOC disease was observed in 33% of patients (19% for cNMIBC and 53% for cT2). Molecular subtyping identified 138 luminal and 88 nonluminal tumors. Rates of upstaging to NOC were 41% in nonluminal and 28% in luminal tumors (univariable <em>p</em> = 0.04), which was not independently significant after adjusting for clinical variables. Upstaging to MIBC+ in cNMIBC patients was lower in luminal versus nonluminal tumors (32% vs 51%, multivariable <em>p</em> = 0.03). Patients with nonluminal tumors had worse OS on multivariable analyses (<em>p</em> &lt; 0.05). Limitations include retrospective design and sample size.</div></div><div><h3>Conclusions and clinical implications</h3><div>Luminal tumors represent less aggressive disease, reflected by lower rates of pathological upstaging and favorable OS with RC compared with nonluminal tumors.</div></div><div><h3>Patient summary</h3><div>Molecular subtyping suggests that in clinically non–muscle-invasive bladder cancer, luminal tumors harbor less aggressive disease, as reflected by lower rates of pathological upstaging to muscle-invasive disease and favorable outcomes with radical cystectomy, in comparison with nonluminal bladder cancer.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"73 ","pages":"Pages 24-30"},"PeriodicalIF":3.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Two Cardiovascular Health Algorithms and Kidney Stones: A Nationwide Cross-sectional Study","authors":"Shan Yin ,&nbsp;Zhenzhen Yang ,&nbsp;Pingyu Zhu ,&nbsp;Xuesong Yang ,&nbsp;Xiaodong Yu ,&nbsp;Tielong Tang ,&nbsp;Yan Borné","doi":"10.1016/j.euros.2025.01.003","DOIUrl":"10.1016/j.euros.2025.01.003","url":null,"abstract":"<div><h3>Background and objective</h3><div>There is limited literature on the relationship between cardiovascular health (CVH) and kidney stones. This study aims to compare the association of Life’s Simple 7 (LS7) and Life’s Essential 8 (LE8) with kidney stone prevalence.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis was conducted utilizing NHANES data (2007–2018). Participants aged ≥20 yr with a history of kidney stones and available LS7 and LE8 scores were included. Both LS7 and LE8 are scored such that higher scores indicate better CVH. Weighted proportions and multivariable logistic regression models assessed the relationship between CVH metrics and kidney stone prevalence, adjusting for confounders. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were determined to distinguish between LS7 and LE8 in terms of their discriminative ability within the model associated with kidney stones.</div></div><div><h3>Key findings and limitations</h3><div>A total of 23 563 adults were included; the mean age was 48.1 yr (48.1% male). Kidney stone prevalence was 10.1%. The mean LS7 and LE8 scores were 8.4 and 68.6, respectively. A multivariate analysis and the restricted cubic spline model indicated a significant nonlinear negative correlation between these CVH measures and kidney stone prevalence. The LS7 ideal group showed a lower prevalence than the poor group (odds ratio [OR] = 0.53; 95% confidence interval [CI] 0.41–0.69). The high CVH group had a lower prevalence than the low CVH group (OR = 0.46; 95% CI 0.36–0.57). The AUCs for evaluating LS7 and kidney stones, as well as for LE8 and kidney stones were 0.676 and 0.677, respectively. Limitations were as follows: cross-sectional design limiting causal inference, recall bias from self-reported data, and potential residual confounding.</div></div><div><h3>Conclusions and clinical implications</h3><div>Both CVH algorithms show a significant nonlinear negative correlation with kidney stone prevalence. LS7 may be more accessible for broader implementation. Further high-quality prospective studies are needed to clarify this relationship.</div></div><div><h3>Patient summary</h3><div>In this study, we explored the connection between heart health and kidney stones using data from a large national survey. We found that better heart health, measured by two different scoring methods, is linked to a lower chance of having kidney stones. Our results suggest that promoting heart health could help reduce the risk of kidney stones in adults.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"73 ","pages":"Pages 8-16"},"PeriodicalIF":3.2,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omission of Contralateral Systematic Biopsies in Unilateral Suspicious Prostate Cancer on Magnetic Resonance Imaging: Implications for Radiation Treatment Selection","authors":"Daniël L. van den Kroonenberg ,&nbsp;Sanne J. Jonker ,&nbsp;Auke Jager ,&nbsp;Joëlle D. Stoter ,&nbsp;Eva Schaake ,&nbsp;Karel A. Hinnen ,&nbsp;Wietse S.C. Eppinga ,&nbsp;Ivo G. Schoots ,&nbsp;Jochem R.N. van der Voort van Zyp ,&nbsp;André N. Vis","doi":"10.1016/j.euros.2025.01.006","DOIUrl":"10.1016/j.euros.2025.01.006","url":null,"abstract":"<div><h3>Background and objective</h3><div>A combined approach of magnetic resonance imaging (MRI) targeted biopsies (TBx) and systematic biopsies (SBx) was recommended previously in patients with unilateral suspicious prostate cancer (PCa) on MRI. Yet, new PCa guidelines suggest that contralateral SBx can be omitted. It is unknown how this guideline modification impacts treatment selection. This study evaluates the value of contralateral SBx in radiation treatment selection in patients with unilateral suspicious lesions (Prostate Imaging Reporting and Data System [PI-RADS] ≥3) on MRI.</div></div><div><h3>Methods</h3><div>Case files of 80 patients with a unilateral suspicious lesion on diagnostic MRI who underwent TBx and bilateral SBx were collected. The cases were presented to four radiation oncologists twice: once with diagnostic information of bilateral SBx and TBx, and once with diagnostic information of ipsilateral SBx and TBx pathology results. Based on this information, external beam radiation treatment (EBRT) fractionation scheme, duration of androgen deprivation therapy (ADT), and feasibility of brachytherapy (monotherapy or brachyboost) were considered.</div></div><div><h3>Key findings and limitations</h3><div>After omitting information of contralateral SBx pathology results, selection of EBRT fractionation scheme and ADT duration changed in 14% (95% confidence interval [CI] 9.8–17) and 15% (95% CI 11–19) of cases, respectively. The feasibility of brachytherapy as monotherapy and brachyboost, respectively, changed in 11% (95% CI 7.9–15) and in 21% (95% CI 17–26) of cases, with overall poor interobserver variability for both diagnostic scenarios (Fleiss’ kappa 0.15 and 0.16).</div></div><div><h3>Conclusions and clinical implications</h3><div>Our findings indicate that omitting contralateral SBx has an impact on the treatment selection of patients who choose for radiation therapy as their treatment for locally confined PCa.</div></div><div><h3>Patient summary</h3><div>In patients with prostate cancer identified via magnetic resonance imaging on one side of the prostate, exclusion of prostate biopsies from the opposite side affected the selection of radiation treatment.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"73 ","pages":"Pages 17-23"},"PeriodicalIF":3.2,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Prebiopsy Multiparametric Magnetic Resonance Imaging on Prostate Cancer Detection in Switzerland","authors":"Thomas Paul Scherer ,&nbsp;Dominik Menges ,&nbsp;Uwe Bieri ,&nbsp;Lea Wildisen ,&nbsp;Katharina Staehelin ,&nbsp;Daniel Eberli ,&nbsp;Sabine Rohrmann ,&nbsp;Cédric Poyet","doi":"10.1016/j.euros.2025.01.004","DOIUrl":"10.1016/j.euros.2025.01.004","url":null,"abstract":"<div><h3>Background and objective</h3><div>Multiparametric magnetic resonance imaging (mpMRI)-guided prostate biopsies have become the standard of care. This study aims to analyze changes in the distribution of detected prostate cancer (PCa) risk groups in Switzerland during the adoption period of a multiparametric magnetic resonance imaging (mpMRI)-guided prostate biopsy.</div></div><div><h3>Methods</h3><div>This ecological study analyzed prostate biopsies from a tertiary hospital and PCa diagnoses from the National Agency for Cancer Registration in Switzerland between January 2005 and December 2019. A survey assessed mpMRI uptake in Swiss urological centers. PCa risk group proportions were calculated and compared for the entire period and annually.</div></div><div><h3>Key findings and limitations</h3><div>A total of 4890 biopsies in the hospital dataset and 74 747 national PCa cases were analyzed. Before mpMRI availability, 72.6% of hospital biopsies were PCa negative, with detected cases including 46.4% low risk (LR), 30.5% intermediate risk (IR), and 23.2% high risk (HR). After the availability of mpMRI, 45.7% were PCa negative, with 24.6% LR, 49.0% IR, and 26.5% HR. National mpMRI uptake began in 2008, surpassing 95% by 2019. In 2005, 3448 PCa cases were recorded across 14 cantons, with 46.3% LR, 33.1% IR, and 20.6% HR. By 2019, 6868 cases were registered in 23 cantons, with 28.0% LR, 48.9% IR, and 23.2% HR.</div></div><div><h3>Conclusions and clinical implications</h3><div>After implementation of mpMRI, fewer negative prostate biopsy results were observed. Furthermore, a shift was detected in the distribution of risk groups, with an increase in the proportion of IR cases and a decline in LR cases alongside the uptake of mpMRI. The proportion of HR cases remained essentially constant over time. Further research is needed to determine whether this reflects improved stratification or an artifact of the changed diagnostic pathway.</div></div><div><h3>Patient summary</h3><div>In this study, we examined how the detected prostate cancer grades changed during the adoption of multiparametric magnetic resonance imaging (mpMRI)-guided prostate biopsies in Switzerland between 2005 and 2019. After mpMRI, fewer negative biopsies occurred and the distribution of prostate cancer grades changed, with more intermediate-risk and fewer low-risk cancers identified, while high-risk cases remained stable.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"73 ","pages":"Pages 1-7"},"PeriodicalIF":3.2,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Detection Rates for Prostate-specific Membrane Antigen–avid Prostate Cancer Recurrence at Low Prostate-specific Antigen levels on Extended Axial Field-of-view Positron Emission Tomography/Computed Tomography","authors":"Sarah Thomas ,&nbsp;Jason Callahan ,&nbsp;Paul Conway ,&nbsp;Daniel Moon ,&nbsp;Hugh Morgan ,&nbsp;Johanna Ingbritsen ,&nbsp;Melissa Munro ,&nbsp;Robert E. Ware ,&nbsp;Phil Dundee ,&nbsp;Rodney J. Hicks","doi":"10.1016/j.euros.2024.11.008","DOIUrl":"10.1016/j.euros.2024.11.008","url":null,"abstract":"<div><h3>Background and objective</h3><div>Although prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) has impacted the investigation and management of biochemical recurrence (BCR) of prostate cancer, negative scans are common at low rising prostate-specific antigen (PSA) levels. PET/CT devices with an extended axial field-of-view, such as the Siemens Biograph Vision Quadra (Quadra) scanner, have substantially higher sensitivity than conventional field-of-view scanners. Our aim was to assess whether the enhanced signal-to-noise ratios achieved on the Quadra scanner improve detection of low-volume disease and thereby increase detection of PC at low PSA levels.</div></div><div><h3>Methods</h3><div>We analysed data for the first 300 consecutive patients who underwent clinically indicated PSMA PET/CT for BCR using a Quadra scanner. We assessed scan positivity and the location of detected disease by PSA category.</div></div><div><h3>Key findings and limitations</h3><div>The positivity rate increased with the PSA level from 67% for PSA &lt;0.2 ng/ml to &gt;90% for PSA &gt;1.0 ng/ml (<em>p</em> &lt; 0.05). Disease location also differed by PSA category, with prostate bed recurrence alone identified in 63% of positive cases with PSA &lt;0.2 ng/ml, but &lt;25% of cases with PSA &gt;1.0 ng/ml, and distant metastases present in only 6% of positive cases with PSA &lt;0.2 ng/ml versus &gt;40% of cases with PSA &gt;1.0 ng/ml. In the group with PSA &lt;0.2 ng/ml, pelvic nodal disease without local recurrence was identified in 31% of cases.</div></div><div><h3>Conclusions and clinical implications</h3><div>In comparison to literature data, the Quadra scanner has substantially higher positivity rates at very low PSA levels. At these levels, disease was largely confined to the pelvis and potentially amenable to salvage radiotherapy. However, more than one-third of these patients had disease exclusively outside the prostate bed, with implications for the efficacy and morbidity of current salvage radiotherapy approaches.</div></div><div><h3>Patient summary</h3><div>We investigated a new PET/CT scanner (positron emission tomography/computed tomography) for detection of prostate cancer recurrence. This more sensitive scanner had a higher detection rate, particularly for patients with low PSA (prostate-specific antigen) in their blood. Our results suggest that the new scanner can detect disease recurrence earlier and more accurately than standard PET/CT scanners, which can help in planning further treatment.</div></div>","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"71 ","pages":"Pages 49-56"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"9 Office-based MRI fusion cryoablation: Impact on PCa treated natural history","authors":"Martínez Salamanca J.I.,&nbsp;W Kattan M.W.K.,&nbsp;Egui-Benatouil G, Maiolino G.,&nbsp;Shafizadeh F.,&nbsp;Bianco Jr F.J.","doi":"10.1016/S2666-1683(25)00040-0","DOIUrl":"10.1016/S2666-1683(25)00040-0","url":null,"abstract":"","PeriodicalId":12254,"journal":{"name":"European Urology Open Science","volume":"71 ","pages":"Pages S9-S10"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143141049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}