European urology oncology最新文献

{"title":"Green Perspectives in Radiation Oncology.","authors":"Jennifer Le Guevelou, David Ali, Stéphane Supiot","doi":"10.1016/j.euo.2025.05.020","DOIUrl":"https://doi.org/10.1016/j.euo.2025.05.020","url":null,"abstract":"<p><p>The health care sector contributes 4.4% of global greenhouse gas emissions. Many countries are aiming for a carbon net-zero health care system by 2040-2050. Climate-smart practices in radiation oncology units include a progressive shift towards stereotactic body radiotherapy, the use of telemedicine, and strategies to streamline treatment workflows. Integration of geographic appropriateness in health care policies can also significantly mitigate the carbon footprint of clinical practice. Our rapid review assesses the environmental impact of climate-smart practices in radiation oncology departments, with a focus on management of prostate cancer. PATIENT SUMMARY: Health care accounts for a significant proportion of greenhouse gas emissions. A number of actions are already possible in radiotherapy departments to limit their environmental impact, such as reducing the number of radiotherapy sessions, simplifying treatment planning, and using telemedicine. These strategies should be combined with government measures to ensure that all cancer patients have access to local care centers.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Prostate-specific Membrane Antigen Positron Emission Tomography and Multiparametric Magnetic Resonance Imaging for the Diagnosis of Clinically Significant Prostate Cancer.","authors":"Kit Mun Chow, Alvin Lee, Daniel Peh, Yu Guang Tan, Kae Jack Tay, Henry Ho, Christopher Cheng, Winnie Lam, Sue Ping Thang, Jeffrey Tuan, Law Yan Mee, Thane Ngo, Li Yan Khor, John Yuen, Renu Eapen, Nathan Lawrentschuk, Michael Hofman, Declan Murphy, Kenneth Chen","doi":"10.1016/j.euo.2025.04.017","DOIUrl":"https://doi.org/10.1016/j.euo.2025.04.017","url":null,"abstract":"<p><strong>Background and objective: </strong>More than half of men who undergo a prostate biopsy based on positive multiparametric magnetic resonance imaging (mpMRI) findings do not have clinically significant prostate cancer (csPCa). Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) may complement mpMRI to better triage men with suspected prostate cancer (PCa) and reduce the number of unnecessary biopsies performed. A diagnostic test accuracy systematic review and meta-analysis was performed to determine the diagnostic accuracy of combined imaging for csPCa detection with pairwise comparisons with mpMRI and PSMA-PET alone. A decision curve analysis (DCA) compared the strategies of performing an upfront biopsy versus combined imaging for suspected PCa patients, across varying thresholds for accepting the risk of missing a csPCa diagnosis.</p><p><strong>Methods: </strong>A search of the PubMed, Embase, Central, and Scopus databases, from inception to January 2024, was conducted. Twenty studies (2153 patients) that referenced combined imaging against histopathology were included. Bivariate meta-analyses and metaregression were performed to determine the diagnostic parameters and assess the differences between imaging modalities.</p><p><strong>Key findings and limitations: </strong>Combined imaging had sensitivity, specificity, positive predictive value (PPV), and negative predictive value of, respectively, 92% (95% confidence interval [CI] 87, 95), 64% (95% CI 48, 77), 80% (95% CI 68, 92), and 82% (95% CI 68, 97) at patient-level, and 82% (95% CI 77, 94), 85% (95% CI 77, 94), 79% (95% CI 52, 97), and 81% (95% CI 74, 98) at lesion-level analyses. Head-to-head comparisons showed significantly higher specificity and PPV than mpMRI at patient- and lesion-level analyses. On the DCA, combined imaging outperforms upfront biopsy at risk thresholds of 8% onwards. Synchronous reading of PSMA-PET/computed tomography (CT) with mpMRI was significantly more sensitive but less specific than PSMA-PET/MRI.</p><p><strong>Conclusions and clinical implications: </strong>Combined imaging improves the diagnostic accuracy of csPCa and may help better select patients for a prostate biopsy.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Hinpetch Daungsupawong and Viroj Wiwanitkit's Letter to the Editor re: Olivier Cussenot, Yoann Taille, Jean-Jacques Portal, et al. Eliciting the Impact of Metformin and Statins on Prostate Cancer Outcomes from a Real-life National Database Analysis. Eur Urol Oncol. In press. https://doi.org/10.1016/j.euo.2025.04.024.","authors":"Olivier Cussenot","doi":"10.1016/j.euo.2025.05.016","DOIUrl":"https://doi.org/10.1016/j.euo.2025.05.016","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Francesca Ambrosini, Nataniele Piol, Matteo Bauckneht, et al. Immunohistochemical Prostate-specific Membrane Antigen (PSMA) Expression Patterns of Primary Prostate Cancer Tissue as a Determining Factor for Prostate Cancer Staging with PSMA Positron Emission Tomography/Computed Tomography. Eur Urol Oncol. In press. https://doi.org/10.1016/j.euo.2025.02.012.","authors":"Alessia Cimadamore, Antonio Lopez-Beltran, Liang Cheng, Rodolfo Montironi","doi":"10.1016/j.euo.2025.05.018","DOIUrl":"https://doi.org/10.1016/j.euo.2025.05.018","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long Noncoding RNAs Identify a Subgroup of Patients with Low-grade Non-muscle-invasive Bladder Cancer with Less Favorable Outcomes.","authors":"Joep J de Jong, Peter C Black, Lars Dyrskjøt, Ewan A Gibb","doi":"10.1016/j.euo.2025.05.013","DOIUrl":"https://doi.org/10.1016/j.euo.2025.05.013","url":null,"abstract":"<p><p>Low-grade (LG) stage Ta non-muscle-invasive bladder cancer (NMIBC) is typically nonaggressive with low progression rates and favorable cancer-specific survival. However, frequent monitoring is required because of the risk of recurrence. In this study, we analyzed RNA sequencing data for 286 LG Ta tumors from the UROMOL consortium. Unsupervised consensus clustering of long noncoding RNA profiles identified a subgroup of patients with significantly worse recurrence-free and progression-free survival. These patients may benefit from intensified intravesical therapy or closer surveillance. Further validation of these molecular subgroups could enhance risk stratification and guide personalized treatment approaches.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Olivier Cussenot, Yoann Taille, Jean-Jacques Portal, et al. Eliciting the Impact of Metformin and Statins on Prostate Cancer Outcomes from a Real-life National Database Analysis. Eur Urol Oncol. In press. https://doi.org/10.1016/j.euo.2025.04.024.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1016/j.euo.2025.05.017","DOIUrl":"https://doi.org/10.1016/j.euo.2025.05.017","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Controlled Phase 2 Trial Comparing Salvage Radiotherapy for Prostate Cancer Delivered in 4 Versus 2 Weeks (SHORTER): Acute Genitourinary and Gastrointestinal Patient-reported Outcomes at a Single Institution.","authors":"Himanshu Nagar, Marshall A Diven, Brady Rippon, Christopher E Barbieri, Jim C Hu, Douglas S Scherr, Pragya Yadav, Lhaden Tshering, Sharanya Chandrasekhar, Sydney Wolfe, Ryan Pennell, Madeline Coonce, Shu Ling Chen, Silvia C Formenti, Paul Strong, Elai Davicioni, Ana M Molina, David M Nanus, Jones T Nauseef, Cora N Sternberg, Xi K Zhou, Wanna Lei, Joseph R Osborne, Ariel E Marciscano, Scott T Tagawa","doi":"10.1016/j.euo.2025.05.014","DOIUrl":"https://doi.org/10.1016/j.euo.2025.05.014","url":null,"abstract":"<p><strong>Background and objective: </strong>Some patients undergoing prostatectomy develop biochemical recurrence or have persistently detectable prostate-specific antigen level. Salvage radiotherapy (RT), delivered over ≥4 wk, is a current standard of care. Our objective was to demonstrate that salvage RT delivered in a five-fraction stereotactic body radiotherapy (SBRT) regimen does not significantly increase patient-reported genitourinary (GU) and gastrointestinal (GI) symptoms compared with a 20-fraction regimen (HYPO).</p><p><strong>Methods: </strong>In this randomized noninferiority study, 137 patients were randomized 1:1 to salvage RT with 32.5 Gy in five fractions or 55 Gy in 20 fractions. We report acute changes in Expanded Prostate Cancer Index Composite (EPIC) scores and Common Terminology Criteria for Adverse Events at 3 and 6 mo.</p><p><strong>Key findings and limitations: </strong>The difference in the changes in EPIC GU scores between SBRT and HYPO was 3.3 (95% confidence interval [CI], -8.53, 1.93), indicating a lack of a clinically meaningful difference. The difference in the changes in EPIC GI scores between SBRT and HYPO was 1.16 (95% CI, -5.15, 7.46), indicating a lack of a clinically meaningful difference.</p><p><strong>Conclusions and clinical implications: </strong>Salvage RT delivered in five fractions was not associated with a significantly worse decline in patient-reported GU or GI toxicities at 3 or 6 mo. Further follow-up is necessary to monitor for potential differences in late toxicity and patient-reported outcomes.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality Indicators for Renal Cancer Care: A Systematic Review.","authors":"Alessio Pecoraro, Sara Costagli, Laura Marandino, Raghav Varma, Maarten Albersen, Umberto Capitanio, Michael Jewett, Alexander Kutikov, Steven MacLennan, Grant D Stewart, Patricia Zondervan, Lorenzo Masieri, Andrea Minervini, Sergio Serni, Axel Bex, Riccardo Campi","doi":"10.1016/j.euo.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.euo.2025.05.012","url":null,"abstract":"<p><strong>Background and objective: </strong>Quality indicators (QIs) are crucial for evaluating health care delivery, including effectiveness, safety, and patient-centered outcomes. In contrast to other fields, the definition and implementation of QIs for renal cell carcinoma (RCC) present distinct challenges and remain unmet needs. We summarized the available data on QIs for RCC, focusing on their characterization throughout the care pathway and the potential areas for further development.</p><p><strong>Methods: </strong>A systematic review of the English-language literature was conducted using the MEDLINE, Embase, and Cochrane databases from January 2000 to March 2025, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (PROSPERO ID: CRD42024511924). Quality assessment was evaluated according to the Appraisal of Indicators through Research and Evaluation (AIRE) instrument.</p><p><strong>Key findings and limitations: </strong>Out of 58948 potentially relevant papers, 12 sets of QIs (including an overall number of 86 distinct QIs) were identified from 12 studies. QI sets had a large variation in development strategy and quality. Only five studies scored a total of ≥50% on the AIRE tool across four domains. The process employed to develop the set of QIs was heterogeneous across the included papers. The number of proposed QIs varied significantly across studies (range: 1-25). Only a few studies specified the target population explicitly. The QIs addressed different stages of RCC care pathways: diagnosis (33%), staging (25%), data collection (25%), treatment (67%), pathology (42%), outcomes (83%), hospital facilities (25%), and follow-up (17%). Although 83% (10/12) sets have been piloted in practice, none of these has been validated externally. Regardless of the domain, most studies did not specifically report any cutoff value to evaluate whether the proposed QIs were fulfilled or not.</p><p><strong>Conclusions and clinical implications: </strong>Our review found a relative lack of evidence on QIs for RCC, as well as heterogeneity in their development strategy, definition, reporting, and the included domains of the RCC care pathway. Further efforts are needed to reach consensus on the appropriately developed QIs that could define the quality of care for RCC and to assess their association with clinical outcomes.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Outcomes and Molecular Profiling for Patients with Metastatic Castration-resistant Prostate Cancer with Lung Metastases: A Long-term Multicenter Experience.","authors":"Giuseppina Bruno, Maria Iole Natalicchio, Marianna Garofoli, Cristian Lolli, Aldo Rosano, Piergiorgio Di Tullio, Guido Giordano, Alice Mancino, Mariachiara Masucci, Vincenzo Emanuele Chiuri, Lucia Fratino, Elisa Zanardi, Giuseppe Schepisi, Luca Galli, Francesco Massari, Matteo Santoni, Nicole Brighi, Elisabetta Cornacchia, Pasquale Rescigno, Giuseppe Fornarini, Francesca Sanguedolce, Daniele Santini, Giuseppe Procopio, Orazio Caffo, Ugo De Giorgi, Matteo Landriscina, Vincenza Conteduca","doi":"10.1016/j.euo.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.euo.2025.05.002","url":null,"abstract":"<p><strong>Background and objective: </strong>The prognostic impact of lung metastases (LuMs) in metastatic castration-resistant prostate cancer (mCRPC) remains poorly defined. Our aim was to evaluate the clinical and molecular characteristics of patients with mCRPC with LuMs and their outcomes.</p><p><strong>Methods: </strong>This retrospective multicenter study included 930 patients with mCRPC across 13 centers in Italy. The primary endpoint was the impact of LuMs on overall survival (OS), progression-free survival (PFS), and prostate-specific antigen (PSA) response. As a secondary endpoint, next-generation sequencing for a subgroup with LuMs was used to identify molecular characteristics that might be useful in guiding personalized therapy.</p><p><strong>Key findings and limitations: </strong>Among mCRPC patients treated with an androgen receptor signaling inhibitor, we observed no significant differences in median OS or PFS and PSA response between the LuMs group and the group with bone ± lymph node metastases. Multivariable analyses revealed that only Eastern Cooperative Oncology Group performance status, PSA level, prior docetaxel treatment, and number of metastatic lesions were significant independent factors for both OS and PFS. Comparison of the groups with LuMs only versus liver metastases revealed a significant association between LuMs and a longer OS (15 vs 10 mo; p = 0.002) and PFS (9 vs 5 mo; p = 0.002). The proportion of patients with a ≥50% PSA decline was higher in the LuMs group (odds ratio 3.57, 95% confidence interval 1.37-9.45; p = 0.004). Molecular profile results showed that TP53 mutations accounted for a lower proportion of the pathogenic variants in LuMs than in liver metastases (15% vs 89%). Limitations include the retrospective design and clinical heterogeneity of the population, in addition to unavailability of metastatic biopsies for more in-depth analyses.</p><p><strong>Conclusions and clinical implications: </strong>Our findings suggest that patients with LuMs in mCRPC exhibit clinical and molecular features more similar to those with bone ± lymph nodal metastases than to patients with liver metastases. Further prospective studies are warranted.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Burden of Genitourinary Malignancies in Southeast Asia from 1990 to 2021.","authors":"Rod Carlo A Columbres, Aryan Selokar, Sybil Jones, James Fan Wu, Sruthi Ranganathan, Jenny Chen, Nikko J Magsanoc, Juan Martin Magsanoc, Jerickson Abbie Flores, Erin Jay G Feliciano, Frances Dominique V Ho, Fabio Ynoe Moraes, Enrico D Tangco, Brandon A Mahal, Puneeth Iyengar, Himanshu Nagar, Kenrick Ng, Melvin L K Chua, Imjai Chitapanarux, Paul L Nguyen, Edward Christopher Dee","doi":"10.1016/j.euo.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.euo.2025.05.008","url":null,"abstract":"<p><strong>Background and objective: </strong>The global burden of genitourinary (GU) cancers is rising; yet, the specific burden on the diverse population of 700 million in Southeast Asia (SEA) remains poorly understood. This study presents the most updated trends in the incidence and mortality of bladder, kidney, prostate, and testicular cancer patients across SEA from 1990 to 2021.</p><p><strong>Methods: </strong>Data from the Global Burden of Disease 2021 database were analyzed for the incidence, deaths, and age-standardized rates by sex and age of patients with four major GU cancers across 11 SEA countries from 1990 to 2021.</p><p><strong>Key findings and limitations: </strong>GU cancer incidence and mortality in SEA primarily increased from 1990 to 2021. Kidney cancer showed the greatest rise in incidence and deaths for both sexes, while prostate cancer had the largest absolute increase in male incidence and mortality. In 2021, Brunei had the highest age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of kidney cancer for both sexes. Singapore had the highest prostate cancer ASIR, with the incidence rising in all countries except in Laos, and the Philippines recorded the highest ASMR. For bladder cancer, Thailand and Brunei recorded the highest ASIR for males and females, respectively, while Malaysia had the highest male ASMR and Brunei the female ASMR. Testicular cancer ASIR was highest in Singapore; however, ASMR in Singapore decreased over the study period, but increased or remained stable across the region.</p><p><strong>Conclusions and clinical implications: </strong>Broadly, the rising age-standardized incidence of GU cancers in SEA reflects not only the evolving patterns of modifiable and nonmodifiable risk factors, but also the development of cancer diagnostic systems and improvements in reporting infrastructure. For many SEA countries, these increases warrant enhanced resource allocation for cancer system strengthening, to support timely diagnosis and equitable access to affordable, effective treatment. Regional and international collaboration is essential to promote equity in access to cancer care in SEA.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}