European urology oncology最新文献

{"title":"PI-RADS v2 and Adverse Prostate Cancer Outcomes: A Cross-cohort Replication Study Across Three Centers.","authors":"Tolou Shadbahr, Juho Pylväläinen, Juho Eineluoto, Alessio Moro, Oleg Kerro, Anu Kenttämies, Eugen Czeizler, Teemu J Murtola, Hyon-Jung Kim-Ollila, Philippe Puech, Jonathan Olivier, Arnauld Villers, Jaakko Peltonen, Matti Nykter, Jing Tang, Tuomas Mirtti, Teemu D Laajala, Antti S Rannikko","doi":"10.1016/j.euo.2026.03.014","DOIUrl":"https://doi.org/10.1016/j.euo.2026.03.014","url":null,"abstract":"<p><strong>Background and objective: </strong>Magnetic resonance imaging (MRI) coupled with Prostate Imaging-Reporting and Data System (PI-RADS) provides standardization for assessing the clinical significance of prostate cancer (PCa). The association between PI-RADS and clinical endpoints has remained underexplored due to limited follow-up data.</p><p><strong>Methods: </strong>Association of PI-RADS with prostate cancer-specific mortality (PCSM), overall survival (OS), metastasis-free survival (MFS), and biochemical recurrence (BCR) was investigated across three retrospective cohorts focusing on the PI-RADS v2 era. The Helsinki University Hospital included 4674 men with clinical suspicion of PCa (MRI during 2015-2019, median follow-up [mFU] 5.0 yr), Tampere University Hospital (N = 1159; 2016-2021, mFU 2.3 yr) with men diagnosed with PCa, and Lille University Hospital (N = 301; 2016-2024, mFU 6.2 yr) with radical prostatectomy-treated men with PCa.</p><p><strong>Key findings and limitations: </strong>In Helsinki cohort, multivariable Cox regression found PI-RADS score 5 to be significantly associated with PCSM (hazard ratio 18.4, 95% confidence interval [6.62-51.1]), along with biopsy GG 5 (5.45 [1.82-16.3]), Charlson's Comorbidity Index (1.53 [1.42-1.7]), and prostate-specific antigen (1.28 [1.11-1.5]). PI-RADS score 5 associated with OS in the Helsinki and Tampere cohorts, and MFS and BCR in the Lille cohort. Main limitation of the work is that all data is retrospective.</p><p><strong>Conclusions and clinical implications: </strong>PI-RADS score 5 is associated with elevated risk of adverse outcomes. The presented clinically strong endpoints have potential to affect decision-making in MRI-based PCa diagnosis and prognosis.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856165","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":"Single Port Robotic Radical Prostatectomy: A Propensity-matched Comparison of Transvesical Versus Extraperitoneal Approaches from the Single Port Advanced Research Consortium.","authors":"Nicolas A Soputro, Jacob Hershenhouse, Sam Cole, Jacob O'Hara, Jack Considine, Mehr Nasir-Moin, Narmina Khanmammadova, Yeonsoo Lee, Ruben Sauer-Calvo, Simon Kim, Alissa Elanjian, Anastasia Mavridis, Sean Horan, Abdulrahman Al-Bayati, Dattatraya Patil, Shamsunnahar Imtiaz, Rui M Bernardino, David G Gelikman, Karim Daher, Firas Abdollah, Adam Lorentz, David I Lee, Ram Pathak, Kshitij Hemal, Jullet Han, Jaschar Shakuri-Rad, Ryan J Nelson, Bertram Yuh, Jeffrey Bassett, Moses Kim, Jean Joseph, Jeffrey W Nix, Chad Ritch, Bruno Nahar, Mihir S Shah, Mutahar Ahmed, Michael D Stifelman, Simone Crivellaro, Riccardo Autorino, Jihad Kaouk","doi":"10.1016/j.euo.2026.04.002","DOIUrl":"https://doi.org/10.1016/j.euo.2026.04.002","url":null,"abstract":"<p><strong>Background and objectives: </strong>Single Port (SP) robotic radical prostatectomy (RARP) has been increasingly used, with Extraperitoneal (EP) and Transvesical (TV) approaches being the most common. This study sought to describe the multi-institutional clinical experience of EP and TV SP-RARP.</p><p><strong>Materials and methods: </strong>A retrospective review was conducted using the prospectively maintained, Institutional Review Board-approved database of the SP Advanced Research Consortium (SPARC) to identify all consecutive patients who underwent EP or TV SP-RARP between 2019 and 2025. A 1:1 propensity score-matched comparison analysis was performed based on the age, prostate volume, PSA levels, and ISUP Grade Groups on the preoperative prostate biopsy.</p><p><strong>Results and limitations: </strong>A total of 2230 patients were reviewed, which included 1699 (76.2%) EP and 531 (23.8%) TV SP-RARP. Following propensity score-matched analysis, 884 patients were included, with 442 being analyzed from each group. History of previous abdominal surgery was more prevalent in the TV cohort (EP 33% vs TV 49.5%, SMD = 0.342). All procedures were completed successfully, with similar operative times (median, 184 vs 192 min, p = 0.733), risk of intraoperative complications (0.6% vs 1%, p = 0.307), and positive surgical margin status (pT2, 13.3% vs 14.7%, p = 0.070). Postoperatively, the SP-TV approach was associated with higher rates of same-day discharges (60.6% vs 78.2%, p < 0.001), a shorter Foley catheter duration (median, 7 vs 5 d, p < 0.001), with no differences in the incidence of major complications (3.2% vs 1.6%, p = 0.185). With 42.3% of patients achieving immediate urine continence following TV SP-RARP, the regionalized technique conferred improved early continence recovery at both 6 wk (44% vs 52.9%, p < 0.001), 3 mo (69.7% vs 79.1%, p = 0.040), and 6 mo (77.9% vs 87.2%, p < 0.001). At 12 mo, satisfactory erectile function was reported in 85.7% and 88.4% of the SP EP and TV groups, respectively (p = 0.174). At a median follow-up duration of 10 mo, biochemical recurrence rates were similar between the two groups (3.1% vs 3.6%, p = 0.678). Limitations of this study included the retrospective study design of the relatively novel surgical techniques, with limited long-term follow-up data.</p><p><strong>Conclusion: </strong>TV SP-RARP offers notable advancements in patient comfort, featuring higher rates of same-day discharges, reduced opioid use, shorter Foley catheter duration, and early recovery of urine continence, whilst maintaining comparable perioperative safety and oncological adequacy to EP SP-RARP.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856133","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":"Toward Improved Kidney Cancer Risk Prediction Using High-risk Genetic Variants and Polygenic Risk Scores.","authors":"James Whitworth","doi":"10.1016/j.euo.2026.04.015","DOIUrl":"https://doi.org/10.1016/j.euo.2026.04.015","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147835729","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":"Pembrolizumab Plus Lenvatinib in Participants with Docetaxel-pretreated Metastatic Castration-resistant Prostate Cancer: Results from KEYNOTE-365 Cohort E.","authors":"Marinela Augustin, Brigitte Laguerre, Capucine Baldini, Ahmed H Zedan, Enrique Gonzalez-Billalabeitia, Peter C Fong, Ruslan Zukov, Peter Hammerer, Mark Prentice, Neal Shore, Andrea Necchi, Tilman Todenhöfer, Elizabeth R Kessler, Fatih Kose, Howard Gurney, Begona P Valderrama, Pengfei Zhu, Kentaro Imai, Yingjie Liu, Ray McDermott","doi":"10.1016/j.euo.2026.03.026","DOIUrl":"https://doi.org/10.1016/j.euo.2026.03.026","url":null,"abstract":"<p><p>Pembrolizumab has shown manageable safety and modest antitumor activity when used as a single agent in participants with metastatic castration-resistant prostate cancer (mCRPC). Preclinical evidence suggests that lenvatinib, a vascular endothelial growth factor-targeted agent, inhibits angiogenesis and cell migration in prostate cancer. Safety and efficacy of pembrolizumab plus lenvatinib in participants with docetaxel-pretreated mCRPC were evaluated in cohort E of the phase 1b/2 KEYNOTE-365 study. Eligible adults with confirmed mCRPC, Eastern Cooperative Oncology Group performance status (ECOG PS) scores of 0 or 1, and prior docetaxel treatment for mCRPC received pembrolizumab 200 mg intravenously every 3 wk, for ≤35 cycles, plus oral lenvatinib 20 mg daily, continuously from day 1 of cycle 1, unless specific discontinuation criteria were met. Primary endpoints were prostate-specific antigen (PSA) response rate; objective response rate (ORR), per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST) v1.1, by blinded independent central review; and safety. A total of 39 participants received treatment, with a median follow-up of 9.7 mo (interquartile range, 8.5-11.3). Confirmed PSA response rate was 34% (95% confidence interval [CI], 20-51). ORR for participants with RECIST-measurable disease was 36% (95% CI, 18-57). Treatment-related adverse events (AEs) of any grade occurred in 92% of participants and grade 3-5 treatment-related AEs occurred in 62% of participants. Two participants died of non-treatment-related AEs (acute kidney injury and unspecified death). Clinical trial registry: NCT02861573.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812840","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":"SBRT for High-risk Localised Prostate Cancer: SHARP and the Limits of Non-randomised Evidence.","authors":"Peter J Hoskin, Ananya Choudhury","doi":"10.1016/j.euo.2026.04.005","DOIUrl":"https://doi.org/10.1016/j.euo.2026.04.005","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812868","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":"Salvage High-intensity Focused Ultrasound for Prostate Cancer Recurrence after Radiotherapy (HIFI-2 Study).","authors":"Guillaume Ploussard, Patrick Coloby, Thierry Chevallier, Bob-Valéry Occéan, Diana Kassab, Nadine Houédé, Arnauld Villers, Pascal Rischmann","doi":"10.1016/j.euo.2026.04.007","DOIUrl":"https://doi.org/10.1016/j.euo.2026.04.007","url":null,"abstract":"<p><strong>Background and objective: </strong>Management of local prostate cancer (PCa) recurrence after primary radiotherapy (RT) remains challenging in daily practice. Salvage high-intensity focused ultrasound (S-HIFU) represents a valid option, but large prospective data are missing.</p><p><strong>Methods: </strong>A prospective, nationwide study was conducted in 32 French centers assessing S-HIFU as a local treatment after RT failure in patients with biopsy-confirmed intraprostatic recurrence without regional or distant metastases. The primary endpoint was androgen deprivation therapy-free survival (ADT-FS). Secondary endpoints were PCa-specific survival and overall survival, and functional outcomes.</p><p><strong>Key findings and limitations: </strong>From 2015 to 2019, 531 patients were included. Median age and prostate-specific antigen (PSA) at S-HIFU were 75 yr and 4.5 ng/ml, respectively. Median PSA was 0.7 and 1.02 ng/ml at 12 and 30 mo after HIFU, respectively. The 30-mo ADT-FS was 71% in the overall cohort (95% CI, 67-76). A pre-S-HIFU PSA level ≤ 4.5 ng/ml and Gleason score 6-7 had the most favorable ADT- FS rates at 30-mo: 84% (95% CI, 78-91). High-grade (>IIIa) complications graded with the Dindo-Clavien classification were reported in 19/531 patients. The number of cases with severe incontinence increased from 7% to 12% after S-HIFU. The quality-of-life study showed no deterioration in the EORTC QLQC-30 median score at 12 mo.</p><p><strong>Conclusion and clinical implications: </strong>This large prospective trial demonstrates good oncologic and functional outcomes after S-HIFU for treating local PCa recurrence after RT. The importance of pre-S-HIFU PSA for efficacy prediction highlights the need for earlier detection of recurrence in patients eligible for local salvage treatment. Further studies should focus on comparisons between different salvage local treatment options within high-level evidence trials.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04307056.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766779","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":"Beyond Clear Cell: Rethinking Postoperative Surveillance for Non-clear Cell Renal Cell Carcinoma Subtypes.","authors":"Arighno Das, Elizabeth E Ellis, Pheroze Tamboli, Priya Rao, Aradhana M Venkatesan, Zhouxuan Li, Wei Qiao, Surena F Matin, Jose A Karam, Brittney H Cotta","doi":"10.1016/j.euo.2026.04.006","DOIUrl":"https://doi.org/10.1016/j.euo.2026.04.006","url":null,"abstract":"<p><strong>Background and objective: </strong>Current risk stratification for non-clear cell renal cell carcinoma (nccRCC) is largely derived from clear cell RCC (ccRCC) data. We evaluated recurrence patterns following surgery for nccRCC and compared the prognostic performances of various international guidelines.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with surgically managed nonmetastatic nccRCC (2003-2015). Patients were stratified by American Urological Association (AUA), European Association of Urology (EAU), and National Comprehensive Cancer Network (NCCN) risk groups. Model performance was assessed via C-index, integrated Brier score (IBS), and calibration plots. Optimal surveillance duration was defined as the time required to capture 95% of recurrences and the time until the 10-yr conditional recurrence risk fell below 5%, accounting for non-RCC deaths as a competing risk.</p><p><strong>Key findings and limitations: </strong>Papillary RCC (pRCC) was the most common subtype (420/712, 59%). Median follow-up was 11.6 yr (IQR: 133-148 mo). Recurrences occurred in 116 patients, most frequently in the abdomen (44/116, 38%). The 5-yr recurrence-free survival (RFS) was 86% (95% confidence interval [CI]: 83-89). Chromophobe RCC (chRCC) had the lowest stage-adjusted subdistribution hazard of recurrence (sHR) (sHR: 0.21, 95% CI: 0.12-0.40). AUA risk-stratification schema provided higher discrimination and lower prediction error (C-index 0.69, IBS 0.104) compared with that of EAU (C-index 0.67, IBS 0.118) and NCCN (C-index 0.66, IBS 0.115). Late recurrences (>5 yr) were common, comprising 27% of all observed recurrences. As a single-center, retrospective study, these findings may not be broadly generalizable. Surveillance duration metrics should be interpreted with caution.</p><p><strong>Conclusions and clinical implications: </strong>Outcomes in this predominantly pRCC and chRCC cohort challenge the current nccRCC surveillance guidelines: abdominal recurrences were the most common, supporting continued cross-sectional imaging. Late recurrences (>5 yr) argue against stopping surveillance at 5 yr and highlight the need for improved risk-adapted surveillance schedules.</p><p><strong>Patient summary: </strong>Current national guidelines for postsurgery follow-up for kidney cancer are based on its most common type. However, their appropriateness for less common forms remains unknown. This study shows that the less common form, non-clear cell renal cell carcinoma, primarily comes back after surgery in the abdomen and can often come back more than 5 yr postoperatively. Therefore, doctors should monitor these patients for a longer duration and focus on abdominal imaging to enable earlier detection. Advancing practice.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766813","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":"When Patients Refuse Radical Cystectomy: Integrating Trimodality Therapy in the Perioperative ICI/ADC Era.","authors":"Martino Pedrani, Alberto De Giorgi, Andrea Gallina, Ursula Vogl, Thomas Zilli","doi":"10.1016/j.euo.2026.04.008","DOIUrl":"https://doi.org/10.1016/j.euo.2026.04.008","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766818","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 A. Light, H. Ahmed H, T. Shah's Letter to the Editor re: M. Baboudjian, A. Uleri, J. Anract, et al. Targeted, Perilesional, and Distant Biopsies in Prostate Cancer Eur Urol Oncol. In press. http://dx.doi.org/10.1016/j.euo.2026.02.006.","authors":"Alessandro Uleri, Romain Diamand, Guillaume Ploussard, Michael Baboudjian","doi":"10.1016/j.euo.2026.04.004","DOIUrl":"https://doi.org/10.1016/j.euo.2026.04.004","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766803","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":"Discovering Predictive Biomarkers in Renal Cell Carcinoma.","authors":"Camillo Porta, Carlo Ganini, Mimma Rizzo, Laura Cosmai","doi":"10.1016/j.euo.2026.03.012","DOIUrl":"https://doi.org/10.1016/j.euo.2026.03.012","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":9.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766800","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}