European urology oncology最新文献

{"title":"Clinical Outcomes of Bladder-sparing Management Versus Early Radical Cystectomy in cT1 Micropapillary Bladder Cancer: A Systematic Review and Meta-analysis.","authors":"Sagar R Patel, Mikael Rauf, Yimin Geng, David Hinojosa-Gonzalez, Joseph B Black, Taeweon Lee, Amanda A Myers, Charles Guo, Roger Li, Joshua J Meeks, Piyush Agarwal, Stephen Williams, Omar Alhalabi, Andrea Necchi, Laura S Mertens, Paolo Gontero, Neema Navai, Ashish M Kamat","doi":"10.1016/j.euo.2026.10.001","DOIUrl":"https://doi.org/10.1016/j.euo.2026.10.001","url":null,"abstract":"<p><strong>Background: </strong>Clinical T1 micropapillary urothelial carcinoma of the bladder is an aggressive variant histology for which early radical cystectomy (RC) is commonly recommended. However, there remain conflicting data on whether conditions in carefully selected patients may be managed with initial bladder-sparing approaches without compromising oncologic outcomes.</p><p><strong>Objective: </strong>The objective is to systematically review and synthesize the available literature comparing bladder-sparing approaches, such as Bacillus Calmette-Guerin (BCG) therapy, and early RC outcomes in clinical stage 1 primary tumor (cT1) micropapillary carcinoma of the bladder.</p><p><strong>Design, setting, and participants: </strong>A systematic search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and Cochrane Handbook for Systematic Reviews of Interventions.</p><p><strong>Outcome measurement and statistical analysis: </strong>The primary end points were overall survival (OS) and cancer-specific survival (CSS). The included articles were descriptively assessed and time-to-event analysis was performed for select endpoints.</p><p><strong>Results and limitations: </strong>Among 461 identified reports, nine retrospective studies met the criteria for quantitative analysis, encompassing 9402 patients of whom 9287 (99%) had non-muscle-invasive bladder cancer (NMIBC) and 1033 (11%) had a micropapillary subtype. A total of 625 patients (62%) underwent bladder-sparing approaches, whereas 392 (39%) underwent early RC. Of the bladder-sparing approaches, 88% of patients received intravesical BCG therapy. For a bladder-sparing approach for cT1 disease with a micropapillary component, pooled unadjusted hazard ratios were not statistically significant for CSS (hazard ratio [HR] 1.32, 95% confidence interval [CI] 0.60-2.88, p = 0.5) and OS (HR 0.85, 95% CI 0.68-1.07, p = 0.16) compared with early RC. Data evaluating bladder-sparing strategies beyond BCG were limited.</p><p><strong>Conclusions: </strong>NMIBC with micropapillary features is an aggressive disease conventionally managed with early RC. In retrospective cohorts of selected patients with micropapillary cT1, available unadjusted data did not provide clear evidence of statistically significant differences in CSS or OS between initial bladder-sparing approaches and early RC.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227410","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: Alfonso Santangelo, Wooju Jeong, Caro Silvani, et al. Long-term Oncological Outcomes of Retzius-sparing Versus Anterior Robot-assisted Radical Prostatectomy: Post Hoc Analysis of a Randomized Cohort. Eur Urol Oncol. In press. https://doi.org/10.1016/j.euo.2026.07.012.","authors":"Denis Seguier, Arnauld Villers, Jonathan Olivier","doi":"10.1016/j.euo.2026.09.019","DOIUrl":"https://doi.org/10.1016/j.euo.2026.09.019","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192022","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":"Machine Learning Models Combining [⁶⁸Ga]Ga-PSMA-11 PET Radiomics and Clinical Features to Predict Overall Survival for Metastatic Castration-resistant Prostate Cancer Treated with [¹⁷⁷Lu]Lu-PSMA Radioligand Therapy.","authors":"Lucas Edouard, Léa Papillon, Loïc Ferrer, Yann Godbert, Marie Meyer, Vincent Prega-Renaud, Céline Subreville, Nadège Anizan, Nicolas Benziane-Ouaritini, Olivier Gallinato, Mathilde Cabart, Diego Teyssonneau, Guilhem Roubaud, Thierry Colin, Paul Schwartz","doi":"10.1016/j.euo.2026.09.015","DOIUrl":"https://doi.org/10.1016/j.euo.2026.09.015","url":null,"abstract":"<p><strong>Purpose: </strong>Metastatic castration-resistant prostate cancer (mCRPC) remains incurable despite recent therapeutic advances. [¹⁷⁷Lu]Lu-PSMA RLT (lutetium-177 labelled prostate-specific membrane antigen radioligand therapy) provides meaningful clinical benefit in selected patients. However, ∼30% of the patients do not respond to [¹⁷⁷Lu]Lu-PSMA RLT. Although several baseline prognostic factors are well known, reliable pretherapeutic predictive biomarkers are still lacking. We developed and compared several predictive machine learning (ML) models integrating clinical, biochemical, and imaging data, including [⁶⁸Ga]Ga-PSMA-11 PET (gallium-68 labelled prostate-specific membrane antigen ligand positron emission tomography) radiomic features, to estimate overall survival (OS) in patients with mCRPC treated with [¹⁷⁷Lu]Lu-PSMA RLT.</p><p><strong>Methods: </strong>This retrospective monocentric study included 102 patients with mCRPC treated with [¹⁷⁷Lu]Lu-PSMA between January 2022 and March 2024. Five lesions per patient were segmented on their pretherapeutic [⁶⁸Ga]Ga-PSMA-11 PET/computed tomography (CT) scans. Radiomic features were extracted following Image Biomarker Standardization Initiative guidelines. Multimodal ML models integrating clinical, genomic, biochemical, and imaging features (including radiomics) were developed to predict OS.</p><p><strong>Results: </strong>Median OS of the total cohort was 11.2 mo. Intralesional homogeneity, characterized by the second-order radiomic feature normalized inverse difference moment, was associated with shorter OS (p = 0.025). The best-performing ML model achieved a 12-mo area under the curve (AUC) of 0.778 by combining 22 clinical, biochemical, genomic, and radiomic features. The model leveraging PET data alone achieved strong performance, with an AUC comparable to the clinical model (0.715 vs 0.766).</p><p><strong>Conclusions: </strong>ML models based on [⁶⁸Ga]Ga-PSMA-11 PET/CT, including radiomic features, offer a noninvasive, standardized, and widely accessible approach to predict OS in patients with mCRPC treated with [¹⁷⁷Lu]Lu-PSMA RLT. This study highlights the strong predictive potential of PSMA PET imaging for patient stratification in a real-world setting.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192085","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: Luc Delobel, Arnauld Villers, Denis Seguier, et al. Long-term Prediction of Metastatic Recurrence in Patients Candidate to Radical Prostatectomy Using MRI and Targeted Biopsy: Insights into Tumor Zonal Origin. Eur Urol Oncol. In press. http://dx.doi.org/10.1016/j.euo.2026.08.009.","authors":"Mohamad Watfa, Jane K Nguyen, Zeyad R Schwen","doi":"10.1016/j.euo.2026.09.020","DOIUrl":"https://doi.org/10.1016/j.euo.2026.09.020","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191998","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":"Prostate Cancer Incidence and Disease Characteristics in Transgender Women Receiving Gender-affirming Hormone Therapy: A Systematic Review with Meta-analysis.","authors":"Kunind Oberoi, Isabella Trevaskis, Sadia Hassan, Kapil Sethi","doi":"10.1016/j.euo.2026.10.002","DOIUrl":"https://doi.org/10.1016/j.euo.2026.10.002","url":null,"abstract":"<p><strong>Background and objective: </strong>Transgender women (TGW) retain lifelong prostate cancer (PCa) risk despite gender-affirming hormone therapy (GAHT), yet its association with PCa incidence and severity is poorly synthesised. This study aimed to quantify pooled PCa incidence in TGW on GAHT relative to cisgender men and characterise disease severity.</p><p><strong>Methods: </strong>This is a systematic review with meta-analysis per Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (International Prospective Register of Systematic Reviews: CRD420261369142). Five databases were searched from inception to April 2026. Eligible studies reported PCa incidence or outcomes in ≥5 TGW or gender-diverse individuals with intact prostates receiving GAHT. Screening, extraction, and risk-of-bias assessment (Risk Of Bias In Non-randomized Studies - of Interventions; JBI) were performed in duplicate. Random-effects meta-analyses pooled standardised incidence ratios (SIR), incidence rates, and proportions with recorded PCa.</p><p><strong>Key findings and limitations: </strong>Nine studies drawn from six independent data sources (54 342 TGW on GAHT; 160 PCa cases) were included. Pooled SIR versus age-adjusted cisgender men was 0.224 (95% confidence interval = 0.146-0.344; κ = 2), a 77.6% relative reduction; pooled incidence rate was 22.9 versus 98.1 per 100 000 person-years. Among 36 cases with reported grade, 33.3% were International Society of Urological Pathology grade group 4-5; prostate-specific antigen (PSA) ranged from 6.5-18.0 ng/ml and was not pooled. Grade and stage data were derived from fewer than 40 patients with no matched cisgender comparison.</p><p><strong>Conclusions and clinical implications: </strong>Detected PCa incidence is substantially lower in TGW receiving GAHT, on very low certainty evidence. Case-level data include a non-negligible proportion of high-grade disease, but whether severity differs from matched cisgender populations remains uncertain. Clinicians should not equate population-level reduction with individual-level protection. Validated PSA thresholds and screening pathways are needed.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192017","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":"Metastasis-free Survival in High-risk Prostate Cancer: A Valid Surrogate, but Is it Transportable Across Strategies of Unequal Systemic Exposure?","authors":"Michael Baboudjian, Alessandro Uleri, Giuseppe Fallara, Alberto Martini, Guillaume Ploussard","doi":"10.1016/j.euo.2026.09.014","DOIUrl":"https://doi.org/10.1016/j.euo.2026.09.014","url":null,"abstract":"<p><p>Metastasis-free survival (MFS) may not have the same meaning after radical prostatectomy (RP) and radiotherapy (RT), largely because RT is typically combined with prolonged androgen-deprivation therapy (ADT), which can delay the clinical emergence of metastases. Therefore, MFS benefits cannot be assumed to have the same implications for overall survival across treatment strategies with different durations of systemic therapy. SPCG-15 will be important to clarify the interpretation of MFS when comparing RP with RT plus long-term ADT.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106248","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":"Efficacy and Safety of Olaparib plus Abiraterone Versus Placebo plus Abiraterone in the Non-BRCA Mutation Subgroup of Patients with Metastatic Castration-resistant Prostate Cancer in the PROpel Trial.","authors":"Niven Mehra, Noel W Clarke, Andrew J Armstrong, Mototsugu Oya, Neal Shore, Giuseppe Procopio, João Daniel Guedes, Cagatay Arslan, Emma Brown, Jae Young Joung, Mikio Sugimoto, Young Deuk Choi, Daniel Castellano, Yüksel Ürün, Christian Hosius, David McGuinness, Arnold Degboe, Fred Saad","doi":"10.1016/j.euo.2026.08.014","DOIUrl":"https://doi.org/10.1016/j.euo.2026.08.014","url":null,"abstract":"<p><strong>Background: </strong>The phase 3 PROpel trial (NCT03732820) demonstrated statistically significant and clinically meaningful radiographic progression-free survival (rPFS) benefit and numerically prolonged overall survival (OS) for olaparib plus abiraterone versus placebo plus abiraterone in first-line metastatic castration-resistant prostate cancer (mCRPC). The greatest benefit was in patients with a BRCA1 and/or BRCA2 mutation (BRCAm).</p><p><strong>Objective: </strong>To inform treatment decision-making, we report analyses in the non-BRCAm subgroup in PROpel.</p><p><strong>Design, setting and participants: </strong>Patients were randomized (1:1) to olaparib plus abiraterone with prednisone/prednisolone versus placebo plus abiraterone with prednisone/prednisolone. Patients without BRCAm were classified as having no positive BRCAm result by at least one prespecified tumour tissue or circulating tumour DNA test. Post hoc exploratory analyses included rPFS, OS, additional efficacy end points, health-related quality of life (HRQoL), and safety.</p><p><strong>Results and limitations: </strong>Median investigator-assessed rPFS in the non-BRCAm subgroup (n = 693) was 24.1 mo for olaparib plus abiraterone versus 19.0 mo for placebo plus abiraterone (hazard ratio [HR] 0.76, 95% confidence interval [CI] 0.61-0.94). Median OS was 39.6 versus 38.0 mo, respectively (HR 0.91, 95% CI 0.73-1.13). Additional post hoc exploratory analyses support these efficacy findings for olaparib plus abiraterone. There was no significant difference in HRQoL between treatment arms. Safety findings were consistent with the overall biomarker-unselected population.</p><p><strong>Conclusions: </strong>Olaparib plus abiraterone provided numerically longer rPFS versus placebo plus abiraterone, with no new safety signals, in the non-BRCAm subgroup of patients with mCRPC in PROpel. Our findings support olaparib plus abiraterone as an important new treatment option for consideration in patients with non-BRCAm mCRPC.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106309","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":"Natural History After Likely Cure Versus Recurrence After Prostate Radiotherapy (RAPTOR).","authors":"Soumyajit Roy, Tahmineh Romero, Mack Roach, Jeff M Michalski, David J Joseph, David Dearnaley, Alison C Tree, Emma Hall, Matthew R Sydes, Luca Incrocci, Wilma Heemsbergen, Floris de Pos, Michel Bolla, Philippe Maingon, Theo de Reijke, Abdenour Nabid, John G Armstrong, Scott C Morgan, Xavier Maldonado, Wee L Ong, Jarad Martin, Eric M Horwitz, Jessica K Wong, Michael Steinberg, Luca Valle, Kekoa Taparra, Angela Y Jia, Nicholas G Zaorsky, Stefano Arcangeli, Giuseppe Sanguineti, Almudena Zapatero, Howard Sandler, Paul L Nguyen, Yilun Sun, Daniel E Spratt, Amar U Kishan","doi":"10.1016/j.euo.2026.09.007","DOIUrl":"https://doi.org/10.1016/j.euo.2026.09.007","url":null,"abstract":"<p><strong>Background: </strong>Whether freedom from biochemical recurrence (BCR) at 5 yr after definitive radiotherapy (RT) for localized prostate cancer (PCa) represents a durable cure remains uncertain.</p><p><strong>Objective: </strong>To evaluate the association between the timing of BCR after RT and the long-term risks of distant metastasis (DM) and PCa-specific mortality (PCSM), overall and according to treatment intensity, including outcomes by BCR timing (≤5 yr, >5 yr, or no BCR).</p><p><strong>Design, setting, and participants: </strong>Post hoc individual patient data analysis of 3120 men with intermediate- (89%) or high-risk (11%) PCa enrolled in 11 randomized trials within the Meta-Analysis of Randomized Trials in Cancer of the Prostate consortium and treated with contemporary high-dose RT (HDRT) ± androgen deprivation therapy (ADT).</p><p><strong>Outcome measurements and statistical analysis: </strong>Cumulative incidences of DM at 8 yr and PCSM at 10 yr after RT were estimated using competing-risk methods. Adjusted cumulative incidences were estimated using average marginal effects, accounting for clinicopathologic factors, treatment intensity, and progressively longer durations remaining free of BCR after RT. A priori, cumulative incidences ≤10% were considered indicative of a favorable long-term prognosis.</p><p><strong>Results and limitations: </strong>Among men without BCR at 5 yr, subsequent risks of DM and PCSM were low overall. In patients with intermediate-risk PCa treated with HDRT alone, the adjusted cumulative incidences of 8-yr DM and 10-yr PCSM were 6.6% and 2.5%, respectively, indicating a favorable long-term prognosis based on the prespecified threshold. In contrast, patients with intermediate-risk PCa treated with HDRT plus short-term ADT and patients with high-risk PCa treated with HDRT plus long-term ADT had higher residual metastatic risk (8-yr adjusted cumulative DM incidence of 11% and 16%, respectively) exceeding the predefined favorable prognosis threshold despite remaining BCR-free for 5 yr. Early BCR (≤5 yr) was associated with substantially higher risks of DM and PCSM across all treatment groups. Limitations include the retrospective nature of the analyses, heterogeneity in BCR definitions across trials, absence of comorbidity data and contemporary risk subclassification, and the pre-prostate-specific membrane antigen imaging era of the constituent trials.</p><p><strong>Conclusions: </strong>A 5-yr BCR-free benchmark was associated with a favorable long-term prognosis for intermediate-risk PCa treated with RT alone, but it appears insufficient for patients requiring ADT intensification. External validation in contemporary cohorts with standardized BCR definitions and modern imaging is warranted.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149106235","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":"Rethinking the 3-cm Rule: Toward Biology-guided Management of Sporadic Bilateral Multifocal Papillary Renal Cell Carcinoma.","authors":"Selcuk Erdem, Chiara Re, Umberto Capitanio","doi":"10.1016/j.euo.2026.09.010","DOIUrl":"https://doi.org/10.1016/j.euo.2026.09.010","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080240","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":"Adjuvant Pembrolizumab in Clear Cell Renal Cell Carcinoma: Eligibility Is Only the Beginning.","authors":"Francesco Rossi, Massimiliano Depalma, Bernardo Rocco, Riccardo Autorino","doi":"10.1016/j.euo.2026.09.008","DOIUrl":"https://doi.org/10.1016/j.euo.2026.09.008","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149059476","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}