European urology oncology最新文献

{"title":"Reply to Roberto M. Scarpa's Letter to the Editor re: Paolo Gontero, Richard Perry, Daisy Bridge, et al. Unmet Treatment Need and Challenges Associated with Comparative Evidence Generation in BCG-unresponsive Non-muscle-invasive Bladder Cancer: An Expert Consensus. Eur Urol Oncol 2026;9(3):652-9.","authors":"Paolo Gontero, Marek Babjuk","doi":"10.1016/j.euo.2026.08.012","DOIUrl":"10.1016/j.euo.2026.08.012","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":"149059513","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":"Individualized Oncologic Surveillance After Radical Prostatectomy for Localized Prostate Cancer.","authors":"Francesco Pellegrino, Ugo Giovanni Falagario, Ahmad Abbadi, Axel Möller, Fredrik Sundquist, Andrea Camilloni, Olof Akre, Markus Aly, Martin Eklund, Tobias Nordström, Anna Lantz, Henrik Grönberg, Peter N Wiklund","doi":"10.1016/j.euo.2026.09.009","DOIUrl":"https://doi.org/10.1016/j.euo.2026.09.009","url":null,"abstract":"<p><strong>Background: </strong>The oncologic surveillance after radical prostatectomy (RP) remains poorly defined.</p><p><strong>Objective: </strong>To evaluate a model-derived, risk-adapted surveillance approach and estimate when the modeled OCM hazard exceeds the modeled recurrence hazard.</p><p><strong>Design, setting, and participants: </strong>Retrospective, population-based study including 11,552 patients undergoing RP.</p><p><strong>Outcome measurements and statistical analysis: </strong>We developed a follow-up schedule based on the per-visit risk of biochemical recurrence (BCR) and high-risk BCR (HR-BCR), according to the EAU and EMBARK criteria, optimizing the number of PSA tests while maintaining the detection rate of the EAU schedule. Weibull regression was used to estimate model-derived time points at which OCM hazard exceeded recurrence hazard.</p><p><strong>Results and limitations: </strong>Overall, 8,662 (75%) patients had adverse pathological features (pT3-4, pN1, positive surgical margins, and/or ISUP>2). Median follow-up among patients without recurrence was 90 months. The 5-year BCR-, EAU-HR-BCR-, EMBARK-HR-BCR-free survival probabilities were 78%, 91%, and 98% , respectively. Compared to the EAU schedule, adverse-feature patients required intensive follow-up in the first years (quarterly for 2 years, biannually up to 6 years), with de-intensification thereafter. Every 9 months visits were sufficient for favorable-feature patients. A similar pattern was observed for HR-BCR, but with a shorter intensive period (up to 3 years). The follow-up year when the hazard of BCR, EAU-HR-BCR, and EMBARK-HR-BCR became lower than the hazard of OCM ranged from 4-20+, 1-12, and 1-4 years, depending on disease characteristics, age, and comorbidity.</p><p><strong>Conclusions: </strong>Our results show that surveillance protocols should be individualized. We presented a post-RP surveillance strategy in which the intensity and duration of follow-up are based on the risk of BCR and OCM according to individual recurrence risk and competing mortality. Future studies are needed to validate this strategy before it can be implemented in clinical practice.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149059546","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 for Surgically Treated Clear Cell Renal Cell Carcinoma: Results from a UK Tertiary Renal Cancer Network.","authors":"Federica Sordelli, Giuseppe Basile, Eduard Roussel, Veda Kudva, Daniel Hughes, Elizabeth Nally, Ravi Barod, Abhishek Reekhaye, Mark Yao, Alzahrani Hani, Prasad Patki, Faiz Mumtaz, Soha El Sheikh, Omid Sedigh, Nicolò Maria Buffi, Ekaterini Boleti, Thomas Powles, Axel Bex, Antonio Rullan","doi":"10.1016/j.euo.2026.09.002","DOIUrl":"https://doi.org/10.1016/j.euo.2026.09.002","url":null,"abstract":"<p><strong>Background: </strong>Adjuvant pembrolizumab has become the standard of care for patients with clear cell renal cell carcinoma (ccRCC) at increased risk of recurrence after surgery. However, evidence regarding its uptake, safety, and oncological outcomes in routine clinical practice remains limited.</p><p><strong>Objective: </strong>To assess the uptake, oncological outcomes, and safety of adjuvant pembrolizumab among patients eligible according to the KEYNOTE-564 criteria within a UK tertiary renal cancer network.</p><p><strong>Design, setting, and participants: </strong>We retrospectively reviewed patients with surgically treated ccRCC who were eligible for adjuvant pembrolizumab and whose cases were discussed at the multidisciplinary team (MDT) of a UK tertiary renal cancer network between November 2022 and April 2024.</p><p><strong>Intervention: </strong>Following individualized counselling and shared decision-making, patients received adjuvant pembrolizumab or underwent surveillance.</p><p><strong>Outcome measurements and statistical analysis: </strong>Study outcomes included discussion of treatment eligibility at the MDT, patients' and clinicians' joint decision regarding adjuvant pembrolizumab, the incidence and type of treatment-related adverse events (TRAEs), treatment discontinuation rate, and management strategies following disease recurrence. Oncological outcomes included disease-free survival (DFS) and overall survival (OS). Survival outcomes were estimated using the Kaplan-Meier method.</p><p><strong>Results and limitations: </strong>Of 154 patients eligible for adjuvant pembrolizumab, 129 were medically fit to receive treatment, of whom 50% declined therapy following counselling. Patients treated with pembrolizumab were younger than those undergoing surveillance (median age 61 vs 67 yr; p < 0.001), had higher tumour necrosis (45% vs 30%; p = 0.075), and had high-risk disease according to the Leibovich score (53% vs 42%; p = 0.2). At 24 mo, the estimated DFS and OS among patients treated with adjuvant pembrolizumab were 69% (95% confidence interval [CI] 55-87) and 95% (95% CI 89-100), respectively. Regarding safety, 92% of treated patients experienced any-grade TRAEs, 19% experienced grade ≥3 TRAEs, 33% required corticosteroids, and 23% discontinued treatment because of toxicity. The retrospective, nonrandomized design and relatively short follow-up represent the main study limitations.</p><p><strong>Conclusions: </strong>The safety and oncological outcomes of adjuvant pembrolizumab in routine clinical practice within a UK tertiary renal cancer network were consistent with those reported in the KEYNOTE-564 trial. Treatment decisions should extend beyond trial-based eligibility and incorporate validated recurrence risk tools, comorbidities, and patient preferences through individualized counselling and shared decision-making.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149037248","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":"Assessing Pathological Response to Neoadjuvant Therapy in Kidney Cancer: Quality over Quantity?","authors":"James O Jones, J C Koen van der Mijn, Axel Bex, Grant D Stewart","doi":"10.1016/j.euo.2026.09.006","DOIUrl":"https://doi.org/10.1016/j.euo.2026.09.006","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030116","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":"Risk-informed Stratification and Counseling for Adjuvant Pembrolizumab in Clear Cell Renal Cell Carcinoma.","authors":"Jeffrey Y Zhong, Hannah M Garcia, Pedro C Barata","doi":"10.1016/j.euo.2026.09.005","DOIUrl":"https://doi.org/10.1016/j.euo.2026.09.005","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016147","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":"Quantity Improves Quality: Better Outcomes for Patients with Testicular Cancer Through Centralised Care: Recommendations from the European Association of Urology Guidelines Panel on Testicular Cancer.","authors":"Christoph Oing, Hege Sagstuen Haugnes, Axel Heidenreich","doi":"10.1016/j.euo.2026.09.001","DOIUrl":"https://doi.org/10.1016/j.euo.2026.09.001","url":null,"abstract":"<p><p>Patients with testicular cancer achieve outstanding cure rates even at advanced metastatic stages. As discussed here, treatment success for advanced disease is closely linked to the multidisciplinary oncological and surgical expertise of the treating centre.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016218","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":"Triplet Therapy in Metastatic Clear Cell Renal Cell Carcinoma: Time to Abandon Empiric, Biomarker-unselected Intensification?","authors":"Javier Molina-Cerrillo, Victoria Gómez Dos Santos, Teresa Alonso-Gordoa","doi":"10.1016/j.euo.2026.09.004","DOIUrl":"https://doi.org/10.1016/j.euo.2026.09.004","url":null,"abstract":"<p><p>Adding a third drug to standard immunotherapy combinations can prolong disease control but has not yet improved survival benefit and, when used empirically, increases toxicity. The priority now is validated biomarkers for patient selection and mechanistically distinct therapies, rather than more unselected triplets.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016192","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":"Integrated Urine and Plasma DNA Analysis for Molecular Staging of Upper Tract Urothelial Carcinoma.","authors":"Maximilian Pallauf, Stephan Bronimann, Stanley Rapiey, Ezra Baraban, Shoujie Chai, Daniel S Fischer, Vincent T Bicocca, Trevor G Levin, David J McConkey, Nirmish Singla","doi":"10.1016/j.euo.2026.08.008","DOIUrl":"https://doi.org/10.1016/j.euo.2026.08.008","url":null,"abstract":"<p><strong>Background and objective: </strong>Current clinical risk stratification for determining neoadjuvant chemotherapy (NAC) usage in nonmetastatic upper tract urothelial carcinoma (UTUC) is frequently inaccurate. This uncertainty leads to suboptimal patient selection, often resulting in either overtreatment of low-stage disease or missed opportunities for NAC in advanced cases. This study evaluates the prognostic performance of urine tumor DNA (utDNA) and plasma circulating tumor DNA (ctDNA) testing as a tool for improving the diagnostic staging and clinical management of UTUC.</p><p><strong>Methods: </strong>A total of 41 patients who underwent surgical extirpation for localized UTUC were evaluated using utDNA and ctDNA. Prognostic performance of utDNA and ctDNA testing was compared to standard-of-care (SOC) risk assessment and pathology at surgery. The primary analysis was validation of utDNA TP53 mutation and ctDNA status as predictors of muscle-invasive UTUC.</p><p><strong>Key findings and limitations: </strong>A total of 21 (51%) patients had muscle-invasive UTUC. Univariable logistic regression identified molecular staging (utDNA TP53 and ctDNA status) as a strong predictor of muscle-invasive disease (odds ratio [OR] 9.6, p = 0.002) and the only significant predictor by multivariable analysis (OR 8.5, p = 0.004). When combined with SOC diagnostic staging (biopsy and imaging), molecular staging had significantly better specificity (70% vs 25%) and postive predictive value (74% vs 53%) compared to SOC risk factors (high-grade biopsy and cytology) for identifying muscle-invasive disease, with equivalent sensitivity (81% vs 81%) and negative predictive value (78% vs 56%, p = 0.15).</p><p><strong>Conclusions and clinical implications: </strong>Composite liquid biopsy testing can significantly enhance noninvasive staging of UTUC. Improved staging and prognostic classification can improve personalized risk assessment and treatment intensification.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008084","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 Roberto Mario Scarpa's Letter to the Editor re: Roberto Contieri, Marco Paciotti, Alessandro Uleri, et al. Second Transurethral Resection of Bladder Tumor Can Be Safely Omitted in Selected Patients with T1 Non-muscle-invasive Bladder Cancer: Results from the Prospective HuNIRe Trial. Eur Urol Oncol 2026;9:404-12.","authors":"Roberto Contieri, Rodolfo Hurle","doi":"10.1016/j.euo.2026.08.015","DOIUrl":"10.1016/j.euo.2026.08.015","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982445","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":"Risk-dependent Benefit of Adjuvant Pembrolizumab in High-risk Clear Cell Renal Cell Carcinoma: A Multi-institutional Study.","authors":"Daniel D Shapiro, Daniel F Roadman, Viraj A Master, Charles C Peyton, Andrew G McIntosh, Brandon J Manley, Philippe E Spiess, Paz Lotan, Dattatraya Patil, Alireza Dehghanmanshadi, Reagan Amason, Max J Bouvette, Benjamin Blittschau, Kendrick H Yim, Nicholas Abreu, Vaishnavi Jayakumar, Glenn O Allen, Wade J Sexton, Edwin Jason Abel","doi":"10.1016/j.euo.2026.08.004","DOIUrl":"https://doi.org/10.1016/j.euo.2026.08.004","url":null,"abstract":"<p><strong>Background: </strong>Adjuvant pembrolizumab improves outcomes in high-risk clear cell renal cell carcinoma (ccRCC), but baseline recurrence risk varies substantially.</p><p><strong>Objective: </strong>To evaluate treatment selection, outcomes, toxicity, and risk-stratified benefit.</p><p><strong>Design, setting, and participants: </strong>A retrospective cohort of consecutive patients with KEYNOTE-564-eligible ccRCC treated surgically at five U.S. tertiary centers (2021-2025).</p><p><strong>Intervention: </strong>Adjuvant pembrolizumab or surveillance, selected through routine care.</p><p><strong>Outcome measurements and statistical analysis: </strong>Disease-free survival (DFS) was evaluated using a 90-day postoperative landmark, multivariable Cox regression, and inverse probability of treatment weighting (IPTW), stratified by ASSURE risk category. Immune-related adverse events were assessed.</p><p><strong>Results and limitations: </strong>Among 739 patients, 288 received pembrolizumab and 451 underwent surveillance; median follow-up was 18.4 months. Treated patients had more adverse pathologic features; 16% experienced grade ≥3 immune-related adverse events. The landmark cohort included 686 patients with median follow-up of 19.8 months, including 212 who initiated pembrolizumab by 90 days. Initiation by 90 days was not significantly associated with DFS in unadjusted (hazard ratio 1.02), multivariable-adjusted (0.91), or IPTW analyses (0.90). At 18 months after the landmark, absolute risk differences favoring pembrolizumab were -9.4%, 3.6%, and 5.7% across low-, intermediate-, and high-risk groups, respectively (interaction p = 0.8). Limitations include nonrandomized treatment allocation and limited follow-up.</p><p><strong>Conclusions: </strong>Baseline recurrence risk varied markedly among eligible patients. Potential absolute benefit appeared greater with higher baseline risk, although the interaction was nonsignificant. Individualized counseling and improved prognostic and predictive tools remain important.</p><p><strong>Patient summary: </strong>After kidney cancer surgery, treatment decisions should consider individual recurrence risk and potential side effects. Serious toxicity affected 16% of recipients.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976214","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}