European urology oncology最新文献

{"title":"Results of the Prospective Randomized UroFollow Trial Comparing Marker-guided Versus Cystoscopy-based Surveillance in Patients with Low/Intermediate-risk Bladder Cancer","authors":"Bernd J. Schmitz-Dräger ,&nbsp;Ekkehardt Bismarck ,&nbsp;Florian Roghmann ,&nbsp;Nicolas von Landenberg ,&nbsp;Joachim Noldus ,&nbsp;Daniela Jahn ,&nbsp;Karoline Kernig ,&nbsp;Oliver W. Hakenberg ,&nbsp;Peter J. Goebell ,&nbsp;Jörg Hennenlotter ,&nbsp;Eva Erne ,&nbsp;Arnulf Stenzl ,&nbsp;Maciej Rowinski ,&nbsp;Guido Schiffhorst ,&nbsp;Thomas Baranek ,&nbsp;Natalya Benderska-Söder","doi":"10.1016/j.euo.2025.04.020","DOIUrl":"10.1016/j.euo.2025.04.020","url":null,"abstract":"<div><h3>Background and objective</h3><div>A growing body of evidence suggests that the intensity of current follow-up in non–muscle-invasive bladder cancer (NMIBC) patients greatly exceeds clinical necessities. The Uro<em>Follow</em> trial investigated the diagnostic accuracy of marker-based follow-up in patients with low/intermediate-risk NMIBC against the standard of care (SOC) for noninferiority (margin: &lt;20%).</div></div><div><h3>Methods</h3><div>Patients with Ta low- and high-grade (G1–2) NMIBC were randomized to the SOC or 6-monthly marker-based follow-up (algorithm comprising urine markers and ultrasound; marker-based surveillance regimen [MA]). After a negative 3-mo cystoscopy (white light cystoscopy [WLC]), only patients with a positive algorithm underwent WLC in the MA. End-of-study WLC was recommended at 3 yr to recurrence-free patients. Simultaneously, several innovative urine markers were examined.</div></div><div><h3>Key findings and limitations</h3><div>In total, 214 patients were randomized to the SOC (<em>n</em> = 109) and MA (<em>n</em> = 105). The median follow-up was 2.4 yr; 30 and 29 cases of tumor recurrence were diagnosed in the SOC and MA arms, respectively. Sensitivity was 96.5% versus 81.5% (<em>p</em> = 0.1), with one and five Ta low-grade tumors being overlooked in the SOC and MA patients, respectively. No tumor progressing in stage or grade was missed. A total of 589 WLC procedures were performed in the SOC and 148 in the MA arm (<em>p</em> &lt; 0.001). Among five other markers (ADX-Bladder, CellDetect, Bladder EpiCheck, UBC rapid, and Xpert bladder cancer monitor [BC-M]), Bladder EpiCheck and the Xpert BC-M showed similar performance to the algorithm.</div></div><div><h3>Conclusions and clinical implications</h3><div>Uro<em>Follow</em> is the first urine marker–based randomized trial in low/intermediate-risk NMIBC patients. We conclude that 6-monthly marker-based follow-up after negative 3-mo WLC is safe in this cohort. Results of contemporary urine markers suggest that their potential for use in marker-based surveillance, however, requires prospective confirmation.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1041-1049"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005284","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":"Avelumab First-line Maintenance for Advanced Urothelial Carcinoma: Long-term Analyses of Patient-reported Outcomes and Quality-adjusted Time Without Symptoms or Toxicity from the JAVELIN Bladder 100 Trial","authors":"Petros Grivas ,&nbsp;Jeanny B. Aragon-Ching ,&nbsp;Joaquim Bellmunt ,&nbsp;Yohann Loriot ,&nbsp;Miguel A. Climent Duran ,&nbsp;Srikala S. Sridhar ,&nbsp;Po-Jung Su ,&nbsp;Se Hoon Park ,&nbsp;Evgeny Kopyltsov ,&nbsp;Yoshiaki Yamamoto ,&nbsp;Natalia Jacob ,&nbsp;Jason Hoffman ,&nbsp;Karin Tyroller ,&nbsp;Juliane Manitz ,&nbsp;Mairead Kearney ,&nbsp;Michael Schlichting ,&nbsp;Thomas Powles","doi":"10.1016/j.euo.2025.04.004","DOIUrl":"10.1016/j.euo.2025.04.004","url":null,"abstract":"<div><h3>Background and objective</h3><div>In JAVELIN Bladder 100, avelumab first-line maintenance plus best supportive care (BSC) significantly prolonged overall survival versus BSC alone, with no detrimental impact on quality of life (QOL), in patients with advanced urothelial carcinoma without progression following first-line platinum-based chemotherapy. We report long-term analyses of patient-reported outcomes (PROs) in patients treated with avelumab (any duration or ≥12 mo) and a post hoc analysis comparing quality-adjusted time without symptoms or toxicity (Q-TWiST) between arms.</div></div><div><h3>Methods</h3><div>PROs were assessed using National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Bladder Symptom Index-18 (FBlSI-18) and EuroQol 5-level EQ-5D (EQ-5D-5L). Q-TWiST was calculated as the utility-weighted sum of mean time in three health states: time with all-cause grade 3/4 toxicity prior to progression, time without grade 3/4 toxicity or symptoms of progression, and time after progression.</div></div><div><h3>Key findings and limitations</h3><div>In the overall avelumab plus BSC arm (<em>n</em> = 350) and the subgroup treated for ≥12 mo (<em>n</em> = 118), completion rates for PRO assessments during treatment were &gt;80%. FBlSI-18 total and EQ-5D-5L index scores remained stable throughout 24 mo of treatment, with no clinically important changes from baseline. The mean Q-TWiST was 18.46 mo with avelumab plus BSC versus 15.13 mo with BSC alone (22% relative improvement). Limitations include open-label trial design and small patient numbers at later cycles.</div></div><div><h3>Conclusions and clinical implications</h3><div>Patients receiving avelumab had preserved health-related QOL and control of cancer-related symptoms with manageable toxicity, further supporting avelumab first-line maintenance as the recommended treatment for advanced urothelial carcinoma not progressed after platinum-based chemotherapy.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 941-951"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005479","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":"Every Other Day or Once a Week: Long-term Oncological Outcomes in the Phase 2 PATRIOT Trial of Prostate Stereotactic Ablative Body Radiotherapy","authors":"Wee Loon Ong ,&nbsp;Harvey Quon ,&nbsp;Aldrich Ong ,&nbsp;Patrick Cheung ,&nbsp;William Chu ,&nbsp;Hans Chung ,&nbsp;Danny Vesprini ,&nbsp;Amit Chowdhury ,&nbsp;Dilip Panjwani ,&nbsp;Yasir Alayed ,&nbsp;Geordi Pang ,&nbsp;Renee Korol ,&nbsp;Melanie Davidson ,&nbsp;Ananth Ravi ,&nbsp;Boyd McCurdy ,&nbsp;Liying Zhang ,&nbsp;Meghan Kulasingham-Poon ,&nbsp;Alexandre Mamedov ,&nbsp;Andrea Deabreu ,&nbsp;Andrew Loblaw","doi":"10.1016/j.euo.2025.03.011","DOIUrl":"10.1016/j.euo.2025.03.011","url":null,"abstract":"<div><h3>Background and objective</h3><div>The PATRIOT multicentre phase 2 trial showed that prolongation of overall treatment time (OTT) for prostate stereotactic ablative body radiotherapy (SABR) was associated with better acute bowel and urinary quality of life. However, the impact on long-term cancer outcomes is unclear.</div></div><div><h3>Methods</h3><div>Men with favourable-risk localised prostate cancer in the PATRIOT trial were randomised to five-fraction prostate SABR every other day (EOD; <em>n</em> = 77) or once weekly (QW; <em>n</em> = 75).The cancer outcomes evaluated in this post hoc analyses were biochemical failure (BF), metastasis-free survival (MFS), prostate cancer–specific survival (PCSS), and overall survival (OS).</div></div><div><h3>Key findings and limitations</h3><div>Median follow-up was 91 mo. The 8-yr cumulative incidence rates for BF were 5.5% in the EOD arm versus 9.6% the QW arm (<em>p</em> = 0.2). The 8-yr probability rates were 100% versus 95.9% for MFS (<em>p</em> = 0.08), 100% versus 97.2% for PCSS (<em>p</em> = 0.2), and 96.0% versus 85.4% for OS (<em>p</em> = 0.3) for the EOD versus QW arms, respectively. The study is limited by the small sample size (powered to detect significant differences in acute bowel quality of life).</div></div><div><h3>Conclusions</h3><div>This study suggests no significant differences in long-term cancer outcomes between EOD and QW schedules for five-fraction prostate SABR.</div><div>This trial is registered on ClinicalTrials.gov as NCT01423474.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 909-913"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005649","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":"Randomized Phase 2 Trial of Presurgical Androgen Deprivation Therapy With or Without Axitinib in Prostate Cancer Presenting With Lymph Node Metastasis","authors":"Amado J. Zurita ,&nbsp;Rebecca S. Tidwell ,&nbsp;Brian F. Chapin ,&nbsp;Deborah R. Harris ,&nbsp;Miao Zhang ,&nbsp;Louis L. Pisters ,&nbsp;Ana Aparicio ,&nbsp;John C. Araujo ,&nbsp;Sara Arce-Gallego ,&nbsp;Keyi Zhu ,&nbsp;Maria L. Lozano ,&nbsp;Lance Pagliaro ,&nbsp;Joaquin Mateo ,&nbsp;Christopher Logothetis ,&nbsp;Patricia Troncoso ,&nbsp;John W. Davis","doi":"10.1016/j.euo.2025.04.015","DOIUrl":"10.1016/j.euo.2025.04.015","url":null,"abstract":"<div><h3>Background and objective</h3><div><span><span>Strategies that combine systemic and locoregional therapies are increasingly used in prostate cancer (PC) with </span>lymph node metastasis (LNM) at presentation. We investigated whether the presurgical combination of androgen deprivation therapy (ADT) and the antiangiogenic agent </span>axitinib would be more effective than ADT alone in achieving time off systemic therapy after surgery in these patients.</div></div><div><h3>Methods</h3><div>Patients with newly diagnosed PC with either clinically detected LNM (cTxN1M0 or cTxNxM1a) or at very high risk for subclinical LNM were treated with ADT for 2 mo and then randomized 2:1 to addition of axitinib to ADT versus continuing ADT alone for an additional 4 mo before surgery and discontinuation of systemic therapy. The primary endpoint was the rate of freedom from treatment failure in the intention-to-treat population at 1 yr postoperatively (“success”). Failure was defined as prostate-specific antigen &gt;1.0 ng/ml, objective progression, or initiation of additional treatment.</div></div><div><h3>Key findings and limitations</h3><div>Of the 73 patients accrued, 49 received axitinib + ADT and 24 received ADT alone. Of the 49 patients who had surgery on protocol, success was achieved in 26, of whom 22 received axitinib + ADT and four received ADT alone. In the node-positive group of 55 patients, the success rate was 36.8% (95% credible interval [CrI] 22.5–52.5%) for axitinib + ADT and 19.0% (95% CrI 5.7–37.9%) for ADT alone; the probability of a higher success rate with axitinib + ADT was 0.935. The median time to progression was 9.8 mo (95% confidence interval [CI] 7.6–17.4) with axitinib + ADT versus 5.7 mo (95% CI 4.0–11.3) with ADT alone (<em>p</em> = 0.03). Pathologic responses, time to metastatic progression, and overall survival were similar between the arms. There were no grade 4–5 toxicities or unexpected perioperative complications.</div></div><div><h3>Conclusions and clinical implications</h3><div>In patients with newly diagnosed PC with LNM, a presurgical strategy that combines axitinib + ADT was feasible and was more likely than ADT alone to achieve significant time off treatment. However, the overall efficacy was limited, suggesting that patient selection and more effective combinations are needed.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1010-1019"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616853","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":"Radiation Therapy in the Management of Muscle-invasive Bladder Cancer with Carcinoma in Situ: Still a No Go?","authors":"Constance Huck ,&nbsp;Vérane Achard ,&nbsp;Jason Efstathiou ,&nbsp;Julien Van Damme ,&nbsp;Alexandre R. Zlotta ,&nbsp;Evanguelos Xylinas ,&nbsp;Ananya Choudhury ,&nbsp;Morgan Rouprêt ,&nbsp;Bertrand Tombal ,&nbsp;Paul Sargos","doi":"10.1016/j.euo.2025.05.028","DOIUrl":"10.1016/j.euo.2025.05.028","url":null,"abstract":"<div><h3>Background and objective</h3><div>This narrative review explores the impact of carcinoma in situ (CIS) on outcomes in muscle-invasive bladder cancer (MIBC) after trimodal therapy (TMT) comprising transurethral resection of bladder tumor, a radiosensitizing agent and radiation therapy (RT). There is limited and inconsistent evidence on the effect of CIS, often considered a contraindication to TMT, on treatment efficacy.</div></div><div><h3>Methods</h3><div>We reviewed studies evaluating the influence of TMT and RT alone on clinical outcomes in CIS-associated MIBC. Endpoints evaluated included complete response (CR) rates, overall survival (OS), disease-specific survival (DSS), and RT protocol variations, such as fractionation schedules, total doses, and the use of image-guided RT.</div></div><div><h3>Key findings and limitations</h3><div>Evidence from studies on RT alone is inconsistent, often because of outdated regimens and inadequate CIS evaluation. Retrospective TMT studies suggest that CIS does not significantly affect CR rates, although its impact on OS and DSS remains uncertain, particularly with suboptimal RT protocols. Emerging evidence supports continuous and moderately hypofractionated RT combined with image-guided RT as potential strategies to improve outcomes. Standardized definitions of extensive CIS and better patient selection are critical for optimizing bladder preservation strategies.</div></div><div><h3>Conclusions and clinical implications</h3><div>CIS presents significant challenges for TMT in MIBC, necessitating precise assessment, advanced RT techniques, and multidisciplinary collaboration. Novel therapies, including immunotherapy and intravesical agents, may further improve outcomes. Research into standardized protocols is essential to optimize treatment strategies.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1165-1173"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505281","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":"Clinical Trial Protocol for ACCURATE: A CCafU-UroCCR Randomized Trial: Three-dimensional Image-guided Robot-assisted Partial Nephrectomy for Renal Complex Tumor (UroCCR 99)","authors":"Gaëlle Margue ,&nbsp;Jean-Christophe Bernhard ,&nbsp;Joris Giai ,&nbsp;Assilah Bouzit ,&nbsp;Solène Ricard ,&nbsp;Manon Jaffredo ,&nbsp;Bénédicte Guillaume ,&nbsp;Eva Jambon ,&nbsp;Gaëlle Fiard ,&nbsp;Pierre Bigot ,&nbsp;Thibaut Waeckel ,&nbsp;Louis Surlemont ,&nbsp;Stéphane De Vergie ,&nbsp;Nicolas Branger ,&nbsp;Nicolas Doumerc ,&nbsp;Romain Boissier ,&nbsp;Hervé Lang ,&nbsp;François Audenet ,&nbsp;Jean-Baptiste Beauval ,&nbsp;Karim Bensalah ,&nbsp;Jean-Luc Descotes","doi":"10.1016/j.euo.2025.03.012","DOIUrl":"10.1016/j.euo.2025.03.012","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and objective&lt;/h3&gt;&lt;div&gt;Renal cancer often requires nephron-sparing surgery for optimal patient outcomes. Despite advances in imaging and robot-assisted surgery, there is a need to enhance surgical precision and renal preservation. This trial evaluates the effectiveness of three-dimensional image-guided robot-assisted partial nephrectomy versus standard methods in improving surgical outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Clinical trial design and timeframe&lt;/h3&gt;&lt;div&gt;This trial is a prospective, 1:1 randomized, single-blind phase 3 superiority study conducted across 14 centers within the French Network for Research on Kidney Cancer, aiming to enroll 694 patients over 36 mo.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Endpoints&lt;/h3&gt;&lt;div&gt;The primary endpoint is a composite trifecta score, including negative surgical margins, no complications, and renal function preservation (estimated glomerular filtration rate &gt;90% at 1 mo). The secondary endpoints include oncological outcomes, conversion rates, perioperative parameters, and economic evaluation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Data sources and statistical analysis plan&lt;/h3&gt;&lt;div&gt;Data are collected via the UroCCR database. Logistic regression will analyze the primary endpoint, and various regression methods will address the secondary outcomes. Economic evaluations involve incremental cost-utility and cost-effectiveness ratios.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Strengths and limitations&lt;/h3&gt;&lt;div&gt;Strengths include the multicenter design and robust randomization. Limitations involve variability in surgeons’ experience with the new three-dimensional technology and logistical challenges in technology adoption.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patient summary&lt;/h3&gt;&lt;div&gt;This clinical trial is designed to evaluate a new surgical technique for treating kidney tumors called three-dimensional (3D) image-guided robot-assisted partial nephrectomy. This study aims to determine whether this new method is more effective and safer than the current standard robot-assisted surgery by improving surgical precision and preserving kidney function. Kidney tumors require precise surgical removal to ensure the best outcomes for patients both during and after surgery. While robotic assistance has improved many surgeries, use of advanced 3D imaging during these procedures might enhance the surgeon’s ability to operate with greater accuracy, potentially leading to better patient outcomes and fewer complications. Participants in the trial will undergo surgery using either the conventional robotic-assisted method or the new 3D image-guided technique. The method used for each participant will remain undisclosed to maintain the study’s integrity. All participants will receive the highest standard of care, and their progress will be monitored closely throughout the trial. This study hopes to demonstrate that the 3D image-guided method can improve surgical precision and outcomes for patients undergoing kidney tumor removal. If successful, this technique could set a new standard for kid","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 914-920"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810822","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":"Corrigendum to “Profiling FGFR3 Expression Based on the Immune Micro-environment in Upper Tract Urothelial Carcinoma” [Eur. Urol. Oncol. 7(6) (2024) 1338-1349]","authors":"Keisuke Shigeta ,&nbsp;Kazuhiro Matsumoto ,&nbsp;Sotaro Kitaoka ,&nbsp;Minami Omura ,&nbsp;Kota Umeda ,&nbsp;Yuki Arita ,&nbsp;Shuji Mikami ,&nbsp;Keishiro Fukumoto ,&nbsp;Yota Yasumizu ,&nbsp;Nobuyuki Tanaka ,&nbsp;Toshikazu Takeda ,&nbsp;Shinya Morita ,&nbsp;Takeo Kosaka ,&nbsp;Ryuichi Mizuno ,&nbsp;Satoshi Hara ,&nbsp;Mototsugu Oya","doi":"10.1016/j.euo.2025.04.023","DOIUrl":"10.1016/j.euo.2025.04.023","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1217-1218"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974067","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":"Patient- and Procedure-specific Risk Factors for Urinary Incontinence After Robot-assisted Radical Prostatectomy: A Nationwide, Population-based Study","authors":"Katarina Koss Modig ,&nbsp;Rebecka Arnsrud Godtman ,&nbsp;Stefan Carlsson ,&nbsp;Pär Stattin ,&nbsp;Johan Styrke ,&nbsp;Marianne Månsson ,&nbsp;Johan Stranne","doi":"10.1016/j.euo.2025.03.015","DOIUrl":"10.1016/j.euo.2025.03.015","url":null,"abstract":"<div><h3>Background and objective</h3><div>Postprostatectomy urinary incontinence (PPI) is a common complication following robot-assisted laparoscopic radical prostatectomy (RALP), with incidence rates of 4–31%. This study examines associations between patient- and surgery-specific risk factors and PPI.</div></div><div><h3>Methods</h3><div>We analysed data from 13 754 men who underwent RALP between 2017 and 2021, registered in the National Prostate Cancer Register of Sweden. Electronic patient-reported outcome measure (ePROM) questions were completed by 37% at 3 mo and 47% after 12 mo, including questions on pad use. PPI was defined as the use of more than one pad (primary) and any pad use (secondary). Poisson regression assessed the associations between PPI and factors such as age, comorbidity, prostate volume, nerve-sparing procedures, and surgical details.</div></div><div><h3>Key findings and limitations</h3><div>At 12 mo, 17% (1086/6413) reported the use of more than one pad and 49% (3113/6413) reported any pad use. Significant risk factors for incontinence in a multivariable analysis (more than one pad) included age ≥75 versus &lt;65 yr (<em>p</em> &lt; 0.001; relative risk [RR] 2.03; 95% confidence interval [CI] 1.67–2.48), urethral division with margin from the apex versus maximal urethra length (<em>p</em> &lt; 0.001; RR 1.95; 95% CI 1.57–2.43), non–nerve-sparing procedures (<em>p</em> &lt; 0.001; RR 1.70; 95% CI 1.432.03), and prostate volume ≥90 versus &lt;30 ml (<em>p</em> = 0.018; RR 1.47; 95% CI 1.07–2.01). Limitations included missing data on surgical variables and a relatively low ePROM response rate.</div></div><div><h3>Conclusions and clinical implications</h3><div>Older age, large prostate size, and non–nerve-sparing surgery increase the risk of PPI, underscoring the importance of shared decision-making in treatment planning. However, these factors explain only a part of PPI.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 932-940"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960725","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 Experience with a Commercial Circulating Tumor DNA Assay in Non–muscle-invasive Bladder Cancer","authors":"Betty Wang ,&nbsp;Laura E. Davis ,&nbsp;Christopher J. Weight ,&nbsp;Robert Abouassaly ,&nbsp;Laura Bukavina","doi":"10.1016/j.euo.2025.05.019","DOIUrl":"10.1016/j.euo.2025.05.019","url":null,"abstract":"<div><div>Circulating tumor DNA (ctDNA) is an emerging biomarker in advanced bladder cancer, but its role in non–muscle-invasive bladder cancer (NMIBC) remains undefined. We conducted a retrospective study of 23 patients with NMIBC who underwent serial ctDNA monitoring using the commercially available Signatera assay at a single institution. ctDNA was detected in 35% of patients, with two illustrative cases highlighting its clinical utility. In one case, baseline ctDNA positivity prompted earlier reimaging that revealed locally advanced disease, leading to initiation of systemic therapy followed by planned consolidative cystectomy. In another case, ctDNA positivity following salvage intravesical therapy detected early recurrence, prompting a shift from maintenance intravesical therapy to radical cystectomy. These findings suggest that ctDNA may facilitate early detection of molecular residual disease and guide treatment decisions in NMIBC, particularly in patients with bacillus Calmette-Guérin–unresponsive disease. Prospective studies are needed to validate the role of ctDNA in risk stratification and treatment optimization for this high-risk population.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 883-887"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293615","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 Outcomes in Immunocompromised Patients: A Systematic Review and Meta-analysis","authors":"Francesco Sanguedolce ,&nbsp;Alessandro Tedde ,&nbsp;Giuseppe Basile ,&nbsp;Francesco Di Bello ,&nbsp;Michael Baboudjian ,&nbsp;Alessandro Uleri ,&nbsp;Stefano Mancon ,&nbsp;Daria Chernysheva ,&nbsp;Marta Roqué Figuls ,&nbsp;Andrea Gallioli ,&nbsp;Angelo Territo ,&nbsp;Morgan Rouprêt ,&nbsp;Joan Palou ,&nbsp;Alberto Breda","doi":"10.1016/j.euo.2025.05.021","DOIUrl":"10.1016/j.euo.2025.05.021","url":null,"abstract":"<div><h3>Background and objective</h3><div>The role of immunosuppression in prostate cancer (PCa) mortality is a debated topic, with a low level of evidence. This review aims to evaluate the cancer-specific mortality (CSM) and overall mortality (OM) of PCa in immunocompromised patients compared with immunocompetent individuals.</div></div><div><h3>Methods</h3><div>A literature search was conducted in the PubMed/Medline, Embase, and Web of Science databases (up to the March 31, 2024). The analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (CRD42022361504). Data were pooled using a fixed-effect model and adjusted hazard ratios (HRs).</div></div><div><h3>Key findings and limitations</h3><div>A total of 13 studies (<em>n</em> ≈ 3.4 million PCa patients) were included in the qualitative analysis; 11 studies were included in the quantitative analysis. The forest plot for CSM in immunocompromised patients failed to reach statistical significance (HR 1.04 [95% confidence interval {CI}, 0.91–1.18], <em>p</em> = 0.57). OM was higher in the immunocompromised cohort (HR 2.04 [95% CI, 1.94–2.15], <em>p</em> &lt; 0.001). CSM for transplanted patients was comparable with that for the controls (HR 1.01 [95% CI, 0.86–1.18], <em>p</em> = 0.94). Patients with human immunodeficiency virus (HIV) had higher CSM rates (HR 1.83 [95% CI, 1.21–2.75], <em>p</em> = 0.004). Limitations included retrospective cohort studies and heterogeneity in reporting PCa stages.</div></div><div><h3>Conclusions and clinical implications</h3><div>Transplanted patients present a CSM rate comparable with the controls, despite a higher OM rate. Other immunocompromised patients present an overall worse prognosis. The treatment algorithm should be applied by international guidelines for transplanted patients, delivering more aggressive treatments and screening strategies.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1140-1149"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324912","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}