European urology oncology最新文献

{"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}

{"title":"Epidemiology of High-risk Biochemical Recurrence After Primary Prostate Cancer Treatment","authors":"Ugo Giovanni Falagario ,&nbsp;Francesco Pellegrino ,&nbsp;Lars Björnebo ,&nbsp;Ahmad Abbadi ,&nbsp;Alberto Martini ,&nbsp;Alexander Valdman ,&nbsp;Vincenza Conteduca ,&nbsp;Giuseppe Carrieri ,&nbsp;Giorgio Gandaglia ,&nbsp;Alberto Briganti ,&nbsp;Francesco Montorsi ,&nbsp;Thorgerdur Palsdottir ,&nbsp;Martin Eklund ,&nbsp;Tobias Nordström ,&nbsp;Henrik Grönberg ,&nbsp;Markus Aly ,&nbsp;Ash Tewari ,&nbsp;Olof Akre ,&nbsp;Anna Lantz ,&nbsp;Peter Wiklund","doi":"10.1016/j.euo.2025.05.026","DOIUrl":"10.1016/j.euo.2025.05.026","url":null,"abstract":"<div><h3>Background and objective</h3><div>Biochemical recurrence (BCR) risk stratification guides treatment decisions after primary prostate cancer (PCa) treatment. We evaluated high-risk BCR (HR-BCR) definitions after radical prostatectomy (RP) or radiotherapy (RT) and their association with PCa-specific mortality (PCSM).</div></div><div><h3>Methods</h3><div>A population-based cohort study including 17 753 men treated with RP (<em>n</em> = 12 010) or RT (<em>n</em> = 5743) for localized PCa in Stockholm County between 2003 and 2021 was conducted. We assessed the cumulative incidence of any BCR (RP: prostate-specific antigen [PSA] ≥0.2; RT: PSA ≥nadir + 2), European Association of Urology (EAU) HR-BCR (PSA doubling time ≤1 yr or pathological International Society of Urological Pathology (ISUP) grade group 4–5 after RP; time to BCR ≤18 mo or biopsy ISUP grade group 4–5 after RT), and EMBARK HR-BCR (PSA doubling time ≤9 mo and PSA &gt;1 ng/ml after RP or PSA ≥nadir + 2 ng/ml after RT). PCSM after HR-BCR was estimated using the competing risk method.</div></div><div><h3>Key findings and limitations</h3><div>The 10-yr incidence of HR-BCR was 10% (95% confidence interval [CI]: 9–11) for EAU HR-BCR and 4% (95% CI: 3–4) for EMBARK HR-BCR after RP, and 10% (95% CI: 9–11) for both definitions after RT. Patients meeting the EMBARK criteria had the highest PCSM (RP: 30%, 95% CI: 24–37; RT: 50%, 95% CI: 45–56). Up to 50% of RP and 31% of RT patients with BCR did not progress to HR-BCR and had lower PCSM.</div></div><div><h3>Conclusions and clinical implications</h3><div>HR-BCR incidence varies by definition and treatment. The EMBARK criteria identify a smaller subset with the highest PCSM risk. Many patients with BCR never develop HR-BCR. Refining BCR definitions with PSA kinetics and imaging may optimize risk stratification, balancing therapeutic efficacy and overtreatment.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1078-1086"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368742","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":"PERSEUS1: An Open-label, Investigator-initiated, Single arm, Phase 2 Trial Testing the Efficacy of Pembrolizumab in Patients with Metastatic Castration-resistant Prostate Cancer with Mismatch Repair Deficiency and Other Immune-sensitive Molecular Subtypes","authors":"Pasquale Rescigno ,&nbsp;Maria Dolores Fenor de la Maza ,&nbsp;Holly Tovey ,&nbsp;Guillermo Villacampa ,&nbsp;Fay Cafferty ,&nbsp;Stephanie Burnett ,&nbsp;Morgaine Stiles ,&nbsp;Bora Gurel ,&nbsp;Nina Tunariu ,&nbsp;Suzanne Carreira ,&nbsp;Ines Figueiredo ,&nbsp;Nick Beije ,&nbsp;Penny Flohr ,&nbsp;Emma Hall ,&nbsp;Alice Hill ,&nbsp;Muneeb Mahmud ,&nbsp;Carla Perna ,&nbsp;Ajit Sarvadikar ,&nbsp;Adam Sharp ,&nbsp;Katarzyna Abramovich ,&nbsp;Johann S. de Bono","doi":"10.1016/j.euo.2025.04.025","DOIUrl":"10.1016/j.euo.2025.04.025","url":null,"abstract":"<div><h3>Background and objective</h3><div>Some metastatic castration-resistant prostate cancers (mCRPCs) present mismatch repair deficiency (MMRd) and other molecular subtypes potentially sensitive to immune checkpoint inhibitors (ICIs). The PERSEUS1 trial evaluated the response to pembrolizumab in these subtypes.</div></div><div><h3>Methods</h3><div>This open-label, investigator-initiated, single-arm, phase 2 trial used a two-stage Simon minimax design. Results from stage 1 are presented here. Tumour biopsies from patients with mCRPC progressing on standard therapies were analysed via targeted next-generation sequencing and immunohistochemistry. Patients with MMRd and/or other molecular subtypes associated with ICI sensitivity were treated with pembrolizumab until disease progression or unacceptable toxicity. The primary outcome was response by 24 wk using a composite of radiological objective response; confirmed decrease in prostate-specific antigen ≥50%; or conversion of circulating tumour cell count. The hypothesised desirable response rate was 40%, with 20% deemed unacceptable; &gt;5/24 responses were required for progression to stage 2.</div></div><div><h3>Key findings and limitations</h3><div>In total, 25 patients from two centres received a median of 6 cycles (range 2–13) of pembrolizumab, with a response observed in seven (28.0%, 95% confidence interval 12.1–49.4%). Median progression-free survival was 2.8 mo and median overall survival was 16.0 mo. Nineteen patients (76%) experienced treatment-related adverse events, including three (12%) grade 3–4 events. There were no treatment-related deaths. While the prespecified threshold for futility was not met, slow accrual meant the study did not progress to stage 2.</div></div><div><h3>Conclusions and clinical implications</h3><div>Pembrolizumab showed antitumour activity against MMRd and/or other mCRPC molecular subtypes, with a manageable toxicity profile. Genomic and molecular stratification and further translational research are needed to refine patient selection for this therapy in the mCRPC setting.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1059-1069"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505280","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 Practices and Perspectives on Prostate Biopsy Techniques Among Urologists: A European Survey","authors":"Alessandro Uleri ,&nbsp;Romain Diamand ,&nbsp;Gaelle Fiard ,&nbsp;Francesco Sanguedolce ,&nbsp;Jonathan Olivier ,&nbsp;Raphaele Renard-Penna ,&nbsp;Arthur Peyrottes ,&nbsp;Guillaume Ploussard ,&nbsp;Michael Baboudjian","doi":"10.1016/j.euo.2025.05.009","DOIUrl":"10.1016/j.euo.2025.05.009","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1213-1214"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157598","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 Testing Between Screening Rounds: Evidence from the STHLM3-MRI Trial","authors":"Daniela Skalt,&nbsp;Ting Chen,&nbsp;Ahmad Abbadi,&nbsp;Anna Lantz,&nbsp;Andrea Discacciati,&nbsp;Martin Eklund,&nbsp;Mark Clements ,&nbsp;Tobias Nordström ,&nbsp;Shuang Hao","doi":"10.1016/j.euo.2025.05.015","DOIUrl":"10.1016/j.euo.2025.05.015","url":null,"abstract":"<div><h3>Background and objective</h3><div>The STHLM3-MRI screening-by-invitation trial found that magnetic resonance imaging (MRI)-based screening for prostate cancer (PCa) improved early detection in comparison to systematic biopsy. The aim of the present study was to describe testing and PCa incidence between screening rounds of the STHLM3-MRI trial.</div></div><div><h3>Methods</h3><div>The study population comprised men aged 50–74 yr in the MRI (experimental) arm of the STHLM3-MRI trial without a PCa diagnosis in the first round. We defined three risk groups: low risk (baseline prostate-specific antigen [PSA] &lt;1.5 ng/ml; not invited to the second round after 2–3 yr); non-elevated risk (1.5 ≤PSA &lt;3 ng/ml and Stockholm3 score &lt;11%); and elevated risk (PSA ≥3 ng/ml or Stockholm3 score ≥11%). Interval events included PSA tests, MRI examinations, biopsies, and PCa detection.</div></div><div><h3>Key findings and limitations</h3><div>In the study population of 7256 men, 33% had at least one PSA test, 2.2% had an MRI examination, 0.8% had a biopsy, 0.3% had a PCa diagnosis, and 0.2% (<em>n</em> = 17) had International Society of Urological Pathology grade group ≥2 PCa between screening rounds. Stratified by risk, 27%, 40%, and 54% of men with low risk (<em>n</em> = 5009), non-elevated risk (<em>n</em> = 1200), and elevated risk (<em>n</em> = 1047), respectively, had a PSA test. The PCa detection rate was low but increased with risk level, at 0.1% for low risk, 0.3% for non-elevated risk, and 1.4% for elevated risk. These results are specific to Sweden and depend on the interval length between screening rounds.</div></div><div><h3>Conclusions and clinical implications</h3><div>We observed a substantial testing rate of 33% between STHLM3-MRI screening rounds, but few PCa cases were detected among men with lower risk. Most cancers were diagnosed in the elevated-risk group. A reduction in opportunistic testing in lower-risk groups will be crucial for optimising the benefits of future screening programmes.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1070-1077"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340071","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":"Pooled Analysis of the SOLAR and SATURN Clinical Trials Comparing Progression of Synchronous Versus Metachronous Prostate-specific Membrane Antigen–defined Oligometastatic Prostate Cancer Following Systemic and Tumor-directed Therapy","authors":"Jesus E. Juarez Casillas ,&nbsp;John Nikitas ,&nbsp;Matthew B. Rettig ,&nbsp;Robert E. Reiter ,&nbsp;Alan Lee ,&nbsp;Michael L. Steinberg ,&nbsp;Luca Valle ,&nbsp;Tahmineh R. Kalbasi ,&nbsp;Jeremie Calais ,&nbsp;Johannes Czernin ,&nbsp;Michelle A. Eala ,&nbsp;Sonny Tsai ,&nbsp;Nathanael Kane ,&nbsp;Abhishek A. Solanki ,&nbsp;Rachael Sexton ,&nbsp;Sai Duriseti ,&nbsp;Gholam R. Berenji ,&nbsp;William J. Aronson ,&nbsp;Isla P. Garraway ,&nbsp;Michael G. Chang ,&nbsp;Amar U. Kishan","doi":"10.1016/j.euo.2025.05.027","DOIUrl":"10.1016/j.euo.2025.05.027","url":null,"abstract":"<div><div><span>Multimodal strategies combining primary and metastasis-directed therapy (MDT) with short-term intensified systemic therapy may improve outcomes in oligometastatic castrate-sensitive prostate cancer (omCSPC) while minimizing long-term toxicity. This post hoc analysis of two prospective phase 2 trials, SOLAR (NCT03298087) and SATURN (NCT03902951), evaluated oncologic outcomes in prostate-specific membrane antigen positron emission tomography–defined synchronous and metachronous omCSPC (≤5 M1a–b lesions), respectively. All patients received 6 mo of intensified systemic therapy (leuprolide, abiraterone acetate with prednisone, and apalutamide) and stereotactic body radiotherapy to oligometastases. SOLAR patients were treatment-naïve and also underwent radical prostatectomy (RP) or definitive prostate-directed radiotherapy (dRT). SATURN enrolled patients with post-RP recurrences: among the 26 patients who completed protocol therapy, 12 (46%) had prior androgen deprivation therapy (ADT), six (23%) had prior MDT, and 17 (65%) had one to three prior recurrences. The primary endpoint for both studies was prostate-specific antigen (PSA) response, defined as &lt;0.05 ng/ml after RP or &lt;2 ng/ml after dRT at 6 mo after testosterone recovery (≥150 ng/dl). Secondary endpoints included progression-free survival (PFS) and eugonadal PFS starting from the time of testosterone recovery. Progression was determined biochemically using PSA thresholds of ≥0.05 ng/ml for post-RP and ≥2 ng/ml for post-dRT patients. Among 50 patients (24 synchronous and 26 metachronous), the synchronous omCSPC group had a significantly higher PSA response rate (83% vs 50%; </span><em>p</em> = 0.018) and significantly longer PFS and eugonadal PFS (<em>p</em> &lt; 0.05). The metachronous subgroup with prior ADT had worse outcomes, suggesting increasing resistance with repeated systemic therapy.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 893-898"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336447","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":"Impact of Histological Subtypes/Divergent Differentiation on Clinicopathological and Oncological Outcomes for Patients with Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy: A Comprehensive Updated Systematic Review and Meta-analysis","authors":"Wojciech Krajewski ,&nbsp;Łukasz Nowak ,&nbsp;Jan Łaszkiewicz ,&nbsp;Joanna Chorbińska ,&nbsp;Wojciech Tomczak ,&nbsp;Adam Gurwin ,&nbsp;Marco Moschini ,&nbsp;Benjamin Pradere ,&nbsp;Andrea Gallioli ,&nbsp;José D. Subiela ,&nbsp;Ekaterina Laukhtina ,&nbsp;Francesco Del Giudice ,&nbsp;Gautier Marcq ,&nbsp;Luca Afferi ,&nbsp;Magdalena Krajewska ,&nbsp;Muhammad S. Khan ,&nbsp;Rajesh Nair ,&nbsp;Bartosz Małkiewicz ,&nbsp;Tomasz Szydełko ,&nbsp;Urothelial Carcinoma Working Group of the European Association of Urology Young Academic Urologists","doi":"10.1016/j.euo.2025.03.003","DOIUrl":"10.1016/j.euo.2025.03.003","url":null,"abstract":"<div><h3>Background and objective</h3><div>Upper tract urothelial carcinoma (UTUC) is associated with poor survival. Recent studies have evaluated whether the presence of histological subtypes or divergent differentiation (HS/DD) is associated with worse UTUC prognosis. Our aim was to assess the relationship between HS/DD and clinicopathological features and oncological outcomes for patients with UTUC undergoing radical nephroureterectomy (RNU) without investigating causal pathways.</div></div><div><h3>Methods</h3><div>A literature search was conducted in September 2024. Patients with UTUC who underwent RNU were included. The main outcomes were differences in clinicopathological features and oncological outcomes between HS/DD and pure urothelial carcinoma (PUC) groups.</div></div><div><h3>Key findings and limitations</h3><div>We included 22 studies involving 14 407 patients in our review. HS/DD was present in 14% of tumours. In comparison to PUC, the HS/DD group had significantly higher rates of ≥pT3 stage, high-grade tumours, lymph node invasion (LNI), lymphovascular invasion (LVI), and receipt of adjuvant chemotherapy. Pooled results revealed that the HS/DD group had significantly worse cancer-specific survival (CSS) (hazard ratio [HR] 1.65, 95% confidence interval CI] 1.39–1.96), overall survival (OS; HR 1.84, 95% CI 1.52–2.22) ,and recurrence-free survival (RFS; HR 1.64, 95% CI 1.43–1.87). Intravesical RFS (IVRFS) and urothelial RFS (URFS) were comparable between the groups.</div></div><div><h3>Conclusions and clinical implications</h3><div>Our findings suggest that UTUC with HS/DD is associated with more advanced/aggressive features, such as higher pathological stage and grade, LNI, and LVI. HS/DD is associated with significantly worse CSS, OS, and RFS, but does not predict worse IVRFS or URFS. Therefore, HS/DD detection should prompt extensive treatment and closer follow-up. To improve the quality of recommendations and patient care, well-designed studies with central pathological review are needed.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1126-1139"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989713","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: Rosemarijn H. Ettema, Jan-Jaap J. Mellema, Dennie Meijer, et al. Early Oncological Outcomes in Patients Who Underwent Staging Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography Compared with Conventional Imaging Before Radical Prostatectomy and Extended Pelvic Lymph Node Dissection. Eur Urol Oncol. In press. https://doi.org/10.1016/j.euo.2024.11.003","authors":"Giacomo Gallo,&nbsp;Alessio Guidotti,&nbsp;Riccardo Lombardo,&nbsp;Cosimo De Nunzio","doi":"10.1016/j.euo.2025.02.016","DOIUrl":"10.1016/j.euo.2025.02.016","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 4","pages":"Pages 1208-1209"},"PeriodicalIF":9.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999342","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}