European urology oncology最新文献

{"title":"Direct Treatment of All Visible Tumour in Synchronous Oligometastatic Prostate Cancer: Total Eradication of Tumour or the Full Monty Treatment.","authors":"Alexander Giesen, Niels De Preter, Tamás Fazekas, Gert De Meerleer, Giorgio Gandaglia, Giancarlo Marra, Shahrokh F Shariat, Steven Joniau, Pawel Rajwa","doi":"10.1016/j.euo.2025.04.011","DOIUrl":"https://doi.org/10.1016/j.euo.2025.04.011","url":null,"abstract":"<p><p>Recent advances in the management of synchronous oligometastatic prostate cancer (PC) highlight the potential of combining local and systemic therapies. However, there is growing interest in metastasis-directed therapy (MDT) in this setting. When all modalities are combined, this is referred as \"total eradication of tumour\" (TET) or \"full monty treatment\" (FMT). Retrospective studies have revealed promising outcomes with approaches such as cytoreductive radical prostatectomy or radiotherapy alongside MDT and combination systemic therapy. Multiple studies have demonstrated a significant proportion of cases with undetectable prostate-specific antigen and noncastrate testosterone, while one comparative trial (± MDT) revealed some evidence of an overall survival benefit. Results from the prospective trials indicate the feasibility and effectiveness of this intensive treatment strategy, with biochemical remission and disease-free states achieved in a significant proportion of cases. Overall, limitations persist, including a reliance on conventional imaging in all studies and the absence of long-term prospective data. Ongoing trials will provide definitive insights into the treatment efficacy and safety of TET/FMT. PATIENT SUMMARY: For patients with a new diagnosis of prostate cancer with only few metastases, cancer control results after treatment with local therapy, hormonal agents, and treatment targeted to all metastatic sites are promising. Further clinical trials of this approach with the inclusion of new scan techniques are eagerly awaited.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959877","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":"Novel Molecular Biomarkers to Guide Treatment Decision-making in Metastatic Urothelial Cancer-A Patient Cohort Analysis.","authors":"Debbie G J Robbrecht, Youssra Salhi, John W M Martens, Maureen J B Aarts, Paul Hamberg, Michiel S van der Heijden, Jens Voortman, Niven Mehra, Hans M Westgeest, Ronald de Wit, Reno Debets, Joost L Boormans, J Alberto Nakauma-González","doi":"10.1016/j.euo.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.euo.2025.04.007","url":null,"abstract":"<p><p>The current options and recent developments in the field of systemic therapy for advanced urothelial cancer (UC) patients urge the need for selection criteria to identify the most optimal therapeutic option for individual patients. The molecular makeup of tumors, including molecular subtype, tumor microenvironment composition, and gene mutations, fusions, and amplifications, has previously been correlated with a response to immune checkpoint inhibitors, erdafitinib, or enfortumab vedotin (EV) monotherapy, and may withhold potential candidate biomarkers. In this study, we aimed to stratify metastatic UC (mUC) patients based on molecular biomarkers that might be associated with a response to EV, a fibroblast growth factor receptor inhibitor, or anti-PD-(L)1, by using whole-genome DNA-sequencing and paired RNA-sequencing data of fresh-frozen metastatic tumor biopsies of 155 mUC patients. We observed that NECTIN4 amplification, FGFR2/3 mutations, and the RNA expression-based T-cell-to-stroma enrichment (TSE) score were mutually exclusive, and may therefore reflect biologically distinct tumors and sensitivity to treatments. This finding was validated in two independent bladder cohorts: the IMvigor210 study and The Cancer Genome Atlas. Stratification of patients into subgroups based on these molecular features is possible. Our data challenge the concept of a one-treatment-fits-all paradigm and support the rationale for prospective clinical trials with biomarker-guided treatment selection of mUC patients.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960572","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, Harvey Quon, Aldrich Ong, Patrick Cheung, William Chu, Hans Chung, Danny Vesprini, Amit Chowdhury, Dilip Panjwani, Yasir Alayed, Geordi Pang, Renee Korol, Melanie Davidson, Ananth Ravi, Boyd McCurdy, Liying Zhang, Meghan Kulasingham-Poon, Alexandre Mamedov, Andrea Deabreu, Andrew Loblaw","doi":"10.1016/j.euo.2025.03.011","DOIUrl":"https://doi.org/10.1016/j.euo.2025.03.011","url":null,"abstract":"<p><strong>Background and objective: </strong>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.</p><p><strong>Methods: </strong>Men with favourable-risk localised prostate cancer in the PATRIOT trial were randomised to five-fraction prostate SABR every other day (EOD; n = 77) or once weekly (QW; n = 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).</p><p><strong>Key findings and limitations: </strong>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 (p = 0.2). The 8-yr probability rates were 100% versus 95.9% for MFS (p = 0.08), 100% versus 97.2% for PCSS (p = 0.2), and 96.0% versus 85.4% for OS (p = 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).</p><p><strong>Conclusions: </strong>This study suggests no significant differences in long-term cancer outcomes between EOD and QW schedules for five-fraction prostate SABR. This trial is registered on ClinicalTrials.gov as NCT01423474.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-26","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":"Oncological Outcomes in Patients with Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography-detected Oligometastatic Prostate Cancer Treated with Metastasis-directed Radiotherapy as the Single Treatment Modality.","authors":"Katelijne C C de Bie, Lotte G Zuur, Dennie Meijer, Philip Meijnen, Karel A Hinnen, Daniela E Oprea-Lager, Pim J van Leeuwen, Andre N Vis","doi":"10.1016/j.euo.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.euo.2025.04.002","url":null,"abstract":"<p><strong>Background and objective: </strong>In patients with biochemical recurrence (BCR), prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) can detect oligometastatic prostate cancer (PCa). However, the optimal treatment approach for oligometastatic disease remains unclear. This study aims to assess the oncological outcomes of metachronous oligometastatic PCa patients treated with metastasis-directed radiotherapy (MDRT).</p><p><strong>Methods: </strong>We retrospectively evaluated patients with hormone-sensitive, metachronous oligometastatic PCa who underwent MDRT for BCR (from July 2012 to September 2022). Patients had one to four lymph nodes and/or bone metastases on PSMA PET/CT and were irradiated with 5 × 7 or 3 × 10 Gy. The biochemical response to MDRT was assessed as undetectable prostate-specific antigen (PSA) at follow-up, PSA response (PSA ≤ pretreatment level), or biochemical progression (PSA > pretreatment level). Biochemical progression-free survival (bPFS) and local remission of disease (absence of disease at the MDRT site on follow-up PSMA PET/CT or undetectable PSA) were evaluated.</p><p><strong>Key findings and limitations: </strong>Eighty patients underwent MDRT for 105 PSMA PET/CT-confirmed lesions. The median time from curative treatment to MDRT was 55 mo (interquartile range [IQR] 31-103). At a median follow-up of 32 mo after MDRT (IQR 21-64), 10% of the patients were PSA free, 10% had a PSA response, and 80% experienced biochemical progression. The bPFS rates at 1 and 2 yr were 54% and 38%, respectively. A total of 87% of patients had local control of disease after MDRT, whereas 72% had new metastatic lesions on repeated PSMA PET/CT. Limitations include the retrospective design and a small cohort.</p><p><strong>Conclusions and clinical implications: </strong>MDRT for oligometastatic disease shows high local efficacy. However, disease progression is observed in a substantial proportion of patients.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062584","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 Immune Checkpoint Inhibitors as Neoadjuvant Therapy for Muscle-invasive Bladder Cancer: A Systematic Review, Meta-analysis, and Network Meta-analysis.","authors":"Akihiro Matsukawa, Angelo Cormio, Marcin Miszczyk, Mehdi Kardoust Parizi, Tamás Fazekas, Ichiro Tsuboi, Stefano Mancon, Robert J Schulz, Giulio Litterio, Ekaterina Laukhtina, Paweł Rajwa, Thomas Seisen, Keiichiro Mori, Francesca Sanguedolce, Andrea Benedetto Galosi, Jun Miki, Takahiro Kimura, Shahrokh F Shariat, Takafumi Yanagisawa","doi":"10.1016/j.euo.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.euo.2025.02.009","url":null,"abstract":"<p><strong>Background and objective: </strong>The availability of immune checkpoint inhibitors (ICIs) has expanded perioperative treatment options for urothelial carcinoma. Our aim was to evaluate the effect of neoadjuvant ICI-based regimens on oncological outcomes for patients with muscle-invasive bladder cancer (MIBC).</p><p><strong>Methods: </strong>We systematically searched MEDLINE, Embase, Web of Science, and ClinicalTrials.gov in September 2024 for studies on neoadjuvant therapies for MIBC. A proportion meta-analysis and network meta-analysis (NMA) using random-effect models were conducted to evaluate pooled pathological complete response (pCR) rates and to compare overall survival (OS) and adverse events. The review is registered on PROSPERO (CRD42024587964).</p><p><strong>Key findings and limitations: </strong>We included 12 randomized controlled trials (RCTs; 5004 patients) and 35 non-RCTs (2964 patients). ICI-chemotherapy combination therapy was associated with a significantly higher pCR rate versus chemotherapy alone (40.6% vs 17.9%; p < 0.01). In the two phase 3 RCTs included (1556 patients) there was no significant difference in OS between dose-dense methotrexate + vinblastine + Adriamycin + cisplatin (ddMVAC) and durvalumab + gemcitabine + cisplatin (GC; hazard ratio 1.06, 95% confidence interval [CI] 0.72-1.55; p = 0.8). ddMVAC significantly increased the risk of grade ≥3 anemia (risk ratio [RR] 2.81, 95% CI 1.62-4.88) and asthenia (RR 3.46, 95% CI 1.68-7.14) in comparison to GC, while durvalumab + GC did not. Limitations include data heterogeneity across studies and the limited number of studies included in the NMA.</p><p><strong>Conclusions and clinical implications: </strong>ICI addition to chemotherapy in the neoadjuvant MIBC setting significantly increased pCR rates in comparison to chemotherapy alone. However, there was no difference in OS between durvalumab + GC and ddMVAC. Further studies are needed to clarify the OS benefit of ICI-based combination therapy in comparison to the current standard chemotherapy regimen.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963822","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":"Presence of an Artificial Intelligence-powered Predictive Biomarker Is Associated with a Poor Response to Intravesical Bacillus Calmette-Guerin but Not to Intravesical Sequential Gemcitabine/Docetaxel in Patients with High-grade Non-muscle-invasive Bladder Cancer.","authors":"Vignesh T Packiam, Ian M McElree, Saum Ghodoussipour, Vivek Nimgaonkar, Viswesh Krishna, Joon Kyung Kim, Derek B Allison, Jordan R Richards, K D Anand Rajan, Stephanie J Chen, Yair Lotan, Stephen B Williams, Haochen Zhang, Drew Watson, Damir Vrabac, Waleed M Abuzeid, Anirudh Joshi, Ashish M Kamat, Michael A O'Donnell, Patrick J Hensley","doi":"10.1016/j.euo.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.euo.2025.04.006","url":null,"abstract":"<p><p>Intravesical bacillus Calmette-Guerin (BCG) is considered first-line adjuvant therapy for high-risk or high-grade non-muscle-invasive bladder cancer (NMIBC). Recently, sequential intravesical gemcitabine and docetaxel (Gem/Doce) has emerged as a promising alternative to intravesical BCG. Biomarkers to select the optimal treatment regimen could facilitate clinical decision-making. The Computational Histologic Artificial Intelligence (CHAI) platform was previously used to develop an artificial intelligence-augmented histologic assay (CHAI biomarker) that identified patients with NMIBC at an increased risk of recurrence and progression events following BCG treatment. In this study, we assessed use of the CHAI biomarker among patients with treatment-naive high-grade NMIBC who received intravesical BCG or Gem/Doce. Among patients with the presence of the CHAI biomarker, those treated with BCG had a 24-mo high-grade recurrence-free survival (HG-RFS) rate of 56% (95% confidence interval [CI] 43-73%) and those treated with Gem/Doce had an HG-RFS rate of 90% (95% CI 79-100%; hazard ratio [HR] 5.4, 95% CI 1.6-18.3, p = 0.007). Among patients with an absence of the CHAI biomarker, those treated with BCG or Gem/Doce had no significant difference in HG-RFS (HR 1.3, 95% CI 0.6-2.6, p = 0.5). The interaction term between the CHAI biomarker and the treatment type was significant (p = 0.029), indicating an association between the biomarker and the clinical outcome that is dependent on the treatment received. This study suggests that the CHAI biomarker predicts which specific high-grade NMIBC patients are less likely to benefit from BCG and may benefit from alternative treatments including, potentially, Gem/Doce.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005098","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":"Associations Between Prostate Cancer and Dementia: A Nationwide Study in Sweden.","authors":"Casey Crump, Pär Stattin, James D Brooks, Jan Sundquist, Jingkai Wei, Weiva Sieh, Kristina Sundquist","doi":"10.1016/j.euo.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.euo.2025.04.001","url":null,"abstract":"<p><strong>Background and objective: </strong>Prostate cancer (PC) and dementia may commonly co-occur; yet, prior evidence for bidirectional associations is inconsistent. This study aims to determine the associations between PC and dementia in large population-based studies, which may further inform clinical care.</p><p><strong>Methods: </strong>To assess the dementia risk in men with PC, a national cohort study was conducted in 178 746 men diagnosed with PC in 1998-2017 and 1 787 460 age-matched control men in Sweden without prior dementia. Cox regression was used to estimate hazard ratios (HRs) for Alzheimer's disease (AD) and vascular dementia (VaD) through 2018. Subanalyses explored differences by PC treatment during 2005-2017. To assess the PC risk in men with dementia, case-control analyses were performed in 180 189 men with PC and 1 801 890 age-matched control men. Logistic regression was used to estimate odds ratios (ORs) for PC associated with prior AD or VaD. All analyses were adjusted for sociodemographic factors and health care utilization.</p><p><strong>Results and limitations: </strong>Among men with high-risk PC, those treated with androgen deprivation therapy (ADT) only had a higher risk of AD (HR, 1.37; 95% confidence interval [CI], 1.19-1.58) and VaD (1.51; 1.29-1.78), but not those who received other treatments. Men with low- or intermediate-risk PC had little or no increased risk of AD (HR, 1.10; 95% CI, 1.03-1.18) or VaD (0.90; 0.83-0.98). Men with AD or VaD had lower odds of high-risk PC (OR, 0.39; 95% CI, 0.35-0.45, and 0.36; 0.30-0.42, respectively) and low- or intermediate-risk PC (0.30; 0.25-0.36, and 0.30; 0.24-0.38, respectively). This study was limited to Sweden and will need replication when feasible.</p><p><strong>Conclusions: </strong>In a large national study, men with high-risk PC treated with ADT had higher risks of AD and VaD. Such men should be monitored for timely detection and treatment of dementia. In contrast, men with AD or VaD had a lower subsequent risk of PC, possibly reflecting reduced screening in these subgroups.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999897","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 of Upgrading at Final Pathology after Transperineal Versus Transrectal Magnetic Resonance Imaging-targeted Prostate Biopsies: A Post Hoc Analysis of the PERFECT Trial.","authors":"Alessandro Uleri, Eric Barret, Gaëlle Fiard, Louis Lenfant, Bernard Malavaud, Raphaële Renard-Penna, François Rozet, Jean-Baptiste Beauval, Ambroise Salin, Morgan Rouprêt, Guillaume Ploussard","doi":"10.1016/j.euo.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.euo.2025.03.018","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965183","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":"Prognostic Value of the Circulating Tumor DNA Fraction in Metastatic Castration-resistant Prostate Cancer: Results from the ProBio Platform Trial.","authors":"Alessio Crippa, Bram De Laere, Andrea Discacciati, Berit Larsson, Maria Persson, Susanne Johansson, Sanne D'hondt, Marie Hjälm-Eriksson, Linn Pettersson, Gunilla Enblad, Anders Ullén, Nicolaas Lumen, Camilla Thellenberg Karlsson, Johan Sandzén, Elin Jänes, Christophe Ghysel, Martha Olsson, Brieuc Sautois, Peter Schatteman, Wendy De Roock, Siska Van Bruwaene, Ingrida Verbiene, Jochen Darras, Els Everaert, Daan De Maeseneer, Mats Anden, Michiel Strijbos, Daisy Luyten, Ashkan Mortezavi, Jan Oldenburg, Piet Ost, Johan Lindberg, Henrik Grönberg, Martin Eklund","doi":"10.1016/j.euo.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.euo.2025.02.002","url":null,"abstract":"<p><strong>Background and objective: </strong>The aim of this study was to evaluate the prognostic value of undetectable circulating tumor DNA (ctDNA) and the dose-response relationship between ctDNA levels and survival outcomes in metastatic castration-resistant prostate cancer (mCRPC).</p><p><strong>Methods: </strong>We analyzed data for patients enrolled in the ProBio trial up to November 2022 who received an androgen receptor pathway inhibitor or taxane. We compared survival outcomes between patients with undetectable ctDNA and those with detectable ctDNA randomized to physician's choice or investigational arms. Time to no longer clinically benefiting (NLCB) and overall survival (OS) were assessed using Bayesian survival models, with results reported as survival time ratios (STRs). Dose-response relationships were estimated using spike-at-zero models.</p><p><strong>Key findings and limitations: </strong>A total of 220 patients were included, of whom 139 had detectable ctDNA (56 in the physician's choice arm, 83 in investigational arms) and 81 had undetectable ctDNA. In comparison to the undetectable ctDNA group, the physician's choice arm had 60% shorter time to NLCB (STR 0.40, 90% credible interval [CrI] 0.31-0.51) and 51% shorter OS (STR 0.49, 90% CrI 0.38-0.61). Similar results were observed in comparison to the investigational arms. Dose-response analysis revealed that the undetectable ctDNA group had twofold longer time to NLCB (STR 2.05, 90% CrI 1.66-2.57) and 1.6-fold longer OS (STR 1.63, 90% CrI 1.33-2.05) in comparison to the subgroup with a ctDNA fraction of 2.5%. Every 10-point increment in the ctDNA fraction corresponded to a 10% reduction in NLCB and OS times.</p><p><strong>Conclusions and clinical implications: </strong>Undetectable ctDNA at baseline predicts superior prognosis in mCRPC, suggesting potential for treatment de-escalation and less intensive monitoring for this subgroup of patients. This trial is registered on ClinicalTrials.gov as NCT03903835.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994606","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":"Oncological Safety and Diagnostic Yield of Percutaneous Needle-core Biopsies in Upper Tract Urothelial Carcinoma: The UPERCUT Study.","authors":"Doriane Prost, Atanas Pachev, Eric De Kerviler, Michael Baboudjian, Evanguelos Xylinas, Thomas Seisen, François Audenet, Lucas Bento, Olivier Traxer, Frédéric Panthier, Benjamin Pradere, Gauthier Marcq, Priscilla Leon, Yves Allory, Constance Thibault, Alexandre Roussel, Xavier Belin, David Chemouni, Morgan Roupret, Yann Neuzillet, François Desgrandchamps, Mathieu Roumiguie, Alexandra Masson-Lecomte","doi":"10.1016/j.euo.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.euo.2025.03.002","url":null,"abstract":"<p><strong>Background and objective: </strong>A percutaneous biopsy of suspected upper tract urothelial carcinoma (UTUC) is considered contraindicated due to potential safety concerns. This study evaluated the risk of tumor seeding along the needle track following a percutaneous needle-core biopsy for UTUC, along with diagnostic yield and oncological outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective multicenter study involving 53 patients who underwent a percutaneous biopsy for upper urinary tract urothelial carcinoma between 2012 and 2022. The primary endpoint was tumor recurrence along the biopsy needle track, assessed through a centralized review of follow-up cross-sectional imaging. The secondary endpoints included biopsy yield, histological concordance in tumor stage and grade compared with final histology in cases of nephroureterectomy, complication rates, and overall oncological outcomes.</p><p><strong>Key findings and limitations: </strong>The cohort consisted of 60% male patients with a mean age of 69 yr. At diagnosis, 32% had metastatic disease. A biopsy was performed due to diagnostic uncertainty regarding renal cell carcinoma or other diseases, distant metastases, or failed endoscopic biopsy. The median follow-up imaging time was 8.3 mo. Tumor track seeding occurred in one case (1.9%) 5 mo after the procedure. Biopsy yield was 94%, with histological concordance rates of 78% for tumor stage and 100% for grade. Complications occurred in 14.8% of cases, including two (3.7%) cases of obstructive pyelonephritis requiring endoscopic management.</p><p><strong>Conclusions and clinical implications: </strong>A percutaneous biopsy is a useful diagnostic tool for high-grade invasive upper urinary tract urothelial carcinoma, with a low risk of tumor track seeding. It provides critical histological confirmation, facilitating future research on neoadjuvant systemic therapies.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004614","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}