International Journal of Urology最新文献

{"title":"The correlation between discrepancies in clinical and pathological T stages and overall survival in upper urinary tract urothelial carcinoma: Analysis of the hospital-based cancer registry data in Japan.","authors":"Masanobu Shiga, Yoshiyuki Nagumo, Kosuke Kojo, Shuya Kandori, Reo Takahashi, Bunpei Isoda, Shuhei Suzuki, Kazuki Hamada, Kozaburo Tanuma, Satoshi Nitta, Akio Hoshi, Hiromitsu Negoro, Bryan J Mathis, Ayako Okuyama, Hiroyuki Nishiyama","doi":"10.1111/iju.15665","DOIUrl":"https://doi.org/10.1111/iju.15665","url":null,"abstract":"<p><strong>Objective: </strong>Our study assessed the correlation between discrepancies in clinical and pathological T stages and overall survival (OS) in patients with upper urinary tract urothelial carcinoma (UTUC), including renal pelvis (UCP) and ureter (UCU) carcinoma, treated with radical surgery.</p><p><strong>Methods: </strong>We utilized data from the Japanese Hospital-Based Cancer Registry (HBCR) to identify UTUC cases (n = 2376), consisting of UCP cases (n = 1196) and UCU cases (n = 1180), diagnosed with cTa-3N0M0 between 2012 and 2013. All cases were histologically confirmed and treated solely with radical surgery, excluding any chemotherapy or radiotherapy. We investigated the correlation between stage classification discrepancies and OS.</p><p><strong>Results: </strong>Among UCP and UCU patients, cT2N0M0 had the highest discrepancy rates between clinical and pathological stages (68% and 51%), while cT3N0M0 had the lowest (21% and 20%). Among UCP and UCU patients with cTa/is/1N0M0, those with up-staging showed significantly worse OS compared to same-staging (HR 1.7 and 2.5, p = 0.001 and <0.001, respectively). In UCU patients with cT2N0M0, the 5-year OS rates were 41.9% for up-staging, 63.7% for same-staging, and 76.4% for down-staging, with significantly worse survival in the up-staged group. Among UCP and UCU patients with cT3N0M0, the 5-year OS rates were 29.3% and 7.7% for those with up-staging, 53.7% and 30.6% for those with same staging, and 79.6% and 65.4% for those with down-staging.</p><p><strong>Conclusion: </strong>Using a large real-world cohort, we found stage discrepancies to be a significant independent prognostic factor in non-metastatic UTUC patients. Treatment should be carefully selected, considering T-staging discrepancies and prognosis.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"α₁-Blockers as a risk factor for hypotension in combination with oral 5-aminolevulimic acid for photodynamic diagnosis in patients with bladder cancer.","authors":"Chihiro Suzuki, Tomonori Minagawa, Hiromu Onuma, Shiro Hiragata, Yoshiaki Kinebuchi","doi":"10.1111/iju.15655","DOIUrl":"https://doi.org/10.1111/iju.15655","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stone at the same location for 2 months predicts impacted stones and stone-free status after shock wave lithotripsy for ureteral stones: A Funabashi clinic expert study.","authors":"Kazuyoshi Nozumi, Shinichi Sakamoto, Xue Zhao, Sangjon Pae, Takaaki Tamura, Kazumi Taguchi, Yasutaka Yamada, Yusuke Goto, Yusuke Imamura, Tomokazu Sazuka, Yusuke Awa, Takahiro Yasui, Kuniyoshi Nozumi, Yukio Naya, Koichiro Akakura, Tomohiko Ichikawa","doi":"10.1111/iju.15662","DOIUrl":"https://doi.org/10.1111/iju.15662","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the success rate of shock wave lithotripsy and identify predictors of stone-free status after shock wave lithotripsy for ureteral stones, focusing on the impact of stones remaining in the same location for 2 months (SSL2).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 501 patients with ureteral stones treated with shock wave lithotripsy by expert surgeons (each with over 1000 shock wave lithotripsy operations) at a single Japanese institution in 2020. Logistic regression analysis identified predictors of stone-free status, including stone length, skin-to-stone distance, stone density (Hounsfield Unit), Hounsfield Unit above/below the stone, stone position, and duration of stone at the same location (SSL2).</p><p><strong>Results: </strong>Ninety patients were excluded, resulting in 411 patients undergoing an average of 1.15 ± 0.4 sessions (range: 1-4). 344 patients (83.7%) achieved stone-free status after a single session. The overall 1-month stone-free rate was 71.4%, and the 3-month stone-free rate was 88.8%. Stone at the same location ≥2 months (SSL2) was an independent predictor of 1-month stone-free status (odds ratio = 2.25, 95%CI: 1.10-4.57, p = 0.025), while mean stone density ≥ 813 HU was an independent predictor of 3-month stone-free status (odds ratio = 2.66, 95% CI: 1.10-6.45, p = 0.03).</p><p><strong>Conclusion: </strong>Stone at the same location ≥2 months (SSL2) was a potent predictor of 1-month and 3-month stone-free status. This condition is associated with impacted stones and can aid in decision-making for shock wave lithotripsy treatment selection.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk assessment of late biochemical recurrence after radical prostatectomy: Usefulness of ultra-sensitive prostate-specific antigen measurement.","authors":"Norihiko Kawamura, Masashi Nakayama, Takuji Hayashi, Akira Nagahara, Yasutomo Nakai, Kazuo Nishimura","doi":"10.1111/iju.15660","DOIUrl":"https://doi.org/10.1111/iju.15660","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate predictors of late biochemical recurrence in patients with no recurrence at 5 years after radical prostatectomy (RP).</p><p><strong>Methods: </strong>We retrospectively investigated patients who underwent RP for prostate cancer in our institute from 1999 to 2016, selecting those with no biochemical recurrence at 5 years post-RP. These patients did not receive neoadjuvant and adjuvant hormone therapy. Following RP, patients were regularly monitored using ultra-sensitive prostate-specific antigen (PSA) measurements, with a detection limit of 0.01 ng/mL. Biochemical recurrence was defined as PSA level ≥0.2 ng/mL, confirmed by subsequent PSA >0.2 ng/mL.</p><p><strong>Results: </strong>Among 581 patients who underwent RP, 312 with no biochemical recurrence at 5 years post-RP were selected. The median follow-up period was 123 months. The 10-year biochemical recurrence-free survival rate for this cohort was 89.6%. Patients with a PSA value <0.02 ng/mL at 5 years post-RP had a 10-year biochemical recurrence-free survival rate of 98.5%. Multivariable regression analysis identified Grade Group ≥4 and PSA value ≥0.02 ng/mL at 5 years post-RP as independent predictors of late biochemical recurrence (hazard ratio 2.23, 95% confidence interval 1.06-4.71, p = 0.035; hazard ratio 37.5, 95% confidence interval 11.6-121.3, p < 0.001, respectively). Patients with Grade Group of 4 or more had a significantly reduced PSA doubling time at biochemical recurrence compared to those with Grade Group of 3 or less.</p><p><strong>Conclusions: </strong>Among patients whose PSA levels remain below 0.02 ng/mL at 5 years after RP, the risk of subsequent late biochemical recurrence is very low. Utilizing ultra-sensitive PSA measurements at the 5-year mark can provide useful information regarding the need for follow-up beyond 5 years.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary continence outcomes after robot-assisted laparoscopic radical prostatectomy: Significance of anterior reconstruction.","authors":"Keisuke Funajima, Sei Naito, Atsushi Fukai, Takafumi Narisawa, Hiroki Fukuhara, Shinta Suenaga, Yuki Takai, Satoshi Takai, Mayu Yagi, Hidenori Kanno, Atsushi Yamagishi, Hayato Nishida, Norihiko Tsuchiya","doi":"10.1111/iju.15654","DOIUrl":"https://doi.org/10.1111/iju.15654","url":null,"abstract":"<p><strong>Objective: </strong>Urinary continence after radical prostatectomy is a crucial aspect of patient quality of life. The aim of this study was to identify the factors influencing urinary continence after robot-assisted laparoscopic radical prostatectomy, focusing on the role of anterior reconstruction.</p><p><strong>Methods: </strong>We collected clinical data from 375 patients at a single institution. Logistic regression analyses for urinary continence rate at 1, 3, 6, and 12 months postoperatively were performed on the entire patient population to determine the influencing factors. Anterior and posterior reconstruction was performed until August 2017, transitioning to posterior reconstruction only. The impact of anterior reconstruction on postoperative urinary continence was evaluated using logistic regression model adjusted by inverse-probability treatment weighting in nerve-sparing and non-nerve-sparing subgroups, respectively.</p><p><strong>Results: </strong>For the entire cohort, the urinary continence rates at 1, 3, 6, and 12 months were 34.7%, 57.6%, 73.1%, and 83.5%, respectively. Anterior reconstruction significantly influenced early urinary continence recovery, and membrane urethral length correlated with continence rates at all postoperative time points. After adjustment using the IPTW method, the chronological trend of urinary continence recovery rate in relation to anterior reconstruction was similar between patients with and without nerve sparing.</p><p><strong>Conclusions: </strong>Anterior reconstruction contributes to early recovery from urinary incontinence after robot-assisted laparoscopic prostatectomy. However, the impact for continence rate 12 months after surgery is limited.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment to \"Predictive value of hematologic parameters and HALP score for testicular viability in adults with testicular torsion: A multicentric study\".","authors":"Marko Bašković","doi":"10.1111/iju.15661","DOIUrl":"https://doi.org/10.1111/iju.15661","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Status of robotic surgery in pediatric genitourinary tumors: A systematic review.","authors":"Priyank Yadav, Dheidan Alshammari, Ihtisham Ahmad, Mohd S Ansari, Mohan S Gundeti","doi":"10.1111/iju.15659","DOIUrl":"https://doi.org/10.1111/iju.15659","url":null,"abstract":"<p><p>Innovative surgical approaches are crucial in pediatric oncology to enhance treatment outcomes and minimize morbidity. Robotic-assisted surgery (RAS) has shown promise in both surgical precision and recovery in pediatric patients. This systematic review aims to address this gap by examining the current role and impact of RAS in managing pediatric genitourinary tumors, focusing on its feasibility, safety, and patient outcomes. This review was registered with PROSPERO (CRD42023464820). We included studies involving pediatric patients undergoing RAS for genitourinary tumors, focusing on outcomes like conversion rates, resection completeness, and complications. Studies were identified through searches in PubMed, EMBASE, and Scopus until October 2023. Study quality and bias were assessed using ROBINS-I for cohort studies and Joanna Briggs Institute tools for case reports and series. Of 2119 citations, 42 studies were included, comprising 29 case reports, five case series, and eight retrospective cohort studies. Robotic-assisted renal surgeries were most common, with favorable outcomes in terms of resection completeness and low recurrence rates. Adrenal, bladder, and retroperitoneal surgeries also showed promising results, although rare instances required conversion to open surgery. Collaborative efforts and perioperative aids like intraoperative ultrasound and three-dimensional modeling were crucial for success. This work is limited by the lack of large cohort studies and addressing the learning curve associated with these procedures. RAS shows promise in treating pediatric genitourinary tumors, offering precise resections and favorable outcomes, warranting further research and refinement.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment on: \"Effect of ICG fluorescence-assisted new nerve-sparing of robot-assisted radical prostatectomy on lower urinary tract symptoms\".","authors":"Yushi Naito","doi":"10.1111/iju.15656","DOIUrl":"https://doi.org/10.1111/iju.15656","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of docetaxel addition to next-generation androgen receptor-axis-targeted therapies and androgen deprivation therapy in metastatic hormone-sensitive prostate cancer: A tumor volume-specific analysis.","authors":"Wei Chen, Soichiro Yoshida, Noriyoshi Miura, Shohei Fukuda, Yuma Waseda, Hajime Tanaka, Yasuhisa Fujii","doi":"10.1111/iju.15657","DOIUrl":"https://doi.org/10.1111/iju.15657","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of docetaxel in addition to next-generation androgen receptor-axis-targeted therapies and androgen deprivation therapy (ADT) for metastatic hormone-sensitive prostate cancer (mHSPC) remains unclear. We evaluated the efficacy of this combination through tumor volume-specific analysis.</p><p><strong>Methods: </strong>Individual patient data were reconstructed from seven clinical trials focusing mHSPC (ARASENS, PEACE-1, TITAN, ENZAMET, ARCHES, STAMPEDE, and LATITUDE) through the Shiny method. Overall survival (OS), radiological progression-free survival (rPFS), and time to castration-resistant prostate cancer (CRPC) were analyzed in the overall cohort and tumor volume-specific (high/low) subgroups. Sensitivity analyses were performed based on treatment methods and metastasis onset.</p><p><strong>Results: </strong>In 6931 cases, adding docetaxel to ARAT and ADT did not significantly improve OS (hazard ratio [HR] = 1.07, 95% confidence interval [CI]: 0.95-1.22, p = 0.27), rPFS (HR = 0.88, 95% CI: 0.73-1.05, p = 0.16), or time to CRPC (HR = 0.97, 95% CI: 0.80-1.18, p = 0.74). High-volume disease showed a non-significant trend toward improved OS with the triplet regimen. Low-volume disease showed a similar trend. Sensitivity analyses for second-generation androgen receptor inhibitors indicated potentially less advantageous OS with docetaxel addition, but no significant differences when stratified by tumor volume. Analyses of the docetaxel-naïve, abiraterone, and synchronous metastasis subgroups showed no statistically significant differences in OS compared with the overall population and volume-stratified cases.</p><p><strong>Conclusions: </strong>Patients with mHSPC did not show significant improvement with docetaxel addition to ARAT-based regimens, regardless of tumor volume. Further research is needed to identify potential beneficiaries of this combination therapy.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-marketing surveillance data for avelumab + axitinib treatment in patients with advanced renal cell carcinoma in Japan: Subgroup analyses by pathological classification.","authors":"Norio Nonomura, Taito Ito, Masashi Sato, Makiko Morita, Masahiro Kajita, Mototsugu Oya","doi":"10.1111/iju.15646","DOIUrl":"https://doi.org/10.1111/iju.15646","url":null,"abstract":"<p><strong>Objective: </strong>Clinical trials have demonstrated the efficacy and safety of avelumab + axitinib in patients with advanced clear cell renal cell carcinoma (ccRCC). However, information is limited regarding the activity of avelumab + axitinib in patients with non-clear cell RCC (nccRCC). In Japan, post-marketing surveillance (PMS) of patients with RCC receiving avelumab + axitinib treatment in general clinical practice was undertaken. We report ad hoc analyses of PMS data according to RCC pathological classification.</p><p><strong>Methods: </strong>Of 328 patients with RCC who received ≥1 dose of avelumab and were enrolled between December 2019 and May 2021, 271 (82.6%) had ccRCC, 22 (6.7%) had nccRCC, and 35 (10.7%) had missing or unknown RCC pathology. Among patients with nccRCC, pathological subtypes were papillary in 12 (3.7%), translocation in 3 (0.9%), acquired cystic disease associated in 3 (0.9%), chromophobe in 2 (0.6%), mucinous tubular and spindle cell in 1 (0.3%), and Bellini duct in 1 (0.3%).</p><p><strong>Results: </strong>Among patients with ccRCC or nccRCC, any-grade adverse drug reactions of safety specifications occurred in 140 (51.7%) and 15 (68.2%), and of grade ≥3 in 48 (17.7%) and 6 (27.3%), respectively. The objective response rate in patients with ccRCC or nccRCC was 36.9% and 22.7%, respectively; in patients with papillary tumors, it was 33.3%. Median overall survival was not reached in patients with ccRCC or nccRCC, and 12-month overall survival rates were 86.8% and 76.7%, respectively.</p><p><strong>Conclusions: </strong>Overall, subgroup analyses of PMS data suggest that avelumab + axitinib improved clinical outcomes in nccRCC in addition to ccRCC.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}