International Journal of Urology最新文献

{"title":"Noninvasive Genotyping Test of Human Papillomavirus in Japanese Male Genital Warts by PCR From Scraping Specimens","authors":"Yu Yoshimura, Mamoru Hashimoto, Takahisa Genji, Kenji Nishimura, Masahisa Ikegami, Kazutoshi Fujita","doi":"10.1111/iju.70374","DOIUrl":"10.1111/iju.70374","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131847","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":"Outcomes of Mini-Endoscopic Combined Intrarenal Surgery in the Geriatric Population: A Matched-Pair Analysis","authors":"Takahiko Watanabe,&nbsp;Hiroki Ito,&nbsp;Tetsuo Fukuda,&nbsp;Fukashi Yamamichi,&nbsp;Yosuke Shibata,&nbsp;Tadashi Tabei,&nbsp;Kazuhide Makiyama,&nbsp;Takaaki Inoue,&nbsp;Junichi Matsuzaki,&nbsp;Kazuki Kobayashi","doi":"10.1111/iju.70372","DOIUrl":"10.1111/iju.70372","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate the safety and efficacy of mini-endoscopic combined intrarenal surgery (ECIRS) in older patients with renal and ureteral stones.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consecutive patients with renal or ureteral stones who underwent mini-ECIRS were retrospectively analyzed at three Japanese tertiary care institutions between 2015 and 2021. Data on patient backgrounds, stone characteristics, and postoperative indications were collected and evaluated. After matching preoperative and intraoperative factors in older patients and other groups, postoperative factors were assessed using univariate analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final analysis included data from 1303 single-session mini-ECIRS of 1432 cases collected. The patients were divided into two groups: those aged &gt; 75 and those aged &lt; 75 years, with 121 and 1182 patients. From each group, 112 cases matched for eight factors, performance status, body mass index, sex, hydronephrosis, percutaneous nephrostomy, pyuria, preoperative urinary tract infection, and preoperative ureteral stenting, were selected. The univariate analysis was performed on postoperative factors between the groups of matched older and matched non-older patients, and there was no significant difference in any factor, including postoperative hospitalization duration, complications, and stone-free rate (SFR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>To the best of our knowledge, this multicenter cohort study is the first to compare the efficacy and safety of the mini-ECIRS between older patients and other groups. It was discovered that surgery could be performed with a similar quality even in patients aged 75 and older compared to that in other groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146124957","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":"Beyond Total PSA: Clinical Significance of S2,3PSA% in Reducing Unnecessary Prostate Biopsies","authors":"Shingo Hatakeyama,&nbsp;Tohru Yoneyama,&nbsp;Chikara Ohyama","doi":"10.1111/iju.70371","DOIUrl":"10.1111/iju.70371","url":null,"abstract":"<p>Prostate-specific antigen (PSA) testing has long been central to prostate cancer detection but is limited by poor specificity, resulting in overdiagnosis and unnecessary prostate biopsies. Although PSA derivatives such as percentage free PSA and the Prostate Health Index (PHI) have improved diagnostic performance, substantial uncertainty persists, particularly in patients with equivocal magnetic resonance imaging (MRI) findings. Cancer-associated alterations in PSA glycosylation have emerged as a promising strategy to address these limitations. Percentage α2,3-linked sialylated PSA (S2,3PSA%) reflects tumor-associated glycoform changes that differ from those observed in benign prostatic conditions. This review summarizes the biological basis, analytical development, and clinical evidence supporting S2,3PSA% as a novel biomarker for prostate cancer diagnosis. We highlight key studies demonstrating that S2,3PSA% improves discrimination of clinically significant prostate cancer and provides complementary information when combined with PHI and MRI. Recent data further indicate that integrated diagnostic approaches incorporating S2,3PSA%, PHI, and PI-RADS scoring can meaningfully reduce unnecessary prostate biopsies without compromising detection of clinically significant disease. Beyond diagnostic accuracy, emerging evidence suggests that S2,3PSA%–guided risk stratification in screening settings may also reduce the number of unnecessary MRI examinations and biopsies, thereby contributing to more efficient use of healthcare resources and potential cost savings. We also discuss the potential role of S2,3PSA% in prostate cancer screening and active surveillance. Collectively, current evidence supports S2,3PSA% as a biologically informed biomarker that helps reduce diagnostic uncertainty inherent to PSA-based decision-making and facilitates more individualized and resource-conscious prostate cancer care.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12867560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Factors of Castration-Resistant Prostate Cancer Among Patients With Localized Prostate Cancer Who Underwent Robot-Assisted Radical Prostatectomy in a Retrospective Multicenter Japanese Cohort (MSUG94)","authors":"Takeshi Sasaki,&nbsp;Atsushi Igarashi,&nbsp;Shin Ebara,&nbsp;Tomoyuki Tatenuma,&nbsp;Yoshinori Ikehata,&nbsp;Akinori Nakayama,&nbsp;Makoto Kawase,&nbsp;Masahiro Toide,&nbsp;Tatsuaki Yoneda,&nbsp;Kazushige Sakaguchi,&nbsp;Jun Teishima,&nbsp;Kazuhide Makiyama,&nbsp;Hiroshi Kitamura,&nbsp;Kazutaka Saito,&nbsp;Takuya Koie,&nbsp;Fumitaka Koga,&nbsp;Shinji Urakami,&nbsp;Toshinari Yamasaki,&nbsp;Takahiro Inoue","doi":"10.1111/iju.70370","DOIUrl":"10.1111/iju.70370","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To explore clinicopathological risk factors associated with the development of castration-resistant prostate cancer (CRPC) in patients who underwent robot-assisted radical prostatectomy (RARP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted in nine Japanese institutions between 2012 and 2021. Patients with clinically metastatic PCa, those who received neoadjuvant or adjuvant therapy, were excluded. Consequently, 2825 patients with PCa were analyzed. Persistent prostate-specific antigen (PSA) was determined as a level ≥ 0.2 ng/mL at 1 month postoperatively and consistently in subsequent measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median follow-up was 42.0 months. Under follow-up, 493 (17.4%) and 25 (0.8%) patients progressed to biochemical recurrence and CRPC, respectively. One hundred and ninety-six patients received salvage radiation therapy, and 229 patients received salvage androgen deprivation therapy. Among the 25 patients with CRPC, the median time to CRPC was 31.8 months. Univariate analysis revealed that preoperative PSA level, biopsy grade group (GG) 5, percentage of positive cancer cores, GG5 in RARP specimens, pT3b, pN1, positive surgical margins, lymphovascular invasion (LVI), and persistent PSA levels were associated with CRPC development. Multivariate analysis revealed that biopsy GG5 (adjusted hazard ratio [aHR] 12.74, <i>p</i> &lt; 0.001), LVI (aHR 3.90, <i>p</i> = 0.011), and persistent PSA levels (aHR 8.66, <i>p</i> &lt; 0.001) were independently associated with CRPC development. Furthermore, using these three factors made it possible to stratify CRPC-free survival among patients with PCa who received RARP and confirmed external validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combination of biopsy GG5, LVI, and persistent PSA levels may stratify the risk of developing CRPC in patients with PCa undergoing RARP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Patient Selection for Aquablation During the Initial Adoption Phase: Prostates Smaller Than 100 mL","authors":"Shin Koike,&nbsp;Yu Ozawa,&nbsp;Kei Ushijima,&nbsp;Keita Okamoto,&nbsp;Toshiaki Kayaba,&nbsp;Sunao Nohara,&nbsp;Masumi Yamada,&nbsp;Keisuke Aoki,&nbsp;Yu Odagaki,&nbsp;Hideo Sakamoto,&nbsp;Kunihiko Yoshioka","doi":"10.1111/iju.70373","DOIUrl":"10.1111/iju.70373","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To identify optimal candidates for Aquablation during the initial adoption phase by determining predictors of operative time and bladder irrigation volume to guide safe implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 123 patients who underwent Aquablation between 2023 and 2025 during the initial implementation of this technique by Aquablation-naïve urologists at our institution. Patients with short operative times and low irrigation volumes were considered optimal candidates. Preoperative variables were assessed using multivariable linear regression. Because prostate volume (PV) demonstrated the strongest association with operative time and irrigation volume, post hoc exploratory locally estimated scatterplot smoothing (LOESS) analysis was performed to define a data-driven PV threshold, and perioperative outcomes were compared above and below this threshold.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PV (median, 78 mL; interquartile range, 60–100 mL) was the only independent predictor of long operative times and great irrigation volumes. LOESS identified a PV threshold near 80 mL for bladder irrigation volume and 100 mL for operative time. Patients with PV &lt; 100 mL had more favorable perioperative outcomes. Compared with PV ≥ 100 mL, PV &lt; 100 mL had shorter operative times (median, 56 vs. 81 min; <i>p</i> &lt; 0.05), lower irrigation volumes (median 9000 vs. 14 000 mL; <i>p</i> &lt; 0.05), and smaller hemoglobin reductions (−0.9 vs. −1.6 mg/dL; <i>p</i> &lt; 0.05); rates of Clavien-Dindo ≥ 3 adverse events, transfusion, and refulguration did not differ.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A PV &lt; 100 mL appears to be a practical criterion for safe early adoption of Aquablation; accurate preoperative estimation of PV is therefore essential.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105346","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":"Impact of the 2025 NCCN Definition Change for Very High-Risk Prostate Cancer on Surgical Outcomes After Robot-Assisted Radical Prostatectomy: A Retrospective Cohort","authors":"Noriyoshi Miura,&nbsp;Masaki Shimbo,&nbsp;Kensuke Shishido,&nbsp;Shota Nobumori,&nbsp;Naoya Sugihara,&nbsp;Takatora Sawada,&nbsp;Shunsuke Haga,&nbsp;Haruna Arai,&nbsp;Keigo Nishida,&nbsp;Osuke Arai,&nbsp;Tomoya Onishi,&nbsp;Ryuta Watanabe,&nbsp;Kenichi Nishimura,&nbsp;Tetsuya Fukumoto,&nbsp;Yuki Miyauchi,&nbsp;Tadahiko Kikugawa,&nbsp;Takato Nishino,&nbsp;Fumiyasu Endo,&nbsp;Kazunori Hattori,&nbsp;Takashi Saika","doi":"10.1111/iju.70366","DOIUrl":"10.1111/iju.70366","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>In 2025, the National Comprehensive Cancer Network (NCCN) updated the definition of very high-risk (VHR) prostate cancer to include individuals meeting at least two of the following: clinical stage ≥ T3, prostate-specific antigen ≥ 40 ng/mL, and Gleason Grade Group (GG) ≥ 4. This revision alters group classification and may impact surgical outcomes. We aimed to compare oncological outcomes under the earlier and 2025 definitions in individuals undergoing robot-assisted radical prostatectomy (RARP) without perioperative systemic therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed 1879 individuals who underwent RARP at two institutions between July 2012 and November 2022. Of these, 641 classified as high risk or above were analyzed: historical high risk (Group 1: <i>n</i> = 377), reclassified from VHR to high risk (Group 2: <i>n</i> = 119), and VHR per 2025 criteria (Group 3: <i>n</i> = 145).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median follow-up was 59.8 months. Five-year biochemical recurrence-free survival rates were 71.1%, 44.7%, and 29.8%; metastasis-free survival rates were 99.6%, 94.1%, and 88.9% for the three groups, respectively. Group 2 showed worse outcomes than Group 1. Exploratory analyses indicated that within Group 3, having &gt; 4 biopsy cores with GG 4–5 was associated with significantly worse recurrence outcomes, whereas those without this factor had results closer to Group 2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In conclusion, both the revised high-risk and VHR categories include heterogeneous populations. Refinement of risk stratification in the surgical setting may help identify subsets requiring tailored perioperative and multimodal strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105371","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":"Clinical Outcomes and Clinicopathological Features of Primary Urethral Carcinoma: A Multicenter Retrospective Study in Japan","authors":"Keita Kobayashi,&nbsp;Kei Daizumoto,&nbsp;Takuya Tsujino,&nbsp;Ryoichi Maenosono,&nbsp;Minoru Kato,&nbsp;Taisuke Matsue,&nbsp;Shuichi Tatarano,&nbsp;Yohei Abe,&nbsp;Rikiya Taoka,&nbsp;Makito Miyake,&nbsp;Hideo Fukuhara,&nbsp;Kohei Ogawa,&nbsp;Kohei Kobatake,&nbsp;Yohei Sekino,&nbsp;Junya Furukawa,&nbsp;Hideki Enokida,&nbsp;Kiyohide Fujimoto,&nbsp;Keiji Inoue,&nbsp;Koichiro Wada,&nbsp;Koji Shiraishi,&nbsp;West Japan Uro-oncology Collaboration group","doi":"10.1111/iju.70367","DOIUrl":"10.1111/iju.70367","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Primary urethral carcinoma is an extremely rare malignancy, and evidence on its treatment and prognosis remains limited. This study aimed to clarify the treatment patterns, clinical outcomes, and prognostic factors for primary urethral carcinoma in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study across 10 institutions included 57 Primary urethral carcinoma cases between 2004 and 2022. Recurrence-free survival and overall survival were estimated using the Kaplan–Meier method, and overall survival–related factors were evaluated using univariate Cox regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort comprised 24 men (42%) and 33 women (58%), with a median tumor size of 30 mm (interquartile range, 15–48 mm). Stage distribution was ≤ I in 17 (30%), II in 10 (18%), III in 8 (14%), and IV in 21 (38%) patients. Urothelial carcinoma, including cases with divergent differentiation, was the predominant histological subtype, identified in 17 men (71%) and 14 women (42%). The median follow-up time was 17.1 months (interquartile range, 6.4–37.7 months). Overall survival did not differ significantly between Stage I and Stage II disease (<i>p</i> = 0.499), whereas it was significantly shorter in patients with Stage III and Stage IV disease compared with Stage I (<i>p</i> = 0.030 and <i>p</i> &lt; 0.001, respectively). Previous urinary catheter placement, urethral diverticulum, and elevated lactate dehydrogenase (&gt; 220 IU/L) were significantly associated with poorer overall survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Stage ≤ II Primary urethral carcinoma has favorable survival following definitive treatment, Stage III–IV disease showed poor outcomes, necessitating multimodal perioperative strategies (chemotherapy and/or radiotherapy).</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105418","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":"Impact of Immunohistochemical PSA and Ki-67 Expression on Prognosis in Metastatic Castration-Sensitive Prostate Cancer","authors":"Miyaka Umemori,&nbsp;Fumihiko Urabe,&nbsp;Yuya Iwamoto,&nbsp;Yu Imai,&nbsp;Kojiro Tashiro,&nbsp;Shun Sato,&nbsp;Hiroyuki Takahashi,&nbsp;Takahiro Kimura","doi":"10.1111/iju.70368","DOIUrl":"10.1111/iju.70368","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Treatment selection for metastatic castration-sensitive prostate cancer (mCSPC) remains challenging, as reliable and practical biomarkers predicting response to androgen receptor pathway inhibitor (ARPI)-based therapy are limited. We evaluated whether prostate-specific antigen (PSA) and Ki-67 expression in diagnostic biopsy specimens can predict oncologic outcomes in patients with mCSPC treated with ARPI–androgen deprivation therapy (ADT) doublet therapy, and whether these biomarkers can guide optimal treatment selection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective multicenter study included 58 patients with mCSPC who received ARPI–ADT doublet therapy between 2018 and 2024. Immunohistochemical staining for PSA and Ki-67 was performed on diagnostic biopsy specimens. Receiver operating characteristic curve analyses were used to determine optimal cutoff values for predicting progression to castration-resistant prostate cancer (CRPC). Survival outcomes were analyzed using the Kaplan–Meier method and Cox proportional hazards models. Exploratory analyses included patients treated with triplet therapy (ADT + docetaxel + darolutamide) or upfront docetaxel.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Low PSA expression, high Ki-67 expression, and a bone metastasis extent of disease (EOD) score ≥ 3 were independently associated with shorter CRPC-free survival (CRPC-FS). Stratification by risk factors (0, 1, or 2) showed a stepwise decline in CRPC-FS. In exploratory analyses, triplet therapy achieved the longest CRPC-FS and progression-free survival 2 among high-risk patients, whereas no significant differences among treatment modalities were observed in the low-risk group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Immunohistochemical PSA and Ki-67 expression provide practical prognostic information for patients with metastatic castration-sensitive prostate cancer. Combined assessment with EOD ≥ 3 identifies a high-risk subgroup with unfavorable clinical outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105411","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 Photodynamic Diagnosis Is Confined to the Low-Risk Subgroup of Intermediate-Risk Non-Muscle-Invasive Bladder Cancer: A Propensity Score Matched Analysis","authors":"Yohei Abe,&nbsp;Rikiya Taoka,&nbsp;Asuka Kaji,&nbsp;Satoshi Harada,&nbsp;Kengo Fujiwara,&nbsp;Kana Kohashiguchi,&nbsp;Hirohito Naito,&nbsp;Yoichiro Tohi,&nbsp;Takuma Kato,&nbsp;Homare Okazoe,&nbsp;Nobufumi Ueda,&nbsp;Mikio Sugimoto","doi":"10.1111/iju.70365","DOIUrl":"10.1111/iju.70365","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Intermediate-risk (IR) non-muscle-invasive bladder cancer (NMIBC) is a heterogeneous disease. In this study, we aimed to evaluate the efficacy of photodynamic diagnosis (PDD)-assisted transurethral resection of the bladder (TURBT) using the recently validated International Bladder Cancer Group (IBCG) risk stratification model for IR-NMIBC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a single-center retrospective analysis of 193 patients with IR-NMIBC who underwent either PDD-assisted with oral 5-aminolevulinic acid (<i>n</i> = 69) or white-light (WL) TURBT (<i>n</i> = 126) between 2009 and 2023. We performed 1:1 propensity score matching (PSM) to balance baseline characteristics. Recurrence-free survival (RFS) was compared between the groups using the Kaplan–Meier method with subgroup analyses based on IBCG risk strata (IR-low, IR-intermediate/high).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After PSM, 69 patients with well-balanced characteristics remained in each group. PDD was associated with a significantly improved RFS compared with WL-TURBT in the overall cohort (<i>p</i> = 0.016). Using subgroup analysis, this benefit was most pronounced in the IR-low risk group (<i>p</i> = 0.025), whereas no significant difference was found in the IR-intermediate/high-risk group (<i>p</i> = 0.14). Regarding multivariate analysis, PDD was an independent predictor of improved RFS in both the entire IR cohort (hazard ratio [HR]: 0.421, <i>p</i> = 0.009) and IR-low subgroup (HR: 0.361, <i>p</i> = 0.047).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PDD-assisted TURBT significantly improved the recurrence outcomes in patients with IR-NMIBC, with the greatest benefit observed in the IR-low risk subgroup. These findings support a stratified approach in which PDD is a cornerstone of management of IR-low patients, while highlighting the need for further research to optimize treatment strategies for IR-intermediate/high patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093286","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":"Validation of the 7-Item Quality of Life Disease-Specific Impact Scale in Patients Undergoing Radical Cystectomy for Bladder Cancer: A Cross-Sectional Study","authors":"Sayaka Shimizu,&nbsp;Takahiro Osawa,&nbsp;Miho Sato,&nbsp;Shuhei Yamada,&nbsp;Toru Harabayashi,&nbsp;Jun Miki,&nbsp;Takashi Kobayashi,&nbsp;Katsuyoshi Hashine,&nbsp;Atsunari Kawashima,&nbsp;Takashi Matsumoto,&nbsp;Takanori Mochizuki,&nbsp;Rikiya Taoka,&nbsp;Fumihiko Urabe,&nbsp;Shuichi Tatarano,&nbsp;Atsuro Sawada,&nbsp;Takahiro Kojima,&nbsp;Atsushi Takahashi,&nbsp;Akira Yokomizo,&nbsp;Shigetaka Suekane,&nbsp;Kohei Hashimoto,&nbsp;Yasuhiro Hashimoto,&nbsp;Junji Yatsuda,&nbsp;Ken Morita,&nbsp;Keita Kobayashi,&nbsp;Yohei Satake,&nbsp;Ataru Sazawa,&nbsp;Yoshiyuki Matsui,&nbsp;Yoichi M. Ito,&nbsp;Hiroyuki Nishiyama,&nbsp;Hiroshi Kitamura,&nbsp;Nobuo Shinohara,&nbsp;Shunichi Fukuhara,&nbsp;the Japanese Urological Oncology Group","doi":"10.1111/iju.70364","DOIUrl":"10.1111/iju.70364","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To validate, for the first time in patients with bladder cancer who underwent radical cystectomy, the recently developed 7-item Quality of Life Disease-specific Impact Scale (QDIS-7), a brief, unidimensional instrument designed for cross-condition comparisons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional study conducted at 24 facilities, patients aged ≥ 20 years who were 3 months post-radical cystectomy for bladder cancer completed self-reported questionnaires. The enrollment period was from January 2020 to October 2022. Quality of life measures included the QDIS-7, the Bladder Cancer Index (BCI), and the Body Image Scale (BIS). Confirmatory factor analysis was performed to test the hypothesized one-factor structure of the QDIS-7. Internal consistency reliability was assessed using Cronbach's alpha coefficient. Criterion-based validity was evaluated using Spearman's correlation coefficients (ρ) between the QDIS-7 scores and the BCI bother subdomains and BIS scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 205 patients (median age, 71 years; 78.5% male) were included. The QDIS-7 score showed no floor or ceiling effects. Confirmatory factor analysis supported the one-factor model (factor loadings, 0.71–0.94). Internal consistency reliability was high (Cronbach's alpha, 0.94). The QDIS-7 score showed moderate correlations with the BIS and the BCI urinary and bowel bother subdomain scores (<i>ρ</i> = 0.654, −0.560, and −0.475, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The QDIS-7 effectively captured urinary and bowel symptom burden and body image impairment in patients undergoing radical cystectomy for bladder cancer. Its brevity, strong psychometric properties, and capacity for comparisons across conditions support its use in patient-centered research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trail Registration</h3>\u0000 \u0000 <p>UMIN-CTR (UMIN000039538)</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146063492","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}