International Journal of Urology最新文献

{"title":"Myosteatosis Predicts Poor Prognosis in Patients With Castration-Resistant Prostate Cancer Treated With Enzalutamide.","authors":"Tomohiro Kanaki, Koji Hatano, Toshiki Oka, Masaru Tani, Masatoshi Konishi, Yutong Liu, Hiromu Horitani, Atsuki Matsukawa, Shunsuke Inoguchi, Akihiro Yoshimura, Yuki Horibe, Nesrine Sassi, Yohei Okuda, Yu Ishizuya, Takuji Hayashi, Yoshiyuki Yamamoto, Taigo Kato, Atsunari Kawashima, Norio Nonomura","doi":"10.1111/iju.70476","DOIUrl":"10.1111/iju.70476","url":null,"abstract":"<p><strong>Objectives: </strong>Prostate cancer prognostication has traditionally emphasized tumor-related factors (e.g., Gleason score and metastatic burden). Emerging evidence suggests that physical (host) factors influence outcomes. This study evaluated whether physical factors, including myosteatosis and sarcopenia, are prognostic factors in patients with androgen receptor signaling inhibitor-naïve, castration-resistant prostate cancer.</p><p><strong>Methods: </strong>We retrospectively analyzed 117 androgen receptor signaling inhibitor-naïve patients with castration-resistant prostate cancer who received enzalutamide treatment at The University of Osaka Hospital between 2014 and 2024. Myosteatosis and sarcopenia were derived from pretreatment abdominal computed tomography. The primary endpoint was failure-free survival. Multivariate Cox proportional hazards analysis was performed to identify independent prognostic factors.</p><p><strong>Results: </strong>Myosteatosis and sarcopenia were present in 49 (42%) and 46 (39%) patients, respectively. In univariate analyses, the Charlson comorbidity index, body mass index, and sarcopenia demonstrated no significant association with failure-free survival, whereas myosteatosis and distant metastasis were associated with a shorter failure-free survival. In multivariable analysis, myosteatosis remained an independent predictor of shorter failure-free survival (hazard ratio 1.91, 95% confidence interval 1.22-2.99, p < 0.01). The median failure-free survival was 6 and 17 months with and without myosteatosis, respectively (p < 0.01).</p><p><strong>Conclusions: </strong>Myosteatosis is an independent failure-free survival predictor in patients with androgen receptor signaling inhibitor-naïve castration-resistant prostate cancer treated with enzalutamide. Computed tomography-based evaluation of muscle quality may be useful for predicting the outcome of androgen receptor signaling inhibitors in patients with castration-resistant prostate cancer.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 5","pages":"e70476"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771278","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":"Editorial Comment on Comparison of Infectious Complications After Transrectal Prostate Biopsy Under Two Antibiotic Prophylaxis Regimens: Ceftriaxone Plus Cefixime Versus Ciprofloxacin Plus Gentamicin.","authors":"Takanori Sekito, Hidetada Hirakawa, Takuya Sadahira","doi":"10.1111/iju.70464","DOIUrl":"https://doi.org/10.1111/iju.70464","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 5","pages":"e70464"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771180","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":"Gleason Regrading After Prostatectomy-Results From the Irish Prostate Cancer Outcome Research (IPCOR) Situated in the International Context.","authors":"Noa Gordon, Ayush Amish Patel, Wasfa Farooq, William Watson, David Galvin","doi":"10.1111/iju.70469","DOIUrl":"https://doi.org/10.1111/iju.70469","url":null,"abstract":"<p><strong>Background: </strong>Accurate Gleason grading is crucial for prostate cancer (PCa) treatment decisions; incorrect assessment can lead to under- or overtreatment; discordance between biopsy and radical prostatectomy (RP) grades is a marker of this inaccuracy. Using the Irish Prostate Cancer Outcomes Research (IPCOR) cohort, we sought to quantify Gleason grade concordance, upgrading, and downgrading trends in PCa RP patients, assess the impact of pre-biopsy MRI on diagnostic accuracy, and compare Irish trends with international findings.</p><p><strong>Methods: </strong>A contextual literature review summarized international regrading rates. IPCOR enrolled 6816 men diagnosed with PCa. We included 1194 men who underwent both biopsy and RP within 180 days. Biopsy and RP Gleason Grade Groups (GG) were compared to estimate concordance, upgrading, and downgrading. Sub-analyses examined regrading by biopsy modality and pre-biopsy MRI.</p><p><strong>Results: </strong>Overall concordance was 57.0%, similar international median of 52.9%. Concordance was lowest for GG1 (32.7%) and highest for GG2 (74.8%), while higher GGs showed frequent downgrading (GG4 46.8%; GG5 33.3%). Among men with TRUS biopsy, pre-biopsy MRI was associated with higher concordance (59.8% vs. 55.8%) and lower upgrading (19.3% vs. 29.4%), though differences were not statistically significant.</p><p><strong>Conclusions: </strong>Gleason regrading patterns in Ireland mirror global experience, with upgrading in lower and downgrading in higher GGs. Pre-biopsy MRI shows a favorable trend toward improved diagnostic accuracy, supporting its integration into clinical pathways.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 5","pages":"e70469"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771211","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":"Ejaculation Sparing Bladder Neck Incision for Young Men With Primary Bladder Neck Obstruction.","authors":"Sanjay Sinha, Daxay Lakhani, Ch Ram Prasad","doi":"10.1111/iju.70478","DOIUrl":"https://doi.org/10.1111/iju.70478","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate clinical and ejaculatory outcomes following ejaculation-sparing bladder neck incision (ESBNI) in young men with primary bladder neck obstruction (PBNO).</p><p><strong>Methods: </strong>Retrospective cohort study with prospective outcome assessment of men ≤ 40 years who underwent ESBNI between 2022 and 2025 for videourodynamically confirmed PBNO. All patients underwent a single bladder neck incision at the 6 o'clock position using standard electrocautery, with distal extent limited to approximately 10 mm proximal to the verumontanum. Ejaculatory outcomes were assessed using the Male Sexual Health Questionnaire-Ejaculatory Dysfunction Short Form (MSHQ-EjD-SF). The primary outcome was preservation of the ability to ejaculate (score ≥ 4 on Question 1). Secondary outcomes included ejaculatory function (sum of Questions 1-3), postoperative maximum flow rate (Q_max), and other key clinical outcomes including complications. Non-parametric statistical tests were used.</p><p><strong>Results: </strong>At a median follow-up of 13 months, antegrade ejaculation was preserved in 100% of patients with available data (51/53), and 90% demonstrated normal ejaculatory function. Median postoperative Q_max was 17 mL/s, with 67% and 27% achieving normal (≥ 15 mL/s) and borderline flow (12-14 mL/s), respectively. Among catheter-dependent patients, 18/19 became catheter-free. In catheter-independent patients, median improvement in Q_max was 9 mL/s. Higher Bladder Outflow Obstruction Index and Detrusor Contraction Index (ICS-DCI) were associated with improved postoperative flow, while ejaculatory function was positively associated with DCI. Three patients required redo surgery. Complications were minimal.</p><p><strong>Conclusions: </strong>Ejaculation-sparing bladder neck incision is a safe and effective surgical option for young men with videourodynamically-confirmed PBNO, providing meaningful improvement in urinary flow with reliable preservation of ejaculation.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 5","pages":"e70478"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771218","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":"Photocurable Gelatin Provides Superior Hemostasis Compared With Fibrin Glue Under Stringent Conditions in a Rabbit Partial Nephrectomy Model.","authors":"Masayuki Shinchi, Kenichiro Ojima, Toshihiro Kushibiki, Yoshine Mayumi, Yuhei Segawa, Kazuki Yanagida, Daisuke Watanabe, Keiichi Ito, Miya Ishihara, Akio Horiguchi","doi":"10.1111/iju.70484","DOIUrl":"https://doi.org/10.1111/iju.70484","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate whether photocurable gelatin can provide effective hemostasis under stringent conditions in a rabbit partial nephrectomy model, in comparison with conventional fibrin glue.</p><p><strong>Methods: </strong>A standardized partial nephrectomy model was established in ten male Japanese white rabbits by creating an 8-mm parenchymal defect. Animals were randomly assigned to receive either fibrin glue (Group A, n = 5) or photocurable gelatin activated by visible light using a ruthenium photoinitiator (Group B, n = 5). Blood loss before and after agent application was quantified, and the requirement for additional suturing was recorded. Histological evaluation was performed 7 days postoperatively.</p><p><strong>Results: </strong>There was no significant difference in control bleeding between the two groups prior to agent application. After treatment, bleeding volume was significantly lower in the photocurable gelatin group than in the fibrin glue group. All rabbits treated with fibrin glue required additional suturing to achieve hemostasis, whereas none of the rabbits treated with photocurable gelatin required suturing. Histological analysis demonstrated milder inflammatory infiltration at the resection surface in the photocurable gelatin group.</p><p><strong>Conclusions: </strong>Under experimentally stringent conditions in which fibrin glue alone was insufficient, photocurable gelatin achieved effective hemostasis without the need for additional suturing. These findings suggested that photocurable gelatin has the physical robustness required to overcome the limitations of conventional fibrin sealants and may represent a promising adjunct for hemostasis in nephron-sparing surgery.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 5","pages":"e70484"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771349","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 Non-Urinary Tract Recurrence After Radical Nephroureterectomy Based on CheckMate 274 Trial Eligibility: A Multicenter Retrospective Study.","authors":"Tetsuya Shindo, Yohei Ueki, Ippei Muranaka, Genki Kobayashi, Shintaro Miyamoto, Yasuharu Kunishima, Shunsuke Sato, Manabu Okada, Shuichi Kato, Ryuichi Kato, Hideki Adachi, Masanori Matsukawa, Akio Takayanagi, Kosuke Shibamori, Atsushi Wanifuchi, Yuki Kyoda, Kohei Hashimoto, Ko Kobayashi, Toshiaki Tanaka, Naoya Masumori","doi":"10.1111/iju.70497","DOIUrl":"https://doi.org/10.1111/iju.70497","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the risk of non-urinary tract recurrence after radical nephroureterectomy for patients with upper urinary tract carcinoma according to CheckMate 274 trial eligibility.</p><p><strong>Methods: </strong>We evaluated patients who underwent radical nephroureterectomy between 2012 and 2022 for upper urinary tract carcinoma. Recurrence was defined as extra-urinary tract recurrence. Univariate and multivariable analyses were used to determine the risk factors for recurrence according to CheckMate 274 trial eligibility.</p><p><strong>Results: </strong>Among 545 patients, 127 (23.3%) experienced recurrence during the follow-up period. Three-hundred sixty two (66.4%) patients were not eligible for CheckMate 274 trial criteria while 183 (33.6%) patients were eligible. The multivariable analysis demonstrated that preoperative renal dysfunction (HR2.24, 95% CI: 1.37-3.65, p = 0.001), presence of lymphovascular invasion (HR1.89, 95% CI: 1.18-3.00, p = 0.008)., positive resection margin (HR2.58, 95% CI: 1.43-4.66, p = 0.002), positive lymph node status (HR: 2.34, 95% CI: 1.21-4.55, p = 0.012) were risk factors for CheckMate 274 eligible patients. On the other hand, among 362 ineligible patients, performing preoperative diagnostic ureteroscopy (HR 3.09, 95% CI: 1.55-6.17, p = 0.001), presence of lymphovascular invasion (HR3.81, 95% CI: 1.78-8.17, p < 0.001), presence of histological subtype (HR4.82, 95% CI: 1.91-12.13, p < 0.001) and pathological T2 stage (HR2.28, 95% CI: 1.08-4.81, p = 0.031) were risk factors for recurrence.</p><p><strong>Conclusions: </strong>According to our study, it may be possible to discuss the needs of adjuvant treatment in each individual. These findings provide a basis for more informed decisions regarding adjuvant therapy in UTUC, with the potential to reduce unnecessary treatment.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 5","pages":"e70497"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856227","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":"Animal Models of Hunner-Type Interstitial Cystitis.","authors":"Yoshiyuki Akiyama, Yi Luo","doi":"10.1111/iju.70487","DOIUrl":"https://doi.org/10.1111/iju.70487","url":null,"abstract":"<p><strong>Background: </strong>Animal models are crucial for mechanistic studies and therapeutic development of human diseases. At present, the etiology of interstitial cystitis/bladder pain syndrome (IC/BPS), a chronic disease of the urinary bladder, remains undefined. Therefore, numerous theories of pathogenesis have been proposed, and various animal models have been developed based on these theories. This enigmatic human disease can be categorized into two subtypes: Hunner-type IC (HIC) and bladder pain syndrome (BPS). These two subtypes of IC/BPS have different pathological mechanisms, but their clinical symptoms overlap. Recent evidence indicates that HIC is an immune-mediated inflammatory disease of the urinary bladder, while BPS is a minimally inflamed bladder condition comprising various clinical phenotypes. Furthermore, increasing evidence suggests that autoimmunity may play a significant role in IC/BPS, particularly in HIC. Today, the rodent models of experimental autoimmune cystitis (EAC) are being used in HIC research.</p><p><strong>Objective: </strong>This article provides an overview of immune-mediated inflammation and autoimmunity in IC/BPS, as well as EAC models that can be used for HIC research, with a focus on the URO-OVA model, a novel transgenic EAC model that effectively mimics HIC.</p><p><strong>Conclusion: </strong>The URO-OVA model develops chronic bladder inflammation, pelvic/bladder pain, and voiding dysfunction seen in human HIC patients. It responds to treatment with dimethyl sulfoxide (DMSO) and specific inhibitors, such as Toll-like receptor (TLR)4, mitogen-activated protein (MAP) kinase, and interferon (IFN)-γ inhibitors. The URO-OVA model is stable and reproducible, providing a unique EAC model for HIC research that incorporates immune/autoimmune components in its pathophysiology.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 5","pages":"e70487"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147814894","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":"Editorial Comment to the Impact of the Relevant Factors as High-Complexity Tumors in Robot-Assisted Partial Nephrectomy.","authors":"Tsunenori Kondo","doi":"10.1111/iju.70472","DOIUrl":"https://doi.org/10.1111/iju.70472","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 5","pages":"e70472"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771157","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":"Robot-Assisted Pyeloplasty in Elderly Patients: A Comprehensive Retrospective Analysis of Safety and Surgical Outcomes.","authors":"Kohei Mori, Izuru Shiba, Yutaka Shiono, Shuhei Hirano, Dai Koguchi, Masaomi Ikeda, Daisuke Ishii, Masatsugu Iwamura, Kazumasa Matsumoto","doi":"10.1111/iju.70479","DOIUrl":"https://doi.org/10.1111/iju.70479","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the safety, feasibility, and surgical outcomes of robot-assisted pyeloplasty (RAP) in elderly compared with non-elderly patients for ureteropelvic junction obstruction (UPJO).</p><p><strong>Methods: </strong>This retrospective study included 83 consecutive patients undergoing RAP between January 2017 and August 2025. Patients were stratified into elderly (≥ 65 years, n = 14) and non-elderly (< 65 years, n = 69) groups. We compared patient backgrounds, perioperative outcomes (operative/anastomosis time, blood loss, and hospital stay), and postoperative complications graded by the Clavien-Dindo classification. Success was defined as symptom resolution and/or improved diuretic renogram flow 6-12 months postoperatively.</p><p><strong>Results: </strong>Mean operative time (214 ± 19 vs. 207 ± 8 min, p = 0.75), anastomosis time (50 ± 4 vs. 43 ± 2 min, p = 0.11), and estimated blood loss (13 vs. 20 g, p = 0.33) showed no significant differences between the elderly and non-elderly groups. The total complication rate did not differ significantly between the two groups (p = 0.22). Surgical success rates were 93.8% in the elderly and 97.1% in the non-elderly group (p = 0.53) over a median 18-month follow-up.</p><p><strong>Conclusion: </strong>RAP is a safe and effective procedure for appropriately selected elderly patients with ureteropelvic junction obstruction, demonstrating perioperative outcomes and surgical success rates largely comparable with those in younger patients.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 5","pages":"e70479"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771253","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 European Association of Urology Combination and Platinum Eligibility on Real-World Treatment Sequences and Survival in Japanese Patients With Metastatic Urothelial Carcinoma.","authors":"Takashi Kawahara, Yoshiyuki Nagumo, Kozaburo Tanuma, Kazuki Hamada, Akane Yamaguchi, Satoshi Nitta, Masanobu Shiga, Atsushi Ikeda, Akio Hoshi, Shuya Kandori, Hiroyuki Nishiyama","doi":"10.1111/iju.70403","DOIUrl":"10.1111/iju.70403","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the prevalence of European Association of Urology-defined combination and platinum eligibility at first-line treatment initiation, and to assess their impact on conventional treatment sequence and overall survival in a real-world Japanese cohort.</p><p><strong>Methods: </strong>We retrospectively analyzed 148 patients with metastatic urothelial carcinoma who initiated systemic chemotherapy between 2018 and 2024 at a single institution in Japan. Cisplatin eligibility was assessed according to the Galsky criteria. Combination therapy eligibility and platinum eligibility were defined according to the European Association of Urology guideline.</p><p><strong>Results: </strong>Among the 148 patients, 128 (86.5%) were combination-eligible and 20 (13.5%) ineligible. Among combination-eligible patients, 70 (54.7%) were cisplatin-eligible, 47 (36.7%) cisplatin-ineligible but platinum-eligible, and 11 (8.6%) platinum-ineligible. Median overall survival was significantly longer in combination-eligible patients than in combination-ineligible patients (25 vs. 16 months, p = 0.019, HR 2.46, 95% CI 1.16-5.23). Within the combination-eligible group, cisplatin-eligible patients tended to show superior median overall survival (not reached) compared with cisplatin-ineligible/platinum-eligible (25 months) and platinum-ineligible (15 months, p = 0.11 and p = 0.082, respectively). Only 25.0% (32/128) of combination-eligible patients received the chemotherapy-immune checkpoint inhibitor-enfortumab vedotin sequence, while 20.0% (4/20) of combination-ineligible patients also completed this sequence.</p><p><strong>Conclusions: </strong>European Association of Urology-defined combination and platinum eligibility were associated with survival outcomes and treatment sequence capability in a real-world setting. These findings highlight the prognostic value but practical limitations of eligibility criteria, emphasizing the need to develop more practical classification frameworks that ensure broader access to effective therapy.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 5","pages":"e70403"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837738","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}