International Journal of Urology最新文献

{"title":"In This Issue.","authors":"Shusuke Akamatsu","doi":"10.1111/iju.70121","DOIUrl":"https://doi.org/10.1111/iju.70121","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136227","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":"PD-L1 and Ki-67 Expression Before and After Neoadjuvant Chemotherapy in Muscle-Invasive Bladder Cancer.","authors":"Daichi Sasaki, Tohru Yoneyama, Fumiya Yoneyama, Kai Ozaki, Yusuke Ozaki, Yuki Miura, Naoki Fujita, Teppei Okamoto, Hayato Yamamoto, Shintaro Goto, Tadashi Yoshizawa, Akira Kurose, Hiroshi Kijima, Chikara Ohyama, Shingo Hatakeyama","doi":"10.1111/iju.70122","DOIUrl":"https://doi.org/10.1111/iju.70122","url":null,"abstract":"<p><strong>Objective: </strong>Programmed cell death ligand 1 (PD-L1) expression is considered a poor prognostic factor in patients with muscle-invasive bladder cancer (MIBC). However, the data regarding the change in PD-L1 expression before and after neoadjuvant chemotherapy (NAC) are limited. We aimed to investigate the longitudinal association between programmed death-ligand 1 (PD-L1) and Ki-67 expression before and after NAC in muscle-invasive bladder cancer (MIBC).</p><p><strong>Methods: </strong>We retrospectively analyzed 191 patients with MIBC who underwent platinum-based NAC followed by radical cystectomy (RC) between June 2010 and March 2022. We excluded ypT0-1 cases because of the difficulty of evaluating PD-L1 and Ki-67 by immunostaining. Finally, we selected 104 patients with matched specimens from transurethral resection of bladder tumor (TURBT) and residual invasive disease in RC. We examined the relationship between PD-L1 expression and Ki-67 labeling index in TURBT and RC specimens. Additionally, we investigated the differential expression of 39 subtype-related genes before and after NAC.</p><p><strong>Results: </strong>Among 104 patients who underwent NAC, the number of PD-L1-positive patients significantly increased from 16 (15.4%) in the TURBT specimens to 30 (28.8%) in the RC specimens. The median Ki-67 labeling index significantly decreased from 30.6% in the TURBT specimens to 9.9% in the RC specimens. The correlation between treatment effects and changes in gene expression was challenging to identify.</p><p><strong>Conclusions: </strong>A significant effect of NAC on PD-L1 expression and Ki-67 labeling index was observed in patients with MIBC. However, the impact of changes in gene expression on prognosis needs further study.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127625","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":"The Role of Serum Testosterone in the Pathogenesis and Treatment of Prostate Cancer: A Review Based on the Clinical Evidence.","authors":"Xue Zhao, Shinichi Sakamoto, Yasutaka Yamada, Kodai Sato, Takaaki Tamura, Hiroki Shibata, Tomokazu Sazuka, Yusuke Imamura, Tomohiko Ichikawa","doi":"10.1111/iju.70125","DOIUrl":"https://doi.org/10.1111/iju.70125","url":null,"abstract":"<p><p>Serum testosterone plays a pivotal role in the pathogenesis and treatment of prostate cancer, influencing tumor growth and progression. This review synthesizes current clinical evidence on the dual role of serum testosterone as both a biomarker of carcinogenesis and a target for therapeutic intervention. We discuss the mechanisms linking androgen signaling to prostate cancer development, emphasizing the role of testosterone in androgen receptor activation and cellular proliferation. Furthermore, we explore the clinical implications of testosterone suppression strategies, including androgen deprivation therapy (ADT) and bipolar androgen therapy (BAT), highlighting their impact on patient outcomes. Emerging evidence on the prognostic significance of nadir testosterone levels, testosterone rebound, and treatment resistance is also analyzed. Finally, we address the challenges and opportunities in testosterone monitoring, aiming to enhance precision medicine approaches for managing prostate cancer. This review underscores the importance of personalized testosterone-based strategies to optimize therapeutic outcomes and improve patient quality of life.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127632","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":"Functional Outcomes in Patients With Prostate Cancer Undergoing Frozen Section Guided Radical Prostatectomy.","authors":"Moritz J Reike, Karl H Tully, Maximilian Schulmeier, Alina Reicherz, Henning Bahlburg, Guido Müller, Peter Bach, Carlo Sternemann, Andrea Tannapfel, Joachim Noldus, Marko Brock, Florian Roghmann","doi":"10.1111/iju.70115","DOIUrl":"https://doi.org/10.1111/iju.70115","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with an intermediate risk prostate cancer (PCa) are not routinely offered nerve sparing (NS). Implementation of whole surface frozen section (FS) made NS-radical prostatectomy (RP) available and oncologically safe. In the present study, we aimed to assess the impact of the addition of FS on NS during RP and potentially improved functional outcomes.</p><p><strong>Methods: </strong>Institutional data of patients (PSA ≤ 20 ng/mL, Gleason-Score ≤ 7, cT1c-cT2c) undergoing RP between 06/2011 and 11/2014 were prospectively collected. Decision for NS was made by the surgeon supported by FS. Only patients with a preoperative International Index of Erectile Function (IIEF-5) ≥ 17 were analyzed for potency. Continence was defined as pad use of ≤ 1 pad/day. Separate multivariable regression analyses were employed to examine predictors for both endpoints (i.e., potency and continence).</p><p><strong>Results: </strong>Overall, 702 patients were included in this study. Final nerve-sparing surgery was performed in 671 patients (95.6%). Before the introduction of FS, only 392 patients (56%) would have undergone NS-RP. FS enabled intraoperative/final NS for 688 (98%) and 666 (95%) patients. No differences at overall follow-up between low- and intermediate-risk patients regarding continence (n = 122 (84.1%) vs. n = 223 (82.6%), p = 0.689) and potency (IIEF-5 ≥ 17, n = 16/47 vs. 26/68, p = 0.646) were detected. Surgeon volume was associated with improved continence (OR 3.69, 95% CI 1.86-7.32, p < 0.001) and erectile function (EF) (OR 2.49, 95% CI 1.23-5.03, p = 0.011).</p><p><strong>Conclusion: </strong>The introduction of FS expanded NS to patients with an intermediate-risk PCa and selected high-risk PCa. This may lead to improved functional outcomes as more patients were eligible for NS.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110591","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 Patients With International Germ Cell Cancer Collaborative Group Good Prognosis Metastatic Seminoma Undergoing De-Escalation Chemotherapy: A Single-Center Retrospective Study.","authors":"Takahiro Kirisawa, Hiroki Hagimoto, Tomoya Okuno, Ayumu Matsuda, Aiko Maejima, Yasuo Shinoda, Eijiro Nakamura, Motokiyo Komiyama, Hiroyuki Fujimoto, Yoshiyuki Matsui","doi":"10.1111/iju.70118","DOIUrl":"https://doi.org/10.1111/iju.70118","url":null,"abstract":"<p><strong>Objective: </strong>To compare the survival outcomes of de-escalation chemotherapy with those of standard first-line chemotherapy in patients with International Germ Cell Cancer Collaborative Group (IGCCCG) good prognosis metastatic seminoma.</p><p><strong>Methods: </strong>The cohort of this retrospective, observational, single-center study comprised 35 patients with clinical Stage I (CSI)-relapsed or de novo IGCCCG good prognosis metastatic seminoma who had undergone induction chemotherapy at our institution between 2007 and 2021. Patients were allocated to standard or de-escalation therapy groups according to average relative dose intensity (ARDI) of induction chemotherapy: ARDI ≥ 90 and ARDI < 90. Overall and recurrence-free survival were compared between these groups using Kaplan-Meier curves and the log-rank test.</p><p><strong>Results: </strong>The de-escalation therapy regimen included three cycles of etoposide and cisplatin (66.7%). Overall and relapse-free survival of patients undergoing de-escalation therapy and that of patients undergoing standard therapy were comparable. In addition, rates of adverse events, including hearing impairment and peripheral neuropathy induced by cisplatin-containing chemotherapy, were slightly, but not significantly, lower in the de-escalation therapy group than in the standard therapy group.</p><p><strong>Conclusions: </strong>Our findings provide a preliminary experimental basis for the development of de-escalation therapy for IGCCCG good prognosis metastatic seminoma. If sufficient tumor regression is achieved, de-escalation therapy incorporating three cycles of etoposide/cisplatin therapy could be considered acceptable for patients with relatively low metastatic tumor burdens, such as those with Stage II CSI-relapsed seminoma. Further studies to validate the efficacy of de-escalation therapy are warranted.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093647","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 of Untreated Recurrence After Radical Surgery for Upper Urinary Tract Carcinoma: 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, Takeshi Maehana, Yuki Kyoda, Kohei Hashimoto, Ko Kobayashi, Toshiaki Tanaka, Naoya Masumori","doi":"10.1111/iju.70111","DOIUrl":"https://doi.org/10.1111/iju.70111","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the prognoses of patients with upper urinary tract carcinoma who had recurrence after radical nephroureterectomy according to the presence or absence of systemic therapy after recurrences. Moreover, to evaluate the reasons for not being treated and to predict these untreated patients using pre-surgical clinical factors.</p><p><strong>Methods: </strong>We retrospectively evaluated patients who underwent radical nephroureterectomy between 2012 and 2022. The reasons for not being treated were retrospectively analyzed. Recurrence was defined as extra-urinary tract recurrence.</p><p><strong>Results: </strong>Among 599 patients, 159 (26.5%) experienced recurrence during the follow-up period. Sixty-six (41.5%) patients who did not receive any systemic therapy at recurrence had a poorer overall survival compared to those who received systemic therapy (Log-rank test, p < 0.001). Among the 159 patients who had recurrence, female gender, low serum albumin level, and age of 75 years or older at the time of radical nephroureterectomy were risk factors for being untreated at the time of recurrence. Additionally, the top 3 reasons for being untreated were older age (57.6%), poor performance status (42.4%), and deteriorated renal function (34.8%).</p><p><strong>Conclusions: </strong>Patients who did not receive systemic therapy at the time of recurrence after radical surgery demonstrated poorer survival outcomes compared to those who underwent systemic therapy. Our data provide essential support for discussions with patients and their families about treatment options, including adjuvant therapy, especially in consideration of the possibility that treatment may not be feasible at the time of recurrence.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093613","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":"Extended Follow-Up of Robot-Assisted Partial Nephrectomy for Renal Hilar Tumor: A Prospective Multi-Institutional Study (ROBOHIT Trial).","authors":"Jun Teishima, Ryoichi Shiroki, Toshio Takagi, Masatoshi Eto, Shuichi Morizane, Toshinari Yamasaki, Yasuo Kohjimoto, Fumiya Hongo, Takuya Tsujino, Kensuke Bekku, Nobuyuki Hinata, Atsushi Okada, Tetsuya Yoshida, Tsunenori Kondo, Naoki Kawamorita, Hayato Yamamoto, Shuji Isotani, Masaki Shimbo, Jun Nagayama, Kunihisa Yamaguchi, Hidefumi Kinoshita, Hideaki Miyake","doi":"10.1111/iju.70116","DOIUrl":"https://doi.org/10.1111/iju.70116","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to evaluate the long-term oncological and functional outcomes after robot-assisted partial nephrectomy (RAPN) for renal hilar tumors.</p><p><strong>Methods: </strong>A total of 22 academic hospitals in Japan participated in a prospective, multicenter, single-arm, open-label trial with a 2-year enrollment period. After undergoing RAPN, 105 patients with clinical T1 renal hilar tumors were followed up for 5 years and evaluated. Recurrence-free survival, overall survival, and trends of renal function were set as oncological and functional outcomes.</p><p><strong>Results: </strong>Five-year overall survival and recurrence-free survival were 98.0% and 89.2%, respectively. Mean estimated glomerular filtration rates (eGFRs) were 69.031 mL/min preoperatively, and were 59.374, 58.334, 58.221, 56.975, and 59.602 mL/min at 1, 2, 3, 4, and 5 years after surgery, respectively. While eGFR was significantly lower than the preoperative one at all points (p < 0.001), eGFRs at 1 and 5 years after surgery did not differ significantly (p = 0.793).</p><p><strong>Conclusion: </strong>After long-term follow-up, RAPN for clinical T1 renal hilar tumors continues to provide functional and oncological outcomes equivalent to those in the perioperative period.</p><p><strong>Trial registration: </strong>The study protocol was registered in the Japan Registry of Clinical Trials (jRCT1052190005, UMIN000023968).</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093617","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 From Dr. Miyake to Effects of Robot-Assisted Radical Cystectomy on Peritoneal Carcinomatosis and Prognosis in Patients With Muscle-Invasive Bladder Cancer: A Multicenter Retrospective Study.","authors":"Makito Miyake","doi":"10.1111/iju.70112","DOIUrl":"https://doi.org/10.1111/iju.70112","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077083","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 \"Serum Lactate Dehydrogenase Level Prior to First-Line Chemotherapy for Metastatic Urothelial Carcinoma is a Prognostic Factor for Avelumab Maintenance Therapy: A Multicenter Retrospective Study\".","authors":"Tetsuya Shindo","doi":"10.1111/iju.70114","DOIUrl":"https://doi.org/10.1111/iju.70114","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077713","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":"Research Landscape on Adrenocortical Carcinoma Over Four Decades.","authors":"Tun-Pang Chu, Chi-Yu Kuo, Shih-Ping Cheng","doi":"10.1111/iju.70117","DOIUrl":"https://doi.org/10.1111/iju.70117","url":null,"abstract":"<p><strong>Objectives: </strong>Adrenocortical carcinoma is a rare but devastating endocrine malignancy. Our objective was to outline the academic output and trends through bibliometric analysis.</p><p><strong>Methods: </strong>We searched the Web of Science Core Collection, PubMed, and Scopus to retrieve publications related to adrenocortical carcinoma using the structured three-step PRISMA methodology. Co-authorship and co-occurrence analyses were conducted to visualize collaborative and thematic networks.</p><p><strong>Results: </strong>This overview comprises 5507 documents. The number of publications on adrenocortical carcinoma has consistently increased over time. Most of these publications originate from North America and Europe. The co-occurrence map identified several major research clusters, with immunotherapy and targeted therapy emerging as new treatment modalities in recent years. The number of co-authoring institutions per publication was positively correlated with citation counts (Spearman's rank coefficient = 0.17, p < 0.0001).</p><p><strong>Conclusions: </strong>This literature analysis provides an overview of the current research landscape on adrenocortical carcinoma, highlighting geographical disparities. International and interdisciplinary collaboration may enhance productivity and foster scientific progress.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077728","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}