Ding-Wei Ye, Hirotsugu Uemura, Byung Ha Chung, Hiroyoshi Suzuki, Suneel Mundle, Amitabha Bhaumik, Anildeep Singh, Simon Chowdhury, Neeraj Agarwal, Kim N Chi, Jian Huang
{"title":"Prostate-specific antigen kinetics in Asian patients with metastatic castration-sensitive prostate cancer treated with apalutamide in the TITAN trial: A post hoc analysis.","authors":"Ding-Wei Ye, Hirotsugu Uemura, Byung Ha Chung, Hiroyoshi Suzuki, Suneel Mundle, Amitabha Bhaumik, Anildeep Singh, Simon Chowdhury, Neeraj Agarwal, Kim N Chi, Jian Huang","doi":"10.1111/iju.15615","DOIUrl":"https://doi.org/10.1111/iju.15615","url":null,"abstract":"<p><strong>Objective: </strong>In the TITAN trial of patients with metastatic castration-sensitive prostate cancer (mCSPC), deep and rapid prostate-specific antigen (PSA) decline with apalutamide plus androgen deprivation therapy (ADT) was associated with longer overall survival (OS), radiographic progression-free survival (rPFS), time to PSA progression (TTPP), and time to castration resistance (TTCR) compared with no decline (all p < 0.0001). This post hoc analysis evaluated PSA kinetics in the Asian subpopulation.</p><p><strong>Methods: </strong>Data were analyzed for patients enrolled in China, Japan, and Korea and treated with apalutamide (n = 111) or placebo (n = 110) plus ADT. Examined were depth of PSA response, rates of PSA decline, and associations between a deep PSA response and clinical outcomes in apalutamide-treated patients.</p><p><strong>Results: </strong>Confirmed PSA response rates were higher with apalutamide than placebo: 73.9% versus 33.6% for PSA ≤0.2 ng/mL, 90.1% versus 58.2% for PSA reduction ≥50% [PSA50], and 74.8% versus 25.5% for PSA reduction ≥90% [PSA90]. Median (Q1; Q3) time to PSA ≤0.2 ng/mL, PSA50 and PSA90 response in the apalutamide group was 1.9 (1.0; 3.7), 1.0 (1.0; 1.0), and 1.8 (1.0; 1.9) months, respectively. PSA responses with apalutamide or placebo were consistent irrespective of high- or low-volume disease. Achievement of confirmed PSA ≤0.2 ng/mL or PSA90 response with apalutamide at landmark 3 months was associated with significantly (nominal p-values) longer OS (hazard ratio: 0.23; p = 0.0009), TTPP (0.16; p = 0.0001), TTCR (0.20; p < 0.0001), and time to progression on first subsequent therapy or death (0.19; p < 0.0001) compared with no decline.</p><p><strong>Conclusion: </strong>PSA kinetics have applications for early prognostic evaluation in Asian patients with mCSPC.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794662","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 need for a second transurethral resection in high-risk non-muscle-invasive bladder cancer based on the Vesicle Imaging-Reporting and Data System.","authors":"Yuki Nakamura, Soichiro Yoshida, Yuki Arita, Ryo Takeshita, Koichiro Kimura, Masaki Kobayashi, Motohiro Fujiwara, Yudai Ishikawa, Shohei Fukuda, Yuma Waseda, Hajime Tanaka, Masahiro Jinzaki, Yasuhisa Fujii","doi":"10.1111/iju.15638","DOIUrl":"https://doi.org/10.1111/iju.15638","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of Vesical Imaging-Reporting and Data System (VI-RADS) for the second transurethral resection (TUR) has not been adequately validated. This study aimed to evaluate the utility of the VI-RADS for high-risk patients with non-muscle-invasive bladder cancer (NMIBC) who are candidates for a second TUR.</p><p><strong>Methods: </strong>We retrospectively analyzed 116 patients who received magnetic resonance imaging (MRI) prior to an initial TUR and underwent a second TUR for a diagnosis of high-risk NMIBC at the initial TUR. MRI images were retrospectively classified according to VI-RADS. Second TUR outcomes and recurrence-free and progression-free survival rates were compared with VI-RADS scores.</p><p><strong>Results: </strong>Ninety-nine (91%) patients were diagnosed with T1 bladder cancer at the initial TUR. At the second TUR, residual cancer was found in 53 (49%) cases, including five (4.6%) cases of muscle invasion. With a median follow-up of 41 months, the 2-year bladder recurrence-free survival rate was 71% and the 2-year progression-free rate was 85%. By two radiologists' consensus, 30 (28%)/49 (45%)/16 (15%)/10 (9.2%)/4 (3.7%) cases were classified as VI-RADS 1/2/3/4/5, respectively. Of five pT2 upstage cases, three were VI-RADS 1, one was VI-RADS 2, and one was VI-RADS 3. There was no significant association between VI-RADS and cancer residual rate and pT2 upstage rate in second TUR outcomes, and recurrence-free and progression-free survival rates.</p><p><strong>Conclusion: </strong>In high-risk NMIBCs, a certain number of residual cancers and pT2 upstage cases exist after the initial TUR, and a second TUR should be performed regardless of VI-RADS scores.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800776","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: \"Underactive bladder as defined by the International Continence Society in the 2023 Japan Community Health Survey\".","authors":"Hiroki Ito","doi":"10.1111/iju.15642","DOIUrl":"https://doi.org/10.1111/iju.15642","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716169","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":"Frailty in kidney transplant recipients.","authors":"Junji Uchida, Tomoaki Iwai, Yuichi Machida","doi":"10.1111/iju.15639","DOIUrl":"https://doi.org/10.1111/iju.15639","url":null,"abstract":"<p><p>Kidney transplantation is the treatment of choice even for the elderly, as it improves quality of life and life expectancy, lowering the financial burden to the health care system compared to dialysis therapy. In Japan, kidney transplant recipients have become older due to the shift in demographics. Compared to community-dwelling elderly adults, elderly kidney transplant recipients undergoing immunosuppressive therapy have a higher risk of age-related outcomes including hospital readmissions, infections, dementia, malignancies, and fractures. In frailty, patients become vulnerable to adverse events after stressors due to a lack of physiologic reserve. Although it is often associated with aging, frailty can also occur in younger individuals with certain chronic illnesses or conditions including chronic kidney disease. Limited compensatory mechanisms result in functional impairment and adverse health outcomes, such as disability, falls, decreased mobility, hospitalization, and death. Although kidney transplant recipients can restore their kidney function after transplantation, most of them still have chronic kidney disease, as well as a gradual decline in graft function as a result of chronic allograft nephropathy. Wait-listed candidates for kidney transplantation with frailty are more likely to experience wait-list removal or death. Frailty at the time of transplantation is associated with complications after kidney transplantation such as delayed graft function, longer hospital stays, rehospitalizations, immunosuppression intolerance, surgical complications, and death. Nevertheless, kidney transplantation can be a viable intervention for frailty in dialysis patients.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710086","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":"Physical, but not laboratory, treatment-related adverse events are associated with favorable outcomes of enfortumab vedotin for advanced urothelial carcinoma: A landmark analysis.","authors":"Satoru Taguchi, Taketo Kawai, Yoshiki Ambe, Kenjiro Kishitani, Michio Noda, Tomoyuki Kaneko, Jimpei Miyakawa, Yu Nakamura, Hayato Hoshina, Daisuke Obinata, Kenya Yamaguchi, Shigenori Kakutani, Yoshitsune Furuya, Yujiro Sato, Yume Adachi, Kazuma Sugimoto, Keigo Sato, Mariko Tabata, Takehiro Tanaka, Katsuhiko Nara, Yukari Uemura, Jun Kamei, Yoshiyuki Akiyama, Yusuke Sato, Yuta Yamada, Aya Niimi, Daisuke Yamada, Tappei Takada, Sayuri Takahashi, Yukio Yamada, Hideyo Miyazaki, Yutaka Enomoto, Hiroaki Nishimatsu, Tetsuya Fujimura, Hiroshi Fukuhara, Tohru Nakagawa, Satoru Takahashi, Haruki Kume","doi":"10.1111/iju.15640","DOIUrl":"https://doi.org/10.1111/iju.15640","url":null,"abstract":"<p><strong>Background: </strong>While the occurrence of immune-related adverse events has been recognized as a prognostic marker in patients receiving immune checkpoint inhibitors, the prognostic significance of treatment-related adverse events (trAEs) in patients undergoing antibody-drug conjugates such as enfortumab vedotin (EV) is controversial.</p><p><strong>Methods: </strong>We reviewed 106 patients with advanced urothelial carcinoma who were treated with EV therapy at 10 institutions between 2021 and 2023. Associations of clinical parameters with overall survival and progression-free survival were assessed using the Cox proportional hazards model. For the assessment of trAEs, landmark analysis was conducted to minimize immortal time bias.</p><p><strong>Results: </strong>Of 106 patients, 55 (51.9%) experienced disease progression and 44 (41.5%) died during the follow-up period. Any grade and grade ≥3 trAEs occurred in 94 (88.7%) and 44 (41.5%) patients, respectively. Common trAEs included skin disorders (74.5%), gastrointestinal disorders (62.3%), fatigue (50.0%), peripheral neuropathy (36.8%), and hematological disorders (37.7%). One patient died of interstitial pneumonia (grade 5). According to landmark analysis using 88 patients who survived for 2 months or more, trAEs were significantly associated with longer survival. Furthermore, when trAEs were classified into \"physical trAEs\" such as skin disorders and \"laboratory trAEs\" such as hematological disorders, the former were associated with longer survival while the latter were associated with shorter survival.</p><p><strong>Conclusions: </strong>Physical, but not laboratory, trAEs are associated with favorable outcomes of EV therapy for advanced urothelial carcinoma. Both managing trAEs and utilizing them as prognostic markers are key points in the use of antibody-drug conjugates such as EV.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686860","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 Comorbidities in Japanese testicular cancer survivors: A multi-institutional, cross-sectional study.","authors":"Yuichiro Nakamura, Kensuke Mitsunari, Ryoichi Imamura","doi":"10.1111/iju.15637","DOIUrl":"https://doi.org/10.1111/iju.15637","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681768","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":"Postoperative infections after robotic-assisted radical prostatectomy in a single large institution: Effect of type and duration of prophylactic antibiotic administration.","authors":"Masao Mitsui, Takuya Sadahira, Naoya Nagasaki, Yuki Maruyama, Takanori Sekito, Takehiro Iwata, Satoshi Katayama, Kensuke Bekku, Motoo Araki","doi":"10.1111/iju.15635","DOIUrl":"10.1111/iju.15635","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated the incidence of and risk factors for postoperative infections after robotic-assisted radical prostatectomy (RARP) according to the type and duration of prophylactic antibiotic administration.</p><p><strong>Methods: </strong>A total of 1038 patients underwent RARP at our institution from 2010 to 2021; 1026 patients (201 in the cefazolin [CEZ] group and 825 in the ampicillin/sulbactam [ABPC/SBT] group) were analyzed, and 12 who used other antibiotics were excluded. The primary endpoint was the incidence of urinary tract infection (UTI), surgical site infection (SSI), and remote infection (RI). T-tests, propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were performed. Multivariate logistic regression analysis was performed to evaluate the effect of type and duration of prophylactic antibiotic administration.</p><p><strong>Results: </strong>The incidence of UTI was 2.5% (5/201) in the CEZ group and 3.2% (26/825) in the ABPC/SBT group, with no significant difference between groups (p = 0.622). The rates of SSI and RI were comparable between groups (p = 0.680 and 0.906, respectively). Although the duration of antimicrobial therapy was longer in the ABPC/SBT group (p < 0.001), there was no significant difference in the incidence of UTI/SSI/RI after PSM and IPTW (all p > 0.05). Multivariate logistic regression analysis showed that neither the type of antibiotic nor the duration of administration affected the incidence of UTI/SSI/RI.</p><p><strong>Conclusion: </strong>The risk of postoperative UTI/SSI/RI after RARP did not change with the type and duration of antimicrobial therapy.</p>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647613","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 AirSeal™ Intelligent Flow System on laparoscopic surgery for urachal remnant with umbilical resection.","authors":"Tsukasa Narukawa, Yuki Ota, Tsuneyuki Nakanouchi, Yuji Okusa, Mai Ujihara, Kazuya Mikami","doi":"10.1111/iju.15634","DOIUrl":"https://doi.org/10.1111/iju.15634","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647612","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 \"Herpes zoster development in living kidney transplant recipients receiving low-dose rituximab\".","authors":"Takafumi Yagisawa, Hideki Ishida, Toshio Takagi","doi":"10.1111/iju.15633","DOIUrl":"https://doi.org/10.1111/iju.15633","url":null,"abstract":"","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604067","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}