Journal of Personalized Medicine最新文献

{"title":"The Role of Oxidative Stress in the Relationship Between Periodontitis and Alzheimer's Disease: A Review of the Literature.","authors":"Konstantinos Antonios Papadakis, Aikaterini-El Doufexi, Mary S Kalamaki, Evangelos Bourazanas, Evgenia Lymperaki","doi":"10.3390/jpm15080384","DOIUrl":"10.3390/jpm15080384","url":null,"abstract":"<p><p>Periodontitis, a chronic inflammatory disease affecting the supporting tissues of the teeth, has been linked to the onset of neurological diseases, including Alzheimer's disease (AD). A primary mechanism connecting these two issues is oxidative stress caused by an imbalance between antioxidant defenses and reactive oxygen species (ROS) synthesis. This review compiles results from both animal and human studies that explore how oxidative stress resulting from periodontitis leads to neuroinflammation, mitochondrial dysfunction, and cognitive decline in AD. Studies in animals indicate that periodontal infections worsen brain oxidative damage, as evidenced by elevated lipid peroxidation markers, such as malondialdehyde (MDA), and indicators of oxidative DNA damage, including 8-hydroxy-2'-deoxyguanosine (8-OHdG). Additionally, significant reductions in crucial antioxidant enzymes, including superoxide dismutase (SOD) and glutathione peroxidase, along with neuroinflammation and cognitive deficits, are observed in mouse models of induced periodontitis. Supporting evidence from human studies reveals lower total antioxidant capacity (TAC) in individuals with both Alzheimer's disease (AD) and periodontitis, as well as increased systemic oxidative stress markers, such as advanced oxidation protein products (AOPRs). These findings suggest a mechanistic relationship through oxidative stress pathways between periodontal inflammation and neurodegeneration. Given the extensive impact of periodontitis, enhancing periodontal health could be a viable strategy to reduce oxidative damage and lower the risk of cognitive decline. Further research is needed to clarify causality and to investigate antioxidant treatments aimed at preventing or slowing the progression of AD in patients with periodontal disease.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12387962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957912","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":"Genetic Modulation of Silodosin Exposure and Efficacy: The Role of CYP3A4, CYP3A5, and UGT2B7 Polymorphisms in Benign Prostatic Hyperplasia Management.","authors":"Shokhrukh P Abdullaev, Maksim N Shatokhin, Pavel O Bochkov, Svetlana N Tuchkova, Oleg B Loran, Sherzod P Abdullaev, Karin B Mirzaev, Dmitry A Sychev","doi":"10.3390/jpm15080386","DOIUrl":"10.3390/jpm15080386","url":null,"abstract":"<p><p><b>Objectives</b>: Silodosin, a selective α1A-adrenoceptor antagonist, is used to treat lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Genetic polymorphisms in drug-metabolizing enzymes and transporters may contribute to interindividual variability in its efficacy and safety. This study aimed to investigate the influence of CYP3A4, CYP3A5, UGT2B7, and ABCB1 polymorphisms on silodosin pharmacokinetics, efficacy, and safety in Russian patients with BPH. <b>Methods</b>: A prospective observational study included 103 Russian male patients with moderate-to-severe LUTS (IPSS > 8) due to BPH, treated with silodosin (8 mg daily) for 8 weeks. Genotyping for CYP3A4*1B, CYP3A4*22, CYP3A5*3, UGT2B7 (rs73823859, rs7439366, and rs7668282), and ABCB1 (rs4148738, rs1045642, rs2032582, and rs1128503) was performed using real-time PCR. The silodosin minimum steady-state plasma concentration (Css min) was measured via HPLC-MS. Efficacy was evaluated by the International Prostate Symptom Score (IPSS), quality of life scale, maximum urinary flow rate (Qmax), residual urine volume (RUV), and prostate volume at the baseline and week 8. Adverse drug reactions (ADRs) were recorded. <b>Results</b>: CYP3A4*22 CT carriers (n = 6) exhibited higher Css min (17.59 ± 2.98 vs. 9.0 ± 10.47 ng/mL, <i>p</i> = 0.049) but less absolute IPSS improvement (<i>p</i> < 0.05), likely due to higher baseline symptom severity. However, the change in IPSS (ΔIPSS_1-4) from the baseline to week 8 did not differ significantly (-5.78 ± 5.29 vs. -6.0 ± 4.54, <i>p</i> = 0.939). CYP3A5*3 GG homozygotes (n = 96) showed greater ΔIPSS_1-4 improvement (-6.25 ± 4.60 vs. 0.0 ± 9.53, <i>p</i> = 0.042) and a lower IPSS at day 28 (7.64 ± 4.50 vs. 20.0 ± 6.55, <i>p</i> < 0.001). UGT2B7 rs7439366 TT carriers (n = 34) had an improved Qmax (ΔQmax_1-4 5.4 vs. 3.3 and 2.0 mL/s for CC and CT, <i>p</i> = 0.041). ABCB1 1236C>T TT homozygotes (n = 25) showed a trend toward reduced RUV (<i>p</i> = 0.053). No polymorphisms were associated with adverse drug reactions (15 events in 42 patients, 35.7%). <b>Conclusions</b>: Genetic polymorphisms CYP3A4*22, CYP3A5*3, and UGT2B7 rs7439366 may modulate silodosin pharmacokinetics and efficacy parameters in BPH patients but not safety. Larger-scale studies are warranted to validate these initial findings.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12387821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958106","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":"Treatment Strategies for Patients with Mitral Regurgitation: A Meta-Analysis of Randomized Controlled Trials.","authors":"Claudia Carassia, Fiorenzo Simonetti, Hector A Alvarez Covarrubias, Bernhard Wolf, Costanza Pellegrini, Tobias Rheude, Patrick Fuchs, Ferdinand Roski, Moritz Kühlein, Edna Blum, Gjin Ndrepepa, Teresa Trenkwalder, Michael Joner, Adnan Kastrati, Salvatore Cassese, Erion Xhepa","doi":"10.3390/jpm15080383","DOIUrl":"10.3390/jpm15080383","url":null,"abstract":"<p><p><b>Background</b>: Several treatment strategies are available for patients with mitral valve regurgitation (MR). However, evidence regarding their comparative effectiveness remains limited. We sought to compare the performance of different treatment strategies for personalized treatment of patients with MR. <b>Methods</b>: We performed a pairwise and network meta-analyses of randomized trials comparing treatment strategies for patients with MR. Patients were divided in two groups: transcatheter mitral valve repair (TMVR, including edge-to-edge repair and indirect percutaneous annuloplasty) and control (surgery or optimal medical therapy). The primary outcome of this analysis was all-cause death. Main secondary outcomes were re-hospitalization for heart failure and re-intervention. <b>Results</b>: A total of seven trials with 2324 participants, with mainly functional MR (TMVR, <i>n</i> = 1373-control, <i>n</i> = 951) were available for the quantitative synthesis. The median follow-up duration was 14 months. Compared to control therapy, TMVR significantly reduced all-cause death (RR 0.77, 95% CI 0.65-0.91, <i>p</i> = 0.002) and re-hospitalization for heart failure (RR 0.67, 95% CI 0.49-0.91, <i>p</i> = 0.01). Among TMVR strategies, the edge-to-edge repair with MitraClip ranked as possibly the best option to reduce all-cause death. <b>Conclusions</b>: In symptomatic patients with significant MR, TMVR is associated with a significant reduction of all-cause death, and re-hospitalization for heart failure, mainly in patients with functional MR. Additional comparative studies are needed to investigate the best TMVR treatment option, for patients with degenerative MR.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12387918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958226","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":"Reply to Fluegge, K.; Fluegge, K. Comment on \"Frye et al. Air Pollution and Maximum Temperature Are Associated with Neurodevelopmental Regressive Events in Autism Spectrum Disorder. <i>J. Pers. Med.</i> 2022, <i>12</i>, 1809\".","authors":"Richard E Frye","doi":"10.3390/jpm15080382","DOIUrl":"10.3390/jpm15080382","url":null,"abstract":"<p><p>I would like to thank Fluegge and Fluegge for their comments on our study which identified air pollution and maximum temperature as potential environmental factors associated with neurodevelopmental regression (NDR) in children with autism spectrum disorder (ASD) [...].</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12387269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958269","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":"Audiogram Shape: Does It Have a Significant Prognostic Role in Idiopathic Sudden Sensorineural Hearing Loss Outcome?","authors":"Gabriella Cadoni, Alberta Rizzuti, Michela Sollazzo, Pasqualina Maria Picciotti, Jacopo Galli","doi":"10.3390/jpm15080379","DOIUrl":"10.3390/jpm15080379","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Sudden sensorineural hearing loss (SSNHL) represents a challenging clinical entity with variable prognosis. Audiometric curve configuration has been proposed as a predictor of recovery. This study aimed to evaluate the association between audiogram morphology at onset and hearing outcome in patients with idiopathic unilateral SSNHL treated with standardized therapy. <b>Methods:</b> We retrospectively analyzed 156 patients with idiopathic SSNHL. Hearing thresholds at key frequencies were measured at baseline and 4 weeks post-treatment. Patients were categorized into upsloping, flat, downsloping, or U-shaped audiogram subgroups. Recovery was classified into four levels. Comparisons were made across subgroups for audiometric and laboratory data using ANOVA and chi-square tests. <b>Results:</b> Baseline PTA values were comparable across audiogram subgroups (<i>p</i> = 0.12). Hearing recovery differed significantly according to audiogram configuration (chi-square, <i>p</i> < 0.001), with upsloping and U-shaped patterns showing the best outcomes. Flat and downsloping curves were associated with poorer recovery, lower HDL, and elevated NLR values. <b>Conclusions:</b> Audiogram configuration is a relevant prognostic marker in SSNHL. Patterns linked to adverse metabolic and inflammatory profiles may benefit from tailored treatment strategies in a personalized medicine framework.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12387619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957999","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":"Comment on Frye et al. Air Pollution and Maximum Temperature Are Associated with Neurodevelopmental Regressive Events in Autism Spectrum Disorder. <i>J. Pers. Med.</i> 2022, <i>12</i>, 1809.","authors":"Keith Fluegge, Kyle Fluegge","doi":"10.3390/jpm15080381","DOIUrl":"10.3390/jpm15080381","url":null,"abstract":"<p><p>Frye et al. [...].</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12387246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958078","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":"Effect of High Altitude on Small Pulmonary Vein and Artery Volume in the COPDGene Cohort: Towards Better Understanding of Lung Physiology and Pulmonary Disease.","authors":"Anastasia K A L Kwee, Esther Pompe, Leticia Gallardo Estrella, Jean-Paul Charbonnier, Stephen M Humphries, Harm A W M Tiddens, James D Crapo, Richard Casaburi, Pim A de Jong, David A Lynch, Firdaus A A Mohamed Hoesein","doi":"10.3390/jpm15080377","DOIUrl":"10.3390/jpm15080377","url":null,"abstract":"<p><p><b>Background:</b> To personalize the care for persons with smoking-related lung disease, a thorough understanding of its etiology is essential. The role of pulmonary vessels remains poorly understood. Living at high altitude provides a natural model to investigate the effects of low oxygen levels on pulmonary vessels. This study aims to evaluate the relationship between living at high altitudes and small pulmonary vein and artery volumes. We hypothesize that small vein and artery volumes were independently associated with living at high altitude. <b>Methods:</b> We quantified small pulmonary vein and artery dimensions (ᴓ < 1 mm) on computed tomography (CT) down to 0.2 mm in diameter and normalized the dimensions by body surface area. In 8931 current and former smokers participating in the COPDGene study, we used multivariate regression models corrected for clinical and technical confounders. <b>Results:</b> 1262 residents (14.1%) were defined as high-altitude residents (~1600 m, Denver, CO, USA). Compared to lower-altitude residents, the high-altitude residents had a higher age (62.0 ± 9.1 vs. 59.6 ± 9.0 years), more pack-years smoked (46.8 vs. 44.1) and a lower FEV₁% predicted (64.6 ± 32.4% vs. 76.8 ± 25.2%). Both mean small artery volume (4.09 ± 0.89 mL/m² vs. 3.85 ± 0.90 mL/m²) and mean small vein volume (2.96 ± 0.53 mL/m² vs. 2.67 ± 0.53 mL/m²) were higher in high-altitude residents. Multivariate linear regression showed that, in those without COPD, high-altitude residents have a higher small vein volume (0.129 mL/m², <i>p</i> < 0.001) and higher small artery volume (0.170 mL/m², <i>p</i> = 0.001) compared to lower-altitude residents. There was no significant association in residents with COPD. <b>Conclusions:</b> In current and former smokers without COPD, higher small pulmonary vein and artery volumes were associated with living at high altitude, independent of lung disease or technical CT parameters. A potential cause includes vascular remodeling due to an elevated need for blood oxygen transport, which becomes concealed when COPD develops.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12387232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957988","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":"Real-World Evidence on Low-Dose Olanzapine (≤1.25 mg) for Personalized Antipsychotic Dosing.","authors":"Danbee Kang, Seongmi Moon, Ji-Hyun Baek, Juhee Cho","doi":"10.3390/jpm15080380","DOIUrl":"10.3390/jpm15080380","url":null,"abstract":"<p><p><b>Background/Objectives</b>: This cohort study aimed to elucidate the real-world treatment course of patients receiving low-dose olanzapine (<2.5 mg), to assess its efficacy, and to examine its metabolic side effects. This study was a cohort study using a clinical registry. <b>Methods</b>: The primary efficacy endpoint was effective medication adherence and appropriate dosing. The primary safety endpoint was the incidence of metabolic adverse events, including diabetes mellitus, dyslipidemia, cardiovascular events, and cerebrovascular events. Cox proportional hazards models were used to compare outcomes between groups. <b>Results</b>: A total of 9565 patients were prescribed olanzapine at Samsung Medical Center from 2002 to 2023, and 1629 (17%) were in the low-dose group. The median maintenance period for low-dose olanzapine was 142 days (IQR, 30-551 days), and 95.5% of patients received low-dose olanzapine with either gradual tapering or gradual dose escalation. During follow-up, the risk of diabetes mellitus (HR = 0.32, 95% CI = 0.17-0.62), dyslipidemia (HR = 0.59, 95% CI = 0.42-0.82), cardiovascular disease (HR = 0.88, 95% CI = 0.51-1.49), and cerebrovascular events (HR = 0.75, 95% CI = 0.41-1.36) was lower in the low-dose group than in the regular-dose group. <b>Conclusions</b>: Low doses of olanzapine have clinical benefits in providing appropriate dosing and a reduced incidence of metabolic side effects. These findings support personalized antipsychotic treatment strategies, particularly in populations with heightened metabolic vulnerability, by informing dose selection based on individual risk-benefit profiles.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12387202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958266","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":"MicroRNAs in Liver Cirrhosis: Diagnostic and Therapeutic Perspectives-A Comprehensive Review.","authors":"Cristian Ichim, Adrian Boicean, Paula Anderco, Samuel Bogdan Todor, Adrian Hașegan, Sabrina Bîrsan, Victoria Bîrluțiu","doi":"10.3390/jpm15080376","DOIUrl":"10.3390/jpm15080376","url":null,"abstract":"<p><p>Liver cirrhosis represents the end-stage of chronic hepatic injury, arising from a diverse range of etiologies including viral hepatitis, alcohol abuse and non-alcoholic fatty liver disease. A key driver of cirrhosis is hepatic fibrogenesis, a multifaceted process involving hepatic stellate cell activation, inflammatory signaling and extracellular matrix accumulation. MicroRNAs (miRNAs), a class of small non-coding RNAs, have emerged as pivotal regulators in this context, modulating gene expression networks that govern inflammation, fibrosis and hepatocarcinogenesis. This review synthesizes current evidence on the role of miRNAs in liver cirrhosis, emphasizing specific miRNAs such as miR-21, miR-122, miR-125, miR-146 and miR-155. These miRNAs influence pathways involving TGF-β, NF-κB and PI3K/Akt signaling, contributing to either fibrogenic progression or its suppression. The unique expression profiles and stability of miRNAs in biological fluids position them as promising non-invasive biomarkers for cirrhosis diagnosis and monitoring. Moreover, therapeutic modulation of miRNA activity through mimics or inhibitors holds future potential, though delivery and safety challenges remain. Advancing our understanding of miRNA-mediated regulation in cirrhosis could transform current diagnostic and therapeutic strategies, enabling more precise and personalized liver disease management.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12387485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958247","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":"Delayed vs. Concomitant Urethrectomy for Non-Metastatic Urothelial Carcinoma of the Urinary Bladder Undergoing Radical Cystectomy: Perioperative and Survival Outcomes from a Single Tertiary Centre in the United Kingdom.","authors":"Francesco Del Giudice, Mohamed Gad, Valerio Santarelli, Rajesh Nair, Yasmin Abu-Ghanem, Elsie Mensah, Ben Challacombe, Jonathan Kam, Youssef Ibrahim, Basil Lufti, Amir Khan, Akra Yeasmin, Kathryn Chatterton, Suzanne Amery, Katarina Spurna, Romerr Alao, Syed Ghazi Ali Kirmani, Felice Crocetto, Biagio Barone, Bernardo Rocco, Alessandro Sciarra, Benjamin I Chung, Ramesh Thurairaja, Muhammad Shamim Khan","doi":"10.3390/jpm15080375","DOIUrl":"10.3390/jpm15080375","url":null,"abstract":"<p><p><b>Introduction:</b> The role of urethrectomy at the time of Robotic-Assisted or Open Radical Cystectomy (RARC, ORC) is controversial. Whether urethrectomy should be performed at the time of RARC/ORC or delayed up to a 3-6 month interval is unclear. We performed a retrospective cohort analysis of perioperative and survival outcomes in patients with high-risk NMIBCs or non-metastatic MIBCs at our institution who underwent either concomitant or deferred urethrectomy after RC. <b>Materials and Methods:</b> cTis-T1 or cT2-T4, N0-1, M0 BC patients who underwent RARC or ORC from 2009 to 2024 were reviewed. Clinical, demographic, tumour, and patient characteristics and perioperative variables were assessed across concomitant and delayed urethrectomy groups. Multivariate logistic analysis was performed to estimate the impact of significant variables on intraoperative and postoperative outcomes. Univariable Kaplan-Meier and multivariable Cox regression modelling was implemented to explore the relative effect of time of urethrectomy on progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS). <b>Results:</b> A total of <i>n</i> = 58 patients (<i>n</i> = 47 delayed vs. <i>n</i> = 11 concomitant) with similar demographic characteristics were included. The concomitant urethrectomy group experienced longer operative time and greater blood loss (379 ± 65 min and 430 ± 101 mL vs. 342 ± 82 min and 422 ± 125 mL, with <i>p</i> = 0.049 and <i>p</i> = 0.028, respectively). Hospital readmission rates were higher in the concomitant urethrectomy group (36.4% vs. 8.5%, <i>p</i> = 0.016; OR: 17.9; 95% CI 1.2-265; <i>p</i> = 0.036). In Cox regression analysis, the timing of urethrectomy had no influence on PFS, CSS, or OS (all <i>p</i> > 0.05). <b>Conclusions:</b> Our study suggests that urethrectomy can be safely deferred unless urothelial disease is clearly present pre- or intraoperatively without compromising survival outcome and with the advantage of reducing surgical morbidity at the time of RC.</p>","PeriodicalId":16722,"journal":{"name":"Journal of Personalized Medicine","volume":"15 8","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12387265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958032","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}