Translational andrology and urology最新文献

{"title":"Urethral stricture excision and primary end-to-end anastomosis: a single-tertiary center long-term experience.","authors":"Duan Gao, Xiaoyu Li, Wenyuan Leng, Xing Ji, Weimin Hu, Zhenpeng Zhu, Chunru Xu, Jian Lin","doi":"10.21037/tau-2025-175","DOIUrl":"10.21037/tau-2025-175","url":null,"abstract":"<p><strong>Background: </strong>Urethral stricture represents a prevalent clinical entity in urological practice, with urethroplasty currently serving as the primary therapeutic approach for complex cases. This study aimed to analyze the efficacy of urethral stricture resection and primary end-to-end anastomosis for treating male urethral strictures and identify potential risk factors for postoperative recurrence.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 37 male patients who underwent this procedure at Peking University First Hospital between February 2018 and September 2024. Clinical data of the patients, including age, preoperative urinary tract infection, etiology of urethral stricture, location of urethral stricture, length of stricture segment, preoperative urethral surgery history, presence of bladder fistula, preoperative and postoperative quality of life (QoL) index, preoperative and postoperative International Prostate Symptom Scores (IPSS) score, postoperative regular dilation, and postoperative complications, were collected and analyzed using statistical methods.</p><p><strong>Results: </strong>The median follow-up time for the patients was 57 [interquartile range (IQR), 39.5-66.5] months, and the stricture length was 20 (IQR, 10-30) mm. The rate of recurrent stricture was 40.54% (15/37), with a median time from surgery to recurrence of 3 (IQR, 1-6) months. The preoperative and postoperative QoL and IPSS scores showed significant differences (P<0.05). Sexual dysfunction and urinary tract infections were the most common postoperative complications. There was no statistically significant difference in efficacy between posterior and anterior urethral strictures.</p><p><strong>Conclusions: </strong>We provided clinical information on stricture resection and end-to-end anastomosis in the treatment of male urethral strictures, providing a baseline reference for relevant research. Individualized assessment and management are crucial for improving surgical success rates and patient QoL.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1645-1651"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675736","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":"Integrated single-cell genomics, transcriptomics, and pathomics to identify potential biomarkers in muscle-invasive bladder cancer.","authors":"Yifeng He, Fazhong Dai, Zhenwei Wang, Shengming Zhang, Deqin Zeng, Juan Duan, Daiwei Zhou, Zongtai Zheng, Xiaofu Qiu","doi":"10.21037/tau-2025-79","DOIUrl":"10.21037/tau-2025-79","url":null,"abstract":"<p><strong>Background: </strong>The integration of multi-omics approaches provides a powerful strategy for understanding cancer. By combining these methods, researchers gain insights into tumor diversity, gene activity, and the tumor microenvironment, which are essential for advancing cancer biology, improving early detection, refining prognostic tools, and developing targeted treatments. This study aims to explore key biomarkers in muscle-invasive bladder cancer (MIBC) and to develop a predictive model for better understanding disease progression and therapeutic responses.</p><p><strong>Methods: </strong>Single-cell analysis of MIBC samples from public datasets identified basal-related genes. Using Cox analysis of The Cancer Genome Atlas (TCGA)-bladder urothelial carcinoma (BLCA) clinical data and the expression matrix, and combining it with weighted gene co-expression network analysis (WGCNA) of another MIBC dataset, a disintegrin and metalloprotease protein 17 (<i>ADAM17</i>) was identified as a key target gene. We collected BLCA patient samples from TCGA, Shanghai Tenth People's Hospital (STPH), and Guangdong Second Provincial General Hospital (GD2H) to develop the pathomics model for predicting <i>ADAM17</i> expression. Single-cell validation of <i>ADAM17</i> expression was performed using GD2H MIBC samples.</p><p><strong>Results: </strong><i>ADAM17</i> was highly expressed in MIBC and associated with poor prognosis. Its expression correlated with clinical features such as non-papillary subtype, advanced pathological stage, and higher tissue grade. <i>ADAM17</i> overexpression was linked to immune reprogramming and drug resistance. The pathomics model effectively predicted <i>ADAM17</i> expression in BLCA samples. Single-cell analysis of GD2H MIBC samples confirmed <i>ADAM17</i> overexpression in epithelial cells and identified key pathways in cell communication, matrix remodeling, tumor invasion, and immune regulation.</p><p><strong>Conclusions: </strong>Multi-omics approaches effectively identify biomarkers for MIBC, with <i>ADAM17</i> emerging as a key biomarker. Further research is needed to clarify its role in MIBC progression.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1610-1630"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675785","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":"Penile calciphylaxis: surgical management in the setting of Fournier's gangrene-a case report and literature review.","authors":"Anh Nguyen, Jacob Veliky, Payal Shah, Rebecca Anderson, Amjad Alwaal","doi":"10.21037/tau-2025-75","DOIUrl":"10.21037/tau-2025-75","url":null,"abstract":"<p><strong>Background: </strong>Penile calciphylaxis is a rare and severe manifestation of calciphylaxis. It refers to calcification of the small subcutaneous vessel network in the otherwise highly vascularized penis. Given how rare the condition is, there are no clear guidelines for treatment yet. The role of biopsy or surgery remains controversial due to concerns about exacerbating the condition in the context of poor wound healing. We had a rare case of penile calciphylaxis with superimposed infection. Through our case as well as through review of additional reports, we aim to further the discussion of treatment for penile calciphylaxis and provide an example of successful surgical resection.</p><p><strong>Case description: </strong>We report a case of penile calciphylaxis complicated by Fournier's gangrene following a partial penectomy. He presented with penile drainage and a foul odor three months after undergoing a partial penectomy at another institution for the treatment of penile calciphylaxis. The patient underwent total penectomy with penoscrotal urethrostomy and was treated with antibiotics. At follow-up, the patient demonstrated good wound healing and recovery.</p><p><strong>Conclusions: </strong>A review of 19 operative case reports on penile calciphylaxis highlights varied management strategies for this highly morbid condition. Current evidence suggests that treatment should be tailored to disease severity. In severe cases with infection, aggressive surgical intervention may be necessary to achieve source control and improve outcomes.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1832-1838"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675789","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":"Epithelial-mesenchymal transition classification based on machine learning for predicting prognosis and treatment response in clear cell renal cell carcinoma.","authors":"Guangqiang Zhu, Ruipeng Tang, Tielong Tang, Xupan Wei, Chunlin Tan","doi":"10.21037/tau-2025-109","DOIUrl":"10.21037/tau-2025-109","url":null,"abstract":"<p><strong>Background: </strong>Renal cell carcinoma (RCC) is the third most common cancer in the genitourinary system. However, factors such as postoperative metastasis, recurrence, and advanced inoperable conditions contribute to its high mortality rate. Epithelial-mesenchymal transition (EMT) is the initial process that enables cells to metastasize. It is crucial for initiating and promoting both tumor cell invasion and metastasis. This study aims to construct a prognostic prediction model for clear cell renal cell carcinoma (ccRCC) patients using EMT-association genes (EAGs) based on public database data to improve the management of ccRCC.</p><p><strong>Methods: </strong>EAGs were identified through clustering and differential expression analysis, and machine learning methods were used to construct a prognostic model. External dataset E-MTAB-1980 was used for model construction and validation. Tumor microenvironment scores, enrichment analysis, and drug sensitivity analysis were used to predict treatment efficacy in different risk score groups. Finally, the \"scissors\" analysis linked high- and low-risk patients to individual cells and further explored the regulatory relationships between high- and low-risk cells through the cell communication network.</p><p><strong>Results: </strong>A final set of 12 EAGs was used for model construction. Risk scores showed statistically significant differences in different stages. Risk scores were independent prognostic factors for ccRCC patients. Significant differences were observed in the infiltration levels of various immune cells, expression levels of immune checkpoint genes, tumor mutation burden, and drug sensitivity between high- and low-risk groups. Validation tests demonstrated that our EAGs model showed good predictive performance in ccRCC. Cell communication analysis indicated that high-risk and low-risk cell subpopulations had different regulatory networks.</p><p><strong>Conclusions: </strong>A new EAGs prognostic signature was constructed, which can be used to assess the prognosis and treatment response of ccRCC.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1742-1758"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675778","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":"Bladder exstrophy: navigating long-term outcomes.","authors":"Morgan Victoria Town, Katherine Jina Kim, Amelia Vu, Ahmad Haffar, Bradley A Morganstern","doi":"10.21037/tau-2024-631","DOIUrl":"10.21037/tau-2024-631","url":null,"abstract":"<p><p>Bladder exstrophy (BE) is a rare congenital malformation of the genitourinary tract, as well as surrounding structures, within the spectrum of the exstrophy-epispadias complex. This review aims to summarize the current literature on repair procedures, specifically the modern staged repair and complete primary reconstruction, along with their associated complications and complication rates. A particular focus is placed on long-term management strategies to address these complications as patients transition into adulthood. Additionally, this review highlights the management of sexual health for both males and females, fertility considerations, and overall quality of life, emphasizing that patient care extends beyond voiding function. By incorporating these broader aspects, the review provides a global perspective on patient management, which is crucial for the entire multidisciplinary care team. Due to the rarity of BE, the available data is inherently limited, and findings may not be generalizable to every patient. Despite these challenges, this review synthesizes the existing literature through comprehensive searches conducted on PubMed and Google Scholar, thematically organizing findings to identify well-recognized complications and their management. The importance of multidisciplinary care, extending beyond pediatric urology and including adult urologists, is critically emphasized to ensure a seamless transition of care as patients age. Finally, this review underscores the need for ongoing research to establish standardized long-term management protocols, particularly as patients with BE are living longer lives due to advances in surgical techniques and medical care.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1797-1806"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675801","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":"Long-term administration of hydrogen-rich water enhances quality of life in diabetic rats and reduces renal neoplasm incidence through modulation of inflammatory and metabolic pathways.","authors":"Qijie Chen, Shaoqing Yu, Yating Pan, Hong Tang, Yang Wang, Ninghan Feng, Hao Wu, Guanzhen Yu","doi":"10.21037/tau-2025-314","DOIUrl":"10.21037/tau-2025-314","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia, leading to severe systemic complications and reduced quality of life. Current therapies often fail to comprehensively alleviate diabetic complications, highlighting the need for novel approaches. Animal studies and clinical trials have demonstrated the therapeutic potential of molecular hydrogen (H₂), particularly in controlling DM. However, no systematic studies have investigated the long-term treatment effects of hydrogen-rich water (HRW) on DM, and the underlying mechanisms remain largely unknown. This study aims to explore the therapeutic efficacy of HRW in mitigating DM-related complications and uncover its molecular mechanisms using a streptozotocin (STZ)-induced diabetic rat model.</p><p><strong>Methods: </strong>The therapeutic effects and mechanisms of HRW were evaluated through RNA sequencing (RNA-seq) analysis of multiple organs from STZ-induced diabetic male rat models after 24 weeks of HRW administration. Parameters such as fasting blood glucose (FBG), body weight (BW), and general condition were monitored. At week 24, tissues from the eyes, testes, penis, sperm, liver, kidneys, stomach, colon, and bones were collected and subjected to hematoxylin and eosin staining. RNA-seq was conducted on fresh testis, liver, kidney, and stomach tissues to identify differentially expressed genes.</p><p><strong>Results: </strong>Long-term administration of HRW significantly decreased FBG levels and increased BW, indicating an improvement in metabolic control. HRW also ameliorated various DM-related complications, including diabetic cataracts, bone loss, diabetic nephropathy, erectile dysfunction, asthenozoospermia, and renal neoplasms. RNA-seq and bioinformatic analyses revealed significant enrichment of metabolic pathway-related genes in testis, liver, kidney, and stomach tissues, suggesting the reprogramming of metabolic functions. The findings suggest that oral ingestion of HRW is a safe, effective, and convenient treatment that improves quality of life for DM patients by reducing blood glucose levels and alleviating diabetic complications.</p><p><strong>Conclusions: </strong>This study advances the understanding of HRW's therapeutic mechanisms, particularly its ability to reprogram metabolic pathways. HRW shows promise as an alternative treatment for diabetes, offering a proactive approach to improving metabolic health and alleviating related complications.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1765-1781"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675788","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":"Phimosis of foreskin uncovering schistosomiasis of the urinary bladder: a case report.","authors":"Natalie Mainland, SriGita Madiraju, Stephenia Nwogu, Stephen Hong, Isaac Zucker, Dalia Ibrahim, Gregor Emmert, Firas G Petros","doi":"10.21037/tau-2025-182","DOIUrl":"10.21037/tau-2025-182","url":null,"abstract":"<p><strong>Background: </strong><i>Schistosoma haematobium</i> (<i>S. haematobium</i>) is a freshwater parasite endemic to Africa and parts of the Middle East. While snails serve as intermediate hosts, second-stage larvae infest humans. These migrate to bladder tissues, where they cause inflammation, leading to fibrosis, obstruction, and squamous cell carcinoma of the bladder.</p><p><strong>Case description: </strong>This report presents a case of schistosomiasis found in a 10-year-old immigrant from Sudan. He initially presented to urology clinic for consideration of circumcision due to phimosis, but thorough patient interview revealed a history of gross hematuria and small amounts of bleeding at the end of micturition associated with occasional abdominal pain for approximately 5 months. A retroperitoneal ultrasound showed a 3.7 cm mass at the dome of the bladder. Cystoscopy was scheduled quickly to rule out underlying tumors such as rhabdomyosarcoma, which often has poor prognosis. Cystoscopy showed two highly vascularized 2.5 cm nodular bladder masses, one on either side of the midline. The bladder was otherwise normal-appearing. The masses were biopsied and sent for frozen section. While the preliminary frozen pathology report was consistent with rhabdoid malignancy, final permanent pathology was negative for malignancy and contained numerous eggs of species <i>S. haematobium</i>, with internal miracidium and scattered calcifications. Upon further investigation, the patient's family reported that he had gone swimming in a freshwater lake during their most recent visit to Sudan. The patient was treated with praziquantel, with plans to repeat treatment in 2-4 weeks. He was scheduled for follow-up urine microscopy in 3 months to confirm a successful cure. However, he was lost for follow-up.</p><p><strong>Conclusions: </strong>In the United States (U.S.), schistosomiasis is extremely rare, and primarily affects patients who have immigrated from countries where it is endemic. This case report provides a further data point for presentation and management of schistosomiasis both in the U.S. and within pediatric populations, and highlights the importance of a thorough urologic history.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1827-1831"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675790","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":"Gene profiling and clinicopathological features for prognostic modeling of recurrence in non-metastatic clear-cell renal cell carcinoma.","authors":"Xuzhi Yan, Jian Chen, Dianzheng Zhang, Xiaodu Xie, Ziqian Wang, Chongliang Zheng, Junhao Jin, Jing Xu, Qian Yan, Qiuli Liu, Weihua Lan, Jun Jiang","doi":"10.21037/tau-2025-177","DOIUrl":"10.21037/tau-2025-177","url":null,"abstract":"<p><strong>Background: </strong>Accurate risk stratification of renal cell carcinoma (RCC) is critical for selecting the most appropriate treatment options. Existing prognostic systems, which incorporate various clinical and pathological parameters, have limitations in terms of accuracy. However, it remains unclear whether integrating molecular data with clinicopathological features can enhance the identification of high-risk tumors. The objective of this study was to establish a model to predict RCC recurrence by integrating molecular data with clinicopathological features and to evaluate circulating tumor DNA (ctDNA) as a non-invasive prognostic marker.</p><p><strong>Methods: </strong>Next-generation sequencing (NGS) was performed on 73 RCC patients, including 54 with clear-cell RCC (ccRCC). A prognostic model for disease-free survival (DFS) in non-metastatic ccRCC (NMCCRCC) was constructed and validated with two external datasets. The prognostic potential of ctDNA was assessed by its detection rates, mutation concordance with tumor tissue DNA, and association with clinical outcomes.</p><p><strong>Results: </strong>Frequently altered genes in ccRCC included <i>VHL</i> (72.22%), <i>PBRM1</i> (25.93%), <i>BAP1</i> (20.37%), <i>TP53</i> (11.11%), <i>KDM5C</i> (11.11%), and <i>SETD2</i> (16.67%). Advanced T stage, BAP1, and SETD2 mutations were independent risk factors for recurrence in NMCCRCC patients. The model achieved a concordance index (C-index) of 0.833 and demonstrated area under the receiver operating characteristic (ROC) curve (AUC) values ranging from 0.900 to 0.821 for 1- to 5-year outcomes. In external validation, the model also demonstrated reliable performance in the external validation cohorts, with AUC values ranging from 0.688 to 0.751 and 0.721 to 0.768, respectively. The mutation concordance between ctDNA and tumor tissue DNA was 61.54%, with higher ctDNA detection rates observed in patients with distant metastasis.</p><p><strong>Conclusions: </strong>Our prognostic model, factoring in T stage and genetic mutations in BAP1 and SETD2, effectively predicted recurrence in NMCCRCC patients. The potential of ctDNA as a non-invasive prognostic biomarker was underscored by its high detection rates and mutation concordance.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1575-1588"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675780","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":"Improvements in the prognosis of patients with stage IV renal cancer according to the era of therapeutic agents: an analysis of National Cancer Registry data.","authors":"Shogo Watari, Takaharu Ichikawa, Soshi Takao, Yuki Kurihara, Azusa Matsumi, Moto Tokunaga, Risa Kubota, Norihiro Kusumi, Tomoyasu Tsushima","doi":"10.21037/tau-2025-163","DOIUrl":"10.21037/tau-2025-163","url":null,"abstract":"<p><strong>Background: </strong>Advances in new drugs have been associated with improvements in the prognoses of individuals with stage IV renal carcinoma. We aimed to retrospectively evaluate the prognostic improvement of stage IV renal cancer over time using the Okayama Cancer Registry database, which is included in the National Cancer Registry (NCR) of Japan.</p><p><strong>Methods: </strong>Patients identified in the database with stage IV renal cancer were included. Survival prognosis was analyzed by three periods according to significant advancements in novel therapeutic agents: early (up to March 2008), mid (April 2008-July 2016), and late (August 2016 onward). Overall survival (OS) was analyzed using the Kaplan-Meier methods and Cox proportional hazards models. Stratified Cox models were used to account for proportional hazards violations. Subgroup analyses included stratification by surgery status and disease extent (T4 <i>vs.</i> M1).</p><p><strong>Results: </strong>In total, 1,182 patients were included in the study. The OS outcomes significantly improved across each period [early: reference; mid: hazard ratio (HR) =0.68, 95% confidence interval (CI): 0.59-0.78; late: HR =0.54, 95% CI: 0.41-0.69]. Subgroup analyses revealed that patients who had undergone initial surgery showed improved prognosis (early: reference; mid: HR =0.44, 95% CI: 0.29-0.69; late: HR =0.30, 95% CI: 0.16-0.56), whereas those receiving no initial surgery did not (early: no case available; mid: reference; late: HR =0.99, 95% CI: 0.64-1.53). Stratified Cox analysis identified age ≥70 years (HR =1.69, 95% CI: 1.47-1.95) and M1 disease (HR =2.95, 95% CI: 2.47-3.52) as independent predictors of worse survival. Significant improvement over time was observed among patients with T4 disease (early: reference; mid: HR =0.59, 95% CI: 0.42-0.82; late: HR =0.47, 95% CI: 0.27-0.81), patients, whereas no improvement was seen in those with M1 disease.</p><p><strong>Conclusions: </strong>Prognosis of patients with stage IV renal cancer has improved over time, particularly among patients with locally advanced disease and those who undergo surgery. Therefore, therapeutic advances may have greater real-world impact on patients with resectable disease than on those with metastatic disease.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1734-1741"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675784","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":"Predicting early death in elderly patients with bladder urothelial carcinoma: a population-based study.","authors":"Qingmai Huang, Qianghua Hu, Manfei Jiang, Baofeng Wang, Xianping Che","doi":"10.21037/tau-2025-225","DOIUrl":"10.21037/tau-2025-225","url":null,"abstract":"<p><strong>Background: </strong>The incidence and mortality rates of bladder urothelial carcinoma significantly increase with age after the age of 60 years. In our study, we aimed to identify and analyze the risk factors for early death (death within 6 months) in elderly patients with bladder urothelial carcinoma and established a reliable Nomogram model, thereby assisting clinicians to choose the best clinical decision-making.</p><p><strong>Methods: </strong>Data of elderly patients with bladder urothelial carcinoma from the Surveillance, Epidemiology, and End Results (SEER) database (version 8.4.4) between 2010 and 2015 were selected. Multivariate logistic regression analysis was used to identify independent risk factors associated with early death. A predictive Nomogram was constructed based on these risk factors to assess the risk of early death. During the training and validation processes, the clinical applicability and predictability of the model was evaluated using receiver operating characteristic (ROC) curves, calibration analysis and decision curve analysis (DCA).</p><p><strong>Results: </strong>In this study, a total of 5,087 patients with bladder urothelial carcinoma were collected, among whom 1,163 experienced early death. Age, marital status, tumor (T)-stage, metastasis (M)-stage, surgery, radiation, chemotherapy, brain metastasis, and tumor size were all identified as independent risk factors for early death. Based on these factors, we constructed a nomogram that can effectively predict early death in elderly patients with bladder urothelial carcinoma. The nomogram shows that the areas under the curve (AUCs) were 0.7938 and 0.8107 for the training and validation cohorts respectively, and the DCA showed that the predictive model performed well and could be applied in the clinic. Limitations of this study: potential selection bias, lack of relevant variables such as comorbidities, family history, and lack of external validation.</p><p><strong>Conclusions: </strong>In this study, we constructed and validated a predictive model (Nomogram) to accurately predict the clinical prognosis of elderly patients with bladder urothelial carcinoma. This predictive tool provides clinicians with an individualized prognostic assessment that can optimize the development of treatment regimens and improve patients' clinical outcomes and quality of survival.</p>","PeriodicalId":23270,"journal":{"name":"Translational andrology and urology","volume":"14 6","pages":"1551-1565"},"PeriodicalIF":1.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12271929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675802","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}