Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Use of staging in intermediate-risk prostate cancer: A real-world data analysis.","authors":"Ben Frederik Hartwieg, Tobias Maurer, Christopher Kniep, Philipp Mandel, Mike Wenzel, Fabian Falkenbach, Lars Budäus, Thomas Steuber, Markus Graefen, Derya Tilki, Felix Preisser","doi":"10.1016/j.urolonc.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.09.011","url":null,"abstract":"<p><strong>Objective: </strong>Current EAU guidelines provide only a weak recommendation for staging (computed tomography [CT], magnetic resonance imaging [MRI], bone scan, or prostate-specific membrane antigen [PSMA] positron emission tomography [PET]/CT) in selected intermediate-risk prostate cancer (irPCa) patients. However, data on the real-world application of staging in this group are limited. We aimed to assess the use of various imaging modalities for distant staging in irPCa patients scheduled for radical prostatectomy (RP).</p><p><strong>Material and methods: </strong>We identified irPCa patients from a high-volume institutional database who underwent primary RP between 2015 and 2021. The use of different staging modalities was assessed, with stratification according to NCCN criteria into favorable and unfavorable intermediate-risk groups. Annual trends were analyzed.</p><p><strong>Results: </strong>Among 9,512 irPCa patients, 37.4% had favorable and 62.6% unfavorable disease. Overall, 42.0% underwent any form of staging prior to RP, with higher rates in unfavorable versus favorable disease (48.5% vs. 31%, P < 0.001). The detection rates of locoregional or metastatic disease using conventional imaging were low (0%-2.0%). For PSMA PET/CT, the rates were 5.0% and 4.3% in the favorable and unfavorable groups, respectively. Bone scans (34.7%) and abdominopelvic CT (28.0%) were most frequently used in unfavorable cases, with 20.1% undergoing both. Only 6.2% (n = 369) of unfavorable patients received PSMA PET/CT. Among favorable cases, 22.0% underwent bone scans and 17.8% abdominopelvic CT; 11.9% had both, and just 2.8% (n = 100) received PSMA PET/CT. MRI was rarely used (1.7%; 1.9% in unfavorable vs. 1.3% in favorable cases, P = 0.1). Overall staging rates remained stable during the study period (EAPC: 0.04, P = 0.9), whereas PSMA PET/CT usage significantly increased in the total cohort (EAPC: 17.9, P < 0.01) and in the unfavorable group (EAPC: 21.1, P < 0.01).</p><p><strong>Conclusions: </strong>Less than half of patients with unfavorable irPCa and approximately one-third of those with favorable irPCa underwent distant staging. Positive findings were rare, especially with conventional imaging. Therefore, conventional staging might be safely omitted in irPCa, while PSMA PET/CT may be considered in selected patients when staging is deemed necessary, as it provides more accurate information.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259216","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":"Corrigendum to 'Stauffer's syndrome: A comprehensive review and proposed updated diagnostic criteria' [Urologic Oncology: Seminars and Original Investigations Volume 36, Issue 7 (2018) 321-326].","authors":"Mário Fontes-Sousa, Helena Magalhães, Fernando Calais da Silva, Maria Joaquina Maurício","doi":"10.1016/j.urolonc.2025.10.001","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.10.001","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259189","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":"An opportunity to save? SBRT is less costly than IMRT for intermediate-risk prostate cancer.","authors":"Vanessa N Peña, Shan Wu, Oluwaseun Orikogbo, Peyton A Skupin, Mitchell Alameddine, Jonathan G Yabes, Daniel Beichner, Adam C Olson, Benjamin J Davies, Lindsay M Sabik, Bruce L Jacobs","doi":"10.1016/j.urolonc.2025.09.008","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.09.008","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Stereotactic body radiation therapy (SBRT) is a novel form of radiotherapy for prostate cancer which uses ultra-hypofractionated radiation and allows for fewer treatment sessions compared to moderately hypofractionated regimens including intensity-modulated radiation therapy (IMRT). Recent studies have demonstrated comparable oncologic outcomes between SBRT and IMRT for intermediate-risk prostate cancer. We sought to compare the cost of SBRT and IMRT for intermediate-risk prostate cancer.</p><p><strong>Methods: </strong>We identified men over age 66 diagnosed with intermediate-risk prostate cancer who underwent IMRT or SBRT from 2008 to 2017 using the Surveillance, Epidemiology and End Results-Medicare Linked Database to compare per patient radiation-specific costs. Patients who received a therapeutic regimen, defined as ≥20 fractions of IMRT and ≥2 fractions of SBRT within 90 days, were included. Additionally, only patients treated in 1 locality was included to account for geographic variability in healthcare costs. Linear mixed-effects regression was used to compare per patient costs.</p><p><strong>Results: </strong>The final cohort included 934 IMRT patients and 237 SBRT patients. Our adjusted model showed the estimated total cost per patient was $20,130 for IMRT and $9,259 for SBRT (P < 0.01). Predictors of higher cost included residing in high-density areas, higher education levels, higher median household income, and earlier years of radiation treatment.</p><p><strong>Conclusion: </strong>SBRT has significantly lower radiation-specific costs compared to IMRT for intermediate-risk prostate cancer. Our findings support the adoption of SBRT for the treatment of localized prostate cancer to lower healthcare costs while maintaining quality prostate cancer care.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259244","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 and histological predictors of treatment outcomes in primary urethral carcinoma.","authors":"Betty Wang, Devika Nandwana, Laura E Davis, Sahab Ram Dewala, Can Aydogdu, Christopher J Weight, Samuel Haywood, Mohamed Eltemamy, Rebecca Campbell, Mohit Sindhani, Robert Abouassaly, Reza Alaghehbandan, Laura Bukavina","doi":"10.1016/j.urolonc.2025.09.003","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.09.003","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Primary urethral cancer (PUC) is a rare malignancy (<1% of all urological cancers). High-grade or advanced cases often require multimodal treatment, including surgery, chemotherapy, immunotherapy, and radiotherapy. This study reviews outcomes and predictors of recurrence and survival in PUC at our tertiary care center.</p><p><strong>Methods: </strong>We conducted a retrospective chart review at a single tertiary care institution, identifying 251 urethral cancer cases from January 1, 2014, to July 1, 2024. After excluding 163 cases due to non-PUC or insufficient follow-up, 88 cases remained. We collected data on demographics, tumor pathology, treatment modality, and oncologic outcomes. Primary outcomes included overall survival (OS) and recurrence-free survival (RFS). Cox regression was used to assess predictors of OS and RFS.</p><p><strong>Results: </strong>The cohort included 53 men (60%), with a median age of 64 years. Squamous cell carcinoma was most common (51%), followed by urothelial carcinoma (20%), adenocarcinoma (20%), and variant histology (8%). At presentation, 45% had locally advanced disease (T3/T4), 23% had nodal involvement, and 12% were metastatic. Treatment included surgery (82%), systemic therapy (40%), radiation (36%), and multimodal therapy (41%). Multivariable analysis showed that nonurothelial histology (HR = 8.09, P = 0.04) was associated with increased risk of recurrence, while nodal involvement (HR = 5.63, P < 0.01) predicted worse OS.</p><p><strong>Conclusion: </strong>In this large North American cohort, nodal involvement predicted worse survival, while nonurothelial histology was linked to shorter recurrence-free survival. These findings support multidisciplinary care and highlight the need for prospective registries in this rare malignancy.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252880","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":"Predicting recurrence after radical nephroureterectomy for upper tract urothelial carcinoma: Development and validation of the JIKEI-YAYOI score.","authors":"Yuya Iwamoto, Halle Foss, Yudai Ishiyama, Yuki Taneda, Hirokazu Kagawa, Naoki Uchida, Yuhei Koike, Shuhei Hara, Keiichiro Miyajima, Kosuke Iwatani, Yu Imai, Kojiro Tashiro, Shunsuke Tsuzuki, Jun Miki, Sounak Gupta, Stephen A Boorjian, Aaron Potretzke, Fumihiko Urabe, Takahiro Kimura","doi":"10.1016/j.urolonc.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.09.006","url":null,"abstract":"<p><strong>Background: </strong>Recent clinical trials have highlighted the benefits of adjuvant therapies for upper tract urothelial carcinoma (UTUC), although their application remains limited by patient-specific factors. This study aimed to develop a prognostic model to predict postoperative outcomes and identify patients who would benefit from adjuvant therapy.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 700 UTUC patients who underwent radical nephroureterectomy at Jikei University Hospital and its affiliated institutions (development cohort), and 405 patients treated at Mayo Clinic (validation cohort). Patients who received neoadjuvant or adjuvant chemotherapy were excluded. In the development cohort, clinical and pathological variables were analyzed to construct a risk prediction model for postoperative recurrence. Statistical analyses included Kaplan-Meier estimation, Cox proportional hazards regression, and internal validation using bootstrapping. The model was externally validated using data from the validation cohort.</p><p><strong>Results: </strong>The final model incorporated pT stage, pN stage, tumor grade, and lymphovascular invasion, resulting in the novel \"JIKEI-YAYOI\" risk score (range: 0-7). The model demonstrated excellent discrimination (C-index: 0.815) and calibration. Patients were stratified into low, intermediate, and high-risk groups, each with distinct recurrence-free survival rates. The JIKEI-YAYOI score provided accurate, individualized risk predictions, facilitating clinical decision-making regarding adjuvant therapy.</p><p><strong>Conclusion: </strong>The JIKEI-YAYOI score reliably predicts disease recurrence following radical surgery for UTUC, supporting personalized patient management and informed decisions about adjuvant therapy.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252816","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":"IsoPSA density improves risk stratification and biopsy decision-making for clinically significant prostate cancer.","authors":"Betty Wang, Tarik Benidir, Kristina Dortche, Jennifer Bullen, Zaeem Lone, Nour Abdallah, Martin Hofmann, Mohamed Eltemamy, Robert Abouassaly, Nima Almassi, Zeyad Schwen, Ruben Olivares, Andrei Purysko, Jane Nguyen, Georges-Pascal Haber, Jihad Kaouk, Eric Klein, Christopher J Weight, Alp Tuna Beksac","doi":"10.1016/j.urolonc.2025.09.001","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.09.001","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the diagnostic performance of IsoPSA density for detecting clinically significant prostate cancer (csCaP), and its utility in guiding biopsy decision-making.</p><p><strong>Materials and methods: </strong>We conducted a retrospective review of 574 patients who underwent IsoPSA testing, prostate MRI, and image-guided biopsy within 1 year. IsoPSA density was calculated as IsoPSA value divided by MRI-derived prostate volume. Multivariable logistic regression, receiver operating characteristic (ROC) analysis, and decision curve analysis were used to assess predictive value. Subgroup analyses were performed in patients with large prostates (>70 ml) and negative MRI (PI-RADS 1-2).</p><p><strong>Results: </strong>The overall prevalence of csCaP on biopsy was 33.8%. IsoPSA density was an independent predictor of csCaP and performed similarly to PSA density, while outperforming PSA and IsoPSA in ROC and decision curve analyses. In the full cohort, IsoPSA density achieved an AUC of 0.69 and demonstrated a high negative predictive value (NPV) of 79% at the optimal cutoff of 0.21. Among men with negative MRI (n = 238), an IsoPSA density threshold of 0.17 yielded an NPV of 97% and sensitivity of 85% for ruling out csCaP. In men with large prostates, higher IsoPSA density trended with increased csCaP risk, though not statistically significant.</p><p><strong>Conclusions: </strong>IsoPSA density performed comparably to PSA density and outperformed traditional clinical predictors of csCaP. In MRI-negative men, its high negative predictive value supports its use as a non-invasive tool to reduce unnecessary biopsies. IsoPSA density may serve as a valuable adjunct in contemporary prostate cancer diagnostic pathways and warrants further validation.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233637","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":"Differences in postoperative communication patterns among patients with limited English proficiency following radical cystectomy for bladder cancer.","authors":"Abby L Chen, Chiyuan A Zhang, John Ogunkeye, Tianjia Jessie Ge, Nathan Nguyen, Eugene Shkolyar, Alan E Thong, John T Leppert, Harcharan S Gill, Jay B Shah, Eila Skinner, Kris B Prado","doi":"10.1016/j.urolonc.2025.08.027","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.08.027","url":null,"abstract":"<p><strong>Introduction: </strong>Consistent urologic oncology follow-up after radical cystectomy (RC) improves survival. However, there is scarce literature describing postoperative communication. We aimed to identify differences in postoperative communication patterns and healthcare utilization among English-speaking patients (ESPs) and patients with limited English proficiency (LEP) following RC.</p><p><strong>Methods: </strong>We conducted a single-institution, retrospective cohort study, examining patients who underwent RC for bladder cancer. We used propensity score matching to match 50 ESPs and 50 patients with LEP on age and sex. We abstracted patient demographics, postoperative communication and healthcare utilization within 90 days of surgery. We fit multivariable linear regression to investigate factors associated with postoperative communication frequency.</p><p><strong>Results: </strong>Postoperative communication was common, with 82% of patients placing ≥1 phone call/message. ESPs communicated more than patients with LEP (6.04 vs. 3.80 average calls/messages), though this difference was not statistically significant (P = 0.08). ESPs were more likely to initiate the communication themselves and have postoperative communication result in reassurance from the surgical team (P = 0.03), while patients with LEP were more likely to have a family member communicate on their behalf (P < 0.001) and have postoperative communication result in outpatient evaluation/treatment (P = 0.01). Patients with a neobladder reconstruction placed an increased number of phone calls/messages. There were no differences in postoperative healthcare utilization between the 2 groups.</p><p><strong>Conclusions: </strong>Postoperative communication is frequent following RC. ESPs communicated nearly twice as often as patients with LEP, suggesting a clinically relevant difference in patient communication following radical cystectomy. Primary language spoken is not associated with differences in postoperative healthcare utilization.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228645","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":"Cover 2 - Masthead","authors":"","doi":"10.1016/S1078-1439(25)00371-0","DOIUrl":"10.1016/S1078-1439(25)00371-0","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 11","pages":"Page IFC"},"PeriodicalIF":2.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190107","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":"PTTG1-mediated reprogramming of asparagine metabolism enhances DNA damage repair and leads to compromised antitumor immunity in prostate cancer.","authors":"Kuo Ma, Zeyu Li, Chunfeng Zhang, Guangye Han, Weihang Song, Lei Li","doi":"10.1016/j.urolonc.2025.09.005","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.09.005","url":null,"abstract":"<p><strong>Background: </strong>CD8⁺T cell dysfunction is a key factor in immune escape of prostate cancer (PCa). While pituitary tumor-transforming gene 1 (PTTG1) exhibits oncogenic effects in multiple cancers, its role in PCa immunoregulation remains unclear.</p><p><strong>Methods: </strong>Bioinformatics analysis of TCGA data evaluated PTTG1 expression, prognosis, and CD8⁺T cell infiltration. qRT-PCR and western blot (WB) assessed PTTG1 levels in PCa cells. CD8⁺T cell cytotoxicity was measured via LDH release and ELISA (GZMB/TNF-α/IFN-γ). DNA damage was quantified by comet assay and γ-H2AX immunofluorescence. The metabolism of asparagine (Asn) was evaluated by detecting the content of Asn through a kit and the expression of asparagine synthase (ASNS) through WB. A mouse model of allograft tumor was constructed, and the mechanism was verified by immunohistochemistry (PTTG1, ASNS, γ-H2AX, KI67) and flow cytometry detection (proportion of CD8⁺T cells).</p><p><strong>Results: </strong>Bioinformatics analysis revealed that PTTG1 was highly expressed in PCa, positively correlated with the poor prognosis of patients, and negatively correlated with CD8⁺T cell infiltration. Cell experiments further demonstrated that PTTG1 inhibited the killing effect of CD8⁺T cells on PCa cells. In addition, in vitro and in vivo experiments showed that PTTG1 promoted DNA damage repair (DDR) of PCa by reprogramming Asn, and targeting PTTG1 enhanced the anti-tumor activity of CD8⁺T cells.</p><p><strong>Conclusion: </strong>PTTG1 promotes DDR by reprogramming Asn metabolism, thereby inhibiting the function of CD8⁺T cells. Targeting PTTG1 can reverse this process, providing a new strategy for PCa immunotherapy.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207724","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":"Commentary on: “Adjuvant vs. salvage radiotherapy in men with pathologically node-positive prostate cancer after radical prostatectomy”","authors":"Saketh Sainag Mandiga M.B.B.S. ,&nbsp;Venkata Dileep Kumar Veldi M.B.B.S. ,&nbsp;Digvijay Singh Rajawat M.B.B.S.","doi":"10.1016/j.urolonc.2025.06.011","DOIUrl":"10.1016/j.urolonc.2025.06.011","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 11","pages":"Pages 657-658"},"PeriodicalIF":2.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189877","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}