Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Understanding the microbiome as a mediator of bladder cancer progression and therapeutic response.","authors":"Mahgol Golshani, John A Taylor, Benjamin L Woolbright","doi":"10.1016/j.urolonc.2024.07.004","DOIUrl":"https://doi.org/10.1016/j.urolonc.2024.07.004","url":null,"abstract":"<p><p>Bladder cancer (BCa) remains a significant source of morbidity and mortality. BCa is one of the most expensive tumors to treat, in part because of a lack of nonsurgical options. The recent advent of immunotherapy, alone or in combination with other compounds, has improved therapeutic options. Resistance to immunotherapy remains common, and many patients do not have durable response. Recent advances indicate immunotherapy efficacy may be tied in part to the endogenous bacteria present in our body, more commonly referred to as the microbiome. Laboratory and clinical data now support the idea that a healthy microbiome is critical to effective response to immunotherapy. At the same time, pathogenic interactions between the microbiome and immune cells can also serve to drive formation of tumors, increasing the complexity of these interactions. Given the rising importance of immunotherapy in BCa, understanding how we might be able to alter the microbiome to improve therapeutic efficacy offers a novel route to improved patient care. The goal of this review is to examine our current understanding of microbial interactions with the immune system and cancer with an emphasis on BCa. We will further attempt to define both current gaps in knowledge and future directions that may yield beneficial results to the field.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907788","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 impact of bladder cuff excision on outcomes after nephroureterectomy for upper tract urothelial carcinoma: An analysis of the ROBUUST 2.0 registry","authors":"Courtney Yong M.D. ,&nbsp;James E. Slaven M.S. ,&nbsp;Zhenjie Wu M.D., Ph.D. ,&nbsp;Vitaly Margulis M.D. ,&nbsp;Hooman Djaladat M.D., M.S. ,&nbsp;Alessandro Antonelli M.D. ,&nbsp;Giuseppe Simone M.D., Ph.D. ,&nbsp;Raj Bhanvadia M.D. ,&nbsp;Alireza Ghoreifi M.D. ,&nbsp;Farshad Sheybaee Moghaddam M.D. ,&nbsp;Francesco Ditonno M.D. ,&nbsp;Gabriele Tuderti M.D., Ph.D. ,&nbsp;Stephan Bronimann M.D. ,&nbsp;Sohail Dhanji M.D. ,&nbsp;Benjamin Eilender M.D. ,&nbsp;Antonio Franco M.D. ,&nbsp;Marco Finati M.D. ,&nbsp;Marco Tozzi M.D. ,&nbsp;Emma Helstrom B.S. ,&nbsp;Dinno F. Mendiola M.D. ,&nbsp;Chandru P. Sundaram M.D.","doi":"10.1016/j.urolonc.2024.06.001","DOIUrl":"10.1016/j.urolonc.2024.06.001","url":null,"abstract":"<div><h3>Objectives</h3><p>We sought to determine whether bladder cuff excision and its technique influence outcomes after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC).</p></div><div><h3>Methods and materials</h3><p>A multicenter, international, retrospective analysis using the ROBotic surgery for Upper tract Urothelial cancer Study (ROBUUST) 2.0 registry identified 1,718 patients undergoing RNU for UTUC between 2015 and 2023 at 17 centers across the United States, Europe, and Asia. Data was gathered on (1) whether bladder cuff excision was performed and (2) what technique was used, including formal excision or other techniques (pluck technique, stripping/intussusception technique) and outcomes. Multivariate and survival analyses were performed to compare the groups.</p></div><div><h3>Results</h3><p>Most patients (90%, 1,540/1,718) underwent formal bladder cuff excision in accordance with EAU and AUA guidelines. Only 4% (68/1,718) underwent resection using other techniques, and 6% (110/1,718) did not have a bladder cuff excised. Median follow up for the cohort was 24 months (IQR 9–44). When comparing formal bladder cuff excision to other excision techniques, there were no differences in oncologic or survival outcomes including bladder recurrence-free survival (BRFS), recurrence-free survival (RFS), metastasis-free survival (MFS), overall survival (OS), or cancer-specific survival (CSS). However, excision of any kind conferred a decreased risk of bladder-specific recurrence compared to no excision. There was no difference in RFS, MFS, OS, or CSS when comparing bladder cuff excision, other techniques, and no excision.</p></div><div><h3>Conclusions</h3><p>Bladder cuff excision improves recurrence-free survival, particularly when considering bladder recurrence. This benefit is conferred regardless of technique, as long as the intramural ureter and ureteral orifice are excised. However, the benefit of bladder cuff excision on metastasis-free, overall, and cancer-specific survival is unclear.</p></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"42 11","pages":"Pages 373.e1-373.e7"},"PeriodicalIF":2.4,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903033","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":"Novel therapeutic regimens in previously untreated metastatic urothelial carcinoma: A systematic review and bayesian network meta-analysis","authors":"David E. Hinojosa-Gonzalez ,&nbsp;Gal Saffati ,&nbsp;Gustavo Salgado-Garza ,&nbsp;Sagar Patel ,&nbsp;Shane Kronstedt ,&nbsp;Jeffrey A. Jones ,&nbsp;Jennifer M. Taylor ,&nbsp;Aihua E. Yen ,&nbsp;Jeremy R. Slawin","doi":"10.1016/j.urolonc.2024.07.006","DOIUrl":"10.1016/j.urolonc.2024.07.006","url":null,"abstract":"<div><p>Metastatic urothelial carcinoma (muC) has historically had few effective therapeutic options. Recently, immune checkpoint inhibitors (ICIs), were introduced as therapeutic options for cisplatin-ineligible patients, however, direct head-to-head trials comparing these treatments are lacking. To address this gap, this study employs a Bayesian framework to indirectly compare the performance of ICIs as first-line agents for muC. A systematic review was performed to identify randomized controlled trials evaluating different ICI for mUC. Data was inputted into Review Manager 5.4 for pairwise meta-analysis. Data was then used to build a network in R Studio. These networks were used to model 200,000 Markov Chains via MonteCarlo sampling. The results are expressed as hazard ratios (HR) with 95% credible intervals (CrI). Six studies with 5,449 patients were included, 3,255 received ICI monotherapy or combination. Moreover, a total of 3,006 had PD-L1 positive tumors and 2,362 were PD-L1 negative. Median overall survival (OS) ranged from 12.1 to 31.5 months across the studies, with the combination of enfortumab vedotin and pembrolizumab demonstrating the most substantial reduction in the risk of death (HR 0.47 [95% CrI: 0.38, 0.58]), followed by avelumab monotherapy (HR 0.69 [95% CrI: 0.56, 0.86]). The limitations of this network meta-analysis include variability in study follow-up duration, lack of standardized methods for assessing PD-L1 positivity, and potential bias introduced by control arms with poorer survival outcomes across included trials. The enfortumab vedotin/pembrolizumab combination significantly improved survival and response rates. Avelumab showed notable single-agent activity. These findings provide a valuable framework to guide clinical decision-making and highlight priority areas for future research, including biomarker refinement and novel combination strategies to enhance antitumor immunity in this challenging malignancy.</p></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"42 11","pages":"Pages 361-369"},"PeriodicalIF":2.4,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903032","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":"Influence of radical prostatectomy on miRNA dynamics in urine extracellular vesicles","authors":"E.V. Shutko B.Sc. ,&nbsp;O.E. Bryzgunova Ph.D. ,&nbsp;E.A Murina M.Sc. ,&nbsp;I.A. Ostaltcev M.B.B.S. ,&nbsp;S.E. Krasilnikov M.D. ,&nbsp;P.P. Laktionov Ph.D. ,&nbsp;M.Y. Konoshenko Ph.D.","doi":"10.1016/j.urolonc.2024.06.017","DOIUrl":"10.1016/j.urolonc.2024.06.017","url":null,"abstract":"<div><h3>Purpose</h3><p>Cancer statistics demonstrate leading growth of prostate cancer. As a rule, radical prostatectomy (RP) is a mandatory option in the treatment of localized prostate cancer (PCa). Over 30% of patients develop biochemical resistance after the surgery and over 30% of these patients experience prostate cancer recurrence and metastasis. Currently used PCa patient's diagnostic features fail to identify PCa recurrence. To identify the risk group of PCa patients after RP we attempt to apply miRNAs which were shown as promising liquid biopsy markers for PCa diagnosis and prognosis.</p></div><div><h3>Materials and methods</h3><p>Expression of 14 miRNAs closely involved in the development of prostate cancer from urine extracellular vesicles (uEV) of PCa patients before as well as 3, 6 and 12 months after radical prostatectomy was assessed using RT PCR and compared with their expression from uEV of healthy donors in the current study.</p></div><div><h3>Results</h3><p>It was shown that 22 miRNA pairs prognostic ratios (MPPRs) significantly changed after radical prostatectomy. MPPRs the most promising in terms of evaluating the effectiveness of radical prostatectomy have been identified. These include two groups: MPPRs significantly changed after surgery towards that in healthy donors; and MPPRs, which divided PCa patients into two significantly different subgroups 3 or 6 months after radical prostatectomy.</p></div><div><h3>Conclusions</h3><p>The obtained data indicate that urine EVs represent a valuable source of both MPDR and MPPR for prostate cancer.</p></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"42 11","pages":"Pages 371.e19-371.e30"},"PeriodicalIF":2.4,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898358","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 ‘MiR-486-5p enhances cisplatin sensitivity of human muscle-invasive bladder cancer cells by induction of apoptosis and down-regulation of metastatic genes. Urol Oncol 2020:38:738.e9–738.e21’","authors":"Jafar Salimian Ph.D. ,&nbsp;Behzad Baradaran Ph.D. ,&nbsp;Sadegh Azimzadeh Jamalkandi Ph.D. ,&nbsp;Abdollah Moridikia M.S. ,&nbsp;Ali Ahmadi Ph.D.","doi":"10.1016/j.urolonc.2024.07.005","DOIUrl":"10.1016/j.urolonc.2024.07.005","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"42 11","pages":"Pages 376-377"},"PeriodicalIF":2.4,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S107814392400543X/pdfft?md5=b4b978bfdab72afe768e9fe9ad9f1b8d&pid=1-s2.0-S107814392400543X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890227","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":"68Ga-PSMA PET/CT and 18F-FDG PET/CT in the diagnosis of prostatic ductal cancer","authors":"Haijun Huang ,&nbsp;Sijuan Zou ,&nbsp;Jie Wan ,&nbsp;Xing Zeng ,&nbsp;Shaogang Wang ,&nbsp;Zhiquan Hu ,&nbsp;Xiaohua Zhu ,&nbsp;Chunguang Yang","doi":"10.1016/j.urolonc.2024.07.011","DOIUrl":"10.1016/j.urolonc.2024.07.011","url":null,"abstract":"<div><h3>Purposes</h3><div>To explore the characteristics of PSMA PET/CT and FDG PET/CT images in prostatic ductal adenocarcinoma (DA) patients.</div></div><div><h3>Methods</h3><div>We retrospectively enrolled prostatic DA patients with PET/CT scans at Tongji Hospital from 2018 to 2022. Patients with prostatic acinar adenocarcinoma (AA) and benign pathology (BP) were enrolled by 1:1 matching. Differences in the uptake of primary and metastatic foci on PET among the groups were analyzed.</div></div><div><h3>Results</h3><div>A total of 42 patients were enrolled: 14 in each group. In primary foci, the mean PSMA uptake in the DA group was lower than that in the AA group (14.2 ± 9.6 vs. 27.1 ± 14.3, <em>P</em> = 0.009) and greater than that in the BP group (14.2 ± 9.6 vs. 4.7 ± 1.3, <em>P</em> = 0.003). The AUCs of the DA-AA ROC curve and DA-BP ROC curve were 0.781 and 0.872, respectively. The median PSMA uptake of metastatic lymph nodes in the DA group was lower than that in the AA group (5.6 vs. 14.2, <em>P</em> = 0.033), with no significant difference in metastatic bone lesions (9.5 vs 19.1, <em>P</em> = 0.485). No significant difference was found in the FDG uptake of primary and metastatic foci between the DA and AA groups (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Prostatic DA has greater PSMA uptake than BP diseases, but lower uptake in both primary foci and metastatic lymph nodes than AA on PSMA PET/CT, aiding in the differential diagnosis of DA, AA and BP diseases. Clinicians should combine traditional imaging with PSMA PET/CT to avoid underestimating the clinical stage of DA patients.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"42 12","pages":"Pages 448.e9-448.e16"},"PeriodicalIF":2.4,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890226","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 time to metastatic disease onset and extent of disease volume across metastatic hormone-sensitive and castration-resistant prostate cancer","authors":"Mike Wenzel M.D., B.Sc. ,&nbsp;Benedikt Hoeh M.D. ,&nbsp;Philipp Kopf M.D. ,&nbsp;Carolin Siech M.D. ,&nbsp;Clara Humke M.D. ,&nbsp;Christoph Würnschimmel M.D. ,&nbsp;Thomas Steuber M.D., Ph.D. ,&nbsp;Markus Graefen M.D., Ph.D. ,&nbsp;Felix Preisser M.D., Ph.D. ,&nbsp;Miriam Traumann M.D. ,&nbsp;Séverine Banek M.D. ,&nbsp;Luis A. Kluth M.D., Ph.D. ,&nbsp;Felix KH. Chun M.D., Ph.D. ,&nbsp;Philipp Mandel M.D., Ph.D.","doi":"10.1016/j.urolonc.2024.06.016","DOIUrl":"10.1016/j.urolonc.2024.06.016","url":null,"abstract":"<div><h3>Objective</h3><p>In recently published phase III trials, overall survival (OS) differences were demonstrated in patients with secondary vs. De Novo and low vs. high volume metastatic hormone-sensitive prostate cancer (mHSPC). We hypothesized that these factors may also be attributable in real-world setting of new intensified combination therapies and in metastatic castration resistant prostate cancer (mCRPC) patients.</p></div><div><h3>Materials and methods</h3><p>We relied on an institutional tertiary-care database to identify mHSPC and subsequent mCRPC patients. The main outcome consisted of time to mCRPC and OS. Patients were stratified according to De Novo vs. secondary and low vs. high volume mHSPC and mCRPC, respectively.</p></div><div><h3>Results</h3><p>Of 504 mHSPC patients, 371 (73.6%) were De Novo vs. 133 (26.4%) secondary mHSPC. Patients with De Novo and high volume mHSPC harbored shorter time to mCRPC and OS than secondary and low volume mHSPC patients (both <em>P</em> &lt; 0.01). After stratification regarding disease volume, median time to mCRPC differed significantly between De Novo high volume (DNHV) vs. De Novo low volume (DNLV) vs. secondary high volume (SecHV) vs. secondary low volume mHSPC patients (SecLV, <em>P</em> &lt; 0.001). Similarly in OS analyses, median OS was 44 vs. 53 vs. 88 vs. 120 months for respectively DNHV vs. SecHV vs. SecLV vs. DNLV mHSPC (<em>P</em> &lt; 0.001). After progression to mCRPC, the effect of onset of metastatic disease and metastatic volume was still observed (all <em>P</em> &lt; 0.01).</p></div><div><h3>Conclusion</h3><p>Patients with DNHV mHSPC harbor worse prognosis in a real world setting and in the light of combination therapies. This effect is also discernible in the context of mCRPC.</p></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"42 11","pages":"Pages 371.e11-371.e18"},"PeriodicalIF":2.4,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S107814392400526X/pdfft?md5=6bb4bb52f16e02360c5ffeb902f9e2a1&pid=1-s2.0-S107814392400526X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890228","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":"Opioid prescription following radical orchiectomy associated with new persistent opioid use","authors":"Muhannad Alsyouf M.D. ,&nbsp;Ala'a Farkouh M.D. ,&nbsp;Erika L. Wood M.D. ,&nbsp;Alireza Ghoreifi M.D. ,&nbsp;Antoin Douglawi M.D. ,&nbsp;Martin Hofmann M.D. ,&nbsp;Brian Hu M.D. ,&nbsp;Anne Schuckman M.D. ,&nbsp;Hooman Djaladat M.D. ,&nbsp;Siamak Daneshmand M.D.","doi":"10.1016/j.urolonc.2024.06.019","DOIUrl":"10.1016/j.urolonc.2024.06.019","url":null,"abstract":"<div><h3>Introduction</h3><p>Opioid dependence represents a public health crisis and can be observed after outpatient urologic procedures. The purpose of this study was to evaluate the risk of persistent opioid usage after radical orchiectomy for testicular cancer.</p></div><div><h3>Materials and methods</h3><p>The TriNetX Research network database was queried for men between 15 and 45 years undergoing radical orchiectomy for a diagnosis of testicular cancer. All patients with N+ or M+ disease, prior opioid use, and patients who underwent chemotherapy, radiotherapy, or retroperitoneal lymph node dissection were excluded. Patients were stratified whether they were prescribed opioids or not at time of orchiectomy. The incidence of new, persistent opioid use, defined as a prescription for opioids between 3 and 15 months after orchiectomy, was evaluated.</p></div><div><h3>Results</h3><p>A total of 2,911 men underwent radical orchiectomy for testicular cancer, of which 89.8% were prescribed opioids at time of orchiectomy. After propensity score matching for age, race, and history of psychiatric diagnosis, 592 patients were included (296 received opioids, 296 did not). Overall, 0% of patients who did not receive postoperative opioids developed new persistent opioid use, whereas 10.5% of patients who received postoperative opioids developed new persistent opioid use. Patients prescribed postoperative opioids for orchiectomy had statistically higher risk difference of developing new persistent opioid use (Risk Difference: 10.5%; 95% CI: 7.0-14.0; Z: 5.7; <em>P</em> &lt; 0.01).</p></div><div><h3>Conclusions</h3><p>Postoperative opioid prescription following radical orchiectomy is significantly associated with developing new persistent opioid use, with 1 in 10 young men who received postoperative opioids obtaining a new prescription for opioids well beyond the postoperative period. Future efforts should emphasize nonopioid pathways for pain control following this generally minor procedure.</p></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"42 11","pages":"Pages 375.e15-375.e21"},"PeriodicalIF":2.4,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890229","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 gut microbiome and dietary metabolites in the treatment of renal cell carcinoma.","authors":"Miguel Zugman, Megan Wong, Salvador Jaime-Casas, Sumanta K Pal","doi":"10.1016/j.urolonc.2024.07.003","DOIUrl":"https://doi.org/10.1016/j.urolonc.2024.07.003","url":null,"abstract":"<p><p>The gut microbiome is interlinked with renal cell carcinoma (RCC) and its response to systemic treatment. Mounting data suggests that certain elements of the gut microbiome may correlate with improved outcomes. New generation sequencing techniques and advanced bioinformatic data curation are accelerating the investigation of specific markers and metabolites that could predict treatment response. A variety of new therapeutic strategies, such as fecal microbiota transplantation, probiotic supplements, and dietary interventions, are currently being developed to modify the gut microbiome and improve anticancer therapies in patients with RCC. This review discusses the preliminary evidence indicating the role of the microbiome in cancer treatment, the techniques and tools necessary for its proper study and some of the current forms with which the microbiome can be modulated to improve patient outcomes.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879473","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":"Prognostic and predictive value of tertiary lymphoid structures in TURBT materials: Should it be seated in the routine pathological examination, and can it be used in deciding on the treatment method?","authors":"Fatih Yilmaz M.D. ,&nbsp;Suleyman Sagir M.D.","doi":"10.1016/j.urolonc.2024.06.010","DOIUrl":"10.1016/j.urolonc.2024.06.010","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to reveal the importance of tertiary lymphoid structures (TLS) in transurethral resection of bladder tumor (TURBT) materials with a practical and applicable method in which the effect of a certain threshold value on survival and treatment response can be implicated.</div></div><div><h3>Methods</h3><div>TURBT materials that had not previously received any treatment (chemotherapy, radiotherapy, or immunotherapy) and were diagnosed for the first time at Mardin Training and Research Hospital between 2014 and 2022 were included in the study. The maximum TLS per 4× magnification field (field diameter: 4.5 mm) was recorded. Grouping and statistical analysis of the TLS number were performed using threshold values of “≥1”, “≥2”, and “≥3”.</div></div><div><h3>Results</h3><div>TLSs were more frequently found in high-grade tumors (<em>P</em> = 0.008) and showed a strong association with stage progression (<em>P</em> &lt; 0.001). It was also significantly associated with many adverse histopathological parameters. Conversely, high TLS (≥1, ≥2, and ≥3) appeared to be associated with fewer recurrences (<em>P</em> = 0.032, <em>P</em> = 0.001, and <em>P</em> = 0.018, respectively), and cases with higher TLS showed longer recurrence-free survival (<em>P</em> = 0.089, <em>P</em> = 0.023, <em>P</em> = 0.037, respectively). TLS≥3 was found to be an independent parameter that was associated with favorable RFS (<em>P</em> = 0.019, HR = 0.401), and multifocality was found to be an independent risk factor for RFS (<em>P</em> = 0.023, HR = 2.302).</div></div><div><h3>Conclusion</h3><div>This study is the first to demonstrate the relationship between the presence and specific thresholds of TLS in TURBT materials with prognostic parameters. Including this information in the routine pathological examination of TURBT materials will allow a more accurate approach to treatment and follow-up, especially in patients with non-muscle invasive bladder cancer (NMIBC).</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"42 12","pages":"Pages 450.e13-450.e22"},"PeriodicalIF":2.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876069","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}