Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Cover 2 - Masthead","authors":"","doi":"10.1016/S1078-1439(25)00230-3","DOIUrl":"10.1016/S1078-1439(25)00230-3","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 8","pages":"Page IFC"},"PeriodicalIF":2.4,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580331","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":"Tumor profiling of advanced urothelial carcinoma: Comparative analysis based on social determinants of health","authors":"Lacey J. Hart MD ,&nbsp;Kenny Barker MD ,&nbsp;Denis Ruzdija MD ,&nbsp;Aaron Bertolo MD ,&nbsp;Irasema Concepcion Paster DO ,&nbsp;Ricardo J. Estrada-Mendizabal MD ,&nbsp;Jose Manuel Guillen MPH ,&nbsp;Alejandro Recio-Boiles MD, FACP ,&nbsp;Juan Chipollini MD, FACS","doi":"10.1016/j.urolonc.2025.06.008","DOIUrl":"10.1016/j.urolonc.2025.06.008","url":null,"abstract":"<div><h3>Background</h3><div>Studies on the genomic characteristics of urothelial carcinoma (UC) patients from diverse backgrounds are scarce. Herein, we sought to characterize genomic landscapes of advanced UC in a regional representative cohort to examine the possibility that patients from different backgrounds may have socioeconomic-influenced molecular changes.</div></div><div><h3>Methods</h3><div>We retrospectively evaluated clinical and genomic findings of UC patients presenting to the University of Arizona Cancer Center (Tucson, AZ) from 2016 to 2023. Molecular profiles were obtained using DNA next-generation sequencing (Caris Life Sciences) and stratified based on Area Deprivation Index (ADI) collected from each patient residential address. Patients were categorized as living in low (1–49) or high (50–100) ADI residences, with increasing scores indicating higher socioeconomic disadvantage.</div></div><div><h3>Results</h3><div>Among 97 patients, 43 resided in low ADI areas and 54 in high ADI areas. Higher Hispanic ethnicity (<em>P</em> = 0.011) and lower mean household income (<em>P</em> &lt; 0.001) were seen in high ADI areas. There were no differences in microsatellite instability, loss of heterozygosity or PD-L1 expression. Patients from high ADI neighborhoods had lower TMB scores (62.7 % vs. 51.3%) when compared to low ADI neighborhoods (<em>P</em> = 0.291). The genes with higher rates of alterations when comparing low vs high ADI areas were PIK3CA (20.9% vs. 16.7%, <em>P</em> = 0.610), TP53 (62.8% vs. 40.7%, <em>P</em> = 0.041), KDM (18.6% vs. 22.2%, <em>P</em> = 0.802), ARID1A (20.9% vs. 25.9%, <em>P</em> = 0.636), and TERT (41.9% vs. 35.2%, <em>P</em> = 0.674). A high rate of immunotherapy use (66.7%) and clinic trial enrollment (73.3%) was noted in high ADI patients. There were no overall survival differences between the groups.</div></div><div><h3>Conclusion</h3><div>Few genomic differences were seen based on socioeconomic status. Lower rates of TP53 alterations and low TMB were seen in patients from disadvantaged neighborhoods. Neighborhood-level factors potentially leading to cancer disparities warrant investigation.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 10","pages":"Pages 596.e1-596.e7"},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601667","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":"Survival outcomes for men with metastatic castration-resistant prostate cancer (mCRPC) with and without homologous recombination deficiencies (HRD) treated with radium 223: Princess Margaret Cancer Centre (PMCC) experience","authors":"Esmail M. Al-Ezzi ,&nbsp;Osama Abdeljalil ,&nbsp;Katherine Lajkosz ,&nbsp;Shreya S. Gramolini ,&nbsp;Husam Alqaisi ,&nbsp;Jenny Peng ,&nbsp;Richard Odwyer ,&nbsp;Mohammed Alghamdi ,&nbsp;Sulaiman Almuthri ,&nbsp;Vikaash Kumar ,&nbsp;Di Maria Jiang ,&nbsp;Nazanin Fallah-Rad ,&nbsp;Neil Fleshner ,&nbsp;Srikala S. Sridhar","doi":"10.1016/j.urolonc.2025.06.004","DOIUrl":"10.1016/j.urolonc.2025.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Radium-223 (²²³<span>Ra) targets bone metastases in metastatic castration resistant prostate cancer (mCRPC) and induces double-strand DNA breaks. We hypothesized that patients with homologous recombination deficiencies (HRD) may exhibit heightened sensitivity to </span>²²³Ra, resulting in improved survival outcomes.</div></div><div><h3>Methods</h3><div><span>This retrospective analysis was performed in men with mCRPC and bone metastases, with and without HRD, treated with androgen deprivation therapy (ADT) and </span>²²³Ra at the PMCC. Demographics, disease characteristics, and/or somatic DNA sequencing data were collected.</div></div><div><h3>Results</h3><div>Between 2015 and 2022, we identified 40 mCRPC patients who underwent ²²³Ra therapy and had germline and/or somatic DNA sequencing data available. HRD mutations were found in 9/40 (22.5%) patients. Median overall survival was longer in the HRD group vs. non-HRD group (24 vs 12 months; <em>p</em> = 0.038). Median progression-free survival was 5.7 vs. 3.3 months (<em>P</em> = 0.74). PSA response was also higher in the HRD group (33.3% vs. 9.7%; <em>P</em> = 0.11), as was ALP response (66.7% vs. 58.1%; <em>p</em> = 0.72). Among patients with an ALP response, 3-year survival probability was 33% in the HRD group vs 11% in the non-HRD group (<em>P</em> = 0.03).</div></div><div><h3>Conclusions</h3><div>Despite the small size, these findings suggest that patient with HRD may have a slight improvement in survival outcomes after ²²³Ra treatment, but prospective validation is required.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 11","pages":"Pages 665.e1-665.e10"},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601666","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":"National trends in diagnoses of subtype histologies in bladder cancer: A population-based study based on the SEER database","authors":"Brendan K. Wallace M.D. ,&nbsp;Zhuo Tony Su M.D. ,&nbsp;James P. Flynn B.S. ,&nbsp;Tyler S. Garman M.D. ,&nbsp;Aidan Weitzner B.S. ,&nbsp;Michael E. Rezaee M.D., M.P.H. ,&nbsp;Ezra G. Baraban M.D. ,&nbsp;Andres Matoso M.D. ,&nbsp;Armine K. Smith M.D. ,&nbsp;Sunil H. Patel M.D., M.A. ,&nbsp;Max R. Kates M.D.","doi":"10.1016/j.urolonc.2025.06.010","DOIUrl":"10.1016/j.urolonc.2025.06.010","url":null,"abstract":"<div><h3>Objective</h3><div>Accurate diagnosis of histological subtypes is critical to inform optimal clinical management of patients with bladder cancer. However, the diagnosis of histological subtypes remains a challenge and significant interobserver variability persists. We analyzed temporal trends in the diagnosis of histological subtypes in bladder cancer in the US.</div></div><div><h3>Methods</h3><div>Utilizing the Surveillance, Epidemiology, and End Results (SEER) 17 registry, we evaluated squamous cell carcinoma (SCC), adenocarcinoma (AC), neuroendocrine carcinoma (NC), and other histological subtypes including micropapillary, sarcomatoid, and plasmacytoid variants, diagnosed in cystectomy specimens for patients with pT2-4 primary bladder carcinoma during 2000-2020. We performed Spearman's rank-order correlation to assess temporal trends in the proportions of patients diagnosed with each histology category. We divided the 21-year analysis period into seven 3-year intervals and aggregated data over each interval to improve the precision of proportion estimates. We conducted multivariable logistic regression to adjust for covariates.</div></div><div><h3>Results</h3><div>We identified 28,160 patients. In unadjusted analysis, the proportion of patients diagnosed with SCC decreased significantly over time (<em>ρ</em> -0.86, <em>P</em> = 0.02). The proportion diagnosed with other histological subtypes increased significantly over time (<em>ρ</em> 1.00, <em>P</em> = 0.001). After adjusting for covariates, a later year of diagnosis was associated with significantly increased odds of NC (OR 1.07, <em>P</em> <em>=</em> 0.001) and other histological subtype diagnoses (OR 1.16, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Variant histological subtypes of muscle-invasive bladder cancer in cystectomy specimens from patients in the US have increased over time. These trends could reflect increasing awareness of histological subtypes among pathologists.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 10","pages":"Pages 596.e9-596.e13"},"PeriodicalIF":2.3,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567879","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":"Age-related differences in unmet needs and their predictors among adults with bladder cancer","authors":"Danielle Scharp Ph.D., APRN, FNP-BC ,&nbsp;Tung-Ming Leung Ph.D. ,&nbsp;Bente Thoft Jensen Ph.D., RN ,&nbsp;Susanne Vahr Lauridsen Ph.D., RN ,&nbsp;Dhruti Patel M.D. ,&nbsp;Randy A. Jones Ph.D., RN, FADLN, FAAN ,&nbsp;Natasha Kyprianou Ph.D. ,&nbsp;Nihal Mohamed Ph.D.","doi":"10.1016/j.urolonc.2025.06.007","DOIUrl":"10.1016/j.urolonc.2025.06.007","url":null,"abstract":"<div><h3>Background</h3><div>Bladder cancer disproportionately affects older adults, making addressing age-specific unmet needs essential. Understanding how sociodemographic, clinical, and personal/social resource factors influence unmet needs can help clinicians deliver tailored interventions to improve outcomes.</div></div><div><h3>Objectives</h3><div>(1) Examine differences in unmet needs for patients aged &lt;65 and ≥65, and (2) determine sociodemographic, clinical, and personal/social resource factors associated with unmet needs for patients aged &lt;65 and ≥65.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study of survey data for adults aged 18 to 85 from the Bladder Cancer Advocacy Network. Unmet needs were identified a priori (psychological, health system and information, physical/daily living, patient care/support, sexuality, logistics, communication with a spouse/partner, and communication with clinicians) and assessed using the Bladder Cancer Needs Assessment Scale-32. Univariate analyses and backward model selection were used to identify sociodemographic, clinical, and personal/social resource variables associated with unmet needs for patients &lt;65 and ≥65.</div></div><div><h3>Results</h3><div>Overall, 155 patients with bladder cancer were included. Patients &lt;65 had more psychological, patient care and support, sexuality, and communication with spouse/partner unmet needs, while patients ≥65 had more health system and information unmet needs. Multivariable analyses revealed significant differences in associations between unmet needs and social support, self-efficacy, and maladaptive coping for each distinct age group. Differences in unmet needs by patient sex emerged, with women experiencing more unmet needs than men in the older group.</div></div><div><h3>Conclusion</h3><div>Findings underscore the need for tailored supportive care strategies accounting for how age, patient sex, and personal/social resources may impact unmet needs to improve bladder cancer care and outcomes.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 10","pages":"Pages 595.e13-595.e24"},"PeriodicalIF":2.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565274","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":"Vigorous physical activity as a potential environmental risk factor in renal medullary carcinoma","authors":"Daniel D. Shapiro M.D., F.A.C.S. ,&nbsp;Sagar S. Mukhida M.P.H. ,&nbsp;Andrew W. Hahn M.D. ,&nbsp;Ayman Isahaku B.S. ,&nbsp;Schyler M. Turner B.S. ,&nbsp;Jessica P. Cheng M.S.N., R.N. ,&nbsp;Pankaj K. Chauhan Ph.D. ,&nbsp;Susan S. Thomas B.S.N., R.N. ,&nbsp;Beei Chan M.S.N., R.N. ,&nbsp;Zita D. Lim P.A. ,&nbsp;Nizar M. Tannir M.D., F.A.C.P. ,&nbsp;Maria Chang Swartz Ph.D., M.P.H., R.D.N., L.D. ,&nbsp;Pavlos Msaouel M.D., Ph.D.","doi":"10.1016/j.urolonc.2025.06.012","DOIUrl":"10.1016/j.urolonc.2025.06.012","url":null,"abstract":"<div><h3>Purpose</h3><div>Renal medullary carcinoma (RMC) is a rare but aggressive kidney cancer affecting young individuals with sickle hemoglobinopathies. Prior retrospective case-control and mouse modeling studies suggest a mechanism linking vigorous intensity physical activity to increased RMC risk in individuals with sickle hemoglobinopathies. This study aimed to prospectively investigate the association between vigorous intensity exercise and RMC.</div></div><div><h3>Materials and methods</h3><div>This study used a validated questionnaire to prospectively assess reported physical activity in a large cohort of patients with RMC compared to the activity of individuals without RMC. Between 2022 and 2024, patients with RMC (<em>N</em> = 39) were prospectively surveyed using the validated Physical Activity Questionnaire from the National Health and Nutritional Examination Survey and compared to responses of a national cohort of healthy individuals (<em>N</em> = 7148). This questionnaire is designed to distinguish between vigorous, moderate, and sedentary activity. To further validate the questionnaire, we performed body-composition analysis to determine if patients reporting vigorous activity had increased skeletal muscle mass and decreased subcutaneous adipose tissue.</div></div><div><h3>Results</h3><div>Individuals had higher odds of RMC diagnosis if reporting vigorous intensity physical activity at work (OR 2.91, 95% CI 1.50–5.66; <em>P</em> = 0.002) or recreationally (OR 4.02, 95% CI 1.85–8.74; <em>P</em> &lt; 0.001) after adjusting for age, biologic sex, and race. Body composition analysis confirmed that patients reporting vigorous physical activity were more likely to have a higher skeletal muscle mass index (median 54.3 vs. 41.2 cm²/m²; <em>P</em> = 0.01) compared to patients not reporting vigorous physical activity.</div></div><div><h3>Conclusion</h3><div>These results prospectively support the association between vigorous physical activity and RMC in individuals with sickle hemoglobinopathies.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 10","pages":"Pages 597.e15-597.e23"},"PeriodicalIF":2.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567891","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":"Robot-assisted nephroureterectomy","authors":"Mohit Butaney ,&nbsp;Michael Wang ,&nbsp;Craig G. Rogers ,&nbsp;Johar Raza","doi":"10.1016/j.urolonc.2025.06.002","DOIUrl":"10.1016/j.urolonc.2025.06.002","url":null,"abstract":"<div><div>Nephroureterectomy is the standard of care for high grade and recurrent low grade upper urinary tract urothelial cell carcinoma (UTUC). Robot-assisted nephroureterectomy (RANU) is an established technique for the minimally invasive performance of nephroureterectomy and has grown to be the favored approach over the past decade. The 3-dimensional vision, efficient wristed suturing, and precise movements of RANU offer advantages over laparoscopic nephroureterectomy (LNU). In addition to the expected benefits with reduced perioperative morbidity, available oncological outcomes are comparable to data associated with other published series. In this review we discuss the indications, preparation, technique, and oncologic outcomes of transperitoneal RANU.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 9","pages":"Pages 511-519"},"PeriodicalIF":2.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561302","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":"Concordance between clinical and pathologic staging of larger (cT2a-b) and more invasive (cT3a) renal cell carcinoma","authors":"Taylor Goodstein M.D. ,&nbsp;Rajvi Goradia M.B.B.S. ,&nbsp;Arnav Srivastava M.D., M.P.H., M.S. ,&nbsp;Akshay Sood M.D. ,&nbsp;Shawn Dason M.D. ,&nbsp;Viraj A. Master M.D., Ph.D. ,&nbsp;Eric A. Singer M.D., M.A., M.S., F.A.C.S., F.A.S.C.O.","doi":"10.1016/j.urolonc.2025.06.003","DOIUrl":"10.1016/j.urolonc.2025.06.003","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Among patients with renal cell carcinoma<span> (RCC), 5%–23% of those with cT1 and smaller cT2 tumors may be upstaged to pT3a disease after surgery. The pathologic restaging rate of larger or clinically more invasive tumors is understudied and has implications for perioperative systemic therapy clinical trial enrollment. We examined rates of pathologic restaging for cT2a-b and cT3a RCC after surgery.</span></div></div><div><h3>Methods</h3><div><span>Using the National Cancer Database, we identified adult patients with cT2a, cT2b, and cT3a RCC undergoing partial or radical nephrectomy. We compared pathologic restaging rates between the clinical stage groups using a Chi-square test. Subgroup analysis of restaging rates was performed for histology (clear cell vs. non–clear cell), clinical nodal status (cN1 vs. cN0), and clinical metastatic status (cM1 vs. cM0). Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for the overall cohort and subgroups. Multivariable </span>logistic regression was performed to assess predictors of pT3a upstaging among patients with cT2a and cT2b tumors.</div></div><div><h3>Results</h3><div>We identified 31,912 patients who met inclusion criteria (13,840 cT2a, 8,079 cT2b, and 9,993 cT3a). The overall rate of pathologic restaging was 47.4% for cT2a disease, 52.5% for cT2b disease and 9.5% for cT3a disease (<em>P</em><span> &lt; 0.001; Fig. 1). Most of the restaging was upstaging for cT2a (36.7%) and cT2b (41.9%) disease. The positive predictive value was 52.5%, 47.5%, and 90.6% for cT2a, cT2b, and cT3a disease, respectively. On multivariable analysis, in patients with cT2 tumors, the presence of clinically node-positive (OR 2.8 [95% CI 2.43–3.17]) or metastatic disease (OR 2.4 [95% CI 2.18–2.65]), as well as higher nuclear grade (OR 6.7 [95% CI 5.1–8.9]) was associated with increased risk of pathologic upstaging (</span><em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Restaging is common for patients with cT2a and cT2b tumors, but the specificity of cT3a staging is high, which suggests that the clinical/imaging characteristics concerning for locally invasive disease are generally accurate.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 10","pages":"Pages 597.e5-597.e14"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555068","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":"Enfortumab vedotin-related skin toxicities in patients with urothelial carcinoma: A systematic review and meta-analysis","authors":"Gabriela Gazzoni M.D. ,&nbsp;Isabella Michelon M.D. ,&nbsp;Maysa Vilbert M.D. ,&nbsp;João Pedro Oliveira ,&nbsp;Maria Inez Dacoregio M.D. ,&nbsp;Pedro C. A. Reis ,&nbsp;Marcelo A. P. Braga ,&nbsp;Clara Aleixo Simões ,&nbsp;Lilia Maria Lima de Oliveira M.D. ,&nbsp;Matthew Zibelman M.D. ,&nbsp;Ana Paula Cardoso M.D.","doi":"10.1016/j.urolonc.2025.05.016","DOIUrl":"10.1016/j.urolonc.2025.05.016","url":null,"abstract":"<div><h3>Background</h3><div>Enfortumab vedotin<span><span> (EV) is an antibody-drug conjugate that binds nectin-4, a cell-adhesion molecule highly expressed in urothelial carcinoma<span> (UC) and epidermal keratinocytes. </span></span>Dermatologic<span><span> events have become important EV-related toxicities in clinical trials and observational studies. We conducted a </span>systematic review and meta-analysis on dermatological toxicity in UC patients treated with EV.</span></span></div></div><div><h3>Methods</h3><div><span><span>We systematically searched PubMed, Cochrane, and Embase for clinical trials (CT) and observational studies reporting EV-related </span>cutaneous toxicities in UC patients. We investigated all-grade and grade ≥ 3 treatment-related </span>adverse events (TRAE) and severe cutaneous adverse reactions (SCAR) in UC patients. The outcomes were presented as overall incidence rates and 95% confidence intervals (95% CI). Statistical analyses were performed using R software.</div></div><div><h3>Results</h3><div><span><span>30 studies comprising 2,554 participants were included, of which 72% (n = 1,845) were male. In a pooled analysis, all-grade skin reaction rate was 49% (95% CI 42%–56%), and grade ≥ 3 events were observed in 10% (95% CI 8%–13%) of cases. The incidence of all-grade and grade ≥ 3 SCAR was 19% (95% CI 16%–23%) and 5% (95% CI 3%–7%), respectively. The frequency of </span>alopecia<span>, pruritus, and dry skin were as follows: 29%, 26%, and 22%. The incidence of all-grade rash was 27%, with </span></span>maculopapular rash (19%), and erythematous rash (6%) as the most common types.</div></div><div><h3>Conclusions</h3><div>To our knowledge, this is the first meta-analysis to characterize EV-related dermatological toxicities. While most cases are manageable, patients on EV should be closely monitored for cutaneous AEs to prevent serious complications and to maintain treatment efficacy.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 10","pages":"Pages 595.e1-595.e11"},"PeriodicalIF":2.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545045","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":"Perioperative outcomes in testicular cancer patients treated with retroperitoneal lymph node dissection","authors":"Letizia Maria Ippolita Jannello ,&nbsp;Andrea Baudo ,&nbsp;Mario de Angelis ,&nbsp;Carolin Siech ,&nbsp;Francesco Di Bello ,&nbsp;Jordan A. Goyal ,&nbsp;Zhe Tian ,&nbsp;Stefano Luzzago ,&nbsp;Francesco A. Mistretta ,&nbsp;Matteo Ferro ,&nbsp;Fred Saad ,&nbsp;Felix K.H. Chun ,&nbsp;Alberto Briganti ,&nbsp;Luca Carmignani ,&nbsp;Nicola Longo ,&nbsp;Ottavio de Cobelli ,&nbsp;Gennaro Musi ,&nbsp;Pierre I. Karakiewicz","doi":"10.1016/j.urolonc.2025.05.017","DOIUrl":"10.1016/j.urolonc.2025.05.017","url":null,"abstract":"<div><h3>Objective</h3><div>No large-scale population-based studies quantified perioperative outcomes in testicular cancer (TC) patients treated with retroperitoneal lymph node dissection (RPLND), especially in non-metastatic and metastatic stages. Moreover, no previous studies compared outcomes in centers of excellence (Indiana University School of Medicine, Memorial Sloan Kettering Cancer Center, and MD Anderson Cancer Center) vs. large-scale population-based databases.</div></div><div><h3>Methods</h3><div>Using the National Inpatient Sample (2000–2015), we identified TC patients undergoing RPLND. Patient, tumor, and hospital characteristics were tested in two separate multivariable models addressing overall complications and length of hospital stay (LOS). Critical care therapy and in-hospital mortality rates were also quantified. All models were weighted and adjusted for clustering, as well as all available patient and hospital characteristics.</div></div><div><h3>Results</h3><div>In 1,988 non-metastatic patients overall complications were recorded in 469 (23.6%) vs. 758 (34.3%) in 2,213 metastatic RPLND patients. The rates of RPLND as well as the overall complications did not change during the study period. LOS increased by two days in both non-metastatic (4 vs. 6 days) and metastatic stages (5 vs. 7 days) in the presence of complications. In multivariable logistic regression models neither teaching hospital status nor hospital bed-size were predictors of overall complications.</div></div><div><h3>Conclusion</h3><div>RPLND patients should be informed about a 1:4 chance of overall complications in non-metastatic settings and of a 1:3 chance of overall complications in metastatic settings. Moreover, complication rates in population-based repertories are 2- to 4-fold higher than centers of excellence.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 9","pages":"Pages 528.e13-528.e20"},"PeriodicalIF":2.3,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529668","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}