Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Metastatic renal cell carcinoma: Synchronous vs. metachronous metastatic disease and its impact on cancer control in the IO-combination era-Real world experiences from a multi-institutional cohort.","authors":"Benedikt Hoeh, Cristina Cano Garcia, Angelika Mattigk, Marcus Sondermann, Niklas Klümper, Alexander Cox, Oliver Hahn, Jonathan Vollemaere, Kati Erdmann, Philipp Schmucker, Luka Flegar, Friedemann Zengerling, Severine Banek, Jörg Ellinger, Johannes Huber, Philip Zeuschner, Charis Kalogirou","doi":"10.1016/j.urolonc.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.04.004","url":null,"abstract":"<p><strong>Purpose: </strong>The association of metastatic timing (synchronous vs. metachronous) in metastatic renal cell carcinoma (mRCC) with survival outcomes in the immunooncology (IO) combination therapy era is not well understood to date. To assess progression-free survival (PFS) and overall survival (OS) based on the time to metastasis in mRCC patients treated with IO therapy combination therapies.</p><p><strong>Material and methods: </strong>Data from a multi-center retrospective German patient cohort was used to compare synchronous metastasis (occurring within 3 months of the initial cancer diagnosis) with metachronous metastasis (4-24 months vs. ≥25 months). PFS and OS were analyzed using Kaplan-Meier curves. Cox multivariable regression analyses were adjusted for baseline characteristics.</p><p><strong>Results: </strong>The cohort comprised 381 mRCC patients treated with 1st-line IO-combination therapies, categorized by time of metastatic onset: 167 (44%) in 0-3 months, 94 (25%) in 4 to 24 months, and 120 (31%) in ≥25 months. Differences in initial diagnosis age, ECOG performance status, local kidney treatment, and systemic treatment type were noted (all P < 0.05). Median PFS was 10.6 months for 0 to 3 months, 13.8 months for 4 to 24 months, and 16.8 months for ≥25 months (log-rank test: P = 0.028). Here, ≥25 months group showed significantly prolonged PFS in univariable (HR: 0.63; 95% CI:0.45-0.83) and multivariable Cox regression (HR: 0.64; 95% CI:0.41-0.99). Median OS was 28.0 months for 0 to 3 months, 39.7 months for 4 to 24 months, and 49.3 months for ≥25 months (P < 0.001). Multivariable Cox regression showed prolonged OS for both 4 to 24 months (HR: 0.45; 95% CI:0.26-0.76) and ≥25 months (HR: 0.56; 95% CI:0.33-0.95).</p><p><strong>Conclusions: </strong>Within this contemporary cohort of mRCC patients treated with IO-combination therapy, timing of metastatic disease and initiation of systemic treatment was associated with OS.</p><p><strong>Patient summary: </strong>This study examined the impact of when metastases occur on survival outcomes in kidney cancer patients treated with first-line immune-combination therapies. The findings show that a longer interval before the development of metastases is associated with better outcomes.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112257","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":"A festschrift in honor of Ian M. Thompson Jr., MD","authors":"Robert S. Svatek ,&nbsp;Donna P. Ankerst ,&nbsp;Anthony V. D’ Amico ,&nbsp;Thomas W. Flaig ,&nbsp;Leslie G. Ford ,&nbsp;Amir Goldkorn ,&nbsp;Javier Hernandez ,&nbsp;A. Pratap Kumar ,&nbsp;Robin J. Leach ,&nbsp;Seth Lerner ,&nbsp;Michael A. Liss ,&nbsp;David J. McConkey ,&nbsp;Lori Minasian ,&nbsp;David Morilak ,&nbsp;Edward J. Mueller ,&nbsp;Dipen J. Parekh ,&nbsp;Elizabeth A. Platz ,&nbsp;Sunil Sudarshan ,&nbsp;Joseph M. Unger","doi":"10.1016/j.urolonc.2024.10.030","DOIUrl":"10.1016/j.urolonc.2024.10.030","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 7","pages":"Pages 423-435"},"PeriodicalIF":2.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154706","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":"Evaluating the role of adjuvant therapy in improving outcomes for patients with lymph node-positive penile cancer following surgical management.","authors":"Radion Garaz, Cristian Mirvald, Cristian Surcel, Asif Muneer, Anita Thomas, Steffen Rausch, Maximilian Niyazi, Hathal Haddad, Elgin Hoffmann, Olesya Vakhrusheva, Igor Tsaur","doi":"10.1016/j.urolonc.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.04.003","url":null,"abstract":"<p><p>Penile squamous cell carcinoma (PeCa) is a rare malignancy with poor outcomes in pN+ cases. Prognosis is particularly poor in patients with extranodal extension (ENE) or pelvic lymph node (PLN) involvement. Despite advancements in surgical techniques, the role of adjuvant therapy (AT)-including radiotherapy (ART), chemotherapy (ACT), and chemoradiotherapy (ACRT)-following radical lymphadenectomy (LAD) remains undefined, and optimal strategies are yet to be established. This review evaluates the impact of AT on survival and recurrence in pN+ PeCa, assesses associated toxicities, and explores personalized treatment approaches. A systematic search of PubMed, Web of Science, Cochrane Library, and Scopus identified studies published between January 2000 and December 2024. Eligible studies focused on AT after LAD, including radiotherapy, chemotherapy, targeted therapies, or combination regimens. ART improves locoregional control in patients with ≥ 2 positive inguinal lymph nodes, particularly in HPV+ tumors. ACT with TIP or TPF regimens enhances disease-free and overall survival in high-risk pN+ patients, including those with PLN involvement. ACRT provides modest benefits in ENE cases but is associated with significant toxicity. Emerging biomarkers, such as HPV status and p53 mutations, show potential for predicting treatment response, while novel agents and immunotherapies represent promising investigational areas. AT improves outcomes in pN+ PeCa but requires individualized strategies based on risk factors and molecular profiles. Prospective, collaborative studies are essential to refine AT protocols, reduce toxicities, and integrate immunotherapies, targeted agents, and biomarkers into treatment algorithms. Multidisciplinary management and centralized care are critical for optimizing outcomes in this malignancy.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086733","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)00160-7","DOIUrl":"10.1016/S1078-1439(25)00160-7","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 6","pages":"Page IFC"},"PeriodicalIF":2.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948422","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 \"Unlocking the secrets: Exploring the connection between HPV and bladder cancer in Pakistan\" [Urologic Oncology: Seminars and Original Investigations, In Press, Corrected Proof].","authors":"Hafsa Yousaf, Aneela Javed, Nuzhat Sultana, Khalid Farouk, Muhammad Usman, Gul Rehman Khan, Miriam Kathleen Gomez, Sobia Asghar, Saira Justin","doi":"10.1016/j.urolonc.2025.04.013","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.04.013","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079825","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":"Patterns of telehealth use in newly diagnosed prostate cancer patients.","authors":"Nicholas W Eyrich, Dattatraya Patil, Siddharth Marthi, Sydney R Sudderth, Juan J Andino, Shreyas S Joshi, Christopher P Filson","doi":"10.1016/j.urolonc.2025.03.028","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.03.028","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize the use of Telehealth in prostate cancer management at a national-level in the United States.</p><p><strong>Methods: </strong>We used a population-level database (MarketScan Commercial Claims and Medicare Supplemental Database, Merative, Ann Arbor, MI) of prostate cancer patients diagnosed with localized prostate cancer from 2017 through 2022 with commercial or Medicare coverage to evaluate variation in telehealth use based on patient factors and place of residence (defined by metropolitan statistical area).</p><p><strong>Results: </strong>We identified 33,236 patients with localized prostate cancer. About 8,574 men (25.8%) had any telehealth usage in the 6 months before or 12 months after diagnosis. 5,483 (16.5%) patients had ≥1 cancer-specific telehealth visit within 12 months after diagnosis. Of these, 4,896 patients (89.3%) reside in a metropolitan statistical area. On multivariable logistic regression analysis, younger vs. older patients, health plan, residing in a metropolitan statistical area, living outside of the Southern US, and year of index biopsy were significantly associated with the receipt of prostate cancer-related telehealth. Telehealth use remarkably increased in early 2020 with decline in late 2020 then remained stably above pre-COVID levels throughout 2021 to 2022.</p><p><strong>Conclusions: </strong>We report the first analysis of telehealth use by men with localized prostate cancer nationwide. Telehealth adoption was associated with year of index biopsy, numerous patient factors, and residing in a large metropolitan area. This work helps clarify geographic patterns of implementation and factors associated with access to telehealth prostate cancer care since COVID-19, which is timely given upcoming legislative decisions to be made surrounding continued coverage flexibilities.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015150","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":"Reclassification of pathologically upstaged T3a Renal Cell Carcinoma is associated with enhanced alignment of outcomes: Analysis of the National Cancer Database.","authors":"Dhruv Puri, Brian R Lane, Natalie Birouty, Luke Wang, Margaret F Meagher, Julian Cortes, Melis Guer, Mimi Nguyen, Aaron Ahdoot, Mai Dabbas, Jonathan Afari, Kit Yuen, Cesare Saitta, Simon Kim, Ithaar H Derweesh","doi":"10.1016/j.urolonc.2024.09.010","DOIUrl":"https://doi.org/10.1016/j.urolonc.2024.09.010","url":null,"abstract":"<p><strong>Purpose: </strong>To compare outcomes of pathological T3a renal cell carcinoma (RCC) based on clinical stage at presentation, and to propose reclassification of T3a RCC based on survival outcomes, as outcomes of current T3a RCC may vary based on initial clinical presentation.</p><p><strong>Methods: </strong>Using the National Cancer Database, patients with pT2 and pT3aN0M0 RCC were categorized by AJCC clinical T stage. Primary outcome was overall survival (OS). Multivariable analysis (MVA) assessed predictors for all-cause mortality (ACM), controlling for presenting clinical T stage. Kaplan-Meier Analysis (KMA) assessed differences between cT1-upstaged pT3a (cT1→pT3a), cT2-upstaged pT3a (cT2→pT3a), clinical/pathological T2 (cT2→pT2), and clinical/pathological T3a (cT3a→pT3a) RCC, and a modified T3a RCC was created based on clustering of survival outcomes between clinical staging groups. ROC/AUC analysis was utilized to compare predictive value of AJCC 8^th edition staging vs. proposed staging.</p><p><strong>Results: </strong>45,097 patients with pT3a disease were analyzed (9,730 cT1→pT3a; 7,209 cT2→pT3a, 19,857 cT2→pT2; and 8,301 cT3a→pT3a). MVA for OS [cT1→pT3a (referent)] demonstrated cT2→pT3a (HR=1.27, p<0.001) and cT3a→pT3a (HR=1.20, p<0.001) were associated with worsened ACM, while cT2→pT2 (HR=0.95, p=0.052) was not significantly different. KMA for 5-year OS using current AJCC demonstrated: cT1→pT3a 73.1%, cT2→pT2 78.0%, cT2→pT3a 60.8%, cT3a→pT3a 59.9% (p<0.001). KMA for 5-year OS of a new pT2 group, comprised of cT1→pT3a and cT2→pT2, while maintaining cT2→pT3a and cT3a→pT3a as T3a was 78.0% vs. 60.3% (p=0.003). ROC analysis for OS revealed AUC of 0.532 (95% CI: 0.530-0.535) for T3 using current AJCC 8^th edition TNM staging and AUC of 0.573 (95% CI: 0.569-0.577) for proposed T3a reclassification (p<0.001).</p><p><strong>Conclusion: </strong>Reclassification of cT1→pT3a and cT2→ pT2 into a new T2 RCC while maintaining cT2→pT3a and cT3a→pT3a RCC in T3a RCC resulted in improved performance of the realigned model for OS. Revised TNM criteria for pT2 and T3a RCC should be considered.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999843","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":"Intravesical gemcitabine and docetaxel in patients with recurrent high-grade nonmuscle invasive bladder cancer-A prospective cohort study.","authors":"Olga M Pijpers, Sarianne G Bosch, Danielle C van Diepen, Joni Y Zee, Arnout R Alberts, Tahlita C M Zuiverloon, Kim E M van Kessel, Joost L Boormans","doi":"10.1016/j.urolonc.2025.03.024","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.03.024","url":null,"abstract":"<p><strong>Background and objective: </strong>Intravesical instillations with gemcitabine and docetaxel (gem/doce) is an alternative treatment option in patients with nonmuscle invasive bladder cancer (NMIBC) in whom Bacillus Calmette-Guerin (BCG) failed or is contraindicated. However, prospective data on the efficacy is lacking. This study prospectively evaluated the efficacy and safety of intravesical gem/doce.</p><p><strong>Methods: </strong>This single-arm, prospective, observational study included patients with recurrent high-grade (HG) NMIBC who received intravesical gem/doce. Treatment involved 6 weekly instillations (induction), followed by monthly instillations for 1 year (maintenance). Follow-up included cystoscopy every 3 months. Histological confirmation of intravesical recurrences was mandatory. The efficacy evaluation was assessed among 37 patients who received at least 4 instillations and had at least 1 cystoscopic evaluation. Primary outcome was HG disease-free survival, defined as time to histologically confirmed HG recurrence, and/or radiologically confirmed lymph node involvement, or distant metastasis. Adverse events were assessed.</p><p><strong>Key findings and limitations: </strong>Thirty-nine patients with NMIBC were enrolled of whom 31 (79%) had Carcinoma in situ. Gem/doce was provided as third-line treatment in 87% (34/39) of the patients. Thirty-five patients had received BCG of whom 72% (28/39) were BCG-unresponsive. The median follow-up for patients without HG recurrence was 14 months (IQR: 7-25). The overall 1-year HG disease-free survival was 67% (95% CI: 53-85), and 73% (57-94) in patients with BCG-unresponsive NMIBC. Only one serious adverse event (grade 3) occurred. A limitation was the small sample size.</p><p><strong>Conclusions and clinical implications: </strong>In patients with recurrent HG NMIBC who are unfit or reluctant to undergo radical cystectomy and in whom BCG failed, intravesical gem/doce was effective and safe.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047315","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":"Is ipsilateral systematic biopsy combined with targeted biopsy the optimal substitute for bilateral systematic biopsy combined with targeted biopsy: A systematic review and meta-analysis","authors":"Qiyou Wu M.D. ,&nbsp;Xiang Tu Ph.D. ,&nbsp;Jinjiang Jiang Ph.D.,&nbsp;Jianjun Ye Ph.D.,&nbsp;Tianhai Lin Ph.D.,&nbsp;Zhenhua Liu Ph.D.,&nbsp;Lu Yang Ph.D.,&nbsp;Shi Qiu Ph.D.,&nbsp;Bo Tang Ph.D.,&nbsp;Yige Bao Ph.D.,&nbsp;Qiang Wei Ph.D.","doi":"10.1016/j.urolonc.2024.11.023","DOIUrl":"10.1016/j.urolonc.2024.11.023","url":null,"abstract":"<div><h3>Background</h3><div>The current standard prostate biopsy method, which combine systematic biopsy (SB) with targeted biopsy (TB), has shortcomings such as overdiagnosis and overtreatment. To evaluate the effectiveness of ipsilateral systematic biopsy (ips-SB) combined with targeted biopsy (ips-SB+TB) and contralateral SB (con-SB) combined with TB (con-SB+TB) as potential alternatives to SB+TB.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted in Cochrane, Embase, Ovid, and PubMed databases until September 2024. 2,732 references were identified, and 11 records were included.</div></div><div><h3>Main findings</h3><div>The study included a total of 5,249 patients and revealed that ips-SB+TB detected slightly less PCa than SB+TB with a relative risk (RR) of 0.95 (95% CI 0.91, 1.00), <em>P</em> = 0.05. In terms of csPCa detection, ips-SB+TB showed a comparable detection rate with SB+TB (RR 0.98 [95% CI 0.94, 1.01], <em>P</em> = 0.60). There was a statistically significant difference in csPCa detection between con-SB+TB and SB+TB (RR 0.92 [95% CI 0.86, 0.99], <em>P</em> = 0.02). The detection rates of clinically insignificant PCa (ciPCa) were comparable between con-SB+TB vs. SB+TB (con-SB+TB vs. SB+TB: RR 0.90 [95% CI 0.79, 1.04], <em>P</em> = 0.15). However, fewer ciPCa cases were detected in ips-SB+TB compared to SB+TB (RR 0.86 [95% CI 0.75, 0.99], <em>P</em> = 0.04).</div></div><div><h3>Conclusions</h3><div>In this review, our analysis highlights ips-SB+TB has the comparable detection efficiency of PCa and csPCa compared to SB+TB, and its potential to be the substitute of the SB+TB with less cores and less detection of ciPCa.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 307-317"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877958","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":"Immediate second resection versus restage transurethral resection of bladder tumor: A prospective randomized clinical trial (IMMERSE trial)","authors":"Shritosh Kumar M.Ch. ,&nbsp;Rishi Nayyar M.Ch. ,&nbsp;Siddharth Jain M.Ch. ,&nbsp;Amlesh Seth M.Ch. ,&nbsp;Seema Kaushal M.D.","doi":"10.1016/j.urolonc.2024.12.276","DOIUrl":"10.1016/j.urolonc.2024.12.276","url":null,"abstract":"<div><h3>Background</h3><div>The role of repeat transurethral resection of bladder tumor (TURBT) for the management of nonmuscle invasive bladder carcinoma is debated, especially when initial resections include detrusor muscle. This study compares immediate second resection (additional deep biopsies in the same session) with standard restage TURBT performed 2–6 weeks post-initial TURBT to determine adequacy in detrusor muscle sampling and compare the disease rate at restage TURBT in both groups.</div></div><div><h3>Material and Methods</h3><div>A randomized trial was conducted at a tertiary care hospital, including patients aged ≥18 years undergoing TURBT with complete primary tumor resection. Cases were randomized into two groups i.e., ‘standard TURBT’ (complete tumor resection with a deep biopsy) and “immediate second resection” (complete tumor resection, deep biopsy and additional deep biopsies). The primary endpoint was the presence of detrusor muscle in biopsy specimens, analyzed by a single pathologist. Secondary endpoints included perioperative complications, residual/ recurrent tumors, and factors affecting these recurrences.</div></div><div><h3>Result</h3><div>The study included 83 patients: 44 in the 'standard TURBT' group and 39 in the 'immediate second resection' group. The detrusor muscle was present in 66% of standard TURBT cases and 97% of immediate second resection cases, showing a statistically significant improvement (<em>P</em> = 0.000). Residual disease was found in 41% of restage TURBT patients in the standard group and 15% in the immediate second resection group, the majority being high-grade and T1 tumors (<em>P</em> = 0.028). There were no significant differences in tumor grade or perioperative complications between the groups. However, immediate second resection showed 18% higher detrusor muscle sampling rates than standard re-stage TURBT done at 2–6 weeks (<em>P</em> = 0.021).</div></div><div><h3>Conclusion</h3><div>Immediate second resection at the time of initial TURBT significantly improves detrusor muscle sampling rates and decreases residual tumors at restage. Despite higher muscle sampling, a considerable proportion of patients still exhibited residual or recurrent tumors in both groups, emphasizing the need for improved detection and biopsy techniques during primary TURBT.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 331.e9-331.e16"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972254","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}