Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Pattern and risk factors of local recurrence and intravesical recurrence after segmental ureterectomy for upper tract urothelial carcinoma","authors":"Bao Guan ,&nbsp;Silu Chen ,&nbsp;Zihao Tao ,&nbsp;Yueyuan Jiang ,&nbsp;Zhenyu Li ,&nbsp;Chunru Xu ,&nbsp;Gengyan Xiong ,&nbsp;Qi Tang ,&nbsp;Yang Liu ,&nbsp;Hongzhen Li ,&nbsp;Xianshu Gao ,&nbsp;Liqun Zhou ,&nbsp;Xuesong Li ,&nbsp;Xiaoying Li","doi":"10.1016/j.urolonc.2025.03.008","DOIUrl":"10.1016/j.urolonc.2025.03.008","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the pattern and risk factors of local recurrence and intravesical recurrence of ureteral upper tract urothelial carcinoma (UTUC) following segmental ureterectomy (SU).</div></div><div><h3>Methods</h3><div>From February 2012 to August 2021, a retrospective analysis was conducted on patients following SU. Univariate and multivariate Cox regression analysis were used to evaluate the risk factors. Kaplan–Meier curves were employed to illustrate survival outcomes.</div></div><div><h3>Results</h3><div>Among 88 patients, 50 (57%) were male, with a median age of 71 (IQR: 62–77) years. The procedures of ureteral reconstruction included ureteral reimplantation in 77 (88%) cases, ureteroureteral anastomosis in 9 (10 %) cases, Boari flap ureteroplasty with psoas hitch in 1 (1%) case, and cutaneous ureterostomy in 1 (1%) case. The median follow-up time was 44.5 months. The 3-year rate of local recurrence, lymph node metastasis, ipsilateral upper urinary tract recurrence and intravesical recurrence was 31.6%, 19.0%, 22.2% and 35.7%, respectively. G3 (HR = 3.355, 95% CI 1.375–8.184, <em>P</em> = 0.008), and lymphatic vascular infiltration (HR = 3.127, 95% CI 1.043–9.373, <em>P</em> = 0.042) were independent risk factors for local recurrence. G3 (HR = 3.782, 95% CI 1.036–13.812, <em>P</em> = 0.044) was an independent risk factor for lymph node metastasis. Sarcomatoid differentiation (HR = 3.943, 95% CI 1.087–14.308, <em>P</em> = 0.037) was an independent risk factor for ipsilateral upper urinary tract recurrence. Previous or concurrent bladder cancer (HR = 3.280, 95% CI 1.667–6.453, <em>P</em> = 0.001) and sarcomatoid differentiation (HR = 4.442, 95% CI 1.317–14.989, <em>P</em> = 0.016) were independent risk factor for intravesical recurrence. The most common regions for bladder recurrence were posterior wall (21%), same lateral wall (16%) and trigon (16%).</div></div><div><h3>Conclusion</h3><div>SU is a feasible treatment for selected UTUC patients, yet it is associated with a considerable risk of local and intravesical recurrence. Careful monitoring and active adjuvant therapy are essential to minimize the recurrence rate for patients with risk factors.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 330.e11-330.e17"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789197","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":"Urologic oncology case volume among early career urologists: An analysis of certification data from the American board of urology between 2003 and 2019","authors":"Devki Shukla M.D. ,&nbsp;Max J. Hyman B.A. ,&nbsp;Piyush K. Agarwal M.D. ,&nbsp;Sarah Faris M.D. ,&nbsp;Ted A. Skolarus M.D., M.P.H. ,&nbsp;Parth K. Modi M.D., M.S.","doi":"10.1016/j.urolonc.2024.09.034","DOIUrl":"10.1016/j.urolonc.2024.09.034","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;The incidence of urologic cancer is expected to increase as the U.S. population ages, but the size of the urologic workforce is not expected to increase at a commensurate rate. To understand this growing imbalance, we explored the extent to which early career urologists performed oncology cases, particularly open surgical cases, between 2003 and 2019.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;We examined case logs submitted by early career urologists applying for their oral American Board of Urology Certifying Examination (Part 2) between 2003 and 2019. We included case logs spanning at least 120 days between the first and last record. We used CPT® codes to identify urologists who performed an open radical cystectomy, nephrectomy, or prostatectomy, as well as those who performed a minimally invasive (MIS) radical nephrectomy or prostatectomy. We calculated the annual percentage of urologists who performed each procedure. Multivariable logistic regression analysis analyzed the association between performing each procedure and specialization or fellowship training in oncology, adjusting for gender, practice type, and year of case log submission.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We identified 4,166 unique urologists submitting case logs between 2003 and 2019. Their average age was 34.9 years, 81.3% were male, 14.2% specialized in oncology, and 8.2% reported oncology fellowship training. From 2003 to 2019, the percentage of urologists who performed open oncologic procedures decreased, while the percentage who performed MIS oncologic procedures increased. Fellowship training in oncology significantly increased the odds of performing the following procedures: open radical cystectomy (72.5% with fellowship training vs. 30.0% without fellowship training, OR 2.51, 95% CI 0.63–0.92, &lt;em&gt;P&lt;/em&gt; &lt; 0.001), open radical nephrectomy (74.3% with fellowship training vs 42.4% without fellowship training, OR 2.02, 95% CI 1.48–2.78, &lt;em&gt;P&lt;/em&gt; &lt; 0.001), open radical prostatectomy (42.1% with fellowship training vs. 26.9% without fellowship training, OR 1.86, 95% CI 1.34–2.58, &lt;em&gt;P&lt;/em&gt; &lt; 0.001) and MIS radical prostatectomy (80.4% with fellowship training vs. 45.0% without fellowship training, OR 1.69, 95% CI 1.16–2.48, &lt;em&gt;P&lt;/em&gt; = 0.006). When comparing those with solely oncology specialization to those with both oncology specialization and fellowship training, we found that those with oncology fellowship training had over 2 times higher odds of performing open radical cystectomy (OR 2.58, CI 1.78–3.74, &lt;em&gt;P&lt;/em&gt; &lt; 0.001), open radical nephrectomy (OR 2.06, CI 1.42–2.99, &lt;em&gt;P&lt;/em&gt; &lt; 0.001) and open radical prostatectomy (OR 2.12, CI 1.44–3.12, &lt;em&gt;P&lt;/em&gt; &lt; 0.001). Female urologists had significantly lower odds of performing each oncologic procedure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;In this analysis of early career urologist case logs, the proportion of urologists performing a radical cystecto","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 335.e9-335.e15"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406953","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 location at trans-urethral resection is predictive of ipsilateral pelvic lymph-nodal metastases in patients undergoing radical cystectomy for bladder cancer","authors":"Francesco Cianflone,&nbsp;Giovanni Mazzucato,&nbsp;Emanuele Rubilotta,&nbsp;Rossella Orlando,&nbsp;Nicola De Maria,&nbsp;Michele Boldini,&nbsp;Francesca Fumanelli,&nbsp;Francesca Montanaro,&nbsp;Greta Pettenuzzo,&nbsp;Luca Roggero,&nbsp;Alessandra Gozzo,&nbsp;Alberto Bianchi,&nbsp;Alessandro Veccia,&nbsp;Riccardo Giuseppe Bertolo,&nbsp;Maria Angela Cerruto,&nbsp;Alessandro Antonelli","doi":"10.1016/j.urolonc.2024.09.037","DOIUrl":"10.1016/j.urolonc.2024.09.037","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether tumor location at diagnostic TURBT is predictive of ipsilateral nodal involvement in patients who underwent radical cystectomy (RC) with lymph-nodes dissection for bladder cancer (BCa).</div></div><div><h3>Materials and methods</h3><div>All patients who underwent RC for BCa at a single institution between 2014–2023 were assessed. Tumor location at TURBT was defined as right-sided, median-line, left-sided, and diffused. Distribution in the percentage of ipsilateral positive lymph-nodes and number of ipsilateral positive lymph-nodes between tumor locations were assessed with Kruskal-Wallis tests. Linear regressions were fitted to assess whether left or right location, compared to the remaining locations grouped, was associated to the percentage and number of positive ipsilateral lymph-nodes.</div></div><div><h3>Results</h3><div>239 patients were included. The number of ipsilateral positive lymph nodes was superior in right-sided tumors when compared to the rest of the bladder (0, I.Q.R. 0–1 vs. 0, I.Q.R. 0–0, <em>P</em> = 0.047), as well as the percentage of ipsilateral positive lymph-nodes (0, I.Q.R. 0–14.3 vs. 0, I.Q.R. 0–3.7, <em>P</em> = 0.042). The number of ipsilateral positive lymph-nodes in left-sided tumors was superior when compared to the rest of the bladder (0, I.Q.R. 0–1 vs. 0, I.Q.R. 0–0, <em>P</em> = 0.02), as well as the percentage (0, I.Q.R. 0–13.7 vs. 0, I.Q.R. 0–0, <em>P =</em> 0.036). At linear regression analyses, right- and left-sided tumors were associated with an increased percentage of ipsilateral positive lymph-nodes (<em>P =</em> 0,019 and <em>P =</em> 0,003) out of the total ipsilateral lymph-nodes excised.</div></div><div><h3>Conclusions</h3><div>Lateral wall tumor location at diagnostic TURBT (either right or left side) predicts a higher percentage of ipsilateral positive lymph-nodes s/p RC.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 331.e1-331.e7"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475879","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 “Clinician interest in clinical decision support for PSA-based prostate cancer screening” [Urol Oncol: Semin Original Investigat. 41(3) March 2023, 145.e17-145.e23]","authors":"Jonathan Harper B.A. ,&nbsp;Trevor C. Hunt M.D. ,&nbsp;Mouneeb Choudry B.S. ,&nbsp;Ashley L. Kapron ,&nbsp;Kathleen A. Cooney M.D. ,&nbsp;Christopher Martin M.D. ,&nbsp;Jacob Ambrose M.S. ,&nbsp;Brock O'Neil M.D.","doi":"10.1016/j.urolonc.2025.03.010","DOIUrl":"10.1016/j.urolonc.2025.03.010","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Page 338"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744088","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":"Prospective evaluation of comprehensive geriatric assessments in multidisciplinary bladder cancer care and implications for personalized vulnerability phenotyping.","authors":"Dana Cavanaugh, Sarah K Holt, Erin Dwyer, Erin Petersen, John L Gore, George R Schade, Petros Grivas, Andrew C Hsieh, John K Lee, Bruce Montgomery, Michael T Schweizer, Todd Yezefski, Evan Y Yu, Jonathan J Chen, Jay J Liao, Emily Weg, Jing Zeng, Samia Jannat, Donna L Berry, Viraj A Master, Jose M Garcia, May J Reed, Itay Bentov, Jonathan L Wright, Sarah P Psutka","doi":"10.1016/j.urolonc.2025.03.025","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.03.025","url":null,"abstract":"<p><strong>Purpose: </strong>Frailty predicts adverse outcomes in bladder cancer (BC). Current guidelines endorse completion of Comprehensive Geriatric Assessments (CGAs) in older adults prior to treatment election to objectively measure frailty, however, these are rarely performed in urologic practice due to inadequate resources. We hypothesized CGA implementation would be feasible and identify multifaceted vulnerabilities beyond standard risk assessments in a multidisciplinary BC clinic and developed a novel method to visualize \"vulnerability phenotypes\" to guide supportive interventions.</p><p><strong>Methods: </strong>Adults with BC were prospectively enrolled (June, 2020-July, 2021). Initially, patients underwent standard of care (SOC) risk assessment (N = 27). Subsequently, patients completed CGAs augmented with body composition assessments (N = 67). CGA completion time, rates, and patient-reported burden were assessed. Interdependence of CGA domains were quantified using Spearman correlation coefficients and compared decisional conflict and regret between arms. Vulnerability phenotypes were visualized using Spider Plots, generated in R. Clinical and survival associations with CGAs were evaluated using Cox proportional hazards models.</p><p><strong>Results: </strong>94 patients were enrolled with a median age of 72 years. Instrument completion in the CGA cohort was 79% to 100%. 91% of patients reported CGA completion was at most minimally burdensome. CGAs identified vulnerabilities including 31% vulnerable-to-moderately frail, 21% with mild-to-severe depression, 3% with mild-moderate dementia, and 40% at risk for malnutrition-malnourished. Frailty measures across instruments were weakly correlated (rho <0.4). In this heterogeneous cohort, vulnerability domains were not significantly associated with decisional conflict/regret, survival, nor complication rates after treatment. A novel Spider Plot tool is proposed to facilitate communication of the dominant vulnerability-driving individual risks.</p><p><strong>Conclusions: </strong>CGAs can be successfully incorporated into uro-oncology practice with low perceived burden, identifying key vulnerabilities with implications for clinical care. Weak correlations across instruments support the value of gathering information across discrete domains. We present a novel approach to visually characterize personalized vulnerability phenotypes.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041801","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":"Real-world treatment patterns and outcomes of patients with unresectable or metastatic urothelial carcinoma receiving systemic therapy in Japan","authors":"Shotaro Yasuoka MD ,&nbsp;Toshihiko Minegishi MS ,&nbsp;Shingo Kojima BP, PMP ,&nbsp;Kotoba Okuyama MS ,&nbsp;Toshiki Fukasawa MS ,&nbsp;Mizuho Akahane MD ,&nbsp;Hidetoshi Uenaka PhD ,&nbsp;Yuichiro Ito MD, PhD ,&nbsp;Makito Miyake MD, PhD","doi":"10.1016/j.urolonc.2024.09.020","DOIUrl":"10.1016/j.urolonc.2024.09.020","url":null,"abstract":"<div><h3>Background</h3><div>Cisplatin-based chemotherapy has traditionally been the standard treatment for unresectable or metastatic urothelial carcinoma (mUC). Recently, the longstanding paradigm has changed with the emergence of immune checkpoint inhibitors and antibody-drug conjugates, such as pembrolizumab and enfortumab vedotin (EV). This longitudinal descriptive study aimed to identify real-world treatment patterns and assess the outcomes of patients with mUC between 2010 and 2023.</div></div><div><h3>Methods</h3><div>Patients with mUC who received first-line systemic therapy were identified from a Japanese electronic medical records database. A Sankey diagram was used to present the proportion of patients who transitioned to second- and third-line therapies. Kaplan–Meier survival analysis was used to estimate the time to next treatment (TTNT) and overall survival (OS).</div></div><div><h3>Results</h3><div>A total of 794 patients were included in this study. The median age of the patients was 73.0 years, and 72.9% were male. The most common primary tumor site was the bladder (59.7%). First-line therapy comprised cisplatin-based regimens in 52.0% of the patients (11.8% at standard doses, 32.4% at reduced doses, and 7.8% at unknown doses), carboplatin-based regimens in 32.1%, and other regimens in 15.9%. Among the patients enrolled after 2017, following the approval of pembrolizumab for mUC progressing after chemotherapy in Japan, 58.2% received pembrolizumab as second-line therapy, and 19.1% received EV monotherapy as third-line therapy. The median OS for the total population was 24.1 months, with patients enrolled between 2010 and 2016 having a shorter OS (21.1 months) than those enrolled between 2017 and 2022 (24.9 months). For patients with eGFRs of ≥60 and &lt;60 mL/min/1.73 m², the median OS was 24.1 and 23.8 months, respectively.</div></div><div><h3>Conclusion</h3><div>Platinum-based regimens, including reduced-dose cisplatin and carboplatin, remain the predominant first-line systemic therapies. Since 2017, pembrolizumab and EV have become widespread choices for second-line and subsequent treatments, gradually surpassing the previously prevalent platinum-based regimens. The introduction of these novel therapies might have prolonged the OS of patients with mUC. A plain language summary is available in this article.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 329.e1-329.e8"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475877","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 ‘Attainment of early, deep prostate-specific antigen response in metastatic castration-sensitive prostate cancer: A comparison of patients initiated on apalutamide or enzalutamide’[Urol Oncol: Semin Original Investigat 41(3) (2023) 253.e1-253.e9]","authors":"Benjamin Lowentritt ,&nbsp;Dominic Pilon ,&nbsp;Ibrahim Khilfeh ,&nbsp;Carmine Rossi ,&nbsp;Erik Muser ,&nbsp;Frederic Kinkead ,&nbsp;Dexter Waters ,&nbsp;Lorie Ellis ,&nbsp;Patrick Lefebvre ,&nbsp;Gordon Brown","doi":"10.1016/j.urolonc.2025.03.011","DOIUrl":"10.1016/j.urolonc.2025.03.011","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Page 339"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744090","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":"Organ preservation and oncological efficacy of peniscopically controlled CO2 laser excision of penile squamous cell carcinoma: Early and late results in a high-volume center","authors":"Sebastiano Nazzani M.D., Ph.D. ,&nbsp;Vito Lorusso M.D. ,&nbsp;Mario Catanzaro M.D. ,&nbsp;Tullio Torelli M.D. ,&nbsp;Carlo Silvani M.D. ,&nbsp;Alberto Macchi M.D. ,&nbsp;Davide Biasoni M.D. ,&nbsp;Ruggero Darisi M.D. ,&nbsp;Claudia Colbacchini M.D. ,&nbsp;Silvia Stagni M.D. ,&nbsp;Antonio Tesone M.D. ,&nbsp;Melanie Claps M.D. ,&nbsp;Patrizia Giannatempo M.D. ,&nbsp;Matteo Zimatore M.D. ,&nbsp;Laura Cattaneo M.D. ,&nbsp;Emanuele Montanari M.D. ,&nbsp;Nicola Nicolai M.D.","doi":"10.1016/j.urolonc.2025.02.024","DOIUrl":"10.1016/j.urolonc.2025.02.024","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate safety and early and long-term efficacy of CO₂ laser conservative treatments for nonulcerative squamous cell carcinoma (SCC) of the penis.</div></div><div><h3>Material and Methods</h3><div>Within our institutional database (2002–2022, included), we identified 122 consecutive cT1-2 cN0 cM0 patients with penile SCC who underwent conservative CO₂ laser treatments. Histologically confirmed local relapses were recorded. Local relapses were classified as early recurrences when occurring &lt;2 years and as late new tumor recurrences when occurring &gt;2 years after first laser treatment. Predictors of disease relapse were analyzed with univariable and multivariable Cox regression models (MCRMs).</div></div><div><h3>Results</h3><div>Median follow-up was 36 months [Interquartile range (IQR) 21-73 months]. Median age was 62 years (IQR: 51-69 years). Median largest lesion size was 10 mm (IQR 5-15 mm). 62 patients had penile intraepithelial neoplasia (PeIN) (51.6%), 30 had pT1 m (24.6%), 28 had pT1 (23%) and 1 had pT2 (0.8%), 2 patients were classified as pTx. In case of invasive lesions, tumor Grade was G1 in 37 (60.7%), G2 in 20 (32.8%), G3 in 4 (6.5%). Early and late recurrences occurred in 28 (22%) and in 21 patients (18%), respectively. Proportion of penis preservation was 93.4% and 92.6% at 2 and 5 years. pT1 stage [Hazard Ratio (HR) 13, Confidence Interval (CI) 1.4-73, p-value 0.02] and flat lesions (HR 7.9, CI 1.06-59, 0.04) achieved independent predictor status for late recurrences. No cancer related deaths were recorded after a median follow-up of 36 months.</div></div><div><h3>Conclusions</h3><div>As far as we know, this is the largest cohort of patients with penile cT1-T2 SCC who underwent conservative CO₂ laser treatment. The vast majority (92%) of these patients preserved their organ at 5 years. Some factors can be of use in preventing or anticipating late recurrences.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 337.e23-337.e30"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765223","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":"“I was in a very deep, dark place... I wasn't prepared for that”: A qualitative assessment of the emotional well-being needs of patients undergoing cystectomy","authors":"Erica Zeng B.S. ,&nbsp;Megan Saucke M.A. ,&nbsp;Alexa Rose B.S. ,&nbsp;Bhabna Pati M.S. ,&nbsp;Taviah Levenson B.S. ,&nbsp;Esra Alagoz Ph.D. ,&nbsp;Kyle A. Richards M.D.","doi":"10.1016/j.urolonc.2024.10.027","DOIUrl":"10.1016/j.urolonc.2024.10.027","url":null,"abstract":"<div><h3>Introduction</h3><div>Studies have shown that cystectomy has a large psychological burden on patients with bladder cancer. However, there has been little work characterizing areas of improvement. This project aimed to understand cystectomy patients' experiences and to identify patient-centered methods to improve perioperative support.</div></div><div><h3>Methods</h3><div>Five focus groups, divided by diversion type and gender, (4 virtual, 1 in person) of patients with bladder cancer (n = 17) who underwent cystectomy were conducted. Conversations were transcribed and qualitatively analyzed using the <em>Sort and Sift, Think and Shift</em>© method. Transcripts were coded in NVivo and themes were summarized in higher-level analysis.</div></div><div><h3>Results</h3><div>Patients described feelings of depression, anger, and anxiety in response to their cancer diagnosis, need for cystectomy, and living with urinary diversion. Patients experienced daily mental hardship while adapting. They experienced distress from diversion visibility in public and private encounters. Many expressed a dichotomy of feeling grateful for the treatment while also feeling bitter about the impact on their daily life. Patients reported that while their care team provided support for tangible needs, they did not provide information for nor discuss mental and sexual health needs during this time. Patients reported that if their provider had initiated discussions and offered referrals, they would have accepted support. Patients also emphasized the benefit of social and peer support networks for emotional support.</div></div><div><h3>Conclusions</h3><div>Groups identified the psychological difficulties of bladder cancer diagnosis and cystectomy. Potential avenues for improvement included incorporating support resources into the care plan and perioperative discussion regarding the emotional impact of surgery.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 328.e1-328.e7"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629029","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":"Delayed partial nephrectomy following complete response to immunotherapy: feasibility and results (UroCCR n°157)","authors":"Gaëlle Margue M.D. ,&nbsp;Clément Klein M.D. ,&nbsp;Bastien Parier M.D. ,&nbsp;Laurence Albiges M.D., Ph.D. ,&nbsp;Géraldine Pignot M.D. ,&nbsp;Gwenaëlle Gravis M.D. ,&nbsp;Pierre Bigot M.D., Ph.D. ,&nbsp;Nathalie Baize M.D. ,&nbsp;Alexandre Ingels M.D., Ph.D. ,&nbsp;Charlotte Joly M.D. ,&nbsp;François Audenet M.D., Ph.D. ,&nbsp;Yann Vano M.D., Ph.D. ,&nbsp;Thibaut Waeckel M.D. ,&nbsp;Romain Levard M.D. ,&nbsp;Philippe Barthelemy M.D., Ph.D. ,&nbsp;Damien Ambrosetti M.D., Ph.D. ,&nbsp;Virginie Verkarre M.D., Ph.D. ,&nbsp;Mokrane Yacoub M.D. ,&nbsp;Marine Gross-Goupil M.D., Ph.D. ,&nbsp;Jean-Christophe Bernhard M.D., Ph.D.","doi":"10.1016/j.urolonc.2024.11.003","DOIUrl":"10.1016/j.urolonc.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Complete responses to immunotherapy in metastatic kidney cancer have led to a renewed interest in primary-site surgery. The prolonged survival of these patients has prompted consideration for nephron-sparing surgery when technically feasible. Given the surgical difficulties reported in the literature, it is essential to assess the feasibility as well as functional and oncological results of partial nephrectomy (PN) after immunotherapy.</div></div><div><h3>Methods</h3><div>Multicentric retrospective study based on UroCCR database, including all metastatic patients who underwent PN after a complete response to immunotherapy at metastatic sites. Morbidity, renal function, positive margin rate, and oncological outcomes were assessed.</div></div><div><h3>Results</h3><div>Thirteen patients underwent PN after immune checkpoint inhibitor (ICI), between January 2019 and September 2023. Median age at surgery was 64 [50–68]; 84.6% received ICI as first-line treatment with a median duration of 11.7 [7.7–14.9] months. None of the patients had positive surgical margins, five patients (38.5%) were ypT0. Two patients (15.4%) presented intraoperative complications and 1 a severe postoperative complication. Median GFR at 3 months was 84.7 [66.6–95.2] mL/min/1.73 m2 with no significant difference from preoperative GFR. After surgery, immunotherapy was not reintroduced in ten patients (77%). Median follow- up was 25.6 [19.6–30.2] months, median treatment-free survival was 22.4 [15.8–34.7] months. RFS at 12 months and at last follow-up were 84.6% and 53.8%. OS rate at last follow-up was 92.3%.</div></div><div><h3>Conclusion</h3><div>This series demonstrates the feasibility of partial nephrectomy following immune checkpoint inhibitor treatment, with acceptable morbidity rates and no major difficulties specifically attributable to the prior treatment. While the data suggest promising functional and oncological outcomes, further investigation is needed. The study underscores the importance of early re-evaluation of metastatic cases in multidisciplinary tumor boards.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 332.e19-332.e26"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740613","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}