Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Increase in workload among genitourinary oncologists drives burnout: Insights from the BUCARE survey","authors":"Alisher Kahharov M.D., Ph.D. ,&nbsp;Ilya Tsimafeyeu M.D., Ph.D. ,&nbsp;Dilyara Kaidarova M.D., Ph.D. ,&nbsp;Djamilya Polatova M.D., Ph.D. ,&nbsp;Fuad Guliyev M.D., Ph.D. ,&nbsp;Bakytzhan Ongarbayev M.D., Ph.D. ,&nbsp;Ramil Abdrakhmanov M.D., Ph.D. ,&nbsp;Timur Mitin M.D., Ph.D.","doi":"10.1016/j.urolonc.2025.03.019","DOIUrl":"10.1016/j.urolonc.2025.03.019","url":null,"abstract":"<div><h3>Background</h3><div>Burnout is a significant issue among GU oncologists, driven by increasing workloads and the emotional demands of patient care. This study aims to identify the prevalence, risk factors, and potential interventions to address burnout in this population.</div></div><div><h3>Methods</h3><div>A comprehensive survey, including a visual mood assessment, was conducted among 674 GU oncologists. The survey assessed work conditions, mood, and burnout indicators, alongside demographic and professional characteristics.</div></div><div><h3>Results</h3><div>Among the respondents, 72% (482 out of 674) displaying symptoms of burnout, characterized by high emotional exhaustion and/or depersonalization. Key risk factors included long working hours (more than 8 hours per day for 54% of respondents), high patient volumes (48% managing over 15 patients daily), and night shifts (16%). Despite signs of burnout in 72% of participants, a visual mood assessment showed that 72% reported being in a good or excellent mood. Additionally, 92% of respondents expressed passion for their work, and 84% showed a strong desire for professional development.</div></div><div><h3>Conclusions</h3><div>Burnout is prevalent among GU oncologists, despite their dedication to their profession. Strategic interventions, such as expanding the workforce and reducing daily patient volumes, are essential to mitigate burnout and improve well-being.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 324-327"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789196","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)00144-9","DOIUrl":"10.1016/S1078-1439(25)00144-9","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Page IFC"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928795","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 efficacy of adjuvant mitotane therapy and radiotherapy following adrenalectomy in patients with adrenocortical carcinoma: A systematic review and meta-analysis","authors":"Ichiro Tsuboi ,&nbsp;Mehdi Kardoust Parizi ,&nbsp;Akihiro Matsukawa ,&nbsp;Stefano Mancon ,&nbsp;Marcin Miszczyk ,&nbsp;Robert J. Schulz ,&nbsp;Tamás Fazekas ,&nbsp;Anna Cadenar ,&nbsp;Ekaterina Laukhtina ,&nbsp;Tatsushi Kawada ,&nbsp;Satoshi Katayama ,&nbsp;Takehiro Iwata ,&nbsp;Kensuke Bekku ,&nbsp;Koichiro Wada ,&nbsp;Mesut Remzi ,&nbsp;Pierre I. Karakiewicz ,&nbsp;Motoo Araki ,&nbsp;Shahrokh F. Shariat","doi":"10.1016/j.urolonc.2024.09.014","DOIUrl":"10.1016/j.urolonc.2024.09.014","url":null,"abstract":"<div><div>Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with a high recurrence rate after surgical therapy with curative intent. Adjuvant radiotherapy (RT) and mitotane therapy have been proposed as options following the adrenalectomy. However, the efficacy of adjuvant RT or mitotane therapy remains controversial. We aimed to evaluate the efficacy of adjuvant therapy in patients who underwent adrenalectomy for localised ACC. The PubMed, Scopus, and Web of Science databases were queried on March 2024 for studies evaluating adjuvant therapies in patients treated with surgery for localized ACC (PROSPERO: CRD42024512849). The endpoints of interest were overall survival (OS) and recurrence-free survival (RFS). Hazard ratios (HR) with 95% confidence intervals (95%CI) were pooled in a random-effects model meta-analysis. One randomized controlled trial (<em>n</em> = 91) and eleven retrospective studies (<em>n</em> = 4,515) were included. Adjuvant mitotane therapy was associated with improved RFS (HR: 0.63, 95%CI: 0.44-0.92, <em>p</em> = 0.016), while adjuvant RT did not reach conventional levels of statistical significance (HR:0.79, 95%CI:0.58-1.06, <em>p</em> = 0.11). Conversely, Adjuvant RT was associated with improved OS (HR:0.69, 95%CI:0.58-0.83, p&lt;0.001), whereas adjuvant mitotane did not (HR: 0.76, 95%CI: 0.57-1.02, <em>p</em> = 0.07). In the subgroup analyses, adjuvant mitotane was associated with better OS (HR:0.46, 95%CI: 0.30-0.69, <em>p</em> &lt; 0.001) and RFS (HR:0.56, 95%CI: 0.32-0.98, <em>p</em> = 0.04) in patients with negative surgical margin. Both adjuvant RT and mitotane were found to be associated with improved oncologic outcomes in patients treated with adrenalectomy for localised ACC. While adjuvant RT significantly improved OS in general population, mitotane appears as an especially promising treatment option in patients with negative surgical margin. These data can support the shared decision-making process, better understanding of the risks, benefits, and effectiveness of these therapies is still needed to guide tailored management of each individual patient.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 297-306"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393713","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":"Critical care therapy and in-hospital mortality after radical nephroureterectomy for nonmetastatic upper urinary tract carcinoma","authors":"Francesco Di Bello M.D. ,&nbsp;Carolin Siech M.D. ,&nbsp;Mario de Angelis M.D. ,&nbsp;Natali Rodriguez Peñaranda M.D. ,&nbsp;Zhe Tian M.Sc. ,&nbsp;Jordan A. Goyal ,&nbsp;Claudia Collà Ruvolo M.D. ,&nbsp;Gianluigi Califano M.D. ,&nbsp;Massimiliano Creta M.D. ,&nbsp;Fred Saad M.D., Ph.D. ,&nbsp;Shahrokh F. Shariat M.D. ,&nbsp;Alberto Briganti M.D., Ph.D. ,&nbsp;Felix K.H. Chun M.D. ,&nbsp;Stefano Puliatti M.D. ,&nbsp;Nicola Longo M.D. ,&nbsp;Pierre I. Karakiewicz M.D.","doi":"10.1016/j.urolonc.2024.09.035","DOIUrl":"10.1016/j.urolonc.2024.09.035","url":null,"abstract":"<div><h3>Background</h3><div>Use of critical care therapies (CCT), that include invasive mechanical ventilation (IMV), total parenteral nutrition (TPN) and other modalities are unknown after radical nephroureterectomy (RNU) for upper urinary tract carcinoma (UUTC). Their relationship with in-hospital mortality is also unknown.</div></div><div><h3>Methods</h3><div>Within the National Inpatient Sample (2008–2019), we identified non-metastatic UUTC patients treated with RNU. Multivariable logistic regression models were used.</div></div><div><h3>Results</h3><div>Of 8,995 patients, 375 (4.2%) received CCT and 82 (0.9%) experienced in-hospital mortality. Of CCT modalities, 215 (2.4%) received IMV and 139 (1.5%) TPN. Temporal CCT, IMV, and TPN trends very closely followed in-hospital mortality trends. Relative to historical UUTC patients (2008–2013), contemporary (2014–2019) patients exhibited lower CCT (Δ = 2.2%, <em>P</em> value &lt; 0.0001), lower IMV (Δ = 1.4%, <em>P</em> &lt; 0.0001), lower TPN (Δ = 2.2%, <em>P</em> &lt; 0.0001), and lower in-hospital mortality (Δ = 0.4%, <em>P</em> = 0.03) rates. Of in-hospital mortalities, 52 out of 82 received CCT but 30 of 82 did not. Median age (&gt; 72 years; odds ratio [OR] 1.4; <em>P</em> = 0.002) and Charlson comorbidity index ≥ 3 (OR 4.1; <em>P</em> &lt; 0.001) and ≥ 1-2 (OR 1.7; <em>P</em> = 0.001) independently predicted overall higher CCT, IMV, TPN, and in-hospital mortality.</div></div><div><h3>Conclusion</h3><div>After RNU, CCT rates parallels in-hospital mortality rates. CCT represents a 5 to 6-fold multiple of in-hospital mortality rate. In RNU patients, CCT rates are higher in older and sicker individuals. Lower CCT rates that are paralleled by lower in-hospital mortality may be interpreted as an indicator of improved quality of care. Ideally all in-hospital mortalities should be predated by CCT exposure.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 328.e9-328.e15"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475859","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":"Pathologic prostate cancer grade concordance among high-resolution micro-ultrasound, systematic transrectal ultrasound and MRI fusion biopsy","authors":"Soum D. Lokeshwar M.D., M.B.A.,&nbsp;Ankur U. Choksi M.D.,&nbsp;Shayan Smani B.S.,&nbsp;Victoria Kong B.S.,&nbsp;Vinaik Sundaresan B.S.,&nbsp;Ryan Sutherland M.P.H, M.Phi.,&nbsp;Joseph Brito M.D.,&nbsp;Joseph F Renzulli M.D.,&nbsp;Preston C. Sprenkle M.D.,&nbsp;Michael S. Leapman M.D., M.H.S.","doi":"10.1016/j.urolonc.2024.10.018","DOIUrl":"10.1016/j.urolonc.2024.10.018","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and Objective&lt;/h3&gt;&lt;div&gt;Comparative studies among biopsy strategies have not been conducted evaluating pathologic concordance at radical prostatectomy(RP), especially with novel micro-ultrasound (micro-US) image-guided biopsy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A retrospective study among patients with PCa who underwent RP following TRUS, MRI-TRUS fusion, microUS, or MRI-microUS fusion biopsy in a multi-site single institution. We compared GG-upgrade from biopsy to RP based on highest GG in any biopsy core and examined clinical/pathologic factors associated with pathologic upgrading using descriptive statistics, and multivariable logistic-regression analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;429 patients between 1/2021 and 6/2023 including 10 (25.6%) who underwent systematic TRUS, 237 (55.2%) MRI-TRUS, 67 (15.6%) MRI-microUS and 15 (3.5%) micoUS-alone biopsy prior to RP. 78 (18.2%) were upgraded on final pathology (TRUS 31 (28.2%), MRI-TRUS 31 (13.1%), MRI-microUS 10 (14.9%), microUS: 6 (40%)) and 99 downgraded. 14 (3.5%) experienced a major upgrade (≥2 GG increase). On multivariable-analysis both MRI-TRUS (odds ratio, OR: 0.31,95% CI:0.17–0.56, &lt;em&gt;P&lt;/em&gt; &lt; 0.001) and MRI-microUS (OR: 0.43,95%CI: 0.19–0.98, &lt;em&gt;P&lt;/em&gt; = 0.044) were associated with lower odds pathological-upgrade compared with TRUS biopsy alone. No significant differences in the odds of upgrade between TRUS and microUS alone (&lt;em&gt;P&lt;/em&gt; &gt; 0.05), or between MRI-microUS and MRI-TRUS(&lt;em&gt;P&lt;/em&gt; = 0.696) on pairwise comparisons. MRI-microUS was associated with lower upgrade compared with microUS (OR: 0.26,95% CI:0.08–0.90, &lt;em&gt;P&lt;/em&gt; = 0.034). No difference among the biopsy strategies in pathologic downgrading or overall GG concordance. Limitations include retrospective analysis, inter-clinician experience and lesion selection in varying biopsy techniques.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Both MRI-microUS and MRI-TRUS fusion were associated with similarly improved GG concordance compared with TRUS biopsy. No significant differences between microUS-alone and TRUS or between MRI-microUS and MRI-TRUS fusion approaches, may suggest similar accuracy performance for disease sampling.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;What does the study add&lt;/h3&gt;&lt;div&gt;To our knowledge, this is the first study to investigate GG concordance based on type of biopsy, especially microUS related GG upgrading after RP. In a moderately sized cohort this is the first to investigate pathologic concordance in MRI-microUS fusion compared to MRI-TRUS fusion biopsy. Our study may help urologists in counseling patients after biopsy and choosing the ideal image guided biopsy technique, however randomized controlled trials are needed to validate our results.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patient Summary&lt;/h3&gt;&lt;div&gt;We performed a study to see if the type of prostate biopsy, including use of MRI assistance as well as a new image-guided biopsy using a more advanced ultrasound, was better able to identify the aggress","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 336.e13-336.e20"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629080","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":"Development of TAR-200: A novel targeted releasing system designed to provide sustained delivery of gemcitabine for patients with bladder cancer","authors":"Siamak Daneshmand M.D. ,&nbsp;Ashish M. Kamat M.D., M.B., B.S. ,&nbsp;Neal D. Shore M.D. ,&nbsp;Joshua J. Meeks M.D., Ph.D. ,&nbsp;Matthew D. Galsky M.D. ,&nbsp;Joseph M. Jacob M.D. ,&nbsp;Michiel S. van der Heijden M.D., Ph.D. ,&nbsp;Stephen B. Williams M.D., M.B.A., M.S. ,&nbsp;Thomas Powles M.D. ,&nbsp;Sam S. Chang M.D. ,&nbsp;James W.F. Catto Ph.D., F.R.C.S. (Urol.) ,&nbsp;Sarah P. Psutka M.D. ,&nbsp;Félix Guerrero-Ramos M.D., Ph.D. ,&nbsp;Evanguelos Xylinas M.D. ,&nbsp;Makito Miyake M.D., Ph.D. ,&nbsp;Giuseppe Simone M.D., Ph.D. ,&nbsp;Karen Daniel Ph.D. ,&nbsp;Hussein Sweiti M.D. ,&nbsp;Christopher Cutie M.D. ,&nbsp;Andrea Necchi M.D.","doi":"10.1016/j.urolonc.2024.12.264","DOIUrl":"10.1016/j.urolonc.2024.12.264","url":null,"abstract":"<div><div>Treatment options for recurrent high-risk non–muscle-invasive bladder cancer (HR NMIBC) and muscle-invasive bladder cancer (MIBC) are limited, highlighting a need for clinically effective, accessible, and better-tolerated alternatives. In this review we examine the clinical development program of TAR-200, a novel targeted releasing system designed to provide sustained intravesical delivery of gemcitabine to address the needs of patients with NMIBC and of those with MIBC. We describe the concept and design of TAR-200 and the clinical development of this gemcitabine intravesical system in the SunRISe portfolio of studies. This includes 3 phase I studies evaluating the safety and initial tumor activity of TAR-200 and 5 phase II/III studies assessing the efficacy and safety of TAR-200, with or without systemic cetrelimab, as a treatment option for patients with HR NMIBC (bacillus Calmette-Guérin naive [papillary and carcinoma in situ] and MIBC (neoadjuvant and patients ineligible for or refusing radical cystectomy). Pharmacokinetics demonstrate intravesical gemcitabine delivery via TAR-200 over a prolonged period without detectable plasma levels. Phase I studies showed that TAR-200 is well tolerated, with preliminary antitumor activity in intermediate-risk NMIBC and MIBC. Preliminary data from the phase IIb SunRISe-1 study demonstrate that TAR-200 monotherapy is safe and effective in patients with bacillus Calmette-Guérin–unresponsive high-risk NMIBC. TAR-200 represents an innovative approach to the local treatment of bladder cancer.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 286-296"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012485","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 obesity on prostatectomy outcomes: Insights from a large prospectively maintained cohort","authors":"Ekamjit S. Deol ,&nbsp;Kelly S. Lehner ,&nbsp;Anthony E. Fadel ,&nbsp;Laureano J. Rangel ,&nbsp;Abhinav Khanna ,&nbsp;Matthew K. Tollefson ,&nbsp;Paras H. Shah ,&nbsp;Igor Frank ,&nbsp;Stephen A. Boorjian ,&nbsp;R. Jeffrey Karnes ,&nbsp;Vidit Sharma","doi":"10.1016/j.urolonc.2025.01.014","DOIUrl":"10.1016/j.urolonc.2025.01.014","url":null,"abstract":"<div><h3>Background</h3><div>In this study we aimed to explore the impact of BMI on perioperative complications, functional outcomes, and oncologic outcomes and longitudinal outcomes.</div></div><div><h3>Methods</h3><div>We queried our prospectively maintained radical prostatectomy (RP) registry from 1986 to 2018 for patients with cM0 prostate adenocarcinoma without prior BPH surgery or radiation therapy. Preoperative BMI was associated with the following outcomes of interest: 30-day complications, 1-year functional outcomes, and oncologic outcomes. Logistic regression analyses were used for complications and surgical outcomes and competing risk Cox proportional hazard models were used for oncologic outcomes.</div></div><div><h3>Results</h3><div>In a cohort of 21,604 patients, 28.9% and 1.0% had BMI &gt; 30 (N = 6,252) and BMI &gt; 40 (N = 222), respectively. Obese patients were more likely to have positive surgical margins (29.4% vs. 25.0%, <em>P</em> &lt; 0.001) and early complications (15.0% vs. 11.1%, <em>P</em> &lt; 0.001) and these were confirmed on multivariable analysis: OR 1.04 (<em>P</em> &lt; 0.001) and OR 1.04 (<em>P</em> &lt; 0.001), respectively. RP on obese patients also had increased operative times and blood loss. Increasing BMI was associated with lower odds for recovering potency (OR 0.95, <em>P</em> &lt; 0.001) but was not associated with lower rates of postoperative continence (OR 1.005, <em>P</em> = 0.403). On multivariable competing risk analysis, patients with BMI &gt; 30 had higher odds of nonprostate cancer mortality but no difference in biochemical failure, metastasis or cancer-specific survival.</div></div><div><h3>Conclusions</h3><div>RP in obese patients can be technically challenging but delivers similar oncologic outcomes to nonobese patients. This information can be useful for patient counseling to support the use of radical prostatectomy in appropriately selected obese patients.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 5","pages":"Pages 334.e7-334.e15"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789195","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":"Assessment of postoperative practices and discharge recommendations after radical prostatectomy.","authors":"Bárbara Vieira Lima Aguiar Melão, Melissa Assel, Maria Pere, Sunny Nalavenkata, Karim A Touijer, Vincent P Laudone, Daniel W Lin, Juan Gomez Rivas, Anders Bjartell, Sigrid V Carlsson","doi":"10.1016/j.urolonc.2025.03.027","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.03.027","url":null,"abstract":"<p><strong>Purpose: </strong>Consistent, accurate postoperative guidance is crucial for early recovery and patient satisfaction in urology, especially for radical prostatectomy (RP) patients. However, patients often receive inconsistent information, highlighting the need for standardized, evidence-based postoperative care guidelines.</p><p><strong>Materials and methods: </strong>We conducted a comprehensive review and evaluation of current postoperative practices for RP. This involved (1) reviewing existing discharge information at Josie Robertson Surgery Center, Memorial Sloan Kettering Cancer Center to identify areas of improvement; (2) systematically evaluating inconsistencies in discharge instructions and their impact on patient care; (3) distributing an anonymous survey to urologists in the US and Europe via REDCap to gather insights into global postoperative care practices. The survey included questions on various aspects of postoperative care, such as catheter use, medication regimens, dietary restrictions, and physical activity guidelines.</p><p><strong>Results: </strong>We received 247 survey responses. Despite some consensus on certain postoperative practices and recommendations, significant variability existed, underscoring the lack of standardized guidelines. Notable differences were observed between US and European cohorts, particularly in postoperative length of stay and discharge practices. Only 1.4% of US responders discharged patients 3 or more days postsurgery compared to 46% in Europe. Variability was also noted in recommendations for erectile function medications and postoperative activity restrictions.</p><p><strong>Conclusion: </strong>This study underscores the significant variability in postoperative care recommendations for RP and the urgent need for standardized, evidence-based guidelines. Implementing such guidelines will enhance patient recovery, satisfaction, and overall outcomes, improving postoperative care across various surgical procedures.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039623","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":"Strengthening causal inference between gut microbiota and prostate cancer: Methodological considerations and recommendations","authors":"Junxian Zhao M.D. ,&nbsp;Junhao Chen M.Sc., M.D. ,&nbsp;Zegang Liu M.D. ,&nbsp;Wentao Zhang M.D. ,&nbsp;Jianzhong Yao M.D.","doi":"10.1016/j.urolonc.2025.02.019","DOIUrl":"10.1016/j.urolonc.2025.02.019","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 7","pages":"Pages 438-439"},"PeriodicalIF":2.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154708","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":"Thermal ablation for local tumor recurrence after previous partial nephrectomy: Perioperative and oncological outcomes","authors":"Chiara Vaccaro MD ,&nbsp;Francesco A. Mistretta MD ,&nbsp;Mattia Luca Piccinelli MD ,&nbsp;Elena Lievore MD ,&nbsp;Letizia Maria Ippolita Jannello MD ,&nbsp;Matteo Fontana MD ,&nbsp;Marco Tozzi MD ,&nbsp;Paolo della Vigna MD ,&nbsp;Guido Bonomo MD ,&nbsp;Gianluca Varano MD ,&nbsp;Federico Mastroleo MD ,&nbsp;Giulia Marvaso MD ,&nbsp;Barbara Alicja Jereczek-Fossa MD ,&nbsp;Stefano Luzzago MD ,&nbsp;Franco Orsi MD ,&nbsp;Gennaro Musi MD","doi":"10.1016/j.urolonc.2025.03.018","DOIUrl":"10.1016/j.urolonc.2025.03.018","url":null,"abstract":"<div><h3>Objectives</h3><div>Percutaneous thermal ablation (PTA) has emerged as an alternative to salvage radical nephrectomy (RN) for the treatment of renal cell carcinoma (RCC) local recurrence. We report perioperative and oncological outcomes of patients treated with PTA for RCC local recurrence.</div></div><div><h3>Materials and methods</h3><div>Twenty-seven patients with on-site recurrence received PTA from 2008 to 2022. Primary endpoints were perioperative outcomes, complications, and readmission rates. Secondary endpoints were on site and out site tumor recurrence. Last, we collected renal function outcomes after PTA.</div></div><div><h3>Results</h3><div>Median (IQR) treatment time was 75 (63–106) minutes. Intraoperative complications occurred in 1 (3.7%) patient, while postoperative in 2 (7.4%). Three patients (11%) received incomplete ablation, which required in one an adjunctive PTA and in 2 RN. Overall, 4 (16%) patients developed on site recurrence after a median follow-up of 30 (23–43) months: complete local control was achieved with subsequent PTA in 3 patients, while one developed bone metastases and, therefore, no other local treatments were performed. Moreover, 6 (24%) patients developed out-site recurrence after a median follow-up of 16 (10–23) months. Last, median creatinine drop at 1 month and at 1 year after PTA was -0.03 (-0.11 to 0.01) and -0.11 (-0.20 to -0.05), while median eGFR drop was 2 (0–7.65) and 9.5 (5–13.45).</div></div><div><h3>Conclusion</h3><div>PTA is a safe and feasible approach for management of on-site recurrences after PN. Low perioperative complication rates and optimal local cancer control were achieved in most patients, with no significant impairment of residual renal function.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 7","pages":"Pages 444.e1-444.e10"},"PeriodicalIF":2.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025344","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}