Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Rates of volume reduction after selective arterial embolization for renal angiomyolipoma","authors":"Ramon Pericas B.S. ,&nbsp;Connie Liou M.D. ,&nbsp;Dwight Aberle M.D. ,&nbsp;Prakash Gorroochurn Ph.D. ,&nbsp;Christopher B. Anderson M.D.","doi":"10.1016/j.urolonc.2025.06.021","DOIUrl":"10.1016/j.urolonc.2025.06.021","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize temporal patterns of renal angiomyolipoma volume reduction after selective arterial embolization and identify factors predictive of reduction rates</div></div><div><h3>Materials and methods</h3><div>Records of patients undergoing renal angiomyolipoma embolization from July 2001 to July 2023 at our center were retrospectively reviewed. Tumor measurements were extracted from available imaging, and lipid content was scored based on tumor attenuation characteristics. Rates of volume reduction were compared for tumors at different follow-up intervals. The primary outcome was monthly tumor volume reduction.</div></div><div><h3>Results</h3><div>Forty-four patients were identified who underwent 77 embolizations for 54 tumors. Of these, 32 patients had available volume data and were included in the analysis of our primary outcome. Tumor volumes decreased significantly faster during the first 6 months after embolization (7.4% per month) compared to years 2 and 3 of follow-up (0.3% per month, <em>P</em> = 0.01 and &lt;0.1% per month, <em>P</em> = 0.01, respectively). Mean tumor size reduction within the first 6 months of initial embolization was 25% lower for patients who ultimately had repeat embolization compared to single-embolization patients. Within the first 6 months, older patients experienced 0.9% lower monthly volume reduction per additional year of age.</div></div><div><h3>Conclusions</h3><div>Embolized tumors in this cohort involuted rapidly during the first 6 months of follow-up, then stabilized, with the rate of volume reduction approaching 0% per month after 2 years. These data contribute to the understanding of angiomyolipoma embolization outcomes and may help providers avoid unnecessary embolization in patients with stable smaller tumors after 1 to 2 years.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 11","pages":"Pages 662.e17-662.e23"},"PeriodicalIF":2.3,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817570","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":"Does ureteral stent drainage prior to radical nephroureterectomy increase the risk of intravesical tumor recurrence?","authors":"Bao Guan ,&nbsp;Guoli Wang ,&nbsp;Huifeng Zhang ,&nbsp;Mancheng Xia ,&nbsp;Zihao Tao ,&nbsp;Qi Tang ,&nbsp;Chunru Xu ,&nbsp;Qian Yang ,&nbsp;Hanzhen Ren ,&nbsp;Yicong Du ,&nbsp;Chao Cao ,&nbsp;Kaishun Luo ,&nbsp;Kai Zhang ,&nbsp;Liqun Zhou ,&nbsp;Xuesong Li","doi":"10.1016/j.urolonc.2025.07.012","DOIUrl":"10.1016/j.urolonc.2025.07.012","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate whether ureteral stent drainage (USD) increases the risk of intravesical recurrence in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU).</div></div><div><h3>Methods</h3><div>This retrospective study was conducted involving 2,756 upper tract urothelial carcinoma (UTUC) patients treated with RNU between 2000 and 2022, of whom 77 had a history of USD. The primary endpoint was to assess the association between USD and post-RNU bladder recurrence-free survival (BRFS). A 1:3 propensity score-matching analysis was performed to compare patients with and without a history of USD. Kaplan-Meier analyses, along with univariate and multivariate Cox proportional hazard modeling, were employed to compare BRFS, overall survival, cancer-specific survival, and contralateral recurrence-free survival.</div></div><div><h3>Results</h3><div>Kaplan–Meier analysis demonstrated a significant difference in BRFS between patients with and without a history of USD in the entire cohort (<em>P</em> = 0.022). However, in the matched cohort, no significant difference in BRFS was observed. Both univariate and multivariate Cox regression analyses revealed that prior ureteroscopy with biopsy was associated with intravesical recurrence, but USD history did not increase the risk of bladder recurrence, regardless of whether ureteroscopy was performed. Further analysis demonstrated that preoperative USD significantly improved pre-RNU renal function in patients with chronic kidney disease stage 3-5.</div></div><div><h3>Conclusion</h3><div>The use of USD does not increase the risk of intravesical recurrence and has minimal impact on oncologic outcomes. Additionally, preoperative USD improves renal function, thereby expanding neoadjuvant treatment options for patients with compromised kidney function.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 11","pages":"Pages 662.e1-662.e8"},"PeriodicalIF":2.3,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817566","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":"Modified Glasgow prognostic score predicts outcomes of tyrosine kinase inhibitor monotherapy and immune checkpoint inhibitor combination therapy for metastatic renal cell carcinoma","authors":"Kazuma Yukihiro M.D. ,&nbsp;Keisuke Goto M.D., Ph.D. ,&nbsp;Nanami Taketomi Ph.D. ,&nbsp;Yasushi Orihashi Ph.D. ,&nbsp;Takashi Babasaki M.D., Ph.D. ,&nbsp;Yoshimasa Kurimura M.D., Ph.D. ,&nbsp;Kenichiro Fukuoka M.D., Ph.D. ,&nbsp;Akira Fujita M.D. ,&nbsp;Kunihiro Hashimoto M.D., Ph.D. ,&nbsp;Takeshi Ueno M.D. ,&nbsp;Hideo Iwamoto M.D., Ph.D. ,&nbsp;Kenichiro Ikeda M.D., Ph.D. ,&nbsp;Kensuke Nishida M.D. ,&nbsp;Kohei Saito M.D. ,&nbsp;Yoshito Kagiyama M.D. ,&nbsp;Nobuyuki Hinata M.D., Ph.D.","doi":"10.1016/j.urolonc.2025.07.018","DOIUrl":"10.1016/j.urolonc.2025.07.018","url":null,"abstract":"<div><h3>Purpose</h3><div>Tyrosine kinase inhibitors (TKI) and immune checkpoint inhibitors (ICI) are standard treatments for metastatic renal cell carcinoma (mRCC). the modified Glasgow prognostic score (mGPS) was suggested as one of promising biomarkers. This study evaluated the clinical utility of mGPS in patients with mRCC receiving TKI and ICI therapy and investigated the differential impact of TKI monotherapy and ICI combination therapy on treatment outcomes.</div></div><div><h3>Materials and Methods</h3><div>We retrospectively analyzed 265 patients with mRCC treated at Hiroshima University and its affiliated hospitals between 2007 and 2023. Patients were stratified according to mGPS (low: score 0; high: score 1, 2) and treatment modality (TKI monotherapy or ICI combination therapy). Overall survival (OS) was analyzed using the Kaplan–Meier method and multivariate Cox regression models. The clinical utility of mGPS was assessed using decision curve analysis.</div></div><div><h3>Results</h3><div>A high mGPS was associated with aggressive disease features and poor prognosis. Multivariate analysis identified mGPS as an independent predictor of OS (HR = 2.101, 95% CI: 1.082–4.078, <em>P</em> = 0.028). Its discriminative ability was comparable to that of the IMDC criteria (C-index: 0.681 vs. 0.682) while providing a superior net benefit, especially within the threshold probability range of 0.30–0.65. In the high-mGPS group, ICI combination therapy significantly improved OS compared to TKI monotherapy (median: 25.4 vs. 8.6 months, <em>P</em> = 0.011).</div></div><div><h3>Conclusions</h3><div>The mGPS effectively predicted the oncological outcomes for mRCC. In particular, it may help identify patients with high mGPS who could benefit from ICI combination therapy.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 11","pages":"Pages 663.e1-663.e9"},"PeriodicalIF":2.3,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817569","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":"Bacillus Calmette-Guérin (BCG) in combination with PANVAC™ vs. BCG alone in adults with high-grade BCG-refractory non-muscle-invasive bladder cancer","authors":"Matthew Ho M.D. ,&nbsp;Alon Lazarovich M.D., M.B.A. ,&nbsp;Ragheed Saoud M.D. ,&nbsp;Aaron Dahmen M.D. ,&nbsp;Samuel Tremblay M.D. ,&nbsp;Siobhan Telfer M.D. ,&nbsp;Mahir Maruf M.D. ,&nbsp;Eric A. Singer M.D., M.A., M.S. ,&nbsp;Robert E. Weiss M.D. ,&nbsp;Thomas L. Jang M.D., M.P.H. ,&nbsp;Sammy E. Elsamra M.D. ,&nbsp;Maria Merino M.D. ,&nbsp;Rebecca Dolan CRNP, MN ,&nbsp;Vladimir Valera M.D. ,&nbsp;Beatriz Walter Rodriquez M.D., Ph.D. ,&nbsp;Reema Railkar Ph.D. ,&nbsp;Sonia Bellfield R.N., M.S.N. ,&nbsp;Lambros Stamatakis M.D. ,&nbsp;Joanna Shih Ph.D. ,&nbsp;Renee N. Donahue Ph.D. ,&nbsp;Piyush K. Agarwal M.D.","doi":"10.1016/j.urolonc.2025.06.006","DOIUrl":"10.1016/j.urolonc.2025.06.006","url":null,"abstract":"<div><h3>Purpose</h3><div>We postulated that PANVAC™, a recombinant poxviral vector vaccine, could enhance the immunologic and clinical response to an additional induction course of bacillus Calmette-Guérin (BCG) in patients with recurrent high-grade non-muscle-invasive bladder cancer (NMIBC).</div></div><div><h3>Methods</h3><div>This was a randomized, open-label, prospective, phase II study in subjects with high-grade NMIBC who had failed at least 1 induction course of intravesical BCG. Patients were randomized to either BCG alone or BCG+PANVAC. All subjects received intravesical BCG for 6 weeks. Patients in the combination arm also received priming and booster doses of PANVAC. The primary endpoint was recurrence-free survival. Secondary endpoints included progression-free survival and radical cystectomy-free survival. We also evaluated exploratory secondary immunological response endpoints.</div></div><div><h3>Results</h3><div>Our study concluded based on preplanned futility analysis. Overall, 32 patients were enrolled; 2 withdrew. Thirty patients (15/arm) were analyzed; 5 (33.3%) in the BCG-alone arm and 5 (33.3%) in the BCG+PANVAC arm met criteria for BCG- unresponsive disease. 12-month recurrence-free survival was 53.3% for the BCG-alone arm and 40% for the BCG+PANVAC arm. Overall recurrence rate at any time point was 73.3% at a median of 10.8 months, for an overall recurrence rate of 66.7% in the BCG-alone arm and 80% in the BCG+PANVAC arm. There was no difference in median recurrence-free survival or progression-free survival.</div></div><div><h3>Conclusions</h3><div>This phase II study demonstrated no improvement in recurrence-free survival with BCG+PANVAC compared to BCG alone in patients with NMIBC who failed to respond to intravesical BCG.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 11","pages":"Pages 660.e1-660.e10"},"PeriodicalIF":2.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804926","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":"Serum Markers as predictors for treatment benefit in castration-resistant prostate cancer","authors":"Tibor Szarvas ,&nbsp;Gero Kramer ,&nbsp;Kiran Jagarlamudi Ph.D. ,&nbsp;Johan Styrke M.D., Ph.D. ,&nbsp;Stig Linder","doi":"10.1016/j.urolonc.2025.06.018","DOIUrl":"10.1016/j.urolonc.2025.06.018","url":null,"abstract":"<div><h3>Purpose</h3><div>While most prostate cancer patients initially respond to androgen-deprivation therapy (ADT), they will develop castration-resistance leading to progressing to castration-resistant prostate cancer (CRPC). Different treatment options are available for CRPC, including androgen receptor pathway inhibitors (ARPIs) and docetaxel (DOC). As tissue samples are difficult to access at this stage, blood-based analyses offer a more feasible approach. Therefore, we examined whether serum markers could potentially support treatment decisions in CRPC.</div></div><div><h3>Materials and Methods</h3><div>Overall survival (OS) was examined in 208 CRPC patients treated with either ARPIs or DOC. Serum markers were chosen to reflect relevant tumor properties: serum thymidine kinase 1 (sTK1) as a proliferation-associated marker, TPS (tissue polypeptide specific antigen) as an epithelial marker, and prostate-specific antigen (PSA).</div></div><div><h3>Results</h3><div>A median OS (mOS) time of 19.6 (IQR: 9.5–35.4) months was observed for the whole cohort. Patients with sTK1^high/TPS^high levels treated with ARPIs showed a mOS time of 6.8 (IQR: 4.2–9.5) months, compared to 14.6 (IQR: 8.7–48.9) months for patients receiving DOC (<em>P</em> = 0.024). Patients with sTK1^low and/or TPS^low levels showed similar mOS times irrespective of treatment. Combinations of sTK1 and TPS with PSA yielded similar findings for ARPI-treated patients and longer OS in DOC-treated patients.</div></div><div><h3>Conclusions</h3><div>This study introduces the concept of identifying proliferating carcinomas using a combination of the serum biomarkers sTK1 and TPS. The results suggest that sTK1^high/TPS^high CRPC patients derive more benefit from DOC, consistent with known mechanisms of drug action. Further randomized studies will be required to prove the therapy-predictive value of these tumor markers in CRPC.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 11","pages":"Pages 664.e11-664.e17"},"PeriodicalIF":2.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800393","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":"Current practices and variability in dynamic sentinel node biopsy for penile cancer: A survey of European Referral Centers","authors":"Sylvia Yan ,&nbsp;Mattia Longoni ,&nbsp;Giuseppe Basile ,&nbsp;Christian D. Fankhauser ,&nbsp;Nicola Di Nardo ,&nbsp;Raul Sanchez ,&nbsp;Jose Maria Gaya ,&nbsp;Laura Elst ,&nbsp;Hielke M. de Vries ,&nbsp;Rick Verdijk ,&nbsp;Benjamin Ayres ,&nbsp;Nicholas Watkin ,&nbsp;Dominik Glombik ,&nbsp;Alberto Breda ,&nbsp;Maarten Albersen ,&nbsp;Andrea Salonia ,&nbsp;Oscar Brouwer ,&nbsp;Marco Bandini ,&nbsp;EAU-YAU Penile and Testis Cancer Working Group","doi":"10.1016/j.urolonc.2025.06.022","DOIUrl":"10.1016/j.urolonc.2025.06.022","url":null,"abstract":"<div><h3>Background</h3><div>Dynamic sentinel node biopsy (DSNB) is the currently preferred staging method of high-risk penile cancer (PeCa) patients with cN0 disease. Recently, there have been advancements in the surgical approach and techniques. This study aims to compare the contemporary DSNB practice and techniques amongst European referral centers.</div></div><div><h3>Materials and Methods</h3><div>An online survey was sent to members of the EAU YAU Penile and Testis Cancer working group. These questions delved into various facets of DSNB, encompassing imaging techniques, tracers, surgical approaches, and postoperative patient care. Participating centers were also required to provide video-recorded DSNB procedures in a standardized manner for a comparative analysis of technical nuances.</div></div><div><h3>Results</h3><div>Responses were received from twelve Urologists from nine European centers. Overall, 83% and 42% of surgeons performed &gt;10 and &gt;50 DSNB procedures per year, respectively. There is a broad consensus on the technique and site of tracer injections. Conversely, 50% of centers use lymphoscintigraphy, 17% use SPECT/CT, while 33% utilize both imaging modalities. The predominant choice of dye is Patent V/blue, but 25% of centers use Indocyanine Green (ICG). Notable variability exists in surgical incision sites and lymphatic ligation techniques. The consensus is leaning towards not leaving a wound drain. Overall, 83% of centers adopt antibiotic surgical prophylaxis, with 83% discontinuing it postoperatively. A quarter of centers would advocate for patients to be discharged with thromboprophylaxis, either using low molecular weight heparin or thromboembolic deterrent stockings. On average, the postoperative length of stay in hospital is 1 day.</div></div><div><h3>Conclusions</h3><div>Variation exists in procedural aspects and postoperative management among centers performing DSNB for PeCa. Newer technologies like fluorescence imaging and SPECT/CT are used in some European centers, but high-quality evidence is sparse, highlighting the need for extensive multicenter research into surgical outcomes and emerging technologies.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 11","pages":"Pages 665.e11-665.e16"},"PeriodicalIF":2.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795644","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":"Prehabilitation: Cognitive considerations.","authors":"David P Sheppard, Sarah P Psutka, Hanna Hunter","doi":"10.1016/j.urolonc.2025.06.017","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.06.017","url":null,"abstract":"<p><p>Urologic cancers and their treatments confer risk for cognitive dysfunction, which can have significant impact on quality of life and overall well-being during survivorship. Current approaches to ameliorate cognitive dysfunction in urologic and other cancers emphasize post-treatment rehabilitation methods of cognitive compensatory strategies or training-based restorative practice. Prehabilitation involves supporting resilience prior to treatment initiation and has demonstrated promise for supporting various clinical outcomes in urologic cancers. However, there is a paucity of studies that have utilized prehabilitation approaches to support cognitive functioning, and few existing prehabilitation studies in urologic cancers have examined cognitive functioning endpoints. The objectives of this literature review are to describe: (1) common cognitive findings in urologic cancers, (2) contemporary evidence for cognitive rehabilitation in cancer populations, (3) existing cognitive prehabilitation approaches that have yet to be implemented in urologic cancers, and (4) prehabilitation efforts addressing physical activity, nutrition, and mood/mental health that could be used in the future to support and study cognitive endpoints. A model for cognitive prehabilitation is proposed to guide future research in urologic cancers.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800392","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":"Oncologic and survival outcomes in patients undergoing radical nephroureterectomy with preoperative or iatrogenic dialysis dependence","authors":"Matthew S. Lee ,&nbsp;Patrick J. Hensley ,&nbsp;Daniel Igel ,&nbsp;Roger Li ,&nbsp;Roderick K. Clark ,&nbsp;Nicholas Bingham ,&nbsp;Maximilian Pallauf ,&nbsp;Prabin Thapa ,&nbsp;Stephen A. Boorjian ,&nbsp;Jay D. Raman ,&nbsp;Nirmish Singla ,&nbsp;Jonathan Coleman ,&nbsp;Vitaly Margulis ,&nbsp;Philippe E. Spiess ,&nbsp;Surena F. Matin ,&nbsp;Aaron M. Potretzke","doi":"10.1016/j.urolonc.2025.06.020","DOIUrl":"10.1016/j.urolonc.2025.06.020","url":null,"abstract":"<div><h3>Purpose</h3><div>Radical nephroureterectomy (RNU) is the gold standard treatment for high-risk upper tract urothelial carcinoma (UTUC). However, the oncologic control afforded by RNU may be accompanied by significant renal function decline. Data regarding patients with immediate end-stage renal disease (ESRD) after RNU is limited. Herein, we investigate outcomes of patients undergoing RNU who were dialysis-dependent prior to surgery or rendered anephric by surgery relative to a matched control cohort.</div></div><div><h3>Materials and Methods</h3><div>We queried our multi-institutional RNU database to identify patients with preoperative ESRD (<em>n</em> = 16) or solitary kidney (<em>n</em> = 12). We matched these 1:2 to a control cohort of RNU patients using age, sex, Charlson Comorbidity Index, smoking status, and pathologic T-stage. Oncologic and survival outcomes were compared using the Kaplan–Meier method.</div></div><div><h3>Results</h3><div>The two groups had similar baseline clinical and oncologic characteristics, including utilization of perioperative systemic therapy. There was no significant difference in time to recurrence or cancer specific mortality. However, the dialysis cohort displayed a higher risk of overall mortality, with 3- and 5-year survival of 29% and 14%, compared to 60% and 57% in the control group (HR 2.13, <em>P</em> = 0.03).</div></div><div><h3>Conclusions</h3><div>Patients undergoing RNU with immediate postoperative ESRD had similar oncologic outcomes but worse overall survival compared to matched controls. These results are likely related to the impact of ESRD and other nononcologic comorbidities, which must factor into treatment decisions. For those who ultimately elect RNU, all efforts should be made to optimize any potentially reversible comorbidities after surgery.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 11","pages":"Pages 662.e9-662.e15"},"PeriodicalIF":2.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776272","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":"Repeat TURBT for Ta and T1 bladder cancer: An updated review","authors":"Matthew DeSanto M.D.,&nbsp;Jordan Campanelli M.S.,&nbsp;Samuel Deem D.O.","doi":"10.1016/j.urolonc.2025.07.007","DOIUrl":"10.1016/j.urolonc.2025.07.007","url":null,"abstract":"<div><h3>Purpose</h3><div>The objective of this study is to determine residual tumor characteristics for high grade Ta and T1 bladder tumors following transurethral resection of bladder tumor (TURBT) at a facility where initial aggressive resection is standard.</div></div><div><h3>Methods</h3><div>This is a retrospective review of patients who had multiple TURBTs done by 2 urologic oncologists at a single facility. During a 5-year period from 2018 to 2022 using specific ICD-10 and CPT codes, the institutional electronic health record was used to identify patients requiring repeat resection for high grade Ta and all T1 bladder cancer. Data compilation and statistical analysis was performed on points of interest from initial to repeat resection, most notably, tumor upstaging and tumor persistence while accounting for multiple demographic variables.</div></div><div><h3>Results</h3><div>Analysis of our institutional data indicates 143 patients who underwent an initial and repeat TURBT at our facility during the 5-year period of interest. Retrospective data demonstrates a tumor persistence rate of 27.7% and 34.6% for Ta and T1 bladder cancer, respectively. Additionally, our data reveals an upstaging rate of only 3.1% and 3.8% for Ta and T1 bladder cancer, respectively.</div></div><div><h3>Conclusion</h3><div>Per current American Urological Association (AUA) guidelines, patients with T1 or high-grade Ta bladder cancer should undergo repeat transurethral resection within 6 weeks as previously published literature reports high rates of tumor upstaging and progression. Our data shows a dramatically lower rate of tumor persistence and tumor upstaging on repeat TURBT compared to historical literature, and our surgical approach could potentially challenge the need for repeat resection for certain patients.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 11","pages":"Pages 660.e11-660.e14"},"PeriodicalIF":2.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776273","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-dependent gene alterations is associated with distinct immune profiles in renal cell carcinoma","authors":"Jean-Pierre (Trey) Kanumuambidi M.P.H. ,&nbsp;Reynier Rodriguez Rosales B.S. ,&nbsp;Arjun Venkatesh M.S. ,&nbsp;Thomas Metzner D.O. ,&nbsp;Mohammed Al-Toubat M.D. ,&nbsp;Yudai Ishiyama M.D. ,&nbsp;Hunter Sceats M.D., Ph.D. ,&nbsp;K.C. Balaji M.D.","doi":"10.1016/j.urolonc.2025.07.009","DOIUrl":"10.1016/j.urolonc.2025.07.009","url":null,"abstract":"<div><h3>Background</h3><div>The role of genetic alterations (GAs) in renal cell carcinoma (RCC) accumulating over time remains unclear. We examined GAs by age group and their associations with overall survival (OS), immune infiltration, and immune checkpoint inhibitor (ICI) response.</div></div><div><h3>Methods</h3><div>Next-generation sequencing data from 3,360 RCC patients in the AACR Project GENIE registry were analyzed. GAs with &gt;5% frequency were stratified by age into &lt;45, 45 to 75, and &gt;75 years. Kaplan-Meier analysis assessed OS. Immune profiles and ICI responses were evaluated using TIMER2.0 and ROC Plotter. Co-occurrence and synthetic lethality (SL) analyses were also performed. <em>P</em> &lt; 0.05 was considered significant.</div></div><div><h3>Results</h3><div>Among 3,360 patients, 53.8% had clear cell, 25.5% papillary, and 12.1% chromophobe RCC. Younger and older patients exhibited significantly higher MUC4 (13.9%), TP53 (9.6%), and VHL (48.4%), TTN (21.0%), and PBRM1 (27.8%) GAs, respectively (<em>P</em> &lt; 0.001). Subtype analysis revealed that clear cell RCC largely drove these patterns. While chromophobe RCC in older patients showed significantly higher KMT2C, MST1, and MUC4 alterations, papillary tumors showed none. TP53, VHL, TTN, and PBRM1 alterations were associated with worse OS (<em>P</em> &lt; 0.001). TP53, TTN, and PBRM1 also showed distinct immune profiles, although differences in ICI response were not demonstrable, presumably due to small sample size. Several novel SL pairs were identified.</div></div><div><h3>Conclusion</h3><div>Age-related GAs in RCC are largely driven by clear cell and chromophobe subtypes. These alterations are associated with differences in survival and immune profiles but not with ICI response.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 11","pages":"Pages 663.e17-663.e24"},"PeriodicalIF":2.3,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790130","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}