Urologia Internationalis最新文献

{"title":"Sustained Response to Anti-PD-1 Therapy in Combination with Nab-Paclitaxel in Metastatic Testicular Germ Cell Tumor Harboring the KRAS-G12V Mutation: A Case Report.","authors":"Jinfeng Pan, Weiqi Yin, Yingzhi Chen, Hui Wang, Wei Wu, Suying Wang, Da Li, Qi Ma","doi":"10.1159/000541588","DOIUrl":"10.1159/000541588","url":null,"abstract":"<p><strong>Introduction: </strong>Cisplatin-based standardized therapy has been established for metastatic testicular germ cell tumors (TGCTs). However, the patient prognosis is considerably less favorable if the disease recurs following failure of first-line therapies. There is a need for novel treatment options for patients with recurrent or metastatic TGCTs, notably for those that are not sensitive to first-line chemotherapy. With the development of next-generation sequencing technologies, an increasing number of gene mutations has been identified in TGCTs. Previously published research studies have established a link between KRAS mutations and chemotherapy resistance, and have demonstrated that KRAS mutations are associated with inflammatory tumor microenvironment and tumor immunogenicity, leading to an improved response to inhibition of programmed death (PD-1) protein expression. Previous studies have reported that the tumor immune microenvironment of TGCT influences therapeutic efficacy.</p><p><strong>Case presentation: </strong>A 65-year-old metastatic patient with TGCT and a KRAS-12 valine-for-glycine gene mutation was described. This patient initially underwent inguinal orchiectomy and received two prior chemotherapeutic regimens. Following the rapid progression of the disease, the patient was treated with anti-PD-1 therapy and nab-paclitaxel chemotherapy, and his condition was successfully controlled by this combination treatment.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the first successful case of KRAS-mutation patient with TGCT who achieved partially and sustained disease remission by combining immune checkpoint inhibitors with chemotherapy. This case provides an excellent example for personalized treatment of metastatic TGCTs.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"197-205"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Urinary Flora and Urinary Stones.","authors":"Sihang Qiao, Jianwei Yang, Li Yang","doi":"10.1159/000540990","DOIUrl":"10.1159/000540990","url":null,"abstract":"<p><strong>Background: </strong>Urinary system stones are a common clinical disease, with significant differences in incidence and recurrence rates between different countries and regions. The etiology and pathogenesis of urinary system stones have not been fully elucidated, but many studies have found that some bacteria and fungi that are difficult to detect in urine constitute a unique urinary microbiome. This special urinary microbiome is closely related to the occurrence and development of urinary system stones. By analyzing the urinary microbiome and its metabolic products, early diagnosis and treatment of urinary system stones can be carried out.</p><p><strong>Summary: </strong>This article reviews the relationship between the urinary microbiome and urinary system stones, discusses the impact of the microbiome on the formation of urinary system stones and its potential therapeutic value, with the aim of providing a reference for the early diagnosis, prevention, and treatment of urinary system stones.</p><p><strong>Key messages: </strong>(i) Urinary stones are a common and recurrent disease, and there is no good way to prevent them. (ii) With advances in testing technology, studies have found that healthy human urine also contains various types of bacteria. (iii) Is there a potential connection between the urinary microbiota and urinary stones, and if so, can understanding these connections offer fresh perspectives and strategies for the diagnosis, treatment, and prevention of urinary stones?</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"89-96"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of SARS-CoV-2 Pandemic on Diagnosis of Prostate Cancer.","authors":"Immanuel A Oppolzer, Marco J Schnabel, Selma Hammer, Hannah Zilles, Maximilian Haas, Christopher Goßler, Maximilian R Müller, Maximilian Burger, Michael Gierth","doi":"10.1159/000541753","DOIUrl":"10.1159/000541753","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to prove if the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic resulted in a delay in diagnosis and treatment of prostate cancer (PC).</p><p><strong>Methods: </strong>A monocentric, retrospective analysis was conducted at a university cancer center. Included were all patients with untreated PC diagnosed between January 2019 and December 2021. The observation covered 22 months of the SARS-CoV-2 pandemic and 14 months preceding it.</p><p><strong>Results: </strong>Nine hundred sixty-nine men prior (T0) and 1,343 during the pandemic (T1) were included. Mean age was 68.0 (SD 8.2). Median initial prostate-specific antigen was 8.1 ng/mL (T0) and 7.9 ng/mL (T1, p = 0.288). Time from biopsy to tumor board (T0: 1.3 months vs. T1: 0.9 months, p = 0.001), to staging (T0: 1.1 months vs. T1: 0.75 months, p = 0.707), and to therapy (T0: 3.0 months vs. T1: 2.0 months, p < 0.001) was shortened during the pandemic. Classified by d'Amico, a significant shift toward higher risk groups was seen (p = 0.024). Local staging showed an insignificant increase in locally advanced PCs. Metastatic diseases decreased from 10.3% to 8.9% (p = 0.433). Pathological staging showed pT3+ in 44.4% versus 44.7% (p = 0.565) and pN+ in 9.9% versus 9.6% (p = 0.899).</p><p><strong>Conclusion: </strong>Regarding the diagnosis and treatment of PC, we could not demonstrate any delays due to the SARS-CoV-2 pandemic.</p><p><strong>Introduction: </strong>The aim of this study was to prove if the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic resulted in a delay in diagnosis and treatment of prostate cancer (PC).</p><p><strong>Methods: </strong>A monocentric, retrospective analysis was conducted at a university cancer center. Included were all patients with untreated PC diagnosed between January 2019 and December 2021. The observation covered 22 months of the SARS-CoV-2 pandemic and 14 months preceding it.</p><p><strong>Results: </strong>Nine hundred sixty-nine men prior (T0) and 1,343 during the pandemic (T1) were included. Mean age was 68.0 (SD 8.2). Median initial prostate-specific antigen was 8.1 ng/mL (T0) and 7.9 ng/mL (T1, p = 0.288). Time from biopsy to tumor board (T0: 1.3 months vs. T1: 0.9 months, p = 0.001), to staging (T0: 1.1 months vs. T1: 0.75 months, p = 0.707), and to therapy (T0: 3.0 months vs. T1: 2.0 months, p < 0.001) was shortened during the pandemic. Classified by d'Amico, a significant shift toward higher risk groups was seen (p = 0.024). Local staging showed an insignificant increase in locally advanced PCs. Metastatic diseases decreased from 10.3% to 8.9% (p = 0.433). Pathological staging showed pT3+ in 44.4% versus 44.7% (p = 0.565) and pN+ in 9.9% versus 9.6% (p = 0.899).</p><p><strong>Conclusion: </strong>Regarding the diagnosis and treatment of PC, we could not demonstrate any delays due to the SARS-CoV-2 pandemic.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"158-166"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Reflux Ureteroileal Anastomosis for Orthotopic Ileal Neobladder Using Wallace Technique in a Single Trough.","authors":"Karim ElSaeed, Hany Moustafa, Sherif Abdelghani, Hossam ElAwady","doi":"10.1159/000541952","DOIUrl":"10.1159/000541952","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate the modification of the subserous extramural tunnel for non-refluxing ureteroileal anastomosis in U-shaped pouches using the Wallace technique with a single trough.</p><p><strong>Methods: </strong>This prospective study was conducted from 2017 to 2022 in a single tertiary center after approval from the Research Ethics Committee of our institution (approval number: FWA 000017585). 45 patients' candidates for radical cystectomy and orthotopic urinary diversion were included in this study. The patients were diverted using a U-shaped pouch with ureteroileal anastomosis, combining the extramural serous-lined tunnel and Wallace techniques in a single trough. Operative time and complications, including ureteric obstruction, reflux, and renal function, were recorded within 1 year.</p><p><strong>Results: </strong>The modified ureteroileal anastomosis combined with the extramural serous-lined tunnel and Wallace techniques had a relatively short operative time (mean 132.2 ± 18.3 min) and short bowel segment incorporation (30 cm). In 43 patients, vesicoureteral reflux occurred in only 2 patients (4.7%). One case of anastomotic stricture was diagnosed (2.3%), which increased to 2 cases (4.7%) after 1 year. Three patients (7%) developed pyelonephritis during the year. The mean serum creatinine level of the patients before the operation was 1.2 mg/dL, which increased to 1.4 mg/dL 6 months postoperatively.</p><p><strong>Conclusion: </strong>A modification of the subserous extramural tunnel for non-refluxing ureteroileal anastomosis in U-shaped pouch appears to be a good simple alternative that is less time consuming and using a shorter segment of bowel for orthotopic diversion with a comparable complication rate.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"182-188"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal Anesthesia versus General Anesthesia in the Endoscopic Management of Proximal Ureteral Stones: A Critical Evaluation Focusing on the Total Anesthesia Time.","authors":"Emre Bulbul, Fahri Yavuz Ilki, Yasin Yitgin, Fatih Ustun, Ali Sezer, Ela Erten, Emine Yitgin, Selahattin Bedir, Kemal Sarica","doi":"10.1159/000543203","DOIUrl":"10.1159/000543203","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to compare spinal and general anesthesia methods in endoscopic management of proximal ureteral stones with a particular emphasis on total anesthesia time.</p><p><strong>Methods: </strong>A total of 246 adult patients undergoing ureteroscopic management for proximal ureteral stones between January 2021 and March 2023 were enrolled. Two different types of anesthesia, namely, spinal (group 1, n = 109) and general (group 2, n = 137) anesthesia, were applied during these procedures.</p><p><strong>Results: </strong>The mean total anesthesia time of group 1 was statistically significantly shorter than that of group 2 (61.4 ± 28.7 and 93.7 ± 29.2 min, respectively, p = 0.013). While 92.7% of patients in group 1 were stone free after the interventions, this value was 92% in group 2 (p = 0.828). There was no statistically significant difference between the two groups regarding peri- (p = 0.126) or postoperative (p = 0.284) complications.</p><p><strong>Conclusions: </strong>Our results demonstrated well that both spinal and general anesthesia methods could be applied in a successful and safe manner in the endoscopic management of proximal ureteral stones. However, a shorter total anesthesia time under spinal anesthesia could be anticipated during endoscopic management of proximal ureteral stones.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"189-196"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Intrarenal Pressure through Dilatation State of the Renal Collecting System.","authors":"Yujun Chen, Heng Yang, Yue Yu, Haibo Xi, Gongxian Wang, Xiaochen Zhou","doi":"10.1159/000541637","DOIUrl":"10.1159/000541637","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to explore the relationship between the dilation states of the renal collecting system in flexible ureteroscopy (f-URS) view and intrarenal pressure (IRP).</p><p><strong>Methods: </strong>Fifteen porcine kidneys were randomly selected and numbered 1 through 15. Pressure transducers were inserted into the renal calyx via puncture and adjusted to a zero position. The distal end of the f-URS probe was placed within the renal pelvis. Perfusion rates of 50 mL/min, 80 mL/min, and 100 mL/min were utilized. We observed the relationship between the dilation state of the renal collecting system and changes in IRP. The state of complete dilation was defined as an unchanging spatial morphology of the renal collecting system as visualized during f-URS.</p><p><strong>Results: </strong>With irrigation rates of 50 mL/min, 80 mL/min, and 100 mL/min, IRP values at the moment of complete dilation of the renal collecting system ranged from 16 to 18 cm H2O, 16-19 cm H2O, and 16-19 cm H2O, respectively. Maximum IRPs ranged from 47 to 49 cm H2O, 82-85 cm H2O, and 97-100 cm H2O, respectively. Prior to complete dilation of the renal collecting system, IRP consistently remained below 20 cm H2O. However, following full dilation of the renal collecting system, IRP rose rapidly and rapidly surpassed 20 cm H2O. Despite sustained elevations in IRP following full dilation, no significant alterations in the renal collecting system dilated morphological were observed with f-URS.</p><p><strong>Conclusions: </strong>In vitro experiments indicate that when the renal collecting system is not fully dilated, the IRP is consistently less than 20 cm H2O. Evaluation of IRP being within a safe range can be determined by assessing the dilation status of the renal collecting system.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"151-157"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Application Value of 3D Model in Partial Nephrectomy of Varying Complexity.","authors":"Yajie Li, Qifei Zhou, Weihao Li, Jiahui Cao, Kangjie An, Shuhui Liu, Yanping Ma, Bo Tao, Ning Wang, Yaodong Jia, Lihong Nie, Ruining Zhao","doi":"10.1159/000542846","DOIUrl":"10.1159/000542846","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to explore the application value of three-dimensional (3D) model in partial nephrectomy across varying RENAL scores.</p><p><strong>Methods: </strong>A total of 126 patients were enrolled, divided into three groups: 25 cases in the 3D-partial nephrectomy (3D-PN), 86 cases in the 2D-partial nephrectomy (2D-PN), and 15 cases in the 3D-robot-assisted PN (3D-RAPN). Preoperative basic data were collected, including age, gender, neutrophil ratio, platelet count, blood glucose, GFR of the kidney, tumor diameter, tumor staging, RENAL score, Mayo Adhesive Probability (MAP) score, surgical time, warm ischemia time, intraoperative bleeding, postoperative drainage volume, postoperative hospital stay, change in creatinine level at 3 months postoperatively, and pathological results. Perioperative data between 3D-PN and 2D-PN, between the RENAL score 4-6 subgroup of 3D-PN and 2D-PN, between the RENAL score ≥7 subgroup of 3D-PN and 2D-PN, and between the 3D-PN and 3D-RAPN were compared. Statistical analysis was performed using SPSS version 26.0.</p><p><strong>Results: </strong>The 3D-PN showed statistically significant differences compared to the 2D-PN in warm ischemia time, intraoperative bleeding volume, postoperative drainage volume, and postoperative hospital stay (p < 0.05). In the RENAL score 4-6 subgroup, the 3D-PN showed statistically significant differences in intraoperative bleeding volume compared to the 2D-PN (p < 0.05). In the RENAL score ≥7 subgroup, the 3D-PN showed statistically significant differences compared to the 2D-PN in surgical time, warm ischemia time, postoperative drainage volume, and postoperative hospital stay (p < 0.05). There were statistically significant differences between the 3D-PN and the 3D-RAPN in warm ischemia time, intraoperative bleeding volume, and postoperative hospital stay (p < 0.05).</p><p><strong>Conclusion: </strong>Patients with RENAL score ≥7 benefit more from preoperative evaluation with 3D model. The combination of 3D model and RARP can further enhance the advantages and expand the convenience of surgery.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"251-259"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Analysis of Renal and Surgical Outcomes of Patients with and without Preoperative Ureteral Stenting before Nephron-Sparing Surgery for Renal Malignancies of Higher Complexity by Using a Propensity Score-Based Approach.","authors":"Marcel Schwinger, Johanna Wege, Oliver Hahn, Hubert Kübler, Vincent Scheper, Charis Kalogirou","doi":"10.1159/000543073","DOIUrl":"10.1159/000543073","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to evaluate the impact of preoperative ureteral stenting on post-operative outcomes, especially the incidence of urinoma, in patients with complex renal tumours undergoing nephron-sparing surgery (NSS).</p><p><strong>Methods: </strong>A retrospective analysis of 35 patients received preoperative ureteral stenting prior to NSS for complex tumours at the University Hospital of Würzburg between 2002 and 2021. A control group of 115 patients was established through 1:3 propensity score matching based on age, gender, T-stage, and RENAL score. Clinical parameters, surgical outcomes, and complications were assessed, and statistical comparisons were performed using the unpaired Student's t test and chi-square test.</p><p><strong>Results: </strong>While both groups showed comparable tumour complexity (RENAL: 7 vs. 7, p = 0.58; PADUA: 9 vs. 8, p = 0.62), there were no significant differences in median hospital stay (12 vs. 11; p = 0.068), surgical time (183 vs. 190 min; p = 0.37), post-operative haemoglobin levels (11 g/dL vs. 11.1 day/dL; p = 0.9), and renal function (GFR 65 mL/min/m2 in both groups). Moreover complication severity during NSS, defined by Clavien-Dindo classification, was similar (none vs. grade I; p = 0.29). No significant difference in the rate of urinoma was observed (11% vs. 4%, p = 0.93).</p><p><strong>Conclusions: </strong>This study found no significant benefits of preoperative ipsilateral ureteral stenting on post-operative outcomes, particularly concerning the development of urinoma. Given these findings, preventive ureteral stenting is not recommended prior to partial kidney resection for complex renal tumours.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"278-284"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Tissue and Urine Microbiota in Male, Intervention Naive Patients with and without Non-Invasive Bladder Cancer.","authors":"Muhammed S Ozer, Canet Incir, Huseyin A Yildiz, Muslim D Deger, Alper E Sarikaya, Yesim Tuncok, Gul Ergor, Nuran Esen, Volkan Sen, Ozan Bozkurt, Adil Esen","doi":"10.1159/000541296","DOIUrl":"10.1159/000541296","url":null,"abstract":"<p><strong>Introduction: </strong>To investigate the presence of dysbiosis in patients with naive bladder cancer.</p><p><strong>Methods: </strong>Twelve male patients with non-invasive bladder cancer and twelve age-matched healthy males had midstream urine and tissue samples taken. A history of endourological interventions was determined as an exclusion criterion, ensuring that the study was designed solely with naïve participants. The bacterial 16s ribosomal RNA V3-V4 regions were used to examine urine and tissue samples. We compared the microbiota composition of the bladder cancer and control groups.</p><p><strong>Results: </strong>Escherichia Shigella (p < 0.001), Staphylococcus (p < 0.001), Delftia (p < 0.001), Acinetobacter (p < 0.001), Corynebacterium (p < 0.001), and Enhydrobacter (p < 0.001) were abundant in bladder cancer tissue samples. Escherichia Shigella (p < 0.001), Ureaplasma (p < 0.001), Lactobacillus (p = 0.005), Stenotrophomonas (p < 0.001), Streptococcus (p < 0.001), Corynebacterium (p < 0.001), and Prevotella (p = 0.039) were abundant in bladder cancer urine samples. Midstream urine has a sensitivity of 83% for detecting dysbiotic bacteria in cancer tissue.</p><p><strong>Conclusions: </strong>Our research is the first microbiota study of bladder cancer done with naive patients who have never had an endourological intervention. Escherichia Shigella, Staphylococcus, Acinetobacter, Enhydrobacter, Delftia, Corynebacterium, and Pseudomonas were detected as dysbiotic bacteria in bladder cancer. The sensitivity of the midstream urine sample in detecting dysbiosis in tissue is 83%.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"81-88"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Lesion-Based Treatment Response after Two Cycles of Lu-177 Prostate Specific Membrane Antigen Treatment in Metastatic Castration-Resistant Prostate Cancer Using Machine Learning.","authors":"Ogün Bülbül, Demet Nak, Sibel Göksel","doi":"10.1159/000541628","DOIUrl":"10.1159/000541628","url":null,"abstract":"<p><strong>Introduction: </strong>Lutetium-177 (Lu-177) prostate-specific membrane antigen (PSMA) therapy is a radionuclide treatment that prolongs overall survival in metastatic castration-resistant prostate cancer (MCRPC). We aimed to predict lesion-based treatment response after Lu-177 PSMA treatment using machine learning with texture analysis data obtained from pretreatment Gallium-68 (Ga-68) PSMA positron emission tomography/computed tomography (PET/CT).</p><p><strong>Methods: </strong>Eighty-three progressed, and 91 nonprogressed malignant foci on pretreatment Ga-68 PSMA PET/CT of 9 patients were used for analysis. Malignant foci with at least a 30% increase in Ga-68 PSMA uptake after two cycles of treatment were considered progressed lesions. All other changes in Ga-68 PSMA uptake of the lesions were considered nonprogressed lesions. The classifiers tried to predict progressed lesions.</p><p><strong>Results: </strong>Logistic regression, Naive Bayes, and k-nearest neighbors' area under the ROC curve (AUC) values in detecting progressed lesions in the training group were 0.956, 0.942, and 0.950, respectively, and their accuracy was 87%, 85%, and 89%, respectively. The AUC values of the classifiers in the testing group were 0.937, 0.954, and 0.867, respectively, and their accuracy was 85%, 88%, and 79%, respectively.</p><p><strong>Conclusion: </strong>Using machine learning with texture analysis data obtained from pretreatment Ga-68 PSMA PET/CT in MCRPC predicted lesion-based treatment response after two cycles of Lu-177 PSMA treatment.</p>","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"128-134"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}