Urologia Internationalis最新文献_第6页

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. 携带KRAS-G12V突变的转移性睾丸生殖细胞瘤对KRAS-G12V突变的抗PD-1联合纳布紫杉醇疗法的持续反应：病例报告。

IF 1.5 4区医学

Urologia Internationalis Pub Date : 2025-01-01 Epub Date: 2024-10-03 DOI: 10.1159/000541588

Jinfeng Pan, Weiqi Yin, Yingzhi Chen, Hui Wang, Wei Wu, Suying Wang, Da Li, Qi Ma

{"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":"Introduction: 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.Case presentation: 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.Conclusion: 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.","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}

引用次数: 0

Anti-Reflux Ureteroileal Anastomosis for Orthotopic Ileal Neobladder Using Wallace Technique in a Single Trough. 使用 Wallace 技术在单槽中为正位回肠新膀胱进行防反流输尿管-回肠吻合术。

IF 1.5 4区医学

Urologia Internationalis Pub Date : 2025-01-01 Epub Date: 2024-10-29 DOI: 10.1159/000541952

Karim ElSaeed, Hany Moustafa, Sherif Abdelghani, Hossam ElAwady

{"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":"Introduction: 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.Methods: 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.Results: 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.Conclusion: 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.","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}

引用次数: 0

Spinal Anesthesia versus General Anesthesia in the Endoscopic Management of Proximal Ureteral Stones: A Critical Evaluation Focusing on the Total Anesthesia Time. 在输尿管近端结石的内镜治疗中，脊髓麻醉与全身麻醉的对比：对总麻醉时间的关键评价。

IF 1.5 4区医学

Urologia Internationalis Pub Date : 2025-01-01 Epub Date: 2024-12-19 DOI: 10.1159/000543203

Emre Bulbul, Fahri Yavuz Ilki, Yasin Yitgin, Fatih Ustun, Ali Sezer, Ela Erten, Emine Yitgin, Selahattin Bedir, Kemal Sarica

{"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":"Introduction: 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.Methods: 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.Results: 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.Conclusions: 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.","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}

引用次数: 0

Renal Transplantation with Triple Ureter Implantation into the Urinary Bladder after Dissolving a Bilateral Ureterocutaneostomy for Posterior Urethral Valves. 为后尿道瓣膜溶解双侧输尿管造口术后，将三输尿管植入膀胱的肾移植手术。

IF 1.5 4区医学

Urologia Internationalis Pub Date : 2025-01-01 Epub Date: 2024-10-28 DOI: 10.1159/000542302

Jonas Jung, Subhajit Mandal, Christer Groeben, Birgit Kortus-Götze, Joachim Hoyer, Johannes Huber, Luka Flegar

{"title":"Renal Transplantation with Triple Ureter Implantation into the Urinary Bladder after Dissolving a Bilateral Ureterocutaneostomy for Posterior Urethral Valves.","authors":"Jonas Jung, Subhajit Mandal, Christer Groeben, Birgit Kortus-Götze, Joachim Hoyer, Johannes Huber, Luka Flegar","doi":"10.1159/000542302","DOIUrl":"10.1159/000542302","url":null,"abstract":"Introduction: We report a progressive treatment of a 31-year-old patient with end-stage renal disease secondary to congenital posterior urethral valve and valve bladder syndrome. He underwent a laser ablation of the urethral valve at the age of six, but on continuance of renal function deterioration ultimately a bilateral ureterocutaneostomy (UC) in the left lower abdomen had to be fashioned as a supravesical urinary diversion.Case presentation: For the management of dialysis dependent end-stage renal disease, an allogenic renal transplantation was planned. When a postmortal organ was available, the patient wished for a complete internalisation of the incontinent diversion if possible. To better delineate the current status of the lower urinary tract, an intraoperative cystoscopy was performed. Besides an elevated bladder neck and a low bladder capacity, there were no distinct pathologies. Therefore, a right iliac allogeneic renal transplantation with simultaneous dissolution of the bilateral UC and an anastomosis of all three ureters to the bladder was performed. Placement of a suprapubic catheter enabled safe urine drainage and a prospective evaluation of the voiding function. Because of obstructive voiding, we performed a transurethral resection of the prostate. This resulted in sufficient spontaneous voiding.Conclusion: After a 19-month observation period, the patient now exhibits good renal function with normal excretion and consistent retention parameters with satisfactory transurethral voiding and quality of life (QoL). This is an encouraging case where it was possible to convert an incontinent urinary diversion to a continent urinary diversion after renal transplantation to improve the patient's QoL.","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"206-210"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523239","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}

引用次数: 0

Assessment of Intrarenal Pressure through Dilatation State of the Renal Collecting System. 通过肾收集系统的扩张状态评估肾内压

IF 1.5 4区医学

Urologia Internationalis Pub Date : 2025-01-01 Epub Date: 2024-10-15 DOI: 10.1159/000541637

Yujun Chen, Heng Yang, Yue Yu, Haibo Xi, Gongxian Wang, Xiaochen Zhou

{"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":"Introduction: 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).Methods: 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.Results: 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.Conclusions: 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.","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}

引用次数: 0

Comparison of Tissue and Urine Microbiota in Male, Intervention Naive Patients with and without Non-Invasive Bladder Cancer. 男性非侵袭性膀胱癌患者和未接受干预的患者组织和尿液微生物群的比较。

IF 1.5 4区医学

Urologia Internationalis Pub Date : 2025-01-01 Epub Date: 2024-09-21 DOI: 10.1159/000541296

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

{"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":"Introduction: To investigate the presence of dysbiosis in patients with naive bladder cancer.Methods: 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.Results: 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.Conclusions: 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%.","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}

引用次数: 0

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. 利用机器学习预测转移性阉割耐药前列腺癌患者接受两个周期 Lu-177 PSMA 治疗后基于病灶的治疗反应。

IF 1.5 4区医学

Urologia Internationalis Pub Date : 2025-01-01 Epub Date: 2024-09-30 DOI: 10.1159/000541628

Ogün Bülbül, Demet Nak, Sibel Göksel

{"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":"Introduction: 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).Methods: 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.Results: 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.Conclusion: 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.","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}

引用次数: 0

Antibiotic Prophylaxis of Transrectal Biopsy of the Prostate: A Plea for Fosfomycin. 经直肠前列腺活检的抗生素预防措施--请求使用磷霉素。

IF 1.5 4区医学

Urologia Internationalis Pub Date : 2025-01-01 Epub Date: 2024-10-03 DOI: 10.1159/000541798

Philipp Julian Spachmann, Daniel Witt, Johannes Breyer, Stefan Denzinger, Maximilian Burger, Daniel Claudius Vergho, Wolfgang Otto, Marco Julius Schnabel

{"title":"Antibiotic Prophylaxis of Transrectal Biopsy of the Prostate: A Plea for Fosfomycin.","authors":"Philipp Julian Spachmann, Daniel Witt, Johannes Breyer, Stefan Denzinger, Maximilian Burger, Daniel Claudius Vergho, Wolfgang Otto, Marco Julius Schnabel","doi":"10.1159/000541798","DOIUrl":"10.1159/000541798","url":null,"abstract":"Introduction: According to guidelines, transrectal random biopsy of the prostate (TRBP) is performed under antibiotic prophylaxis (AP). Fosfomycin-trometamol (FOS) is not approved in Germany, but TRBP as indication was listed in the product information falsely. The aim was to investigate infectious complications of TRBP under FOS as a single dose.Methods: All TRBPs under FOS 3,000 mg as a single dose between July 1, 2020, and June 30, 2021, at a university institution were recorded. 357 patients (41-85 years old, median 66) were included. 243 received first TRBP, 321 TRBP were MRI-fusionated. 10-22 cores were taken (median 14). Prostate-specific antigen (PSA) was 0.1-1224 ng/mL (median 7.7 ng/mL), prostate volume 5-263 mL (median 50 mL). Analysis was performed using Chi square test or Fisher's exact test, Mann-Whitney U test, and t test.Results: Four patients suffered an infection (1.1%), without significant difference according to age (p = 0.849), PSA (p = 0.957), number of cores (p = 0.905), and increase in volume (p = 0.456). Limiting is the retrospective character.Conclusion: The complication rate was 1.1%, and FOS single dose therefore represents sufficient AP for TRBP in this collective. FOS as a single dose should be reevaluated in a prospective study to obtain approval in Germany for this indication.","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"146-150"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372982","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}

引用次数: 0

Adjuvant Therapy with Pembrolizumab in Renal Cell Carcinoma: Real-World Experiences from a Retrospective, Multi-Institutional Cohort. pembrolizumab辅助治疗肾细胞癌：来自回顾性，多机构队列的真实世界经验

IF 1.5 4区医学

Urologia Internationalis Pub Date : 2024-12-24 DOI: 10.1159/000543278

Angelika Mattigk, Cristina Cano Garcia, Niklas Klümper, Alexander Cox, Oliver Hahn, Kerstin Junker, Kati Erdmann, Philipp Schmucker, Luka Flegar, Friedemann Zengerling, Severine Banek, Jörg Ellinger, Bjoern Thorben Buerk, Johannes Huber, Charis Kalogirou, Philip Zeuschner, Benedikt Hoeh

{"title":"Adjuvant Therapy with Pembrolizumab in Renal Cell Carcinoma: Real-World Experiences from a Retrospective, Multi-Institutional Cohort.","authors":"Angelika Mattigk, Cristina Cano Garcia, Niklas Klümper, Alexander Cox, Oliver Hahn, Kerstin Junker, Kati Erdmann, Philipp Schmucker, Luka Flegar, Friedemann Zengerling, Severine Banek, Jörg Ellinger, Bjoern Thorben Buerk, Johannes Huber, Charis Kalogirou, Philip Zeuschner, Benedikt Hoeh","doi":"10.1159/000543278","DOIUrl":"10.1159/000543278","url":null,"abstract":"Introduction: Adjuvant pembrolizumab versus placebo significantly improved disease-free survival (DFS) in renal cell carcinoma (RCC) patients at high risk (HR) of recurrence following nephrectomy in KEYNOTE-564 trial (NCT03142334). The objective of this study was to evaluate efficacy and safety of adjuvant pembrolizumab in a real-world setting.Methods: In this multicenter retrospective study, RCC patients receiving adjuvant pembrolizumab between 01/22 and 10/23 at seven tertiary referral centers were included. DFS and treatment safety were assessed.Results: Fifty-two patients with RCC were included. 24 (46%), 5 (9.6%), 22 (42%), and 1 (1.9%) patients were classified as intermediate to high risk (IR to HR), HR, M1 with no evidence of disease (M1NED), and unknown. At a median follow-up of 6 months, DFS rates at 6 months were 64.2% in the overall cohort. In subgroup analyses, M1NED patients demonstrated significantly lower DFS compared to non-metastatic (combined: IR to HR/HR) patients (log-rank: p = 0.025). Regarding toxicity, grade 3 or higher adverse events occurred in 26% of patients. Treatment discontinuations were reported in 20% of the patients.Conclusion: Recurrence rates in the M1NED group remained high and occurred earlier in our real-world compared to KEYNOTE-564. Long-term toxicities were comparable to clinical trials data.","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886135","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}

引用次数: 0

Does Time Matter in Early Radical Cystectomy? Comparing Outcome, Clinical, and Pathological Characteristics of Immediate versus Deferred Radical Cystectomy. 早期根治性膀胱切除术时间重要吗？比较即时与延期根治性膀胱切除术的预后、临床及病理特征。

IF 1.5 4区医学

Urologia Internationalis Pub Date : 2024-12-23 DOI: 10.1159/000543235

Yushan Yang, Sonja Holbach, Maximilian Haas, Simon Udo Engelmann, Christopher Gossler, Roman Mayr, Maximilian Burger, Johannes Breyer, Michael Gierth

{"title":"Does Time Matter in Early Radical Cystectomy? Comparing Outcome, Clinical, and Pathological Characteristics of Immediate versus Deferred Radical Cystectomy.","authors":"Yushan Yang, Sonja Holbach, Maximilian Haas, Simon Udo Engelmann, Christopher Gossler, Roman Mayr, Maximilian Burger, Johannes Breyer, Michael Gierth","doi":"10.1159/000543235","DOIUrl":"10.1159/000543235","url":null,"abstract":"Introduction: Early radical cystectomy (eRC) can be performed for high or very high risk non-muscle-invasive bladder cancer (NMIBC). Whether immediate eRC is beneficial is still unclear. The objective of this study was to compare outcomes between immediate eRC, delayed eRC, and radical cystectomy (RC) at the diagnosis of muscle-invasive bladder cancer (MIBC).Methods: The single-center cohort consisting of patients with RC between 2008 and 2020 was divided into 4 populations: patients who received immediate eRC within 3 months of diagnosis of NMIBC (IEC), patients who received eRC at recurrence of NMIBC (REC), patients who underwent RC after primary diagnosis of MIBC (primMIBC), and patients with the initial diagnosis of NMIBC who received RC after progression to MIBC (progMIBC).Results: Among the 463 patients included, 39 had IEC, 58 had REC, 314 had primMIBC, and 53 had progMIBC. No statistically significant differences for OS, CSS, and RFS between the two groups receiving eRC were found. Patients with pT1 tumors (p = 0.003) and tumor size ≥3 cm (p = 0.012) were more likely to receive immediate RC.Conclusion: Immediate and delayed eRC show comparable survival outcomes. The present study emphasizes the need for accurate risk stratification of patients with NMIBC to identify the most advantageous therapy for individual patients.","PeriodicalId":23414,"journal":{"name":"Urologia Internationalis","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883079","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}

引用次数: 0