World Journal of Urology最新文献

{"title":"Impact of tumor dissecting technique on trifecta achievement in patients requiring extended warm ischemia during robot-assisted partial nephrectomy.","authors":"Yudai Ishiyama, Tsunenori Kondo, Kazuhiko Yoshida, Junpei Iizuka, Toshio Takagi","doi":"10.1007/s00345-024-05299-1","DOIUrl":"10.1007/s00345-024-05299-1","url":null,"abstract":"<p><strong>Purpose: </strong>To clarify specific factors associated with surgical outcomes in robot-assisted partial nephrectomy (RAPN) that require extended warm ischemia time (WIT), which may have a negative impact, but cannot always be avoided.</p><p><strong>Methods: </strong>We included 1,182 patients who had RAPN performed between January 2016 and December 2022 from a prospectively generated multi-institutional RAPN database, divided into normal WIT (nWIT) (≤ 20 min; 843 patients) and extended WIT (eWIT) (> 20 min; 339 patients) groups. Primary outcome measures were WIT and the Surface-Intermediate-Base (SIB) margin score, which contribute to postoperative trifecta achievement. Results were compared between the two groups using logistic regression.</p><p><strong>Results: </strong>Patients in the eWIT group had larger tumors, higher RENAL nephrometry scores, and lower SIB scores than those of the nWIT group. The trifecta achievement rate was significantly different between the two groups (nWIT: 70.1 vs. 49.0%, p < 0.001). In the nWIT group, WIT (coefficient: -0.105 [standard error 0.020], p < 0.001) and SIB score (coefficient: -0.107 [0.053], p = 0.045) were significant predictors of trifecta achievement. In the eWIT group, the SIB score (coefficient - 0.216 [0.082], p = 0.008) was significantly associated with trifecta attainment, whereas WIT only showed a trend toward significance. Limitations included a lack of long-term survival, renal function, and chronic complications data.</p><p><strong>Conclusions: </strong>For patients with eWIT during RAPN, the tumor dissection technique may be more important than WIT in predicting postoperative outcomes. Further prospective studies are required to confirm our results.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"582"},"PeriodicalIF":2.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy and safety of three different single-use ureteroscopes in retrograde intrarenal surgery: a comparative analysis of a single surgeon's experience in a single center.","authors":"Mehmet Fatih Şahin, Erdem Can Topkaç, Serkan Şeramet, Çağrı Doğan, Cenk Murat Yazıcı","doi":"10.1007/s00345-024-05283-9","DOIUrl":"https://doi.org/10.1007/s00345-024-05283-9","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate and compare the clinical results of different single-use flexible ureteroscopes (su-fURS) used in retrograde intrarenal surgery (RIRS).</p><p><strong>Materials and methods: </strong>RIRS cases performed identically by an experienced surgeon between 2022 and 2023 in a single center were retrospectively analyzed. These surgeries were performed with three su-fURS (Redpine RP-U-C12, Hugemed HU30, and Pusen Uscope 3022 A). In the study, the age, gender, body mass index, and Charlson comorbidity index of the patients were compared, along with their clinical details, such as the stone size, volume, density, location, and history of hydronephrosis or a double J stent or SWL. Operation time, stone-free rates (SFR), perioperative and postoperative complications, and hospitalization times were also compared.</p><p><strong>Results: </strong>The study included 208 patients. Pusen had 63 cases, Hugemed had 62, and Redpine had 83. The comparison of the patient's demographic and clinical properties with stone-related variables was similar between the groups. The SFR was similar between the groups (p = 0.056). Perioperative, postoperative, and total complication rates and the need for a second intervention showed no significant differences among the three groups (p = 0.324, 0.088, 0.061, and 0.052, respectively).</p><p><strong>Conclusion: </strong>In the first study comparing the clinical results of cases in which different su-fURS were used, no difference was observed in surgical outcomes and complications, even though the technical features of these devices were different. Urologists should select su-fURS based on clinical requirements, financial constraints, and personal experiences.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"583"},"PeriodicalIF":2.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative and functionnal outcomes of robot-assisted laparoscopic versus open ureterovesical reimplantation for benign lower ureteral pathologies: a single-center comparative study.","authors":"Anthony Kanbar, Ugo Pinar, Louis Lenfant, Jérome Parra, Christophe Vaessen, Sarah Drouin, Pierre Mozer, Aurélien Beaugerie, Emmanuel Chartier-Kastler, Morgan Roupret, Thomas Seisen","doi":"10.1007/s00345-024-05269-7","DOIUrl":"https://doi.org/10.1007/s00345-024-05269-7","url":null,"abstract":"<p><strong>Purpose: </strong>The robot-assisted laparoscopic (RALUVR) and open (OUVR) approaches have both been described for ureterovesical reimplantation to treat benign lower ureteral pathologies. Thus, we aimed to compare the perioperative and functional outcomes of RALUVR vs. OUVR.</p><p><strong>Methods: </strong>We performed a retrospective comparative study including all consecutive patients treated with RALUVR or OUVR for benign lower ureteral pathologies between January 2013 and December 2022 at our center. Logistic regression analyses were used to assess the predictors of complication ≥ Clavien-Dindo (CD) III within 90 days, prolonged length of stay (LOS), and 90-day overall success. The Kaplan-Meier method and Cox regression analyses were used to assess vesicoureteral reflux-free (VU-RFS) and stenosis-free (SFS) survivals.</p><p><strong>Results: </strong>Overall, 44 patients underwent RALUVR (n = 19; 43%) and OUVR (n = 25; 57%). In univariable logistic regression analyses, the use of RALUVR vs. OUVR was not significantly associated with postoperative complications ≥ CDIII (OR = 0.98; 95% CI=[0.17-5.09]; p = 0.98), and 90-day overall success (OR = 1.43; 95% CI=[0.24-11.28]; p = 0.7). Despite a shorter median LOS after RALUVR vs. OUVR (4 vs. 10 days, respectively; p < 0.001), multivariable logistic regression analysis showed no impact of the surgical approach on prolonged LOS (OR = 0.51, 95% CI=[0.03-13.86]; p = 0.65). No significant difference was observed in 2-year VU-RFS (72.9% vs. 100%, respectively; p = 0.2) and 2-year SFS between the RALUVR and OUVR groups (85.7% vs. 87.7%, respectively; p = 0.8). In Cox regression analysis, the use of RALUVR vs. OUVR was not significantly associated with VU-RFS (HR = 4.26; 95% CI=[0.38-47.84]; p = 0.24) or SFS (HR = 1.32; 95% CI=[0.22-8.01]; p = 0.76).</p><p><strong>Conclusion: </strong>We observed that RALUVR provides similar perioperative and functional outcomes as compared to OUVR, except for potentially shorter LOS.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"580"},"PeriodicalIF":2.8,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Androgen deprivation therapy, neoadjuvant androgen deprivation therapy, and adjuvant androgen deprivation therapy in patients with locally advanced prostate cancer: a multi-center real-world retrospective study.","authors":"Zhenglin Yi, Huihuang Li, Mingyong Li, Jiao Hu, Zhiyong Cai, Zhi Liu, Chunyu Zhang, Chunliang Cheng, Yunbo He, Jinbo Chen, Xiongbing Zu, Ruizhe Wang","doi":"10.1007/s00345-024-05286-6","DOIUrl":"https://doi.org/10.1007/s00345-024-05286-6","url":null,"abstract":"<p><strong>Purpose: </strong>Determining the potential benefit of neoadjuvant androgen deprivation therapy (ADT) and adjuvant ADT in patients with locally advanced prostate cancer (LAPC) undergoing complete resection.</p><p><strong>Methods: </strong>139 patients diagnosed with cT3-4, or cN+ LAPC in Xiangya Hospital and The First Affiliated Hospital of University of South China from 2010 to 2021 were collected. Cancer-specific survival (CSS) and overall survival (OS) of patients were assessed using Kaplan-Meier and Cox proportional risk analysis. We also analyzed the functional outcomes of two subgroups of patients who underwent radical prostatectomy (RP).</p><p><strong>Results: </strong>Of the 182 patients with cT3-4, or cN+ LAPC, 139 patients (76.4%) were enrolled in the study with a 5-year survival rate of 82.3%. 45 patients (32.4%) received ADT alone, 46 patients (33.1%) received neoadjuvant ADT before surgery, and the remaining 48 patients (34.5%) received surgery with adjuvant ADT. Neoadjuvant ADT before surgery and surgery with adjuvant ADT were associated with significantly improved survival compared with ADT alone. Multivariate Cox models showed that neoadjuvant ADT before surgery (hazard ratio [HR], 0.29; 95% CI 0.13-0.92) or surgery with adjuvant ADT (HR, 0.26; 95% CI 0.16-0.78) was associated with improved CSS compared with ADT alone. Regional lymph node metastasis, positive lymphovascular invasion, and Gleason score 9 + were independent predictors of LAPC CSS and OS. More patients in the neoadjuvant ADT before surgery group achieved final continence status within 12 months after surgery (93.48% v 77.08%).</p><p><strong>Conclusion: </strong>CSS and OS were significantly prolonged in cT3-4, or cN+ LAPC patients who received neoadjuvant ADT before surgery and surgery with adjuvant ADT compared to ADT alone.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"581"},"PeriodicalIF":2.8,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in urolithiasis: a systematic review of utilization and effectiveness.","authors":"Abdullah Altunhan, Selim Soyturk, Furkan Guldibi, Atinc Tozsin, Abdullatif Aydın, Arif Aydın, Kemal Sarica, Selcuk Guven, Kamran Ahmed","doi":"10.1007/s00345-024-05268-8","DOIUrl":"10.1007/s00345-024-05268-8","url":null,"abstract":"<p><strong>Purpose: </strong>Mirroring global trends, artificial intelligence advances in medicine, notably urolithiasis. It promises accurate diagnoses, effective treatments, and forecasting epidemiological risks and stone passage. This systematic review aims to identify the types of AI models utilised in urolithiasis studies and evaluate their effectiveness.</p><p><strong>Methods: </strong>The study was registered with PROSPERO. Pubmed, EMBASE, Google Scholar, and Cochrane Library databases were searched for relevant literature, using keywords such as 'urology,' 'artificial intelligence,' and 'machine learning.' Only original AI studies on urolithiasis were included, excluding reviews, unrelated studies, and non-English articles. PRISMA guidelines followed.</p><p><strong>Results: </strong>Out of 4851 studies initially identified, 71 were included for comprehensive analysis in the application of AI in urolithiasis. AI showed notable proficiency in stone composition analysis in 12 studies, achieving an average precision of 88.2% (Range 0.65-1). In the domain of stone detection, the average precision remarkably reached 96.9%. AI's accuracy rate in predicting spontaneous ureteral stone passage averaged 87%, while its performance in treatment modalities such as PCNL and SWL achieved average accuracy rates of 82% and 83%, respectively. These AI models were generally superior to traditional diagnostic and treatment methods.</p><p><strong>Conclusion: </strong>The consolidated data underscores AI's increasing significance in urolithiasis management. Across various dimensions-diagnosis, monitoring, and treatment-AI outperformed conventional methodologies. High precision and accuracy rates indicate that AI is not only effective but also poised for integration into routine clinical practice. Further research is warranted to establish AI's long-term utility and to validate its role as a standard tool in urological care.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"579"},"PeriodicalIF":2.8,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of symptomatic relief in water vapor thermal therapy for prostatic hyperplasia: 36-month prospective study.","authors":"Juan Sebastián Arroyave, Francisca Larenas, Ragheb Massouh, Diego Gonzalez, Pablo Villafranca Brown, Sebastián Arroyo Concha, Tania Avayú Zaliasnik, Belén Giménez, Michael Palese, Juan Fulla","doi":"10.1007/s00345-024-05295-5","DOIUrl":"https://doi.org/10.1007/s00345-024-05295-5","url":null,"abstract":"<p><strong>Purpose: </strong>Existing literature lacks an analysis of factors predicting the achievement of minimum clinically important differences (MCID) after water vapor thermal therapy (WVTT) for prostatic hyperplasia. This study aims to identify these predictors over a 36-month post-WVTT period.</p><p><strong>Methods: </strong>This prospective single surgeon case series assessed male patients receiving WVTT. Eligibility criteria included being at least 45 years old, having an estimated prostate volume (EPV) of 30-80 cc, an International Prostate Symptom Score (IPSS) of 12 points or more, and a maximum urinary flow rate (Qmax) under 16 mL/sec. MCID, representing the smallest symptomatic improvement perceived by patients, was calculated using the distribution-based method, considering half a standard deviation of baseline IPSS scores. Correlation and linear regression analyses assessed MCID attainment. Multivariable logistic regression evaluated MCID achievement, considering multicollinearity, heteroskedasticity, and normality.</p><p><strong>Results: </strong>Of 206 men with a median 29.1-month follow-up (Range: 24-36), 13.6% didn't achieve MCID for IPSS, and 7.2% for QoL scores. Significant hindrances to MCID attainment for IPSS were a large median lobe (> 10 mm protrusion) (OR = 3.01, 95% CI: 2.3-3.72), increased median lobe treatments (OR = 1.73, 95% CI: 1.23-2.35), and high preoperative irritative IPSS scores (OR = 1.25, 95% CI: 1.13-1.38). Factors for QoL MCID non-achievement included age over 75 (OR = 1.25, 95% CI: 1.13-1.38), a large median lobe (OR = 1.87, 95% CI: 1.62-2.01), and EPV over 60 cc (OR = 1.55, 95% CI: 1.16-1.97). A 6.3% surgical re-intervention rate was noted.</p><p><strong>Conclusions: </strong>The characteristics of the median lobe as well as the severity of lower urinary tract symptoms are crucial for treatment success. These should be integral to preoperative assessments and patient discussions on treatment options.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"576"},"PeriodicalIF":2.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bladder Cancer detection by urinary methylation markers GHSR/MAL: a validation study.","authors":"I J Beijert, Y van den Burgt, A E Hentschel, J Bosschieter, P C Kauer, B I Lissenberg-Witte, R J A van Moorselaar, J A Nieuwenhuijzen, R D M Steenbergen","doi":"10.1007/s00345-024-05287-5","DOIUrl":"10.1007/s00345-024-05287-5","url":null,"abstract":"<p><strong>Purpose: </strong>Although cystoscopy is a reliable tool for detecting bladder cancer, it poses a high burden on patients and entails high costs. This highlights the need for non-invasive and cost-effective alternatives. This study aimed to validate a previously developed urinary methylation marker panel containing GHSR and MAL.</p><p><strong>Methods: </strong>We enrolled 134 patients who underwent cystoscopy because of hematuria, including 63 individuals with primary bladder cancer and 71 with non-malignant findings. Urine samples were self-collected at home and sent via regular mail. Subsequently, DNA was extracted and the hypermethylation of GHSR and MAL was evaluated using quantitative methylation-specific polymerase chain reaction. The performance of methylation markers was assessed using area-under-the-curve (AUC) analysis and sensitivity and specificity based on pre-established cut-off values.</p><p><strong>Results: </strong>Validation of the marker panel GHSR/MAL resulted in an AUC of 0.87 at 79% sensitivity and 80% specificity. Sensitivity was comparable to the previous investigation (P > 0.9), though specificity was significantly lower (P = 0.026). Sensitivity was higher for high-grade tumors compared to low-grade tumors (94% vs. 60%, P = 0.002).</p><p><strong>Conclusion: </strong>Validation of the GHSR/MAL methylation marker panel on at home collected urine samples confirms its robust performance for bladder cancer detection in a hematuria population, and underscores the diagnostic potential for future clinical application.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"578"},"PeriodicalIF":2.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second-generation MOSES 2.0 versus MOSES 1.0 pulse-modulation technologies for holmium laser enucleation of the prostate (HoLEP).","authors":"Hazem Elmansy, Ryan Boudreau, Amr Hodhod, Saud Alhelal, Husain Alaradi, Khaled Alotaibi, Ruba Abdul Hadi, Oksana Blahitko, Ryan Kelly, Ahmed S Zakaria","doi":"10.1007/s00345-024-05277-7","DOIUrl":"https://doi.org/10.1007/s00345-024-05277-7","url":null,"abstract":"<p><strong>Introduction and objective: </strong>To report our initial experience with enhanced MOSES 2.0 technology in patients who underwent holmium laser enucleation of the prostate (HoLEP) for the treatment of benign prostatic hyperplasia (BPH), in comparison to those who underwent HoLEP with MOSES 1.0 technology at our institution.</p><p><strong>Methods: </strong>We retrospectively reviewed data of patients who underwent HoLEP using MOSES 1.0 or MOSES 2.0 pulse-modulation technology from December 2020 to September 2023. Preoperative and intraoperative parameters, postoperative outcomes, as well as perioperative complications were collected and analyzed.</p><p><strong>Results: </strong>A total of 196 patients were included in the study. Among them, 146 patients underwent MOSES 1.0 HoLEP, while 50 had MOSES 2.0 HoLEP. No statistically significant differences in preoperative characteristics were observed between the two groups. The median prostate volume for the MOSES 1.0 and MOSES 2.0 HoLEP groups was 109 cc and 117.5 cc, respectively. Patients in the MOSES 2.0 group had a shorter median enucleation time (52.5 vs. 42.5 min, p < 0.001) and hemostasis time (8 vs. 6 min, p = 0.002), along with lower laser energy usage (101 vs. 86.4 kJ, p = 0.012), when compared to those in the MOSES 1.0 cohort. Postoperative outcomes, including IPSS, QoL, Qmax, and PVR, were comparable between the two groups at 1, 3, and 6 months postoperative. The incidence of hospital readmission (p = 0.42), as well as one-month postoperative urge urinary incontinence (p = 0.2) and stress urinary incontinence (p = 0.13) were also comparable between the cohorts.</p><p><strong>Conclusions: </strong>HoLEP with second-generation MOSES 2.0 technology is a safe and effective treatment option for BPH. It offers notable improvements, including reduced enucleation and hemostasis times, while using less energy when compared to MOSES 1.0.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"577"},"PeriodicalIF":2.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of neoadjuvant chemotherapy in patients with locally advanced and clinically positive nodes Upper Tract Urothelial Carcinoma treated with Nephroureterectomy: real-world data from the ROBUUST 2.0 Registry.","authors":"Gabriele Tuderti, Riccardo Mastroianni, Flavia Proietti, Zhenjie Wu, Linhui Wang, Antonio Franco, Firas Abdollah, Marco Finati, Matteo Ferro, Marco Tozzi, Francesco Porpiglia, Enrico Checcucci, Raj Bhanvadia, Vitaly Margulis, Stephan Bronimann, Nirmish Singla, Kevin Hakimi, Ithaar H Derweesh, Andreas Correa, Emma Helstrom, Dinno F Mendiola, Mark L Gonzalgo, Reuben Ben David, Reza Mehrazin, Sol C Moon, Soroush Rais-Bahrami, Courtney Yong, Chandru P Sundaram, Antonio Tufano, Sisto Perdonà, Alireza Ghoreifi, Farshad S Moghaddam, Hooman Djaladat, Francesco Ditonno, Alessandro Antonelli, Riccardo Autorino, Giuseppe Simone","doi":"10.1007/s00345-024-05267-9","DOIUrl":"10.1007/s00345-024-05267-9","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the impact of neoadjuvant and adjuvant chemotherapy on survival outcomes, within a large multicenter cohort of Upper tract urothelial carcinoma patients treated with Nephroureterectomy.</p><p><strong>Methods: </strong>A multicenter retrospective analysis utilizing the Robotic surgery for Upper Tract Urothelial Cancer Study registry was performed. Baseline, preoperative, perioperative, and pathologic variables of three groups of patients receiving surgery only, neoadjuvant or adjuvant chemotherapy were compared. Categorical and continuous variables among the three subgroups were compared with Chi square and ANOVA tests. The impact of perioperative chemotherapy on survival outcomes was assessed with the Kaplan Meier method. Univariable and multivariable Cox regression analyses were performed to identify predictors of survival.</p><p><strong>Results: </strong>Overall, 1,994 patients were included. Overall and Clavien grade ≥3 complications rates were comparable among the three subgroups (p = 0.65 and p = 0.92). At Kaplan Meier analysis, neoadjuvant chemotherapy significantly improved cancer-specific survival (p = 0.03) and overall survival (p = 0.03) probabilities of patients with cT ≥ 3 tumors and of those with positive cN (p = 0.03 and p = 0.02). On multivariable analysis, neoadjuvant chemotherapy was independently associated with an improvement of cancer-specific survival in cT ≥ 3 patients (HR 0.44; p = 0.04), and of both cancer-specific survival (HR 0.50; p = 0.03) and overall survival (HR 0.53; p = 0.02) probabilities in positive cN patients.</p><p><strong>Conclusions: </strong>This large multicenter retrospective analysis suggests significant survival benefit in Upper tract urothelial carcinoma patients with either locally advanced or clinically positive nodes disease receiving neoadjuvant chemotherapy. These findings can be regarded as \"hypothesis generating\", stimulating future trials focusing on such advanced stages.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"575"},"PeriodicalIF":4.6,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between kidney stones and life's essential 8: incorporation of additional clinically relevant covariates is recommended.","authors":"Bei Zhang, Yajie Wang","doi":"10.1007/s00345-024-05288-4","DOIUrl":"https://doi.org/10.1007/s00345-024-05288-4","url":null,"abstract":"","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"42 1","pages":"574"},"PeriodicalIF":2.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}