Actas urologicas espanolas最新文献

{"title":"¿Es necesario el estado 100% libre de litiasis en los casos de cálculos coraliformes?","authors":"G. Freschi ,&nbsp;D.P. Resuto ,&nbsp;R.H. Astolfi ,&nbsp;W.R. Molina ,&nbsp;A. Meller","doi":"10.1016/j.acuro.2025.501812","DOIUrl":"10.1016/j.acuro.2025.501812","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>To evaluate long-term outcomes in staghorn stone patients with residual fragments following surgical treatment.</div></div><div><h3>Materials and methods</h3><div>A retrospective study of patients who underwent percutaneous nephrolithotripsy for staghorn stones and long term follow up were divided into two groups: residual stones versus non-residual stones. The occurrence of new stones or fragment growth, infectious events, and renal function were evaluated. Patients with a follow-up period of less than one year were excluded.</div></div><div><h3>Results</h3><div>A total of 87 patients (75.9% female) were included in the study. Of these, 21.8% were stone-free, while 78.2% exhibited residual fragments with a median size of 7<!--> <!-->mm (3.5-11.5<!--> <!-->mm). The average follow-up period was 27 months (21-36 months). Only 24.1% experienced recurrence or growth of residual fragments, with a median growth of 10<!--> <!-->mm (6-12<!--> <!-->mm). Additionally, 14.9% of patients developed urinary infections during the follow-up period. No significant differences were observed between stone-free patients and those with residual fragments in terms of recurrence, residual fragments growth, infectious events, or deterioration in renal function. Similarly, no differences were noted when comparing patients with positive or negative cultures.</div></div><div><h3>Conclusions</h3><div>The incidence of recurrence, growth of residual fragments, infectious events, and deterioration of renal function was comparable between patients with and without residual stones. Furthermore, the presence of positive preoperative or intraoperative cultures did not influence these outcomes.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501812"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922097","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":"Manejo de la corrección fallida de hipospadias: revisión exhaustiva de estrategias y resultados","authors":"L.E. Jesus ,&nbsp;J.L. Pippi-Salle","doi":"10.1016/j.acuro.2025.501809","DOIUrl":"10.1016/j.acuro.2025.501809","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypospadias surgery has a failure rate ranging from 10% for distal cases to over 30% for proximal cases. However, real-world outcomes may be worse, as some complications emerge late in puberty or are underreported. The expectations for surgical success have evolved, shifting from basic urinary and sexual functionality to achieving a normal penile appearance. Bias in research favors retrospective studies with short follow-ups, and qualitative research remains scarce. This review describes complications following hypospadias surgery, their management, and prognosis.</div></div><div><h3>Method</h3><div>A non-systematic critical review of existing literature on hypospadias complications and surgical management was conducted.</div></div><div><h3>Results</h3><div>Common complications include urethrocutaneous fistulae (UCF), glans dehiscence (GD), urethral stenosis (US), urethral diverticulae (UD), urine spraying, and recurrent curvature (RC). UCF is the most frequently reported complication, treated through multilayer closure with vascularized flap coverage. GD occurs more frequently in proximal hypospadias, requiring glans reformatting and tissue augmentation. US often manifests as meatal stenosis or neourethral strictures, requiring meatoplasty or staged urethroplasty. UD arises from loose urethral segments subjected to high urinary flow resistance and is managed via excision or remodeling. Urine spraying is linked to insufficient glans fusion or meatal irregularities, sometimes requiring surgical correction. RC is a significant complication impacting sexual function, requiring individualized correction through dorsal plication or ventral lengthening.</div></div><div><h3>Conclusions</h3><div>Hypospadias complications require individualized assessment and surgical planning. Late complications, often underrecognized, should be considered in long-term follow-up. Proper surgical technique selection and postoperative evaluation help mitigate recurrence and improve patient outcomes.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501809"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922157","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":"Mapeo de las disparidades regionales en la mortalidad por cáncer de testículo en España (2004-2023)","authors":"L. Cayuela ,&nbsp;S. Cabrera Fernández ,&nbsp;R. Roldán Testillano ,&nbsp;M. Ortega Calvo ,&nbsp;A. Cayuela","doi":"10.1016/j.acuro.2025.501800","DOIUrl":"10.1016/j.acuro.2025.501800","url":null,"abstract":"<div><h3>Introduction</h3><div>This study investigates testicular cancer (TC) mortality trends and spatial patterns in Spain, utilizing provincial-level spatial analysis to identify high-risk clusters.</div></div><div><h3>Methods</h3><div>An ecological study was conducted using TC mortality data (ICD-10 code C62) from the Spanish National Institute of Statistics (2004-2023). Age-standardized mortality rates were calculated using the direct method. Temporal trends were analyzed with Joinpoint regression. Spatial patterns were assessed using standardized mortality ratios, smoothed relative risk, and posterior probabilities through Bayesian hierarchical models. Spatial clustering was examined with Tango's test and Kulldorff's likelihood ratio test.</div></div><div><h3>Results</h3><div>A total of 909 TC deaths were recorded, with age-standardized mortality rates ranging from 0.14 to 0.26 per 1,000,000 inhabitants. No significant temporal trends were observed. Age-specific mortality showed a bimodal distribution, peaking at ages 35-39 and 85+. The highest standardized mortality ratios were found in Zamora (2.58), Segovia (2.64), and Soria (2.39), while the lowest were in Madrid (0.66) and Barcelona (0.55). Bayesian spatial analysis identified elevated relative risk in Badajoz (1.6), Huelva (1.47), and Sevilla (1.4). Kulldorff's analysis revealed a high-mortality cluster in southwestern Spain (Huelva, Sevilla, Badajoz), with a secondary cluster extending to neighbouring provinces.</div></div><div><h3>Conclusions</h3><div>While TC mortality in Spain remained stable, significant regional disparities exist. High-risk provinces and mortality clusters highlight potential inequalities in healthcare access, socioeconomic conditions, and environmental exposures.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501800"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922085","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":"Competencias quirúrgicas en urología: concordancia entre la percepción de residentes y profesionales en ejercicio en un país latinoamericano","authors":"J. Scherñuk,&nbsp;M.G. Dorsemaine,&nbsp;J.K. Toapanta Ortega,&nbsp;D. Zimmermann,&nbsp;I.P. Tobia,&nbsp;D. Santillán","doi":"10.1016/j.acuro.2025.501794","DOIUrl":"10.1016/j.acuro.2025.501794","url":null,"abstract":"<div><h3>Introduction</h3><div>Consensus remains lacking on which surgeries should be deemed essential for general urologists and which should be reserved for subspecialists. This study aims to compare the perceptions of urology trainees (Trainees) and practicing urologists (PractUrol) regarding the relevance of surgeries for independent practice and subspecialist training.</div></div><div><h3>Methods</h3><div>Cross-sectional comparative study on Trainees and PractUrol from a Latin-American country. Participants completed a Google Forms® questionnaire on 56 urological surgeries in September-October 2023, categorizing each as Essential Index (E-index), Supervised Index (Sup-index), or Subspecialty (Subspec). Statistical comparisons were performed using Chi-square or Fisher's exact tests with Bonferroni correction.</div></div><div><h3>Results</h3><div>Among 138 participants (109 PractUrol, 29 Trainees), 78.6% (44/56) of surgeries showed agreement between groups, with 13 surgeries achieving over 75% concordance. Disagreements were noted for 21.4% (12/56) of surgeries: (1) Microvaricocelectomy, penectomy, DVIU, ureteral reimplantation, and vesicovaginal fístula repair were more often classified as Subspec by Trainees but as E-index by PractUrol. (2) Radical cystectomy with orthotopic diversion and Boari Flap were classified as Subspec by Trainees but as Sup-index by PractUrol. (3) Partial cystectomy, pelvic, and inguinal lymphadenectomy were more frequently deemed Subspec by Trainees. (4) Flexible ureteroscopy was considered E-index by Trainees but Sup-index by PractUrol. (5) Artificial urinary sphincter placement was more often classified as Sup-index by PractUrol.</div></div><div><h3>Conclusion</h3><div>There is substantial agreement on the relevance of urological surgeries between PractUrol and Trainees, including 13 surgeries deemed essential by over 75% of participants. However, differing opinions on 12 surgeries highlight areas for further discussion.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501794"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922098","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":"Nuevas perspectivas y estrategias emergentes de preservación vesical para el tumor vesical músculo invasivo","authors":"J.D. Subiela ,&nbsp;F. Guerrero-Ramos ,&nbsp;Ó. Rodríguez-Faba ,&nbsp;J. Aumatell ,&nbsp;P. Gajate ,&nbsp;F. López-Campos ,&nbsp;E. Sevillano ,&nbsp;M. Hernández-Arroyo ,&nbsp;E. García-Rojo ,&nbsp;A. Artiles Medina ,&nbsp;D. Sáenz-Calzada ,&nbsp;C. Gómez-Cañizo ,&nbsp;J. Romero-Otero ,&nbsp;F. Couñago","doi":"10.1016/j.acuro.2025.501758","DOIUrl":"10.1016/j.acuro.2025.501758","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Muscle-invasive bladder cancer (MIBC) poses significant challenges, traditionally treated with radical cystectomy, a procedure with considerable morbidity and impact on quality of life. Bladder-sparing approaches aim to preserve the bladder while maintaining oncological efficacy. This review explores emerging perspectives in bladder-sparing strategies for MIBC, focusing on patient selection criteria, molecular characterization, non-invasive treatment response assessment, systemic therapies, radiation techniques, and the role of intravesical devices.</div></div><div><h3>Methods</h3><div>A comprehensive narrative review provides insights into novel perspectives in bladder-sparing strategies for treating MIBC.</div></div><div><h3>Results</h3><div>Patient selection criteria for bladder preservation remain challenging. While the traditional approach focuses on selecting candidates with MIBC with fewer clinicopathological risk characteristics, some studies suggest that histological variants and the presence of hydronephrosis may not be absolute exclusion criteria. Molecular classification data shows promise but lacks sufficient evidence, while immune cell infiltration may provide insights into potential treatment response. MRI and radiomics offer the potential for non-invasive treatment response assessment. Ongoing trials investigate new systemic therapies, radiation therapy approaches, and the role of intravesical devices in bladder preservation, with some preliminary data appearing promising.</div></div><div><h3>Conclusion</h3><div>Bladder-sparing strategies for MIBC are currently experiencing substantial evolution. Achieving optimal patient selection may entail the integration of clinical, radiological, histopathological, and molecular data. It is likely that shortly, multimodal approaches incorporating neoadjuvant systemic therapy, radiotherapy, intravesical devices, and possibly maintenance or adjuvant regimens guided by biomarker-driven strategies will become standard practice.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501758"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922081","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":"Duración de la deprivación androgénica con la radioterapia de rescate en los pacientes con cáncer de próstata con recidiva bioquímica tras cirugía: datos iniciales de reclutamiento en el ensayo fase III URONCOR 06-24","authors":"C. González San Segundo ,&nbsp;F. López-Campos ,&nbsp;A. Gómez Iturriaga ,&nbsp;M. Santos ,&nbsp;A. Ocanto ,&nbsp;L. Montezuma ,&nbsp;A.M. Boladeras-Inglada ,&nbsp;L. Glaria ,&nbsp;S. Guardado ,&nbsp;A. Rodríguez ,&nbsp;I. Henríquez ,&nbsp;J. Olivera ,&nbsp;V. Duque-Santana ,&nbsp;J. Garre ,&nbsp;S. Moreno ,&nbsp;J. Valero ,&nbsp;A.J. Conde ,&nbsp;A. Doval ,&nbsp;G. Sancho ,&nbsp;P. Martín Nieto ,&nbsp;F. Couñago","doi":"10.1016/j.acuro.2025.501823","DOIUrl":"10.1016/j.acuro.2025.501823","url":null,"abstract":"<div><h3>Introduction</h3><div>URONCOR 06-24 (NCT05781217) is a prospective, multicenter, randomized, open-label, phase III trial evaluating the impact on distant metastasis-free survival (MFS) of short-term (6 months) versus long-term (24 months) androgen deprivation therapy (ADT) in combination with salvage radiotherapy in high- and intermediate-risk patients after biochemical recurrence (BCR).</div></div><div><h3>Material and method</h3><div>A total of 534 men will be randomized to receive either 6 or 24 months of ADT. Stratification is based on risk group (intermediate vs high) and nodal status (pN0 vs pNx).</div></div><div><h3>Results</h3><div>From March 2023 to November 2024, 122 patients have been enrolled: 34 (28%) with intermediate risk and 88 (72%) with high risk. Fifty-five patients (45%) are pNx. The mean time from surgery to BCR is 25.4 months, and the PSA at inclusion was 0.55 ng/ml. Restaging was performed in 89 patients, 75 of whom underwent PET/CT (97%, PSMA PET/CT). Hypofractionation was used in 68% of cases, and elective pelvic irradiation in 33%. At the time of analysis, all patients had PSA normalization. No severe ADT-related toxicity has been reported</div></div><div><h3>Conclusion</h3><div>URONCOR 06-24 is the first clinical trial comparing long- versus short-term ADT in the setting of BCR after prostatectomy, with stratification by risk group. Initial recruitment data show a balanced distribution of prognostic factors between both arms and no serious adverse events related to ADT.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501823"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922082","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":"Densidad de inyección en Rezum®: menos puede no ser más. Un estudio internacional multicéntrico","authors":"I. Schwartzmann ,&nbsp;S. Secco ,&nbsp;A. Farré ,&nbsp;S. García-Barreras ,&nbsp;E. Fernández ,&nbsp;M. D’Anna ,&nbsp;L. Cindolo ,&nbsp;V. Parejo ,&nbsp;J.I. Tornero ,&nbsp;G. Ferrari ,&nbsp;F. Varvello ,&nbsp;J. Ponce de León ,&nbsp;I. Povo","doi":"10.1016/j.acuro.2025.501824","DOIUrl":"10.1016/j.acuro.2025.501824","url":null,"abstract":"<div><h3>Introduction</h3><div>Water vapor thermal therapy (WVTT) has emerged as a minimally invasive surgical therapy (MIST) for benign prostatic obstruction. However, the optimal number of intraprostatic injections remains debated. This study introduces injection density (ID), defined as the number of injections per 10 cc of prostate volume, to assess its impact on treatment failure after WVTT.</div></div><div><h3>Methods</h3><div>Multicentric retrospective study across 11 European centers, analysing patients who underwent WVTT between March 2019 and March 2024. Baseline, surgical, and postoperative data were collected during a 24 months follow-up. The primary outcome was treatment failure, defined as the need for medical or surgical intervention 12 months post-WVTT. Secondary outcomes included sexual function and postoperative complications. Logistic regression was performed across ID cut-off points from 0.75 to 2.5 injections per 10 cc.</div></div><div><h3>Results</h3><div>A total of 722 patients underwent WVTT with a mean age of 64 years and a mean prostate volume of 60 cc. Baseline Qmax was 8.0<!--> <!-->±<!--> <!-->3.6<!--> <!-->ml/s. Intermediate ID cut-off points (1.25-1.75) suggested a protective effect against treatment failure, with 1.75 being the first to reach statistical significance (p<!--> <!-->=<!--> <!-->0.028). Higher ID cut-off points (2.00-2.50) maintained a protective effect, but only 2.25 reached significance (<em>P</em>=.024). No significant relationship was found between ID and complications. Sexual function remained stable across ID thresholds.</div></div><div><h3>Conclusions</h3><div>Optimizing ID during WVTT may improve success rates without increasing complications or negatively impacting sexual function. These findings support a volumetric approach over the traditional linear injection technique to enhance WVTT outcomes.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501824"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922083","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":"Perfil clínico y factores de riesgo identificados en pacientes con cáncer renal en población mexicana","authors":"G. Sánchez-Villaseñor ,&nbsp;E.A. Pérez-Du Pond ,&nbsp;I. Jasso-García ,&nbsp;S.J. Vázquez-Sánchez ,&nbsp;R.C. García-Romero ,&nbsp;J.P. Gómez-Sierra ,&nbsp;M.G. Castillo Cardiel ,&nbsp;A.S. Álvarez-Villaseñor ,&nbsp;G. Cervantes-Guevara ,&nbsp;E. Cervantes-Pérez ,&nbsp;S. Ramírez-Ochoa ,&nbsp;A. González-Ojeda ,&nbsp;C. Fuentes-Orozco","doi":"10.1016/j.acuro.2025.501814","DOIUrl":"10.1016/j.acuro.2025.501814","url":null,"abstract":"<div><h3>Introduction</h3><div>Renal cell carcinoma, ranked 14th in global incidence, is more common in men. Its incidence rates increase with age, peaking in individuals older than 75<!--> <!-->years. The classic triad is present in only 17% of cases. Surgical management involves total or partial nephrectomy, both associated with potential complications.</div></div><div><h3>Objective</h3><div>To identify the clinical profile and risk factors in patients with renal cell carcinoma.</div></div><div><h3>Methodology</h3><div>An observational, cross-sectional, and analytical study was conducted on patients with renal cell carcinoma treated surgically in the Urology Department from January 2020 to June 2023. Demographic and clinical characteristics were analyzed in relation to TNM staging, histologic subtype, and morbidity and mortality.</div></div><div><h3>Results</h3><div>Among 83 patients, 48 (57%) were men, with a mean age of 59.2 years (SD 10.5). Hypertension (HTN) and obesity were the most frequent comorbidities, each affecting 37 patients (44.6%). Flank pain (37 patients, 44.6%) and hematuria (23 patients, 27.7%) were the most common manifestations. Age &gt;<!--> <!-->50<!--> <!-->years was associated with advanced stages (<em>P</em> <!-->=<!--> <!-->.003, OR: 5.744, 95%<!--> <!-->CI: 1.698-19.424), while obesity was associated with a lower risk of advanced stages (<em>P</em> <!-->=<!--> <!-->.0042, OR: 0.220, 95%<!--> <!-->CI: 0.075-0.648). Complications of open nephrectomy included bleeding in 26 patients (38.8%) and organ injury in 2 patients (2.9%). Mortality was reported in 1 patient.</div></div><div><h3>Conclusion</h3><div>Age &gt;<!--> <!-->50<!--> <!-->years is a risk factor for advanced stages, while obesity is associated with a lower risk. Hematuria and flank pain were common, whereas abdominal mass was rarely reported.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 7","pages":"Article 501814"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922084","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":"Comparación del P-score de Prostatype® y los modelos de riesgo tradicionales para predecir los resultados del cáncer de próstata en España","authors":"P. González-Peramato ,&nbsp;M. Álvarez-Maestro ,&nbsp;V. Heredia-Soto ,&nbsp;M. Mendiola Sabio ,&nbsp;E. Linares ,&nbsp;Á. Serrano ,&nbsp;J.L. Álvarez-Ossorio ,&nbsp;E. López Alcina ,&nbsp;L. Prieto ,&nbsp;F. Vázquez Alonso ,&nbsp;M. Aller Rodríguez ,&nbsp;E. Berglund","doi":"10.1016/j.acuro.2025.501788","DOIUrl":"10.1016/j.acuro.2025.501788","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer (PCa) shows varied aggressiveness, complicating personalised treatment decisions. Traditional risk stratification systems rely on clinical parameters but may miss crucial genetic insights. The Prostatype® score (P-score) integrates gene expression with clinical data to improve PCa risk assessment precision.</div></div><div><h3>Objectives</h3><div>To validate the P-score's predictive performance for prostate cancer-specific mortality (PCSM) and metastasis in a Spanish cohort, comparing it with NCCN, D’Amico, and EAU systems.</div></div><div><h3>Materials and Methods</h3><div>This study was multicentre, retrospective and included seven Spanish hospitals. Of 154 core needle biopsies, 93 met RNA criteria, and for those, P-score was calculated based on <em>IGFBP3</em>, <em>VGLL3</em>, and <em>F3</em> genes expression and clinical data.</div><div>The primary endpoint was PCa-specific mortality (PCSM), with secondary endpoints being development of metastasis, adverse pathology (AP), and International Society of Urological Pathology (ISUP) grading.</div></div><div><h3>Results</h3><div>The P-score demonstrated superior accuracy in predicting 10-year PCSM, with an AUC of 0.81 and a C-index of 0.75, outperforming NCCN (AUC 0.77, C-index 0.69) and D’Amico/EAU (AUC 0.70, C-index 0.62). For metastasis prediction, the P-score achieved a C-index of 0.77, significantly higher than NCCN, D’Amico, and EAU (0.58). Kaplan-Meier analysis underscored the P-score's ability to better stratify patients by risk, especially high-risk groups. Additionally, the P-score correlated with tumour burden, showing significant associations with positive biopsy cores (p<!--> <!-->=<!--> <!-->0.017) and ISUP grade at radical prostatectomy (p<!--> <!-->=<!--> <!-->0.0028).</div></div><div><h3>Conclusions</h3><div>In this Spanish cohort, the P-score outperformed traditional clinicopathological systems in predicting PCSM, development of metastasis, and pathological markers, supporting its clinical utility for more personalised PCa management.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501788"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517658","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":"La influencia de la invasión linfovascular en la recurrencia y progresión del cáncer vesical no músculo invasivo tratado con bacilo de Calmette-Guérin","authors":"U. Aydin ,&nbsp;S. Cetin ,&nbsp;M. Yavuz Koparal ,&nbsp;C. Coskun ,&nbsp;I.I. Gonul ,&nbsp;S. Yesil ,&nbsp;T.S. Sozen","doi":"10.1016/j.acuro.2025.501785","DOIUrl":"10.1016/j.acuro.2025.501785","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>To investigate whether lymphovascular invasion (LVI) could be a factor in predicting recurrence and progression in patients with high and very high-risk non-muscle-invasive bladder cancer (NMIBC) who received Bacillus Calmette-Guérin (BCG) treatment.</div></div><div><h3>Methods</h3><div>Ninety-three patients with high and very high-risk NMIBC, diagnosed initially in our clinic, were treated with at least 1 year of BCG therapy, and they were followed up to assess recurrence and progression, comparing those with and without LVI at the time of diagnosis.</div></div><div><h3>Results</h3><div>In the entire cohort, LVI was present in 33 (35.5%) patients while absent in 60 (64.5%) patients. Among patients with LVI, 17 (51.5%) showed recurrence, and 11 (33.3%) showed progression. Statistically significant differences were observed in both recurrence and progression in patients with LVI compared to those without LVI (<em>P</em> <!-->&lt;<!--> <!-->.001 and .04, respectively). Additionally, univariate and multivariate regression analysis revealed that the presence of LVI was an independent factor predicting recurrence (<em>P</em> <!-->=<!--> <!-->.001).</div></div><div><h3>Conclusion</h3><div>In our study, we demonstrated the importance of being cautious regarding recurrence and progression in patients with high and very high-risk NMIBC who also have LVI despite receiving standard treatment. We found that approximately one-third of these patients may experience recurrence within one year.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501785"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517662","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}