BJUI compass最新文献

{"title":"First validation of the Prostatype® P-score in an Asian cohort: Improving risk stratification for prostate cancer","authors":"See-Tong Pang,&nbsp;Po-Hung Lin,&nbsp;Emelie Berglund,&nbsp;Lidi Xu,&nbsp;I-Hung Shao,&nbsp;Kai-Jie Yu,&nbsp;Chin-Hsuan Hsieh,&nbsp;Tzu-Hsuan Chang,&nbsp;Yu Chen,&nbsp;Wen-Hui Weng,&nbsp;Cheng-Keng Chuang","doi":"10.1002/bco2.70026","DOIUrl":"https://doi.org/10.1002/bco2.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the prognostic performance of the Prostatype® score (P-score) in the Asian prostate cancer (PCa) cohort and to assess its ability to refine risk stratification compared to the National Comprehensive Cancer Network (NCCN) guidelines. This study aimed to determine whether the P-score, previously validated in European populations, maintains its predictive accuracy in a genetically and clinically distinct high-risk Asian cohort, where late-stage diagnosis is more common.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>This retrospective study included 148 PCa patients diagnosed at Taiwan Chang Gung Memorial Hospital between 2012 and 2017. Of these, 56 had primary metastases at diagnosis. The P-score was calculated based on gene expression in core needle biopsies and clinical data collected from patients' medical records. The primary endpoint was PCa-specific mortality (PCSM). The secondary endpoints were adverse pathology (AP) and biochemical failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The P-score significantly outperformed NCCN in predicting PCSM, achieving a higher C-index (0.90 vs. 0.73, P &lt; 0.005), which reflects superior prognostic accuracy. Notably, 19.6% of patients were reclassified into different risk categories compared to NCCN, improving risk stratification and potentially altering treatment decisions for nearly one in five patients. The P-score was also an independent predictor of adverse pathology (P = 0.003, AUC: 0.81) and biochemical failure (P = 0.03, AUC: 0.89).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study validated the P-score for the first time in a non-European population, confirming its predictive power in an Asian high-risk setting. The reclassification of 19.6% of patients suggests that the P-score refines risk stratification beyond NCCN, offering a more precise distinction between favourable and unfavourable outcomes, enabling more informed treatment decisions. These findings highlight the global applicability of the P-score and its potential to improve risk assessment and personalized treatment for PCa patients worldwide.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRAME is not a frequently expressed antigen in renal cell carcinoma","authors":"Irvin Yi,&nbsp;Yael Derdikman Ofir,&nbsp;Jacqueline Mann,&nbsp;David Su,&nbsp;Tara Kim,&nbsp;Oscar Perales,&nbsp;Lin Zhang,&nbsp;Adebowale Adeniran,&nbsp;Harriet M. Kluger,&nbsp;David A. Schoenfeld","doi":"10.1002/bco2.70037","DOIUrl":"https://doi.org/10.1002/bco2.70037","url":null,"abstract":"&lt;p&gt;In patients with advanced renal cell carcinoma (RCC), immune checkpoint inhibitors (ICIs) have led to significant improvements in overall survival. However, not all patients respond to ICI-based regimens, and most patients that do will eventually develop resistance.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; This highlights the need for complementary and alternative immunotherapeutic strategies in RCC. Many newer strategies are tumour antigen targeted, such as antibody-drug conjugates, CAR T-cell therapy, T-cell receptor therapy and bispecific T-cell engagers.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Such therapies have demonstrated promising anti-tumour activity in early-phase trials.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The identification of targetable tumour-specific antigens is thus an important step for ICI-resistant RCC.&lt;/p&gt;&lt;p&gt;Preferentially expressed antigen in melanoma (PRAME) is a protein classified under the cancer/testis antigen family. PRAME functions primarily as a repressor of retinoic acid signalling, preventing retinoic acid induced cell differentiation and proliferation arrest.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; It also contains multiple HLA-specific epitopes that can be presented by MHC class I molecules, activating CD8&lt;sup&gt;+&lt;/sup&gt; T cells.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The normal expression of PRAME is limited to testes and ovarian cells, but it is pathologically expressed in numerous solid and haematological malignancies. For example, PRAME expression is observed in 88% of primary melanomas and 95% of metastatic melanomas, 80% of non-small cell lung cancers (NSCLCs) and 53% of breast cancers, among others.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; PRAME expression has been shown to be prognostic and is associated with advanced tumour stage and poor overall survival.&lt;/p&gt;&lt;p&gt;The combination of PRAME's restricted cancer overexpression and immunomodulatory potential have made it a promising immunotherapeutic target. PRAME-targeting therapies have been in development for multiple malignancies using a variety of approaches, including bispecific T cell engagers, T-cell receptor adoptive cell therapies and antibody-drug conjugates. Ongoing trials include a Phase III trial testing a T cell receptor bispecific protein targeting PRAME and CD3 in melanoma (PRISM-MEL-301, NCT06112314) and Phase I/II trials enrolling PRAME-positive patients in multiple solid tumours.&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt; Early results from these trials have demonstrated safety and anti-tumour activity in heavily pretreated patients across tumour types, including melanoma, ovarian cancer, head and neck cancer and synovial sarcoma.&lt;span&gt;&lt;sup&gt;3, 4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;PRAME expression patterns have not been thoroughly evaluated in RCC. A limited study found &lt;i&gt;PRAME&lt;/i&gt; mRNA positivity in 15 of 39 (38%) RCC samples.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; A more systematic analysis of PRAME expression in epithelial tumours observed PRAME positivity by immunohistochemistry (IHC) in 20 of 175 clear cell RCC samples, with a 22% positivity rate in grade 3/4 samples","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incorporating the NICE Cambridge Prognostic Groups and Predict Prostate into a structured informed-decision making clinic reduces over-treatment rates of early prostate cancer","authors":"Vincent J. Gnanapragasam,&nbsp;Vineetha Thankapannair","doi":"10.1002/bco2.70036","DOIUrl":"https://doi.org/10.1002/bco2.70036","url":null,"abstract":"&lt;p&gt;Prostate cancer poses a unique conundrum in the delivery of high-quality care in uro-oncology. Despite having a high prevalence, actual mortality from a diagnosis remains low.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; These facts mean that efforts on screening or increased PSA testing will likely result in even more cancers diagnosed for which active treatment may be unnecessary and conversely result in harm to the well-being of an individual. Health care systems consistently neglect the fundamental fact that most clinicians are not good at estimating prognosis and treatment benefit or conveying this to patients.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; As a result, in the United Kingdom and elsewhere, there is considerable centre-to-centre and clinician-to-clinician variation in how prostate cancer is managed and what advice is given to patients with data from the National Prostate Cancer Audit on treatment variations clearly illustrating this fact.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Informed decision-making is critical in counselling men with newly diagnosed prostate cancer. Yet there has been (until recently) a paucity of evidence based prognostic models and individualised tools to use in informed decision making. As a result, clinicians often use their own personal judgement, prior experience and a plethora of risk models (validated and unvalidated) rather than objective data to guide their counselling.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Not surprisingly, it is difficult for patients to receive consistent unbiased advice and balance benefits vs harms in decisions about how best to manage early prostate cancer. In 2021, the National Institute for Heath and Care Excellence (NICE) replaced the out-dated 3-tier biochemical relapse risk stratification system with the 5-tier Cambridge Prognostic Groups (CPG).&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; This for the first time allowed prostate cancer patients to be stratified by a model that predicted outcome based on the risk of prostate cancer mortality. The CPG prognostic model (https://cambridgeprognosticgroup.com) defines distinct subgroups of men within the old intermediate-risk and high-risk criteria who have very different prognostic outcomes. In head-to-head comparisons, the CPG model has been shown to outperform current classifiers including the EAU, AUA and NCCN models. In the same year, the Predict Prostate individualised prognostic tool (https://prostate.predict.cam) was also endorsed by NICE for informed decision making and counselling. Based on patient characteristics and clinicopathological features, Predict Prostate (video at https://www.youtube.com/watch?v=TL53pULR-94&amp;feature=youtu.be) produces personalised prostate cancer specific and overall survival estimates displayed in a range of visual outputs to contextualise the potential benefits of radical treatment. It does not tell a patient what to do but provides an estimate of the likely gain from survival from immediate treatment versus surveillance. The use of these tools is strongly recommende","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel neoadjuvant therapies for muscle-invasive bladder cancer: Systematic review and meta-analysis","authors":"Shugo Yajima,&nbsp;Naoki Imasato,&nbsp;Hitoshi Masuda","doi":"10.1002/bco2.70031","DOIUrl":"https://doi.org/10.1002/bco2.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to evaluate the efficacy and safety of novel neoadjuvant therapies including immune checkpoint inhibitors (ICI), molecular targeted agents (MTA) and antibody-drug conjugates in muscle-invasive bladder cancer through a systematic review and meta-analysis of prospective clinical trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects/Patients and Methods</h3>\u0000 \u0000 <p>A systematic search was performed using PubMed, Web of Science, Cochrane Library, Google Scholar and ClinicalTrials.gov through December 2024. Eligible studies were phase II or higher prospective trials investigating novel agents as neoadjuvant therapy. Primary endpoints were pathologic complete response and downstaging rates. Secondary endpoints included biomarker analysis, survival outcomes and safety profiles. Data were extracted following PRISMA guidelines, and random-effects meta-analyses were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen trials comprising 1977 patients were analysed. ICI-based treatments were associated with pathologic complete response rates of 37% (95% CI, 34%–40%) and downstaging rates of 55% (95% CI, 48%–61%). ICI monotherapy was associated with higher response rates compared with MTA monotherapy (pathologic complete response: 34% vs. 5%; downstaging: 47% vs. 27%). Grade ≥3 adverse events occurred less frequently with ICI-based treatments than MTA-based treatments (35% vs. 62%). High PD-L1 expression was associated with improved pathologic response (OR, 2.60; 95% CI, 1.44–4.71). Two-year overall survival rates were 81% for ICI-based regimens and 86% for MTA-based regimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Novel neoadjuvant therapies, particularly ICI-based regimens, were associated with meaningful pathologic response rates and acceptable safety profiles. PD-L1 expression may help guide patient selection for ICI-based therapy. Randomized trials are needed to establish optimal treatment algorithms and validate predictive biomarkers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144140544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective analysis of ureteral stenting during radical cystectomy and ileal conduit urinary diversion: Paediatric feeding tubes versus single-J stents","authors":"Jonathan T. Ryan,&nbsp;Tarek Ajami,&nbsp;Adam Williams,&nbsp;Dinno Mendiola,&nbsp;Bruno Nahar,&nbsp;Sanoj Punnen,&nbsp;Chad R. Ritch,&nbsp;Dipen J. Parekh,&nbsp;Mark L. Gonzalgo","doi":"10.1002/bco2.70032","DOIUrl":"https://doi.org/10.1002/bco2.70032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study compares postoperative outcomes of radical cystectomy (RC) with ileal conduit urinary diversion (ICUD) using paediatric feeding tubes versus single-J ureteral stents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Patients underwent RC with ICUD for bladder cancer between 2011 and 2018. Prospective preoperative clinical, operative and postoperative data were collected. Postoperative complications including stricture, urine leak, urinary tract infection (UTI) and ileus were compared between patients who received 5-Fr paediatric feeding tubes or 7-Fr single-J ureteral stents during surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred thirty-four patients underwent RC with ICUD including 26 with paediatric feeding tubes and 208 with single-J ureteral stents; 41% had robotic cystectomy, with 36% of these undergoing intracorporeal ICUD. Both groups were comparable in age, gender, kidney function and comorbidities. No significant differences were observed between groups for rates of ileus (20% vs. 34%, <i>p</i> = 0.14), urine leak (4% vs. 10%, <i>p</i> = 0.3), uretero-ileal stricture (16% vs. 18%, <i>p</i> = 0.7) or overall urinary complications (20% vs. 37%, <i>p</i> = 0.12), except for a lower UTI rate in the feeding tube group (4% vs. 23%, <i>p</i> = 0.02). Median hospital stay was shorter in the feeding tube group (6 vs. 8 days, <i>p</i> = 0.015) with similar readmission rates compared to the stent group (<i>p</i> = 0.96).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Using 5-Fr feeding tubes for ureteral stenting during RC with ICUD is a safe alternative to 7-Fr single-J stents, especially for patients with small ureters or delicate anatomy. Stent type showed no significant impact on postoperative urinary complications except for a lower UTI rate with feeding tubes, suggesting comparable overall outcomes between the two stent types.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance and safety of transverse scrotal vs transperineal AUS for PPUI: A retrospective cohort study","authors":"Christine R. Reus,&nbsp;Izabelle Brattås,&nbsp;Daniela Volz,&nbsp;Filip Sydén,&nbsp;Renata Zelic,&nbsp;Katarina Hallén Grufman,&nbsp;Lotta Renström Koskela","doi":"10.1002/bco2.70027","DOIUrl":"https://doi.org/10.1002/bco2.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To primarily compare efficacy and safety of transverse scrotal (TS) versus transperineal (TP) artificial urinary sphincter (AUS) implantation for post-prostatectomy urinary incontinence (PPUI). The AUS is the gold standard for managing severe refractory male SUI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This single-centre, retrospective, cohort study, analyses 179 consecutive patients who underwent primary AUS implantation for PPUI between 2005 and 2018. Data on 24-h pad weight tests (PWT), validated quality of life questionnaires (I-QoL), surgical technique, related complications, salvage radiation and transcorporeal cuff placement (TC) were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The TP approach was performed in 43 cases, whilst 136 patients underwent TS incision, of which 31 benefited from TC placement. The median PWT reduction was 458 g (320, 701) in the TP and 479 g (258, 745) in the TS group (p = 0.807). The median I-QoL index increase was 40 (26, 52) in the TP and 48 (36, 60) in the TS group, showing a significant difference in favour of the TS group (p = 0.012). The overall postoperative infection rate was 3.9%, with a lower risk in the TS group (RR = 0.23, p = 0.049). Erosion occurred in 9.0% of patients, with a higher relative risk observed in the TS group (<i>RR = 1.34, p = 0.636</i>); however, we found that the TC patients (consisting of salvage radiation patients) in the TS group drove this higher risk. Mechanical failure and subsequent revision were lower in the TS cohort <i>(RR = 0.43, p = 0.004)</i> and <i>(RR = 0.42, p = 0.002),</i> respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TS and TP approaches resulted in similar improvements in continence but a greater increase in quality of life in the TS group. While post-operative erosion rates and device survival were comparable, the TP group had higher rates of infection and mechanical failure, which may be relevant for surgical decision-making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PSMA PET/CT findings in high-risk biochemical recurrence after local treatment of prostate cancer","authors":"Nicole Handa,&nbsp;Richard Bennett IV,&nbsp;Eric V. Li,&nbsp;Austin Ho,&nbsp;Mitchell M. Huang,&nbsp;Sai Kumar,&nbsp;Clayton Neill,&nbsp;Ridwan Alam,&nbsp;Hiten D. Patel,&nbsp;Edward M. Schaeffer,&nbsp;Ashley E. Ross","doi":"10.1002/bco2.70028","DOIUrl":"https://doi.org/10.1002/bco2.70028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To describe PSMA PET/CT characteristics of patients with high-risk BCR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects/patients and methods</h3>\u0000 \u0000 <p>This was a retrospective analysis of patients with high-risk BCR prostate cancer (PSA ≥ 2 ng/ml above nadir after radiation therapy [RT] or ≥1 ng/ml after radical prostatectomy [RP] +/− RT) who underwent PET/CT from July 2021–March 2023. Patients with prior cytotoxic chemotherapy, androgen deprivation therapy (ADT) initiated &gt;3 months prior to PET/CT or positive conventional imaging within 3 months of PET/CT were excluded. Neoadjuvant/adjuvant ADT completed ≥9 months prior was allowed. Logistic regression, Pearson's Chi-squared, Wilcoxon rank sum and Fisher's exact tests were used for analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 113 of 145 (77%) included patients in the analysis had ≥1 lesion on PSMA PET/CT. There was no difference in PSMA PET/CT positivity based on age, race, Gleason Grade at initial biopsy or PSA. Overall, 29 (20%) patients had lesions in the prostate/prostate bed only, 31 (21%) had lesions consistent with N1M0 disease and 53 (37%) had lesions consistent with M1 disease. For M1 patients, 21/53 (40%) had oligometastatic disease (1–3 lesions), and 32/53 (60%) had a higher burden (&gt;3 lesions). Local recurrence was more common with RT and nodal recurrence with RP, with no difference in distant metastasis by initial treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Nearly 80% of patients with high-risk BCR after local treatment for prostate cancer with RP and/or RT will have positive findings on PSMA PET/CT. In addition to intensified systemic therapy, up to 55% of the patients may have benefitted from salvage local therapy, nodal pelvic radiation or metastasis-directed therapies for oligometastatic disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concordance of renal tumour assessments by urologists using CT scans versus Hyper-Accuracy 3D Virtual Models for surgical planning: A single-centre multireviewer analysis","authors":"Francesco Ditonno,&nbsp;Michele Boldini,&nbsp;Francesco Cianflone,&nbsp;Lorenzo Treccani,&nbsp;Lorenzo De Bon,&nbsp;Francesca Fumanelli,&nbsp;Francesco Artoni,&nbsp;Claudio Brancelli,&nbsp;Iolanda Palumbo,&nbsp;Alberto Baielli,&nbsp;Alberto Bianchi,&nbsp;Filippo Migliorini,&nbsp;Riccardo Bertolo,&nbsp;Alessandro Veccia,&nbsp;Alessandro Antonelli","doi":"10.1002/bco2.70002","DOIUrl":"https://doi.org/10.1002/bco2.70002","url":null,"abstract":"&lt;p&gt;Robot-assisted partial nephrectomy (RAPN) might represent a surgically demanding procedure that conceals several pitfalls, including proximity to vessels or calyces and lesions not visible upon kidney exposure. Therefore, a comprehensive understanding of key anatomical landmarks is crucial for precise surgical planning and procedural success. Several innovative technological tools have been proposed, including three-dimensional virtual models (3DVMs).&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Their routine use could enhance preoperative and intraoperative guidance, broadening the indication for RAPN.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The primary aim of the present study was to evaluate the inter-rater agreement of urologists interpreting conventional CT scans versus hyperaccuracy (HA)-3DVMs (MEDICS Srl, Turin, Italy) to guide preoperative planning for renal masses.&lt;/p&gt;&lt;p&gt;A prospectively maintained database of patients undergoing kidney surgery for renal masses at our Institution was queried to retrieve data of all consecutive RAPN interventions, with preoperative CT scans and HA-3DVMs available. Patients with a history of prior renal surgery and bilateral or multiple ipsilateral tumours were discarded. Performance of CT scans followed a standard internal protocol for staging solid renal masses, using a contrast-medium multidetector CT with 3/5-mm sections from the pulmonary base to the pelvis, with basal, arterial, venous, and excretory phases. The respective HA-3DVMs were developed in selected cases as previously described,&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; based on the expected surgical complexity.&lt;/p&gt;&lt;p&gt;The primary outcome was interobserver agreement across 12 specific preoperative surgical planning domains, assessed using a custom-designed questionnaire (Supplementary Material).&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; The questionnaire comprised 12 items covering different aspects of preoperative surgical planning. Twelve urologists, including six residents and six experienced practitioners, evaluated each clinical case using both the CT scan and the respective HA-3DVMs.&lt;/p&gt;&lt;p&gt;Interobserver agreement was measured using Cohen's kappa (k) statistics for each domain across multiple raters, with 95% confidence intervals (CI) determined by 1000 bootstrap repetitions. Kappa values could range from 0 to 1, with agreement defined as almost perfect (&lt;i&gt;k&lt;/i&gt; &gt; 0.8), substantial (&lt;i&gt;k&lt;/i&gt; &gt; 0.6), moderate (&lt;i&gt;k&lt;/i&gt; &gt; 0.4), fair (&lt;i&gt;k&lt;/i&gt; &gt; 0.2), or none to slight (&lt;i&gt;k&lt;/i&gt; &lt; 0.2).&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Each clinician evaluated all 31 cases twice: once using CT scans and once with HA-3DVMs. The order of evaluation (CT first or HA-3DVM first) was left to clinicians' preference. Each imaging modality was reviewed independently, without back-to-back comparisons, to ensure an unbiased assessment. The time required to complete the evaluation of either the CT scan or HA-3DVMs was recorded. Differences in evaluation times were estimated using the Wilcoxon signed-rank test. A subgrou","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes in BCG failure: Outcome from a single centre UK experience","authors":"Elizabeth Day,&nbsp;Rachel Aquilina,&nbsp;Lazaros Tzelves,&nbsp;Ashwin Sridhar,&nbsp;Anthony Ta,&nbsp;John Kelly,&nbsp;Bernadett Szabados","doi":"10.1002/bco2.70025","DOIUrl":"https://doi.org/10.1002/bco2.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe real-world outcomes of patients with BCG failure undergoing bladder-sparing treatments (BSTs) vs radical cystectomy in the UK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A single institution audit was conducted at a tertiary bladder cancer referral service (UCLH, London, UK). Patients with BCG failure treated between January 2017 and September 2022 were included. BSTs included endoscopic surveillance, hyperthermic mitomycin and further BCG. The primary outcome was event free survival (EFS). Complete response (CR) rate and duration of response (DoR) were investigated in patients undergoing BST. The secondary outcomes were 3- and 5-year cancer-specific (CSS) and overall survival (OS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 112 patients were included: 30% (34/112), 32% (36/112) and 27% (30/112) had BCG unresponsive, exposed and intolerant disease and 11% (12/112) had progressed to muscle invasive disease (MIBC).</p>\u0000 \u0000 <p>In the BCG unresponsive and exposed groups, 79% (27/34) and 72% (26/36) underwent RC, with the remaining receiving BSTs. Comparing RC vs BST in BCG unresponsive and exposed groups combined, there was a significantly poorer EFS in the BST group (p &lt; 0.001); 35.3% (6/17) patients transitioned to second-line BST due to recurrence or intolerance and a further 50% (3/6) transitioned a third line BST. There was no significant difference in CSS or OS rates. In BCG intolerance, the EFS rate was 90% as three patients experienced high-grade recurrence and underwent RC. There were no cancer-related deaths. In MIBC group, 5/12 presented with metastatic disease and 3- and 5-year CSS rates was 66% and 0%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This data reports real-world practice in a UK centre. BSTs in BCG unresponsive and exposed disease are supported as an alternative to RC providing the increased risk of recurrence is accepted. Additionally, consideration of formal guidance supporting BST is needed in BCG intolerance, which appears to have an excellent outcome in a cohort managed with endoscopic surveillance. Upstaging to MIBC remains a poor prognostic factor and is key to improving survival outcomes in BCG failure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of upper urinary tract urothelial carcinoma after primary non-muscle-invasive urinary bladder cancer: A nationwide population-based cohort study","authors":"Christel Häggström,&nbsp;Oskar Hagberg,&nbsp;Lars Holmberg,&nbsp;Abolfazl Hosseini,&nbsp;Tomas Jerlström,&nbsp;Viveka Ströck,&nbsp;Karin Söderkvist,&nbsp;Anders Ullén,&nbsp;Fredrik Liedberg,&nbsp;Staffan Jahnson,&nbsp;Firas Aljabery","doi":"10.1002/bco2.70021","DOIUrl":"https://doi.org/10.1002/bco2.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate the risk of upper urinary tract urothelial carcinoma (UTUC) in patients with non-muscle-invasive bladder cancer (NMIBC), in relation to the primary NMIBC tumour risk categories, calendar time trends and intravesical Bacillus Calmette-Guerin (BCG) treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient and methods</h3>\u0000 \u0000 <p>All patients with primary NMIBC diagnosed 1997–2019 registered in Bladder Cancer Data base Sweden (BladderBaSe) 2.0 were included in the study. Risk of UTUC was calculated by cumulative incidence proportion using competing risk analysis. Associations with risk of UTUC by tumour stage category, calendar time, and intravesical BCG treatment was estimated by hazard ratios from multivariable Cox regression analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 36 038 NMIBC patients, 537 (1.5%) were diagnosed with UTUC during a mean time of 7 years in follow-up. The risk of UTUC within 10 years from NMIBC diagnosis was 1.7% (95% 1.6–1.9) with highest estimates for TaG3/CIS. Stage T1 and TaG3/CIS, as compared with TaG1–2 was associated to risk, with stronger associations during later calendar times. Within high-risk NMIBC patients (CIS/TaG3/T1), intravesical BCG treatment was associated with higher risk of UTUC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This large study of more than 36 000 patients with NMIBC found 1.7% (95% 1.6–1.9) risk of UTUC within 10 years of diagnosis. Differences by tumour stage category indicate the need for refined studies accounting for tumour characteristics, location in the bladder and given treatment to optimise follow-up routines in NMIBC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143905037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}