BJUI compass最新文献

{"title":"Comparison of the oncological and functional outcomes among patients with high-risk upper tract urothelial cancer undergoing segmental ureterectomy based on tumour location","authors":"Maksym Pikul, Prokip Gordiychuk, Eduard Stakhovsky","doi":"10.1002/bco2.70046","DOIUrl":"https://doi.org/10.1002/bco2.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Segmental ureterectomy (SU) represents a viable alternative to radical nephroureterectomy (RNU) for the management of distal ureteral tumours when technically feasible. However, SU of the proximal two-thirds of the ureter is associated with higher failure rates compared to distal ureteral tumours. This study aims to compare oncologic outcomes and renal function in patients undergoing SU for tumours located in the distal versus proximal ureter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospective, non-randomized cohort study, which included adult patients with high-risk cT2–3 cN0–1 M0 ureteral tumours deemed suitable for SU, with preoperative affected kidney function > 15 ml/min. Patients were treated at a reference centre between March 2019 and March 2023. Patients were divided into two cohorts based on the primary tumour location: distal or proximal two-thirds of the ureter. All patients received neoadjuvant chemotherapy (Gem-Cis) and cases that underwent RNU were excluded from the study. Kaplan–Meier analysis was employed to evaluate local- recurrence-free survival (L-RFS), progression-free survival (PFS) and overall survival (OS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 41 patients underwent SU (21/20 proximal/distal location). The cohorts were matched by age, sex, BMI, ECOG status, T-stage, pN status, tumour length, preoperative eGFR, primary pathology and positive cytology (p > 0.05). Following segmental ureterectomy, all patients with distal ureteral tumours underwent neostomy reconstruction. In the proximal ureter group, reconstruction techniques included end-to-end anastomosis in 9 (43%), Andersen-Heinz plasty in 8 (38%) and ureter-ileum interposition in 4 cases (19%).</p>\u0000 \u0000 <p>No statistically significant differences were observed between the two cohorts in terms of surgery duration, average blood loss, Grade ≥3 complications, length of postoperative stay or 30-day readmission rate (p > 0.05). Postoperative eGFR was similar between the groups (60.4 ± 8.5 vs. 59.4 ± 11.4; p = 0.81). Furthermore, no significant differences were found between patients with proximal versus distal ureteral tumours in terms of 2-year L-RFS (72% vs. 85%; p = 0.29), PFS (85% vs. 77%; p = 0.69) or OS (65% vs. 77%; p = 0.43).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The current study demonstrates that segmental ureterectomy provides comparable oncologic outcomes and renal function preservation for both proximal and distal ureteral cancer. SU can be considere","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315044","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":"Mental well-being in prostate cancer: A multi-institutional prospective cohort study","authors":"Oliver Brunckhorst,&nbsp;Jaroslaw Liszka,&nbsp;Callum James,&nbsp;Jack B. Fanshawe,&nbsp;Mohamed Hammadeh,&nbsp;Robert Thomas,&nbsp;Shahid Khan,&nbsp;Matin Sheriff,&nbsp;Gordon Muir,&nbsp;Hashim U. Ahmed,&nbsp;Mieke Van Hemelrijck,&nbsp;Robert Stewart,&nbsp;Prokar Dasgupta,&nbsp;Kamran Ahmed","doi":"10.1002/bco2.70040","DOIUrl":"https://doi.org/10.1002/bco2.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the patient, treatment and oncological prognostic factors for multiple mental well-being outcomes in prostate cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient and Methods</h3>\u0000 \u0000 <p>The MIND-P study was a multi-institutional prospective cohort study recruiting newly diagnosed prostate cancer patients for 12 months post-diagnosis across eight centres. Periodic data collection evaluated mental, physical and social well-being measures incorporating five mental well-being outcomes selected based on prior research as important measures in patients with prostate cancer. This included depression, anxiety, fear of recurrence, body image, and masculinity. Treatment, patient, and oncological prognostic factors for developing significant well-being symptoms were evaluated along with symptom trajectories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 300 patients recruited, 13.7% and 11.0% developed depression or anxiety symptoms, with 45.0% developing at least one significant mental well-being symptom. Those undergoing hormone monotherapy had higher depression scores from 6 months post-diagnosis (all <i>p</i> &lt; 0.05), with prostatectomy patients having poorer body image and masculinity scores, when compared with surveillance patients (all <i>p</i> &lt; 0.02). Metastatic disease at diagnosis was associated with increased depression, anxiety and fear of cancer recurrence. Patient factors for poorer mental well-being included younger age, a previous psychiatric history, social deprivation, poorer baseline mental health symptoms and poorer baseline sexual and urinary function. Symptom trajectory analysis demonstrated the increasing symptom load in body image and masculine self-esteem experienced post any active treatment modality, with more stable scores for other mental well-being measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A high incidence of multiple mental well-being issues was identified post-diagnosis, highlighting their individual importance during follow-up. Baseline mental and functional symptoms, a previous psychiatric history and stage at diagnosis appear to be particularly important prognostic factors for the development of significant symptoms. A comprehensive initial biopsychosocial assessment incorporating these could identify high-risk patients for improved monitoring and subsequent support.</p>\u0000 \u0000 <p>ClinicalTrials.gov number - NCT04647474.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300466","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":"Questionable role of opioids for analgesia in renal colic and its urological interventions","authors":"Anna Krieger,&nbsp;Nadim Zaidan,&nbsp;Philip Zhao,&nbsp;James F. Borin,&nbsp;David S. Goldfarb","doi":"10.1002/bco2.70038","DOIUrl":"https://doi.org/10.1002/bco2.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To review the different analgesic modalities and benefits of non-opioid pain management options as well as their evidence-based, established superiority, compared to opioid medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials</h3>\u0000 \u0000 <p>We review the updated literature about pain management of renal colic, a prevalent and painful urologic condition. Prescribers must know the efficacy, safety and possible ramifications of analgesic selections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Commonly prescribed medications in the United States (US) include non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and opioids. In the context of the current epidemic of death from overdoses of opioids in the US, the frequency of opioid prescribing for renal colic is likely excessive, problematic and potentially remediable. We also present analgesic modalities revolving around interventions with peri-procedural pain management for ureteroscopy and percutaneous nephrolithotomy. After touching on the implications of misguided opioid use, especially in the context of kidney stone disease, and despite the evidence and consensus guidelines supporting NSAIDs in renal colic, current evidence has shown that many clinicians continue to prescribe opioids as first-line treatment. Finally, we highlight current efforts targeted at the reduction of opioid use and prescription in the setting of provider education and decision aids in curbing misguided opioid use in renal colic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While the evidence against treating kidney stones with opioids is clear, more work is needed to shift current practices to reflect that renal colic is a non-opioid-requiring condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256033","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":"Real-world oncological and toxicity outcomes with the Moscow strain of intravesical BCG for non-muscle invasive bladder cancer—Implications for global shortage","authors":"Amandeep Arora,&nbsp;Sugam Godse,&nbsp;Mahendra Pal,&nbsp;Ankit Misra,&nbsp;Ravi Teja Sepuri,&nbsp;Naveen Thimiri Mallikarjun,&nbsp;Ajit Gujela,&nbsp;Sachin Patel,&nbsp;Anuj Sharma,&nbsp;Santosh Menon,&nbsp;Ganesh Bakshi,&nbsp;Gagan Prakash","doi":"10.1002/bco2.70034","DOIUrl":"https://doi.org/10.1002/bco2.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to determine the oncological effectiveness and adverse-effect profile of the Moscow strain of intravesical bacille Calmette–Guérin (BCG) for intermediate and high-risk non-muscle invasive bladder cancer (NMIBC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>We performed a retrospective search of consecutive intermediate and high-risk non-muscle invasive bladder cancer patients who were started on intravesical BCG at 80 mg dose from January 2020 to December 2021. Data were collected for oncological outcomes and adverse effects of BCG. High-grade recurrence-free survival (HGRFS) was defined as any relapse of high-grade (HG) urothelial cancer or carcinoma in situ (CIS). The primary outcome was to determine the HGRFS for those with originally HG disease. The RFS and HGRFS were calculated for the entire cohort, and also stratified by whether the patients had received adequate BCG or not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 166 patients during the study period, of which 79.6% had HG disease. There were 25 recurrences (15.1%) in the entire cohort over a median follow-up of 29 months. The RFS for the entire cohort at 12 and 24 months was 89.8% and 86.7%, respectively. For those with baseline HG disease, the 12- and 24-month HG-RFS was 90.9% and 87.1%. For the overall cohort, those who had received adequate BCG (<i>n</i> = 130, 78.3%) had a 12- and 24-month RFS of 96.9% and 95.4%, which was significantly higher than those who were not able to receive adequate BCG (<i>n</i> = 31, 18.6%) (12- and 24-month RFS of 74.2% and 64.5%), <i>p</i> &lt; 0.001. Around 10% patients dropped out at each sequential maintenance phase, either because of BCG intolerance or because of failure to comply with the BCG instillation schedule. Severe side effects led to BCG discontinuation in 38.5% patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Moscow strain BCG at 80 mg dose has excellent oncological outcomes, especially in patients who can take adequate BCG instillations, but BCG intolerance is a problem in a significant proportion of patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244718","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":"Low-carbohydrate diet score and risk of bladder cancer: Findings from a prospective cohort study","authors":"Yen Thi-Hai Pham,&nbsp;Renwei Wang,&nbsp;Jian-Min Yuan,&nbsp;Hung N. Luu","doi":"10.1002/bco2.70033","DOIUrl":"https://doi.org/10.1002/bco2.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Low carbohydrate diet (LCD), a summary score considering sources of all macronutrients in a dietary pattern, is defined by lower intakes of carbohydrates and higher intakes of proteins and fats. Research on the role of LCD and risk of bladder cancer is scare. We, therefore, prospectively examined the association between LCS scores and bladder cancer risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>We used data from the Singapore Chinese Health Study, a prospective cohort study of 63 275 participants aged 45–74 living in Singapore who were recruited during 1993–1998 period. LCD scores were derived from the semi-quantitative food frequency questionnaire at baseline. Bladder cancer cases were identified through record linkage with the Singapore cancer registry. Cox proportional hazard regression method was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for bladder cancer in relation with LCD scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After 17.6 years of follow-up with 819 573 person-years, 250 participants developed bladder cancer. We found a statistically significant, positive association for bladder cancer risk with increasing level of animal-based LCD (HR_{per-SD increment} = 1.16, 95% CI: 1.02–1.32; <i>P</i>_<i>trend</i> = 0.01), but a null association with an increased level of plant-based LCD (HR_{per-SD increment} = 1.08, 95% CI: 0.91–1.28, <i>P</i>_<i>trend</i> = 0.78).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In summary, we showed that an LCD diet with fat and protein from animal-based food was associated with increased risk while an LCD diet with fat and protein derived mainly from plant-based food was not associated with bladder cancer risk. Our findings have implications for diet modifications in the prevention and control program of bladder cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197517","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":"Incidental crossed fused renal ectopia detected during prostate cancer staging: A photorealistic three-dimensional rendering","authors":"Kei Ushijima,&nbsp;Kosuke Kojo,&nbsp;Tomoyuki Ohta,&nbsp;Keita Okamoto,&nbsp;Daisuke Numahata,&nbsp;Hiromu Inai,&nbsp;Katsunori Uchida,&nbsp;Hideki Takeshita,&nbsp;Hiroyuki Nishiyama,&nbsp;Tatsuya Takayama","doi":"10.1002/bco2.70039","DOIUrl":"https://doi.org/10.1002/bco2.70039","url":null,"abstract":"&lt;p&gt;Crossed fused renal ectopia (CFRE), also referred to as crossed fused ectopic kidney, is a congenital malformation in which both kidneys are located unilaterally, and one ureter opens into the ureteral orifice on the contralateral side.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; In addition to cases detected in infancy due to multiple congenital anomalies or in adolescence due to delayed menarche associated with concurrent genital malformations, CFRE is often incidentally discovered in adults without significant complications.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; An autopsy series reported an incidence of 1 in 2000–7500 cases, while a large CT study estimated an occurrence rate of approximately 1 in 3078 scans, making CFRE the second most common fusion anomaly after horseshoe kidneys.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;However, the clinical significance of asymptomatic CFRE in older adults is unclear. Notably, only three published cases have reported CFRE in patients undergoing evaluation for prostate cancer.&lt;span&gt;&lt;sup&gt;3-5&lt;/sup&gt;&lt;/span&gt; Herein, we present the fourth case discovered incidentally in a 72-year-old man with no remarkable medical history. He underwent a prostate biopsy to confirm prostate cancer, and a subsequent CT scan for metastatic screening revealed a CFRE. With his written informed consent, we reconstructed a photorealistic three-dimensional (3D) image from the CT data for illustrative purposes.&lt;/p&gt;&lt;p&gt;This imaging study was conducted as a part of an ongoing multi-institutional observational research project aimed at visualising various genitourinary malformations (University of Tsukuba, Institutional Review Board approval number: R05-199). Portal-phase contrast-enhanced CT images (2-mm slice thickness) were acquired for prostate cancer staging. We performed image segmentation and reconstruction using SYNAPSE 3D Version 7.00 (Fujifilm Medical Co., Ltd., Tokyo, Japan), also known as SYNAPSE VINCENT in Japan, following a previously described manual approach.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; We meticulously segmented the renal parenchyma, associated arteries and veins (including bilateral gonadal veins), ureters, bilateral adrenal glands and bones. For final rendering, we employed a technique commonly known as cinematic rendering, provided as ‘Photorealistic Rendering’ in SYNAPSE 3D. Compared with standard volume rendering, cinematic rendering offers enhanced shadow realism and depth perception, producing ‘photo-like’ images that could potentially improve anatomical education for students, enhance communication with patients and help clinicians plan surgical interventions by providing images that more closely resemble the intraoperative view.&lt;span&gt;&lt;sup&gt;7&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Figure 1 presents the final rendering clearly demonstrating the inferior location of the ectopic kidney relative to the orthotopic kidney. Both renal pelves were oriented in the same direction, classically described by McDonald and McClellan as ‘inferior ectopia’, the most common subtype of CFRE.&lt;span&gt;&lt;","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190832","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":"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}