BJUI compass最新文献

{"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}

{"title":"The outcomes of salvage robotic radical prostatectomy following radiation versus focal therapy: Does the primary treatment modality matter?","authors":"Alireza Ghoreifi,&nbsp;Lorenzo Storino Ramacciotti,&nbsp;Masatomo Kaneko,&nbsp;Luis G. Medina,&nbsp;Giovanni E. Cacciamani,&nbsp;Shiran Konganige,&nbsp;Manju Aron,&nbsp;Sarmad Sadeghi,&nbsp;Hossein Jadvar,&nbsp;Hooman Djaladat,&nbsp;Rene Sotelo,&nbsp;Mihir M. Desai,&nbsp;Inderbir S. Gill,&nbsp;Monish Aron,&nbsp;Andre Luis Abreu","doi":"10.1002/bco2.70019","DOIUrl":"https://doi.org/10.1002/bco2.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aim to compare salvage robotic radical prostatectomy (sRRP) for recurrent prostate cancer (PCa) after primary radiation (RT) versus focal therapy (FT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Patients who underwent sRRP following primary local therapy for PCa were identified. Perioperative findings and functional/oncologic outcomes were compared in RT versus FT groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 112 patients were included, with 84 receiving RT and 28 FT as primary treatment. Median age and PSA were 68 years and 5.4 ng/mL, respectively. There was one rectal injury in the RT group. The overall 90-day complications were significantly higher in RT group (33% vs. 11%, <i>p</i> = 0.03). On multivariable analysis, history of RT and prolonged operative time were associated with a higher rate of 90-day complications. The 6- and 12-month continence rates were higher in FT group (50% vs. 20%, <i>p</i> = 0.02 and 69% vs. 33%, <i>p</i> = 0.03). Potency at 12 months was better preserved in FT group (46% vs. 12%, <i>p</i> = 0.01). On final sRRP pathology, the rates of grade group ≥ 4 (51% vs. 36%, <i>p</i> = 0.2), pT3 (69% vs. 75%, <i>p</i> = 0.6), positive nodes (30% vs. 18%, <i>p</i> = 0.2) and positive margins (33% vs. 39%, <i>p</i> = 0.5) were similar for RT versus FT, respectively. The 3-year biochemical recurrence-free survival was 86% for RT versus 94% for FT (<i>p</i> = 0.6).</p>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>sRRP for recurrent PCa after FT is associated with lower complications and higher urinary continence and potency rates than patients who received primary RT.</p>\u0000 </section>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896818","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":"Association of overactive bladder with all-cause and cardiovascular mortality in women: A propensity-matched NHANES study","authors":"Weipu Mao,&nbsp;Sagar Barge,&nbsp;Zhaobo Luo,&nbsp;Weiqun Yu","doi":"10.1002/bco2.70022","DOIUrl":"https://doi.org/10.1002/bco2.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine the impact of overactive bladder (OAB) on all-cause and cardiovascular mortality in women in a real-world setting, and to examine the association of TyG-related indices with OAB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on 6580 women aged ≥20 years were collected from the National Health and Nutrition Examination Survey (NHANES) database. Kaplan–Meier curves and Cox survival analysis were used to evaluate the association between OAB and all-cause and cardiovascular mortality. Biomarkers for metabolic syndrome were assessed for their association with OAB, including triglyceride-glucose (TyG) and TyG-related indices. The association between TyG-related indices and OAB was evaluated using restricted cubic splines (RCS), receiver operating characteristic (ROC) curves and multivariate logistic regression, with propensity score matching (PSM) employed to balance confounders between OAB and non-OAB groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Kaplan–Meier curves showed that OAB was associated with a poorer prognosis, and multivariate Cox regression analyses indicated that OAB was an independent risk factor for both all-cause and cardiovascular mortality. RCS revealed a positive association between TyG-related indices and OAB. Both ROC curves and multivariate logistic regression analysis indicated that TyG-WHtR (TyG combined with waist-to-height ratio) was strongly associated with OAB, with a higher TyG-WHtR associated with an increased risk of OAB. The retrospective design and selection bias may be the potential limitations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>OAB is positively associated with all-cause and cardiovascular mortality in women. TyG-related indices are positively associated with OAB, with TyG-WHtR as the most effective index.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889079","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":"Female urethral stricture: A multi-centre experience and lessons learnt","authors":"Madeleine Bain,&nbsp;Daniel Esteban Gomez Zapata,&nbsp;Kapilan Ravichandran,&nbsp;Cora Fogaing,&nbsp;Apurva Anand,&nbsp;Amey Talpallikar,&nbsp;Shreyas Bhadranawar,&nbsp;Sanjay Kulkarni,&nbsp;Devang Desai,&nbsp;Pankaj Joshi","doi":"10.1002/bco2.70024","DOIUrl":"https://doi.org/10.1002/bco2.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To review demographics, surgical techniques and outcomes of female patients undergoing buccal mucosal graft substitution urethroplasty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>An international multi-institutional study was performed through a retrospective review of a prospectively managed database of female urethroplasty outcomes at two sites from December 2016 to June 2023. Institutions included a high-volume tertiary referral centre performing 500 urethroplasties annually, and a regional centre with a fellowship-trained urethroplasty surgeon performing ~50 urethroplasties annually. Female urethroplasty accounted for 2% of urethroplasties performed, utilising dorsal onlay, ventral inlay and double-face techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-two patients underwent female urethroplasty between 2016 and 2023; 20 dorsal onlay grafts, 14 ventral inlay grafts and 8 double-face urethroplasty. The mean age was 45 years (SD 12.07) and mean follow-up 27 months (SD 17.22). The most common aetiology was idiopathic in 59%. The most common presenting symptom was obstructive lower urinary tract symptoms in 86%. Urethral dilatations were the most common treatment before urethroplasty, with a mean of 9 (SD 1.2) dilations pre-urethroplasty. Stricture locations seen were; proximal 7%, proximal to mid-14%, mid-31%, mid to distal 10% and distal 38%. A total of 88% were successful overall; dorsal onlay was 100%, ventral inlay urethroplasties 71% and double-face 88%. Mean Qmax improvement was 291% at 6 months. In those who required dilatations or further surgery postoperatively (n = 5); four were ventral inlay (one mid-distal, three distal), and one double-face distal stricture. All patients including those requiring secondary treatments were continent and did not require intermittent self-catheterisation or suprapubic catheter insertion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Urethroplasty is an effective long-term therapeutic option for managing female urethral strictures. Dorsal onlay urethroplasty demonstrated the highest success rate, and stands out as a versatile technique, addressing distal to proximal urethral strictures. However, the chosen urethroplasty technique should be tailored to the characteristics of the stricture, patient and surgeons experience.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889030","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":"VPAC receptor positivity in comparison with mp-MRI in the diagnosis of prostate cancer: A preliminary study","authors":"Nishant Setya,&nbsp;Shridhar C. Ghagane,&nbsp;Rajendra B. Nerli,&nbsp;Ashwin Bokare,&nbsp;Madhukar L. Thakur,&nbsp;Leonard Gomella","doi":"10.1002/bco2.70006","DOIUrl":"https://doi.org/10.1002/bco2.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study aimed to prospectively evaluate the feasibility of diagnosing PCa using voided urine samples and by targeting the genomic VPAC (vasoactive intestinal peptide and pituitary adenylate cyclase-activating peptide) receptors in comparison with multiparametric magnetic resonance imaging (mp-MRI) in male patients (≥40 years of age) with lower urinary tract symptoms and having a serum PSA of &gt;4 but &lt;15 ng/ml.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Male patients attending urological services ≥40 years old, with lower urinary tract symptoms and serum PSA levels of &gt;4 but &lt;15 ng/ml formed the study group. Voided urine samples were collected to target VPAC receptors on malignant cells. All patients underwent mp-MRI. A 12-core transrectal ultrasound-guided prostate biopsy was performed in all, and the results were compared for the diagnosis of PCa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 61 patients with a median age of 65.33 ± 8.11 years and with a median serum PSA of 9.56 ± 2.78 ng/ml were further evaluated with both urinary biomarker assessment and mp-MRI. Histopathological (HPR) confirmation of PCa was noted in 25 (40.98%) patients and benign prostatic hyperplasia in the remaining 36 (59.01%) patients. Of the 25 patients with histologically proven PCa, the urinary biomarker (VPAC positivity) was positive for malignancy in 24 (96%), one case showed false negative results (4%) and there were no false positive cases (0%). HPR confirming PCa was seen in 3/16 patients with a PIRADS 2 score, 7/21 patients with a PIRADS 3 score, 7/14 patients with a PIRADS 4 score and 8/8 patients with a PIRADS score of 5.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>VPAC receptor positivity of prostate cancer cells is an easy test to perform using a voided urine sample. VPAC receptor positivity can be used as an indication for prostate biopsy in patients having a negative previous biopsy but highly suspicious of cancer, in patients with an elevated serum PSA but with a normal digital rectal examination and in patients with benign features and borderline elevation of serum PSA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857163","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 modified Delphi consensus statement on the role of biopsy in small renal masses","authors":"Darryl E. Bernstein,&nbsp;Hannah Warren,&nbsp;Joseph Santiapillai,&nbsp;Geraldine Fox,&nbsp;William H. Wildgoose,&nbsp;Grant D. Stewart,&nbsp;Jim Armitage,&nbsp;Pieter Le Roux,&nbsp;Frank X. Keeley Jr,&nbsp;Nicholas Campain,&nbsp;Ben Challacombe,&nbsp;Hazel Warburton,&nbsp;Carlotta Palumbo,&nbsp;Riccardo Campi,&nbsp;Stjin H. J. Muselaers,&nbsp;Miles Walkden,&nbsp;Steve Bandula,&nbsp;Dominic Yu,&nbsp;Michael Gonsalves,&nbsp;My-Anh Tran-Dang,&nbsp;Nazanin Etessami,&nbsp;Pedro Oliveira,&nbsp;Anna Calio,&nbsp;Soha El-Sheikh,&nbsp;Tze Wah,&nbsp;Axel Bex,&nbsp;Ravi Barod,&nbsp;Kurinchi Gurusamy,&nbsp;Maxine G. B. Tran","doi":"10.1002/bco2.70018","DOIUrl":"https://doi.org/10.1002/bco2.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To understand the variable utilisation of diagnostic biopsy for small renal masses (SRM) across the urology community, we worked with expert clinicians and patients to produce a consensus statement on the role of biopsy and to identify research gaps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In phase I, qualitative interviews were performed to identify potential statements on the role of biopsy and research gaps. In phase II, an expert panel including patients scored statements on a 9-point scale through a modified Delphi process involving three rounds of web-based surveys. Consensus was considered to have been reached when 70% of participants scored a statement greater than or equal to seven. Panel members could propose additional statements for consideration after the first round. Following the second round, a moderation meeting was held to discuss statements where threshold of agreement was not met.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 35 participants were involved in this project and consisted of 23 clinicians and 12 patients, with 29 participants completing all three rounds. Overall, 18 statements reached consensus, 11 of which pertained to when and how a biopsy should be used in SRM management and 7 research recommendations to improve the evidence base for biopsy use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Clinical Implications</h3>\u0000 \u0000 <p>This Delphi consensus statement, co-produced by patients and clinicians, provides best-practice guidance on the current role of renal tumour biopsy, including offering biopsy prior to active treatment if the outcome would affect management and offering a second attempt should the first biopsy be non-diagnostic. Priority areas for future research included studies to evaluate how a biopsy affects choice of treatment and patient anxiety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857162","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":"Does total lesion prostate-specific membrane antigen (PSMA) activity on 68Ga-PSMA PET/CT correlate with PSA and prostatectomy histopathological/clinical outcomes in patients with localised primary prostate cancer?","authors":"Jeremy Cheng,&nbsp;Mohammadmehdi Adhami,&nbsp;Tho Pham,&nbsp;David P. Nadebaum,&nbsp;Ashley Baring,&nbsp;Eldho Paul,&nbsp;Martin Cherk,&nbsp;Jeremy Grummet","doi":"10.1002/bco2.70015","DOIUrl":"https://doi.org/10.1002/bco2.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the relationship between total lesion PSMA (PSMA_TL), serum PSA, histopathological findings and biochemical recurrence (BCR) in patients with localised prostate cancer (PCa).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>This retrospective study assessed men undergoing ⁶⁸Ga-PSMA-11 PET/CT for newly diagnosed or treatment-naïve PCa localised to the prostate gland. Volumes of interest were manually mapped to derive SUV_max, SUV_mean, PSMA-avid tumour volume and PSMA_TL. PSMA_TL was defined as the product of PSMA-avid primary tumour volume and SUV_mean. Spearman correlation tests evaluated associations between PET parameters and PSA, ISUP GG and radical prostatectomy (RP) histopathological outcomes. Associations between PET parameters and clinical outcomes were determined using Cox proportional hazards regression with results presented as HR and 95% CI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 200 patients were included, with a median age of 68 (IQR 62–73) years, PSA of 9.5 (6.6–13.0) ng/ml and follow-up of 41 (25–60) months. Median PSMA_TL was 29.6 (14.8–54.8) and SUV_max 11.0 (6.8–17.9). PSMA_TL and SUV_max demonstrated a weak correlation with baseline PSA (ρ = 0.334, p &lt; 0.001 and ρ = 0.343, p &lt; 0.001), and PSMA_TL showed a weak correlation with PSA density in the RP subgroup (ρ = 0.242, p = 0.021). Among 109 (54.5%) patients undergoing RP, PSMA_TL and SUV_max showed a weak correlation with ISUP GG (ρ = 0.233, p = 0.015 and ρ = 0.340, p &lt; 0.001). There was a weak correlation between PSMA_TL and primary tumour stage (ρ = 0.244, p = 0.010) and lymph node stage (ρ = 0.259, p = 0.007). PSMA_TL was significantly higher in those with seminal vesicle involvement (p = 0.011), perineural invasion (p = 0.025) and lymphovascular invasion (p = 0.002). BCR occurred in 46 patients (42%), with a 1% increased risk of BCR per unit increase in PSMA_TL (HR 1.01, 95% CI 1.00–1.02, p = 0.011).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PSMA_TL correlates with PSA, PSA density, ISUP GG, RP histopathological findings and BCR. As an adjunct to SUV_max, PSMA_TL has the potential to be a useful prognostic tool. Further research is needed to assess its clinical utility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836433","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":"Multicentre assessment of transperineal targeted prostate biopsy performed as part of a targeted and systematic biopsy diagnostic strategy in men without previous prostate biopsies","authors":"Mohammed Sheweita,&nbsp;Liam Blaney,&nbsp;Jon Oxley,&nbsp;Douglas Kopcke,&nbsp;Stefanos Bolomytis,&nbsp;Paul Burn,&nbsp;Adrian Andreou,&nbsp;Jon Heron,&nbsp;Raj Persad,&nbsp;Nick Burns-Cox,&nbsp;Jonathan Aning,&nbsp;the South West Prostate Dashboard collaborative","doi":"10.1002/bco2.70020","DOIUrl":"https://doi.org/10.1002/bco2.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the added value of systematic biopsies in men referred with suspected PCa undergoing visual registration targeted local anaesthetic transperineal prostate biopsies (LATPB) as their first biopsy for MRI-P visible lesions (MRI Score≥3) in a real-world setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and methods</h3>\u0000 \u0000 <p>The outcomes of 2611 biopsy naïve men with MRI Score≥3 who underwent visual registration combined targeted and systematic LATPB at 5 hospitals between 2021 and 2024 were studied. The primary outcome was the clinically significant PCa (csPCa [Gleason≥ 3 + 4 = 7])) cancer detection rate at targeted prostate biopsy without upgrading contributed by the systematic component of the biopsies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, PCa was diagnosed in 2079/2611 (80%) patients. The targeted biopsy csPCa detection rate in MRI Score 3,4 and 5 lesions was 108/534 (20%), 461/940 (49%) and 865/1137 (76%), respectively. The csPCa detection rate for combined biopsies in MRI Score 3, 4 and 5 lesions was 150/534 (28%), 579/940 (62%) and 959/1137 (84%). The NPV for targeted biopsies for MRI scores 3,4 and 5 lesions were 81.7%, 95% CI = (78.0%, 84.9%), 68.4%, 95% CI = (63.5%, 73.0%) and 55.7%, 95% CI = (48.0%, 63.1%), respectively. Increasing PSA-D was strongly associated with increased detection of csPCa at targeted prostate biopsy irrespective of MRI score (chi-square test p &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An MRI-P and targeted prostate biopsy-only approach should be considered in all biopsy naïve men with MRI score 5 lesions and MRI score 4 lesions with a PSA Density greater than 0.15.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient summary</h3>\u0000 \u0000 <p>We looked at the difference between sampling a specific area of interest identified by prostate MRI compared to sampling the area of interest and additionally the prostate zones. In our study, we concluded that sampling the area of interest guided by the MRI scan alone can be more beneficial with less risk of missing out on clinically important prostate cancer in real-life practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836432","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":"Peak early-phase enhancement ratio on contrast-enhanced MRI to differentiate chromophobe renal cell carcinoma from oncocytoma","authors":"Deanna Thorson,&nbsp;Davide Bova,&nbsp;Maria M. Picken,&nbsp;Marcus L. Quek,&nbsp;Gopal N. Gupta,&nbsp;Hiten D. Patel","doi":"10.1002/bco2.70017","DOIUrl":"https://doi.org/10.1002/bco2.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the feasibility of using the peak early-phase enhancement ratio (PEER) of tumour to renal cortex measured on contrast-enhanced magnetic resonance imaging (MRI) to distinguish between chromophobe renal cell carcinoma (chRCC) and oncocytoma, which are difficult to differentiate on renal mass biopsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>A consecutive case–control study was conducted of patients with chRCC or oncocytoma based on surgical pathology (2006–2020). Two radiologists blinded to pathology results independently measured PEER values on MRI for each tumour. PEER values were compared with surgical pathology results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For the 18 renal tumours evaluated, PEER values were higher for the 7 oncocytomas than for the 11 chRCCs (median 1.33 versus 0.55, p &lt; 0.001). Agreement between the image interpreters was high (Pearson's: 0.90). PEER cutoff values ranging from 0.98 to 1.05 provided high performance in identifying chRCC. A PEER cutoff value of ≤1.05 had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 100% for the averaged PEER measurements between the two radiologists. High accuracy in identifying chRCC was also achieved for each individual image interpreter using the cutoff value of ≤1.05, with sensitivity of 100%, specificity of 85.7%, PPV of 91.7% and NPV of 100% for radiologist #1 and sensitivity of 90.9%, specificity of 85.7%, PPV of 90.9% and NPV of 85.7% for radiologist #2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Differentiating chRCCs from oncocytomas using PEER measurements obtained from contrast-enhanced MRI is feasible and reproducible between radiologists. We identified an accurate range for PEER cutoff values (0.98 to 1.05) requiring validation and adjustment in additional cohorts to maintain high sensitivity for detecting chRCC and negative predictive value. Using MRI PEER to evaluate oncocytic tumours with a differential diagnosis of chRCC versus oncocytoma based on biopsy pathology may help avoid unnecessary intervention for oncocytomas.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143822006","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}