{"title":"Test yourself: MCQ and single best answer","authors":"Adrian Ben Cresswell","doi":"10.1016/j.mpsur.2025.07.021","DOIUrl":"10.1016/j.mpsur.2025.07.021","url":null,"abstract":"","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 10","pages":"Pages 690-691"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Upper tract urothelial cancer","authors":"Ihab HY Barsoum, Jacques WT Roux","doi":"10.1016/j.mpsur.2025.07.019","DOIUrl":"10.1016/j.mpsur.2025.07.019","url":null,"abstract":"<div><div>Upper tract urothelial carcinoma is a relatively uncommon yet aggressive malignancy. It accounts for roughly 5–10% of all urothelial carcinomas. Contrasted to bladder cancer, UTUC is more frequently diagnosed at an advanced stage, contributing to poorer prognostic outcomes. Guided predominantly by risk stratification, management of low-risk cancer generally favours kidney-sparing interventions, whereas high-risk patients typically require radical nephroureterectomy with bladder cuff excision.</div><div>The impact of perioperative systemic therapies including neoadjuvant chemotherapy and adjuvant immunotherapy on survival outcomes is being explored. Additionally, emerging diagnostic modalities such as urinary biomarkers or narrow-band imaging are showing promise in early detection and risk assessment. However, agreement on optimal surveillance strategies is yet to be established, particularly in cases with hereditary predispositions, such as those with Lynch syndrome. This review provides a comprehensive overview of the contemporary developments in the management of UTUC.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 10","pages":"Pages 673-678"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The management of testis cancer","authors":"Lara Hemsworth, Narin Suleyman","doi":"10.1016/j.mpsur.2025.07.018","DOIUrl":"10.1016/j.mpsur.2025.07.018","url":null,"abstract":"<div><div>Testicular cancers diagnosed in adults are primarily germ cell tumours (GCT, 95%) with a smaller proportion being sex cord-stromal tumours (5%). GCTs are a histologically diverse spectrum of tumours, broadly categorized to seminoma and non-seminomatous germ cell tumour (NSGCT). Treatment is based on histological subtype and stage and involves radical inguinal orchidectomy alongside surveillance, chemotherapy, radiotherapy or retroperitoneal lymph node dissection. Serum tumour markers including β-human chorionic gonadotrophin and α-fetoprotein and lactate dehydrogenase have a unique role in staging, prognosis, treatment planning and surveillance after initial orchidectomy. In this review we outline staging and prognostic classifications used in testicular GCT and the surgical and non-surgical treatment of testicular GCT as advised by the US National Comprehensive Cancer Network (NCCN), the European Association of Urology (EAU) and the consensus recommendations from The European Society for Medical Oncology (ESMO). Additional considerations related to GCT treatment are also outlined including fertility preservation, chemotherapy and radiotherapy toxicity and late secondary malignancy.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 10","pages":"Pages 664-672"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Updates in male genital tract tumours","authors":"Priyanka Phadnis, Mahomed A Dada","doi":"10.1016/j.mpsur.2025.07.014","DOIUrl":"10.1016/j.mpsur.2025.07.014","url":null,"abstract":"<div><div>This chapter provides a comprehensive overview of the recent updates in the classification and diagnosis of tumours of the male genital tract. With reference to the World Health Organization (WHO) Classification of Tumours 5th edition (2022), we explore the significant changes in the understanding of prostatic, testicular, penile and scrotal tumours. The discussion includes epidemiological data, current classification systems, histopathological features, molecular characteristics, and prognostic factors. This chapter serves as an essential resource for pathologists, urologists, and oncologists seeking to understand contemporary approaches to male genital tract tumours.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 10","pages":"Pages 636-642"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Urological investigations of haematuria","authors":"Vaki Antoniou, Tony Tien, Daniel Cohen","doi":"10.1016/j.mpsur.2025.07.015","DOIUrl":"10.1016/j.mpsur.2025.07.015","url":null,"abstract":"<div><div>Visible and non-visible haematuria have a wide range of possible causes including urinary tract malignancy, stone disease, infection, trauma or nephrological causes. Systematic investigation is recommended to determine the cause and management of haematuria, although up to 60% of patients will have no cause identified.</div><div>This article outlines the different causes of both visible and non-visible haematuria; investigation strategies; when to refer to urology and/or nephrology for further assessment; and areas of future development and research. The evidence behind current practice in the UK is discussed and guidelines explored. Clear explanations are given of investigation and imaging modalities.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 10","pages":"Pages 643-647"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prostate cancer diagnosis, classification and treatment overview","authors":"Greg Shaw, Ricardo Almeida-Magana","doi":"10.1016/j.mpsur.2025.07.016","DOIUrl":"10.1016/j.mpsur.2025.07.016","url":null,"abstract":"<div><div>Prostate cancer is the most frequently diagnosed malignancy in adult males. It has a multifactorial aetiology and highly variable clinical course which ranges from an indolent disease, suitable for active surveillance, to an aggressive disease requiring multimodal treatment. Early detection is guided by prostate-specific antigen (PSA) testing, imaging, and biopsy, while management of localized disease is based on risk stratification. Advances in systemic therapies have significantly improved survival and quality of life in advanced stages. This article provides an up-to-date overview of the evolving landscape of prostate cancer diagnosis and treatment.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 10","pages":"Pages 648-656"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pathology of tumours of the kidney and urinary tract","authors":"Sophia M Green, Susan Prendeville","doi":"10.1016/j.mpsur.2025.07.013","DOIUrl":"10.1016/j.mpsur.2025.07.013","url":null,"abstract":"<div><div>This article provides an overview of the most common tumour types arising in the kidney and urinary tract, along with key aspects of pathologic assessment. The classification of kidney tumours has evolved significantly in recent years, driven by an improved understanding of molecular features. Clear cell renal cell carcinoma is the most common subtype, while non-clear cell renal cell carcinoma encompasses various subtypes and accurate classification has important therapeutic and prognostic implications.</div><div>Urothelial neoplasms can develop throughout the urinary tract but most commonly occur in the bladder. Certain subtypes of urothelial carcinoma are particularly important to recognize due to their aggressive clinical behaviour. Pathologic evaluation of kidney and urinary tract specimens is critical for determining tumor subtype, grade, stage, and other adverse histologic features that guide clinical management. Some of the challenges and limitations in pathologic assessment, as well as the importance of integrating pathologic and clinical data through multidisciplinary collaboration, are also discussed.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 10","pages":"Pages 629-635"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bladder cancer","authors":"Mu'taz Alatoum, Rami Issa","doi":"10.1016/j.mpsur.2025.07.020","DOIUrl":"10.1016/j.mpsur.2025.07.020","url":null,"abstract":"<div><div>Bladder cancer is the second most common malignancy affecting the urinary tract and represents 3% of all cancer deaths in the UK. The most common presentation is visible haematuria which accounts for 85% of cases. Initial evaluation utilizes white light flexible cystoscopy and upper urinary tract imaging, through ultrasound or CT urography. Alternatives to white light cystoscopy include photodynamic diagnosis and narrow-band imaging which may improve detection of tumours. Initial treatment is with transurethral resection of the bladder tumour (TURBT). En-bloc resection using either laser or electrocautery shows promise in improving the quality of transurethral resection. For patients with muscle-invasive bladder cancer, robot-assisted radical cystectomy has been shown to be oncologically equivalent to open radical cystectomy with recent evidence showing benefit reducing pain and in inpatient stay. Bladder preservation treatment in muscle-invasive cancer is trimodal therapy utilizing transurethral resection and chemoradiotherapy in selected patients. Management of locally advanced and metastatic disease has rapidly advanced through the use of systemic immunotherapy agents targeting the programmed death ligand-1/programmed cell death protein-1 (PD-L1/PD-1) axis.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 10","pages":"Pages 679-689"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Husay Janebdar, Megan Fernandes, David Manson-Bahr
{"title":"Renal cancer","authors":"Husay Janebdar, Megan Fernandes, David Manson-Bahr","doi":"10.1016/j.mpsur.2025.07.017","DOIUrl":"10.1016/j.mpsur.2025.07.017","url":null,"abstract":"<div><div>Renal cell carcinoma (RCC) is an adenocarcinoma of the renal cortex. It is the commonest type of kidney cancer and accounts for over 85% of renal cancer diagnoses. The remaining malignancies are transitional cell carcinomas, sarcomas, Wilms’ tumour, and rarely lymphomas and metastatic deposits. 10–15% of renal masses are benign, such as oncocytomas and angiomyolipomas. Simple renal cysts are benign, however more complex renal cysts have a risk of being malignant. RCC is commonly diagnosed at an earlier stage due to the widespread availability of imaging, and as a result the described classic triad of symptoms of haematuria, renal angle pain and a palpable mass is increasingly uncommon. The management of renal cancer includes active surveillance for older, comorbid patients, nephron-sparing surgery or ablative therapies for smaller renal masses, radical nephrectomy for larger tumours, and systemic treatment with a combination of immunotherapies and tyrosine kinase inhibitors and for metastatic disease.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 10","pages":"Pages 657-663"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Visceral volvulae and management","authors":"Ryan Preece, Daniel White","doi":"10.1016/j.mpsur.2025.07.008","DOIUrl":"10.1016/j.mpsur.2025.07.008","url":null,"abstract":"<div><div>Volvulus refers to torsion of a segment of the gastrointestinal tract, which often leads to bowel obstruction. Obstruction of the intestinal lumen and impairment of vascular perfusion occur when the degree of torsion exceeds 180° and 360°, respectively. Visceral volvulus causing obstruction is a common presentation to the emergency department. Ascertaining the gastrointestinal level and grading the severity of the obstruction is paramount as each can be managed entirely differently. A spectrum from nasogastric or rectal tube decompression, to endoscopic decompression with or without fixation, and finally, surgical intervention are all at the surgeon's disposal. Clinical and radiographic assessment of both the pathological process and the patient provide all the necessary detail for appropriate management of what is often a highly comorbid cohort of patients. This article will summarize current evidence for management of the most common sources of volvulus; gastric, small bowel, and colonic.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 9","pages":"Pages 601-606"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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