BJU International最新文献

{"title":"Pain location after ureteroscopy differs based on sex and stone location: results from STENTS.","authors":"Andrew K Rabley,Naim M Maalouf,Hongqiu Yang,Charles D Scales,Alana C Desai,Peter P Reese,H Henry Lai,Michele Curatolo,Ziya Kirkali,Hussein R Al-Khalidi,Brooke Piskator,Rebecca McCune,Robert M Sweet,Mathew D Sorensen,Jonathan D Harper,","doi":"10.1111/bju.16839","DOIUrl":"https://doi.org/10.1111/bju.16839","url":null,"abstract":"OBJECTIVESTo expand understanding of the patient experience after ureteroscopy with stent placement for ureteric and/or renal stones using a body map to identify pain location and site-specific pain intensity over time, while evaluating the associations of sex and stone location.PATIENTS AND METHODSParticipants in a multicentre prospective observational cohort study completed questionnaires at baseline and on postoperative days (PODs) 1, 3 and 5. Pain distribution and intensity were assessed using the Brief Pain Inventory body and genitalia maps, with results stratified by sex and stone location.RESULTSA total of 424 participants (47% female, mean age 49 years) at four centres were included. The most frequent sites of stent-associated pain were the back, followed by the abdomen and pubic regions. Male participants were more likely to report the ipsilateral back as the site with most intense pain on POD 1 (43% vs 19%; P < 0.01) and POD 3 (43% vs 24%; P < 0.01), independent of stone location; they also reported more burning during urination on all PODs (P < 0.01). Female participants more often reported pain in the abdomen on POD 1 (67% vs 50%; P = 0.01) and in the pubic region on POD 3 (56% vs 37%; P < 0.01). Genital pain was common and peaked on POD 1 in both sexes. Participants with a renal stone were more likely to report back pain (70% vs 53%; P = 0.009) and a higher pain intensity score in the back (P = 0.014) on POD 1. Participants with ureteric stones were more likely to have baseline abdominal pain, most intense pain in the pubic region (27% vs 14%; P = 0.017), and burning during urination on POD 1 (P < 0.001).CONCLUSIONSBody pain map analysis provides new insights into patient experiences after ureteroscopy, with significant differences in pain location and intensity based on sex and stone location. These results can inform patient-specific counselling in the preoperative setting, contribute to a better understanding of the patient experience, and help tailor management decisions.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"19 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144521020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the R.E.N.A.L. complexity score on outcomes of stereotactic ablative body radiotherapy for primary renal cell carcinoma","authors":"Muhammad Ali, Mathias Bressel, David Chang, Sheng F. Oon, Rajeev Ravi, Daniel Moon, Declan G. Murphy, Renu S. Eapen, Marlon Perera, Nathan Lawrentschuk, Arun A. Azad, Sarat Chander, Mark Shaw, Nicholas Hardcastle, Shankar Siva","doi":"10.1111/bju.16843","DOIUrl":"https://doi.org/10.1111/bju.16843","url":null,"abstract":"ObjectiveTo evaluate the predictive value of the R.E.N.A.L. ([R]adius, [E]xophytic/endophytic properties, [N]earness of tumour to the collecting system or sinus, [A]nterior/posterior descriptor, and [L]ocation relative to polar lines) nephrometry score (RNS) for outcomes following stereotactic ablative body radiotherapy (SABR) for primary renal cell carcinoma (RCC), as the impact of tumour complexity on outcomes following nephron‐sparing SABR treatment is unclear.Patients and MethodsThis was a single institutional retrospective analysis of patients with primary RCC receiving SABR between 2012 and 2020. The primary outcome was the change in renal function post‐SABR, measured by estimated glomerular filtration rate (eGFR), and the effect of baseline RNS on it was assessed using linear mixed models (LMMs).ResultsA total of 90 patients with a median (interquartile range [IQR]) age of 77 (71–82) years and a median (IQR) follow‐up of 4.8 (2.8–7.8) years were included. In all, 52 patients (58%) had T1b disease, nine (10%) had T2 disease, and three (3%) had T3 disease. The median (IQR) maximum tumour size was 4.6 (2.1–8.4) cm. Most patients had moderate–complex renal tumours with a median (IQR) RNS of 9 (7–10). The baseline median eGFR was 53.6 mL/min/1.73 m<jats:sup>2</jats:sup> (95% confidence interval [CI] 49.7–57.5 mL/min/1.73 m<jats:sup>2</jats:sup>). The eGFR declined by −8.1 mL/min/1.73 m<jats:sup>2</jats:sup> (95% CI −6.5 to −9.6 mL/min/1.73 m<jats:sup>2</jats:sup>) at 1 year. The <jats:italic>P</jats:italic> value for the post‐SABR eGFR trajectory according to baseline RNS was <jats:italic>P</jats:italic> = 0.06. Two patients (2.2%) underwent dialysis. Three patients (3.3%) experienced local progression. The 3‐ and 5‐year estimates for freedom from local failure were 97% (95% CI 89–99%), and 91% (95% CI 68–98%), respectively. Four (4.4%) patients experienced Grade 3 toxicities.ConclusionStereotactic ablative body radiotherapy is an effective treatment option, with acceptable decline in renal function and toxicity for medically inoperable patients with complex primary kidney tumours. The association between baseline RNS and renal function trajectories is worthy of further investigation.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"102 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144503392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate cancer detection by MRI‐ultrasonography fusion transperineal vs transrectal biopsy: a randomised control trial","authors":"Nicola Schieda, Christopher Morash, Luke T. Lavallee, Trevor A. Flood, Ilias Cagiannos, Ehab Elzayat, Zoya Patni, Tim Ramsay, Rodney H. Breau","doi":"10.1111/bju.16831","DOIUrl":"https://doi.org/10.1111/bju.16831","url":null,"abstract":"ObjectiveTo compare clinically significant prostate cancer (CS‐PCa) detection by transperineal (TP) compared to transrectal (TR) magnetic resonance imaging (MRI)‐ultrasonography (US) fusion prostate biopsy.Patients and MethodsMales with abnormal prostate MRI (one or more lesion[s], Prostate Imaging‐Reporting and Data System [PI‐RADS] score ≥3) consenting to prostate biopsy were enrolled in a randomised control trial (NCT03936127) performed at single‐site tertiary care referral centre from October 2022 to June 2024. The patients were randomised to either TP or TR biopsy approach. The primary outcome was CS‐PCa (International Society of Urogenital Pathology Grade Group ≥2). Subgroup analysis of the primary outcome was stratified by lesion location (posterior, anterior; and apex, middle, base) and PI‐RADS score. Secondary outcomes were detection of any grade PCa, infection, and patient pain score.ResultsIn total, 233 patients were randomised (119 patients with 168 lesions in the TP group and 114 patients with 151 lesions in the TR group). CS‐PCa was detected in: 61% (73/119; 95% confidence interval [CI] 52–70%) for TP and 54% (62/114; 95% CI 45–64%) for TR (relative risk [RR] 1.13, 95% CI 0.93–1.38, <jats:italic>P</jats:italic> = 0.23). Adjusted CS‐PCa detection rates were higher for TP in anterior lesions: 29% (95% CI 15–49%) vs 16% (95% CI 7–31%) (RR 1.81, 95% CI 1.05–3.12; <jats:italic>P</jats:italic> = 0.03) and PI‐RADS score 4 lesions: 51% (95% CI 39–62%) vs 30% (95% CI 19–43%) (RR 1.77, 95% CI 1.13–2.76; <jats:italic>P</jats:italic> = 0.01), with no difference in apical lesions (RR 0.91, 95% CI 0.60–1.37; <jats:italic>P</jats:italic> = 0.65). The median (interquartile range) pain score was 3 (2–4) in the TP group and 2 (1–5) in the TR group (<jats:italic>P</jats:italic> = 0.09). There were no urinary tract infections or urosepsis events in either group. No patient was withdrawn due to adverse events.ConclusionsIn this trial, we failed to demonstrate a statistically significant, increase in the detection of CS‐PCa using TP compared to TR biopsy. There were no sepsis events and biopsy was tolerated in both patient groups. MRI‐US fusion prostate biopsy using a TP approach may be more advantageous for anterior and smaller lesions, higher powered studies are needed.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"53 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144503413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate cancer detection by MRI-ultrasonography fusion transperineal vs transrectal biopsy: a randomised control trial.","authors":"Nicola Schieda, Christopher Morash, Luke T Lavallee, Trevor A Flood, Ilias Cagiannos, Ehab Elzayat, Zoya Patni, Tim Ramsay, Rodney H Breau","doi":"10.1111/bju.16831","DOIUrl":"https://doi.org/10.1111/bju.16831","url":null,"abstract":"<p><strong>Objective: </strong>To compare clinically significant prostate cancer (CS-PCa) detection by transperineal (TP) compared to transrectal (TR) magnetic resonance imaging (MRI)-ultrasonography (US) fusion prostate biopsy.</p><p><strong>Patients and methods: </strong>Males with abnormal prostate MRI (one or more lesion[s], Prostate Imaging-Reporting and Data System [PI-RADS] score ≥3) consenting to prostate biopsy were enrolled in a randomised control trial (NCT03936127) performed at single-site tertiary care referral centre from October 2022 to June 2024. The patients were randomised to either TP or TR biopsy approach. The primary outcome was CS-PCa (International Society of Urogenital Pathology Grade Group ≥2). Subgroup analysis of the primary outcome was stratified by lesion location (posterior, anterior; and apex, middle, base) and PI-RADS score. Secondary outcomes were detection of any grade PCa, infection, and patient pain score.</p><p><strong>Results: </strong>In total, 233 patients were randomised (119 patients with 168 lesions in the TP group and 114 patients with 151 lesions in the TR group). CS-PCa was detected in: 61% (73/119; 95% confidence interval [CI] 52-70%) for TP and 54% (62/114; 95% CI 45-64%) for TR (relative risk [RR] 1.13, 95% CI 0.93-1.38, P = 0.23). Adjusted CS-PCa detection rates were higher for TP in anterior lesions: 29% (95% CI 15-49%) vs 16% (95% CI 7-31%) (RR 1.81, 95% CI 1.05-3.12; P = 0.03) and PI-RADS score 4 lesions: 51% (95% CI 39-62%) vs 30% (95% CI 19-43%) (RR 1.77, 95% CI 1.13-2.76; P = 0.01), with no difference in apical lesions (RR 0.91, 95% CI 0.60-1.37; P = 0.65). The median (interquartile range) pain score was 3 (2-4) in the TP group and 2 (1-5) in the TR group (P = 0.09). There were no urinary tract infections or urosepsis events in either group. No patient was withdrawn due to adverse events.</p><p><strong>Conclusions: </strong>In this trial, we failed to demonstrate a statistically significant, increase in the detection of CS-PCa using TP compared to TR biopsy. There were no sepsis events and biopsy was tolerated in both patient groups. MRI-US fusion prostate biopsy using a TP approach may be more advantageous for anterior and smaller lesions, higher powered studies are needed.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on 'The diagnostic value of MRI for persistent prostate cancer following irreversible electroporation focal therapy'.","authors":"Venkata Dileep Kumar Veldi,Rachana Mehta,Ranjana Sah","doi":"10.1111/bju.16841","DOIUrl":"https://doi.org/10.1111/bju.16841","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"40 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What spatial omics is teaching us about field cancerisation in prostate and bladder cancer.","authors":"Matthew H V Byrne,Thineskrishna Anbarasan,Lisa Browning,Dan J Woodcock","doi":"10.1111/bju.16830","DOIUrl":"https://doi.org/10.1111/bju.16830","url":null,"abstract":"BACKGROUND AND OBJECTIVESField cancerisation is the process that results in a group of cells acquiring some of the phenotypic changes of cancer prior to transformation into cancer. Clinically, an important challenge remains the ability to distinguish clonal lineages and microenvironments within cancerised fields that will remain indolent from those that will progress to malignant transformation. Spatial 'omics' can help us investigate genetic, epigenetic, transcriptomic, proteomic, and cellular microenvironments that transform normal cells into a cancerised field, and subsequently into cancer. In this review, we will discuss how spatial omics techniques have expanded our understanding of field cancerisation in prostate and bladder cancer, and the challenges associated with this research.METHODSWe identified key articles relating to field cancerisation in bladder and prostate cancer. Special emphasis was placed on studies that used modern spatial profiling technologies and studies that were designed to investigate changes within normal tissue rather than simply using it as a control for tumour tissue.RESULTSSpatial omics research into field cancerisation has identified interesting early findings that have informed our understanding of: transformation of the benign epithelium and mechanisms of intra-prostatic clonal expansion for prostate cancer; clonal expansion within the normal urothelium; mutations that are unique to cancerised fields within the bladder; and how field cancerisation may prime the urothelium for cancer transformation.CONCLUSIONSSpatial omics profiling of field cancerisation can inform risk stratification and personalised treatment options. However, there are a number of challenges associated with the technologies that must be overcome before the potential of spatial omics can be fully realised in clinical practice.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"26 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144488266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced prognostic value of four-tier hybrid grading system in Ta non-muscle-invasive bladder cancer.","authors":"Matteo Ferro,Michele Catellani,Roberto Bianchi,Giuseppe Fallara,Marco Tozzi,Martina Maggi,Francesco Chierigo,Alessandro Uleri,Luigi Filippo Da Pozzo,Ludovica Cella,Rodolfo Hurle,Mauro Savino Di Stasi,Enrico Checcucci,Pierluigi Bove,Francesco Maiorino,Mihai Dorin Vartolomei,Emanuele Montanari,Giancarlo Albo,Elisa De Lorenzis,Luca Boeri,Giovanni Liguori,Francesca Vedovo,Beat Roth,Gian Maria Busetto,Ugo Falagario,Riccardo Mastroianni,Massimo Madonia,Alessandro Tedde,Pasquale Di Tonno,Giuseppe Lucarelli,Saverio Forte,Giorgio Ivan Russo,Arturo Lo Giudice,Fabrizio Verweij,Marco Racioppi,Francesco Pio Bizzarri,Alessandro Crestani,Marco Rinaldi,Maria Angela Cerruto,Francesco Claps,Andrea Conti,Sisto Perdonà,Fabrizio Dal Moro,Fabio Zattoni,Ciro Imbimbo,Felice Crocetto,Achille Aveta,Savio Domenico Pandolfo,Angelo Porreca,Giuseppe Carrieri,Luca Carmignani,Cosimo De Nunzio,Giuseppe Simone,Luigi Cormio,Marco Borghesi,Alessandro Antonelli,Francesco Porpiglia,Bernardo Rocco,Biagio Barone,Roberto Contieri","doi":"10.1111/bju.16828","DOIUrl":"https://doi.org/10.1111/bju.16828","url":null,"abstract":"OBJECTIVESTo compare the predictive performance of the World Health Organization (WHO) 1973, WHO 2004/2022, the three-tier (low grade [LG]/Grade 1 [G1]-G2, high grade [HG]/G2, and HG/G3), and four-tier (LG/G1, LG/G2, HG/G2, and HG/G3) hybrid grading systems in Ta non-muscle-invasive bladder cancer (NMIBC), by evaluating recurrence-free survival (RFS) and progression-free survival (PFS).PATIENTS AND METHODSThis retrospective multicentre study included 1233 patients with pTa NMIBC treated with transurethral resection of bladder tumour, eventually followed by intravesical instillations as determined by their physicians, between 2010 and 2023, across 18 Italian hospitals. Pathologists graded resected tissues using the WHO 1973, WHO 2004/2022 classifications, and hybrid three-tier (LG, HG/G2, HG/G3) and four-tier (LG/G1, LG/G2, HG/G2, HG/G3) systems. Kaplan-Meier curves estimated RFS and PFS. Discriminative performance was assessed using Harrell's concordance index (C-index).RESULTSAmong 1233 patients with pTa NMIBC, 890 were classified as LG and 343 as HG according to the WHO 2004/2022 grading system, while 586, 405, and 242 were categorised as G1, G2, and G3, respectively, under the WHO 1973 system. With a median (interquartile range) follow-up of 26 (14-48) months, 418 patients experienced recurrence, including 184 with HG recurrence and 42 who progressed to MIBC. The C-index values for RFS were 0.60, 0.56, 0.57, and 0.61 for the WHO 1973, WHO 2004/2022, hybrid three-tier, and four-tier grading systems, respectively. For progression, the C-index values were 0.80, 0.74, 0.75, and 0.81 across the same systems, underscoring the superior predictive capacity of the four-tier classification. Nonetheless, the low number of MIBC progression events limits the robustness of these analyses.CONCLUSIONOur findings highlight the superior prognostic accuracy of the four-tier hybrid classification in predicting recurrence and progression in patients with stage Ta NMIBC. By combining strengths from the WHO 1973 and 2004/2022, this hybrid model shows promise as tool for enhancing NMIBC patient management in clinical practice.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"159 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic analysis of minimally invasive surgical treatments for BPH in the Australian public healthcare system.","authors":"Niranjan Sathianathen,Peter Stapleton,Damien Bolton,Joseph Ischia,Nathan Lawrentschuk","doi":"10.1111/bju.16833","DOIUrl":"https://doi.org/10.1111/bju.16833","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"25 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing R.E.N.A.L., PADUA, and RPN Scores: Is RPN the More Logical Choice in the Robotic Era?","authors":"Peitong Li, Nathan Papa, Niall M Corcoran, Dinesh K Agarwal","doi":"10.1111/bju.16807","DOIUrl":"https://doi.org/10.1111/bju.16807","url":null,"abstract":"<p><strong>Background and objective: </strong>Since their introduction in 2009, first-generation nephrometry systems, the Radius, Exophytic/endophytic, Nearness to collecting system or sinus, Anterior/posterior, Location (R.E.N.A.L.) and Preoperative Aspects and Dimensions Used for an Anatomical Classification (PADUA), have dominated the academic landscape in providing a structured manner to characterise kidney cancers. Their use has extended to predicting perioperative outcomes of partial nephrectomies (PN). In 2022, the Radius, Position of the tumour, iNvasion of renal sinus (RPN), a new nephrometry system was introduced to streamline the process of evaluating renal tumours for their surgical difficulty specific to the robot-assisted laparoscopic approach, with clinically relevant validation. This paper critically compares these three nephrometry systems in terms of their aims, methodologies, performance in validation studies and ease of use.</p><p><strong>Methods: </strong>Key information about the nephrometry systems was extracted into a table. Categories compared include nomenclature, tumour-specific characteristics, use of suffixes, methodological differences, validation, and ease of use.</p><p><strong>Key findings and limitations: </strong>The comparison of the R.E.N.A.L., PADUA, and RPN nephrometry systems highlights distinct differences in their methodologies and objectives. While the R.E.N.A.L. and PADUA systems focus on aiding decision-making and data reporting for PN, neither system is specific to the robot-assisted approach. In contrast, the RPN system is specifically tailored for robot-assisted partial nephrectomy (RAPN), aiming to assess preoperative surgical difficulty and ensure consistency in reporting data for RAPN series. Further validation is needed to elucidate the RPN system's utility in modern RAPN practice.</p><p><strong>Conclusion: </strong>In the current era of RAPN, surgeons require a simple and easy to use nephrometry system to evaluate a renal tumour's surgical complexity quickly and accurately. RPN demonstrates promise in fulfilling this role.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating follow-up in patients with lymph node-negative penile cancer at a high-volume centre.","authors":"Manon T A Vreeburg,Gerben M Vaessen,Hielke M de Vries,Birthe C Heeres,Margriet C van Dijk-de Haan,Vincent van der Noort,Erik H van Muilekom,Jolien van Kesteren,Niels M Graafland,Kees Hendricksen,Bas W G van Rhijn,Henk G van der Poel,Oscar R Brouwer","doi":"10.1111/bju.16838","DOIUrl":"https://doi.org/10.1111/bju.16838","url":null,"abstract":"OBJECTIVESTo evaluate the current European Association of Urology/American Society of Clinical Oncology follow-up (FU) schedule with routine use of ultrasonography (US) ± US-guided fine-needle aspiration cytology (FNAC) in patients with lymph node (LN)-negative penile squamous cell carcinoma (PSCC).PATIENTS AND METHODSWe evaluated FU outcomes for low-risk clinically LN-negative (cN0) and intermediate- to high-risk sentinel node (SN) negative (pathological N-stage [pN]0) patients with PSCC at a high-volume centre. We analysed routine inguinal US ± FNAC (in case of a suspicious LN) during FU. A competing risk analysis was performed to calculate the cumulative risk of LN metastases in these groups, with local recurrence as competing risk.RESULTSA total of 201 patients with PSCC were analysed, with 2694 inguinal US investigations being evaluated. FNAC was performed during 270 US procedures (10.0%). A LN metastasis was found in four of 270 US + FNAC procedures (1.5%, 0.2% of all US). All tumours were intermediate- to high-risk tumours. Three occurred within the first year after primary treatment, and one at 20 months. The cumulative risk of developing LN metastases in cN0 low-risk tumours was 0% (no events occurred) and in SN-negative intermediate- to high-risk group 2.0%, both at 1 year of FU. Two (out of four) patients with LN recurrence died from disease.CONCLUSIONAfter adequate staging and treatment, patients with cN0/pN0 PSCC rarely develop LN metastasis during FU. As these metastases generally occur within 1 year after treatment, we recommend (3-monthly) routine inguinal US only during the first year of FU. Thereafter, the frequency of FU visits and examinations can be reduced in patients capable of self-examination of the penis, resulting in a substantial (up to a 50%) reduction of FU visits compared to current guideline recommendations.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"13 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}