BJU International最新文献

{"title":"Impact of intraprostatic PSMA maximum standardised uptake value following prostatectomy: a systematic review and meta-analysis","authors":"David C. Chen, Siyu Huang, Nathan Papa, Shankar Siva, Damien M. Bolton, Nathan Lawrentschuk, Louise Emmett, Declan G. Murphy, Michael S. Hofman, Marlon L. Perera","doi":"10.1111/bju.16608","DOIUrl":"https://doi.org/10.1111/bju.16608","url":null,"abstract":"To perform a systematic review and meta-analysis to assess the relationship between intraprostatic maximum standardised uptake value (SUV_max) of the dominant prostatic lesion as measured on preoperative prostate-specific membrane antigen (PSMA) positron emission tomography (PET) with radical prostatectomy International Society of Urological Pathology (ISUP) Grade Group, pathological tumour (pT) staging, and biochemical recurrence (BCR).","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"28 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142935107","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":"‘BJUI Clinical Dilemma’: the incidental small renal mass in a solitary kidney","authors":"Bruce Gao, Pratik Kanabur, Riccardo Campi, Maxine Tran, Jaime Landman, Ivan Pedrosa, Ben Challacombe, Tze Min Wah, Shankar Siva, Michael Jewett, Grant D. Stewart, Brian Shuch, Ralph Clayman","doi":"10.1111/bju.16627","DOIUrl":"https://doi.org/10.1111/bju.16627","url":null,"abstract":"<h2> Introduction</h2>\u0000<p>The incidental small renal mass (SRM; ≤4 cm; clinical T stage [cT]1a) has become increasingly common due to the widespread utilisation of ultrasonography and cross-sectional imaging. Today, most such patients present with asymptomatic, localised disease that can be surgically treated with curative intent; however, up to 25% of SRMs are benign [<span>1</span>]. This creates a clinical dilemma: balancing the removal of malignant tumours with avoiding needless active treatment for benign masses.</p>\u0000<p>This ‘<i>BJUI</i> Clinical Dilemma’ presents a structured format to address the common clinical presentation of a SRM through a case vignette approach. Following the vignette, leading experts will provide brief commentary, explaining the rationale behind their preferred management strategies. This approach encourages a balanced, expert-driven discussion on alternative strategies, offering readers insights into decision-making processes for common, yet nuanced cases in urological practice.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"35 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142935138","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":"Selective treatment de-escalation in advanced prostate cancer: have we come full circle?","authors":"Bryan Chong, Marniza Saad, Tsung Wen Chong, John Thng, Yu Guang Tan, Kae Jack Tay, Christopher Cheng, Po-Hung Lin, Jeremy Teoh, Peter Ka-Fung Chiu, Nathan Lawrentschuk, Renu Eapen, Declan Murphy, Johan Chan, Melvin L.K. Chua, Jeffrey Tuan, John Yuen, Ravindran Kanesvaran, Kenneth Chen","doi":"10.1111/bju.16632","DOIUrl":"https://doi.org/10.1111/bju.16632","url":null,"abstract":"Compelling evidence has solidified the notion of early treatment intensification in managing patients with metastatic hormone-sensitive prostate cancer (mHSPC). Landmark trials have provided Level 1 evidence for the survival benefits achieved by combining multiple agents. The efficacy of combined therapy relies not only on how treatment is intensified but also on how it is de-escalated. This underscores the importance of tailored treatment approaches, potentially involving a reduction in therapy for specific patients, to strike a balance between the benefits of hormonal treatment and its associated adverse effects. While de-escalation of therapy in mHSPC remains challenging due to limited evidence, it is recommended for elderly or frail patients, those with poor performance status, or experiencing significant toxicity. However, for patients with excellent prostate-specific antigen responses or favourable biomarkers, decisions should be personalised, weighing the potential benefits of continued treatment against the risk of long-term side effects, using risk stratification tools where appropriate.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"132 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142917426","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":"Response to utilising the differential renal length index in paediatric pyeloplasty: clinical applications and considerations.","authors":"Ketaki Gharpure, Abraham Cherian","doi":"10.1111/bju.16510","DOIUrl":"10.1111/bju.16510","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":"177"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071946","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":"Bladder-centric benign prostatic hyperplasia management post-laser enucleation of the prostate.","authors":"Yu-Hsiang Lin, Chih-Te Lin, Kuo-Jen Lin","doi":"10.1111/bju.16544","DOIUrl":"10.1111/bju.16544","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":"180"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387697","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":"External validation of an artificial intelligence model for Gleason grading of prostate cancer on prostatectomy specimens.","authors":"Bogdana Schmidt, Simon John Christoph Soerensen, Hriday P Bhambhvani, Richard E Fan, Indrani Bhattacharya, Moon Hyung Choi, Christian A Kunder, Chia-Sui Kao, John Higgins, Mirabela Rusu, Geoffrey A Sonn","doi":"10.1111/bju.16464","DOIUrl":"10.1111/bju.16464","url":null,"abstract":"<p><strong>Objectives: </strong>To externally validate the performance of the DeepDx Prostate artificial intelligence (AI) algorithm (Deep Bio Inc., Seoul, South Korea) for Gleason grading on whole-mount prostate histopathology, considering potential variations observed when applying AI models trained on biopsy samples to radical prostatectomy (RP) specimens due to inherent differences in tissue representation and sample size.</p><p><strong>Materials and methods: </strong>The commercially available DeepDx Prostate AI algorithm is an automated Gleason grading system that was previously trained using 1133 prostate core biopsy images and validated on 700 biopsy images from two institutions. We assessed the AI algorithm's performance, which outputs Gleason patterns (3, 4, or 5), on 500 1-mm² tiles created from 150 whole-mount RP specimens from a third institution. These patterns were then grouped into grade groups (GGs) for comparison with expert pathologist assessments. The reference standard was the International Society of Urological Pathology GG as established by two experienced uropathologists with a third expert to adjudicate discordant cases. We defined the main metric as the agreement with the reference standard, using Cohen's kappa.</p><p><strong>Results: </strong>The agreement between the two experienced pathologists in determining GGs at the tile level had a quadratically weighted Cohen's kappa of 0.94. The agreement between the AI algorithm and the reference standard in differentiating cancerous vs non-cancerous tissue had an unweighted Cohen's kappa of 0.91. Additionally, the AI algorithm's agreement with the reference standard in classifying tiles into GGs had a quadratically weighted Cohen's kappa of 0.89. In distinguishing cancerous vs non-cancerous tissue, the AI algorithm achieved a sensitivity of 0.997 and specificity of 0.88; in classifying GG ≥2 vs GG 1 and non-cancerous tissue, it demonstrated a sensitivity of 0.98 and specificity of 0.85.</p><p><strong>Conclusion: </strong>The DeepDx Prostate AI algorithm had excellent agreement with expert uropathologists and performance in cancer identification and grading on RP specimens, despite being trained on biopsy specimens from an entirely different patient population.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":"133-139"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141578863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary continence networks in Parkinson's disease: a resting state functional MRI study.","authors":"Holly A Roy, Christopher Roy, Heidi Tempest, Alexander L Green, Ricarda A L Menke","doi":"10.1111/bju.16518","DOIUrl":"10.1111/bju.16518","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":"57-59"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salvage stereotactic ablative body radiotherapy after thermal ablation of primary kidney cancer.","authors":"Muhammad Ali, Young Suk Kwon, Kendrick Koo, Anna Bruynzeel, David Pryor, Daniel G Schep, Michael Huo, Maggie Stein, Anand Swaminath, Raquibul Hannan, Shankar Siva","doi":"10.1111/bju.16520","DOIUrl":"10.1111/bju.16520","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness and safety of salvage stereotactic ablative body radiotherapy (SABR) for recurrent renal cell carcinoma (RCC) after thermal ablation (TA).</p><p><strong>Materials and methods: </strong>This study was a multi-institutional retrospective analysis of patients with recurrent RCC following TA who received SABR between 2016 and 2020. The primary study outcome was freedom from local failure, evaluated radiographically based on Response Evaluation Criteria in Solid Tumours (RECIST) v1.1. Distant failure, cancer-specific survival (CSS), overall survival (OS), treatment-related toxicity and renal function changes following SABR were the secondary outcomes. The Kaplan-Meier method was used to estimate freedom from local and distant failure, CSS and OS.</p><p><strong>Results: </strong>Seventeen patients with 18 biopsy-confirmed RCCs were included, with a median (interquartile range [IQR]) age at time of SABR of 75.2 (72.6-68.7) years, a median (IQR) tumour size of 3.5 (1.9-4.1) cm and follow-up (reverse Kaplan-Meier method) of 3.36 (95% confidence interval [CI] 1.6-4.1) years. Six of the 17 patients had a solitary kidney. Five patients had failed repeat TA prior to SABR. The median (IQR) time from TA procedure to SABR was 3.03 (1.5-5.1) years. No patient experienced local progression, with a local control rate of 100%. Four patients, two with baseline metastatic disease, experienced distant progression. The distant progression-free survival, CSS and OS at 3 years were 72.1% (95% CI 51.9%-100%), 92.3% (95% CI 78.9%-100%) and 82.1% (95% CI 62.1%-100%), respectively. The median (IQR) glomerular filtration rate before SABR was 58 (40-71) mL/min, and at last follow-up, it was 48 (33-57) mL/min. No patient experienced grade 3+ toxicity or went on to develop end-stage renal disease.</p><p><strong>Conclusion: </strong>The results showed that SABR appears to be an effective and safe salvage strategy in patients with recurrent RCC following TA.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":"110-116"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071947","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":"Prognostic role of the neutrophil/lymphocyte ratio in high-risk BCG-naïve non-muscle-invasive bladder cancer treated with intravesical gemcitabine/docetaxel.","authors":"Mohamad Abou Chakra, Riitta Lassila, Nancy El Beayni, Sarah L Mott, Michael A O'Donnell","doi":"10.1111/bju.16486","DOIUrl":"10.1111/bju.16486","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the role of pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in the prediction of response to sequential intravesical therapy, gemcitabine and docetaxel (Gem/Doce), given to patients with bacille Calmette-Guérin (BCG)- naïve high-risk non-muscle-invasive bladder cancer (NMIBC).</p><p><strong>Patients and methods: </strong>A retrospective analysis was conducted on 115 patients who received intravesical Gem/Doce for high-risk NMIBC between January 2011 and December 2021. Data were computed as the median (interquartile range [IQR]) or mean (standard deviation [sd]). Cox regression analysis was performed to determine if neutrophilia, NLR, platelet counts, and PLR before instillation therapy were predictive of recurrence-free survival (RFS) and overall survival (OS). Predictive performance was estimated using Uno's C-statistic.</p><p><strong>Results: </strong>The median (IQR) follow-up for the overall cohort was 23 (13-36) months. The mean (sd) values for NLR, PLR and platelet counts were 3.4 (2.3), 142.2 (85.5), and 225.2 (75.1) × 10⁹/L, respectively. NLR was associated with RFS, with a hazard ratio of 1.32 (95% confidence interval CI 1.19-1.46). Concordance analysis showed that NLR had a good ability to predict RFS (C-index: 0.7, P < 0.01). The PLR and platelet count were not associated with RFS and did not predict recurrence. In terms of OS, none of these cellular inflammatory markers showed any prediction value.</p><p><strong>Conclusion: </strong>Pre-treatment NLR provides some predictive accuracy for RFS in high-risk BCG-naïve patients receiving Gem/Doce. Further prospective trials are needed to validate this finding.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":"125-132"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854668","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":"The impact of progression-directed therapy on survival in metastatic castration-refractory prostate cancer: MEDCARE phase 3 trial.","authors":"Kato Rans, Karolien Goffin, Steven Joniau, Gedske Daugaard, Julie den Hartog, Lodewijk Van Wynsberge, Gert De Meerleer","doi":"10.1111/bju.16574","DOIUrl":"10.1111/bju.16574","url":null,"abstract":"<p><strong>Background: </strong>Metastatic castration-refractory prostate cancer (mCRPC) presents a therapeutic challenge despite advancements in treatment. Once mCRPC is attained, patients face limited survival prospects. Next-line systemic treatment (NEST) is the standard of care for progressive mCRPC, encompassing various therapeutic options with associated toxicity and costs. In patients with oligoprogressive mCRPC, data suggest that progression-directed therapy (PDT), such as metastasectomy or stereotactic body radiotherapy, delays the initiation of NEST.</p><p><strong>Methods and design: </strong>The MEDCARE phase III trial aims to assess the impact of PDT on overall survival (OS) in oligoprogressive mCRPC. In this multicentric, randomised, prospective trial, we aim to randomise 246 patients in 1:1 allocation ratio between the standard-of-care therapy (surveillance or NEST) or PDT while continuing the current systemic treatment. Patients will be stratified based on number of progressive lesions (one vs ≥one), location of progressive lesions (local recurrence, N or M1a vs M1b or M1c) and previous systemic therapy (palliative androgen-deprivation therapy [pADT] vs pADT + androgen receptor-targeted agent or patients who received docetaxel in the past). The primary endpoint is OS, and the secondary endpoints include quality of life, radiographic progression-free survival (PFS), modified PFS, prostate cancer-specific survival and PDT-induced toxicity.</p><p><strong>Discussion: </strong>This is the first randomised phase 3 trial in the setting of PDT in patients with oligoprogressive mCRPC with OS as the primary endpoint.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":"63-70"},"PeriodicalIF":3.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590035","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}