Clinical genitourinary cancer最新文献

{"title":"EVOLUTE: Enfortumab Vedotin in OLder patients with locally advanced/metastatic UroThElial carcinoma.","authors":"Ilgın Akbıyık, Mathilde Cabart, Arnaud Pagès, Leticia Aptecar, Mathilde Cancel, Helen Boyle, Théophile Bertail, Loïc Mourey, Cedric Pobel, Yohann Loriot, Natacha Naoun, Maxime Frélaut","doi":"10.1016/j.clgc.2026.102660","DOIUrl":"https://doi.org/10.1016/j.clgc.2026.102660","url":null,"abstract":"<p><strong>Background: </strong>Enfortumab vedotin (EV) has been a standard-of-care treatment for advanced/metastatic urothelial carcinoma (a/mUC). However, real-world data regarding its safety and efficacy in older patients remain limited. This study evaluated EV outcomes in a real-world setting, focusing on age-related toxicity.</p><p><strong>Patients and methods: </strong>We conducted a multicenter, retrospective cohort study including 99 patients with a/mUC treated with EV monotherapy. Patients were classified by age (< 70 vs. ≥ 70 years). Grade ≥ 3 toxicity, treatment modifications, and survival were evaluated. Multivariable logistic regression was performed to identify risk factors for grade ≥ 3 toxicity.</p><p><strong>Results: </strong>In the overall cohort, 33.3% experienced grade ≥ 3 toxicity. Multivariable analysis identified age ≥ 70 years as the only independent predictor for severe toxicity (Odds Ratio: 2.63, 95% Confidence Interval: 1.05-6.58; P = .039). Older patients had significantly higher rates of treatment discontinuation due to toxicity (34.6% vs. 4.3%; P < .001). Despite increased toxicity, patients aged ≥ 70 demonstrated numerically longer median PFS (6.3 vs. 3.1 months; P = .173) and OS (11.6 vs. 10.2 months; P = .830) compared to younger patients. Twelve patients receiving an upfront reduced dose (< 1.25 mg/kg) experienced no grade ≥ 3 toxicities while maintaining comparable survival outcomes to standard dosing.</p><p><strong>Conclusion: </strong>EV demonstrates comparable efficacy in older patients, but age ≥ 70 years is a significant predictor of severe toxicity, and close monitoring is warranted. Upfront dose reduction is a promising strategy to reduce severe toxicity without compromising efficacy and requires prospective evaluation in patients with a high comorbidity burden or reduced performance status.</p>","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":" ","pages":"102660"},"PeriodicalIF":2.7,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042527","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":"Accuracy of Intraoperative Frozen Section Analysis of Sentinel Node Biopsies in Penile Cancer.","authors":"Ida Marie Nordanger, Torjan Magne Haslerud, Alexander Marks, Alfred Honoré, Tor Kristian Thorkelsen, Patrick Juliebø-Jones, Daniela Elena Costea, Christian Beisland, Ellen Berget, Christian Arvei Moen","doi":"10.1016/j.clgc.2026.102655","DOIUrl":"https://doi.org/10.1016/j.clgc.2026.102655","url":null,"abstract":"<p><strong>Background: </strong>In penile squamous cell carcinoma (PSCC), surgical nodal staging can be performed using the dynamic sentinel node biopsy (DSNB) procedure. This study aimed to evaluate the diagnostic accuracy of intraoperative frozen section analysis of sentinel nodes (SNs) for the detection of inguinal metastases.</p><p><strong>Patients and methods: </strong>Between 2011 and 2025, 89 patients underwent unilateral (n = 18) or bilateral (n = 71) DSNB with intraoperative frozen section analysis during PSCC surgery. Clinicopathological variables and disease course were registered. Diagnostic accuracy of frozen section analysis compared with final histopathology was assessed across 160 groin examinations.</p><p><strong>Results: </strong>No false-positive frozen section results were observed. There were 19 true-positive, 139 true-negative, and 2 false-negative cases. Both false-negative examinations contained micrometastatic deposits measuring 0.4 mm and 1.2 mm located outside the plane of the frozen sections. Sensitivity and specificity were 0.90 (95% confidence intervals [CI]: 0.70-0.99) and 1.00 (95% CI: 0.97-1.00), respectively. Inguinal metastases were identified on frozen sections in 16 of 89 patients (18%), including 13 unilateral and 3 bilateral cases. Metastatic deposits ranged in size from 1.1 mm to 31.5 mm. During a median follow-up of 27 months, only one groin recurrence occurred among the 160 investigated groins.</p><p><strong>Conclusion: </strong>Intraoperative frozen section analysis of sentinel lymph nodes appears to be a safe, reproducible, and accurate method for detecting inguinal lymph node metastases. The findings led to intraoperative changes in management in approximately one in 5 patients, underscoring its potential clinical impact. However, micrometastatic disease may still be missed, and in cases with negative frozen section findings, definitive treatment decisions should await final histopathological assessment.</p>","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":" ","pages":"102655"},"PeriodicalIF":2.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009653","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 Value of Bayesian Statistics in Prostate Cancer Research: A Clinician-Oriented Review.","authors":"Shugo Yajima, Soichiro Yoshida, Yuki Arita, Hiroyuki Sato, Akihiro Hirakawa, Hitoshi Masuda, Yasuhisa Fujii","doi":"10.1016/j.clgc.2026.102656","DOIUrl":"https://doi.org/10.1016/j.clgc.2026.102656","url":null,"abstract":"<p><p>Bayesian statistics provide direct probabilistic interpretations that align with clinical decision-making in prostate cancer. Unlike frequentist approaches, which yield P-values and confidence intervals, Bayesian methods generate posterior probabilities that directly address patient-facing questions. This review synthesizes Bayesian applications across the prostate cancer continuum. We conducted a narrative review informed by a structured search of PubMed, Web of Science, and the Cochrane Library. Searches yielded 465 records; after removal of 144 duplicates, 321 were screened, and 11 representative studies were selected. The review was prepared with reference to the Scale for the Assessment of Narrative Review Articles (SANRA) guidance. Bayesian methods produced clinically interpretable probabilities and individualized predictions across prostate cancer care. Joint modeling of longitudinal prostate-specific antigen with time-to-event outcomes enabled dynamic recurrence forecasting, and risk-triggered active surveillance schedules reduced biopsies while maintaining timely upgrading detection. Bayesian network meta-analyses ranked systemic therapies and imaging tracers. Adaptive, model-based designs optimized radiotherapy and radioligand dosing, while population pharmacokinetic/pharmacodynamic frameworks supported hypothesis-generating personalization. Bayesian networks also improved causal adjustment in observational studies. Collectively, these applications enhanced evidence synthesis, decision transparency, patient communication, and model calibration. Bayesian statistics complement frequentist methods by providing interpretable probabilities, incorporating prior knowledge, and supporting transparent clinical decisions. Familiarity with key concepts-posterior probabilities, credible intervals, prior specification, and calibration-enables clinicians to critically appraise Bayesian studies and communicate results effectively. As prostate cancer management increasingly emphasizes longitudinal monitoring and personalized treatment, Bayesian methods offer natural frameworks for evidence synthesis and decision-making under uncertainty.</p>","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":" ","pages":"102656"},"PeriodicalIF":2.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978700","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":"Assessment of Bone Metastases, Skeletal-Related Events and Bone-Targeting Agents in Patients With Metastatic Renal Cell Carcinoma Receiving First-Line Systemic Therapy (Meet-URO 33 Study Subanalysis).","authors":"Anna Amela Valsecchi, Sara Elena Rebuzzi, Maria Concetta Cursano, Francesco Pantano, Rossana Berardi, Davide Bimbatti, Lucia Bonomi, Giovanni Bozza, Enrico Bronte, Sebastiano Buti, Claudia Carella, Alessia Cavo, Emilia Cocorocchio, Alberto Dalla Volta, Filippo Maria Deppieri, Andrea Di Marco, Marilena Di Napoli, Martina Fanelli, Emanuela Fantinel, Arianna Dri, Roberto Filippi, Giuseppe Fornarini, Luca Galli, Annalisa Guida, Massimiliano Icardi, Francesca La Russa, Cristian Lolli, Laura Lombardo, Francesca Maines, Brigida Anna Maiorano, Cristina Masini, Carlo Messina, Cecilia Nasso, Cinzia Ortega, Francesco Pierantoni, Giuseppe Procopio, Sarah Scagliarini, Alessio Signori, Mariella Sorarù, Luca Tondulli, Elena Verzoni, Francesca Vignani, Maria Giuseppa Vitale, Silvia Zai, Paolo Andrea Zucali, Ugo De Giorgi, Daniele Santini, Massimo Di Maio","doi":"10.1016/j.clgc.2026.102654","DOIUrl":"https://doi.org/10.1016/j.clgc.2026.102654","url":null,"abstract":"<p><strong>Introduction: </strong>Bone metastases (BMs) in patients with metastatic renal cell carcinoma (mRCC) negatively affect survival, quality of life, and increase the risk of skeletal-related events (SREs). Evidence remains limited in the era of first-line immune-based combinations.</p><p><strong>Patients and methods: </strong>Meet-URO 33 is an Italian multicenter observational retrospective-prospective study enrolling mRCC patients receiving first-line therapy. The primary endpoint was overall survival (OS). Secondary endpoints included progression-free survival (PFS), clinical characterization, incidence of SREs, and impact of bone-targeting agents (BTAs). Survival was analyzed using the Kaplan-Meier method, log-rank test and Cox proportional hazards model.</p><p><strong>Results: </strong>A total of 1696 patients enrolled between 2021 and 2025 were included; 526 (31%) had BMs at metastatic diagnosis. Patients with BMs more frequently had poorer performance status and unfavorable International mRCC Database Consortium (IMDC) risk. The presence of BMs was associated with significantly worse OS (median 26.9 vs. 102.1 months; hazard ratio [HR] 0.53; P < .001) and worse PFS (median 14.2 vs. 19.4 months; HR 0.71; P < .001), with OS and PFS varying according to first-line regimen. Worse OS persisted across IMDC risk classes and treatment types; PFS differences were not significant in favorable/intermediate IMDC risk groups and with tyrosine kinase inhibitor monotherapy. Neither anatomical site nor number of BMs significantly affected OS. SRE incidence in patients with BMs was 26.8%, more frequent with spinal, rib, or other-site involvement, and more common in BTA-treated patients (22.2% vs. 13.7%, P = .03), likely reflecting selection bias.</p><p><strong>Conclusion: </strong>BMs are confirmed a negative prognostic factor in mRCC involving persistent unmet clinical needs.</p>","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":" ","pages":"102654"},"PeriodicalIF":2.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003163","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":"Real-World Clinical Outcomes Among Patients With High-Risk Non-Muscle-Invasive Bladder Cancer Treated With Bacillus Calmette-Guérin: A SEER-Medicare Analysis.","authors":"Yair Lotan, Monika Raut, Shujing Zhang, Yizhen Lai, Sandy S Chang, Hema Dave, Rituparna Bhattacharya, Haojie Li, Wei Gao, Yan Song, Honghao Fang, Jiayang Li, Pangsibo Shen","doi":"10.1016/j.clgc.2026.102641","DOIUrl":"https://doi.org/10.1016/j.clgc.2026.102641","url":null,"abstract":"<p><strong>Introduction: </strong>Contemporary data on clinical outcomes following Bacillus Calmette-Guérin (BCG) treatment in high-risk non-muscle-invasive bladder cancer (HR-NMIBC) are needed. This study evaluated recurrence and survival in US patients with HR-NMIBC who received BCG.</p><p><strong>Methods: </strong>Using Surveillance, Epidemiology and End Results-Medicare data, we identified patients aged ≥ 65 years with a primary diagnosis of HR-NMIBC who received BCG (initiation date = index date). Post-BCG recurrence was assessed overall and by local NMIBC recurrence, progression to muscle-invasive bladder cancer (MIBC), and distant metastasis (DM). Event-free and overall survival were estimated using Kaplan-Meier analysis. Cystectomy use following recurrence was also evaluated.</p><p><strong>Results: </strong>A total of 5490 patients with HR-NMIBC who received BCG were included, of whom 33.6% had high-grade Ta, 55.0% T1 (± Ta), and 11.4% Tis (± Ta/T1) at initial diagnosis. Over a median follow-up of 2.9 years, 2178 (39.7%) patients experienced recurrence, 97.2% occurring within the first 5 years after BCG initiation. Recurrence rates for local NMIBC recurrence, progression to MIBC, and DM increased from 15.9%, 4.1%, and 3.7% at 1 year to 33.6%, 15.9%, and 16.7% at 10 years, respectively. Recurrence was similarly high among patients with Tis (42.1%) and T1 (40.6%) disease. Among patients with recurrence, 312 (14.3%) underwent cystectomy, 83.3% of which within 1 year after recurrence.</p><p><strong>Conclusions: </strong>In this population-based study, patients with HR-NMIBC experienced substantial recurrence burden following BCG treatment, with the majority of recurrences occurring within 5 years after BCG initiation. These findings underscore the need for improved strategies to effectively delay or prevent recurrence in HR-NMIBC.</p>","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":" ","pages":"102641"},"PeriodicalIF":2.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978375","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 impact of a multidisciplinary tumour board (MTB) on treatment decision making for patients with renal cell carcinoma (RCC): 5-year data analysis","authors":"L. Brink, A. Ruiter, B. Lagerveld, N. Graafland, A. Bex, H. Beerlage, R.J.M. van Moorselaar, P. Zondervan","doi":"10.1016/j.clgc.2024.01.021","DOIUrl":"https://doi.org/10.1016/j.clgc.2024.01.021","url":null,"abstract":"","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":"327 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139822790","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 Role of Radical Cystectomy in Clinically Node Positive Bladder Cancer: A US Veterans Health Administration Study","authors":"Margaret Meagher, Kylie M. Morgan, Leah N. Deshler, Dhruv Puri, Kit Yuen, Aditya Bagrodia, Brent Rose, Tyler F Stewart, A. Salmasi","doi":"10.1016/j.clgc.2024.02.006","DOIUrl":"https://doi.org/10.1016/j.clgc.2024.02.006","url":null,"abstract":"","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":"76 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139887499","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":"Treatment patterns and survival outcomes before and after access to immune checkpoint inhibitors for patients with metastatic urothelial carcinoma: A single-centre retrospective study from 2004 to 2021.","authors":"Jose C. Tapia, Freya Bosma, J. Gavira, Sofia Sanchez, Maria Alejandra Molina, J. Sanz-Beltran, Cristina Martín-Lorente, G. Anguera, Pablo Maroto","doi":"10.1016/j.clgc.2024.01.019","DOIUrl":"https://doi.org/10.1016/j.clgc.2024.01.019","url":null,"abstract":"","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139815806","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":"Value of Cystatin C-Based Sarcopenia Index in Patients Undergoing Surgery for Renal Tumors","authors":"S. Yajima, Y. Nakanishi, Ryo Andy Ogasawara, Naoki Imasato, Kohei Hirose, Sao Katsumura, M. Kataoka, H. Masuda","doi":"10.1016/j.clgc.2024.02.002","DOIUrl":"https://doi.org/10.1016/j.clgc.2024.02.002","url":null,"abstract":"","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":"56 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139829352","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":"Clinical Profile and Outcomes of Carcinoma Penis patients receiving systemic therapy at an Indian tertiary care centre: A retrospective observational study","authors":"V. Noronha, Venkatesh Kapu, Amit Joshi, N. Menon, Ajay Singh, G. Prakash, S. Menon, N. Sable, V. Murthy, M. Pal, Amandeepsingh Arora, Sravan Kumar, S. Banavali, K. Prabhash","doi":"10.1016/j.clgc.2024.02.004","DOIUrl":"https://doi.org/10.1016/j.clgc.2024.02.004","url":null,"abstract":"","PeriodicalId":93941,"journal":{"name":"Clinical genitourinary cancer","volume":"1353 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139830965","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}