European urology最新文献

{"title":"Re: [177Lu]-PSMA-617-PSMA-617 in Oligometastatic Hormone Sensitive Prostate Cancer (BULLSEYE): An Open-label, Randomised, Phase 2 Study.","authors":"Colin Belliveau, Amar U Kishan, Jeremie Calais, Nicolas Plouznikoff, Cynthia Ménard","doi":"10.1016/j.eururo.2026.07.007","DOIUrl":"https://doi.org/10.1016/j.eururo.2026.07.007","url":null,"abstract":"","PeriodicalId":94000,"journal":{"name":"European urology","volume":" ","pages":""},"PeriodicalIF":25.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148458282","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":"BCG-unresponsive NMIBC: An Obsolete Definition in a Multimodal and Evolving Therapeutic Landscape.","authors":"Pierre-Etienne Gabriel, Alec Zhu, Paolo Gontero, Morgan Rouprêt, Evanguelos Xylinas, John P Sfakianos","doi":"10.1016/j.eururo.2026.03.028","DOIUrl":"https://doi.org/10.1016/j.eururo.2026.03.028","url":null,"abstract":"","PeriodicalId":94000,"journal":{"name":"European urology","volume":" ","pages":""},"PeriodicalIF":25.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148458172","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":"Re: Luka Cavka, Subhiksha Nandakumar, Qingqing Wu, et al. IDH1 Mutations Are Associated with Favorable Outcomes in Prostate Cancer. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2026.03.014.","authors":"Isabel Heidegger","doi":"10.1016/j.eururo.2026.06.025","DOIUrl":"https://doi.org/10.1016/j.eururo.2026.06.025","url":null,"abstract":"","PeriodicalId":94000,"journal":{"name":"European urology","volume":" ","pages":""},"PeriodicalIF":25.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440484","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":"Confirmation of Prostate-specific Antigen (PSA) Values Improves Prostate Cancer Screening in Early Middle-Aged Men - Data from the PROBASE Trial.","authors":"Agne Krilaviciute, Nikolaus Becker, Sigrid V Carlsson, Rudolf Kaaks, Petra Seibold, Jale Lakes, Rouvier Al-Monajjed, Markus Kuczyk, Nina N Harke, Mohammed Rafea Kanaan, Jürgen Debus, Christoph A Grott, Jakob Liermann, Jürgen E Gschwend, Kathleen Herkommer, Victoria A Göldner, Glen Kristiansen, Gerald Antoch, Lars Schimmöller, Christian Arsov, Boris Hadaschik, Peter Albers","doi":"10.1016/j.eururo.2026.06.016","DOIUrl":"https://doi.org/10.1016/j.eururo.2026.06.016","url":null,"abstract":"<p><strong>Background and objective: </strong>To assess the effectiveness of a confirmatory prostate-specific antigen (PSA) test as a safeguard against unnecessary work-up and to improve the specificity of prostate cancer (PCa) screening.</p><p><strong>Methods: </strong>Overall, 72,157 PSA values corresponding to screening rounds at age 45-55 yr in the PROBASE trial were analyzed. Positive PSA tests were reported as the proportion of men with an initial or confirmatory PSA ≥3 ng/ml. The cumulative PCa number over 6 yr was described for men with and without confirmatory PSA decrease at baseline screening (age 45 yr). Sankey diagrams were plotted to illustrate changes in PSA values over 10 yr with 2-yearly PSA screening.</p><p><strong>Key findings and limitations: </strong>Overall, 2782 initial PSAs and 2702 (97%) confirmatory PSAs were observed. A total of 38% (95% confidence interval [CI] 36, 40) of men with initial PSA ≥3 ng/ml had a PSA <3 ng/ml at confirmatory testing. Estimates differed by age and screening round: 46% (95% CI 41, 51) in 45-yr-olds and 34% (95% CI 31, 38) in 50-yr-olds. PSA was repeated at a median of 28 d (interquartile range [IQR] 20, 39). Median change was -0.5 ng/ml (IQR -1.3, +0.06). PCa risk at 6 yr was 33% in those with confirmed PSA and 7.0% in those with PSA decrease at age 45 yr (risk ratio 4.68, CI 2.55, 8.59). The main limitation is incomplete biopsy information.</p><p><strong>Conclusion: </strong>PSA elevations in early-middle-aged men are common and PSA should be confirmed before initiating diagnostic work-up in a screening setting.</p><p><strong>Clinical implications: </strong>Repeating PSA before initiating diagnostic work-up reduces immediate further diagnostics.</p>","PeriodicalId":94000,"journal":{"name":"European urology","volume":" ","pages":""},"PeriodicalIF":25.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440546","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":"Re: David-Dan Nguyen, Borna Tadayon Najafabadi, Lauren Lin, et al. Effect of Prostate Cancer Screening with Prostate-specific Antigen Testing on Long-term Prostate Cancer-specific Mortality: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2026.04.005.","authors":"Yu Seob Shin, Jae Heon Kim","doi":"10.1016/j.eururo.2026.06.023","DOIUrl":"https://doi.org/10.1016/j.eururo.2026.06.023","url":null,"abstract":"","PeriodicalId":94000,"journal":{"name":"European urology","volume":" ","pages":""},"PeriodicalIF":25.2,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427501","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":"Oncological Outcomes Following Focal HIFU and Cryotherapy for Treatment of Nonmetastatic Prostate Cancer in the United Kingdom: An Updated Analysis of 3477 Patients from the Prospective HEAT and ICE Registries.","authors":"Alexander Light, Max Peters, Archana Gopalakrishnan, Nikhil Mayor, Emma Cullen, Ranil Johann Boaz, Joseph M Norris, Samuel Morris, Manit Arya, Mariana Bertoncelli Tanaka, Alan Doherty, Tim Dudderidge, Amr Emara, Mark Emberton, Alistair Grey, Richard Hindley, Marc Laniado, Stuart McCraken, Caroline M Moore, Raj Nigam, Mohamed Noureldin, Clement Orczyk, Arnas Rakauskas, Lucy Simmons, Jaspal Virdi, John Withington, Paimaun Zakikhani, Hashim U Ahmed, Taimur T Shah","doi":"10.1016/j.eururo.2026.05.007","DOIUrl":"https://doi.org/10.1016/j.eururo.2026.05.007","url":null,"abstract":"<p><strong>Background and objective: </strong>Long-term outcome data for focal therapy using high-intensity focused ultrasound (HIFU) or cryotherapy for nonmetastatic prostate cancer are needed. We report 10-yr cancer control outcomes.</p><p><strong>Methods: </strong>Patients with nonmetastatic prostate cancer who underwent primary focal HIFU or cryotherapy and had at least 6 mo follow-up were identified from the UK HIFU Evaluation and Assessment of Treatment (HEAT) and International Cryotherapy Evaluation (ICE) prospectively maintained registries. The intervention included up to two focal ablative sessions. The primary outcome was cancer-specific mortality. Secondary outcomes were all-cause mortality, metastasis, local retreatment, radical treatment, and androgen-deprivation therapy (ADT) use.</p><p><strong>Key findings and limitations: </strong>A total of 3477 patients (HIFU: n = 2897; cryotherapy: n = 580) were included from 14 UK centres (2004-2024). A total of 48%, 23%, and 25% had European Association of Urology (EAU) 2025-version favourable intermediate-, unfavourable-intermediate-, and high-risk disease, respectively. Ten-yr cancer-specific mortality was 0.13% (95% confidence interval [CI] = 0.027-0.45%). Ten-yr all-cause mortality and metastases were 12% (95% CI = 8.8-15%) and 3.3% (95% CI = 2.1-4.9%), respectively. Ten-yr ADT use was 14% (95% CI = 11-17%). Ten-yr local retreatment and radical treatment were 33% (95% CI = 30-37%) and 30% (95% CI = 27-34%), respectively, on an intention-to-treat basis. In a post hoc per-protocol analysis, undertaken to estimate outcomes under stricter adherence to the two focal ablative session protocol, patients who underwent radical treatment despite being potentially eligible for a further focal ablative session were censored at the time of radical treatment; 10-yr local retreatment and radical treatment were 13% (95% CI = 11-16%) and 8.9% (95% CI = 6.9-11%), respectively. The observational study design is the main limitation.</p><p><strong>Conclusions and clinical implications: </strong>Focal therapy using up to two sessions of focal HIFU or cryotherapy could be considered as a first-line treatment for well-selected patients of nonmetastatic prostate cancer alongside radical treatment. Future research priorities should include the development of a dedicated prognostic risk calculator, further prospective assessment of focal therapy for high-risk disease, and improvements in the detection and management of locally recurrent disease.</p>","PeriodicalId":94000,"journal":{"name":"European urology","volume":" ","pages":""},"PeriodicalIF":25.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427344","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":"Cognitive Versus Software-based Fusion Targeted Biopsy for the Diagnosis of Clinically Significant Prostate Cancer: A Multicenter, Randomized, Noninferiority Trial (IMAGINATION).","authors":"Bi-Ming He, Keqin Zhang, Zhien Zhou, Xingfa Chen, Yi Liu, Biao Dong, Yong Wang, Yaping Xing, WenQiang He, Zhichao Jin, Tongqing Zhang, Tianrui Feng, Liang Liang, Bo Chen, Shouzhen Chen, Zhenquan Lu, Shuming Zhou, Yanfang Zhao, Yingtao Liu, Zhimin Wang, Rong Na, Xuepei Zhang, Benkang Shi, Hai-Feng Wang","doi":"10.1016/j.eururo.2026.06.020","DOIUrl":"https://doi.org/10.1016/j.eururo.2026.06.020","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance imaging-targeted prostate biopsy relies heavily on costly software-fusion platforms, limiting global accessibility.</p><p><strong>Objective: </strong>We aimed to determine whether cognitive fusion (mental registration) is noninferior to software-based fusion targeted biopsy for detecting clinically significant prostate cancer (csPCa).</p><p><strong>Design, setting, and participants: </strong>This multicenter, randomized, blinded, noninferiority trial enrolled 648 predominantly biopsy-naive men (prostate-specific antigen 4-20 ng/ml; Prostate Imaging Reporting and Data System ≥3) at nine centers in China.</p><p><strong>Intervention: </strong>Participants were randomly assigned 1:1 to cognitive fusion or software-based fusion targeted biopsy, followed by systematic biopsy.</p><p><strong>Outcome measurements and statistical analysis: </strong>The primary outcome was csPCa (ISUP grade group ≥2) detection on targeted biopsy, evaluated using generalized estimating equations with a prespecified -10 percentage point noninferiority margin.</p><p><strong>Results and limitations: </strong>In the intention-to-treat population (327 cognitive and 321 software), targeted biopsy detected csPCa in 32% and 34% of the patients, respectively. The adjusted risk difference was -1.02 percentage points (90% confidence interval [CI], -5.6 to 3.6), establishing noninferiority. Combined targeted and systematic biopsy detected csPCa in 35-39% of the patients, respectively (difference, -1.50% [90% CI, -6.4 to 3.4]). A significant body mass index (BMI) interaction was observed (p < 0.001): cognitive fusion performed best in men with BMI <24 kg/m², whereas software-based fusion improved detection in men with BMI ≥24 kg/m². Adverse event rates were comparable (15% vs 18%). Limitations include conducting the trial predominantly in Asian populations, necessitating cautious geographic extrapolation of specific BMI cutoffs.</p><p><strong>Conclusions: </strong>Cognitive fusion is diagnostically noninferior to software-based fusion within a prespecified -10% margin overall. However, a significant BMI interaction raises serious concerns regarding the diagnostic feasibility of cognitive fusion in obese populations, where software-based fusion is strictly superior. Future prospective trials in both Asian and Western populations must evaluate the BMI effect as a primary end point.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT04271527.</p>","PeriodicalId":94000,"journal":{"name":"European urology","volume":" ","pages":""},"PeriodicalIF":25.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427320","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":"Rethinking Perioperative Strategies in Clinically Node-positive Upper Tract Urothelial Carcinoma in the KEYNOTE-B15 Era.","authors":"Pierre-Etienne Gabriel, Matthew D Galsky","doi":"10.1016/j.eururo.2026.06.017","DOIUrl":"https://doi.org/10.1016/j.eururo.2026.06.017","url":null,"abstract":"","PeriodicalId":94000,"journal":{"name":"European urology","volume":" ","pages":""},"PeriodicalIF":25.2,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427523","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":"Re: Ultra-hypofractionated Stereotactic Ablative Body Radiotherapy for Primary Renal Cell Carcinoma: 5-year Outcomes from a Pooled Analysis of the FASTRACK Trials.","authors":"Tonghu Liu, Congcong Zhu, Zechen Yan","doi":"10.1016/j.eururo.2026.06.004","DOIUrl":"https://doi.org/10.1016/j.eururo.2026.06.004","url":null,"abstract":"","PeriodicalId":94000,"journal":{"name":"European urology","volume":" ","pages":""},"PeriodicalIF":25.2,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364557","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":"Re: Alexander D. Sherry, Van To, Criselle D'souza, et al. Metastasis-directed Therapy With or Without Pembrolizumab for Oligometastatic Clear Cell Renal Cell Carcinoma: Pooled Analysis of Two Prospective Single-arm Phase 2 Trials. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2026.03.024.","authors":"Antonio Cigliola, Andrea Necchi, Umberto Capitanio","doi":"10.1016/j.eururo.2026.05.037","DOIUrl":"https://doi.org/10.1016/j.eururo.2026.05.037","url":null,"abstract":"","PeriodicalId":94000,"journal":{"name":"European urology","volume":" ","pages":""},"PeriodicalIF":25.2,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364551","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}