Actas urologicas espanolas最新文献

{"title":"Comparison of thulium fiber laser and holmium:YAG laser lithotripsy in retrograde intrarenal surgery for kidney Stone treatment: A randomized prospective study.","authors":"B Kozubaev, S Oguz Demirdogen, T Aksakalli, F Ozkaya, S Adanur","doi":"10.1016/j.acuroe.2025.501808","DOIUrl":"10.1016/j.acuroe.2025.501808","url":null,"abstract":"<p><strong>Objective: </strong>This study compares the clinical outcomes of Holmium:YAG (Ho:YAG) laser lithotripsy and Thulium Fiber Laser (TFL) lithotripsy in retrograde intrarenal surgery (RIRS) for kidney stones <20 mm.</p><p><strong>Materials and methods: </strong>Patients who underwent RIRS for renal stones <20 mm between September 2022 and November 2023 were prospectively analyzed. They were randomly assigned to either the TFL or Ho:YAG laser group using a sealed-envelope method. Preoperative demographics, stone characteristics, kidney-ureter-bladder x-ray (KUB), ultrasound and noncontrast computer tomography (NCCT) scan findings were recorded. Operative time, laser usage time, postoperative stone-free rate (SFR), and complications were assessed and statistically analyzed.</p><p><strong>Results: </strong>A total of 126 patients (mean age: 49.16 ± 15.18 years; 64.3% male, 35.7% female) were included. The TFL group (n = 64, 50.8%) had significantly shorter operative and laser usage times than the Ho:YAG laser group (n = 62, 49.2%) (operative time: 45.77 ± 15.67 min vs. 52.79 ± 18.11 min, p = 0.031; laser usage: 29.84 ± 13.32 min vs. 36.39 ± 15.75 min, p = 0.024). No significant SFR difference was found between groups (TFL group: n = 57, 91.8% vs. Ho:YAG laser group: n = 60, 93.8% ; p = 0.488).</p><p><strong>Conclusion: </strong>In the treatment of kidney stones smaller than 20 mm using laser lithotripsy, both TFL and Ho:YAG laser are effective, safe, and associated with low complication rates. However, the use of TFL significantly reduces operative time and lithotripsy time, potentially improving surgical efficiency. Further studies with larger patient cohorts are necessary to validate these findings and provide additional insights into the advantages and limitations of each laser type.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501808"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602743","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":"Acute toxicity of SBRT in localized prostate cancer: A Spanish multicenter study.","authors":"S E Romero Zoghbi, F López Campos, D Sanz-Rosa, J Fernández Ibiza, I J Thuissard-Vasallo, C Andreu-Vázquez, C Laria, J Andreescu Yagüe, E Krumina, A Ocanto, M Mateos, L A Glaría, J A García Cuesta, D Gonsalves, C Fernández, D Esteban, J Begara de la Fuente, D Rivas, E López Ramírez, L Aakki, J A González Ferreira, A Ristori, A B Bezares Alarcón, L Larrea, R García García, F Couñago","doi":"10.1016/j.acuroe.2025.501798","DOIUrl":"10.1016/j.acuroe.2025.501798","url":null,"abstract":"<p><strong>Introduction: </strong>Stereotactic body radiation therapy (SBRT) has emerged as an effective option for the treatment of localized prostate cancer; however, data from real-world clinical practice remain limited.</p><p><strong>Material and methods: </strong>Between January 2020 and December 2023, 251 patients with localized prostate cancer treated with SBRT were included in 12 centers in Spain. The treatment volume included prostate ± seminal vesicles, without prophylactic pelvic radiotherapy. A dose of 35-40 Gy was prescribed in 5 fractions, every other day. Acute genitourinary (GU), gastrointestinal (GI) and sexual toxicity was assessed up to 6 months post-treatment using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0.</p><p><strong>Results: </strong>A total of 251 patients were classified based on the National Comprehensive Cancer Network (NCCN®) classification. Four percent of patients had very low-risk disease, 26.3% low-risk, and 66.5% intermediate-risk (27.1% favorable intermediate and 39.4% unfavorable intermediate). Additionally, 2.8% were classified as high-risk and 0.4% as very high-risk. The median patient age was 72 years (range: 65-76), and the baseline PSA was 6.7 ng/ml (range: 5.3-8.7). The median SBRT dose was 40 Gy (range: 35-40 Gy). Grade 2 acute GU toxicity occurred in 6.4% of patients, and grade 3 in 0.4%. Grade 2 GI toxicity was observed in 0.8%, with no cases of grade 3 GI toxicity. Regarding sexual toxicity, 11.2% of patients experienced grade 2, and 1.2% grade 3 toxicity.</p><p><strong>Conclusions: </strong>Five-fraction SBRT is a feasible and safe treatment with a low incidence of acute toxicity.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501798"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602734","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":"Managing hypospadias failure: A comprehensive review of strategies and outcomes.","authors":"L E Jesus, J L Pippi-Salle","doi":"10.1016/j.acuroe.2025.501809","DOIUrl":"10.1016/j.acuroe.2025.501809","url":null,"abstract":"<p><strong>Introduction: </strong>Hypospadias surgery has a failure rate ranging from 10% for distal cases to over 30% for proximal cases. However, real-world outcomes may be worse, as some complications emerge late in puberty or are underreported. The expectations for surgical success have evolved, shifting from basic urinary and sexual functionality to achieving a normal penile appearance. Bias in research favors retrospective studies with short follow-ups, and qualitative research remains scarce. This review describes complications following hypospadias surgery, their management, and prognosis.</p><p><strong>Methodology: </strong>A non-systematic critical review of existing literature on hypospadias complications and surgical management was conducted.</p><p><strong>Results: </strong>Common complications include urethrocutaneous fistulae (UCF), glans dehiscence (GD), urethral stenosis (US), urethral diverticulae (UD), urine spraying, and recurrent curvature (RC). UCF is the most frequently reported complication, treated through multilayer closure with vascularized flap coverage. GD occurs more frequently in proximal hypospadias, requiring glans reformatting and tissue augmentation. US often manifests as meatal stenosis or neourethral strictures, requiring meatoplasty or staged urethroplasty. UD arises from loose urethral segments subjected to high urinary flow resistance and is managed via excision or remodeling. Urine spraying is linked to insufficient glans fusion or meatal irregularities, sometimes requiring surgical correction. RC is a significant complication impacting sexual function, requiring individualized correction through dorsal plication or ventral lengthening.</p><p><strong>Conclusion: </strong>Hypospadias complications require individualized assessment and surgical planning. Late complications, often underrecognized, should be considered in long-term follow-up. Proper surgical technique selection and postoperative evaluation help mitigate recurrence and improve patient outcomes.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501809"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602745","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":"Mapping regional disparities in testicular cancer mortality across Spain (2004-2023).","authors":"L Cayuela, S Cabrera Fernández, R Roldán Testillano, M Ortega Calvo, A Cayuela","doi":"10.1016/j.acuroe.2025.501800","DOIUrl":"10.1016/j.acuroe.2025.501800","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigates testicular cancer (TC) mortality trends and spatial patterns in Spain, utilizing provincial-level spatial analysis to identify high-risk clusters.</p><p><strong>Methods: </strong>An ecological study was conducted using TC mortality data (ICD-10 code C62) from the Spanish National Institute of Statistics (2004-2023). Age-standardized mortality rates (ASMRs) were calculated using the direct method. Temporal trends were analyzed with joinpoint regression. Spatial patterns were assessed using standardized mortality ratios (SMR), smoothed relative risk (RR), and posterior probabilities (PP) through Bayesian hierarchical models. Spatial clustering was examined with Tango's test and Kulldorff's likelihood ratio test.</p><p><strong>Results: </strong>A total of 909 TC deaths were recorded, with ASMRs ranging from 0.14 to 0.26 per 1,000,000 inhabitants. No significant temporal trends were observed. Age-specific mortality showed a bimodal distribution, peaking at ages 35-39 and 85+. The highest SMRs were found in Zamora (2.58), Segovia (2.64), and Soria (2.39), while the lowest were in Madrid (0.66) and Barcelona (0.55). Bayesian spatial analysis identified elevated relative risk in Badajoz (RR 1.6), Huelva (RR 1.47), and Sevilla (RR 1.4). Kulldorff's analysis revealed a high-mortality cluster in southwestern Spain (Huelva, Sevilla, Badajoz), with a secondary cluster extending to neighbouring provinces.</p><p><strong>Conclusions: </strong>While TC mortality in Spain remained stable, significant regional disparities exist. High-risk provinces and mortality clusters highlight potential inequalities in healthcare access, socioeconomic conditions, and environmental exposures.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501800"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577507","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":"Is it truly necessary to achieve complete stone-free status in cases of staghorn calculi?","authors":"G Freschi, D P Resuto, R H Astolfi, W R Molina, A Meller","doi":"10.1016/j.acuroe.2025.501812","DOIUrl":"10.1016/j.acuroe.2025.501812","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>To evaluate long-term outcomes in staghorn stone patients with residual fragments following surgical treatment.</p><p><strong>Materials and methods: </strong>A retrospective study of patients who underwent percutaneous nephrolithotripsy for staghorn stones and long term follow up were divided into two groups: residual stones versus non-residual stones. The occurrence of new stones or fragment growth, infectious events, and renal function were evaluated. Patients with a follow-up period of less than one year were excluded.</p><p><strong>Results: </strong>A total of 87 patients (75.9% female) were included in the study. Of these, 21.8% were stone-free, while 78.2% exhibited residual fragments with a median size of 7mm (3.5-11.5mm). The average follow-up period was 27 months (21-36 months). Only 24.1% experienced recurrence or growth of residual fragments, with a median growth of 10mm (6-12mm). Additionally, 14.9% of patients developed urinary infections during the follow-up period. No significant differences were observed between stone-free patients and those with residual fragments in terms of recurrence, residual fragments growth, infectious events, or deterioration in renal function. Similarly, no differences were noted when comparing patients with positive or negative cultures.</p><p><strong>Conclusions: </strong>The incidence of recurrence, growth of residual fragments, infectious events, and deterioration of renal function was comparable between patients with and without residual stones. Furthermore, the presence of positive preoperative or intraoperative cultures did not influence these outcomes.</p>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":" ","pages":"501812"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577506","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":"Molecular detection and clinical relevance of Haemophilus spp. in male urethritis: Prevalence and risk factors","authors":"O. Mar-Herrera,&nbsp;J. Llaca-Díaz,&nbsp;A. Flores-Aréchiga,&nbsp;N. Casillas-Vega","doi":"10.1016/j.acuroe.2025.501790","DOIUrl":"10.1016/j.acuroe.2025.501790","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Urethritis is the most common sexually transmitted infection in men. <em>Haemophilus influenzae</em> and <em>Haemophilus parainfluenzae</em>, commensal microorganisms of the respiratory and oral tract, have been proposed as potential etiological agents of non-gonococcal urethritis (NGU). This study aimed to determine the prevalence of these species in urine samples from men with urethritis and analyze their clinical correlation.</div></div><div><h3>Methods</h3><div>A total of 200 urinary DNA samples from patients diagnosed with urethritis were analyzed. Microorganisms were identified through multiplex PCR, amplifying the <em>P6</em> and <em>16S rRNA</em> genes. Associations between risk factors and infection were evaluated by calculating odds ratios (OR) and 95% confidence intervals (CI) using OpenEpi 3.03a.</div></div><div><h3>Results</h3><div>The mean age of the population was 55 years (range 20–95). Among the participants, 32.5% had received prior sexual education, and 75% reported not using contraceptive methods. <em>H. influenzae</em> was not detected in any sample, whereas <em>H. parainfluenzae</em> was present in 9.5% (n = 19) of cases. Significant associations were identified with the absence of formal education, a history of more than ten sexual partners, masturbation, and sexual intercourse under the influence of alcohol and/or drugs.</div></div><div><h3>Conclusions</h3><div>Although <em>H. influenzae</em> and <em>H. parainfluenzae</em> have been rarely identified in urethritis, their high transmissibility and clinical relevance suggest the need for their detection in high-risk populations. Their identification may contribute to improving diagnosis and the implementation of therapeutic strategies.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501790"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251707","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":"Phyllanthus niruri in the management of nephrolithiasis: A systematic review of the literature","authors":"J. Iregui-Parra ,&nbsp;V. Rojas Ossa ,&nbsp;C.M. Arias Salazar ,&nbsp;A.D. López Estupiñán ,&nbsp;D. Díaz Varela ,&nbsp;L.M. Sinisterra Parra ,&nbsp;L. Diéguez ,&nbsp;E. Emiliani","doi":"10.1016/j.acuroe.2025.501791","DOIUrl":"10.1016/j.acuroe.2025.501791","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Nephrolithiasis is one of the most prevalent urological pathologies worldwide, with an increasing incidence and multifactorial etiology, particularly influenced by diet. Surgical interventions or extracorporeal shock wave lithotripsy (ESWL) are the cornerstone treatments. However, as emphasized by the EAU and AUA guidelines, post-surgical medical management is recommended to reduce recurrence risk. <em>Phyllanthus niruri</em> (PN), widely used in traditional medicine, has been extensively researched, yielding mixed results and presenting an opportunity to explore its role further. This review aims to evaluate PN’s potential in enhancing treatment efficacy and reducing stone recurrence.</div></div><div><h3>Materials and methods</h3><div>A systematic literature review was conducted, encompassing articles published from January 1994 to September 2022 in English and Spanish. The review included studies on humans and rats accessible through the authors’ institutional affiliations. Titles and abstracts were screened, and relevant studies were selected for in-depth analysis.</div></div><div><h3>Results</h3><div>Out of the 16 selected studies, various mechanisms of action for PN were identified, such as promoting glycosaminoglycan (GAG) aggregation, inhibiting nucleation processes, and altering stone density to favor a stone-free state (SFR). Evidence consistently supports PN’s long-term safety, confirmed by serial measurements of serum electrolytes and liver function. Novel applications, such as PN as an adjuvant to ESWL, show benefits for lower renal pole stones.</div></div><div><h3>Conclusions</h3><div>Growing evidence suggests that PN, when used alongside traditional interventions, is safe, without significant adverse effects, and may improve SFR outcomes after ESWL.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501791"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251708","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":"Identification of risk factors for evisceration in open radical cystectomy","authors":"R. Monsonís-Usó ,&nbsp;P. Ponce-Blasco ,&nbsp;B. Amaya-Barroso ,&nbsp;P. Martínez-Meneu ,&nbsp;A. Sánchez-Llopis ,&nbsp;L. Barrios-Arnau ,&nbsp;C. Garau-Perelló ,&nbsp;P. Juan ,&nbsp;M. Rodrigo-Aliaga","doi":"10.1016/j.acuroe.2025.501759","DOIUrl":"10.1016/j.acuroe.2025.501759","url":null,"abstract":"<div><h3>Introduction</h3><div>Abdominal wall closure defects (AWCD) represent a cause of morbidity and mortality in patients undergoing laparotomy.</div></div><div><h3>Objective</h3><div>The aim of this study was to determine the risk factors contributing to the appearance of AWCD in open radical cystectomy.</div></div><div><h3>Methods</h3><div>A retrospective, analytical, observational, descriptive study and multivariate analysis was conducted including patients who underwent open radical cystectomy for bladder cancer at the General University Hospital of Castellón between January 2018 and December 2021.</div></div><div><h3>Results</h3><div>A total of 80 patients were included. The mean age was 70 years, with 86.3% being men. Sixteen presented with an evisceration (20%). Risk factors in the multivariate analysis were age, history of vascular or coronary disease, preoperative albumin, hemodynamic instability, and surgical time. Eight patients presented with an eventration (10%). A higher body mass index and a lower preoperative hemoglobin level were associated with eventration.</div></div><div><h3>Conclusion</h3><div>The risk factors associated with abdominal wall closure defects are identifiable and preventable.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501759"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049536","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":"Is the presence of lymphovascular invasion associated with recurrence and progression in bladder cancer patients that have received adequate BCG therapy?","authors":"U. Aydin ,&nbsp;S. Cetin ,&nbsp;M. Yavuz Koparal ,&nbsp;C. Coskun ,&nbsp;I. Isık Gonul ,&nbsp;S. Yesil ,&nbsp;T.S. Sozen","doi":"10.1016/j.acuroe.2025.501785","DOIUrl":"10.1016/j.acuroe.2025.501785","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>To investigate whether lymphovascular invasion (LVI) could be a factor in predicting recurrence and progression in patients with high and very high-risk non-muscle-invasive bladder cancer (NMIBC) who received Bacillus Calmette-Guérin (BCG) treatment.</div></div><div><h3>Methods</h3><div>Ninety-three patients with high and very high-risk NMIBC, diagnosed initially in our clinic, were treated with at least 1 year of BCG therapy, and they were followed up to assess recurrence and progression, comparing those with and without lymphovascular invasion (LVI) at the time of diagnosis.</div></div><div><h3>Results</h3><div>In the entire cohort, LVI was present in 33 (35.5%) patients while absent in 60 (64.5%) patients. Among patients with LVI, 17 (51.5%) showed recurrence, and 11 (33.3%) showed progression. Statistically significant differences were observed in both recurrence and progression in patients with LVI compared to those without LVI (p &lt; 0.001 and 0.04, respectively). Additionally, univariate and multivariate regression analysis revealed that the presence of LVI was an independent factor predicting recurrence (p = 0.001).</div></div><div><h3>Conclusion</h3><div>In our study, we demonstrated the importance of being cautious regarding recurrence and progression in patients with high and very high-risk NMIBC who also have LVI despite receiving standard treatment. We found that approximately one-third of these patients may experience recurrence within one year.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501785"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048938","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":"Comparing Prostatype P-score and traditional risk models for predicting prostate cancer outcomes in Spain","authors":"P. González-Peramato ,&nbsp;M. Álvarez-Maestro ,&nbsp;V. Heredia-Soto ,&nbsp;M. Mendiola Sabio ,&nbsp;E. Linares ,&nbsp;Á. Serrano ,&nbsp;J.L. Álvarez-Ossorio ,&nbsp;E. López Alcina ,&nbsp;L. Prieto ,&nbsp;F. Vázquez Alonso ,&nbsp;M. Aller Rodríguez ,&nbsp;E. Berglund","doi":"10.1016/j.acuroe.2025.501788","DOIUrl":"10.1016/j.acuroe.2025.501788","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer (PCa) shows varied aggressiveness, complicating personalised treatment decisions. Traditional risk stratification systems rely on clinical parameters but may miss crucial genetic insights. The Prostatype® score (P-score) integrates gene expression with clinical data to improve PCa risk assessment precision.</div></div><div><h3>Objectives</h3><div>To validate the P-score’s predictive performance for prostate cancer-specific mortality (PCSM) and metastasis in a Spanish cohort, comparing it with NCCN, D’Amico, and EAU systems.</div></div><div><h3>Materials and methods</h3><div>This study was multicentre, retrospective and included seven Spanish hospitals. Of 154 core needle biopsies, 93 met RNA criteria, and for those, P-score was calculated based on IGFBP3, VGLL3, and F3 genes expression and clinical data.</div><div>The primary endpoint was PCa-specific mortality (PCSM), with secondary endpoints being development of metastasis, adverse pathology (AP), and International Society of Urological Pathology (ISUP) grading.</div></div><div><h3>Results</h3><div>The P-score demonstrated superior accuracy in predicting 10-year PCSM, with an AUC of 0.81 and a C-index of 0.75, outperforming NCCN (AUC 0.77, C-index 0.69) and D’Amico/EAU (AUC 0.70, C-index 0.62). For metastasis prediction, the P-score achieved a C-index of 0.77, significantly higher than NCCN, D’Amico, and EAU (0.58). Kaplan–Meier analysis underscored the P-score’s ability to better stratify patients by risk, especially high-risk groups. Additionally, the P-score correlated with tumour burden, showing significant associations with positive biopsy cores (p = 0.017) and ISUP grade at radical prostatectomy (p = 0.0028).</div></div><div><h3>Conclusions</h3><div>In this Spanish cohort, the P-score outperformed traditional clinicopathological systems in predicting PCSM, development of metastasis, and pathological markers, supporting its clinical utility for more personalised PCa management.</div></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"49 6","pages":"Article 501788"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152535","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}