Clinical genitourinary cancer最新文献

{"title":"Impact of Proton Pump Inhibitor Use on the Efficacy of IO–IO Versus IO–TKI Therapy in Metastatic Renal Cell Carcinoma","authors":"Lan Inoki ,&nbsp;Shingo Toyoda ,&nbsp;Wataru Fukuokaya ,&nbsp;Takafumi Yanagisawa ,&nbsp;Teruo Inamoto ,&nbsp;Takuhisa Nukaya ,&nbsp;Kiyoshi Takahara ,&nbsp;Takuya Tsujino ,&nbsp;Ryoichi Maenosono ,&nbsp;Kazumasa Komura ,&nbsp;Kensuke Bekku ,&nbsp;Motoo Araki ,&nbsp;Takehiro Iwata ,&nbsp;Kazutoshi Fujita ,&nbsp;JK-FOOT study group","doi":"10.1016/j.clgc.2025.102500","DOIUrl":"10.1016/j.clgc.2025.102500","url":null,"abstract":"<div><h3>Basckground</h3><div>Immune checkpoint inhibitor (ICI)-based combination therapies have become the standard first-line treatment for metastatic renal cell carcinoma (mRCC). Proton-pump inhibitors (PPIs), frequently used to treat gastrointestinal conditions, have been implicated in modulating ICI efficacy, potentially through gut microbiome dysbiosis. However, the impact of PPIs on ICI-based therapies for mRCC remains unclear.</div></div><div><h3>Methods</h3><div>This multicenter retrospective cohort study analyzed 427 patients with mRCC classified as intermediate or poor risk according to the IMDC criteria treated with first-line IO-IO (ipilimumab plus nivolumab) or IO-TKI (ICI plus tyrosine kinase inhibitor) therapies. Patients were stratified by PPI use during the 30 days before and including the day of ICI initiation. Overall survival (OS), progression-free survival (PFS), and objective response rate (ORR) were compared between PPI users and nonusers.</div></div><div><h3>Results</h3><div>PPI use was significantly associated with shorter OS in patients receiving IO-IO therapy (median OS, 23.34 months vs. not reached; <em>P</em> = .002), but not in those receiving IO-TKI therapy (<em>P</em> = .909). Multivariate analysis confirmed PPIs as an independent prognostic factor for OS in the IO-IO group (HR, 1.647; 95% CI, 1.007-2.693; <em>P</em> = .046). No significant differences in PFS or ORR were observed between PPI users and nonusers in either group, although the complete response rate was notably lower in PPI users treated with IO-IO (1.6% vs. 10.3%; <em>P</em> = .025).</div></div><div><h3>Conclusions</h3><div>PPI use was associated with inferior survival in mRCC patients receiving IO-IO therapy, potentially through microbiome modulation and other immunologic or clinical mechanisms; however, these findings are based on retrospective data and should be regarded as hypothesis-generating. Caution is advised when prescribing PPIs to patients undergoing ICI-based therapy, particularly IO-IO regimens, and prospective studies are needed to confirm whether avoiding unnecessary PPI use can improve clinical outcomes.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102500"},"PeriodicalIF":2.7,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Main Genomic Findings in Penile Cancer: An Update","authors":"Herney Andrés García-Perdomo ,&nbsp;Scott Tagawa","doi":"10.1016/j.clgc.2025.102493","DOIUrl":"10.1016/j.clgc.2025.102493","url":null,"abstract":"<div><div>Penile squamous cell carcinoma (PSCC) is a rare but highly heterogeneous malignancy accounting for over 95% of penile cancers. While it is more prevalent in regions such as South America, parts of Africa, and South Asia, its global rarity has historically limited molecular research. Recent advances in high-throughput sequencing have enabled the detailed genomic and epigenomic characterization of HPV-associated and HPV-independent carcinogenesis, unveiling critical differences between these two processes. These discoveries are reshaping classification, prognosis, and therapeutic decision-making in PSCC</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102493"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of PD-L1 and PD-1 Expression With Clinicopathological Characteristics and Prognosis in Upper Tract Urothelial Carcinoma","authors":"Peng Li ,&nbsp;Xiaolei Zhang ,&nbsp;Xiao Yang ,&nbsp;Hai Li ,&nbsp;Guoxin Song ,&nbsp;Qiang Lu ,&nbsp;Li Pengchao","doi":"10.1016/j.clgc.2025.102497","DOIUrl":"10.1016/j.clgc.2025.102497","url":null,"abstract":"<div><h3>Introduction</h3><div>To investigate the expression of PD-L1/PD-1 in tumor cells and tumor-infiltrating immune cells (TIICs) and their association with clinicopathologic characteristics and prognosis in UTUC.</div></div><div><h3>Patients and Methods</h3><div>Immunohistochemistry (IHC) was performed to detect the expression of PD-L1 and PD-1 in 124 formalin-fixed paraffin embedded tumor specimens in UTUC. Clinicopathological variables and overall survival (OS) were documented. Association between PD-L1, PD1 with clinicopathologic characteristics and OS were evaluated using binary logistic regression or Cox regression. Statistical significance was considered at 0.05.</div></div><div><h3>Results</h3><div>Of 113 eligible patients (11 excluded due to insufficient tissue), 31.9% (36/113) showed PD-L1⁺ tumor cells, and 28.8% (29/101) had PD-L1⁺ TIICs. PD-1⁺ TIICs were observed in 58.4% (59/101). PD-L1 expression in tumor cells correlated significantly with high tumor grade (<em>P</em> = .029). PD-L1⁺ tumor cells predicted reduced OS in univariate (HR = 1.83, <em>P</em> = .025) and multivariable analyses (HR = 2.15, <em>P</em> = .007). PD-1⁺ TIICs associated with early-stage disease (<em>P</em> = .005) but not OS (<em>P</em> = .166). PD-L1⁺ TIICs also showed no OS association (<em>P</em> = .644).</div></div><div><h3>Conclusions</h3><div>PD-L1 is expressed in 31.9% of UTUC tumors and 28.8% of TIICs, while PD-1 is detected in 58.4% of TIICs. Tumor cell PD-L1 positivity independently predicts poor survival and may drive UTUC progression. PD-1⁺ TIICs correlate with early-stage disease but lack prognostic value for OS. These findings highlight PD-L1 as a potential biomarker for risk stratification in UTUC.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102497"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146026255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Physician Documentation of Patients’ Prostate-Specific Antigen Doubling Time Affect Treatment Decisions in High-Risk Biochemically Recurrent Prostate Cancer?","authors":"Alicia K. Morgans ,&nbsp;Maelys Touya ,&nbsp;Nader El-Chaar ,&nbsp;Dina ElSouda ,&nbsp;Lisa Mucha ,&nbsp;Krishnan Ramaswamy ,&nbsp;Kelechi L. Adejumo ,&nbsp;Tammy Schuler ,&nbsp;Jason Sharpe ,&nbsp;Bruce Feinberg ,&nbsp;Parisa Asgarisabet ,&nbsp;Prathamesh Pathak ,&nbsp;Stephen J. Freedland","doi":"10.1016/j.clgc.2025.102496","DOIUrl":"10.1016/j.clgc.2025.102496","url":null,"abstract":"<div><h3>Introduction</h3><div>Nearly half of patients with prostate cancer experience biochemical recurrence (BCR) within 10 years after definitive treatment. Among them, patients with high-risk BCR are those who have a prostate-specific antigen (PSA) doubling time (PSADT) of ≤ 9 months, which is one of the strongest predictors of poor outcomes. This study aimed to define characteristics and treatment patterns among patients whose PSADT was documented or undocumented by treating physicians at the time of high-risk BCR diagnosis.</div></div><div><h3>Patients and Methods</h3><div>Participating physicians from the United States Cardinal Health Oncology Provider Extended Network abstracted medical record data of patients with high-risk BCR into electronic case report forms (index: 2018-2020; follow-up through 2022). Physicians reported PSADT values at index using labs, clinical judgment, or online calculation. If not provided, PSADT was retrospectively calculated using PSA data from the case report forms. Baseline characteristics and treatment patterns were compared between patients with documented versus undocumented PSADT.</div></div><div><h3>Results</h3><div>Among 284 patients, PSADT was not documented by treating physicians in 180 patients (63%) at the time of high-risk BCR diagnosis. For the 104 patients (37%) for whom PSADT was documented, physicians often overestimated PSADT compared with retrospective calculations based on validated tools, underestimating progression risk. Notably, patients with documented PSADT had a significantly shorter median time to treatment than those with undocumented PSADT (1.0 vs. 6.7 months; hazard ratio: 3.4; 95% confidence interval: 2.6-4.4; <em>P</em> &lt; .0001).</div></div><div><h3>Conclusion</h3><div>Many patients with high-risk BCR may be unidentified in practice despite widespread availability of PSADT calculators to characterize risk. Physicians that document PSADT are more likely to prescribe treatment early, despite underestimating progression risk (ie, overestimating PSADT). Efforts should be made to improve consistent, accurate PSADT calculation and documentation by physicians to inform treatment decision-making for management of high-risk BCR.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102496"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Signet Ring and Non-Signet Ring Urachal Adenocarcinomas: A National Cancer Database Study","authors":"Deerush Kannan Sakthivel,&nbsp;Pushan Prabhakar,&nbsp;Mohamed Javid Raja Iyub,&nbsp;Rohan Garje,&nbsp;Murugesan Manoharan","doi":"10.1016/j.clgc.2025.102495","DOIUrl":"10.1016/j.clgc.2025.102495","url":null,"abstract":"<div><h3>Introduction</h3><div>Primary urachal adenocarcinomas are rare and histologically diverse. Signet ring cell carcinoma (SRCC), a poorly cohesive and aggressive variant, is associated with poor prognosis compared to non-signet ring urachal adenocarcinoma (UA). This study aims to compare the clinicopathologic features, treatment patterns, and survival outcomes between SRCC and UA.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from the National Cancer Database (2004-2020), including patients aged ≥ 18 with SRCC or non-signet ring UA located at the bladder dome. Demographics, staging, treatment modalities, and overall survival (OS) were compared using chi-square tests and Kaplan–Meier analysis.</div></div><div><h3>Results</h3><div>Among 550 patients, 60 had SRCC and 490 had non-signet ring UA. Baseline characteristics were comparable, though SRCC cases showed more frequent under-staging and treatment at community centers. Median OS was significantly shorter for SRCC (29.6 vs. 79.0 months, <em>P</em> &lt; .001). Partial cystectomy conferred better survival than radical cystectomy in both groups. Chemotherapy did not improve outcomes in SRCC and was associated with worse survival in UA, likely due to selection bias.</div></div><div><h3>Conclusion</h3><div>SRCC of the urachus is a biologically distinct subtype with significantly worse outcomes than non-signet ring UA, regardless of surgical approach. Histology-specific strategies are needed to improve survival in this rare, aggressive cancer.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102495"},"PeriodicalIF":2.7,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic Prostate Cancer with Low-Volume Primary Tumors – A National Cancer Database Analysis on Metastasis Profile and Survival Outcomes","authors":"Mohamed Javid Raja Iyub ,&nbsp;Pushan Prabhakar ,&nbsp;Deerush Kannan Sakthivel ,&nbsp;Aditi Chandrasekaran ,&nbsp;Rohan Garje ,&nbsp;Murugesan Manoharan","doi":"10.1016/j.clgc.2025.102494","DOIUrl":"10.1016/j.clgc.2025.102494","url":null,"abstract":"<div><h3>Introduction</h3><div>A tumor confined within the prostate gland is termed localized prostate cancer (PCa). However, metastasis could rarely develop in such low-volume primary tumors. The nature of these metastatic prostate cancers with low-volume primary tumors is largely underexplored. The objective of our study was to analyze the baseline characteristics, metastatic patterns, and survival outcomes of this condition from the National Cancer Database (NCDB).</div></div><div><h3>Methods</h3><div>Data from patients diagnosed with metastatic prostate cancer with low-volume primary tumors between 2004 and 2021 were analyzed for patient characteristics, metastatic trends, variations by histopathology type, and survival outcomes. Multivariable logistic regression was used to identify various factors associated with this condition. Survival outcomes were evaluated using the Kaplan–Meier analysis.</div></div><div><h3>Results</h3><div>A total of 1,613,004 individuals diagnosed with clinically localized PCa were analyzed. Among them, 45,010 patients had distant metastasis. The most common site of metastasis was bone, followed by lung, liver, and brain. The most common histopathology type was adenocarcinoma (94.3%). The median overall survival (OS) of metastatic prostate cancer with low-volume primary tumors was 37.13 (95% Confidence Interval (CI), 36.57-37.68) months. The best OS in single-site metastasis was seen in lung metastasis (median OS: 54.34 [95% CI, 42.10-66.58] months), and the worst was seen in liver metastasis (median OS: 18.17 [95% CI, 12.70-23.63] months). Adenocarcinoma had a better prognosis (median OS: 38.51 [95% CI, 37.91-39.10] months) than non-adenocarcinoma (median OS: 17.58 [95% CI, 16.40-18.75] months). All results had a <em>P</em>-value less than .001.</div></div><div><h3>Conclusion</h3><div>This comprehensive analysis reveals that metastatic prostate cancer with low-volume primary tumors is relatively uncommon (2.8% of ≤ T2 disease), with bone being the most common metastatic site. Isolated metastasis in the lungs and adenocarcinoma had better OS among the metastasis sites and histopathology type, respectively.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102494"},"PeriodicalIF":2.7,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146026254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integral Approach in the Follow-up of Prostate Cancer Patients: SOGUG Multidisciplinary Expert Panel Insights","authors":"María José Méndez-Vidal ,&nbsp;Enrique Gallardo ,&nbsp;Alfonso Gómez de Iturriaga ,&nbsp;Fernando López Campos ,&nbsp;Claudio Martínez Ballesteros ,&nbsp;Julia Ruiz Vozmediano ,&nbsp;Aránzazu González-del-Alba ,&nbsp;Jesús Muñoz-Rodríguez","doi":"10.1016/j.clgc.2025.102489","DOIUrl":"10.1016/j.clgc.2025.102489","url":null,"abstract":"<div><div>Prostate cancer (PCa) is the most common malignancy in men in the majority of countries globally and although most cases follow an indolent course, the disease is heterogeneous with some patients exhibiting an aggressive clinical course with progression and metastasis. Castration-resistant metastatic disease has an overall poor prognosis with most patients dying within 2 years of diagnosis. The diagnosis, treatment, and monitoring strategies of patients with PCa have experienced remarkable improvements due to advances in genetic biomarkers, novel imaging techniques, androgen receptor (AR) signaling targeting agents, next-generation chemotherapeutic drugs, bone-seeking agents, poly (ADP-ribose) polymerase (PARP) inhibitors and therapeutic radiopharmaceuticals. All these new therapeutic options are added to standard radiation therapy and radical surgical procedures. However, the treatment outcomes of PCa can be improved by understanding the current therapeutic options and their appropriate sequencing use. Hence, a panel of experts summarized the current challenges in optimizing management, monitoring patients and assessing treatment response across different risk groups and tumor stages. Treatment-decision making in the framework of multidisciplinary teams, better understanding of the patient journey, and identification of unmet needs for improving quality of life are essential considerations in the managing patients in the real-world setting.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102489"},"PeriodicalIF":2.7,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146076074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Oncologic Outcomes of Cryoablation, Laser Ablation, and Hyperthermia for Localized Prostate Cancer: A Population-Based Cohort Study Using the SEER Database","authors":"Run-Qi Guo,&nbsp;Jie Sun,&nbsp;Zhi-Xin Bie,&nbsp;Yuan-Ming Li","doi":"10.1016/j.clgc.2025.102490","DOIUrl":"10.1016/j.clgc.2025.102490","url":null,"abstract":"<div><h3>Objective</h3><div>Ablative therapies, including cryoablation (CA), laser ablation (LA), and hyperthermia (HT), are increasingly used for localized prostate cancer, but large-scale comparative evidence on their long-term oncologic outcomes is scarce. This study aimed to compare cancer-specific survival (CSS) and overall survival (OS) among patients treated with these modalities.</div></div><div><h3>Methods</h3><div>Using the Surveillance, Epidemiology, and End Results (SEER) database (2000-2019), we identified patients with localized prostate cancer treated with CA, LA, or HT between 2010 and 2019. Propensity score matching (PSM) at a 1:1 ratio was performed to balance baseline characteristics. OS and CSS were estimated using the Kaplan–Meier method, and competing risk analysis was performed to assess cancer-specific mortality (CSM) and other-cause mortality (OCM).</div></div><div><h3>Results</h3><div>After PSM, 712 patients per group were compared between CA and LA. No significant difference was observed in CSS (Hazard Ratio [HR] = 1.58, 95% Confidence Interval [CI] 0.94-2.66; <em>P</em> = .083) or OS (HR = 1.09, 95% CI, 0.88-1.35; <em>P</em> = .481). The median follow-up was 64 months, with 18 and 23 cancer-specific deaths in the CA and LA groups, respectively. In comparisons involving HT (<em>n</em> = 107 per group post-PSM), no statistically significant differences in survival were detected against CA or LA. However, these HT-related findings must be interpreted with extreme caution due to the significant heterogeneity of the HT category, the small sample size, and resulting low statistical power.</div></div><div><h3>Conclusion</h3><div>In this large population-based study, CA and LA demonstrated comparable long-term oncologic outcomes for localized prostate cancer. While no survival differences were detected for HT, definitive conclusions cannot be drawn for this modality due to major methodological limitations. Further prospective, well-designed randomized controlled trials are essential to validate these findings and provide more robust evidence.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102490"},"PeriodicalIF":2.7,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Urologists and/or Radiation Oncologists Biased when Reporting of Advantages and Disadvantages of Surgery versus Radiation in Consultations for Early-Stage Prostate Cancer?","authors":"Nadine A. Friedrich ,&nbsp;Michael Luu ,&nbsp;Rebecca Gale ,&nbsp;Antwon Chaplin ,&nbsp;Reva Polineni ,&nbsp;Alex Shiang ,&nbsp;Dong Shin ,&nbsp;Stephen J. Freedland ,&nbsp;Brennan Spiegel ,&nbsp;Leslie K. Ballas ,&nbsp;Paul Kokorowski ,&nbsp;Timothy J. Daskivich","doi":"10.1016/j.clgc.2025.102486","DOIUrl":"10.1016/j.clgc.2025.102486","url":null,"abstract":"<div><h3>Background</h3><div>Treatment choice for early-stage prostate cancer (PC) is strongly influenced by the counseling physician's specialty. Whether a physician’s specialty biases how treatment advantages and disadvantages are presented in consultations is unclear. To investigate this, we analyzed content discussed by urologists and radiation oncologists when comparing radical prostatectomy and radiation therapy in PC consultations.</div></div><div><h3>Methods</h3><div>Consultations of 39 men with nonmetastatic PC across 6 urologists and radiation oncologists were recorded and transcribed. Analysts thematically characterized statements comparing advantages and disadvantages of surgery versus radiation (and vice versa) using an open coding approach. Frequency of thematic content by specialty was reported at a consultation level. Themes exceeding 10% and differing by ≥ 25% between specialties were reported.</div></div><div><h3>Results</h3><div>Our dataset included 1171 statements from 28 Urology and 11 Radiation Oncology consults. Major themes discussed included side effects (90%), cancer control (84%), convenience (56%), salvage options (48%) and invasiveness (43%). Differences in content between specialties were observed for all themes except convenience. For side effects, radiation oncologists (vs. urologists) more often noted that radiation has better urinary (55% vs. 0%) and erectile side effects than surgery (37% vs. 0%). For salvage therapy, urologists more often mentioned inability to get radiation twice (32% vs. 0%) and difficulties with salvage prostatectomy (36% vs. 0%). For cancer control, urologists more often noted long-term data on surgery outcomes as an advantage of surgery (25% vs. 0%). For invasiveness, radiation oncologists more often described radiation as less invasive (36% vs. 11%).</div></div><div><h3>Conclusions</h3><div>While specialists acknowledge obvious limitations of their treatments, they selectively highlight advantages of their procedures and the disadvantages of competing treatments.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 2","pages":"Article 102486"},"PeriodicalIF":2.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Treatment and Survival in Locally Advanced Prostate Cancer: Real-World Outcomes","authors":"Anne Holck Storås ,&nbsp;Kaitlyn M Tsuruda ,&nbsp;Tor Åge Myklebust ,&nbsp;Erik S Haug ,&nbsp;Sophie D Fosså ,&nbsp;Bettina Kulle Andreassen","doi":"10.1016/j.clgc.2025.102480","DOIUrl":"10.1016/j.clgc.2025.102480","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate real-world postoperative treatment patterns and survival outcomes among men with nonmetastatic locally advanced prostate cancer (laPCa) undergoing radical prostatectomy (RP) to improve the shared decision-making process.</div></div><div><h3>Material and Methods</h3><div>All 3022 patients diagnosed with laPCa prostate cancer and registered in Cancer registry of Norway (CRN) who underwent RP within 1 year after diagnosis during 2008-21 were included. Data on disease characteristic’s and radiotherapy were derived from the CRN and data on endocrine treatment and additional systemic therapy (docetaxel, abiraterone, enzalutamide) were provided from the Norwegian Prescription Database and the Norwegian Patient Registry. Cause-specific mortality was estimated using a competing risk framework. Overall survival was calculated as 1 minus the all-cause mortality. The cumulative probability of starting postoperative treatment for relapse was also calculated.</div></div><div><h3>Results</h3><div>Median follow-up was 4.8 years. Within 10 years post-RP, 34% received postoperative radiotherapy, 19% received endocrine therapy as first treatment, and 14% received additional systemic therapy. Higher PSA, cT3b stage, and ISUP grade 4 to 5 were associated with increased likelihood of postoperative treatment. The 10-year overall mortality was 16%, with most deaths from non-prostate cancer causes. Patients receiving postoperative radiotherapy had low 10-year prostate cancer-specific mortality (2%), whereas those starting endocrine therapy first experienced higher prostate cancer mortality (31%). Among patients progressing to systemic therapy, 5-year mortality was 65%, predominantly due to prostate cancer.</div></div><div><h3>Conclusion</h3><div>In this large, unselected national cohort, laPCa patients treated with RP had generally favorable long-term survival, but more than half required relapse-directed therapy within 10 years. Relapse risk was strongly linked to baseline tumor characteristics and persisted throughout follow-up, underscoring the need for prolonged surveillance. Future studies should address long-term functional outcomes and quality-of-life after multimodal postoperative treatment.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102480"},"PeriodicalIF":2.7,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}