Clinical genitourinary cancer最新文献

{"title":"Gleason Score 3 + 4 (Grade Group 2) Prostate Cancer on Biopsy and Postoperative Pathological Upgrading: A Systematic Review and Meta-Analysis","authors":"Shulin Wu ,&nbsp;Sharron X. Lin ,&nbsp;Adam S. Feldman ,&nbsp;Chin-Lee Wu ,&nbsp;Douglas M. Dahl","doi":"10.1016/j.clgc.2025.102461","DOIUrl":"10.1016/j.clgc.2025.102461","url":null,"abstract":"<div><div>The clinical heterogeneity of needle biopsy (Bx)3 + 4 presents uncertainty to active surveillance as a treatment option for prostate cancer (PCa) patients. This meta-analysis demonstrates that 23.4% of Bx3 + 4 were upgraded at radical prostatectomy (RP). Age, cT, PI-RADS, greatest percentage of cancer involvement in biopsy (GPC) and number of positive cores are independent upgrading predictors, while Bx approaches showed no significant difference. Current guidelines recognize active surveillance as a treatment option for patients with intermediate-risk (IR)-PCa including selected cases with a diagnosis of Bx3 + 4. However, the upgrading of Bx3 + 4 in the RP is a critical but unaddressed concern. We investigated pathological RP upgrading from Bx3 + 4 and assessed its impact on oncological outcomes. A systematic literature search was performed up to February 2025 to identify the eligible studies discussing Bx3 + 4 on adverse RP pathology. Meta-analyses were performed on parameters with available information. Forty-eight studies comprising 63,119 patients with matched Bx3 + 4 and subsequent RP pathology were included. The median incidence of Bx3 + 4 upgraded to RP ≥ 4 + 3 and to RP ≥ 8 was 23.4% (IQR: 18.3%-23.7%) and 3.6% (IQR: 2.7%-4.9%), respectively. Age, cT, PI-RADS, GPC and No. positive cores were identified as independent and significant predictors for upgrading in Meta-analyses. No significant differences in upgrading were observed between systematic Bx (SBx) and MRI-targeted biopsy (TBx) methods or Transrectal (TR) and transperineal (TP) approaches<em>.</em> RP upgrading from Bx3 + 4 occurred in 23.4% cases, who may have a significantly worse biochemical recurrence survival. Different Bx methods did not make a significant impact on the rate of Bx3 + 4 to RP ≥ 4 + 3 upgrading.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102461"},"PeriodicalIF":2.7,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607363","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":"Metastasis Profile and Survival Outcomes of Metastatic Non-Muscle Invasive Bladder Cancer: A National Cancer Database Analysis","authors":"Mohamed Javid Raja Iyub ,&nbsp;Pushan Prabhakar ,&nbsp;Deerush Kannan Sakthivel ,&nbsp;Aditi Chandrasekaran ,&nbsp;Manuel Ozambela Jr ,&nbsp;Murugesan Manoharan","doi":"10.1016/j.clgc.2025.102462","DOIUrl":"10.1016/j.clgc.2025.102462","url":null,"abstract":"<div><h3>Introduction</h3><div>Metastatic non-muscle invasive bladder cancer (mNMIBC) is a condition in which bladder cancer patients develop metastasis in the absence of muscle invasion. The nature of mNMIBC is understudied due to its recent increased recognition. The study aimed to analyze the baseline characteristics, metastatic patterns, and survival outcomes of this condition.</div></div><div><h3>Methods</h3><div>A retrospective analysis of the National Cancer Database (NCDB) (2004-2021) was done to identify NMIBC patients who presented with distant metastasis at diagnosis, as defined in the NCDB. The patient characteristics, metastatic trends, and survival outcomes were analyzed. Multivariable logistic regression was performed to identify the variables associated with mNMIBC. Cox proportional hazards regression and Kaplan–Meier analysis were used to analyze the survival outcomes (overall survival).</div></div><div><h3>Results</h3><div>Among the 537,674 patients diagnosed with NMIBC, 3982 (0.74%) patients had metastasis. The most common sites of metastasis were the bone (15.3%), followed by the lung (13.6%), liver (7.1%), and brain (0.9%). Furthermore, 15.1% of patients had multiple metastases. The median overall survival (OS) for mNMIBC was 6.54 months (95% Confidence Interval [CI]: 6.04-7.03). The OS was poorer among patients with metastasis to multiple sites (median OS: 3.55 months; 95% CI, 3.05-4.04) compared to those with metastasis to a single site. The best OS in isolated metastasis was seen in lung metastasis (median OS: 8.48 months; 95% CI, 6.68-10.27), and the worst OS was seen in liver metastasis (median OS: 3.70 months; 95% CI, 2.80-4.56<strong>).</strong> Older age, higher Charlson comorbidity score, and non-urothelial histology were associated with worse OS (<em>P</em> &lt; .05).</div></div><div><h3>Conclusion</h3><div>mNMIBC is an uncommon condition with poor OS. Metastases to multiple sites have a poorer prognosis than metastases to a single site. Among the single-site metastases, the most common metastatic site was bone, and the best OS was seen in lung metastasis.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102462"},"PeriodicalIF":2.7,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552381","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":"Predictors of Survival and Recurrence After Partial or Radical Nephrectomy in Women with Localized Renal Cell Carcinoma: A Multicenter Analysis","authors":"Mai R. Dabbas ,&nbsp;Melis Guer ,&nbsp;Giacomo Musso ,&nbsp;Giuseppe Garofano ,&nbsp;Margaret F. Meagher ,&nbsp;Dhruv Puri ,&nbsp;Kit L. Yuen ,&nbsp;Umberto Capitanio ,&nbsp;Alessandro Larcher ,&nbsp;Cesare Saitta ,&nbsp;Breanna Kim ,&nbsp;Sanjana Karamcheti ,&nbsp;Benjamin H. Baker ,&nbsp;Kazutaka Saito ,&nbsp;Yosuke Yasuda ,&nbsp;Dattatraya Patil ,&nbsp;Alberto Briganti ,&nbsp;Andrea Salonia ,&nbsp;Yasuhisa Fujii ,&nbsp;Viraj Master ,&nbsp;Ithaar H. Derweesh","doi":"10.1016/j.clgc.2025.102460","DOIUrl":"10.1016/j.clgc.2025.102460","url":null,"abstract":"<div><h3>Introduction</h3><div>Renal cell carcinoma (RCC) is marked by significant gender differences in incidence. While RCC is more common in men, limited data exist on survival outcomes in women following surgery. We investigated survival outcomes and predictive factors in women with localized RCC.</div></div><div><h3>Patients and Methods</h3><div>We conducted a retrospective multicenter analysis of women who underwent surgery for Stage I–III RCC. Primary outcome was recurrence. Multivariable Cox regression assessed predictors of All-Cause Mortality (ACM), Cancer-Specific Mortality (CSM), and recurrence. Kaplan–Meier analysis (KMA) evaluated overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) across racial/ethnic groups.</div></div><div><h3>Results</h3><div>We analyzed 3218 women (median age 61 years; follow-up 63 months), with 454 (14.1%) experiencing recurrence. On multivariable analysis, high Charlson score (HR 1.89, <em>P</em> &lt; .001), AJCC stage II/III (HR 2.44, <em>P</em> &lt; .001), high-grade (HR 2.24, <em>P</em> &lt; .001), and positive margins (HR 2.02, <em>P</em> &lt; .001) were associated with recurrence. Black race (HR 0.68, <em>P</em> = .046) and chromophobe histology (HR 0.32, <em>P</em> = .002) were protective. For ACM, increasing age (HR 1.04, <em>P</em> &lt; .001), High/Intermediate Charlson score (HR 1.52, HR 1.34: <em>P</em> = .006, <em>P</em> &lt; .001), AJCC stage II/III (HR 1.46, <em>P</em> &lt; .001), high-grade (HR 1.51, <em>P</em> &lt; .001), GFR &lt;45 (HR 1.63, <em>P</em> &lt; .001), recurrence (HR 1.45, <em>P</em> &lt; .001) were predictive, while Asian (HR 0.40, <em>P</em> &lt; .001) and Hispanic (HR 0.53, <em>P</em> = .048) race were protective. CSM was associated with age (HR 1.04, <em>P</em> &lt; .001), AJCC stage II/III (HR 2.06, <em>P</em> = .006), high-grade (HR 1.62, <em>P</em> &lt; .001), and recurrence (HR 5.38, <em>P</em> &lt; .001); Asian race (HR 0.52, <em>P</em> &lt; .001) was protective. KMA showed significant differences in OS and CSS (<em>P</em> &lt; .001), but not RFS (<em>P</em> = .136).</div></div><div><h3>Conclusion</h3><div>In addition to known clinico-pathologic predictors, ethno-racial differences were noted in survival and recurrence among women with RCC. Recurrence was a major determinant of mortality. Black women had lower recurrence risk, while Asian and Hispanic women had improved survival. These findings highlight the influence of systemic disparities beyond tumor biology.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102460"},"PeriodicalIF":2.7,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598253","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":"Aggressive Paratesticular Spindle Cell Rhabdomyosarcoma in an Adult: A Rare Case and Review of Reported Adult Cases","authors":"İsmail Bayrakçı ,&nbsp;İvo Gökmen ,&nbsp;Elif Mercan Demirtaş ,&nbsp;Didem Divriklioğlu ,&nbsp;Tayyip İlker Aydın ,&nbsp;Muhammet Bekir Hacıoğlu","doi":"10.1016/j.clgc.2025.102459","DOIUrl":"10.1016/j.clgc.2025.102459","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>What is already known about this topic?</div><div>Paratesticular spindle cell rhabdomyosarcoma (RMS) is an extremely rare histological subtype of soft tissue sarcoma in adults. Most available data come from pediatric populations, and adult cases are limited to sporadic case reports. Due to its rarity, there is no consensus on the optimal management strategy for adult patients.</div></span></li><li><span>•</span><span><div>What this study adds?</div><div>This case report presents a rare adult patient with paratesticular spindle cell RMS, highlighting the diagnostic challenges, pathological features, and treatment course, including surgery and adjuvant chemotherapy. By comparing this case with previously reported adult cases in the literature, this study provides valuable insights into prognosis and therapeutic approaches for this uncommon entity in adults.</div></span></li></ul></div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102459"},"PeriodicalIF":2.7,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519001","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":"A Multi-Center Comparative Analysis of the G8-Score and Charlson Comorbidity Index as General Health Assessment Tools in Older Patients With Prostate Cancer","authors":"Brecht Chys ,&nbsp;Philip R. Debruyne ,&nbsp;Lore Decoster ,&nbsp;Cindy Kenis ,&nbsp;Hans Wildiers ,&nbsp;Diederik Ponette ,&nbsp;Steven Joniau","doi":"10.1016/j.clgc.2025.102454","DOIUrl":"10.1016/j.clgc.2025.102454","url":null,"abstract":"<div><h3>Introduction</h3><div>Frail and older patients who develop prostate cancer (PCa), are at risk of overtreatment. Multiple general health assessment (GHA) tools have been validated in oncology. we aim to validate and compare the performance of the G8 screening tool, age and Charlson Comorbidity Index (CCI) as a predictor of overall survival (OS) in men older than 70 years with a newly diagnosed prostate cancer. Is it possible to identify a CCI cut-off indicative for frailty?</div></div><div><h3>Patients and methods</h3><div>Between 2009 and 2015, a national multicenter initiative on geriatric screening and GHA’s took place in Belgium. Baseline characteristics were collected on the date of inclusion on which a specialist nurse completed multiple GHA questionnaires for each patient. We performed a sub analysis on the prostate cancer (<em>n</em> = 182) cohort, ≥ 70 years old. GHA’s were compared through multivariate-, Kaplan-Meier- and sensitivity analysis. If indicated, Case-control matching was applied to reduce variate heterogeneity. Ten-year OS is the primary endpoint.</div></div><div><h3>Results</h3><div>Men with a G8-score of ≤14 points had a significantly worse OS both in the unmatched: 86.8 months (95% CI: 70.5-103.1) vs. 137.9 months (95% CI: 129.4-146.4) (<em>P</em> &lt; .001) and matched population: 99.3 months (95% CI 81.9-116.73) vs. 136.0 months (95% CI: 121.8-150.2) (<em>P</em> &lt; .05). Defining frailty as the presence of comorbidities (CCI ≥ 1 point) shows inferior (HR:1.3, 95% CI: 0.8-2.1—AUC: 0.583) accuracy compared to the G8-score (HR 2.9, 95% CI 1.8-4.5—AUC: 0.715). If the frailty threshold of the CCI is raised to ≥ 2 points, accuracy is matched (HR 4.9, 95% CI 2.8-8.4—AUC 0.735).</div></div><div><h3>Conclusion</h3><div>This multicenter analysis validates the predictive value of the G8-score and CCI on OS in newly diagnosed PCa in the older patient. Both GHA’s appear more accurate than age. A CCI ≥ 2 points approximates the sensitivity of G8 defined frailty. External validation of these findings is needed.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 6","pages":"Article 102454"},"PeriodicalIF":2.7,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454263","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":"Regional Lymph Node Dissection is associated with Improved Survival for Patients with Urothelial Cell Carcinoma Undergoing Definitive Surgery","authors":"Abigail Kohut-Jackson,&nbsp;Madison Schanz,&nbsp;Julian Giakas,&nbsp;Paula Buchanan,&nbsp;Krithika Kumanan,&nbsp;Luke Wang,&nbsp;Zachary Hamilton","doi":"10.1016/j.clgc.2025.102456","DOIUrl":"10.1016/j.clgc.2025.102456","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate practice patterns and overall survival outcomes for the performance of radical nephroureterectomy or ureterectomy stratified by utilization of lymph node dissection (LND) for patients with upper tract urothelial cell carcinoma.</div></div><div><h3>Methods</h3><div>The National Cancer Database was queried for patients with upper tract urothelial cell carcinoma, cTanyN0M0 and cTanyN+M0, stratified by LND (pN0-1) versus no lymph node dissection (pNx) from 2006 to 2016. 17,455 patients met criteria for analysis; 9365 patients had primary renal tumors, and 8090 patients had primary ureteral tumors. We retrospectively analyzed trends in overall survival and 30- and 90-day mortality.</div></div><div><h3>Results</h3><div>In the 9365 patients with primary renal or renal pelvis tumors, 48.8% underwent LND with 5.2% having pN+ disease. LND was associated with improved overall survival when compared with no LND (62.3% vs. 57.3%, <em>P</em> &lt; .001). In the 8090 patients with primary ureteral tumors, 50.9% underwent LND and 3.6% had pN+ disease. Similarly, LND was associated with improved overall survival when compared with no LND (61.4% vs. 50.3%, <em>P</em> &lt; .001). Multivariate analysis also demonstrated significant lower overall mortality in ureteral patients undergoing LND controlled for patient and clinical characteristics. Furthermore, in the ureteral group, patients with pN0 disease had improved 5-year-survival compared to pNx disease.</div></div><div><h3>Conclusions</h3><div>LND in the setting of radical nephroureterectomy or ureterectomy has been historically underutilized, with less than half of patients with primary renal or primary ureteral tumors receiving LND from 2006 to 2016. Our analysis demonstrates a potential decreased mortality associated with LND for patients with upper tract urothelial cell carcinoma, notably in those with ureteral tumors, regardless of patient and clinical characteristics.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102456"},"PeriodicalIF":2.7,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524517","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":"Comparisons of Pembrolizumab Plus Lenvatinib, Nivolumab Plus Cabozantinib, and Cabozantinib Monotherapy in Advanced Non-Clear Cell Renal Cell Carcinoma Based on Individual Patient Data Reconstruction","authors":"Wei Chen ,&nbsp;Hajime Tanaka ,&nbsp;Soichiro Yoshida ,&nbsp;Shunya Matsumoto ,&nbsp;Masaki Kobayashi ,&nbsp;Shohei Fukuda ,&nbsp;Hiroshi Fukushima ,&nbsp;Yuma Waseda ,&nbsp;Yasuhisa Fujii","doi":"10.1016/j.clgc.2025.102458","DOIUrl":"10.1016/j.clgc.2025.102458","url":null,"abstract":"<div><h3>Introduction</h3><div>The optimal treatment strategy for advanced non-clear cell renal cell carcinoma (nccRCC) remains unclear. This study compares the efficacy of pembrolizumab plus lenvatinib (Pem+Len), nivolumab plus cabozantinib (Nivo+Cabo), and cabozantinib monotherapy (Cabo) for advanced nccRCC.</div></div><div><h3>Patients and Methods</h3><div>A systematic literature search was conducted to identify clinical trials investigating the 3 treatment regimens for advanced nccRCC. Individual patient data (IPD) were reconstructed from Kaplan–Meier curves for progression-free survival (PFS) and overall survival (OS) using the IPDfromKM package. The outcomes were compared across treatment regimens. A subgroup analysis was conducted for papillary RCC (pRCC).</div></div><div><h3>Results</h3><div>Three clinical trials (NCT02761057, NCT03635892, and NCT04704219) were included; 242 patients were analyzed, including 158/40/44 patients receiving Pem+Len/Nivo+Cabo/Cabo, respectively. Patients with pRCC accounted for 59%/80%/100% of each treatment cohort, respectively. Pem+Len yielded significantly superior PFS (HR = 0.52, 95% CI, 0.34-0.81, <em>P</em> &lt; .01) and OS (HR = 0.50, 95% CI, 0.28-0.89, <em>P</em> = .02) compared with Cabo. Nivo+Cabo showed potential superiority over Cabo in PFS (HR = 0.73, 95% CI, 0.44-1.20, <em>P</em> = .21) and OS (HR = 0.64, 95% CI, 0.35-1.16, <em>P</em> = .14), although these differences did not reach statistical significance. Our analysis did not reveal a clear superiority/inferiority between Pem+Len and Nivo+Cabo. The subgroup analysis for pRCC demonstrated significantly better PFS with Pem+Len (HR = 0.48, 95% CI, 0.29-0.77, <em>P</em> &lt; .01) compared with Cabo, while the benefit of Nivo+Cabo was not significant (HR = 0.66, 95% CI, 0.37-1.15, <em>P</em> = .14). Limitations included its retrospective design and inconsistent follow-up periods among the trials.</div></div><div><h3>Conclusions</h3><div>The IPD reconstruction analysis suggested better PFS and OS with Pem+Len and Nivo+Cabo compared with Cabo, supporting the use of these combination therapies for advanced nccRCC. Further comparative studies are needed to validate these findings.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 6","pages":"Article 102458"},"PeriodicalIF":2.7,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454271","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":"Impact of Hemoglobin A1c on the Obesity Paradox and Survival in Patients With Non-Metastatic Renal Cell Carcinoma","authors":"Alexander Abdollahzadeh ,&nbsp;Reza Lahiji ,&nbsp;Ernest Allen Morton ,&nbsp;Lorenzo Storino Ramacciotti ,&nbsp;Adam Braunschweig ,&nbsp;Dattatraya Patil ,&nbsp;Valentina Grajales ,&nbsp;Shreyas S. Joshi ,&nbsp;Vikram M. Narayan ,&nbsp;Reza Nabavizadeh ,&nbsp;Mohammad Hajiha ,&nbsp;Kenneth Ogan ,&nbsp;Viraj A. Master","doi":"10.1016/j.clgc.2025.102457","DOIUrl":"10.1016/j.clgc.2025.102457","url":null,"abstract":"<div><h3>Introduction</h3><div>The “obesity paradox” suggests that patients with various cancers, including renal cell carcinoma (RCC), and body mass index (BMI) ≥ 30 kg/m² may experience improved survival. However, the influence of glycemic control on this association remains unclear. This study evaluates whether elevated hemoglobin A1c (HbA1c) modifies the survival benefit associated with the obesity paradox in patients undergoing nephrectomy for non-metastatic RCC.</div></div><div><h3>Methods</h3><div>Patients undergoing nephrectomy for non-metastatic RCC at a single academic center from 2005 to 2024 were screened for inclusion. Inclusion criteria included HbA1c measured within 3 months preoperatively and ≥ 6 months of follow-up. Obesity was defined as BMI ≥ 30 kg/m²; elevated HbA1c as ≥ 7%. Overall survival (OS) and cancer-specific survival (CSS) were assessed using Cox proportional hazards models and Kaplan-Meier analysis.</div></div><div><h3>Results</h3><div>770 patients met inclusion criteria. Median follow-up was 45.2 months; 172 (22%) mortality events occurred. Among patients with HbA1c &lt; 7%, patients with obesity demonstrated improved CSS (HR 0.21 [95% CI, 0.09-0.48], <em>P</em> &lt; .001) compared to non-obese counterparts after controlling for confounders. In patients with HbA1c ≥ 7%, no significant survival advantage in CSS was seen with obesity (HR 0.69 [95% CI, 0.16-3.03], <em>P</em> = .627). In patients with obesity, HbA1c ≥ 7% independently predicted worse OS (HR 2.36 [95% CI, 1.40-3.98], <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>The survival benefit from the obesity paradox in RCC patients appears limited to patients with well-controlled HbA1c. Elevated HbA1c may negate this effect, suggesting optimization of metabolic health and glycemic control may improve outcomes.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 6","pages":"Article 102457"},"PeriodicalIF":2.7,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145463149","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":"The Clinicopathological Characteristics and Survival Outcomes of Primary Squamous Cell Carcinoma of the Kidney: A SEER-Based Population Analysis","authors":"Cagatay Ozsoy,&nbsp;Erhan Ates","doi":"10.1016/j.clgc.2025.102455","DOIUrl":"10.1016/j.clgc.2025.102455","url":null,"abstract":"<div><h3>Introduction</h3><div>Primary squamous cell carcinoma (SCC) of the kidney is an exceptionally rare malignancy, current knowledge being limited to isolated case reports and small case series. This study represents the first population-based analysis of SCC of the kidney using data from the Surveillance, Epidemiology, and End Results (SEER) database.</div></div><div><h3>Patients and Methods</h3><div>This retrospective cohort study was conducted using the SEER Research Data (2000-2022). Patients aged ≥ 15 years with histologically confirmed primary renal SCC and tumor site C64.9 (kidney) were included. Patients were categorized into metastatic and non-metastatic subgroups. Survival outcomes in the overall cohort were estimated using the Aalen–Johansen method to generate cumulative incidence functions, while Gray’s test was applied for subgroup comparisons. Prognostic factors associated with cancer-specific mortality (CSM) in the overall cohort and the metastatic subgroup were evaluated using the Fine–Gray proportional subdistribution hazards model.</div></div><div><h3>Results</h3><div>The 2-year CSM rate among the 114 patients was 83.7%. The majority of patients (78.9%) were aged ≥ 60 years. In the overall cohort, right-sided tumor location (<em>P</em> = .026) and bone metastasis at diagnosis (<em>P</em> &lt; .001) were significantly associated with an increased risk of CSM, while unmarried status (<em>P</em> = .090), lack of surgical treatment (<em>P</em> = .054), and receipt of radiotherapy (<em>P</em> = .050) exhibited borderline associations with an increased risk. At multivariate analysis, right-sided tumor location and radiotherapy were independently associated with poorer survival, while surgical treatment emerged as an independent predictor of improved survival in the metastatic group.</div></div><div><h3>Conclusions</h3><div>Primary SCC of the kidney is a rare and aggressive malignancy, typically diagnosed at advanced stages and associated with poor outcomes. Unmarried status, right-sided tumor location, bone metastasis at diagnosis, lack of surgical treatment, and receipt of radiotherapy were associated with an increased risk of CSM. Further multicenter studies with detailed clinical data are now needed to guide evidence-based management of this uncommon disease.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 6","pages":"Article 102455"},"PeriodicalIF":2.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460948","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":"Real-World Outcomes of Enfortumab Vedotin and Pembrolizumab in Advanced Urothelial Carcinoma: A Multicenter Retrospective Analysis","authors":"Prateek Jain ,&nbsp;Syed Arsalan Ahmed Naqvi ,&nbsp;Nikita Tripathi ,&nbsp;Japneet K Oberoi ,&nbsp;Muhammad Abdullah Humayun ,&nbsp;Yousef Zakharia ,&nbsp;Jacob J Orme ,&nbsp;Adam Kase ,&nbsp;Dan S Childs ,&nbsp;Ruqin Chen ,&nbsp;Irbaz B Riaz ,&nbsp;Parminder Singh","doi":"10.1016/j.clgc.2025.102453","DOIUrl":"10.1016/j.clgc.2025.102453","url":null,"abstract":"<div><h3>Introduction</h3><div>Enfortumab vedotin plus pembrolizumab has emerged as a new standard of care for previously untreated patients with advanced urothelial carcinoma following the EV-302 trial. However, data on its efficacy and safety in routine clinical practice remain limited. Herein, we evaluated real-world clinical outcomes for patients with advanced urothelial carcinoma receiving the combination as first-line or subsequent-line therapy.</div></div><div><h3>Patients and Methods</h3><div>This retrospective cohort study included adults (≥18 years) with histologically confirmed bladder or upper tract urothelial carcinoma (other histologic type variants were also included), who initiated treatment with enfortumab vedotin-pembrolizumab therapy between May 2020 and December 2024 at the Mayo Clinic. Patients initiating therapy after December 2024 or with incomplete data were excluded. Patients were stratified by line of therapy: Cohort A included patients who received enfortumab vedotin-pembrolizumab as first-line therapy, and Cohort B included patients who received it as subsequent-line therapy. The primary endpoint was to estimate median progression-free survival in cohort A and cohort B.</div></div><div><h3>Results</h3><div>A total of 183 patients with advanced urothelial carcinoma treated with the enfortumab vedotin-pembrolizumab combination were included. The median age at treatment initiation was 71.9 years (IQR, 64.7-77.4). Most patients were male (71.0%) and white (90.7%). The median progression-free survival was 12.9 months (95% CI, 9.5-NE) in Cohort A and 9.3 months (95% CI, 6.3-NE) in Cohort B. This difference was not statistically significant (HR, 1.30; 95% CI, 0.83-2.04; <em>P</em> = .246). Treatment-related adverse events of any grade were reported in 93.4% of patients, with 30.6% experiencing Grade ≥3 AEs.</div></div><div><h3>Conclusion</h3><div>In this real-world cohort, enfortumab vedotin-pembrolizumab combination demonstrated meaningful clinical activity and manageable toxicity in both first-line and subsequent-line settings, consistent with results from the EV-302 trial.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 6","pages":"Article 102453"},"PeriodicalIF":2.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433037","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}