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High Sensitivity Circulating Tumor-DNA Assays in Renal Cell Carcinoma–Are we there yet? 肾细胞癌中的高灵敏度循环肿瘤 DNA 检测--我们做到了吗?
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-10-10 DOI: 10.1016/j.clgc.2024.102235
Fady Sidhom , Shefali Patel , Arpita Desai , Arnab Basu
As therapeutics in renal cell carcinoma (RCC) continues to advance with approval of novel treatments and recently, adjuvant therapy, the need for highly sensitive tests that go beyond traditional methods to measure disease is becoming more crucial. Tumor informed high sensitivity circulating tumor DNA (ctDNA) assays originally developed for detection of minimal residual disease (MRD) theoretically could be utilized for initial detection of occult disease but also potentially for risk and response assessment in the management of advanced RCC. There are concerns related to the sensitivity of ctDNA based assays in RCC. This article aims to summarize the available evidence for high sensitivity MRD assays in RCC. We included studies with both localized and metastatic stages of RCC. The studies show a varying sensitivity depending on disease settings but a high specificity (∼100%) regardless. Detectable ctDNA appeared to be a significant negative prognostic risk factor for subsequent progressive disease. ctDNA may provide significant lead time allowing physicians to adapt therapy. Several high sensitivity assays with novel analytic approaches are in development for solid tumors including RCC.
随着肾细胞癌(RCC)治疗方法的不断进步,新型治疗方法和最近的辅助治疗方法获得批准,对超越传统方法测量疾病的高灵敏度检测的需求变得越来越重要。肿瘤信息高灵敏度循环肿瘤DNA(ctDNA)检测最初是为检测最小残留病(MRD)而开发的,理论上可用于隐匿性疾病的初步检测,也可用于晚期RCC管理中的风险和反应评估。基于ctDNA的检测方法在RCC中的灵敏度令人担忧。本文旨在总结RCC中高灵敏度MRD测定的现有证据。我们纳入了RCC局部和转移阶段的研究。这些研究显示,不同疾病的敏感性不同,但特异性都很高(100%)。可检测到的ctDNA似乎是后续进展性疾病的一个重要的负面预后风险因素。目前正在针对包括RCC在内的实体瘤开发几种具有新型分析方法的高灵敏度检测方法。
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引用次数: 0
Appearance of New Lesions Associate With Poor Prognosis in Pembrolizumab-Treated Urothelial Carcinoma 新病变的出现与 Pembrolizumab 治疗尿路上皮癌的不良预后有关。
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-10-09 DOI: 10.1016/j.clgc.2024.102236
Takuto Hara, Jun Teishima, Yasuyoshi Okamura, Kotaro Suzuki, Yukari Bando, Tomoaki Terakawa, Koji Chiba, Yoji Hyodo, Yuzo Nakano, Hideaki Miyake

Objectives

This study investigated the variations in response patterns, including target lesion enlargement and the emergence of new lesions, in patients with urothelial carcinoma receiving pembrolizumab therapy and assessed the impact of new lesions on patient outcomes.

Methods

This retrospective analysis included patients with urothelial carcinoma treated with pembrolizumab following platinum failure. Response Evaluation Criteria in Solid Tumors criteria were used to assess the target lesion size and appearance of new lesions. Patients were categorized into 2 groups: the primary progressive disease (PD) group, consisting of patients who progressed within 28 to 84 days of treatment initiation, and the secondary PD group, consisting of patients who progressed more than 84 days after treatment initiation. Survival analyses were performed to evaluate the impact of new lesions on patient outcomes.

Results

In this study, 42 patients experienced primary PD, and 37 experienced secondary PD. Among patients with primary PD, 64.3%, 73.8%, 45.2% had an increase of 20% or more in target lesion size, newly emerged lesions, and both an increase in target lesion size and new lesions, respectively. Kaplan–Meier analysis revealed that patients with primary PD and new lesions had significantly shorter overall survival after PD than those with only target lesion growth and those with secondary PD (both P < .001).

Conclusion

This study revealed the heterogeneity of response patterns during pembrolizumab therapy in patients with urothelial carcinoma and primary pembrolizumab resistance and the presence of new lesions early in treatment. Earlier imaging evaluation should be performed to assess for the appearance of new lesions, leading to sequential treatment.
研究目的本研究调查了接受pembrolizumab治疗的尿路上皮癌患者的反应模式变化,包括靶病灶扩大和新病灶的出现,并评估了新病灶对患者预后的影响:这项回顾性分析纳入了铂类治疗失败后接受pembrolizumab治疗的尿路癌患者。实体瘤反应评价标准用于评估靶病灶大小和新病灶的出现。患者被分为两组:原发性进展性疾病(PD)组,包括治疗开始后28至84天内出现进展的患者;继发性进展性疾病组,包括治疗开始后超过84天出现进展的患者。研究人员进行了生存分析,以评估新病变对患者预后的影响:在这项研究中,42 名患者经历了原发性 PD,37 名患者经历了继发性 PD。在原发性 PD 患者中,目标病灶大小增加 20% 或以上、新出现病灶以及目标病灶大小和新病灶同时增加的患者分别占 64.3%、73.8% 和 45.2%。Kaplan-Meier分析显示,原发性PD和新发病灶患者在PD后的总生存期明显短于仅有靶病灶增长的患者和继发性PD患者(P均<0.001):本研究揭示了尿路上皮癌患者在接受pembrolizumab治疗期间反应模式的异质性,以及原发性pembrolizumab耐药和治疗早期出现新病灶的情况。应尽早进行影像学评估,以评估新病灶的出现,从而进行序贯治疗。
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引用次数: 0
Concordance Between the Expert Reading of Biparametric-MRI and the Nonexpert Multiparametric-MRI for the Detection of Clinically Significant Prostate Cancer: Clinical Implications 专家解读双参数-MRI 与非专家解读多参数-MRI 在检测具有临床意义的前列腺癌方面的一致性:临床意义。
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-10-05 DOI: 10.1016/j.clgc.2024.102233
Nahuel Paesano , María José Gutiérrez Vallecillo , Violeta Catalá , Larisa Tcholakian , Xavier Alomar , Miguel Barranco , Abel González-Huete , Jonathan Hernández Mancera , Enric Trilla , Juan Morote

Purpose

Prostate-magnetic resonance imaging (MRI) interpretation is challenging, with expertise playing a crucial role. Biparametric MRI (bpMRI) is gaining popularity in experienced centers due to its time and cost advantages over multiparametric MRI (mpMRI). We aim to analyze concordance between nonexpert radiologist PI-RADS from mpMRI and expert radiologist PI-RADS from bpMRI, and its clinical implications.

Material and Methods

222 men suspected of having prostate cancer (PCa) and mpMRI reported by nonexpert radiologists were referred to a reference center for transperineal MRI-TRUS fusion biopsy where an expert radiologist reported bpMRI PI-RADS 2.1 and segmentation, blinded to external mpMRI. Mapping targeted suspected lesions and 12-core systematic biopsies were performed. Clinically significant PCa (csPCa) was diagnosed when ISUP-grade group was ≥2.

Results

Concordance between both PI-RADS existed in 49.1% of cases (Kappa index 0.288). In 102 cases (45.9%), expert reclassification to lower PI-RADS existed, while an increase existed in 11 cases (5.0%), P < .001. Agreement existed in 30.8% of nonexpert PI-RADS 3, 43.6% of PI-RADS 4, and 83.7% of PI-RADS 5, P < .001. Potential clinical implications included 27% reduction in prostate biopsies when using expert bpMRI readings compared to nonexpert mpMRI readings (P < 0.001), while undetected csPCa were 4.2% and 3.4%, respectively, P = .669. Over-detection reduction of insignificant PCa was 29.4% and 0%, respectively, P = .034.

Conclusions

Concordance between nonexpert PI-RADS mpMRI and expert PI-RADS bpMRI was low, increasing with nonexpert PI-RADS. Expert reclassification would reduce prostate biopsies by more than one quarter and over-detection of iPCa, while csPCa detection remained similar.
目的:前列腺磁共振成像(MRI)的解读具有挑战性,专业知识起着至关重要的作用。与多参数磁共振成像(mpMRI)相比,双参数磁共振成像(bpMRI)具有时间和成本优势,因此在经验丰富的中心越来越受欢迎。我们旨在分析非专家放射科医师的 mpMRI PI-RADS 与专家放射科医师的 bpMRI PI-RADS 之间的一致性及其临床意义。材料与方法:222 名疑似患有前列腺癌(PCa)且非专家放射科医师报告了 mpMRI 的男性被转诊至参考中心进行经会阴部 MRI-TRUS 融合活检,由专家放射科医师报告 bpMRI PI-RADS 2.1 和分割,并对外部 mpMRI 进行盲检。针对可疑病灶进行绘图,并进行 12 核系统性活检。当ISUP分级组≥2时,诊断为有临床意义的PCa(csPCa):49.1%的病例(Kappa指数为0.288)两种PI-RADS之间存在一致性。在 102 个病例(45.9%)中,专家将其重新分类为较低的 PI-RADS,而在 11 个病例(5.0%)中,专家将其重新分类为较高的 PI-RADS,P < .001。30.8% 的非专家 PI-RADS 3、43.6% 的 PI-RADS 4 和 83.7% 的 PI-RADS 5 达成了一致,P < .001。潜在的临床意义包括:与非专家 mpMRI 读数相比,使用专家 bpMRI 读数时前列腺活检减少 27%(P < 0.001),而未检测到的 csPCa 分别为 4.2% 和 3.4%,P = .669。未发现的 PCa 的过度检测率分别为 29.4% 和 0%,P = .034:非专家 PI-RADS mpMRI 与专家 PI-RADS bpMRI 之间的一致性较低,随着非专家 PI-RADS 的增加而增加。专家重新分类将减少四分之一以上的前列腺活检和 iPCa 的过度检测,而 csPCa 的检测则保持相似。
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引用次数: 0
Docetaxel Versus Androgen-Receptor Signaling Inhibitors (ARSI) as Second-Line Therapy After Failure of First-Line Alternative ARSI for the Elderly ≥ 75 Years Old With Metastatic Castration-Resistant Prostate Cancer (mCRPC): A SPARTACUSS—Meet-URO 26 Real-World Study 多西他赛与雄激素受体信号转导抑制剂 (ARSI) 作为二线疗法,用于治疗≥ 75 岁的转移性阉割抗性前列腺癌 (mCRPC) 老年患者:SPARTACUSS-Meet-URO 26 真实世界研究》。
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-10-05 DOI: 10.1016/j.clgc.2024.102230
Anna Patrikidou , Calogero Saieva , Richard Lee-Ying , Pier Vitale Nuzzo , Talal El Zarif , Heather McClure , Matthew Davidsohn , Marc Eid , Gian Paolo Spinelli , Fabio Catalano , Malvina Cremante , Giuseppe Fotia , Sabrina Rossetti , Loana Valenca , Charles Vauchier , Carlotta Ottanelli , Livia Andrade , Vincenzo Gennusa , Ricardo Pereira Mestre , Giuseppe Fornarini , Edoardo Francini

Background

Androgen receptor signalling inhibitors (ARSIs) abiraterone acetate (AA) enzalutamide (Enza), are currently the standard first-line (L1) treatments for metastatic castration-resistant prostate cancer (mCRPC), and docetaxel (D) is reserved as second-line (L2) after ARSI failure. Nonetheless, D use in men ≥ 75 years old is restricted owing to treatment toxicities and patient comorbidities, and a L2 alternative ARSI is frequently used. We aimed to evaluate real-life survival and toxicity outcomes of these elderly patients after failure of L1 ARSI treatment.

Material and Methods

We retrospectively evaluated efficacy and safety in a real-world international cohort of consecutive patients ≥ 75 years old when starting L1 ARSI for mCRPC according to the choice of L2 treatment (D versus alternative ARSI).

Results

Of the 122 identified patients, 57 (46.7%) had received L2 ARSI and 65 (53.3%) L2 D. No difference was found in the L1 overall survival (OS) for the ARSI and D groups (32.8 vs. 30.0 months, respectively; Hazard ratio [HR] = 1.22; 95% CI, 0.77-1.95; P = .40) or in the L2 OS (18.5 vs. 17.8 months, respectively; HR = 1.09; 95% CI, 0.69-1.74; P = .71). No difference was observed for rPFS from L2 (P = .12), although a trend was observed for a numerically improved rPFS on D.

Conclusion

Within the limitations of a retrospective design and small population, our study suggests that D or ARSI after failure of L1 alternative ARSI are clinically comparable L2 options for elderly patients with mCRPC.
背景:雄激素受体信号抑制剂(ARSIs)醋酸阿比特龙(AA)恩扎鲁胺(Enza)是目前治疗转移性去势抵抗性前列腺癌(mCRPC)的标准一线(L1)疗法,多西他赛(D)则是ARSI失败后的二线(L2)疗法。然而,由于治疗毒性和患者的合并症,多西他赛在年龄≥ 75 岁男性中的使用受到限制,因此经常使用 ARSI 作为二线替代疗法。我们的目的是评估 L1 ARSI 治疗失败后这些老年患者的实际生存和毒性结果:我们回顾性评估了一个真实世界的国际队列中年龄≥75岁的连续患者在开始L1 ARSI治疗mCRPC时根据L2治疗选择(D与替代ARSI)的疗效和安全性:ARSI组和D组的L1总生存期(OS)(分别为32.8个月和30.0个月;危险比[HR] = 1.22;95% CI,0.77-1.95;P = .40)或L2 OS(分别为18.5个月和17.8个月;HR = 1.09;95% CI,0.69-1.74;P = .71)均无差异。从L2开始的rPFS没有观察到差异(P = .12),但观察到D的rPFS在数值上有改善的趋势:结论:在回顾性设计和小规模人群的限制下,我们的研究表明,对于老年 mCRPC 患者来说,在 L1 替代 ARSI 失败后,D 或 ARSI 是临床上具有可比性的 L2 选项。
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引用次数: 0
Immune Checkpoint Blockade Therapies Efficacy and Toxicity in Patients With Impaired Renal Function in Metastatic Bladder Cancer 免疫检查点阻断疗法在肾功能受损的转移性膀胱癌患者中的疗效和毒性
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-10-04 DOI: 10.1016/j.clgc.2024.102228
Deniz Tural , Cagatay Arslan , Fatih Selcukbiricik , Omer Fatih Olmez , Emre Akar , Mustafa Erman , Yüksel Ürün , Dilek Erdem , Saadettin Kilickap

Background

In this study, we reported the real-life results of data from impaired renal patients with urothelial carcinoma who were treated with ICTs.

Methods

The patients were categorized into 3 different groups GFR ≥60mL/min (normal), 60mL/min-30mL/min (low), and less than 30 mL/min (very low) based on GFR. The primary endpoints were the overall response rate (ORR), overall survival (OS), duration of response with ICT, and safety. Median follow-up and OS were estimated by using the Kaplan-Meier method.

Results

One hundred-five (60.3%) of patients were GFR normal, 26.4% were GFR low with 30mL/min-60mL/min, and 13.2% were very low group. ORR for GFR normal, low and very low groups were 36% (n = 38), 26% (n = 12) and %31 (7); P = .2, respectively. The median duration of response for GFR normal, low and very low groups were 47.2 months (95% CI, 24.5-51.4), 33.1 months (95% CI, 26.9-47), and 23.5 months (95% CI, 12.2-43.7); P = .01, respectively. The Median OS rate for GFR normal, low and very low groups were 11.9 (7.2-16.5) months, 4.7 (1.8-7.7) and 6.8 (1.1-13.6) months, P = .015, respectively. In addition, GFR <60 ml/min HR = 1.6; 95% CI 1.12-1.80; P = .02, maintained a significant association with OS in multivariate analysis.

Conclusions

Long-term follow-up of real-world data confirms that the overall survival rate and durable response rate with ICT were higher in patients with GFR >60mL/min. On the other hand, we demonstrated that ICT was effective and a durable response seen in a group of patients with renal inpairement who did not have an effective systemic treatment option.
背景在这项研究中,我们报告了肾功能受损的尿路上皮癌患者接受信息通信技术治疗的实际结果:根据 GFR 将患者分为 GFR ≥60mL/min(正常)、60mL/min-30mL/min(低)和小于 30 mL/min(极低)三组。主要终点是总反应率(ORR)、总生存期(OS)、ICT反应持续时间和安全性。中位随访时间和OS采用Kaplan-Meier法估算:结果:15 名患者(60.3%)的 GFR 正常,26.4% 的患者 GFR 较低,在 30mL/min-60mL/min 之间,13.2% 的患者 GFR 很低。GFR正常组、低组和极低组的ORR分别为36%(38人)、26%(12人)和%31(7人);P = .2。GFR正常组、低组和极低组的中位反应持续时间分别为47.2个月(95% CI,24.5-51.4)、33.1个月(95% CI,26.9-47)和23.5个月(95% CI,12.2-43.7);P = .01。GFR正常组、低组和极低组的中位OS率分别为11.9(7.2-16.5)个月、4.7(1.8-7.7)个月和6.8(1.1-13.6)个月,P = .015。此外,GFR对真实世界数据的长期随访证实,GFR>60mL/min的患者使用ICT的总生存率和持久应答率更高。另一方面,我们也证明了 ICT 的疗效,并在一组没有有效全身治疗方案的肾功能不全患者中看到了持久的反应。
{"title":"Immune Checkpoint Blockade Therapies Efficacy and Toxicity in Patients With Impaired Renal Function in Metastatic Bladder Cancer","authors":"Deniz Tural ,&nbsp;Cagatay Arslan ,&nbsp;Fatih Selcukbiricik ,&nbsp;Omer Fatih Olmez ,&nbsp;Emre Akar ,&nbsp;Mustafa Erman ,&nbsp;Yüksel Ürün ,&nbsp;Dilek Erdem ,&nbsp;Saadettin Kilickap","doi":"10.1016/j.clgc.2024.102228","DOIUrl":"10.1016/j.clgc.2024.102228","url":null,"abstract":"<div><h3>Background</h3><div>In this study, we reported the real-life results of data from impaired renal patients with urothelial carcinoma who were treated with ICTs.</div></div><div><h3>Methods</h3><div>The patients were categorized into 3 different groups GFR ≥60mL/min (normal), 60mL/min-30mL/min (low), and less than 30 mL/min (very low) based on GFR. The primary endpoints were the overall response rate (ORR), overall survival (OS), duration of response with ICT, and safety. Median follow-up and OS were estimated by using the Kaplan-Meier method.</div></div><div><h3>Results</h3><div>One hundred-five (60.3%) of patients were GFR normal, 26.4% were GFR low with 30mL/min-60mL/min, and 13.2% were very low group. ORR for GFR normal, low and very low groups were 36% (<em>n</em> = 38), 26% (<em>n</em> = 12) and %31 (7); <em>P</em> = .2, respectively. The median duration of response for GFR normal, low and very low groups were 47.2 months (95% CI, 24.5-51.4), 33.1 months (95% CI, 26.9-47), and 23.5 months (95% CI, 12.2-43.7); <em>P</em> = .01, respectively. The Median OS rate for GFR normal, low and very low groups were 11.9 (7.2-16.5) months, 4.7 (1.8-7.7) and 6.8 (1.1-13.6) months, <em>P</em> = .015, respectively. In addition, GFR &lt;60 ml/min HR = 1.6; 95% CI 1.12-1.80; <em>P</em> = .02, maintained a significant association with OS in multivariate analysis.</div></div><div><h3>Conclusions</h3><div>Long-term follow-up of real-world data confirms that the overall survival rate and durable response rate with ICT were higher in patients with GFR &gt;60mL/min. On the other hand, we demonstrated that ICT was effective and a durable response seen in a group of patients with renal inpairement who did not have an effective systemic treatment option.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102228"},"PeriodicalIF":2.3,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514711","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}
引用次数: 0
Chemomobilisation Using Gemcitabine-Oxaliplatin for Salvage High Dose Chemotherapy and Autologous Stem Cell Transplant in Advanced Testicular Germ Cell Cancer 在晚期睾丸生殖细胞癌中使用吉西他滨-奥沙利铂化疗动员疗法进行挽救性大剂量化疗和自体干细胞移植
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-10-04 DOI: 10.1016/j.clgc.2024.102234
Jane McKenzie , Ciara Conduit , Melissa Ng Liet Hing , Kristina Zlatic , Kerrie Stokes , Sharlea Disney , Amit Khot , Simon J. Harrison , Jeremy Lewin , Ben Tran
  • At relapse, testicular germ cell tumors may be treated with high-dose chemotherapy and autologous stem cell transplant.
  • Traditional chemomobilisation protocols for autologous stem cell transplant may be unsuitable for pretreated patients.
  • Gemcitabine and Oxaliplatin provides satisfactory stem cell mobilization and treatment outcomes for this high-risk group.
-睾丸生殖细胞肿瘤复发时,可采用大剂量化疗和自体干细胞移植治疗。-自体干细胞移植的传统化学动员方案可能不适合预处理患者。
{"title":"Chemomobilisation Using Gemcitabine-Oxaliplatin for Salvage High Dose Chemotherapy and Autologous Stem Cell Transplant in Advanced Testicular Germ Cell Cancer","authors":"Jane McKenzie ,&nbsp;Ciara Conduit ,&nbsp;Melissa Ng Liet Hing ,&nbsp;Kristina Zlatic ,&nbsp;Kerrie Stokes ,&nbsp;Sharlea Disney ,&nbsp;Amit Khot ,&nbsp;Simon J. Harrison ,&nbsp;Jeremy Lewin ,&nbsp;Ben Tran","doi":"10.1016/j.clgc.2024.102234","DOIUrl":"10.1016/j.clgc.2024.102234","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>At relapse, testicular germ cell tumors may be treated with high-dose chemotherapy and autologous stem cell transplant.</div></span></li><li><span>•</span><span><div>Traditional chemomobilisation protocols for autologous stem cell transplant may be unsuitable for pretreated patients.</div></span></li><li><span>•</span><span><div>Gemcitabine and Oxaliplatin provides satisfactory stem cell mobilization and treatment outcomes for this high-risk group.</div></span></li></ul></div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102234"},"PeriodicalIF":2.3,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535138","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}
引用次数: 0
Age Does Not Impact Cancer Specific Mortality: From Sub-Distributional and Cause-Specific Hazard Analysis in RCC Patients Undergoing Radical Nephrectomy and Thrombectomy 年龄不会影响癌症特异性死亡率:接受根治性肾切除术和血栓切除术的 RCC 患者的亚分布和特定病因危害分析。
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-10-03 DOI: 10.1016/j.clgc.2024.102231
Younjuong Kim , Jun Gyo Gwon , Hyun Young Lee , Bumjin Lim , Jung Kwon Kim , Cheryn Song , Dalsan You , In Gab Jeong , Jun Hyuk Hong , Bumsik Hong , Hanjong Ahn , Jungyo Suh

Objective

To assess the impact of age on cancer-specific mortality (CSM) and other-cause mortality (OCM) in patients undergoing radical nephrectomy with thrombectomy (RNTx) for renal cell carcinoma (RCC) with venous thrombus.

Patients and Methods

We retrospectively analyzed 196 patients who underwent RNTx for RCC with venous thrombus between 1990 and 2018 at a single tertiary referral center. Patients were categorized into three age groups: <60, 60-69, and ≥70 years. The cumulative incidence function (CIF) for CSM and OCM was calculated using the Aalen-Johansen estimator, and hazard ratios (HR) from sub-distributional hazard (SDH) and cause-specific hazard (CSH) models were employed to assess the impact of age on mortality.

Results

The median follow-up was 40.5 months. Of the 196 patients, 105 experienced disease progression, 125 had cancerrelated deaths, and 155 died from any cause. Perioperative outcomes, including ICU admission, 90-day readmission, and 90-day mortality, were similar across age groups. The CIF for 5-year CSM differed significantly among age groups (p = 0.032), though this difference was not observed at 10 years. OCM increased significantly with age, particularly in the ≥70 group at 10 years (p = 0.045). Multivariable SDH and CSH models showed no significant differences in CSM between age groups.

Conclusion

While age was associated with increased OCM, it did not significantly impact the hazard of CSM. Older age alone should not be considered a contraindication for surgical intervention in RCC with venous thrombus.
目的评估年龄对因肾细胞癌(RCC)伴静脉血栓接受根治性肾切除加血栓切除术(RNTx)患者的癌症特异性死亡率(CSM)和其他原因死亡率(OCM)的影响:我们回顾性分析了 1990 年至 2018 年期间在一家三级转诊中心接受 RNTx 治疗的 196 例伴有静脉血栓的 RCC 患者。患者分为三个年龄组:结果:中位随访时间为 40.5 个月。在196名患者中,105人病情恶化,125人死于癌症,155人死于任何原因。不同年龄组的围手术期结果相似,包括入住重症监护室、90 天再入院和 90 天死亡率。各年龄组 5 年 CSM 的 CIF 有显著差异(p = 0.032),但在 10 年时没有观察到这种差异。随着年龄的增长,OCM明显增加,尤其是在≥70岁的10岁组中(p = 0.045)。多变量 SDH 和 CSH 模型显示,不同年龄组的 CSM 没有明显差异:结论:虽然年龄与 OCM 的增加有关,但对 CSM 的危险性没有显著影响。结论:虽然年龄与 OCM 的增加有关,但年龄对 CSM 的危险性并无明显影响。对于有静脉血栓的 RCC 患者,不应仅将年龄视为手术干预的禁忌症。
{"title":"Age Does Not Impact Cancer Specific Mortality: From Sub-Distributional and Cause-Specific Hazard Analysis in RCC Patients Undergoing Radical Nephrectomy and Thrombectomy","authors":"Younjuong Kim ,&nbsp;Jun Gyo Gwon ,&nbsp;Hyun Young Lee ,&nbsp;Bumjin Lim ,&nbsp;Jung Kwon Kim ,&nbsp;Cheryn Song ,&nbsp;Dalsan You ,&nbsp;In Gab Jeong ,&nbsp;Jun Hyuk Hong ,&nbsp;Bumsik Hong ,&nbsp;Hanjong Ahn ,&nbsp;Jungyo Suh","doi":"10.1016/j.clgc.2024.102231","DOIUrl":"10.1016/j.clgc.2024.102231","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the impact of age on cancer-specific mortality (CSM) and other-cause mortality (OCM) in patients undergoing radical nephrectomy with thrombectomy (RNTx) for renal cell carcinoma (RCC) with venous thrombus.</div></div><div><h3>Patients and Methods</h3><div>We retrospectively analyzed 196 patients who underwent RNTx for RCC with venous thrombus between 1990 and 2018 at a single tertiary referral center. Patients were categorized into three age groups: &lt;60, 60-69, and ≥70 years. The cumulative incidence function (CIF) for CSM and OCM was calculated using the Aalen-Johansen estimator, and hazard ratios (HR) from sub-distributional hazard (SDH) and cause-specific hazard (CSH) models were employed to assess the impact of age on mortality.</div></div><div><h3>Results</h3><div>The median follow-up was 40.5 months. Of the 196 patients, 105 experienced disease progression, 125 had cancerrelated deaths, and 155 died from any cause. Perioperative outcomes, including ICU admission, 90-day readmission, and 90-day mortality, were similar across age groups. The CIF for 5-year CSM differed significantly among age groups (<em>p</em> = 0.032), though this difference was not observed at 10 years. OCM increased significantly with age, particularly in the ≥70 group at 10 years (<em>p</em> = 0.045). Multivariable SDH and CSH models showed no significant differences in CSM between age groups.</div></div><div><h3>Conclusion</h3><div>While age was associated with increased OCM, it did not significantly impact the hazard of CSM. Older age alone should not be considered a contraindication for surgical intervention in RCC with venous thrombus.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102231"},"PeriodicalIF":2.3,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549465","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}
引用次数: 0
The Association of Statin Use With Survival Outcomes in Patients With Metastatic Castration-Resistant Prostate Cancer (mCRPC) Treated With Androgen Receptor Targeted Therapies (ART) 他汀类药物的使用与接受雄激素受体靶向疗法 (ART) 治疗的转移性钙化抗性前列腺癌 (mCRPC) 患者的生存结果之间的关系。
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-09-24 DOI: 10.1016/j.clgc.2024.102227
Zakaria Chakrani , Mann Patel , George Mellgard , Stephen McCroskery , Nathaniel Saffran , Nicole Taylor , Bobby C. Liaw , Matthew Galsky , William Oh , Che-Kai Tsao , Teja Ganta , Vaibhav Patel

Background

Statins may provide a compounded effect on ART by decreasing cholesterol levels thus decreasing de novo androgen synthesis and tumor cell viability. We investigated the clinical efficacy of concurrent statin use on outcomes of patients with mCRPC taking ART.

Methods

A single-institution retrospective analysis of patients with mCRPC receiving ART from 2010 to 2021 was performed. Our primary outcome was PSA progression free survival (PFS), and our secondary outcomes were overall survival (OS). Patient characteristics were collected in addition to ART treatment course, statin treatment, and survival outcomes. Cox proportional hazards regression model was used to estimate hazard ratios (HR) for OS and PSA PFS and multivariable logistic regression to determine risk factors.

Results

153 patients with mCRPC treated with ART were included. A total of 67 patients (43.8%) received concurrent statins. Median PSA PFS was 20.4 months for patients that received statins versus 15.3 months for patients who did not receive statins. Median OS was 45.1 months for patients who received concurrent statins versus 29.7 months for patients who did not. On univariate and multivariate survival analyses, there was no statistically significant difference between groups for PSA PFS (HR 0.7; CI 0.44-1.1; P = .123) and OS (HR 0.67; CI 0.42-1.06; P = .089).

Conclusions

Our analysis suggests that statins do not significantly improve clinical outcomes in patients with mCRPC. Ultimately, current understanding remains limited, and prospective studies are needed, but here we provide a cost-effective, timely, and selective preliminary analysis.
背景:他汀类药物可降低胆固醇水平,从而减少雄激素的合成,降低肿瘤细胞的活力,从而为抗逆转录病毒疗法提供复合效应。我们研究了同时使用他汀类药物对服用抗逆转录病毒疗法的 mCRPC 患者的临床疗效:我们对 2010 年至 2021 年期间接受抗逆转录病毒疗法的 mCRPC 患者进行了单机构回顾性分析。我们的主要结果是PSA无进展生存期(PFS),次要结果是总生存期(OS)。除 ART 治疗过程、他汀类药物治疗和生存结果外,我们还收集了患者的特征。采用Cox比例危险回归模型估算OS和PSA无进展生存期的危险比(HR),并采用多变量逻辑回归确定风险因素:共纳入153例接受抗逆转录病毒疗法治疗的mCRPC患者。共有67名患者(43.8%)同时服用了他汀类药物。接受他汀类药物治疗的患者中位 PSA PFS 为 20.4 个月,而未接受他汀类药物治疗的患者为 15.3 个月。同时接受他汀类药物治疗的患者的中位 OS 为 45.1 个月,而未接受他汀类药物治疗的患者的中位 OS 为 29.7 个月。在单变量和多变量生存分析中,PSA PFS(HR 0.7;CI 0.44-1.1;P = .123)和OS(HR 0.67;CI 0.42-1.06;P = .089)组间差异无统计学意义:我们的分析表明,他汀类药物并不能显著改善mCRPC患者的临床预后。我们的分析表明,他汀类药物并不能明显改善mCRPC患者的临床预后。归根结底,目前的认识仍然有限,需要进行前瞻性研究,但我们在此提供了一项具有成本效益、及时且有选择性的初步分析。
{"title":"The Association of Statin Use With Survival Outcomes in Patients With Metastatic Castration-Resistant Prostate Cancer (mCRPC) Treated With Androgen Receptor Targeted Therapies (ART)","authors":"Zakaria Chakrani ,&nbsp;Mann Patel ,&nbsp;George Mellgard ,&nbsp;Stephen McCroskery ,&nbsp;Nathaniel Saffran ,&nbsp;Nicole Taylor ,&nbsp;Bobby C. Liaw ,&nbsp;Matthew Galsky ,&nbsp;William Oh ,&nbsp;Che-Kai Tsao ,&nbsp;Teja Ganta ,&nbsp;Vaibhav Patel","doi":"10.1016/j.clgc.2024.102227","DOIUrl":"10.1016/j.clgc.2024.102227","url":null,"abstract":"<div><h3>Background</h3><div>Statins may provide a compounded effect on ART by decreasing cholesterol levels thus decreasing de novo androgen synthesis and tumor cell viability. We investigated the clinical efficacy of concurrent statin use on outcomes of patients with mCRPC taking ART.</div></div><div><h3>Methods</h3><div>A single-institution retrospective analysis of patients with mCRPC receiving ART from 2010 to 2021 was performed. Our primary outcome was PSA progression free survival (PFS), and our secondary outcomes were overall survival (OS). Patient characteristics were collected in addition to ART treatment course, statin treatment, and survival outcomes. Cox proportional hazards regression model was used to estimate hazard ratios (HR) for OS and PSA PFS and multivariable logistic regression to determine risk factors.</div></div><div><h3>Results</h3><div>153 patients with mCRPC treated with ART were included. A total of 67 patients (43.8%) received concurrent statins. Median PSA PFS was 20.4 months for patients that received statins versus 15.3 months for patients who did not receive statins. Median OS was 45.1 months for patients who received concurrent statins versus 29.7 months for patients who did not. On univariate and multivariate survival analyses, there was no statistically significant difference between groups for PSA PFS (HR 0.7; CI 0.44-1.1; <em>P</em> = .123) and OS (HR 0.67; CI 0.42-1.06; <em>P</em> = .089).</div></div><div><h3>Conclusions</h3><div>Our analysis suggests that statins do not significantly improve clinical outcomes in patients with mCRPC. Ultimately, current understanding remains limited, and prospective studies are needed, but here we provide a cost-effective, timely, and selective preliminary analysis.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102227"},"PeriodicalIF":2.3,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514712","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}
引用次数: 0
Distinct Gene Expression Patterns Identify Patients who Relapse After Neoadjuvant Pembrolizumab and Radical Cystectomy in the PURE-01 Study 在 PURE-01 研究中,通过不同的基因表达模式识别新辅助 Pembrolizumab 和根治性膀胱切除术后复发的患者。
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-09-20 DOI: 10.1016/j.clgc.2024.102214
Moritz J. Reike , Daniele Raggi , Chiara Mercinelli , Antonio Cigliola , Valentina Tateo , Damiano Alfio Patanè , Emanuele Crupi , Tiago Costa de Padua , Peter C. Black , Ewan A. Gibb , Andrea Necchi

Purpose

The PURE-01 clinical trial reported the use of neoadjuvant treatment with pembrolizumab prior to radical cystectomy (RC) in patients with muscle-invasive bladder. Specific molecular subtypes and immune signatures were reported to be associated with a favorable survival. However, reports on the detailed tumor biology of patients relapsing after neoadjuvant pembrolizumab are lacking.

Materials and Methods

Microarray data from transurethral resection of the bladder tumor (TURBT; n = 102) and matched RC (N = 25) tissue from patients in PURE-01 who experience a disease relapse were analyzed, with gene expression signatures and molecular subtypes. The Kaplan–Meier method was used to estimate differences in patient outcomes. Immune-signatures were split by median for survival analysis. All significance testing used a two-sided t-test at a threshold of P < .05.

Results

The study cohort consisted of 102 patients, of whom N = 19 (19%) experienced relapse. Molecular subtyping revealed that neuroendocrine-like tumors had the worst outcomes, while tumors classified as Claudin-low did show only one recurrence event. Differential gene expression analysis identified genes associated with relapse, including KRT20, H19, and immune-associated genes such as CXCL9 and CXCL11.

Conclusion

This study provides a detailed characterization of patients who relapsed after neoadjuvant pembrolizumab and RC and identifies distinct gene expression patterns associated with relapse. These findings may have implications for predicting patient response and guiding treatment decisions in the neoadjuvant setting.
目的:PURE-01 临床试验报告了在对肌肉浸润性膀胱患者进行根治性膀胱切除术(RC)前使用 pembrolizumab 进行新辅助治疗的情况。据报道,特定的分子亚型和免疫特征与良好的生存率有关。然而,关于新辅助治疗后复发的患者的详细肿瘤生物学情况还缺乏报道:分析了 PURE-01 中复发患者经尿道膀胱肿瘤切除术(TURBT;n = 102)和匹配的 RC(n = 25)组织的微阵列数据,以及基因表达特征和分子亚型。采用 Kaplan-Meier 法估计患者预后的差异。免疫特征按中位数分割,用于生存分析。所有显著性检验均采用双侧 t 检验,阈值为 P <.05:研究队列由102名患者组成,其中19人(19%)复发。分子亚型分析显示,神经内分泌样肿瘤的预后最差,而被归类为Claudin-low的肿瘤仅有一次复发。差异基因表达分析确定了与复发相关的基因,包括KRT20、H19和免疫相关基因,如CXCL9和CXCL11:这项研究详细描述了新辅助治疗彭博利珠单抗和RC后复发患者的特征,并确定了与复发相关的不同基因表达模式。这些发现可能会对预测患者反应和指导新辅助治疗决策产生影响。
{"title":"Distinct Gene Expression Patterns Identify Patients who Relapse After Neoadjuvant Pembrolizumab and Radical Cystectomy in the PURE-01 Study","authors":"Moritz J. Reike ,&nbsp;Daniele Raggi ,&nbsp;Chiara Mercinelli ,&nbsp;Antonio Cigliola ,&nbsp;Valentina Tateo ,&nbsp;Damiano Alfio Patanè ,&nbsp;Emanuele Crupi ,&nbsp;Tiago Costa de Padua ,&nbsp;Peter C. Black ,&nbsp;Ewan A. Gibb ,&nbsp;Andrea Necchi","doi":"10.1016/j.clgc.2024.102214","DOIUrl":"10.1016/j.clgc.2024.102214","url":null,"abstract":"<div><h3>Purpose</h3><div>The PURE-01 clinical trial reported the use of neoadjuvant treatment with pembrolizumab prior to radical cystectomy (RC) in patients with muscle-invasive bladder. Specific molecular subtypes and immune signatures were reported to be associated with a favorable survival. However, reports on the detailed tumor biology of patients relapsing after neoadjuvant pembrolizumab are lacking.</div></div><div><h3>Materials and Methods</h3><div>Microarray data from transurethral resection of the bladder tumor (TURBT; n = 102) and matched RC (N = 25) tissue from patients in PURE-01 who experience a disease relapse were analyzed, with gene expression signatures and molecular subtypes. The Kaplan–Meier method was used to estimate differences in patient outcomes. Immune-signatures were split by median for survival analysis. All significance testing used a two-sided t-test at a threshold of <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>The study cohort consisted of 102 patients, of whom N = 19 (19%) experienced relapse. Molecular subtyping revealed that neuroendocrine-like tumors had the worst outcomes, while tumors classified as Claudin-low did show only one recurrence event. Differential gene expression analysis identified genes associated with relapse, including KRT20, H19, and immune-associated genes such as CXCL9 and CXCL11.</div></div><div><h3>Conclusion</h3><div>This study provides a detailed characterization of patients who relapsed after neoadjuvant pembrolizumab and RC and identifies distinct gene expression patterns associated with relapse. These findings may have implications for predicting patient response and guiding treatment decisions in the neoadjuvant setting.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102214"},"PeriodicalIF":2.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514698","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}
引用次数: 0
Analysis of Neoadjuvant Chemotherapy Utilization, Pathologic Response, and Overall Survival in Upper Tract Urothelial Carcinoma 上尿路上皮癌的新辅助化疗使用、病理反应和总生存率分析
IF 2.3 3区 医学 Q3 ONCOLOGY Pub Date : 2024-09-17 DOI: 10.1016/j.clgc.2024.102224
Vincent E. Xu , Oluwafolajimi Adesanya , Sarah Azari , Samita Islam , Matthew Klein , Arthur Drouaud , Ryan M. Antar , Phat Chang , Armine Smith , Michael J Whalen

Introduction

Upper tract urothelial carcinoma (UTUC) is a rare malignancy with poor prognosis. Radical nephroureterectomy (RNU) remains the standard treatment for high-risk UTUC. Considering the decline in renal function with RNU and results from prospective trials, NAC has emerged as a favored perioperative treatment for chemo-eligible patients with UTUC. However, strong evidence of the efficacy of NAC and predictors for its use are scarce. We aimed to assess trends in NAC utilization and pathologic outcomes and survival with NAC use.

Methods

The National Cancer Database was queried for patients with high-grade cTanyNanyM0 UTUC treated with RNU from 2004 to 2019. Outcomes included overall survival (OS), pathologic response (pR) and pathologic complete response (pCR), defined as ≤pT1pN0/X and pT0pN0/X, respectively.

Results

Of 6,645 patients treated with RNU, 209 received RNU NAC. Greater distance from treatment facility decreased the likelihood of receiving NAC. Higher cT stages (OR 1.72, P = .028), cN+ status (OR 7.40, P < .001) and treatment at an academic facility (OR 2.02, P < .001) predicted NAC treatment. NAC was associated with 34.0% pR and 5.3% pCR. In multivariable analysis, patients with pR and pCR had improved OS (HR = 0.176, P < .014).

Conclusion

We report significant response rates with NAC and improved OS in patients who experienced pR or pCR. Over a 15-year study period, NAC was underutilized, especially in nonacademic settings and among patients living farther from care facilities, underscoring the need for improved regionalization and multidisciplinary approaches in UTUC management.
导言上尿路上皮癌(UTUC)是一种罕见的恶性肿瘤,预后较差。根治性肾切除术(RNU)仍是高危UTUC的标准治疗方法。考虑到 RNU 会导致肾功能下降以及前瞻性试验的结果,NAC 已成为符合化疗条件的 UTUC 患者首选的围手术期治疗方法。然而,有关 NAC 疗效的有力证据以及使用 NAC 的预测因素却很少。我们旨在评估NAC的使用趋势以及使用NAC后的病理结果和生存率。方法查询了2004年至2019年接受RNU治疗的高级别cTanyNanyM0 UTUC患者的国家癌症数据库。结果在接受RNU治疗的6645名患者中,有209人接受了RNU NAC治疗。与治疗机构的距离越远,接受 NAC 的可能性越小。较高的 cT 分期(OR 1.72,P = .028)、cN+ 状态(OR 7.40,P < .001)和在学术机构接受治疗(OR 2.02,P < .001)预示着 NAC 治疗。NAC与34.0%的pR和5.3%的pCR相关。在多变量分析中,pR 和 pCR 患者的 OS 有所改善(HR = 0.176,P < .014)。在长达15年的研究期间,NAC的使用率较低,尤其是在非学术环境和远离医疗机构的患者中,这说明在UTUC管理中需要改进区域化和多学科方法。
{"title":"Analysis of Neoadjuvant Chemotherapy Utilization, Pathologic Response, and Overall Survival in Upper Tract Urothelial Carcinoma","authors":"Vincent E. Xu ,&nbsp;Oluwafolajimi Adesanya ,&nbsp;Sarah Azari ,&nbsp;Samita Islam ,&nbsp;Matthew Klein ,&nbsp;Arthur Drouaud ,&nbsp;Ryan M. Antar ,&nbsp;Phat Chang ,&nbsp;Armine Smith ,&nbsp;Michael J Whalen","doi":"10.1016/j.clgc.2024.102224","DOIUrl":"10.1016/j.clgc.2024.102224","url":null,"abstract":"<div><h3>Introduction</h3><div>Upper tract urothelial carcinoma (UTUC) is a rare malignancy with poor prognosis. Radical nephroureterectomy (RNU) remains the standard treatment for high-risk UTUC. Considering the decline in renal function with RNU and results from prospective trials, NAC has emerged as a favored perioperative treatment for chemo-eligible patients with UTUC. However, strong evidence of the efficacy of NAC and predictors for its use are scarce. We aimed to assess trends in NAC utilization and pathologic outcomes and survival with NAC use.</div></div><div><h3>Methods</h3><div>The National Cancer Database was queried for patients with high-grade cTanyNanyM0 UTUC treated with RNU from 2004 to 2019. Outcomes included overall survival (OS), pathologic response (pR) and pathologic complete response (pCR), defined as ≤pT1pN0/X and pT0pN0/X, respectively.</div></div><div><h3>Results</h3><div>Of 6,645 patients treated with RNU, 209 received RNU NAC. Greater distance from treatment facility decreased the likelihood of receiving NAC. Higher cT stages (OR 1.72, <em>P</em> = .028), cN+ status (OR 7.40, <em>P</em> &lt; .001) and treatment at an academic facility (OR 2.02, <em>P</em> &lt; .001) predicted NAC treatment. NAC was associated with 34.0% pR and 5.3% pCR. In multivariable analysis, patients with pR and pCR had improved OS (HR = 0.176, <em>P</em> &lt; .014).</div></div><div><h3>Conclusion</h3><div>We report significant response rates with NAC and improved OS in patients who experienced pR or pCR. Over a 15-year study period, NAC was underutilized, especially in nonacademic settings and among patients living farther from care facilities, underscoring the need for improved regionalization and multidisciplinary approaches in UTUC management.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102224"},"PeriodicalIF":2.3,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441172","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}
引用次数: 0
期刊
Clinical genitourinary cancer
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