European urology focus最新文献

{"title":"Urothelial Cancer: What Is the Role of Expression-based Subtypes to Guide Neoadjuvant Therapy in Muscle-invasive Bladder Cancer?","authors":"Joshua J. Meeks","doi":"10.1016/j.euf.2025.11.014","DOIUrl":"10.1016/j.euf.2025.11.014","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"12 1","pages":"Pages 49-50"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate Cancer: Current Status of Novel Molecular Imaging and Future Prospects","authors":"Donald C. Wunsch 3rd,&nbsp;Baris Turkbey","doi":"10.1016/j.euf.2025.11.013","DOIUrl":"10.1016/j.euf.2025.11.013","url":null,"abstract":"<div><div>Molecular imaging has become an essential component of diagnosis, treatment planning, and monitoring in prostate cancer. Prostate-specific membrane antigen–targeted positron emission tomography is now the most widely used molecular imaging approach in prostate cancer. This mini review provides an overview of the status and prospects of novel molecular imaging in prostate cancer management.</div></div><div><h3>Patient summary</h3><div>Recent years have seen improvements in scans for prostate cancer. Our mini review focuses on PSMA PET (prostate-specific membrane antigen positron emission tomography) for diagnosis of prostate cancer, especially metastatic disease, and treatment planning and monitoring. The results show that in the right setting, PSMA PET has benefits in improving outcomes for patients with prostate cancer.</div></div>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"12 1","pages":"Pages 28-30"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Standard for High-risk Upper Tract Urothelial Cancer: Platinum-based Chemotherapy—Proven, Not Postulated","authors":"Alison J. Birtle","doi":"10.1016/j.euf.2025.11.012","DOIUrl":"10.1016/j.euf.2025.11.012","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"12 1","pages":"Pages 12-13"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145695969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Oncological Outcomes for Patients with Non–muscle-invasive Bladder Cancer Treated with Bacillus Calmette-Guérin (BCG): A Comparative Analysis of Adequate Versus Inadequate BCG Treatment","authors":"Pietro Scilipoti ,&nbsp;Mattia Longoni ,&nbsp;Mario de Angelis ,&nbsp;Paolo Zaurito ,&nbsp;Aleksander Ślusarczyk ,&nbsp;Francesco Soria ,&nbsp;Benjamin Pradere ,&nbsp;Wojciech Krajewski ,&nbsp;David D’Andrea ,&nbsp;Andrea Mari ,&nbsp;Francesco Del Giudice ,&nbsp;Renate Pichler ,&nbsp;José Daniel Subiela ,&nbsp;Gautier Marcq ,&nbsp;Andrea Gallioli ,&nbsp;Luca Afferi ,&nbsp;Riccardo Mastroianni ,&nbsp;Giuseppe Simone ,&nbsp;Simone Albisinni ,&nbsp;Laura S. Mertens ,&nbsp;Marco Moschini","doi":"10.1016/j.euf.2025.04.033","DOIUrl":"10.1016/j.euf.2025.04.033","url":null,"abstract":"<div><h3>Background and objective</h3><div>Intravesical bacillus Calmette-Guérin (BCG) instillation is recommended for intermediate-risk (IR) and high-risk (HiR) non–muscle-invasive bladder cancer (NMIBC). There are limited comparisons of long-term outcomes between adequate and inadequate BCG.</div></div><div><h3>Methods</h3><div>We analyzed data from a multicenter European database (2010–2024) for 1558 patients diagnosed with IR- or HiR-NMIBC who underwent BCG treatment and received at least five BCG instillations. Adequate BCG was defined as at least five of six induction instillations and two of three maintenance doses, or two of six doses of a reinduction course. A 3-mo landmark analysis was conducted. Recurrence-free survival (RFS), high-grade RFS (HG-RFS), progression-free survival (PFS), and overall survival (OS) were estimated using inverse probability of treatment weighting (IPTW)-adjusted Kaplan-Meier curves and IPTW-adjusted multivariable Cox regression models. Cancer-specific mortality (CSM) was assessed via cumulative incidence curves and Fine-Gray competing-risks regression analysis.</div></div><div><h3>Key findings and limitations</h3><div>The cohort included 606 IR-NMIBC (39%), 840 HiR-NMIBC (54%), and 112 very HiR (VHR)-NMIBC (7.1%) cases. Adequate BCG was administered to 1226 patients (78%). Among 1239 patients (80%) with documented treatment termination reasons, 503 (41%) completed guideline-recommended treatment and 150 (12%) discontinued because of BCG intolerance. Over median follow-up of 37 mo, adequate BCG was associated with higher IPTW-adjusted 5-yr RFS (72% vs 52%; hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.31–0.85; <em>p</em> &lt; 0.001), HG-RFS (83% vs 68%; HR 0.43, 95% CI 0.32–0.58; <em>p</em> &lt; 0.001), PFS (92% vs 85%; HR 0.47, 95% CI 0.30–0.74; <em>p</em> = 0.001), and OS (88% vs 71%; HR 0.52, 95% CI 0.37–0.74; <em>p</em> = 0.001). CSM rates were comparable between the groups (3% vs 4.9%; <em>p</em> = 0.3).</div></div><div><h3>Conclusions and clinical implications</h3><div>Adequate BCG, as defined by the International Bladder Cancer Group (IBCG), was associated with significantly better RFS, PFS, and OS. These findings support use of the IBCG definition as a standardized benchmark for BCG exposure. However, further prospective validation to confirm causality is needed.</div></div>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"12 1","pages":"Pages 70-78"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exciting Times in Urological Oncology: Rapid Advances and Greater Complexity Are Changing Practice and Improving Outcomes","authors":"Shilpa Gupta ,&nbsp;James W.F. Catto","doi":"10.1016/j.euf.2025.11.017","DOIUrl":"10.1016/j.euf.2025.11.017","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"12 1","pages":"Pages 1-2"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145700049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bladder Preservation After Neoadjuvant Therapy for Muscle-invasive Bladder Cancer in the Current Era: Myth and Reality","authors":"Emanuele Crupi ,&nbsp;Andrea Necchi ,&nbsp;Ashish M. Kamat","doi":"10.1016/j.euf.2025.11.002","DOIUrl":"10.1016/j.euf.2025.11.002","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"12 1","pages":"Pages 3-6"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Adjuvant Immune Checkpoint Inhibition Therapy Have a Future in Operable Bladder Cancer?","authors":"Sara Coca Membribes,&nbsp;Thomas Powles","doi":"10.1016/j.euf.2025.12.015","DOIUrl":"10.1016/j.euf.2025.12.015","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"12 1","pages":"Pages 10-11"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound for the Diagnosis of Testicular Torsion: A Systematic Review and Meta-analysis of Diagnostic Accuracy","authors":"Cameron E. Alexander ,&nbsp;Hannah Warren ,&nbsp;Alexander Light ,&nbsp;Ridhi Agarwal ,&nbsp;Aqua Asif ,&nbsp;Bing Jie Chow ,&nbsp;Keiran Clement ,&nbsp;Vinson Chan ,&nbsp;Eleanor Zimmermann ,&nbsp;Sinan Khadhouri ,&nbsp;Pieter Jan Eyskens ,&nbsp;Taimur T. Shah ,&nbsp;Arjun Nathan ,&nbsp;Kevin Byrnes ,&nbsp;Nikita Bhatt ,&nbsp;Nick Mani ,&nbsp;Cathy Yuhong Yuan ,&nbsp;Paul S. Sidhu ,&nbsp;Yemisi Takwoingi ,&nbsp;Veeru Kasivisvanathan","doi":"10.1016/j.euf.2025.04.026","DOIUrl":"10.1016/j.euf.2025.04.026","url":null,"abstract":"<div><h3>Background and objective</h3><div>Uncertainty regarding the diagnostic accuracy of ultrasound for testicular torsion (TT) and a lack of high-level evidence to inform international guidelines have led to significant global variation in its use. The objective of this study was to assess the diagnostic accuracy of ultrasound for TT.</div></div><div><h3>Methods</h3><div>This systematic review was undertaken in accordance with the <em>Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy</em>. A comprehensive electronic search strategy was applied up to January 4, 2024. Colour Doppler sonography (CDS) was the primary index test, with surgical scrotal exploration or clinical follow-up as the reference standard. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the risk of bias and applicability. Meta-analyses were performed using bivariate models.</div></div><div><h3>Key findings and limitations</h3><div>Sixty-three studies met the inclusion criteria; 54 (85.7%) assessed CDS, and the others assessed spectral doppler sonography (<em>n</em> = 6), contrast enhanced ultrasound (<em>n</em> = 1), or an alternative combination of ultrasound technologies (<em>n</em> = 2). The summary sensitivity (95% confidence interval [CI]) and specificity (95% CI) of CDS for the diagnosis of TT were 95.3% (91.4–97.5) and 98.3% (96.2–99.3), respectively (42 studies, 4422 participants). Patient selection (related to the risk of bias and applicability concern) was identified as the domain of the greatest methodological concern on QUADAS-2 assessment.</div></div><div><h3>Conclusions and clinical implications</h3><div>CDS has high diagnostic accuracy for TT. The ideal patient pathway for suspected TT should integrate timely access to ultrasound alongside clinical assessment, with careful patient counselling.</div></div>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"12 1","pages":"Pages 96-108"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urothelial Cancer: Leveraging Circulating Tumor DNA To Avoid Unnecessary Bladder-directed and Systemic Therapies","authors":"Jonathan Chatzkel ,&nbsp;Joshua Linscott ,&nbsp;G. Daniel Grass ,&nbsp;Roger Li","doi":"10.1016/j.euf.2025.07.012","DOIUrl":"10.1016/j.euf.2025.07.012","url":null,"abstract":"<div><div>Several studies have demonstrated the potential of circulating tumor DNA (ctDNA) for personalization of perioperative systemic treatment in muscle-invasive urothelial carcinoma (UC). Early studies focused on the ability to identify patients with residual disease who may benefit from additional systemic treatment. Further studies have suggested the potential of ctDNA measurement to tailor systemic and local treatments for patients with MIUC. This biomarker may ultimately reduce overtreatment, toxicity, and the financial burden associated with UC care. As ctDNA testing matures, it may offer clinicians a means to truly personalize treatment and thereby improve oncologic outcomes and enhance patients’ quality of life.</div></div><div><h3>Patient summary</h3><div>Our mini review looks at studies in which DNA from bladder cancer tumors that is circulating in the blood (called circulating tumor DNA, or ctDNA) is measured. Measurement of ctDNA levels after chemotherapy or immunotherapy can help predict cancer outcomes in patients undergoing bladder removal surgery.</div></div>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"12 1","pages":"Pages 38-40"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Future of Novel Antibody-drug Conjugates in Localized Urothelial Cancer","authors":"Mikolaj Filon,&nbsp;Bogdana Schmidt","doi":"10.1016/j.euf.2025.07.016","DOIUrl":"10.1016/j.euf.2025.07.016","url":null,"abstract":"<div><div>Antibody-drug conjugates (ADCs) have recently transformed the paradigm for metastatic urothelial carcinoma treatment. As these therapies demonstrate increasing efficacy and tolerability, attention is turning toward their use in earlier stages of disease. The current molecular targets for ADCs featured in large-scale trials have been Nectin-4 and TROP-2, leading to the development of enfortumab vedotin and sacituzumab govitecan; however, additional promising targets under investigation include HER2, FGFR3, EGFR, and CD-44. While identification of these targets is exciting, the next challenge is harnessing delivery mechanisms to maximize local responses, while limiting systemic toxicity. ADCs have the potential to enhance our ability to offer bladder-sparing therapies to patients with refractory non–muscle-invasive and potentially muscle-invasive disease, who were previously relying on radical cystectomy for treatment. ADCs represent an emerging frontier in the therapeutic landscape of urothelial carcinoma. While their use has thus far been limited to advanced disease, ongoing clinical trials and emerging data suggest possible expanded applications for ADCs in localized bladder cancer.</div></div><div><h3>Patient summary</h3><div>A new standard has emerged for metastatic urothelial carcinoma treatment with the combination of immunotherapy and antibody-drug conjugates. The use of these agents has the potential to transform the space of localized bladder cancer. While promising, many questions remain unanswered about how these new agents will be integrated into the treatment paradigm of non–muscle-invasive and localized muscle-invasive disease.</div></div>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"12 1","pages":"Pages 34-37"},"PeriodicalIF":5.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}