European urology oncology最新文献

{"title":"Risk of Upgrading at Final Pathology after Transperineal Versus Transrectal Magnetic Resonance Imaging–targeted Prostate Biopsies: A Post Hoc Analysis of the PERFECT Trial","authors":"Alessandro Uleri , Eric Barret , Gaëlle Fiard , Louis Lenfant , Bernard Malavaud , Raphaële Renard-Penna , François Rozet , Jean-Baptiste Beauval , Ambroise Salin , Morgan Rouprêt , Guillaume Ploussard","doi":"10.1016/j.euo.2025.03.018","DOIUrl":"10.1016/j.euo.2025.03.018","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 6","pages":"Pages 1457-1458"},"PeriodicalIF":9.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of the Circulating Tumor DNA Fraction in Metastatic Castration-resistant Prostate Cancer: Results from the ProBio Platform Trial","authors":"Alessio Crippa ,&nbsp;Bram De Laere ,&nbsp;Andrea Discacciati ,&nbsp;Berit Larsson ,&nbsp;Maria Persson ,&nbsp;Susanne Johansson ,&nbsp;Sanne D’hondt ,&nbsp;Marie Hjälm-Eriksson ,&nbsp;Linn Pettersson ,&nbsp;Gunilla Enblad ,&nbsp;Anders Ullén ,&nbsp;Nicolaas Lumen ,&nbsp;Camilla Thellenberg Karlsson ,&nbsp;Johan Sandzén ,&nbsp;Elin Jänes ,&nbsp;Christophe Ghysel ,&nbsp;Martha Olsson ,&nbsp;Brieuc Sautois ,&nbsp;Peter Schatteman ,&nbsp;Wendy De Roock ,&nbsp;Martin Eklund","doi":"10.1016/j.euo.2025.02.002","DOIUrl":"10.1016/j.euo.2025.02.002","url":null,"abstract":"<div><h3>Background and objective</h3><div>The aim of this study was to evaluate the prognostic value of undetectable circulating tumor DNA (ctDNA) and the dose-response relationship between ctDNA levels and survival outcomes in metastatic castration-resistant prostate cancer (mCRPC).</div></div><div><h3>Methods</h3><div>We analyzed data for patients enrolled in the ProBio trial up to November 2022 who received an androgen receptor pathway inhibitor or taxane. We compared survival outcomes between patients with undetectable ctDNA and those with detectable ctDNA randomized to physician’s choice or investigational arms. Time to no longer clinically benefiting (NLCB) and overall survival (OS) were assessed using Bayesian survival models, with results reported as survival time ratios (STRs). Dose-response relationships were estimated using spike-at-zero models.</div></div><div><h3>Key findings and limitations</h3><div>A total of 220 patients were included, of whom 139 had detectable ctDNA (56 in the physician’s choice arm, 83 in investigational arms) and 81 had undetectable ctDNA. In comparison to the undetectable ctDNA group, the physician’s choice arm had 60% shorter time to NLCB (STR 0.40, 90% credible interval [CrI] 0.31–0.51) and 51% shorter OS (STR 0.49, 90% CrI 0.38–0.61). Similar results were observed in comparison to the investigational arms. Dose-response analysis revealed that the undetectable ctDNA group had twofold longer time to NLCB (STR 2.05, 90% CrI 1.66–2.57) and 1.6-fold longer OS (STR 1.63, 90% CrI 1.33–2.05) in comparison to the subgroup with a ctDNA fraction of 2.5%. Every 10-point increment in the ctDNA fraction corresponded to a 10% reduction in NLCB and OS times.</div></div><div><h3>Conclusions and clinical implications</h3><div>Undetectable ctDNA at baseline predicts superior prognosis in mCRPC, suggesting potential for treatment de-escalation and less intensive monitoring for this subgroup of patients.</div><div>This trial is registered on ClinicalTrials.gov as NCT03903835.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 6","pages":"Pages 1486-1495"},"PeriodicalIF":9.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Kidney, Liver, and Immune Function on Circulating Tumor DNA Detection in Muscle-invasive Bladder Cancer","authors":"Deema Radif ,&nbsp;Sia Viborg Lindskrog ,&nbsp;Iver Nordentoft ,&nbsp;Karin Birkenkamp-Demtröder ,&nbsp;Jørgen Bjerggaard Jensen ,&nbsp;Mads Agerbæk ,&nbsp;Lars Dyrskjøt","doi":"10.1016/j.euo.2025.09.012","DOIUrl":"10.1016/j.euo.2025.09.012","url":null,"abstract":"<div><h3>Background and objective</h3><div>The kidneys and liver play key roles in the metabolism of circulating molecules, including nucleic acids. To advance the clinical utility of circulating tumor DNA (ctDNA), it is essential to examine factors potentially affecting plasma ctDNA levels, including those influencing the clearance of cell-free DNA and ctDNA. This study evaluated the associations between plasma ctDNA detection and biochemical markers indicative of kidney and liver function, and leukocyte-based immune function and inflammation in patients with muscle-invasive bladder cancer (MIBC), along with their prognostic potential.</div></div><div><h3>Methods</h3><div>A tumor-informed plasma ctDNA analysis was conducted for 276 MIBC patients treated at Aarhus University Hospital. Biochemical measurements collected within 10 d of available ctDNA tests were retrieved from electronic health records. Statistical analyses included multivariable logistic and linear regression models, and false discovery rate correction.</div></div><div><h3>Key findings and limitations</h3><div>Significant associations between kidney or liver function markers and ctDNA detection were not observed. Leukocyte count (odds ratio [OR] = 1.29 [95% confidence interval: 1.07; 1.54]), neutrophil count (OR = 1.50 [1.17; 1.92]), and neutrophil-to-lymphocyte ratio (OR = 4.01 [1.85; 8.71]) were significantly associated with ctDNA detection. Associations between biochemical parameters and pathological downstaging or recurrence were not observed. Limitations include the nonconcurrent timing of biochemical and ctDNA measurements.</div></div><div><h3>Conclusions and clinical implications</h3><div>This study shows no evidence that plasma ctDNA detection is affected by kidney/liver function, ensuring the reliability of using ctDNA to monitor MIBC patients. Elevated leukocyte-based immune markers were observed in ctDNA-positive patients, but the evaluated biochemical parameters showed no prognostic value. Further studies are warranted to confirm these findings.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 6","pages":"Pages 1598-1606"},"PeriodicalIF":9.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MicroRNA as a Liquid Biomarker to Detect Malignancy in Small Testicular Masses","authors":"Julian Chavarriaga ,&nbsp;Carley Langleben ,&nbsp;João Lobo ,&nbsp;Lucia Nappi ,&nbsp;George M. Yousef ,&nbsp;Gizem Ozcan ,&nbsp;Nastaran Khazamipour ,&nbsp;Nuno Tiago Tavares ,&nbsp;Ioannis Prassas ,&nbsp;Lampros Dimitrakopoulos ,&nbsp;Xiaotian Yuan ,&nbsp;Adam Bobrowski ,&nbsp;Susan Prendeville ,&nbsp;Lynn Anson-Cartwright ,&nbsp;Carmen Jeronimo ,&nbsp;Keith Jarvi ,&nbsp;Martin O’Malley ,&nbsp;Ricardo Leão ,&nbsp;Katherine Lajkosz ,&nbsp;Robert J. Hamilton","doi":"10.1016/j.euo.2025.08.004","DOIUrl":"10.1016/j.euo.2025.08.004","url":null,"abstract":"<div><h3>Background and objective</h3><div>Approximately 1–4% of individuals undergoing scrotal ultrasound are found with incidental small (≤2 cm) testicular masses (STMs), with the vast majority being benign (∼13–21% malignant). This study explores the potential of microRNAs (miRNAs) as liquid biomarkers for predicting germ cell tumors (GCTs) in STMs.</div></div><div><h3>Methods</h3><div>From 2009 to 2023, we identified patients with STMs who had banked serum/plasma prior to orchiectomy. Eligible samples were analyzed using different miRNA expression methods (reverse transcription quantitative polymerase chain reaction [RT-qPCR] and digital droplet polymerase chain reaction) and platforms across three research laboratory facilities (Portugal, Vancouver, and Toronto). The miRNA assays included 371a-3p, 372, 373, and 367. The primary objective was to evaluate the diagnostic accuracy of miR-371a-3p to predict the presence of testicular cancer using the area under the curve (AUC).</div></div><div><h3>Key findings and limitations</h3><div>Our cohort included 61 patients: 37 patients with confirmed GCTs, 20 patients with benign histology, and four patients who had been on surveillance for &gt;24 mo and were deemed to have benign STMs. Across all three laboratories, miR-371a-3p consistently outperformed all the miRNAs, with the other miRNAs proving uninformative. Extraction from plasma and an RT-qPCR analysis (Vancouver laboratory) proved best, with sensitivity of 87% and specificity of 91%, translating into an AUC of 0.93. The receiver operating characteristic scores for the other two laboratories were 0.77 and 0.73 for Portugal and Toronto, respectively. This single-center study is limited by a potential selection bias and fewer evaluable samples due to technical and logistical issues.</div></div><div><h3>Conclusions and clinical implications</h3><div>This is the largest series of STMs with banked blood/serum to date. Among the miRNAs, miR-371a-3p was found to be sensitive and specific for detecting the presence of GCTs in STMs. Plasma with an RT-qPCR approach proved to be a superior method of analysis.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 6","pages":"Pages 1575-1582"},"PeriodicalIF":9.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Implementation of Risk Calculators for the Selection of Extended Pelvic Lymph Node Dissection Candidates: 20-year Experience from a Tertiary Referral Centre","authors":"Francesco Barletta ,&nbsp;Simone Scuderi ,&nbsp;Pietro Scilipoti ,&nbsp;Mattia Longoni ,&nbsp;Leonardo Quarta ,&nbsp;Antony Pellegrino ,&nbsp;Donato Cannoletta ,&nbsp;Riccardo Leni ,&nbsp;Paolo Zaurito ,&nbsp;Alfonso Santangelo ,&nbsp;Abigail Gettman ,&nbsp;Alessandro Viti ,&nbsp;Andrea Cosenza ,&nbsp;Michele Brancaccio ,&nbsp;Armando Stabile ,&nbsp;Francesco Montorsi ,&nbsp;Giorgio Gandaglia ,&nbsp;Alberto Briganti","doi":"10.1016/j.euo.2025.08.006","DOIUrl":"10.1016/j.euo.2025.08.006","url":null,"abstract":"<div><h3>Background and objective</h3><div>Several models predicting the lymph node invasion (LNI) risk in radical prostatectomy (RP) patients have been proposed to identify extended pelvic lymph node dissection (ePLND) candidates. We hypothesised that the implementation of these tools in the clinical practice would not hamper nodal staging accuracy, with benefits in perioperative outcomes.</div></div><div><h3>Methods</h3><div>A total of 7371 patients treated with RP ± ePLND between 2002 and 2023 were identified at a referral centre where the use of preoperative risk tools (Briganti nomograms) was implemented. Differences in pN stage (pNx vs pN0 vs pN1), ePLND-specific complications, and readmission rates (available from 2017, <em>n</em> = 1161) were displayed using the estimated annual percent change (EAPC). Multivariable linear regression tested the association of year of surgery with operative time, among cases performed with a robot-assisted approach by experienced surgeons (<em>n</em> = 1484). Survival analyses focused on biochemical (BCR) and clinical (CR) recurrence risks according to pN status (pNx vs pN0/1) in patients with a Briganti 2012 risk of &lt;5% (<em>n</em> = 3774).</div></div><div><h3>Key findings and limitations</h3><div>Overall, 5352 (73%) versus1222 (17%) versus 797 (11%) patients were at pN0 versus pNx versus pN1 stage. A total of 509 (6.9%) patients experienced ePLND-specific complications. The rates of pNx and pN1 during the study period ranged from 4.7% to 38% (EAPC: 8.9%, <em>p</em> &lt; 0.001) and from 14% to 15% (EAPC: 1.6%, 95% confidence interval 0.29–3, <em>p</em> = 0.02), respectively. Decreased ePLND-specific complication rates were observed over the study period (EAPC: –4.6%, <em>p</em> = 0.01). Readmission rates decreased from 8% to 2.3% (EAPC: –13%, <em>p</em> = 0.046). Year of surgery was independently associated with reduced operative time (β coefficient –6.3, <em>p</em> &lt; 0.001). In multivariable Cox-regression models, pN0/1 patients exhibited similar BCR (hazard ratio [HR]: 1.1, <em>p</em> = 0.4) and CR (HR: 0.98, <em>p</em> = 0.95) risks to pNx patients. A study limitation is represented by the lack of individual LNI risk data on which the decision to perform ePLND was based.</div></div><div><h3>Conclusions and clinical implications</h3><div>The implementation of nomograms for preoperative LNI risk did not hamper nodal staging accuracy and reduced the number of ePLND procedures performed, with significant benefits in terms of RP patients’ outcomes.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 6","pages":"Pages 1583-1591"},"PeriodicalIF":9.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Himanshu Nagar, Marshall A. Diven, Brady Rippon, et al. A Randomized Controlled Phase 2 Trial Comparing Salvage Radiotherapy for Prostate Cancer Delivered in 4 Versus 2 Weeks (SHORTER): Acute Genitourinary and Gastrointestinal Patient-reported Outcomes at a Single Institution. Eur Urol Oncol. In press. https://doi.org/10.1016/j.euo.2025.05.014","authors":"Francesco Montorsi ,&nbsp;Paolo Zaurito ,&nbsp;Giorgio Gandaglia ,&nbsp;Alberto Briganti","doi":"10.1016/j.euo.2025.08.010","DOIUrl":"10.1016/j.euo.2025.08.010","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 6","pages":"Page 1712"},"PeriodicalIF":9.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Matthew J. Roberts, Philip Cornford, Derya Tilki. Oncological Benefits of Extended Pelvic Lymph Node Dissection: More Fog or Clarity to the Debate? Eur Urol. In press. https://doi.org/10.1016/j.eururo.2024.12.001","authors":"Maria Chiara Sighinolfi ,&nbsp;Bernardo Rocco","doi":"10.1016/j.euo.2025.01.014","DOIUrl":"10.1016/j.euo.2025.01.014","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 6","pages":"Pages 1708-1709"},"PeriodicalIF":9.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bladder Cancer with Undetectable Circulating Tumor DNA After Radical Cystectomy May Be Amenable to a Less Intense Imaging Surveillance Protocol: A Diagnostic Accuracy Study","authors":"Ahmed Eraky ,&nbsp;Reuben Ben-David ,&nbsp;Brenda Hug,&nbsp;Kaushik P. Kolanukuduru,&nbsp;Mohammed Almoflihi,&nbsp;Nikhil Waingankar,&nbsp;Kyrollis Attalla,&nbsp;Peter Wiklund,&nbsp;Reza Mehrazin,&nbsp;John P. Sfakianos","doi":"10.1016/j.euo.2025.04.027","DOIUrl":"10.1016/j.euo.2025.04.027","url":null,"abstract":"<div><h3>Background and objective</h3><div>Circulating tumor DNA (ctDNA) has shown promise as a prognostic biomarker for bladder cancer management. Current surveillance guidelines for patients with muscle-invasive bladder cancer recommend intense postoperative surveillance. Our aim was to assess the diagnostic performance of ctDNA in comparison to imaging studies for detection of disease recurrence after radical cystectomy.</div></div><div><h3>Methods</h3><div>We analyzed patients who underwent robot-assisted radical cystectomy and prospective tumor-informed ctDNA analysis (Signatera™) between 2021 and 2023 at a single institution. Patients with postoperative imaging and ctDNA results were included; patients with nonurothelial histology or missing ctDNA data were excluded. Diagnostic accuracy was evaluated at the patient level using imaging findings as the reference standard and ctDNA as the index test. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ctDNA measurement were calculated.</div></div><div><h3>Key findings and limitations</h3><div>A total of 94 patients were included (median age 70 yr, interquartile range [IQR] 63–77). Most had ≥pT2 disease (75.4%) that was node-negative disease (71.3%). Over median follow-up of 16 mo (IQR 9–22), 388 imaging studies and 283 ctDNA tests were performed. ctDNA demonstrated sensitivity and an NPV of 100.0% (95% confidence interval [CI] 100.0–100.0%), specificity of 91.8% (95% CI 87.6–95.5%), and a PPV of 84.5% (95% CI 76.8–91.3%).</div></div><div><h3>Conclusions and clinical implications</h3><div>ctDNA measurement may serve as a valuable tool for bladder cancer surveillance after cystectomy. Patients with persistently undetectable ctDNA may benefit from less intensive surveillance protocols aligned with their lower risk of recurrence. This strategy warrants further research to validate its clinical utility and support integration into routine practice.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 6","pages":"Pages 1505-1512"},"PeriodicalIF":9.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Conundrum of Intermediate Risk in Localised Prostate Cancer: One Group, Many Realities","authors":"Arthur Peyrottes ,&nbsp;Guillaume Ploussard ,&nbsp;Paul Sargos ,&nbsp;Eric Barret ,&nbsp;Michael Baboudjian","doi":"10.1016/j.euo.2025.09.017","DOIUrl":"10.1016/j.euo.2025.09.017","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 6","pages":"Pages 1451-1453"},"PeriodicalIF":9.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Paradox of Our Time: Evidence-based Guidelines are Blocking Evidence-based Artificial Intelligence","authors":"Vincent Misrai ,&nbsp;Alena Bruchon","doi":"10.1016/j.euo.2025.10.008","DOIUrl":"10.1016/j.euo.2025.10.008","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"8 6","pages":"Pages 1454-1456"},"PeriodicalIF":9.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}