International Journal of Urology最新文献_第9页

Abiraterone Acetate Triggers ER Stress-Mediated Androgen Receptor Suppression via PERK/ATF4/CHOP Signaling in Prostate Cancer 前列腺癌中，醋酸阿比特龙通过PERK/ATF4/CHOP信号触发内质网应激介导的雄激素受体抑制

IF 2.2 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2025-12-03 DOI: 10.1111/iju.70304

Ekrem Basaran, Ceyhan Hacioglu

Objectives

Prostate cancer (PCa) is a leading malignancy among men, with treatment resistance posing significant clinical challenges, especially in advanced, castration-resistant cases. Abiraterone acetate (AA), a CYP17A1 inhibitor, suppresses androgen biosynthesis and is used to manage metastatic disease; however, its complete mechanism of action is not fully understood. This study investigates whether AA modulates androgen receptor (AR) expression via endoplasmic reticulum (ER) stress in PCa.

Methods

LNCaP (androgen-sensitive) and 22Rv1 (AR-variant-expressing) PCa cells were treated with AA (0.5–16 μM) for 24–72 h. Cytotoxicity and proliferation were assessed via CCK-8 and BrdU assays. Apoptosis was quantified by caspase-3/7 activation. ER stress markers (PERK, ATF4, CHOP) and AR were evaluated using RT-qPCR, Western blot, and immunofluorescence staining. Pharmacological PERK inhibition (GSK2656157) and activation (CCT020312) validated pathway involvement.

Results

AA induced concentration/time-dependent cytotoxicity in LNCaP cells (24 h IC₅₀ = 4.8 μM) and 22Rv1 cells (24 h IC₅₀ = 15.2 μM) and proliferation decreased by 54.1% and 7.3% at 4.8 μM, respectively. AA triggered apoptosis in LNCaP cells, increasing caspase-3/7-positive cells to 71.58% vs. 1.73% in controls (p < 0.0001). Mechanistically, AA upregulated PERK, ATF4, and CHOP mRNA/protein (p < 0.0001) while downregulating AR. Immunofluorescence confirmed reciprocal ATF4 nuclear accumulation and AR reduction in AA-treated LNCaP cells. PERK inhibition reversed AA-induced effects, while PERK activation phenocopied AA's AR suppression and cytotoxicity, confirming ER stress mediation via the PERK/ATF4/CHOP axis.

Conclusions

AA induces ER stress, leading to transcriptional downregulation of the AR and suppression of PCa cell viability and proliferation. Targeting the PERK pathway may enhance AA efficacy in AR-driven PCa.

目的：前列腺癌（PCa）是男性的主要恶性肿瘤，其治疗耐药性构成了重大的临床挑战，特别是在晚期，去势抵抗病例中。醋酸阿比特龙（AA）是一种CYP17A1抑制剂，可抑制雄激素的生物合成，并用于治疗转移性疾病；然而，其完整的作用机制尚不完全清楚。本研究探讨AA是否通过内质网（ER）应激调节雄激素受体（AR）的表达。方法：用AA （0.5 ~ 16 μM）处理LNCaP（雄激素敏感型）和22Rv1 （ar变异表达型）PCa细胞24 ~ 72 h。通过CCK-8和BrdU检测细胞毒性和增殖。caspase-3/7活化法测定细胞凋亡。采用RT-qPCR、Western blot和免疫荧光染色评估内质网应激标志物（PERK、ATF4、CHOP）和AR。药理PERK抑制（GSK2656157）和激活（CCT020312）证实了途径参与。结果：AA诱导LNCaP细胞（24 h IC₅₀= 4.8 μM）和22Rv1细胞（24 h IC₅₀= 15.2 μM）的浓度/时间依赖性细胞毒性，增殖在4.8 μM时分别下降54.1%和7.3%。AA触发LNCaP细胞凋亡，使caspase-3/7阳性细胞增加71.58%，而对照组为1.73% (p)。结论：AA诱导内质网应激，导致AR转录下调，抑制PCa细胞活力和增殖。靶向PERK通路可增强AA在ar驱动型PCa中的疗效。

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引用次数: 0

Editorial Comment on “A Comparative Study of Simultaneous and Delayed Penile Prosthesis During Robot-Assisted Radical Prostatectomy” “机器人辅助根治性前列腺切除术中同步和延迟阴茎假体的比较研究”的评论。

IF 2.2 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2025-12-03 DOI: 10.1111/iju.70310

Shirin Razdan

引用次数: 0

Bayesian Reanalysis of Adjuvant Nivolumab in Japanese Patients With High-Risk Muscle-Invasive Urothelial Carcinoma 日本高危肌侵性尿路上皮癌患者中Nivolumab辅助治疗的贝叶斯再分析

IF 2.2 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2025-12-03 DOI: 10.1111/iju.70305

Yosuke Yasuda, Soichiro Yoshida, Shugo Yajima, Hiroshi Fukushima, Akihiro Hirakawa, Yasuhisa Fujii

引用次数: 0

Editorial Comments on the Preliminary Analysis of Prostate Cancer Screening Results and Exploration of a Screening Model for Elderly Males in Rural Areas of Songjiang District, Shanghai 上海市松江区农村老年男性前列腺癌筛查结果初步分析及筛查模式探索

IF 2.2 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2025-12-03 DOI: 10.1111/iju.70308

Kensuke Mitsunari, Yuichiro Nakamura, Ryoichi Imamura

引用次数: 0

Operative Time Prediction by Machine Learning for Robot-Assisted Laparoscopic Radical Prostatectomy 机器学习预测机器人辅助腹腔镜根治性前列腺切除术的手术时间。

IF 2.2 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2025-11-30 DOI: 10.1111/iju.70292

Yu Suzuki, Shinya Sonobe, Yoshihide Kawasaki, Saori Ikumi, Eichi Takaya, Carlos Makoto Miyauchi, Tomoya Kobayashi, Junya Iwazaki, Hisanobu Adachi, Naoki Kawamorita, Akihiro Ito

Objectives

Operative time prediction is crucial for efficient operating room scheduling. This study developed and validated an operative time prediction system for robot-assisted laparoscopic radical prostatectomy using data from two institutions.

Methods

Retrospectively identified 557 and 150 patients who underwent RARP at Tohoku University Hospital and Miyagi Cancer Center were analyzed. The following variables were collected as explanatory variables for the prediction system: Age, height, body mass index, comorbidities, performance status, prostate volume, tumor extent of local invasion, grade group, prostatitis, preoperative treatment, history of intraperitoneal surgery, lymphadenectomy, and nerve-sparing. In addition, the observed operative time was collected as a source variable for the objective variable. The observed operative time was calculated as the sum of components related to institutional, operator, and patient factors. Approximation curves were applied to the first two components, while a random forest-based machine learning model was applied to the latter, resulting in the development of an integrated prediction system.

Results

The normalized root mean square error between the observed and predicted operative times was 0.107 in internal validation and 0.148 in external validation, demonstrating greater reliability than the expected operative time by operators in advance. Factors that are known to impact operative time, such as lymphadenectomy, grade group, prostate volume, and body mass index, were identified as contributing variables.

Conclusions

The system provides a reliable and robust prediction focusing on factors known to impact operative time. It has the potential to improve the efficiency of operating room scheduling.

目的：手术时间预测是手术室高效调度的关键。本研究利用两家机构的数据，开发并验证了机器人辅助腹腔镜根治性前列腺切除术的手术时间预测系统。方法：回顾性分析在东北大学医院和宫城癌症中心接受RARP治疗的557例和150例患者。收集以下变量作为预测系统的解释变量：年龄、身高、体重指数、合并症、运动状态、前列腺体积、肿瘤局部侵袭程度、分级组、前列腺炎、术前治疗、腹膜内手术史、淋巴结切除术、神经保留。另外，收集观察到的手术时间作为源变量作为目标变量。观察到的手术时间计算为机构、操作人员和患者因素相关成分的总和。将近似曲线应用于前两个组件，将基于随机森林的机器学习模型应用于后一个组件，从而开发了一个集成的预测系统。结果：观察到的手术时间与预测手术时间的归一化均方根误差在内部验证为0.107，在外部验证为0.148，比操作者事先预期的手术时间具有更高的可靠性。已知影响手术时间的因素，如淋巴结切除术、分级组、前列腺体积和体重指数，被确定为影响变量。结论：该系统对影响手术时间的已知因素提供了可靠和稳健的预测。它具有提高手术室调度效率的潜力。

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引用次数: 0

DNA Methylation Levels at the C3orf37 Loci Correlate With Prostate Cancer Grade C3orf37基因座DNA甲基化水平与前列腺癌分级相关

IF 2.2 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2025-11-27 DOI: 10.1111/iju.70299

Satoshi Sako, Saya Ito, Takashi Ueda, Yusuke Gabata, Hikaru Takahashi, Junki Murashita, Masayoshi Okumi, Fumiya Hongo, Osamu Ukimura

Objective

In addition to pathological diagnosis, the identification of a diagnostic index to determine indolent and index cancers will be useful for prostate cancer diagnosis. The present study aimed to provide evidence that quantification of DNA methylation levels at specific gene positions can serve as an indicator for the diagnosis of prostate cancer malignancy.

Methods

First, we attempted to identify genomic positions where cancer cells could be discriminated from normal cells using prostate-derived cultured cells by quantification of DNA methylation levels with methylation-specific PCR (MSP). Using needle biopsy tissue from patients with prostate cancer bisected by a tissue divider, we quantified DNA methylation levels at four candidate loci identified in cultured cells and analyzed the pathology. Finally, we examined the correlation between DNA methylation levels and gene expression levels in nearby genomic regions using identical tissue from patients with prostate cancer.

Results

Quantitative analysis using prostate-derived cultured cells and needle biopsy tissue from prostate cancer patients showed that DNA methylation levels at CpG sites near four genes (BCAT1, C3orf37, PCDHA1-8, and RAI1) were significantly higher in cancer than in normal. In particular, DNA methylation levels near the C3orf37 gene were higher in high-grade cancers compared to intermediate-grade cancers, showing a significant correlation with cancer grade. In addition, a correlation tendency between DNA methylation levels and gene expression levels was found at the PCDHA1 locus among the four genetic loci.

Conclusions

Quantitative analysis of DNA methylation at CpG sites near the C3orf37 gene appears to be a promising approach to distinguish between index and indolent prostate cancer cells.

目的：在病理诊断的基础上，鉴别出一种诊断指标来判断前列腺癌的惰性和指标性，将有助于前列腺癌的诊断。本研究旨在提供证据，量化特定基因位置的DNA甲基化水平可作为前列腺癌恶性诊断的指标。方法：首先，我们试图通过甲基化特异性PCR （methyl- specific PCR， MSP）定量DNA甲基化水平，在前列腺来源的培养细胞中确定癌细胞与正常细胞区分的基因组位置。利用组织分裂器对前列腺癌患者的穿刺活检组织进行切片，我们量化了培养细胞中鉴定的四个候选位点的DNA甲基化水平，并分析了病理学。最后，我们使用来自前列腺癌患者的相同组织检查了DNA甲基化水平与附近基因组区域基因表达水平之间的相关性。结果：对前列腺癌患者的前列腺源性培养细胞和穿刺活检组织进行定量分析显示，癌症患者的四个基因（BCAT1、C3orf37、PCDHA1-8和RAI1）附近的CpG位点的DNA甲基化水平显著高于正常患者。特别是，与中度癌症相比，高级别癌症中C3orf37基因附近的DNA甲基化水平更高，显示出与癌症级别的显著相关性。此外，在4个遗传位点中，PCDHA1位点的DNA甲基化水平与基因表达水平存在相关趋势。结论：定量分析C3orf37基因附近CpG位点的DNA甲基化似乎是区分指数和惰性前列腺癌细胞的一种有希望的方法。

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引用次数: 0

Anatomy of Adipose Compartments and Fascial Structures in the Posterolateral Region of the Kidney With Special Focus on the Thin Adipose Compartment 肾脏后外侧区域脂肪隔室和筋膜结构的解剖，特别关注薄脂肪隔室。

IF 2.2 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2025-11-27 DOI: 10.1111/iju.70303

Atsuhiko Ochi, Satoru Muro, Sho Mitsumaru, Akimoto Nimura, Keiichi Akita

Objectives

To anatomically and histologically define the adipose and fascial structures posterior and lateral to the kidney and propose a compartment-based anatomical model aligned with intraoperative observations.

Methods

Seven cadavers were used for macroscopic and histological analyses. In the macroscopic analysis, the spatial relationships between the perirenal fat (PeRF), pararenal fat, posterior renal fascia (PRF), and extraperitoneal fascia (EPF) were examined. Histological observations focused on the distribution and continuity of adipose compartments and the organization of the surrounding dense fibrous connective tissue.

Results

Macroscopically, the EPF covered the anteromedial pararenal fat and extended posteriorly to the kidney. Upon incision, a small amount of adipose tissue was observed directly beneath it. Removing this TAC exposes the peritoneum and PRF with a clear demarcation between them. Histological analysis confirmed that the posterior renal and EPF were distinct, with dense connective tissue structures enclosing a separate TAC. This compartment extended anteriorly between the PeRF and peritoneum, and laterally between the peritoneum and EPF. These extensions converge near the peritoneal reflection in the lateral renal region, forming a characteristic triradiate configuration of adipose tissue.

Conclusions

Our findings challenge the classical notion that the renal fascia is a single continuous layer, supporting a compartment-centered anatomical model. The posterior and lateral regions of the kidney contain a distinct third adipose compartment, bordered by the posterior renal and extraperitoneal fasciae. This model offers improved anatomical clarity and may aid understanding during laparoscopic, retroperitoneoscopic, and robot-assisted surgeries.

目的：从解剖学和组织学上确定肾脏后部和外侧的脂肪和筋膜结构，并根据术中观察提出一个基于腔室的解剖模型。方法：对7具尸体进行宏观和组织学分析。在宏观分析中，检查了肾周脂肪（PeRF）、肾旁脂肪、肾后筋膜（PRF）和腹膜外筋膜（EPF）之间的空间关系。组织学观察的重点是脂肪室的分布和连续性以及周围致密纤维结缔组织的组织。结果：宏观上，EPF覆盖了前内侧肾旁脂肪，并向后延伸至肾脏。切开后，在其正下方可见少量脂肪组织。切除这个TAC暴露腹膜和PRF，两者之间有明确的界限。组织学分析证实后肾和EPF是不同的，致密的结缔组织结构包围着一个单独的TAC。这个隔室向前延伸至PeRF和腹膜之间，向外侧延伸至腹膜和EPF之间。这些延伸在侧肾区靠近腹膜反射处收敛，形成脂肪组织的特征性三辐射状结构。结论：我们的研究结果挑战了肾筋膜是单一连续层的传统观念，支持室中心解剖模型。肾脏后部和外侧区域包含明显的第三脂肪隔室，由肾后筋膜和腹膜外筋膜隔开。该模型提高了解剖清晰度，有助于在腹腔镜、后腹膜镜和机器人辅助手术中理解。

{"title":"Anatomy of Adipose Compartments and Fascial Structures in the Posterolateral Region of the Kidney With Special Focus on the Thin Adipose Compartment","authors":"Atsuhiko Ochi, Satoru Muro, Sho Mitsumaru, Akimoto Nimura, Keiichi Akita","doi":"10.1111/iju.70303","DOIUrl":"10.1111/iju.70303","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To anatomically and histologically define the adipose and fascial structures posterior and lateral to the kidney and propose a compartment-based anatomical model aligned with intraoperative observations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seven cadavers were used for macroscopic and histological analyses. In the macroscopic analysis, the spatial relationships between the perirenal fat (PeRF), pararenal fat, posterior renal fascia (PRF), and extraperitoneal fascia (EPF) were examined. Histological observations focused on the distribution and continuity of adipose compartments and the organization of the surrounding dense fibrous connective tissue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Macroscopically, the EPF covered the anteromedial pararenal fat and extended posteriorly to the kidney. Upon incision, a small amount of adipose tissue was observed directly beneath it. Removing this TAC exposes the peritoneum and PRF with a clear demarcation between them. Histological analysis confirmed that the posterior renal and EPF were distinct, with dense connective tissue structures enclosing a separate TAC. This compartment extended anteriorly between the PeRF and peritoneum, and laterally between the peritoneum and EPF. These extensions converge near the peritoneal reflection in the lateral renal region, forming a characteristic triradiate configuration of adipose tissue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings challenge the classical notion that the renal fascia is a single continuous layer, supporting a compartment-centered anatomical model. The posterior and lateral regions of the kidney contain a distinct third adipose compartment, bordered by the posterior renal and extraperitoneal fasciae. This model offers improved anatomical clarity and may aid understanding during laparoscopic, retroperitoneoscopic, and robot-assisted surgeries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Malpractice Stress Syndrome and Defensive Medicine in Surgical Specialties: Evidence From Urologists in Turkey 医疗事故应激综合征和防御医学在外科专科：证据从泌尿科医生在土耳其。

IF 2.2 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2025-11-27 DOI: 10.1111/iju.70302

Alper Şimşek, Aykut Başer

Objectives

Malpractice litigation is an increasing concern in surgical specialties, with significant psychological and behavioral consequences. Defensive medicine is a frequent response, but data in urology are scarce. This study evaluated malpractice-related stress and defensive medical practices among Turkish urologists.

Methods

A cross-sectional online survey was conducted between June and July 2025 among practicing urologists in Turkey. The questionnaire, developed according to the CHERRIES checklist, included demographics, malpractice experiences, anxiety related to litigation, and defensive attitudes. Defensive practices were assessed using the validated Turkish version of the Defensive Medicine Attitude Scale. Statistical analyses were performed with Chi-square, Fisher's Exact, Mann–Whitney U, and Kruskal–Wallis tests.

Results

A total of 152 urologists participated. The largest age group was 30–39 years (32.9%), and 44.7% had ≥ 20 years of experience. Overall, 73% had malpractice lawsuit experience (personal or colleague), and 91.4% reported litigation-related anxiety. High compensation concerns were significantly associated with avoidance of patients likely to sue (p = 0.032) and complex patients (p < 0.001). Senior physicians and those with academic titles more often spent time with patients (p = 0.012, p = 0.014).

Conclusion

Malpractice stress and defensive medicine are highly prevalent among Turkish urologists. These behaviors reflect physicians' psychological burden and influence clinical decision-making. Professional support and legislative reforms are essential to mitigate malpractice-related stress and reduce defensive practices.

目的：医疗事故诉讼日益受到外科专业的关注，具有显著的心理和行为后果。防御医学是常见的反应，但泌尿科的数据很少。本研究评估了土耳其泌尿科医生的医疗事故相关压力和防御性医疗实践。方法：于2025年6月至7月对土耳其执业泌尿科医生进行横断面在线调查。调查问卷，根据樱桃检查表，包括人口统计，医疗事故的经验，与诉讼有关的焦虑，和防御态度。使用经过验证的土耳其版防御性医学态度量表评估防御性做法。采用卡方检验、Fisher’s Exact检验、Mann-Whitney U检验和Kruskal-Wallis检验进行统计分析。结果：共有152名泌尿科医师参与。30-39岁占比最大（32.9%），≥20年经验占比44.7%。总体而言，73%的人有医疗事故诉讼经历（个人或同事），91.4%的人有诉讼相关的焦虑。高赔偿问题与患者可能会起诉的回避显著相关（p = 0.032）和复杂的患者(p结论：医疗事故压力和防御性药物在土耳其泌尿科医生中非常普遍。这些行为反映了医生的心理负担，影响了临床决策。专业支持和立法改革对于减轻与不当行为有关的压力和减少防御行为至关重要。

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引用次数: 0

Outcomes of Nivolumab-Plus-Ipilimumab in Metastatic Renal Cell Carcinoma: Second Interim Analysis of the J-ENCORE Study nivolumab + ipilimumab治疗转移性肾细胞癌的结果：J-ENCORE研究的第二次中期分析

IF 2.2 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2025-11-25 DOI: 10.1111/iju.70281

Tomokazu Sazuka, Katsunori Tatsugami, Suguru Shirotake, Shuzo Hamamoto, Masahiro Nozawa, Kazuyuki Numakura, Atsushi Mizokami, Tsunenori Kondo, Sei Naito, Takashige Abe, Kojiro Ohba, Go Kimura, Shunta Onodera, Katsumi Yamaguchi, Hirotsugu Uemura

Objectives

J-ENCORE is a multicenter prospective observational study in Japan involving advanced or metastatic renal cell carcinoma patients receiving nivolumab-plus-ipilimumab (NIVO+IPI) as first-line treatment. The minimum 1-year observation revealed the efficacy and safety of NIVO+IPI comparable to those in CheckMate 214, and evaluated patient characteristics across subgroups for response and early progression. This minimum 2-year observation focuses on the post-treatment status after NIVO+IPI discontinuation.

Methods

The objective response rate (ORR), response duration, progression-free survival (PFS), overall survival (OS), treatment-related adverse events (TRAEs), treatment-free status, and second-line treatment were evaluated.

Results

The study included 274 patients (median age, 68 years; 24.8% aged ≥ 75 years; 15.7% had an Eastern Cooperative Oncology Group performance status ≥ 2; 58.0%, intermediate risk; 42.0%, poor risk) from 37 sites, with a median follow-up of 35.4 (range, 24.4–47.0) months. The ORR was 37.6%, with a median real-world duration of response at 17.1 months; 30.2% had real-world PFS ≥ 24 months, and the OS rate at 24 months was 67.2%. TRAEs of any grade, grade 3/4, and grade 5 occurred in 77.4%, 42.7%, and 1.1% of patients, respectively. Furthermore, 11.1% experienced late-onset TRAEs 28–100 days after discontinuation. For patients discontinuing NIVO+IPI due to adverse events, median treatment-free survival was 7.4 months; 34.9% had a treatment-free interval ≥ 12 months. Second-line treatment ORR was 22.0%, with cabozantinib as the most common choice.

Conclusions

We determined the long-term real-world effectiveness and safety of NIVO+IPI, providing beneficial information on post-treatment status.

Trial Registration

UMIN Clinical Trials Registry number: UMIN000036772; ClinicalTrials.gov identifier: NCT04043975

J-ENCORE是一项在日本进行的多中心前瞻性观察性研究，研究对象为接受nivolumab + ipilimumab （NIVO+IPI）作为一线治疗的晚期或转移性肾癌患者。至少1年的观察显示NIVO+IPI的有效性和安全性与CheckMate 214相当，并评估了亚组患者的反应和早期进展特征。这项至少2年的观察主要关注NIVO+IPI停药后的治疗状态。方法：评估客观缓解率（ORR）、缓解持续时间、无进展生存期（PFS）、总生存期（OS）、治疗相关不良事件（TRAEs）、无治疗状态、二线治疗。结果：研究纳入了来自37个地点的274例患者（中位年龄68岁；24.8%年龄≥75岁；15.7%的患者在东方肿瘤合作组的表现状态≥2；58.0%为中危；42.0%为低危），中位随访35.4个月（范围24.4-47.0）。ORR为37.6%，实际反应持续时间中位数为17.1个月；30.2%的患者真实PFS≥24个月，24个月OS率为67.2%。任何级别、3/4级和5级trae分别发生在77.4%、42.7%和1.1%的患者中。此外，11.1%的患者在停药后28-100天出现迟发性trae。对于因不良事件而停止NIVO+IPI治疗的患者，中位无治疗生存期为7.4个月；34.9%患者无治疗间隔≥12个月。二线治疗ORR为22.0%，卡博赞替尼是最常见的选择。结论：我们确定了NIVO+IPI的长期实际有效性和安全性，提供了治疗后状态的有益信息。试验注册：UMIN临床试验注册号：UMIN000036772；ClinicalTrials.gov识别码：NCT04043975。

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引用次数: 0

Editorial Comment of Antibiotic Prophylaxis in Men Undergoing Transurethral Resection of Prostate: A Systematic Review and Network Meta-Analysis 经尿道前列腺切除术男性抗生素预防：系统回顾和网络荟萃分析。

IF 2.2 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology

Pub Date : 2025-11-25 DOI: 10.1111/iju.70294

Yoshikazu Togo

引用次数: 0