Pub Date : 2025-03-12DOI: 10.1097/JU.0000000000004524
Nicholas A Pickersgill, Joel M Vetter, Dylan J Mittauer, Lauren Elson, Joshua K Palka, Nimrod S Barashi, Eric H Kim, Ramakrishna Venkatesh, Sam B Bhayani, R Sherburne Figenshau
Purpose: Cryoablation (CA) and partial nephrectomy (PN) are effective nephron-sparing treatments for small renal masses. While guidelines list thermal ablation as an option for tumors <3 cm, limited data compare PN and CA in larger tumors. We compared intermediate-term oncologic outcomes between PN and CA in renal masses >3 cm.
Materials and methods: Patients treated with PN or CA for cT1/cT2, N0M0 renal masses >3 cm between 2006 and 2016 were identified. Propensity score matching was performed in a 1:2 ratio for patients undergoing CA or PN based on age, BMI, Charlson Comorbidity Index (CCI), tumor size, and nephrometry score. Disease-free survival (DFS), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS) were estimated using Kaplan-Meier analysis.
Results: One hundred thirteen and 57 patients underwent PN and CA with median follow-up of 4.5 and 3.8 years, respectively. CA was associated with significantly lower 5-year DFS compared to PN (75% vs. 94%, p<0.001). Local recurrence was more common after CA compared to PN (5.3% vs. 1.8%). Technical failure occurred with 32% of PCA. However, no significant differences were observed in 5-year MFS (100% for CA vs. 96% for PN, p=0.2) or CSS (100% for CA vs. 98% for PN, p=0.4).
Conclusions: CA is associated with lower DFS but similar MFS and CSS compared to PN in renal masses >3 cm. CA is a viable option for well-selected patients with comorbidities or high surgical risk, when combined with salvage ablation as indicated.
{"title":"Intermediate-Term Oncologic Outcomes of Partial Nephrectomy Versus Cryoablation in Renal Tumors >3 cm: A Propensity Score Matched Analysis.","authors":"Nicholas A Pickersgill, Joel M Vetter, Dylan J Mittauer, Lauren Elson, Joshua K Palka, Nimrod S Barashi, Eric H Kim, Ramakrishna Venkatesh, Sam B Bhayani, R Sherburne Figenshau","doi":"10.1097/JU.0000000000004524","DOIUrl":"https://doi.org/10.1097/JU.0000000000004524","url":null,"abstract":"<p><strong>Purpose: </strong>Cryoablation (CA) and partial nephrectomy (PN) are effective nephron-sparing treatments for small renal masses. While guidelines list thermal ablation as an option for tumors <3 cm, limited data compare PN and CA in larger tumors. We compared intermediate-term oncologic outcomes between PN and CA in renal masses >3 cm.</p><p><strong>Materials and methods: </strong>Patients treated with PN or CA for cT1/cT2, N0M0 renal masses >3 cm between 2006 and 2016 were identified. Propensity score matching was performed in a 1:2 ratio for patients undergoing CA or PN based on age, BMI, Charlson Comorbidity Index (CCI), tumor size, and nephrometry score. Disease-free survival (DFS), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS) were estimated using Kaplan-Meier analysis.</p><p><strong>Results: </strong>One hundred thirteen and 57 patients underwent PN and CA with median follow-up of 4.5 and 3.8 years, respectively. CA was associated with significantly lower 5-year DFS compared to PN (75% vs. 94%, <i>p</i><0.001). Local recurrence was more common after CA compared to PN (5.3% vs. 1.8%). Technical failure occurred with 32% of PCA. However, no significant differences were observed in 5-year MFS (100% for CA vs. 96% for PN, <i>p</i>=0.2) or CSS (100% for CA vs. 98% for PN, <i>p</i>=0.4).</p><p><strong>Conclusions: </strong>CA is associated with lower DFS but similar MFS and CSS compared to PN in renal masses >3 cm. CA is a viable option for well-selected patients with comorbidities or high surgical risk, when combined with salvage ablation as indicated.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"101097JU0000000000004524"},"PeriodicalIF":5.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615840","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}
Pub Date : 2025-03-11DOI: 10.1097/JU.0000000000004495
Henrique L Lepine, Rodrigo Gilles, William Carlos Nahas, Leopoldo Alves Ribeiro-Filho, Caio Vinícius Suartz
{"title":"Letter: Intraoperative Tranexamic Acid in Radical Cystectomy: Impact on Bleeding, Thromboembolism, and Survival Outcomes.","authors":"Henrique L Lepine, Rodrigo Gilles, William Carlos Nahas, Leopoldo Alves Ribeiro-Filho, Caio Vinícius Suartz","doi":"10.1097/JU.0000000000004495","DOIUrl":"https://doi.org/10.1097/JU.0000000000004495","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"101097JU0000000000004495"},"PeriodicalIF":5.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604943","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}
Pub Date : 2025-03-07DOI: 10.1097/JU.0000000000004413
Aidin Abedi, Luis Morales Ojeda, Stefania Montero, Nhi Ha, Priya Kohli, Petr Gaburak, Armita Abedi, David Chapman, Evgeniy Kreydin, David A Ginsberg
{"title":"Reply by Authors.","authors":"Aidin Abedi, Luis Morales Ojeda, Stefania Montero, Nhi Ha, Priya Kohli, Petr Gaburak, Armita Abedi, David Chapman, Evgeniy Kreydin, David A Ginsberg","doi":"10.1097/JU.0000000000004413","DOIUrl":"https://doi.org/10.1097/JU.0000000000004413","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"101097JU0000000000004413"},"PeriodicalIF":5.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575708","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}
Pub Date : 2025-03-06DOI: 10.1097/JU.0000000000004419
Sean P Elliott
{"title":"Trauma and Genital and Urethral Reconstruction.","authors":"Sean P Elliott","doi":"10.1097/JU.0000000000004419","DOIUrl":"https://doi.org/10.1097/JU.0000000000004419","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"101097JU0000000000004419"},"PeriodicalIF":5.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573124","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}
Pub Date : 2025-03-06DOI: 10.1097/JU.0000000000004511
Angela M Stover, Dana Mueller, Jessica Carda-Auten, Alison Hilton, Victoria Tsurutis, Angela B Smith
Purpose: Adults with low-grade intermediate risk non-muscle-invasive bladder cancer (LG-IR-NMIBC) commonly ask urologists how their routine/responsibilities will be affected by treatments, including the standard of care, transurethral resection of bladder tumor (TURBT). We asked patients in the ENVISION trial (NCT05243550) to compare TURBT to a non-surgical primary treatment (UGN-102 containing mitomycin) for acceptability and impact on their routine/responsibilities.
Materials and methods: ENVISION (NCT05243550) is a phase 3, single arm trial where UGN-102 was administered as six weekly intravesical instillations. Interviews with U.S. patients were conducted at enrollment (before instillations) and 3 months (primary trial endpoint). Transcripts were coded by three coders using the gold standard of content analysis to derive interview themes.
Results: Forty-one U.S. patients from 31 sites were eligible, and 29/41 completed both interviews. Most participants were men (62%), White (83%), and age 65+ (69%). Three themes were derived: 1) Patients perceived that TURBT interfered more with their routine/responsibilities. 2) Urinary symptoms were perceived to be similar, but bleeding, catheter issues, and time to resuming sexual activity lasted longer with TURBT. For UGN-102, uncommon reports were internal itching and difficulty keeping gel in the bladder during instillations. 3) Patients would recommend UGN-102 to other patients because it was perceived to be less invasive, painful, and time-consuming than TURBT.
Conclusion: Patients perceived UGN-102 to be a favorable primary treatment alternative to traditional surgical resections for LG-IR-NMIBC. By focusing on the underexplored area of patient perceptions, this study provides key information urologists will need to conduct shared decision-making conversations.
{"title":"Perceived impact on patient routines/responsibilities for surgery and a non-surgical primary treatment option in recurrent LG-IR-NMIBC: findings from the ENVISION phase 3 trial.","authors":"Angela M Stover, Dana Mueller, Jessica Carda-Auten, Alison Hilton, Victoria Tsurutis, Angela B Smith","doi":"10.1097/JU.0000000000004511","DOIUrl":"https://doi.org/10.1097/JU.0000000000004511","url":null,"abstract":"<p><strong>Purpose: </strong>Adults with low-grade intermediate risk non-muscle-invasive bladder cancer (LG-IR-NMIBC) commonly ask urologists how their routine/responsibilities will be affected by treatments, including the standard of care, transurethral resection of bladder tumor (TURBT). We asked patients in the ENVISION trial (NCT05243550) to compare TURBT to a non-surgical primary treatment (UGN-102 containing mitomycin) for acceptability and impact on their routine/responsibilities.</p><p><strong>Materials and methods: </strong>ENVISION (NCT05243550) is a phase 3, single arm trial where UGN-102 was administered as six weekly intravesical instillations. Interviews with U.S. patients were conducted at enrollment (before instillations) and 3 months (primary trial endpoint). Transcripts were coded by three coders using the gold standard of content analysis to derive interview themes.</p><p><strong>Results: </strong>Forty-one U.S. patients from 31 sites were eligible, and 29/41 completed both interviews. Most participants were men (62%), White (83%), and age 65+ (69%). Three themes were derived: 1) Patients perceived that TURBT interfered more with their routine/responsibilities. 2) Urinary symptoms were perceived to be similar, but bleeding, catheter issues, and time to resuming sexual activity lasted longer with TURBT. For UGN-102, uncommon reports were internal itching and difficulty keeping gel in the bladder during instillations. 3) Patients would recommend UGN-102 to other patients because it was perceived to be less invasive, painful, and time-consuming than TURBT.</p><p><strong>Conclusion: </strong>Patients perceived UGN-102 to be a favorable primary treatment alternative to traditional surgical resections for LG-IR-NMIBC. By focusing on the underexplored area of patient perceptions, this study provides key information urologists will need to conduct shared decision-making conversations.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"101097JU0000000000004511"},"PeriodicalIF":5.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573120","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}
Pub Date : 2025-03-06DOI: 10.1097/JU.0000000000004414
Fei Zhang, Sheng Li
{"title":"Letter: A Tailored Electronic Survivorship Care Plan for Prostate Cancer Survivors: A Multicenter Randomized Controlled Trial.","authors":"Fei Zhang, Sheng Li","doi":"10.1097/JU.0000000000004414","DOIUrl":"https://doi.org/10.1097/JU.0000000000004414","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"101097JU0000000000004414"},"PeriodicalIF":5.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573115","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}
Pub Date : 2025-03-06DOI: 10.1097/JU.0000000000004394
Junshu Xu, Minjun Jiang, Lingxiang Lu
{"title":"Letter: Validation of Prognostic Models for Renal Cell Carcinoma Recurrence, Cancer Specific Mortality, and All-Cause Mortality.","authors":"Junshu Xu, Minjun Jiang, Lingxiang Lu","doi":"10.1097/JU.0000000000004394","DOIUrl":"https://doi.org/10.1097/JU.0000000000004394","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"101097JU0000000000004394"},"PeriodicalIF":5.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573118","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}
Pub Date : 2025-03-05DOI: 10.1097/JU.0000000000004491
Samir S Taneja
{"title":"Urologic Oncology: Prostate Cancer.","authors":"Samir S Taneja","doi":"10.1097/JU.0000000000004491","DOIUrl":"https://doi.org/10.1097/JU.0000000000004491","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"101097JU0000000000004491"},"PeriodicalIF":5.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557223","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}