Translational andrology and urology最新文献

Background: Wilms tumor (WT) is the most common pediatric malignant renal tumor in children. Overall, the prognosis for recurrent WT remains poor, with an overall survival (OS) rate of approximately 50%. This study aimed to characterize the clinical features and outcomes of patients with relapsed unilateral WT.

Methods: We conducted a retrospective study of patients diagnosed with and treated for relapsed unilateral WT at Beijing Children's Hospital between January 2010 and December 2022.

Results: A total of 46 patients with recurrent WT were included in the study. The 5-year event-free survival (EFS) and OS rates from the time of first relapse were 44.5% [95% confidence interval (CI): 28.4-59.4%] and 54.7% (95% CI: 37.4-69.0%), respectively. Multivariable Cox proportional hazards regression analysis revealed that early relapse and nonoperative management after relapse were independent risk factors for a second recurrence. Patients who relapsed within six months had a significantly higher risk of second recurrence than those who relapsed after six months [hazard ratio (HR) 3.0; 95% CI: 1.1-8.8; P=0.03]. Patients who did not undergo surgery after relapse had a significantly higher risk of second recurrence than those who did (HR 3.9; 95% CI: 1.4-11.4; P=0.01). In addition, the only factor significantly associated with OS in this cohort was the histology of the initial tumor. Focal or diffuse anaplasia in the initial tumor was associated with a markedly higher risk of death (HR 10.3; 95% CI: 2.1-50.9; P=0.007).

Conclusions: We emphasize the importance of identifying adverse risk factors for recurrent WT. Early relapse (within six months) and nonoperative management after relapse are independent predictors of a second recurrence. Furthermore, unfavorable histology of the initial tumor independently predicts mortality in recurrent WT.

Background: The tumor microenvironment of clear cell renal cell carcinoma (ccRCC) is heterogeneous, leading to diverse prognoses among patients. Neutrophils, as a key component of the tumor microenvironment, have predictive value for the prognosis of ccRCC. However, there are currently no predictive models based on neutrophil-related genes. This study aimed to construct and validate a prognostic model for ccRCC based on neutrophil-related genes to facilitate risk stratification and treatment guidance. This study aimed to construct and validate a prognostic model for ccRCC based on neutrophil-related genes to facilitate risk stratification and treatment guidance.

Methods: We analyzed the RNA sequencing (RNA-seq) data and clinical information of ccRCC, screened out 10 neutrophil-related prognostic genes using R software, and constructed a risk prediction model. Single/multivariate Cox regression and least absolute shrinkage and selection operator (LASSO) regression were used for gene screening.

Results: Model validation showed that the area under the curve (AUC) values of the model for predicting 1-, 2-, and 3-year overall survival (OS) were 0.704, 0.674, and 0.656 in the test set. Its performance in the training set was better, with AUC values of 0.796, 0.784, and 0.793, respectively. The calibration curve confirmed that the model had good consistency. Kaplan-Meier (KM) survival analysis showed that the survival rate of patients in the high-risk group was significantly lower than that in the low-risk group (P<0.05), and the risk score prediction efficiency was better than clinical indicators such as age. In summary, this model demonstrated strong predictive performance on both the training and multiple validation sets, effectively identifying high-risk patients with poor prognosis who required intensive treatment and close follow-up. Further analysis showed that four drugs, such as axitinib_1021, may have anti-tumor potential, and the immune infiltration characteristics showed that the infiltration levels of B cells (naive) and CD4 memory activated T cells in the high-risk group were significantly increased.

Conclusions: The proposed 10 neutrophil-related genes are promising biomarkers to predict survival and therapeutic responses in ccRCC patients.

Background and objective: Non-muscle-invasive bladder cancer (NMIBC) unresponsive to Bacillus Calmette-Guérin (BCG) therapy poses a significant clinical challenge, as the standard intervention of radical cystectomy (RC) is associated with substantial morbidity. Immune checkpoint inhibitors (ICIs) have emerged as a promising strategy that may enable bladder preservation. This review critically evaluates current evidence regarding the efficacy and safety of ICIs in this high-risk patient population, aiming to inform clinical decision-making and guide future research.

Methods: A comprehensive literature search was conducted in PubMed and Web of Science up to July 2025. The search strategy combined keywords and Medical Subject Headings (MeSH) terms related to bladder cancer, ICIs, and BCG treatment failure. Only studies published in English were included.

Key content and findings: This review integrates findings from key clinical trials evaluating ICIs, such as pembrolizumab and atezolizumab, used alone or alongside BCG, emphasizing their capacity to elicit sustained therapeutic benefits. It also examines the significance of predictive biomarkers, including programmed death-ligand 1 (PD-L1) expression, tumor mutational burden (TMB), and characteristics of the tumor microenvironment. In addition, the review outlines current approaches for detecting and managing immune-related adverse events (irAEs).

Conclusions: ICIs represent a promising therapeutic avenue for patients with BCG-unresponsive NMIBC, supporting a shift toward bladder-preserving management strategies. Future research should focus on biomarker-guided patient selection and explore combination regimens to optimize clinical outcomes, thereby informing both clinical practice and investigational priorities.