Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Beyond tunnel vision – reconsidering real-world evidence on staging in intermediate-risk prostate cancer","authors":"Cem Onal MD , Aysenur Elmali MD , Ozan Cem Guler MD","doi":"10.1016/j.urolonc.2025.10.025","DOIUrl":"10.1016/j.urolonc.2025.10.025","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 2","pages":"Pages 114-115"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Featured SUO fellow: Jiping Zeng, MD","authors":"","doi":"10.1016/j.urolonc.2025.12.008","DOIUrl":"10.1016/j.urolonc.2025.12.008","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 2","pages":"Page 109"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial comment for “Neoadjuvant pembrolizumab and tyrosine kinase inhibitor to facilitate imperative partial nephrectomy for renal cell carcinoma”","authors":"Taylor Goodstein M.D. , Eric A. Singer M.D., M.A., M.S., F.A.C.S., F.A.C.S.O.","doi":"10.1016/j.urolonc.2025.11.016","DOIUrl":"10.1016/j.urolonc.2025.11.016","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 2","pages":"Pages 123.e17-123.e18"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partial vs. radical nephrectomy in pT3a renal cancer: Cancer-specific mortality according to fat invasion pattern","authors":"Michele Nicolazzini M.D. ,&nbsp;Calogero Catanzaro M.D. ,&nbsp;Federico Polverino M.D. ,&nbsp;Jordan A. Goyal ,&nbsp;Riccardo Schiavina M.D. ,&nbsp;Nicola Longo M.D., Ph.D. ,&nbsp;Fred Saad M.D. ,&nbsp;Shahrokh F. Shariat M.D. ,&nbsp;Carlotta Palumbo M.D. ,&nbsp;Alessandro Volpe M.D. ,&nbsp;Pierre I. Karakiewicz M.D., Ph.D.","doi":"10.1016/j.urolonc.2025.10.017","DOIUrl":"10.1016/j.urolonc.2025.10.017","url":null,"abstract":"<div><h3>Introduction</h3><div>Within the SEER database (2010–2021), we tested for differences in cancer-specific mortality (CSM) between partial (PN) vs. radical (RN) nephrectomy in patients with pT3a renal cell carcinoma with either perinephric fat invasion (PFI) or sinus fat invasion (SFI).</div></div><div><h3>Patients and Methods</h3><div>Separate propensity score matching (PSM), multivariable competing risk regression (mCRR) analyses and cumulative incidence plots addressed CSM in patients with PFI and subsequently in patients with SFI, according to PN vs. RN. Subgroup analyses focused on patients with additional adverse pathological features: tumor size &gt;4 cm, high nuclear grade or sarcomatoid dedifferentiation.</div></div><div><h3>Results</h3><div>Of 9,664 pT3aN0M0 RCC patients with fat invasion, 4379 (45.3%) had exclusive PFI vs. 4398 (45.5%) had exclusive SFI. In PFI patients, 1,321 (30.2%) patients underwent PN vs. 3,058 (69.8%) RN. After 1:1 PSM, 5-years CSM rates were 8.2 vs. 9.3% in PN vs. RN patients. In mCRR, PN vs. RN did not affect CSM (HR 0.99, <em>P</em> = 0.9), even in patients with additional adverse pathological features. In SFI patients, 395 (9.0%) patients underwent PN vs. 4003 (91.0%) RN. After 1:3 PSM, 5-years CSM rates were 7.5 vs. 10.3% in PN vs. RN patients. In mCRR, PN vs. RN did not affect CSM (HR 0.74, <em>P</em> = 0.2), even in patients with additional adverse pathological features.</div></div><div><h3>Conclusion</h3><div>PN does not predispose patients to a survival disadvantage in presence of either PFI or SFI, even in those with additional adverse pathological features defined as tumor size &gt;4 cm, high nuclear grade or sarcomatoid dedifferentiation.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 2","pages":"Pages 122.e1-122.e10"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145550968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative use of venous thromboembolism prophylaxis following major urologic oncology surgeries: A survey of the Society of Urologic Oncology","authors":"Michelle Slinger M.D. ,&nbsp;Katharine F. Michel M.D. ,&nbsp;Leilei Xia M.D. ,&nbsp;Shirley Wang M.D. ,&nbsp;Thomas J. Guzzo M.D. ,&nbsp;Daniel J. Lee M.D., M.S. ,&nbsp;Stanley Bruce Malkowicz M.D. ,&nbsp;Trinity J. Bivalacqua M.D., Ph.D.","doi":"10.1016/j.urolonc.2025.10.020","DOIUrl":"10.1016/j.urolonc.2025.10.020","url":null,"abstract":"<div><h3>Introduction</h3><div>Venous thromboembolism (VTE) is a significant concern following radical cystectomy (RC) and other major urologic oncologic surgeries. In a 2019 survey of the Society of Urologic Oncology (SUO), 80% of respondents reported using extended VTE prophylaxis (EP), usually enoxaparin, though many cited financial concerns, poor compliance, and administration difficulty as barriers. We hypothesize that practice patterns may have changed since the adoption of apixaban for EP, and aim to describe current practices for RC and other oncologic surgeries, as well as compare barriers to both forms of EP.</div></div><div><h3>Methods</h3><div>A survey of SUO members was conducted between August and September 2023. Participants reported their EP practices following RC, retroperitoneal lymph node dissection (RPLND), robotic-assisted laparoscopic prostatectomy (RALP), and nephrectomies. Demographic and practice data were analyzed alongside trends in EP usage, preferred agents, and barriers to adoption.</div></div><div><h3>Results</h3><div>Sixty-two SUO members (6% response rate) completed the survey. EP use after RC increased from 80% in 2019 to 98% (<em>P</em> &lt; 0.001), with 70% now prescribing apixaban compared to 0% previously. Other urologic procedures, such as RPLND and RALP, saw EP usage in only ∼30% of cases. Enoxaparin was reported as less favored due to patient compliance issues, while apixaban faced challenges with cost and insurance coverage. Cost aids, such as manufacturer coupons, were noted as helpful in reducing apixaban’s financial barriers.</div></div><div><h3>Conclusions</h3><div>EP after RC has increased substantially, with apixaban emerging as the preferred agent. However, usage remains limited for other urologic procedures, reflecting variability in perceived VTE risk. Barriers such as cost and accessibility persist but may be alleviated by the introduction of generic apixaban. Efforts to address these barriers are crucial for optimizing VTE prevention across urologic oncology.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 2","pages":"Pages 102-108"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Somatic alterations of genitourinary malignancy of Chinese population based on tumor NGS data","authors":"Xin Lu M.D. ,&nbsp;Xiang Zhang M.Med. ,&nbsp;Shaochen Cheng Ph.D. ,&nbsp;Weiqiang Ning B.S. ,&nbsp;Shuhua Zhao B.S. ,&nbsp;Yuan Shao M.D. ,&nbsp;Wei Chen M.D. ,&nbsp;Jun Zhang M.D.","doi":"10.1016/j.urolonc.2025.11.007","DOIUrl":"10.1016/j.urolonc.2025.11.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Genitourinary malignancies represent a major global health burden, with rising incidence and mortality rates, particularly in China. Comprehensive genomic profiling in Chinese patients remains limited. This study aimed to characterize the mutational landscape of genitourinary cancers to identify potential biomarkers for improved diagnosis and treatment.</div></div><div><h3>Patients and Methods</h3><div>Tumor tissues from 244 Chinese patients, encompassing 321 samples of bladder, renal, and prostate cancers, were analyzed using next-generation sequencing (NGS) with a 680-gene cancer-specific panel. Somatic mutation profiles were compared across cancer types and with Western (MSK-IMPACT) cohorts.</div></div><div><h3>Results</h3><div>PD-L1 positivity was observed in 13.89 % of bladder, 10.00 % of renal, and 4.55 % of prostate cancers. Median tumor mutational burden (TMB) was 3.29 mut/Mb for bladder, 2.13 mut/Mb for renal, and 0.66 mut/Mb for prostate cancer. Frequently mutated genes included VHL (20.45 %), TP53 (20.07 %), KMT2D (13.01 %), KMT2C (10.04 %), and TERT (9.67 %). Across tumor types, gene–PD-L1 correlations were modest to moderate. In bladder cancer, TP53 (<em>r</em> = 0.551, FDR = 0.0086) and CCNE1 (<em>r</em> = 0.469, FDR = 0.0338) showed significant positive associations with PD-L1 expression, while AXL and AKT2 were borderline significant. In renal and prostate cancers, AXL, RARA, and LARP4 exhibited weaker yet significant correlations. Comparative analysis with Western cohorts revealed moderate gene overlap (Jaccard ≈ 0.20–0.24) but weak frequency concordance (<em>r</em> &lt; 0.25), indicating population-specific genomic heterogeneity.</div></div><div><h3>Conclusion</h3><div>This study delineates the genomic landscape of bladder, renal, and prostate cancers in Chinese patients and identifies distinct mutational profiles compared with Western populations, supporting region-tailored precision oncology in genitourinary malignancies.</div></div><div><h3>Microabstract</h3><div>This study analyzed 321 tumor samples from 244 Chinese patients with genitourinary cancers using targeted NGS. Distinct mutational landscapes and PD-L1–associated genes were identified across bladder, renal, and prostate cancers. Comparative analysis with Western cohorts revealed population-specific genomic heterogeneity, supporting region-tailored precision oncology.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 2","pages":"Pages 126.e11-126.e21"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant pembrolizumab and tyrosine kinase inhibitor to facilitate imperative partial nephrectomy for renal cell carcinoma","authors":"Ashley N. Gonzalez M.D. ,&nbsp;Wadih Issa M.D. ,&nbsp;Tian Zhang M.D. ,&nbsp;Hans Hammers M.D., Ph.D. ,&nbsp;Vitaly Margulis M.D. ,&nbsp;Jeffrey A. Cadeddu M.D.","doi":"10.1016/j.urolonc.2025.11.001","DOIUrl":"10.1016/j.urolonc.2025.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>To describe clinical outcomes of patients who received neoadjuvant therapy for tumor downsizing to facilitate imperative partial nephrectomy (PN), including patients with a solitary kidney, bilateral complex renal masses, or chronic kidney disease.</div></div><div><h3>Patients and Methods</h3><div>All patients who received neoadjuvant immunotherapy (IO) prior to planned surgery were reviewed and data extracted from chart review, including neoadjuvant regimen, patient characteristics, tumor characteristics, medication adverse events, and peri‑operative outcomes. Choice of neoadjuvant IO regimen was selected at the discretion of the medical oncologist—all were IO-tyrosine kinase inhibitor regimens.</div></div><div><h3>Results</h3><div>A case series of nine patients and 11 tumors was identified, with median pretherapy tumor size of 7.6 cm and RENAL score 10. Of nine patients (11 tumors) who completed at least 1 month of therapy, 90% responded with measurable tumor size decrease, and all were able to undergo surgery, without stage progression on therapy. Median tumor diameter was decreased by 2.1 cm following neoadjuvant therapy, and RENAL nephrometry score was reduced by a median 1 point. Pathologic complete response rate was 27%.</div></div><div><h3>Conclusions</h3><div>Neoadjuvant IO-based combinations result in a significant decrease in primary renal tumor size that may facilitate nephron-sparing surgery for those patients with an imperative indication and otherwise infeasible PN prior to treatment.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 2","pages":"Pages 123.e11-123.e15"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical operation duration as a predictor of venous thromboembolism risk after radical cystectomy.","authors":"Furkan Dursun, Burak Akgul, Jonathan A Gelfond, Robin J Leach, Teresa L Johnson Pais, Ahmed M Mansour, Michael A Liss","doi":"10.1016/j.urolonc.2025.12.019","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.12.019","url":null,"abstract":"<p><strong>Objective: </strong>We assess the impact of operation duration (OD) on the occurrence of symptomatic venous thromboembolism (VTE) in patients undergoing radical cystectomy (RC). We also seek to determine a threshold OD and quantify additional risk beyond this benchmark.</p><p><strong>Methods: </strong>The National Surgical Quality Improvement Program database was utilized to identify RC patients from 2007 to 2022. Patient demographics, preoperative lab results, surgical features, and medical history were compared between VTE patients and those without it. Multivariable logistic regression analyses were performed, taking into account major confounders such as age, gender, body mass index (BMI), functional stage, tobacco use, bleeding disease history, transfusions within 72 hours, and surgical type.</p><p><strong>Results: </strong>Of 24,503 RC patients identified, the median OD was 5.43 hours. VTE incidence within 30 days post-operation was 3.6% (n = 880). OD exceeding 6 hours emerged as an independent predictor of VTE (OR 1.16; 95% CI 1.10-1.21), with each additional hour beyond 6 hours escalating the risk by 16%. Higher BMI, advancing age, transfusions within 72 hours, immunosuppressive treatment, and continent diversion during RC were associated with increased VTE odds.</p><p><strong>Conclusions: </strong>Extended OD during RC heightens VTE risk, with each hour beyond 6 hours posing a 16% increased risk. Establishing a definitive OD threshold and addressing factors affecting OD may mitigate VTE complications. Further research is warranted to explore interventions optimizing surgical efficiency and reducing VTE risk in RC patients.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":"110983"},"PeriodicalIF":2.3,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing age- and gender-sensitive supportive care and follow-up strategies in bladder cancer","authors":"Alessio Rizzo R.N., M.Sc., Ph.D. student ,&nbsp;Antonio Valenti R.N., C.N.S.","doi":"10.1016/j.urolonc.2025.07.031","DOIUrl":"10.1016/j.urolonc.2025.07.031","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 1","pages":"Pages 57-58"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144970765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mucinous tubular and spindle cell carcinoma and its prognostic paradox: A population-based study","authors":"Omar Tluli ,&nbsp;Humam Emad Rajha ,&nbsp;Dina Tluli ,&nbsp;Ahmad Hamdan ,&nbsp;Giridhara Rathnaiah Babu MD, PhD ,&nbsp;Ivan Damjanov MD, PhD ,&nbsp;Semir Vranic MD, PhD","doi":"10.1016/j.urolonc.2025.09.022","DOIUrl":"10.1016/j.urolonc.2025.09.022","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the clinicopathologic features, treatment patterns, and survival outcomes of mucinous tubular and spindle cell carcinoma (MTSCC) with those of clear cell renal cell carcinoma (ccRCC) and papillary renal cell carcinoma (PRCC).</div></div><div><h3>Subjects and Methods</h3><div>This retrospective cohort study used SEER data from 1983 to 2022, including 461 MTSCC, 133,229 ccRCC, and 29,442 PRCC cases. Demographic, clinical, and treatment variables were analyzed using chi-square, ANOVA/Kruskal-Wallis tests, and Kaplan-Meier methods. Cox proportional hazards regression models were applied to estimate hazard ratios (HRs) for overall (OS) and disease-specific survival (DSS), adjusting for age, sex, race, stage, grade, treatment, and metastasis status.</div></div><div><h3>Results</h3><div>MTSCC patients were more often female (54.9%), Black (20.6%), and aged ≥70 years (50.5%) compared to ccRCC and PRCC (<em>P</em> &lt; 0.001). MTSCC had a lower incidence of distant metastasis than ccRCC (8.7% vs. 9.5%), but higher than PRCC (4.2%). Although most MTSCC patients presented with early-stage disease and underwent surgery (87.9%), they had the shortest mean survival (47.9 months) and the highest proportion of deaths within 100 months (83.5%). Kaplan–Meier analysis showed higher early mortality for MTSCC, with survival curves converging after 75 to 100 months. In adjusted models, MTSCC was associated with a nonsignificant increase in mortality compared to ccRCC (OS HR: 1.36, <em>P</em> = 0.422; DSS HR: 1.13, <em>P</em> = 0.832), while PRCC had a significantly higher DSS risk (HR: 1.24, <em>P</em> = 0.001). Poor survival in MTSCC was associated with older age, high-grade tumors, distant metastases, and absence of surgery.</div></div><div><h3>Conclusion</h3><div>MTSCC shows distinct demographic and clinical features and a paradoxically shorter survival despite early-stage presentation. Early mortality may contribute to its poorer outcomes, indicating that MTSCC is not uniformly indolent. Closer surveillance and individualized risk assessment are warranted in selected patients.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 1","pages":"Pages 68.e23-68.e33"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}