Urologic Oncology-seminars and Original Investigations最新文献

{"title":"The predictive value of lesion density in enhancing multiparametric MRI for detecting clinically significant prostate cancer","authors":"Ali Khatib M.D., M.Sc. ,&nbsp;Zizo Al-Daqqaq M.D. ,&nbsp;Anna J. Black M.D. ,&nbsp;Silvia Chang M.D. ,&nbsp;Martin E Gleave M.D. ,&nbsp;Miles P. Mannas M.D., M.Sc.","doi":"10.1016/j.urolonc.2025.12.017","DOIUrl":"10.1016/j.urolonc.2025.12.017","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to evaluate the predictive value of lesion density on mpMRI for detecting clinically significant prostate cancer (csPCa) in men undergoing targeted prostate biopsy.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients who underwent MRI-targeted transperineal or transrectal biopsy between 2019 and 2023. Lesion density was calculated as longest lesion diameter divided by prostate volume, with weighted averages used for multiple lesions. Multivariable logistic regression and receiver operating characteristic (ROC) analysis assessed predictors of csPCa. Threshold analysis evaluated trade-offs between missed csPCa and avoided biopsies.</div></div><div><h3>Results</h3><div>csPCa was diagnosed in 241/460 patients (52.4%). Median lesion density was higher in csPCa vs. non-csPCa cases (0.34 mm/cc, IQR 0.22–0.52 vs. 0.22 mm/cc, IQR 0.14–0.33; <em>P</em> &lt; 0.001). Lesion density was independently predictive in models with (OR 6.2, 95% CI 1.4–27.9) and without PI-RADS (OR 13.7, 95% CI 3.2–59.0). It achieved the highest AUC (0.71) compared with PSA density (0.69) and age (0.63). At a lesion density threshold of 0.15 mm/cc, 29.2% of biopsies would have been avoided with &lt;10% missed csPCa.</div></div><div><h3>Conclusion</h3><div>Lesion density was an independent predictor of csPCa on targeted biopsy. It may complement PI-RADS and PSA density and provide a pragmatic threshold-based tool to guide biopsy decision-making.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110981"},"PeriodicalIF":2.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079592","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":"Molecular pathology of rare histologic variants and treatment-resistant lineages of prostate cancer","authors":"Ryuta Watanabe M.D., Ph.D. ,&nbsp;Noriyoshi Miura M.D., Ph.D. ,&nbsp;Tadahiko Kikugawa M.D., Ph.D. ,&nbsp;Takashi Saika M.D., Ph.D. ,&nbsp;Michael C. Haffner M.D., Ph.D. ,&nbsp;Peter S. Nelson M.D.","doi":"10.1016/j.urolonc.2025.110987","DOIUrl":"10.1016/j.urolonc.2025.110987","url":null,"abstract":"<div><div>Rare histological variants of prostate cancer—including ductal adenocarcinoma, intraductal carcinoma of the prostate (IDC-P), neuroendocrine carcinoma, basal cell/adenoid cystic carcinoma, squamous cell carcinoma, sarcomatoid carcinoma, and stromal tumors—exhibit highly diverse biological behaviors and distinct molecular features. Accurate pathological recognition is essential, as these entities frequently diverge from conventional acinar adenocarcinoma in morphology, genomic alterations, therapeutic responsiveness, and clinical outcomes. Intraductal carcinoma of the prostate (IDC-P) and ductal adenocarcinoma often display genomic instability and aggressive clinical behavior, including enrichment for homologous recombination repair (HRR) defects and hypoxia-related pathways. Neuroendocrine subtypes, including <em>de novo</em> and treatment-related NEPC as well as double-negative prostate cancer (DNPC), are characterized by androgen receptor (AR) independence, <em>RB1/TP53</em> loss, low prostate-specific antigen (PSA) production, and poor prognosis, reflecting lineage plasticity under therapeutic pressure. Other rare tumors—such as basal cell carcinoma/adenoid cystic carcinoma, squamous cell carcinoma, and stromal tumors (STUMP and prostatic stromal sarcoma)—demonstrate unique pathological patterns and limited responsiveness to standard systemic therapies, underscoring the importance of tailored diagnostic and management strategies. This review integrates the histopathological, molecular, and emerging spatial transcriptomic insights across this spectrum of rare and treatment-resistant prostate cancer subtypes. By highlighting shared mechanisms such as genomic instability, androgen receptor (AR) pathway bypass, and microenvironmental remodeling, we outline key diagnostic considerations and evolving therapeutic implications relevant to precision oncology.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110987"},"PeriodicalIF":2.3,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079505","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":"Efficacy and safety of tislelizumab plus intravesical chemotherapy in recurrent high-risk non-muscle-invasive bladder cancer: A retrospective single-center real-world study","authors":"Qing Chen PhD ,&nbsp;Rongpan Wu PhD ,&nbsp;Chen Zhang PhD ,&nbsp;Jiaxin Xie PhD ,&nbsp;Yi Wang PhD ,&nbsp;Xufeng Yu PhD ,&nbsp;Wei He PhD ,&nbsp;Maoyu Wang PhD ,&nbsp;Junjie Zhao PhD ,&nbsp;Zhensheng Zhang PhD ,&nbsp;Shuxiong Zeng PhD ,&nbsp;Chuanliang Xu PhD","doi":"10.1016/j.urolonc.2025.110988","DOIUrl":"10.1016/j.urolonc.2025.110988","url":null,"abstract":"<div><h3>Background</h3><div>Recurrent high-risk non-muscle-invasive bladder cancer (HR-NMIBC) poses significant therapeutic challenges due to frequent recurrences. <em>Bacillus</em> Calmette-Guérin (BCG) therapy limitations including global shortages, resistance and adverse effect. Patients often decline cystectomy due to significant impact on quality of life and complications, underscoring the need for effective bladder-preserving strategies.</div></div><div><h3>Methods</h3><div>In a retrospective single-center analysis, 43 recurrent HR-NMIBC patients received intravenous tislelizumab every 3 weeks for up to 17 cycles alongside intravesical chemotherapy. Intravesical instillation agents included gemcitabine, epirubicin or mitomycin C administered per protocol. The primary endpoint was 3-month complete response rate, defined as absence of tumor confirmed by biopsy, cystoscopy, cytology and imaging. Secondary endpoints encompassed duration of response, survival metrics, and adverse events graded per CTCAE v5.0.</div></div><div><h3>Results</h3><div>Among 43 recurrent HR-NMIBC patients with median age 67 years, 88.4% achieved 3-month complete response. Responders maintained a 24-month sustained response rate of 71.1% during median 28.4-month follow-up. The entire cohort demonstrated 36-month progression-free survival, overall survival, and cancer-specific survival rates of 82.8%, 85.0%, and 95.0% respectively. Subgroups with variant histology, BCG-unresponsive/intolerant disease, or multiple prior recurrences showed reduced responses. Treatment-related adverse events occurred in 90.7% of patients, with urinary frequency and hematuria being most common, which might stem from intravesical chemotherapy exposure. Grade 3 events affected 18.6% of patients, while immune-related adverse events led to discontinuation in 4.7%. No grade 4 or 5 toxicities were observed.</div></div><div><h3>Conclusion</h3><div>Tislelizumab plus intravesical chemotherapy achieves high response rates and durable survival benefits with manageable toxicity in recurrent HR-NMIBC, representing a promising non-BCG-dependent bladder-preserving strategy for surgically ineligible patients.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110988"},"PeriodicalIF":2.3,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025456","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":"Circulating tumor DNA in urothelial cancer as an intermediate disease state between localized and advanced stages: Moving from risk factors to micrometastatic disease in the perioperative setting","authors":"Sergio Bracarda M.D.,&nbsp;Giulia Mammone M.D.,&nbsp;Claudia Mosillo M.D.,&nbsp;Grazia Sirgiovanni M.D.,&nbsp;Annalisa Guida M.D.","doi":"10.1016/j.urolonc.2025.110986","DOIUrl":"10.1016/j.urolonc.2025.110986","url":null,"abstract":"<div><div>Urothelial carcinoma, especially muscle-invasive bladder cancer, presents a high risk of recurrence despite curative-intent surgery and perioperative therapies. A major clinical challenge remains the early identification of micrometastatic disease, undetectable with conventional imaging. Circulating tumor DNA (ctDNA), a minimally invasive biomarker, is emerging as a transformative tool for detecting minimal residual disease, allowing for earlier intervention and more tailored and efficacious treatment strategies. This review explores the evolving role of ctDNA in urothelial carcinoma, particularly in the perioperative setting. The negative adjuvant IMvigor010 trial established ctDNA as a prognostic and potentially predictive marker, demonstrating that ctDNA-positive patients postcystectomy were at higher risk of relapse but could benefit from adjuvant immunotherapy. Building on this, IMvigor011 prospectively validated a ctDNA-guided immunotherapy approach, showing that ctDNA clearance correlates with improved disease-free survival. We discuss ctDNA potential to redefine disease staging, introducing an “intermediate” category (M0, ctDNA-positive) between localized and overtly metastatic disease. ctDNA also offers value in surveillance, treatment de-escalation, and monitoring therapeutic response. Advances in tumor-informed assays have enhanced the sensitivity of ctDNA detection, though standardization and accessibility remain key challenges. In summary, ctDNA represents a paradigm shift in urothelial carcinoma management, enabling precision oncology through real-time disease monitoring and personalized treatments. Its integration into clinical practice may improve outcomes by addressing micrometastatic disease before clinical relapse or progression, transforming the way we stratify and treat patients across the urothelial carcinoma continuum.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110986"},"PeriodicalIF":2.3,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025454","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":"Distinct pathways of disease progression with dual checkpoint blockade versus immunotargeted therapy in metastatic renal cell carcinoma","authors":"Ilya Tsimafeyeu ,&nbsp;Fuad Guliyev ,&nbsp;Bakytzhan Ongarbayev ,&nbsp;Gunel Musaeva ,&nbsp;Ramil Abdrakhmanov ,&nbsp;Vyacheslav Chubenko ,&nbsp;Olga Baklanova ,&nbsp;Ruslan Zukov ,&nbsp;Vladislav Petkau ,&nbsp;Dilyara Kaidarova","doi":"10.1016/j.urolonc.2025.110989","DOIUrl":"10.1016/j.urolonc.2025.110989","url":null,"abstract":"<div><h3>Background</h3><div>Patterns of progression under immuno-oncology regimens in metastatic renal cell carcinoma (mRCC) remain poorly described. This study characterizes site-specific disease progression in patients receiving first-line dual immunotherapy or immunotargeted therapy.</div></div><div><h3>Methods</h3><div>This retrospective, observational cohort study included patients with clear-cell metastatic renal cell carcinoma treated between 2018 and 2024 with standard-dose regimens of nivolumab-ipilimumab (IO-IO) or pembrolizumab-axitinib and avelumab-axitinib combinations (IO-axitinib). The primary endpoint was the occurrence of new metastatic lesions at progression. Secondary endpoints included progression by &gt;20% increase in target lesion size.</div></div><div><h3>Results</h3><div>Of 334 patients identified, 233 were evaluable for analysis. Radiographic progression occurred in 86.3% of IO-IO and 60% of IO-axitinib. Development of new metastatic lesions was more frequent with Nivo-Ipi (39.3% vs. 22.2%), most commonly involving the lungs and bones. In contrast, IO-axitinib combinations showed a greater propensity for progression through enlargement of pre-existing lesions (77.8% vs. 60.7%), accompanied by the emergence of new adrenal gland metastases. Across both treatment groups, lymph nodes emerged as the most frequent new site of disease progression.</div></div><div><h3>Conclusions</h3><div>Nivo-Ipi was associated with more frequent development of new metastatic lesions, particularly in the lungs, bones, and lymph nodes, while axitinib-based combinations more often resulted in regrowth of existing disease with higher rates of adrenal involvement.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110989"},"PeriodicalIF":2.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025455","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":"Lack of survival benefit of pelvic lymph node dissection for patients with radical prostatectomy and postprostatectomy radiotherapy","authors":"Isaac E. Kim Jr. M.D., Ph.D. ,&nbsp;Dhruv Puri M.D. ,&nbsp;Nityam Rathi M.D., M.S. ,&nbsp;Michael S. Leapman M.D., M.H.S. ,&nbsp;Isaac Y. Kim M.D., Ph.D., M.B.A.","doi":"10.1016/j.urolonc.2025.110985","DOIUrl":"10.1016/j.urolonc.2025.110985","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>The survival benefit of pelvic lymph node dissection (PLND) during radical prostatectomy (RP) remains unclear. Recent guidelines suggest that PLND may be therapeutic in subsets of patients with limited nodal disease, however, differences in outcome could be obscured by subsequent therapy. Thus, the objective of this study was to evaluate the association between PLND and extent of nodal resection and overall survival (OS) among patients treated with RP and postprostatectomy radiotherapy.</div></div><div><h3>Materials and methods</h3><div>Using the National Cancer Database (NCDB), we examined the association between OS and PLND status among patients diagnosed with prostate cancer from 2012 to 2021 who underwent RP with postprostatectomy radiotherapy. Propensity score matching (PSM) was performed based on pathologic T stage, age, PSA, race, hormonal therapy, and the number of nodes examined. We then compared the OS of patients who did and did not undergo pelvic lymph node dissection (PLND) as well as the extent of PLND (1-9 nodes vs. 10+ nodes and 1-14 nodes vs. 15+ nodes thresholds) stratified by National Comprehensive Cancer Network (NCCN) risk group.</div></div><div><h3>Results</h3><div>Of 28946 patients treated with RP who later underwent post-RP radiotherapy, 4254 were selected for the matched cohort (2127 PLND and 2127 non-PLND). There was no significant OS difference between PLND and non-PLND patients both overall (<em>P</em> = 0.74) and across all risk groups (low: <em>P</em> = 0.73, intermediate: <em>P</em> = 0.70, high: <em>P</em> = 0.60). There were also no significant OS differences between 1 and 9 node PLND and more extensive 10+ node PLND patients overall and across all risk groups. Patients who received 15+ node PLND had lower Charlson-Deyo scores than those who did not receive a PLND. Thus, while high-risk patients who received a 15+ node PLND did experience initial improved OS compared to those who underwent 1-14 node PLND (baseline aHR 0.52, 95% CI, 0.30-0.92, <em>P</em> = 0.02) and no PLND (baHR 0.35, 95% CI, 0.13-0.95, <em>P</em> = 0.04), a subset analysis of high-risk patients with Charlson-Deyo score of 0 found no survival differences in 1-14 node and 15+ node PLND patients when compared to non-PLND (1-14 node PLND: aHR 0.81, 95% CI, 0.54-1.21, <em>P</em> = 0.31; 15+ node PLND: aHR 0.97, 95% CI, 0.47-1.98, <em>P</em> = 0.93).</div></div><div><h3>Conclusions</h3><div>Among RP patients receiving post-RP radiotherapy, there were no OS differences between patients who received no PLND and PLND as well as between non-PLND, 1-14 node PLND, and 15+ node PLND patients when controlling for Charlson-Deyo comorbidity. These findings suggest that PLND may not be associated with a long-term OS benefit for patients undergoing prostatectomy and post-RP radiotherapy.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110985"},"PeriodicalIF":2.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146025453","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":"Pharmacologic synergy versus independent action in androgen receptor-axis-targeted agent-docetaxel triplet therapy for metastatic hormone-sensitive prostate cancer: a copula-based analysis","authors":"Wei Chen M.D. ,&nbsp;Soichiro Yoshida M.D., Ph.D. ,&nbsp;Shugo Yajima M.D. ,&nbsp;Hiroyuki Sato Ph.D. ,&nbsp;Akihiro Hirakawa Ph.D. ,&nbsp;Kenji Tanabe M.D. ,&nbsp;Hiroshi Fukushima M.D., Ph.D. ,&nbsp;Yosuke Yasuda M.D., Ph.D. ,&nbsp;Hajime Tanaka M.D., Ph.D. ,&nbsp;Hitoshi Masuda M.D., Ph.D. ,&nbsp;Yasuhisa Fujii M.D., Ph.D.","doi":"10.1016/j.urolonc.2025.110990","DOIUrl":"10.1016/j.urolonc.2025.110990","url":null,"abstract":"<div><h3>Background</h3><div>Triplet therapy combining androgen deprivation therapy (ADT), docetaxel, and androgen receptor-axis-targeted agents (ARATs) has exhibited survival benefits in metastatic hormone-sensitive prostate cancer (mHSPC). Whether these benefits originate from pharmacologic synergy or independent drug action (IDA) remains unclear.</div></div><div><h3>Methods</h3><div>Using reconstructed individual patient data from phase III trials, we applied a copula-based independent-action model to compare observed triplet outcomes with counterfactual predictions derived from docetaxel- and ARAT-based doublets. The primary analysis used weak positive dependence (θ = 0.24), with sensitivity analyses across a plausible range.</div></div><div><h3>Results</h3><div>The triplet, docetaxel-doublet, and ARAT-doublet cohorts comprised 138/355, 206/355, and 637/1,667 events/patients for rPFS, respectively. The observed triplet outcomes did not exceed independent-action predictions (observed/predicted Hazard ration [HR] 1.39; 95% Confidence Interval [95% CI] 1.12–1.74), with excellent concordance in curve shape (<em>r</em> = 0.99) and a difference of restricted mean survival time (ΔRMST) of 4.47 months favoring the prediction. Drug-matched analyses using abiraterone further reduced the discrepancy (HR 1.16; 95% CI 0.93–1.44; ΔRMST 2.93 months). Across the full plausible dependence range (θ = 0.08–0.40), findings remained consistent (HR 1.35–1.44). For overall survival, observed/predicted differences were larger (HR 1.87; 95% CI 1.61–2.17; <em>r</em> = 0.97; ΔRMST 7.59 months), but these results were considered exploratory due to substantial confounding from postprogression therapies.</div></div><div><h3>Conclusions</h3><div>These findings did not identify any population-level benefit of triplet therapy that clearly exceeded predictions under an independent-action model, although synergistic effects at the individual-patient level cannot be excluded. These findings support selective or sequential treatment strategies to optimize the benefit-toxicity balance in appropriate patient populations.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110990"},"PeriodicalIF":2.3,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024973","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":"Does the urinary microbiome reflect the bladder-cancer-associated microbiome? Characterizing the microbiome in urine and cancer tissue in bladder cancer","authors":"Ahmed A. Hussein ,&nbsp;Yakov Klugman ,&nbsp;Jordan Carlson ,&nbsp;Tariq A. Bhat ,&nbsp;Zhe Jing ,&nbsp;Eduardo Cortes Gomez ,&nbsp;Prashant K. Singh ,&nbsp;Jianmin Wang ,&nbsp;Justine Jacobi ,&nbsp;Gary Smith ,&nbsp;David Goodrich ,&nbsp;Khurshid A. Guru","doi":"10.1016/j.urolonc.2025.12.014","DOIUrl":"10.1016/j.urolonc.2025.12.014","url":null,"abstract":"<div><h3>Introduction</h3><div>We sought to characterize the microbiome in bladder cancer tissue samples and to compare it with the microbiome in simultaneously collected urine.</div></div><div><h3>Methods</h3><div>Bladder cancer tissue and transurethral urine specimens were collected simultaneously from consecutive patients with bladder cancer at the time of transurethral resection of bladder tumor (TURBT) or radical cystectomy (RC). Samples were analyzed using 16S rRNA sequencing. Urinary and tissue microbiome were compared. Overlaps among bladder cancer tissue and respective urine samples were described. Microbiome was further described in terms of alpha (diversity within a sample measured by Observed, Chao1, Shannon, and Simpson indices), beta diversities (diversity among different samples measured by Bray Curtis Diversity index) and differential abundance of bacteria at the genus level.</div></div><div><h3>Results</h3><div>Twenty-one patients were included in the study (15 males and 6 females). Transurethral urine samples were available for all but 3 patients, where voided samples were used. Nineteen patients had high grade urothelial carcinoma and 2 had low grade. Looking at the overlapping genera among the urine and tissue samples, only <em>Pseudomonas, Staphylococcus, Acinetobacter, Corynebacterium, Escherichia-Shigella, Anaerococcus, Streptococcus</em>, and <em>Prevotella</em> were present in &gt;75% of both urine and tissue samples. Comparing tissue and urine specimens, there was no significant difference across all alpha diversity indices, while Bray Curtis for beta diversity showed significant dissimilarity (p&lt;0.0001). There was significantly higher abundance of <em>Moraxella, Herbaspirillum, Clostridium sensu stricto 8, Cellulomonas, Pleomorphomonas, Conchiformibius, Prevotella_9, Lachnospiraceae, Marmoricola, Pseudoglutamicbacter, Helicobacter, Jeotgalicoccus, Roseburia, Granulicatella, Lachnoclostridium, Odoribacter, Dermabacter, Akkermansia, Abiotrophia</em>, and <em>Reinbacterium</em> in the urine samples. On the other hand, there was significantly higher abundance of <em>Conexibacter, Cnuella, Mobilitalea, Fulvimonas, Pedomicrobium, Pectobacterium, Weissella, Selenomonas, Tannerella, Aliterella, Xanthobacter, Sporosarcina, Gordonia, Bosea, Pantoea, SM1A02, Vibrio, Pediococcus, Lacticaseibacillus</em> and <em>Blastococcus</em> in the tissue specimens.</div></div><div><h3>Conclusion</h3><div>In this cohort, bladder-cancer tissue associated microbiome exhibited a distinct microbial signature when compared to urine. These results suggest that the urinary microbiome may not provide an accurate representation of the bladder-cancer associated microbiome. Validation in larger, standardized cohorts with contamination control is warranted.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110978"},"PeriodicalIF":2.3,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019814","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":"LncRNA NPSR1-AS1 affects the malignant biological behavior of bladder cancer through miR-199a-3p and the clinical value of urine-derived lncRNA NPSR1-AS1","authors":"Weijing He M.D. ,&nbsp;Yong Wen M.D. ,&nbsp;Huiling Qin M.D.","doi":"10.1016/j.urolonc.2025.12.016","DOIUrl":"10.1016/j.urolonc.2025.12.016","url":null,"abstract":"<div><h3>Background</h3><div>The alteration of long noncoding RNA (lncRNA) expression is significantly associated with the occurrence and progression of various human tumors.</div></div><div><h3>Aim</h3><div>To explore the possible mechanism by which lncRNA NPSR1-AS1 affects bladder cancer, as well as its diagnostic and prognostic value.</div></div><div><h3>Material and methods</h3><div>The data related to bladder cancer were mined from the GEO database. RT-qPCR was used to determine the expression of lncRNA NPSR1-AS1 and miR-199a-3p in BCa tissues, cell lines and urine. Cell proliferation, migration and apoptosis and other cell functions were tested in UMUC3, T24 and cells. The interactions between molecules were studied using the luciferase reporter gene, RIP and Spearman correlation analysis. ROC, K-M and COX regression analyses were used to evaluate the clinical value of lncRNA NPSR1-AS1.</div></div><div><h3>Results</h3><div>The lncRNA NPSR1-AS1 was expressed at higher levels in BCa tissue cell lines and urine, while miR-199a-3p expression of was decreased. The lncRNA NPSR1-AS1 affected the malignant biological behavior of BCa by sponging miR-199a-3p. Cell function experiments demonstrated that silencing lncRNA NPSR1-AS1 could inhibit the proliferation, migration and apoptosis of UMUC3, T24 and RT4 cells, while the inhibition of miR-199a-3p reversed this effect. Clinically, lncRNA NPSR1-AS1 may serve as a diagnostic and prognostic marker for BCa.</div></div><div><h3>Conclusion</h3><div>LncRNA NPSR1-AS1 targets miR-199a-3p and affects the progression of BCa. Moreover, it can serve as a biomarker for BCa.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110980"},"PeriodicalIF":2.3,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012401","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}