Urologic Oncology-seminars and Original Investigations最新文献

{"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}

{"title":"Cover 2 - Masthead","authors":"","doi":"10.1016/S1078-1439(25)00505-8","DOIUrl":"10.1016/S1078-1439(25)00505-8","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 2","pages":"Page IFC"},"PeriodicalIF":2.3,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986753","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":"High AST and the presence of liver metastases may guide for the need for FDG PET in advanced prostate cancer patients","authors":"Tugce Telli M.D., F.E.B.N.M. ,&nbsp;Murat Tuncel M.D. ,&nbsp;Erdem Karabulut Ph.D. ,&nbsp;Sercan Aksoy M.D. ,&nbsp;Mustafa Erman M.D. ,&nbsp;Bulent Akdogan M.D. ,&nbsp;Meltem Caglar M.D.","doi":"10.1016/j.urolonc.2025.12.010","DOIUrl":"10.1016/j.urolonc.2025.12.010","url":null,"abstract":"<div><h3>Objective</h3><div>[68Ga]/[18F] labeled Prostate Specific Membrane Antigen (PSMA) is the radiotracer of choice for imaging localized and metastatic prostate cancer with high sensitivity and specificity. On the other hand, 2-[¹⁸F]fluoro-D-glucose (FDG) Positron Emission Tomograpy/Computed Tomography (PET/CT) may help to evaluate the tumor heterogeneity in patients with metastatic castration-resistant prostate cancer (mCRPC) and determine treatment eligibility for Prostate Specific Membrane Antigen (PSMA) targeted radioligand therapy (PSMA-RLT) . The aim of the study is to evaluate the biochemical and clinical parameters which can predict the presence of FDG-PSMA discordant disease.</div></div><div><h3>Material and Methods</h3><div>A total of 70 advanced mCRPC patients who underwent [⁶⁸Ga]Ga-PSMA-11 PET and FDG PET/CT between August 2016 and June 2021 were retrospectively analyzed. Inter-tumoral heterogeneity was both visually and semi-quantitatively evaluated. Baseline clinical, laboratory and PSMA PET/CT related semi-quantitative parameters were analyzed to predict FDG discordant disease with logistic regression analysis.</div></div><div><h3>Results</h3><div>29/70 (41.4%) of the patients had FDG-PSMA discordant disease. Overall 427 mismatch lesions (FDG+PSMA-) were detected: the majority of these lesions were in the bones (<em>n</em> = 236, 55.2%), lymph nodes (<em>n</em> = 95, 22.2%), and visceral organs (<em>n</em> = 88, 20.6%). Most significant parameters to predict FDG-PSMA discordant disease were liver metastases (HR= 26.5, 95%CI 2.3-302.9, <em>P</em> = 0.008) and serum AST (HR= 1.15, 95%CI 1.04-1.26, <em>P</em> = 0.007).</div></div><div><h3>Conclusion</h3><div>The presence of liver metastases and elevated AST may be easily used in clinical practice to predict FDG-PSMA discordant disease.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 4","pages":"Article 110974"},"PeriodicalIF":2.3,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145982027","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":"Real-world treatment patterns, recurrence, and overall survival of patients with muscle-invasive bladder cancer undergoing radical cystectomy in U.S. oncology practice","authors":"Patrick Squires Pharm.D., Ph.D. ,&nbsp;Francesca Coutinho M.B.B.S., M.P.H. ,&nbsp;Jon G. Tepsick M.S. ,&nbsp;Aljosja Rogiers M.D., Ph.D. ,&nbsp;Chethan Ramamurthy M.D. ,&nbsp;Haojie Li M.D., Ph.D. ,&nbsp;Todd M. Morgan M.D.","doi":"10.1016/j.urolonc.2025.12.018","DOIUrl":"10.1016/j.urolonc.2025.12.018","url":null,"abstract":"<div><h3>Background</h3><div>The most common treatment for muscle-invasive bladder cancer (MIBC) is radical cystectomy (RC), typically combined with neoadjuvant and/or adjuvant therapy. This study aimed to describe patient characteristics, treatment patterns, recurrence, and overall survival (OS) among a contemporary cohort of patients with MIBC who underwent RC.</div></div><div><h3>Methods</h3><div>This retrospective study included adult patients with MIBC (T2-T4aN0M0/T1-T4aN1M0) who underwent RC between January 1, 2008 and July 31, 2023 and were captured in the U.S. ConcertAI Patient360™ Bladder Cancer electronic medical record database. Index date was defined as the date of RC. Recurrence (first evidence of disease following RC) and OS were analyzed using Kaplan-Meier methods and stratified by disease stage and treatment received. The association of recurrence with OS was assessed using Cox regression.</div></div><div><h3>Results</h3><div>A total of 783 RC-treated MIBC patients were included (median age 68 years; male 78.8%; White 87.6%; de novo MIBC 77.1%; pure urothelial histology 76.6%), with a median follow-up of 26.2 months. Neoadjuvant therapy use increased from 30.3% in 2011–2013 to 67.9% in 2020–2022. Among patients who received neoadjuvant therapy, 26.3% achieved pathological complete response (pT0N0) at RC. The 5-year recurrence and OS rates were 45.2% and 48.2%, respectively, varying by stage and treatments received. Mortality was 4.4 times higher [95% CI: 3.5, 5.6] among patients with recurrence compared with those without.</div></div><div><h3>Conclusion</h3><div>Despite increased utilization of perioperative therapy over the past 2 decades, MIBC patients undergoing RC continue to experience high rates of disease recurrence, which are associated with increased mortality.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 3","pages":"Article 110982"},"PeriodicalIF":2.3,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979865","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":"Microbiome-linked transcriptomic signatures in NMIBC: Toward personalized uro-oncology","authors":"Manoj Das MBBS, MS, MCh ,&nbsp;Shree Rath MBBS ,&nbsp;Rohith Gorepatti MBBS, MS, MCh ,&nbsp;Rishikesh Dash MSc ,&nbsp;Abhishek Akella MBBS ,&nbsp;Abhay Singh Gaur MBBS, MS, MCh ,&nbsp;Giriprasad Venugopal MSc, PhD ,&nbsp;Zaiba Hasan Khan MSc, PhD ,&nbsp;Balamurugan Ramadass MSc (Med), PhD ,&nbsp;Prasant Nayak MBBS, MS, MCh","doi":"10.1016/j.urolonc.2025.12.013","DOIUrl":"10.1016/j.urolonc.2025.12.013","url":null,"abstract":"<div><h3>Background</h3><div>Nonmuscle Invasive Bladder Cancer (NMIBC) is a prevalent malignancy marked by high recurrence and progression rates. Emerging evidence suggests that demographic and environmental factors may alter the bladder’s native oncobiome, influencing tumor behavior. This exploratory pilot study examined whether paired tumor and adjacent normal bladder mucosa exhibit distinct host transcriptomic and microbial signatures that may illuminate early tumor–microbiome interactions in NMIBC.</div></div><div><h3>Methods</h3><div>A meta-transcriptomic analysis was conducted on paired tumor and adjacent normal bladder mucosa from 6 NMIBC patients. Shotgun RNA sequencing was used to profile differential gene expression and microbial composition. Functional annotation and correlation analyses were performed to explore gene–microbe interactions.</div></div><div><h3>Results</h3><div>Fifty-seven differentially expressed genes (DEGs) across 6 patients and 12 paired samples were identified, including 45 downregulated and 12 upregulated genes, primarily involved in extracellular matrix organization and structural integrity. Tumor tissues exhibited significantly reduced microbial species richness compared to the adjacent normal mucosa (<em>P</em> = 0.026). Propionibacterium acnes showed increased abundance in tumor sites (23.88%) versus the adjacent normal mucosa (13%), suggesting a protumorigenic role. Veillonella dispar and Corynebacterium durum were strongly associated with matrix-regulating genes, while Bifidobacterium longum—more abundant in the adjacent normal tissues—correlated with genes linked to extracellular homeostasis, indicating a potential protective role.</div></div><div><h3>Conclusion</h3><div>This pilot study reveals distinct transcriptomic and microbial signatures in NMIBC, highlighting the role of microbial dysbiosis, which denotes an altered microbial community; reduced diversity and shifts in key taxa relative to the adjacent bladder mucosa, in extracellular matrix remodeling and tumor progression. These host–microbe interactions may contribute to disease pathogenesis and recurrence. Further studies are warranted to elucidate the underlying mechanisms and therapeutic implications.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 3","pages":"Article 110977"},"PeriodicalIF":2.3,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979866","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":"Alopecia following single-dose postoperative intravesical gemcitabine in nonmuscle-invasive bladder cancer: A multi-institutional case series","authors":"Anosh Dadabhoy M.S. ,&nbsp;Chirag Doshi M.S. ,&nbsp;Mazyar Zahir M.D. ,&nbsp;Sanam Ladi-Seyedian M.D. ,&nbsp;Domenique Escobar M.D. ,&nbsp;Leilei Xia M.D. ,&nbsp;Anne Schuckman M.D. ,&nbsp;Christopher B. Anderson M.D. ,&nbsp;Max Kates M.D. ,&nbsp;Piyush K. Agarwal M.D. ,&nbsp;Seth P. Lerner M.D. ,&nbsp;Karim Chamie M.D. ,&nbsp;Alon Weizer M.D. ,&nbsp;Siamak Daneshmand M.D.","doi":"10.1016/j.urolonc.2025.12.020","DOIUrl":"10.1016/j.urolonc.2025.12.020","url":null,"abstract":"<div><h3>Introduction</h3><div>Single-dose intravesical gemcitabine therapy (IVGT) is a standard of care option following transurethral resection (TURBT) for low- to intermediate-risk nonmuscle invasive bladder cancer (NMIBC). The side-effect profile of IVGT has primarily focused on well-established urinary symptoms. Herein we present several cases of treatment-related alopecia following a single postoperative dose of IVGT for NMIBC.</div></div><div><h3>Methods</h3><div>Urologic oncologists from 7 high-volume bladder cancer referral centers in the United States were surveyed about incidents of alopecia, as well as the severity of hair loss, following a single postoperative dose of IVGT after TURBT- either for primary or for known NMIBC. Patients were identified either through self-reported concerns or by physician-observed alopecia during follow-up visits.</div></div><div><h3>Results</h3><div>Between January 2020 and December 2024, a total of 20 patients (6 male, 14 female) experienced hair loss, with the majority (<em>N</em> = 12, 60%) occurring within the first month post-TURBT. Thirteen of the 20 patients (65%) experienced severe alopecia. None of the patients were on medications known to cause hair loss or receiving other chemotherapy. Five patients had large resections (&gt;5 cm), ten had medium (2–5 cm), and 5 had small (&lt;2 cm) resections. Two patients had previously received IVGT without hair loss. Additionally, 4 patients had previously received intravesical <em>Bacillus</em> Calmette-Guérin (BCG), and 1 had received intravesical mitomycin C. No cases of bladder perforation were reported.</div></div><div><h3>Conclusion</h3><div>Hair loss appears to be an underreported side effect of IVGT post-TURBT. Patients should be counseled about this potential adverse event prior to treatment, and routine inquiry regarding alopecia should be considered in those undergoing IVGT post-TURBT. Prospective multicenter studies are encouraged to better evaluate the incidence and risk factors associated with this adverse event.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 3","pages":"Article 110984"},"PeriodicalIF":2.3,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967064","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}