Urologic Oncology-seminars and Original Investigations最新文献_第4页

The role of intravesical chemotherapy following nephroureterectomy in upper tract urothelial carcinoma: A systematic review and meta-analysis 上尿路尿路上皮癌肾切除术后膀胱内化疗的作用：系统综述和荟萃分析。

IF 2.4 3区医学 Q3 ONCOLOGY

Urologic Oncology-seminars and Original Investigations

Pub Date : 2025-03-01 DOI: 10.1016/j.urolonc.2024.10.035

Stefano Moretto , Andrea Piccolini , Andrea Gallioli , Roberto Contieri , Nicolomaria Buffi , Giovanni Lughezzani , Alberto Breda , Michael Baboudjian , Bas WG van Rhijn , Morgan Roupret , Alessandro Uleri , Benjamin Pradere

Introduction

Intravesical recurrence of upper tract urothelial carcinoma after radical nephroureterectomy occurs in 22% to 47%. Intravesical chemotherapy is still underused due to concerns about its efficacy and safety. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of intravesical chemotherapy regimens in reducing the risk of intravesical recurrence following radical nephroureterectomy.

Materials and methods

A literature search was conducted using PubMed/Medline, Embase, and Web of Science databases to identify reports published until March 2024. The PRISMA guidelines were followed to identify eligible studies. The outcomes measured were intravesical recurrence rates and complications in patients treated with different intravesical instillation chemotherapy and timing after radical nephroureterectomy. Sub-analyses were performed on randomized controlled trials and studies involving patients with no history of bladder cancer.

Results

Eighteen studies met our inclusion criteria, and data from 2,483 patients were reviewed. Intravesical chemotherapy significantly reduced the risk of intravesical recurrence at 12 months (OR = 0.46; 95% CI: 0.33–0.65; P < 0.001;) and at 24 months (OR = 0.41, 95% CI: 0.28–0.61; P < 0.001). Notably, no association was found when confronting intra and postoperative instillations (OR = 0.66; 95% CI: 0.34–1.28; P = 0.2), nor single vs. multiple instillation (OR = 1.37; 95% CI: 0.75–2.50; P = 0.3). The pooled rate for minor and major complications was 9% and 0.9%, respectively.

Conclusion

This study demonstrates that intravesical chemotherapy significantly reduces intravesical recurrence rates after radical nephroureterectomy at 12 and 24 months. Additionally, it underscores the favorable safety profile of intravesical chemotherapy, with a low incidence of major complications. The ideal instillation scheme and chemotherapy agent should be further defined.

导言：根治性肾切除术后上尿路上皮癌的膀胱内复发率为 22% 至 47%。由于担心膀胱内化疗的疗效和安全性，目前膀胱内化疗仍未得到充分利用。本系统综述和荟萃分析旨在评估膀胱内化疗方案在降低根治性肾切除术后膀胱内复发风险方面的有效性和安全性：使用PubMed/Medline、Embase和Web of Science数据库进行文献检索，以确定2024年3月之前发表的报告。在确定符合条件的研究时遵循了 PRISMA 指南。衡量的结果是根治性肾切除术后接受不同膀胱内灌注化疗和时机治疗的患者的膀胱内复发率和并发症。对随机对照试验和涉及无膀胱癌病史患者的研究进行了子分析：结果：18 项研究符合我们的纳入标准，共审查了 2,483 名患者的数据。膀胱内化疗可显著降低膀胱内12个月复发风险（OR = 0.46；95% CI：0.33-0.65；P < 0.001；）和24个月复发风险（OR = 0.41；95% CI：0.28-0.61；P < 0.001）。值得注意的是，面对术中和术后灌注（OR = 0.66；95% CI：0.34-1.28；P = 0.2），以及单次灌注和多次灌注（OR = 1.37；95% CI：0.75-2.50；P = 0.3），均未发现相关性。轻微和严重并发症的总发生率分别为 9% 和 0.9%：这项研究表明，膀胱内化疗可显著降低根治性肾切除术后12个月和24个月的膀胱内复发率。此外，该研究还强调了膀胱内化疗的良好安全性，主要并发症的发生率较低。理想的灌注方案和化疗药物有待进一步确定。

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引用次数: 0

Exploring prostate-specific antigen (PSA) Testing rates and screening disparities in the all of us dataset 探索前列腺特异性抗原（PSA）的检测率和筛选差异在我们所有的数据集。

IF 2.4 3区医学 Q3 ONCOLOGY

Urologic Oncology-seminars and Original Investigations

Pub Date : 2025-03-01 DOI: 10.1016/j.urolonc.2024.11.011

Jonathan T. Ryan B.S. , William Jin M.D. , Joao G. Porto M.D. , Dinno Mendiola M.D. , Tarek Ajami M.D. , Hui Yu Ph.D. , Brandon A. Mahal M.D. , Sanoj Punnen M.D.

Purpose

To examine prostate cancer (PCa) screening disparities among ethnic groups in the U.S. using the All of Us database.

Material and Methods

White, Black, Hispanic, and Asian males ≥ 40 years old were included, excluding diagnosis's that conflict with PCa screening. We analyzed prostate-specific antigen (PSA) screening rates by age based on American Urological Association guidelines, using multivariable logistic regression (MLR) and a Cox time-to-event models that considered race, age, income, education, insurance, and home ownership as independent variables. Initial screening ages and biopsy rates were also compared.

Results

Of 56,473 individuals, 18,088 had PSA measurements: 74% White, 15% Black, 9% Hispanic, and 2% Asian. Hispanic (20%) and Black (21%) minorities were less likely to undergo PSA screening compared to White men (39%, P < 0.001). However, minorities had their initial PSA earlier with their first test from 53–54 years old compared to White men at 58 years (P < 0.001). MLR revealed race, age, income, education, insurance type, and home ownership as screening predictors (P < 0.001). Screened Black men had higher odds of an elevated PSA (P < 0.001), but the likelihood of receiving a biopsy postelevated PSA did not significantly differ from White men (P = 0.821). Additionally, those screened at age ≥ 70 were more likely to be White, have at least a college education, and be homeowners (P < 0.001).

Conclusions

White men, despite starting at a later age, are screened with PSAs more frequently than minorities, and often undergo screening at older ages outside the recommended guidelines. Black men did not have a higher rate of biopsy after having an elevated PSA compared to White men.

目的：利用All of Us数据库研究美国不同种族前列腺癌（PCa）筛查的差异。材料和方法：包括白人、黑人、西班牙裔和亚洲男性，年龄≥40岁，排除与PCa筛查相冲突的诊断。我们根据美国泌尿学会指南，使用多变量logistic回归（MLR）和Cox时间-事件模型，将种族、年龄、收入、教育、保险和房屋所有权作为独立变量，分析前列腺特异性抗原（PSA）筛查率。还比较了初始筛查年龄和活检率。结果：在56,473人中，18,088人进行了PSA检测：白人占74%，黑人占15%，西班牙裔占9%，亚洲人占2%。与白人男性相比，西班牙裔（20%）和黑人（21%）少数族裔接受PSA筛查的可能性较低（39%,P < 0.001）。然而，与白人男性在58岁时首次检测PSA相比，少数族裔在53-54岁时首次检测PSA较早（P < 0.001）。MLR显示种族、年龄、收入、教育程度、保险类型和房屋所有权是筛选预测因子（P < 0.001）。筛查后的黑人男性PSA升高的几率更高（P < 0.001），但PSA升高后接受活检的可能性与白人男性没有显著差异（P = 0.821）。此外，年龄≥70岁的筛查者更有可能是白人，至少受过大学教育，并且是房主（P < 0.001）。结论：白人男性尽管开始年龄较晚，但接受psa筛查的频率高于少数民族男性，而且通常在推荐指南之外的年龄进行筛查。与白人男性相比，黑人男性PSA升高后的活检率并不高。

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引用次数: 0

QUALITY OF LIFE OUTCOMES WITH NEUROMODULATION IN PROSTATE CANCER SURVIVORS

IF 2.4 3区医学 Q3 ONCOLOGY

Urologic Oncology-seminars and Original Investigations

Pub Date : 2025-03-01 DOI: 10.1016/j.urolonc.2024.12.100

Bryn Launer, Melissa Kaufman

Introduction

Prostate cancer (PCa) survivors experience significant impact on urinary function following treatment. While therapies to address stress urinary incontinence in PCa survivors have been well described, there is a dearth of information regarding urgency urinary incontinence and the role of sacral neuromodulation (SNM). This study aims to characterize outcomes for PCa survivors with medication refractory lower urinary tract symptoms who underwent SNM with Interstim.

Methods

A total of 50 male patients, all PCa survivors, from 12 institutions were included in a retrospective analysis. Patients were consented as part of the post-market Medtronic Product Surveillance Registry. Demographic information was collected, as well as outcomes data measured by the Patient Gobal Impression of Improvement (PGII) scale over multiple follow-up visits up to 96 months after SNM device placement.

Results

Patients were an average age of 73 at time of SNM device placement, with average BMI of 29. Ninety percent (45/50) were white, 8% (4/50) were Black or African American, and 2% (1/50) identified as Hispanic or Latino. Most patients (88%, 44/50) were enrolled following initial device placement, with 8% (4/50) undergoing replacement procedures. Forty-three percent (26/40) had previously undergone prostate surgery, and 51% (15/29) had previously undergone prostate radiation. The most common indication for device use was urinary urgency incontinence (54%, 27/50), followed by urinary urgency/frequency (24%, 12/50).

Mean follow up was 32 months, median follow up was 21 months, with a range from 0 months to 96 months. The majority reported improvement in symptoms as measured by the PGII at each follow up visit, with 73% (11/15) reporting improvement at 6 months, 83% (10/12) at 12 months, and 83% (5/6) at 72 months (Fig. 1).

Conclusions

Use of SNM in PCa survivors shows durable symptom improvement in this small cohort with mean follow up of almost 3 years. SNM should be considered as a treatment modality for patients with mixed LUTS after PCa treatment, aided by functional diagnosis with urodynamics. This study presents an opportunity for investigation into prospective studies to enhance our specificity for treatment to optimize outcomes in PCa survivors.

{"title":"QUALITY OF LIFE OUTCOMES WITH NEUROMODULATION IN PROSTATE CANCER SURVIVORS","authors":"Bryn Launer, Melissa Kaufman","doi":"10.1016/j.urolonc.2024.12.100","DOIUrl":"10.1016/j.urolonc.2024.12.100","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer (PCa) survivors experience significant impact on urinary function following treatment. While therapies to address stress urinary incontinence in PCa survivors have been well described, there is a dearth of information regarding urgency urinary incontinence and the role of sacral neuromodulation (SNM). This study aims to characterize outcomes for PCa survivors with medication refractory lower urinary tract symptoms who underwent SNM with Interstim.</div></div><div><h3>Methods</h3><div>A total of 50 male patients, all PCa survivors, from 12 institutions were included in a retrospective analysis. Patients were consented as part of the post-market Medtronic Product Surveillance Registry. Demographic information was collected, as well as outcomes data measured by the Patient Gobal Impression of Improvement (PGII) scale over multiple follow-up visits up to 96 months after SNM device placement.</div></div><div><h3>Results</h3><div>Patients were an average age of 73 at time of SNM device placement, with average BMI of 29. Ninety percent (45/50) were white, 8% (4/50) were Black or African American, and 2% (1/50) identified as Hispanic or Latino. Most patients (88%, 44/50) were enrolled following initial device placement, with 8% (4/50) undergoing replacement procedures. Forty-three percent (26/40) had previously undergone prostate surgery, and 51% (15/29) had previously undergone prostate radiation. The most common indication for device use was urinary urgency incontinence (54%, 27/50), followed by urinary urgency/frequency (24%, 12/50).</div><div>Mean follow up was 32 months, median follow up was 21 months, with a range from 0 months to 96 months. The majority reported improvement in symptoms as measured by the PGII at each follow up visit, with 73% (11/15) reporting improvement at 6 months, 83% (10/12) at 12 months, and 83% (5/6) at 72 months (Fig. 1).</div></div><div><h3>Conclusions</h3><div>Use of SNM in PCa survivors shows durable symptom improvement in this small cohort with mean follow up of almost 3 years. SNM should be considered as a treatment modality for patients with mixed LUTS after PCa treatment, aided by functional diagnosis with urodynamics. This study presents an opportunity for investigation into prospective studies to enhance our specificity for treatment to optimize outcomes in PCa survivors.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 3","pages":"Page 40"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509806","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}

引用次数: 0

ANALYSIS OF THE INCREASED INCIDENCE OF AGGRESSIVE PROSTATE CANCER AFTER PRIOR TESTICULAR CANCER

IF 2.4 3区医学 Q3 ONCOLOGY

Urologic Oncology-seminars and Original Investigations

Pub Date : 2025-03-01 DOI: 10.1016/j.urolonc.2024.12.101

Kevin Joseph Xu, Amir Khan, Minhaj Siddiqui

Introduction

Some recent studies have suggested that testicular cancer survivors are at increased risk of developing aggressive prostate cancer compared to the general population while others have not found this link. The objective of this study is to determine if testicular cancer survivors are predisposed to higher incidence of aggressive prostate cancer later in life and greater risks of prostate cancer specific mortality.

Methods

This was a retrospective case-control study of patients who developed prostate cancer and who previously had either testicular cancer or a control group cancer greater than five years prior. We used the Surveillance, Epidemiology, and End Results (SEER) database to access national cancer patient data from 1975-2020 and identify if patients with a history of testicular cancer have an earlier development of more aggressive secondary prostate cancer with higher mortality compared to those in the control group. Due to the high 5-year relative survival of testicular cancer, the control group included breast, bladder, cranial nerves and nervous system (excluding the brain), eye/orbital, oral cavity, skin, renal, thyroid cancers. Patient morbidity and mortality was assessed using Gleason scores, PSA, tumor stage, and survival time and stratified into low, moderate, and high risk accordingly. Cox regression models were used to determine the risk of mortality.

Results

We identified that prostate cancer does occur globally more in patients with testicular cancer compared to controls. The mean age in years of prostate cancer diagnosis for the testicular cancer group was 61.62 +/- 7.88, while the control group was 66.66 +/- 8.8. By the age of 60, we found that 10.7% of patients in the testicular cancer group had developed prostate cancer, compared to 6.8% of the control group. Patients in the testicular cancer group saw a decreased survival time in months (105) compared to the control (136).

Conclusions

We determined that patients with a history of testicular cancer may be at an increased risk of developing prostate cancer earlier with a higher mortality rate compared to other cancer survivors. Confirmatory studies are warranted.

{"title":"ANALYSIS OF THE INCREASED INCIDENCE OF AGGRESSIVE PROSTATE CANCER AFTER PRIOR TESTICULAR CANCER","authors":"Kevin Joseph Xu, Amir Khan, Minhaj Siddiqui","doi":"10.1016/j.urolonc.2024.12.101","DOIUrl":"10.1016/j.urolonc.2024.12.101","url":null,"abstract":"<div><h3>Introduction</h3><div>Some recent studies have suggested that testicular cancer survivors are at increased risk of developing aggressive prostate cancer compared to the general population while others have not found this link. The objective of this study is to determine if testicular cancer survivors are predisposed to higher incidence of aggressive prostate cancer later in life and greater risks of prostate cancer specific mortality.</div></div><div><h3>Methods</h3><div>This was a retrospective case-control study of patients who developed prostate cancer and who previously had either testicular cancer or a control group cancer greater than five years prior. We used the Surveillance, Epidemiology, and End Results (SEER) database to access national cancer patient data from 1975-2020 and identify if patients with a history of testicular cancer have an earlier development of more aggressive secondary prostate cancer with higher mortality compared to those in the control group. Due to the high 5-year relative survival of testicular cancer, the control group included breast, bladder, cranial nerves and nervous system (excluding the brain), eye/orbital, oral cavity, skin, renal, thyroid cancers. Patient morbidity and mortality was assessed using Gleason scores, PSA, tumor stage, and survival time and stratified into low, moderate, and high risk accordingly. Cox regression models were used to determine the risk of mortality.</div></div><div><h3>Results</h3><div>We identified that prostate cancer does occur globally more in patients with testicular cancer compared to controls. The mean age in years of prostate cancer diagnosis for the testicular cancer group was 61.62 +/- 7.88, while the control group was 66.66 +/- 8.8. By the age of 60, we found that 10.7% of patients in the testicular cancer group had developed prostate cancer, compared to 6.8% of the control group. Patients in the testicular cancer group saw a decreased survival time in months (105) compared to the control (136).</div></div><div><h3>Conclusions</h3><div>We determined that patients with a history of testicular cancer may be at an increased risk of developing prostate cancer earlier with a higher mortality rate compared to other cancer survivors. Confirmatory studies are warranted.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 3","pages":"Pages 40-41"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509812","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}

引用次数: 0

Cover 2 - Masthead

IF 2.4 3区医学 Q3 ONCOLOGY

Urologic Oncology-seminars and Original Investigations

Pub Date : 2025-03-01 DOI: 10.1016/S1078-1439(25)00047-X

引用次数: 0

UTILIZATION OF TELEMEDICINE IN CANCER PATIENTS: CONTEMPORARY ANALYSIS OF THE NATIONAL HEALTH INTERVIEW SURVEY DURING AND POST COVID-19 ERA

IF 2.4 3区医学 Q3 ONCOLOGY

Urologic Oncology-seminars and Original Investigations

Pub Date : 2025-03-01 DOI: 10.1016/j.urolonc.2024.12.033

Madhumita Parmar, Khalid Y. Alkhatib, Sydney Chambule, Yash Shah, Avanti Rangnekar, Roby Daniel, Morgan Leff, Katharine F. Michel, Thomas J. Guzzo, Phillip M. Pierorazio

Introduction

During and after COVID-19 pandemic, the demand for telemedicine has skyrocketed. Evidence suggests that high-quality Uro-oncological care can be delivered by means of telemedicine, with some caveats. Against this backdrop, we sought to analyze the use of telemedicine among cancers, hypothesizing that its use may be higher for certain oncological conditions relative to others.

Methods

We conducted a cross-sectional study on cancer patients using data starting from July 2020 using in the National Health Interview Survey (NHIS). We utilized an affirmative answer to “Have you EVER been told by a doctor or other health professional that you had Cancer or a malignancy of any kind?” to identify patients with cancer history. We used the question “In the past 12 months, have you had an appointment with a doctor, nurse, or other health professional by video or by phone?” to identify telemedicine recipients. Survey-weighted multivariable Poisson regression analysis adjusted for potential confounders was conducted to estimate risk ratios (RR) for receipt of telemedicine, and a two-way interaction between currently receiving treatment and cancer type was assessed for any effect modification.

Results

We identified 7,784 individuals with a cancer history, representing a weighted population of 40 million. The prevalence of telemedicine utilization was 47.8%. Relative to breast cancer, we found that PCa was a significant predictor of receipt of telemedicine (RR: 1.39, 95% CI: [1.06-1.81], P= 0.02), (see Table). A significant interaction was found between those currently receiving treatment for cancer and cancer type P_int<0.01; marginal probability analysis showed patients currently receiving PCa treatment were more likely to receive telemedicine, with an adjusted risk difference of 0.18, (95% CI[0.01-0.35], P=0.04).

Conclusions

Our study suggests that telemedicine appointments were widely used among cancer survivors after July 2020, with PCa survivors more likely to use telemedicine compared to other malignancies. Such findings may point to wider adoption of telemedicine among urologists, as suggested by other studies, or that PCa care lends itself better to telemedicine, compared to other malignancies. Future studies should focus on understanding the dynamics of such patient- and provider-level factors.

{"title":"UTILIZATION OF TELEMEDICINE IN CANCER PATIENTS: CONTEMPORARY ANALYSIS OF THE NATIONAL HEALTH INTERVIEW SURVEY DURING AND POST COVID-19 ERA","authors":"Madhumita Parmar, Khalid Y. Alkhatib, Sydney Chambule, Yash Shah, Avanti Rangnekar, Roby Daniel, Morgan Leff, Katharine F. Michel, Thomas J. Guzzo, Phillip M. Pierorazio","doi":"10.1016/j.urolonc.2024.12.033","DOIUrl":"10.1016/j.urolonc.2024.12.033","url":null,"abstract":"<div><h3>Introduction</h3><div>During and after COVID-19 pandemic, the demand for telemedicine has skyrocketed. Evidence suggests that high-quality Uro-oncological care can be delivered by means of telemedicine, with some caveats. Against this backdrop, we sought to analyze the use of telemedicine among cancers, hypothesizing that its use may be higher for certain oncological conditions relative to others.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study on cancer patients using data starting from July 2020 using in the National Health Interview Survey (NHIS). We utilized an affirmative answer to <em>“Have you EVER been told by a doctor or other health professional that you had Cancer or a malignancy of any kind?”</em> to identify patients with cancer history. We used the question <em>“In the past 12 months, have you had an appointment with a doctor, nurse, or other health professional by video or by phone?”</em> to identify telemedicine recipients. Survey-weighted multivariable Poisson regression analysis adjusted for potential confounders was conducted to estimate risk ratios (RR) for receipt of telemedicine, and a two-way interaction between currently receiving treatment and cancer type was assessed for any effect modification.</div></div><div><h3>Results</h3><div>We identified 7,784 individuals with a cancer history, representing a weighted population of 40 million. The prevalence of telemedicine utilization was 47.8%. Relative to breast cancer, we found that PCa was a significant predictor of receipt of telemedicine (RR: 1.39, 95% CI: [1.06-1.81], P= 0.02), (see Table). A significant interaction was found between those currently receiving treatment for cancer and cancer type P<sub>int</sub><0.01; marginal probability analysis showed patients currently receiving PCa treatment were more likely to receive telemedicine, with an adjusted risk difference of 0.18, (95% CI[0.01-0.35], P=0.04).</div></div><div><h3>Conclusions</h3><div>Our study suggests that telemedicine appointments were widely used among cancer survivors after July 2020, with PCa survivors more likely to use telemedicine compared to other malignancies. Such findings may point to wider adoption of telemedicine among urologists, as suggested by other studies, or that PCa care lends itself better to telemedicine, compared to other malignancies. Future studies should focus on understanding the dynamics of such patient- and provider-level factors.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 3","pages":"Page 13"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509713","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}

引用次数: 0

ROBOTIC PARTIAL CYSTECTOMY FOLLOWING NEOADJUVANT CHEMOTHERAPY FOR MUSCLE INVASIVE BLADDER CANCER: A SINGLE CENTER EXPERIENCE WITH A MULTIMODAL BLADDER-PRESERVING REGIMEN

IF 2.4 3区医学 Q3 ONCOLOGY

Urologic Oncology-seminars and Original Investigations

Pub Date : 2025-03-01 DOI: 10.1016/j.urolonc.2024.12.037

Samuel Gold, Sidney Roberts, Vitaly Margulis

<div><h3>Introduction</h3><div>Utilizing advances in multimodal treatment paradigms and minimally invasive surgical techniques, we investigated the role of robotic-assisted partial cystectomy (RAPC) as an alternative to radical cystectomy in a select cohort of patients with muscle-invasive bladder cancer (MIBC). Along with standard-of-care neoadjuvant platinum-based chemotherapy, we sought to assess whether RAPC provides similar oncologic efficacy as radical cystectomy with reduced rates of associated morbidity.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted of all patients with MIBC of primarily urothelial origin who underwent platinum-based neoadjuvant chemotherapy (NAC) and RAPC at our institution between 2018-2023. Patients with MIBC and unifocal tumors at the anterior, anterolateral bladder, or bladder dome were considered for RAPC. Biopsy and restaging was performed with transurethral resection of bladder tumor (TURBT). Immediately prior to RAPC, intravesical chemotherapy was administered. A robotic transperitoneal approach was used with concurrent cystoscopy to guide bladder resection. Bilateral pelvic lymph node dissection was performed. Pathology data was collected after each surgical episode. Primary endpoint was 30-day complications. Secondary endpoints included intravesical recurrences, disease progression to metastasis, systemic chemotherapy/immunotherapy, and/or death.</div></div><div><h3>Results</h3><div>Seventeen patients met inclusion criteria. Median operative time was 289 minutes (IQR 229-312) and EBL was 100 mL (IQR 75-150). No patients experienced intraoperative complications, 11/17 (65%) were discharged on postoperative day 1. There was one 30-day complication: pelvic abscess requiring percutaneous drain placement and IV antibiotics.</div><div>Eight patients were ypT0 (47%) after RAPC. Of the seven patients who had no malignancy on post-NAC TURBT, 6/7 (86%) were ypT0 and one was ypTIS. Seven patients (41%) had MIBC on final pathology. No patients had positive margins.</div><div>Median follow-up was 6.8 months (IQR 3.7-20.3) with 7 patients having follow-up >12 months. Three (19%) had intravesical recurrences: CIS (x2) and MIBC with CIS (x1). Time to recurrence ranged 7.2-12.5 months. No patients required salvage cystectomy. One patient developed metastatic progression; he was ypT0 after RAPC. Two patients died; neither had evidence of disease at times of death.</div></div><div><h3>Conclusions</h3><div>While the gold standard treatment for MIBC remains platinum-based chemotherapy followed by radical cystectomy, there is significant morbidity associated with this surgical intervention. In a selected patient population, RAPC may serve as a less toxic surgical alternative. In this study population, RAPC is shown to be a safe procedure with minimal long-term morbidity. In the short term, response to NAC predicted pathologic complete response after RAPC. Durability of response is an ongoing focus of t

{"title":"ROBOTIC PARTIAL CYSTECTOMY FOLLOWING NEOADJUVANT CHEMOTHERAPY FOR MUSCLE INVASIVE BLADDER CANCER: A SINGLE CENTER EXPERIENCE WITH A MULTIMODAL BLADDER-PRESERVING REGIMEN","authors":"Samuel Gold, Sidney Roberts, Vitaly Margulis","doi":"10.1016/j.urolonc.2024.12.037","DOIUrl":"10.1016/j.urolonc.2024.12.037","url":null,"abstract":"<div><h3>Introduction</h3><div>Utilizing advances in multimodal treatment paradigms and minimally invasive surgical techniques, we investigated the role of robotic-assisted partial cystectomy (RAPC) as an alternative to radical cystectomy in a select cohort of patients with muscle-invasive bladder cancer (MIBC). Along with standard-of-care neoadjuvant platinum-based chemotherapy, we sought to assess whether RAPC provides similar oncologic efficacy as radical cystectomy with reduced rates of associated morbidity.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted of all patients with MIBC of primarily urothelial origin who underwent platinum-based neoadjuvant chemotherapy (NAC) and RAPC at our institution between 2018-2023. Patients with MIBC and unifocal tumors at the anterior, anterolateral bladder, or bladder dome were considered for RAPC. Biopsy and restaging was performed with transurethral resection of bladder tumor (TURBT). Immediately prior to RAPC, intravesical chemotherapy was administered. A robotic transperitoneal approach was used with concurrent cystoscopy to guide bladder resection. Bilateral pelvic lymph node dissection was performed. Pathology data was collected after each surgical episode. Primary endpoint was 30-day complications. Secondary endpoints included intravesical recurrences, disease progression to metastasis, systemic chemotherapy/immunotherapy, and/or death.</div></div><div><h3>Results</h3><div>Seventeen patients met inclusion criteria. Median operative time was 289 minutes (IQR 229-312) and EBL was 100 mL (IQR 75-150). No patients experienced intraoperative complications, 11/17 (65%) were discharged on postoperative day 1. There was one 30-day complication: pelvic abscess requiring percutaneous drain placement and IV antibiotics.</div><div>Eight patients were ypT0 (47%) after RAPC. Of the seven patients who had no malignancy on post-NAC TURBT, 6/7 (86%) were ypT0 and one was ypTIS. Seven patients (41%) had MIBC on final pathology. No patients had positive margins.</div><div>Median follow-up was 6.8 months (IQR 3.7-20.3) with 7 patients having follow-up >12 months. Three (19%) had intravesical recurrences: CIS (x2) and MIBC with CIS (x1). Time to recurrence ranged 7.2-12.5 months. No patients required salvage cystectomy. One patient developed metastatic progression; he was ypT0 after RAPC. Two patients died; neither had evidence of disease at times of death.</div></div><div><h3>Conclusions</h3><div>While the gold standard treatment for MIBC remains platinum-based chemotherapy followed by radical cystectomy, there is significant morbidity associated with this surgical intervention. In a selected patient population, RAPC may serve as a less toxic surgical alternative. In this study population, RAPC is shown to be a safe procedure with minimal long-term morbidity. In the short term, response to NAC predicted pathologic complete response after RAPC. Durability of response is an ongoing focus of t","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 3","pages":"Pages 14-15"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509716","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}

引用次数: 0

UNDETECTABLE PRECYSTECTOMY TUMOR-INFORMED CTDNA AND CONVERSION DYNAMICS AFTER RADICAL CYSTECTOMY PREDICTS IMPROVED ONCOLOGICAL OUTCOMES

IF 2.4 3区医学 Q3 ONCOLOGY

Urologic Oncology-seminars and Original Investigations

Pub Date : 2025-03-01 DOI: 10.1016/j.urolonc.2024.12.038

Reuben Ben-David, Sarah Lidagoster, Jack Gedulding, Kaushik P. Kolanukuduru, Yuval Elkun, Neeraja Tillu, Asher Mandel, Mohammed Almoflihi, Basil Kaufmann, Kyrollis Attalla, Reza Mehrazin, Peter Wiklund, John P. Sfakianos

Introduction

umor-informed circulating tumor DNA (ctDNA) has emerged as a novel prognostic biomarker in bladder cancer. We seek to assess recurrence-free survival (RFS) outcomes in patients with undetectable precystectomy ctDNA and to evaluate if patients who converted from detectable to undetectable ctDNA status post radical cystectomy have similar RFS outcomes as those with persistently undetectable ctDNA status.

Methods

Patients who underwent radical cystectomy had prospectively and longitudinally collected tumor-informed ctDNA analyses during 2021-2023. The ctDNA status was informed from the pre-cystectomy specimen. The minimal residual disease (MRD) window was defined as the initial 90 days after radical cystectomy. RFS was evaluated using the Kaplan-Meier method.

Results

The cohort included 135 patients with 647 ctDNA analyses. The median age was 71 years (IQR 63-77). During a median follow-up time of 11 months (IQR 7-18), 41 patients (30%) had a recurrence. Precystectomy undetectable ctDNA status was found in 54 patients (40%). The RFS rates at 6, 12, and 21 months were 98%, 93%, and 82%, respectively. Seventy-seven patients had undetectable ctDNA status at the MRD window available for conversion dynamics analysis (Table 1); 43 had persistently undetectable ctDNA status (both at precystectomy and MRD window) and 31 converted from precystectomy detectable to MRD undetectable status (conversion group). The persistently undetectable group had significantly better RFS than the conversion group (log-rank, p=0.0002), with 12- month RFS rates of 97% vs. 51%, and 18-month RFS rates of 88% vs. 51%, respectively (Figure 1).

Conclusions

Patients with undetectable precystectomy ctDNA status have a favorable prognosis and may be candidates for treatment de-escalation. Those with persistently undetectable ctDNA had superior RFS compared to the conversion group. Precystectomy ctDNA status should be incorporated in trials examining the use of ctDNA in clinical decision-making.

{"title":"UNDETECTABLE PRECYSTECTOMY TUMOR-INFORMED CTDNA AND CONVERSION DYNAMICS AFTER RADICAL CYSTECTOMY PREDICTS IMPROVED ONCOLOGICAL OUTCOMES","authors":"Reuben Ben-David, Sarah Lidagoster, Jack Gedulding, Kaushik P. Kolanukuduru, Yuval Elkun, Neeraja Tillu, Asher Mandel, Mohammed Almoflihi, Basil Kaufmann, Kyrollis Attalla, Reza Mehrazin, Peter Wiklund, John P. Sfakianos","doi":"10.1016/j.urolonc.2024.12.038","DOIUrl":"10.1016/j.urolonc.2024.12.038","url":null,"abstract":"<div><h3>Introduction</h3><div>umor-informed circulating tumor DNA (ctDNA) has emerged as a novel prognostic biomarker in bladder cancer. We seek to assess recurrence-free survival (RFS) outcomes in patients with undetectable precystectomy ctDNA and to evaluate if patients who converted from detectable to undetectable ctDNA status post radical cystectomy have similar RFS outcomes as those with persistently undetectable ctDNA status.</div></div><div><h3>Methods</h3><div>Patients who underwent radical cystectomy had prospectively and longitudinally collected tumor-informed ctDNA analyses during 2021-2023. The ctDNA status was informed from the pre-cystectomy specimen. The minimal residual disease (MRD) window was defined as the initial 90 days after radical cystectomy. RFS was evaluated using the Kaplan-Meier method.</div></div><div><h3>Results</h3><div>The cohort included 135 patients with 647 ctDNA analyses. The median age was 71 years (IQR 63-77). During a median follow-up time of 11 months (IQR 7-18), 41 patients (30%) had a recurrence. Precystectomy undetectable ctDNA status was found in 54 patients (40%). The RFS rates at 6, 12, and 21 months were 98%, 93%, and 82%, respectively. Seventy-seven patients had undetectable ctDNA status at the MRD window available for conversion dynamics analysis (Table 1); 43 had persistently undetectable ctDNA status (both at precystectomy and MRD window) and 31 converted from precystectomy detectable to MRD undetectable status (conversion group). The persistently undetectable group had significantly better RFS than the conversion group (log-rank, p=0.0002), with 12- month RFS rates of 97% vs. 51%, and 18-month RFS rates of 88% vs. 51%, respectively (Figure 1).</div></div><div><h3>Conclusions</h3><div>Patients with undetectable precystectomy ctDNA status have a favorable prognosis and may be candidates for treatment de-escalation. Those with persistently undetectable ctDNA had superior RFS compared to the conversion group. Precystectomy ctDNA status should be incorporated in trials examining the use of ctDNA in clinical decision-making.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 3","pages":"Page 15"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509717","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}

引用次数: 0

IMPROVING GERMLINE TESTING IN AT-RISK PATIENTS WITH PROSTATE CANCER

IF 2.4 3区医学 Q3 ONCOLOGY

Urologic Oncology-seminars and Original Investigations

Pub Date : 2025-03-01 DOI: 10.1016/j.urolonc.2024.12.074

Juan Javier-DesLoges MD, Ana Flores Pimentel, Yu-Wei Chen MD, Yasoda Satpathy, James Michael Randall MD, Christopher Kane MD, Lisa Madlensky PhD, Matthew Savage PhD, Samuel Pena, Tyler Stewart MD, Aditya Bagrodia MD, Rana McKay MD

<div><h3>Introduction</h3><div>Germline testing is recommended for patients with high risk localized, locally advanced, and metastatic prostate cancer. Despite this recommendation, implementation of germline testing in prostate cancer has been suboptimal. There is a need for novel strategies to engage oncology clinicians and patients in germline testing and integrate germline testing into the clinic.</div></div><div><h3>Methods</h3><div>We designed a single-arm investigator-initiated study utilizing video education as a means of delivering pre-test counseling to patients who meet the National Cancer Comprehensive Network testing criteria for germline testing. Inclusion criteria includes men greater than or equal to 18 years of age, diagnosis of prostate cancer of any histology, and NCCN indication for germline testing. Patients who consented to the study underwent a one-on-one in-person education session with an educational video about germline testing. Patients completed pre and post-intervention questionnaires to assess their knowledge and satisfaction with the intervention. The primary endpoint was the proportion of patients who underwent germline testing among those enrolled to the study. Key secondary endpoints include the impact of education intervention on change in knowledge of germline testing and patient perceptions of germline testing.</div></div><div><h3>Results</h3><div>The study enrolled a total of 58 patients, 50 patients completed the study protocol. The majority of patients were White 78.0% (39/50), Non-Hispanic 92.0% (46/50), spoke English 98.0% (49/50), and were college educated 70% (35/50). The majority of patients had high risk localized disease 46.0% (23/50) or metastatic castrate sensitive prostate cancer 26.0% (13/5). Overall, 82.0% (41/50) of patients choose to participate in germline testing following the intervention. Of the tests ordered, 26.0% (13/50) were by urologists and 74.0% (37/50) were by medical oncologists. In this cohort 12.0% (6/50) of patients had a P/LP mutation, 14.0% (7/50) had a VUS. The most important factor influencing patients to pursue genetic testing would be if the results guide treatment selection. The most important factor influencing patients to not pursue genetic testing would be if the results had no clinical value. Most patients had a high level of understanding of genetics knowledge prior to the intervention with a mean score of 9.1 out of 11 in the genetics knowledge test. There was no significant increase or decrease genetics knowledge after the intervention (p = 0.88). A majority of patients were satisfied with the intervention and found it useful 94% (47/50).</div></div><div><h3>Conclusions</h3><div>The uptake of germline testing after the video intervention was high, most patients already had an understanding of genetics, but were more likely to pursue testing after the intervention and if it would influence their treatment. Furthermore, utilization of virtual educational aids should

{"title":"IMPROVING GERMLINE TESTING IN AT-RISK PATIENTS WITH PROSTATE CANCER","authors":"Juan Javier-DesLoges MD, Ana Flores Pimentel, Yu-Wei Chen MD, Yasoda Satpathy, James Michael Randall MD, Christopher Kane MD, Lisa Madlensky PhD, Matthew Savage PhD, Samuel Pena, Tyler Stewart MD, Aditya Bagrodia MD, Rana McKay MD","doi":"10.1016/j.urolonc.2024.12.074","DOIUrl":"10.1016/j.urolonc.2024.12.074","url":null,"abstract":"<div><h3>Introduction</h3><div>Germline testing is recommended for patients with high risk localized, locally advanced, and metastatic prostate cancer. Despite this recommendation, implementation of germline testing in prostate cancer has been suboptimal. There is a need for novel strategies to engage oncology clinicians and patients in germline testing and integrate germline testing into the clinic.</div></div><div><h3>Methods</h3><div>We designed a single-arm investigator-initiated study utilizing video education as a means of delivering pre-test counseling to patients who meet the National Cancer Comprehensive Network testing criteria for germline testing. Inclusion criteria includes men greater than or equal to 18 years of age, diagnosis of prostate cancer of any histology, and NCCN indication for germline testing. Patients who consented to the study underwent a one-on-one in-person education session with an educational video about germline testing. Patients completed pre and post-intervention questionnaires to assess their knowledge and satisfaction with the intervention. The primary endpoint was the proportion of patients who underwent germline testing among those enrolled to the study. Key secondary endpoints include the impact of education intervention on change in knowledge of germline testing and patient perceptions of germline testing.</div></div><div><h3>Results</h3><div>The study enrolled a total of 58 patients, 50 patients completed the study protocol. The majority of patients were White 78.0% (39/50), Non-Hispanic 92.0% (46/50), spoke English 98.0% (49/50), and were college educated 70% (35/50). The majority of patients had high risk localized disease 46.0% (23/50) or metastatic castrate sensitive prostate cancer 26.0% (13/5). Overall, 82.0% (41/50) of patients choose to participate in germline testing following the intervention. Of the tests ordered, 26.0% (13/50) were by urologists and 74.0% (37/50) were by medical oncologists. In this cohort 12.0% (6/50) of patients had a P/LP mutation, 14.0% (7/50) had a VUS. The most important factor influencing patients to pursue genetic testing would be if the results guide treatment selection. The most important factor influencing patients to not pursue genetic testing would be if the results had no clinical value. Most patients had a high level of understanding of genetics knowledge prior to the intervention with a mean score of 9.1 out of 11 in the genetics knowledge test. There was no significant increase or decrease genetics knowledge after the intervention (p = 0.88). A majority of patients were satisfied with the intervention and found it useful 94% (47/50).</div></div><div><h3>Conclusions</h3><div>The uptake of germline testing after the video intervention was high, most patients already had an understanding of genetics, but were more likely to pursue testing after the intervention and if it would influence their treatment. Furthermore, utilization of virtual educational aids should ","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 3","pages":"Page 29"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509920","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}

引用次数: 0

PROPENSITY SCORE-MATCHED ANALYSIS OF NEOADJUVANT VS. ADJUVANT THERAPY IN RENAL CELL CARCINOMA

IF 2.4 3区医学 Q3 ONCOLOGY

Urologic Oncology-seminars and Original Investigations

Pub Date : 2025-03-01 DOI: 10.1016/j.urolonc.2024.12.051

Cesare Saitta, Mimi V. Nguyen, Giacomo Musso, Kevin Hakimi, Dattatraya Patil, Hajime Tanaka, Luke Wang, Margaret F. Meagher, Dhruv Puri, Kit Yuen, Masaki Kobayashi, Shohei Fukuda, Giuseppe Garofano, Giovanni Lughezzani, Nicolò M. Buffi, Viraj Master, Ithaar H. Derweesh

Introduction

To compare outcomes in high-risk localized RCC (HRL-RCC) patients treated with adjuvant (AT) and neoadjuvant therapy (NT) utilizing a propensity score matched model (PSM)

Methods

We conducted a multicenter analysis for patients who underwent AT or NT. AT was defined as systemic therapy given postoperatively in absence of metastases; NT was presurgical therapy in setting of localized disease. AT and NT utilized included target molecular therapy (TMT) or immunotherapy (IO). PSM model was conducted using a nearest neighbor matching algorithm in a 1:2 ratio. Primary outcome was all-cause mortality (ACM); secondary outcomes were cancer-specific mortality (CSM) and recurrence. Cox regression multivariable analysis (MVA) was fitted to elucidate predictors of outcomes.

Results

After PSM 311 patients were analyzed [adjuvant n=221, 127 TMT vs. 94 IO; neoadjuvant n=90, 61 TMT vs. 29 IO]; median follow-up 44 (IQR 20-74) months. MVA revealed AT as associated with increased ACM (HR=1.97, p=0.007), CSM (HR=2.37, p=0.007) and recurrence (HR 1.64, p=0.02). Sub-analysis of AT cohort revealed IO to be associated with decreased ACM (HR 0.59, p=0.015). In the neoadjuvant cohort TMT and IO were associated with decreased ACM (HR 0.49; p=0.016; HR 0.32, p=0.016, respectively) and CSM risk (HR 0.47, p=0.036; HR 0.18, p=0.017).

Conclusions

Our findings suggest a potential advantage of NT for HRL-RCC. Adjuvant immunotherapy was associated with decreased risk of ACM, while in the neoadjuvant TMT and IO therapy had similar outcomes. Our findings call for consideration of a clinical trial to compare outcomes of AT vs. NT.

{"title":"PROPENSITY SCORE-MATCHED ANALYSIS OF NEOADJUVANT VS. ADJUVANT THERAPY IN RENAL CELL CARCINOMA","authors":"Cesare Saitta, Mimi V. Nguyen, Giacomo Musso, Kevin Hakimi, Dattatraya Patil, Hajime Tanaka, Luke Wang, Margaret F. Meagher, Dhruv Puri, Kit Yuen, Masaki Kobayashi, Shohei Fukuda, Giuseppe Garofano, Giovanni Lughezzani, Nicolò M. Buffi, Viraj Master, Ithaar H. Derweesh","doi":"10.1016/j.urolonc.2024.12.051","DOIUrl":"10.1016/j.urolonc.2024.12.051","url":null,"abstract":"<div><h3>Introduction</h3><div>To compare outcomes in high-risk localized RCC (HRL-RCC) patients treated with adjuvant (AT) and neoadjuvant therapy (NT) utilizing a propensity score matched model (PSM)</div></div><div><h3>Methods</h3><div>We conducted a multicenter analysis for patients who underwent AT or NT. AT was defined as systemic therapy given postoperatively in absence of metastases; NT was presurgical therapy in setting of localized disease. AT and NT utilized included target molecular therapy (TMT) or immunotherapy (IO). PSM model was conducted using a nearest neighbor matching algorithm in a 1:2 ratio. Primary outcome was all-cause mortality (ACM); secondary outcomes were cancer-specific mortality (CSM) and recurrence. Cox regression multivariable analysis (MVA) was fitted to elucidate predictors of outcomes.</div></div><div><h3>Results</h3><div>After PSM 311 patients were analyzed [adjuvant n=221, 127 TMT vs. 94 IO; neoadjuvant n=90, 61 TMT vs. 29 IO]; median follow-up 44 (IQR 20-74) months. MVA revealed AT as associated with increased ACM (HR=1.97, p=0.007), CSM (HR=2.37, p=0.007) and recurrence (HR 1.64, p=0.02). Sub-analysis of AT cohort revealed IO to be associated with decreased ACM (HR 0.59, p=0.015). In the neoadjuvant cohort TMT and IO were associated with decreased ACM (HR 0.49; p=0.016; HR 0.32, p=0.016, respectively) and CSM risk (HR 0.47, p=0.036; HR 0.18, p=0.017).</div></div><div><h3>Conclusions</h3><div>Our findings suggest a potential advantage of NT for HRL-RCC. Adjuvant immunotherapy was associated with decreased risk of ACM, while in the neoadjuvant TMT and IO therapy had similar outcomes. Our findings call for consideration of a clinical trial to compare outcomes of AT vs. NT.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 3","pages":"Page 20"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510047","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}

引用次数: 0