Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Efficacy of disitamab vedotin-based therapy in HER2-negative and HER2-low locally advanced or metastatic urothelial carcinoma: A systematic review and meta-analysis.","authors":"Jianjun Ye, Yanxin Li, Mengni Zhang, Xinyang Liao, Qihao Wang, Zeyu Chen, Xiang Tu, Ping Tan, Peng Zhang, Hao Zeng, Yali Shen, Qiang Wei, Yige Bao","doi":"10.1016/j.urolonc.2026.111034","DOIUrl":"https://doi.org/10.1016/j.urolonc.2026.111034","url":null,"abstract":"<p><p>While disitamab vedotin (DV) shows promising efficacy in HER2-positive locally advanced/metastatic urothelial carcinoma (la/mUC), its clinical efficacy in HER2-negative and HER2-low (immunohistochemistry [IHC] 0 and 1+) populations is unclear. This meta-analysis aims to evaluate DV-based therapy in these underserved subgroups. PubMed, Scopus, Embase, and Cochrane were main databases when searching articles published from January 2000 to December 2025 (PROSPERO: CRD420251130969). Primary endpoints were objective response rate (ORR) and median progression-free survival (mPFS). Secondary endpoints included disease control rate (DCR) and median overall survival (mOS). Random-effects models assessed pooled effects, with subgroup analyses by HER2 expression. Nonrandomized studies of interventions version I tool (ROBINS-I) was used to evaluate the risk of bias. 16 studies with 279 HER2-negative and HER2-low la/mUC cases were included. DV-based therapy achieved an ORR of 51% (95% confidence interval [CI], 44%-57%), DCR of 75% (95% CI, 63%-84%), and mPFS of 5.48 (95% CI, 4.99-5.97) months, with better outcomes in HER2-low (ORR, 55%; 95% CI, 48%-63%) versus HER2-negative (ORR, 34%; 95% CI, 22%-49%) subgroups. Insufficient available data precluding formal meta-analytic synthesis of mOS. Limitations include small sample size and the inability to perform in-depth subgroup analyses. This study establishes the first comprehensive evidence for the clinical efficacy of DV-based therapy in HER2-negative and HER2-low la/mUC, providing a foundation for expanding DV applications in biomarker-selected la/mUC patients. Future high-quality studies are warranted to further elucidate the clinical efficacy of DV-based therapy in this patient population.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":"111034"},"PeriodicalIF":2.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial comment on \"Comparison of 4 local anesthetic techniques for open radical cystectomy: A prospective, randomized controlled trial\".","authors":"Alireza Ghoreifi, Hooman Djaladat","doi":"10.1016/j.urolonc.2026.111001","DOIUrl":"https://doi.org/10.1016/j.urolonc.2026.111001","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":"111001"},"PeriodicalIF":2.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137864","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":"Statin use and outcomes in advanced prostate cancer:Secondary analysis of the SPARTAN trial.","authors":"Ahmad Mousa, Julian Chavarriaga, Katherine Lajkosz, Linda Z Penn, Najia Khurram, Robert J Hamilton","doi":"10.1016/j.urolonc.2026.110992","DOIUrl":"https://doi.org/10.1016/j.urolonc.2026.110992","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the impact of statin use on survival outcomes in the phase III SPARTAN trial of apalutamide for nonmetastatic castration-resistant prostate cancer.</p><p><strong>Subjects and methods: </strong>We analyzed data from all 1,207 SPARTAN participants, identifying baseline statin users and matching them 1:1 to nonusers using propensity scores. The primary endpoint was metastasis-free survival (MFS), compared between groups using Kaplan-Meier analysis. A multivariable Cox proportional hazards model, adjusted for key covariates, was applied to the matched cohort to assess associations between statin use and survival outcomes.</p><p><strong>Results: </strong>Of the 1,207 SPARTAN participants, 463 (38%) were baseline statin users; 456 users were propensity matched to 456 nonusers with balanced characteristics. Statin and nonstatin users were similarly distributed across treatment arms. While statin use was not associated with differences in metastasis-free survival (MFS) overall (P = 0.64), we observed a significant interaction by treatment arm (P = 0.018), with statin use linked to worse MFS in the placebo group (Hazard Ratio [HR] 1.40, 95% Confidence Interval [95% CI] 1.04-1.88). Statin use was also not associated with secondary endpoints overall, but again showed interaction for anticancer therapy-free survival, with harm in the placebo group (HR 1.32) and benefit in the apalutamide group (HR 0.79).</p><p><strong>Conclusion: </strong>In this secondary analysis of the SPARTAN trial, statin use was not associated with improved survival outcomes overall. However, a significant interaction was observed, with statin use linked to worse metastasis-free survival in the placebo arm. These findings suggest a hypothesized interplay between statins and androgen receptor inhibition that warrants further prospective investigation.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":"110992"},"PeriodicalIF":2.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137828","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":"Protocol-driven same day discharge for robotic radical prostatectomy","authors":"Emily H. Roebuck M.D. ,&nbsp;Lila G. McGrath B.S. ,&nbsp;Myra Robinson M.S.P.H. ,&nbsp;Katherine Whitton N.P. ,&nbsp;Justin T. Matulay M.D. ,&nbsp;Peter E. Clark M.D. ,&nbsp;Stephen B. Riggs M.D., M.B.A.","doi":"10.1016/j.urolonc.2025.10.013","DOIUrl":"10.1016/j.urolonc.2025.10.013","url":null,"abstract":"<div><h3>Purpose</h3><div>Average length of stay following robot-assisted laparoscopic prostatectomy (RALP) ranges from 24 to 48 hours. This study evaluates the implementation, safety, and efficacy of a standardized same-day discharge (SDD) protocol for RALP patients compared to inpatient stay.</div></div><div><h3>Materials and Methods</h3><div>We conducted a retrospective cohort study of 220 patients who underwent RALP at a single academic center from January 2022 to September 2023. We implemented a standardized SDD protocol on August 1, 2022, expanding eligibility criteria and formalizing perioperative management. Patients were categorized into same-day discharge (SDD) or inpatient (IP-RALP) groups for analysis. Categorical endpoints were compared between cohorts with Fisher’s exact tests while continuous outcomes were compared with Wilcoxon rank sum tests.</div></div><div><h3>Results</h3><div>220 males underwent RALP, with 132 (88.6%) of 149 SDD-initiated patients successfully discharged on the same day. Outcomes including ED visits, 30-day readmission rates, were similar between groups, with no significant differences observed in 24-hour readmissions (SDD 0.8%, IP-RALP 0%, <em>P</em> &gt; 0.99). While 30-day readmissions were slightly higher in SDD (9.1% vs. 4.6%), this was not statistically significant (<em>P</em> = 0.29). Complication rates and number of follow-up calls were similar across cohorts. Formal SDD protocol implementation improved POD1 contact rates (48% vs. 73.8%, <em>P</em> = 0.01) and consistency in discharge medication management.</div></div><div><h3>Conclusions</h3><div>Our findings suggest SDD after prostatectomy is safe, with no observed increased risk of ED visits, readmissions, or complications compared to IP-RALP. Formal SDD protocol implementation improved consistency in discharge processes. Future studies are needed to further elucidate preoperative risk stratification for appropriate tailoring of protocol driven care.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 2","pages":"Pages 124.e17-124.e24"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507247","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":"Single dose perioperative intravesical instillation of gemcitabine versus mitomycin-C following resection of non-muscle invasive bladder cancer: A randomized controlled trial","authors":"Kevin Arulraj ,&nbsp;Nitish Aggarwal ,&nbsp;Brusabhanu Nayak,&nbsp;Rishi Nayyar,&nbsp;Rajeev Kumar,&nbsp;Amlesh Seth","doi":"10.1016/j.urolonc.2025.10.022","DOIUrl":"10.1016/j.urolonc.2025.10.022","url":null,"abstract":"<div><h3>Purpose</h3><div>Immediate intravesical chemotherapy reduces recurrence in non-muscle invasive bladder cancer (NMIBC). Common agents currently used are mitomycin C (MMC) and gemcitabine. Gemcitabine was shown to reduce recurrence by 20% when compared to saline in the SWOG S0337 trial. There is no study that compares gemcitabine with MMC as an immediate intravesical agent in NMIBC.</div></div><div><h3>Methodology</h3><div>This was a phase II RCT involving patients suspected of NMIBC who underwent transurethral resection (TUR) in our center. Informed consent was obtained from all participants. We excluded patients with suspected bladder perforation, incomplete resection, urethral or ureteric disease, history of radiation, chronic kidney, or liver disease. Patients received either 2 g of gemcitabine or 40 mg of MMC within 6 hours after surgery. The primary outcomes were recurrence and progression at one year. The secondary outcomes were time to recurrence, time to progression, and adverse events.</div></div><div><h3>Results</h3><div>A total of 44 patients in the gemcitabine arm and 48 patients in the MMC arm were considered for analysis. Baseline parameters, operative and histopathological characteristics were comparable between the 2 groups. At 1 year the recurrence rate was comparable between the 2 groups (12.6% vs. 18.7%; <em>P</em> = 0.96). One patient who received MMC had disease progression. The mean time to recurrence, cost of therapy, and incidence of adverse events were comparable between the 2 groups.</div></div><div><h3>Conclusions</h3><div>Immediate post-resection intravesical instillation of gemcitabine or MMC in patients with suspected NMIBC has comparable recurrence rates, time to recurrence, adverse effects, and cost. Longer follow-up and a larger patient cohort will strengthen our results.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 2","pages":"Pages 118.e7-118.e13"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565657","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":"Clinical outcomes of retreatment or discontinuation after interruption of nivolumab plus ipilimumab due to immune-related adverse events in metastatic renal cell carcinoma patients: A retrospective multicenter study","authors":"Yuta Sano M.D. ,&nbsp;Masaharu Inoue M.D., Ph.D ,&nbsp;Satoshi Washino M.D., Ph.D ,&nbsp;Suguru Shirotake M.D., PhD ,&nbsp;Hideki Takeshita M.D., Ph.D ,&nbsp;Yuji Miura M.D., Ph.D ,&nbsp;Akinari Nakayama M.D., Ph.D ,&nbsp;Shoichi Nagamoto M.D., Ph.D ,&nbsp;Tomoaki Miyagawa M.D., Ph.D ,&nbsp;Masafumi Oyama M.D., Ph.D ,&nbsp;Satoru Kawakami M.D., Ph.D ,&nbsp;Kazutaka Saito M.D., Ph.D ,&nbsp;Yoh Matsuoka M.D., Ph.D","doi":"10.1016/j.urolonc.2025.10.021","DOIUrl":"10.1016/j.urolonc.2025.10.021","url":null,"abstract":"<div><h3>Introduction</h3><div>We aimed to investigate clinical outcomes in patients with metastatic renal cell carcinoma (mRCC) treated with nivolumab plus ipilimumab (Nivo/Ipi) who either resumed or permanently discontinued treatment following immune-related adverse events (irAEs) that necessitated treatment interruption.</div></div><div><h3>Patients and Methods</h3><div>A database of 129 metastatic renal cell carcinoma (mRCC) patients treated with Nivo/Ipi at 6 Japanese institutions was analyzed, dividing the patients into 3 groups: those without treatment interruption (“no interruption”), those who resumed treatment after irAEs (“retreatment”), and those who permanently discontinued treatment after irAEs (“discontinuation”).</div></div><div><h3>Results</h3><div>The no interruption, retreatment, and discontinuation group included 58, 35, and 36 patients, respectively. Median time to initial irAE requiring treatment interruption was comparable between the retreatment and discontinuation groups (2.1 vs. 2.6 months, <em>P</em> = 0.53). Although the type and severity of initial irAEs leading to interruption were evenly distributed between the retreatment and discontinuation groups, high-dose glucocorticoids were required less frequently in the retreatment group (7 vs. 16 patients, <em>P</em> = 0.033). Among the 35 patients in the retreatment group, 5 developed new irAEs and 2 experienced recurrences of previous irAEs, with grade 3/4 irAEs occurring in 3 patients. Objective response rates to Nivo/Ipi were 30%, 63%, and 64% in the no interruption, retreatment, and discontinuation groups, respectively. Progression-free survival (PFS) and overall survival (OS) were comparable between the retreatment and discontinuation groups (median PFS: 28.5 vs. 26.0 months, <em>P</em> = 0.60; 3-year OS: 69% vs. 78%, <em>P</em> = 0.70), whereas both were significantly shorter in the no interruption group (median PFS: 4.1 months; 3-year OS: 28%).</div></div><div><h3>Conclusion</h3><div>Although resuming Nivo after irAEs requiring treatment interruption appears to be safe in carefully selected patients, permanent discontinuation also offers favorable oncological outcomes, indicating it may be a viable alternative.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 2","pages":"Pages 123.e1-123.e9"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558077","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":"Zip code, race, and ethnicity: The impact of socioeconomic hardship on cancer presentation and survival among patients with testicular germ cell tumors","authors":"Serkan Karakus M.D.,&nbsp;Jackson Forrest Harmon B.S.,&nbsp;Anand Ganesh Iyer B.S.,&nbsp;Daniel Carlisle M.D.,&nbsp;Eric Umbreit M.D.,&nbsp;Deepak K Pruthi M.D, FRCSC, MSCI-TS","doi":"10.1016/j.urolonc.2025.10.011","DOIUrl":"10.1016/j.urolonc.2025.10.011","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Testicular germ cell tumors (GCTs) are highly curable when diagnosed at early stages. Despite effective treatments, disparities in socioeconomic status (SES) play a significant role in cancer outcomes. We aim to explore the impact of the hardship index (HI), a composite metric encompassing factors such as poverty levels, per capita income, unemployment rates, educational attainment, housing density, and the dependency ratio (the proportion of young and elderly individuals), on patient presentation and survival rates.</div></div><div><h3>Methods</h3><div>We conducted a county-wide audit of all GCT cases diagnosed in Bexar, Texas, from 2012 to 2023. For cancer stage analysis, logistic regression was utilized using HI, insurance status, and distance to hospital. Cox proportional hazards (COX) models and Kaplan–Meier (KM) analyses were employed to estimate the impact of the HI on progression-free survival (PFS) and overall survival (OS). Lower HI scores indicate greater socioeconomic hardship.</div></div><div><h3>Results</h3><div>Of the 645 subjects, 297 GCT met the inclusion criteria. Neither age nor race/ethnicity (non-Hispanic White/Black, Hispanic, Other) was associated with late-stage diagnosis (Stages II–III). Greater hardship was significantly associated with late-stage diagnosis (OR: 1.02 per unit decrease, 95% CI: [1.01, 1.03], <em>P</em> = 0.002). Patients without insurance (OR: 2.30, <em>P</em> &lt; 0.001) and those with greater distance to hospital (OR: 1.07 per mile, <em>P</em> = 0.001) were also more likely to present with late-stage disease. Uninsured patients had significantly longer treatment delays (median: 83 vs. 40 days, <em>P</em> = 0.034). Furthermore, Cox analysis revealed that patients with greater hardship (scores ≤30) had a higher risk of progression (HR: 4.10, <em>P</em> = 0.0019). KM analysis demonstrated poorer PFS for the greater hardship group overall (<em>P</em> = 0.006) and for NSGCT patients (<em>P</em> = 0.0063), with no significant difference for seminoma patients (<em>P</em> = 0.43).</div></div><div><h3>Conclusions</h3><div>When GCTs are assessed comprehensively by evaluating socioeconomic hardship, those with greater hardship were more likely to present with late-stage diagnosis and have poorer PFS. Uninsured patients and those living farther from care are at higher risk for advanced-stage presentation. By comprehensively addressing economic, educational, and geographic barriers, early diagnosis and avoidance of toxic curative therapy may be achievable for this highly treatable disease, even in advanced stages. Interventions targeting these barriers could ultimately improve survival outcomes.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 2","pages":"Pages 126.e1-126.e9"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514337","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":"Immune-related adverse events associated with immune checkpoint inhibitor therapy in bladder cancer patients: A systematic review and meta-analysis","authors":"Pooja Gokhale Pharm.D.,&nbsp;Akwasi Akosah Pharm.D., M.P.H.,&nbsp;Lorenzo Villa Zapata Ph.D.","doi":"10.1016/j.urolonc.2025.11.010","DOIUrl":"10.1016/j.urolonc.2025.11.010","url":null,"abstract":"<div><div>Immune-related adverse events (irAEs) are commonly associated with immune checkpoint inhibitor (ICI) therapy. ICIs are recommended at various stages of bladder cancer treatment, and appropriate management of irAEs is important in improving long-term outcomes in bladder cancer. This systematic review and meta-analysis of randomized controlled trials (RCTs) aims to assess irAEs associated with ICI therapy in bladder cancer. A comprehensive literature search was conducted across PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and Epistemonikos from inception till January 2025. The references of the included studies, clinicaltrials.gov, annual meeting abstracts of ASCO and ESMO, and the WHO International Clinical Trials Registry Platform were also searched for additional studies. Phase II or III randomized controlled trials (RCTs) where one of the experimental arms consisted of atezolizumab, pembrolizumab, nivolumab, or avelumab monotherapy were included. A Random effects model was used to conduct the meta-analysis in R Statistical Software, version 4.3.3. From the initial 1,092 articles screened, 12 were included in the systematic review and meta-analysis, comprising a total of 7,333 patients. Hypothyroidism (RR: 5.87 (3.23, 10.67)), hyperthyroidism (RR: 11.05 (4.20, 29.03)), pruritus (RR: 4.95 (2.82, 8.70)), rash (RR: 2.92 (1.51, 5.64)), colitis (RR: 2.15 (1.11, 4.15)), pneumonitis (RR: 3.91 (2.18, 7.02)), and nephritis (RR: 4.97 (1.43, 17.33)) were found to be significant irAEs associated with ICI therapy. Bladder cancer patients treated with ICIs are at significant risk of irAEs. These events vary in severity, and appropriate management of these adverse events should be prioritized to improve quality of life.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 2","pages":"Pages 79-91"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744629","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":"Urine metabolic analysis as a noninvasive method to diagnose prostate cancer","authors":"Jorge Panach-Navarrete M.D., Ph.D. ,&nbsp;Vannina González-Marrachelli M.D., Ph.D. ,&nbsp;José Manuel Morales-Tatay M.D., Ph.D. ,&nbsp;Francisco García-Morata M.D. ,&nbsp;María Ángeles Sales-Maicas M.D. ,&nbsp;Daniel Monleón-Salvado Ph.D. ,&nbsp;José María Martínez-Jabaloyas M.D., Ph.D.","doi":"10.1016/j.urolonc.2025.10.015","DOIUrl":"10.1016/j.urolonc.2025.10.015","url":null,"abstract":"<div><h3>Objectives</h3><div>This study used urine NMR spectroscopy to define a potential metabolic profile indicating presence of prostate cancer, which could be a useful noninvasive method for diagnosis of this neoplasia.</div></div><div><h3>Methods</h3><div>Urine samples were obtained from patients undergoing transrectal prostate biopsy after prostate massage. Patients were classified as diseased if cancerous tissue was obtained from biopsy histology, and all spectra were acquired using a Bruker Avance III DRX 600 spectrometer. Univariate and multivariate analyses were performed with metabolites and clinical variables with the objective of predicting tumor presence.</div></div><div><h3>Results</h3><div>A total of 201 patients were included in the study, with a mean age of 67.20 ± 7.90 years. Prostate cancer was diagnosed in 107 (53.2%) cases, with a negative result for malignancy in the other 94 (46.8%).Metabolic analysis revealed metabolic pathways such as glycolysis, Krebs cycle, and the metabolism of different amino acids as involved in the presence of prostate cancer. The 28 metabolites detected in urine, together with prostate volume and ultrasound suspicion for tumor, formed a predictive model of prostate cancer in tissue, with an area under the curve (AUC) of 0.89, a sensitivity of 89%, a positive predictive value (PPV) of 82% and a negative predictive value (NPV) of 83%.</div></div><div><h3>Conclusions</h3><div>Metabolomics can be used to build a useful predictive model for diagnosing prostate cancer from the metabolic profile in urine, using a total of 28 metabolites. Combining metabolites, particularly molecules of glycerophospholipid metabolism, glycolysis, and amino acid metabolism, with clinical variables provides an effective strategy.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 2","pages":"Pages 125.e1-125.e10"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524340","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":"Heterogeneous expression of BMP7, HIF-2α, Ki-67, and E-Cadherin in clear cell renal carcinoma: Prognostic implications based on tumor region","authors":"Tamara Eliana Barnes PhD. ,&nbsp;Gabriela Beatriz Olea PhD. ,&nbsp;Juan Pablo Melana Colavita PhD. ,&nbsp;Juan Pablo Rodríguez PhD. ,&nbsp;Juan Santiago Todaro PhD. ,&nbsp;Daniel Marcelo Lombardo PhD. ,&nbsp;María Victoria Aguirre PhD.","doi":"10.1016/j.urolonc.2025.10.010","DOIUrl":"10.1016/j.urolonc.2025.10.010","url":null,"abstract":"<div><h3>Background</h3><div>The transforming growth factor-beta (TGF-β) signaling pathway plays a critical role in tumor development and includes bone morphogenetic proteins (BMPs). Among them, BMP7 is essential for renal development and tissue homeostasis and has been implicated in several malignancies, particularly renal cell carcinoma (RCC). Despite its relevance, the expression pattern and prognostic value of BMP7 in clear cell RCC (ccRCC) remain poorly characterized. In parallel, hypoxia represents a major driver of tumor progression by promoting cell survival and epithelial-to-mesenchymal transition (EMT).</div></div><div><h3>Objectives</h3><div>To characterize the spatial expression patterns of BMP7, HIF-2α (hypoxia-inducible factor 2α), Ki-67, and E-cadherin (E-CAD) in human ccRCC tissues and cell lines, and to explore their potential associations and prognostic implications.</div></div><div><h3>Methods</h3><div>Multiparametric analyses were performed on human ccRCC tumor samples and corresponding cell lines to assess the expression levels of BMP7, HIF-2α, Ki-67, and E-CAD. Expression was evaluated in both tumor core and peripheral regions. Correlation analyses were conducted to identify associations between markers.</div></div><div><h3>Results</h3><div>BMP7 expression was significantly upregulated in ccRCC. Both BMP7 and HIF-2α showed higher expression in the tumor core compared to the periphery, whereas E-CAD expression was predominant in peripheral regions. A positive correlation between HIF-2α and Ki-67 in the tumor core supported a link between hypoxia and cell proliferation. Conversely, a strong negative correlation between BMP7 and E-CAD in the periphery suggested a possible involvement in EMT regulation.</div></div><div><h3>Conclusions</h3><div>This study demonstrates the spatial heterogeneity of BMP7, HIF-2α, Ki-67, and E-CAD expression in ccRCC. The observed expression patterns provide insights into hypoxia-driven tumor progression and EMT mechanisms and suggest that these markers could serve as potential prognostic indicators in renal cancer.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 2","pages":"Pages 121.e1-121.e14"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483080","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}