Pub Date : 2025-06-01DOI: 10.1016/j.acuro.2025.501716
C. Giulioni , V. de Stefano , O. Traxer , D. Ragoori , N. Gadzhiev , Y. Tanidir , T. Inoue , E. Emiliani , S. Bin Hamri , M.A. Lakmichi , C.M. Vaddi , C.T. Heng , B. Soebhali , S. More , V. Sridharan , M.I. Gökce , A.N. Tursunkulov , A. Ganpule , G.M. Pirola , A. Naselli , D. Castellani
Objective
To evaluate outcomes of same sitting bilateral retrograde intrarenal surgery for kidney stone in patients aged ≥ 70 years.
Methods
We retrospectively reviewed patients with bilateral kidney stones who underwent same sitting bilateral retrograde intrarenal surgery in 21 centers (January 2015-June 2022). Inclusion criteria: patients aged ≥ 70 years, bilateral kidney stones diagnosed due to either unilateral or bilateral symptomatic presentation. Patients were divided into 2 groups: group 1, patients aged 70-74 years, group 2, patients aged ≥ 75 years.
Results
There were 86 patients in group 1 and 60 patients in group 2. There was no difference between the groups for gender, ASA score, BMI, comorbidities, presenting symptoms, and positive preoperative urine culture. Group 2 had a significantly higher proportion of recurrent stone formers (54.7 vs. 35.0%, p = 0.03), and a higher proportion of bilaterally pre-stented patients were present in group 2 (37.9 vs. 18.6%). There was no difference in total operation time and rate of post-operative uni- and bilateral stent positioning. Surgery was discontinued in 15.1% and 18.3% of cases in groups 1 and 2, respectively (p = 0.773). Median length of postoperative stay was 2 days in both groups. The most frequent complication was fever requiring antibiotics and prolonged admission (10.5% in group 1 and 11.7% in group 2, p > 0.99). Sepsis rate was 2.3% patients in group 1 and none in group 2. In group 1, 1.2% required a blood transfusion due to hematuria. Bilateral stone-free rate was similar (60.0 vs. 47.7%, p = 0.194) in both groups.
Conclusions
Same sitting bilateral retrograde intrarenal surgery in elderly patients demonstrated an acceptable safety profile with good bilateral stone-free rate.
目的评价年龄≥70岁患者行同坐位双侧逆行肾内手术治疗肾结石的疗效。方法回顾性分析21个中心（2015年1月- 2022年6月）行相同坐位双侧逆行肾内手术的双侧肾结石患者。纳入标准：年龄≥70岁，单侧或双侧症状表现诊断为双侧肾结石的患者。患者分为2组：1组70 ~ 74岁，2组≥75岁。结果1组86例，2组60例。两组在性别、ASA评分、BMI、合并症、表现症状和术前尿培养阳性方面无差异。第2组复发性结石患者的比例显著高于第2组（54.7 vs. 35.0%, p = 0.03），第2组双侧预支架患者的比例更高（37.9 vs. 18.6%）。术后单侧和双侧支架放置的总手术时间和比例无差异。1组和2组分别有15.1%和18.3%的患者停止手术（p = 0.773）。两组患者术后平均住院时间均为2天。最常见的并发症是需要抗生素治疗的发热和住院时间延长（组1 10.5%，组2 11.7%）。0.99)。1组脓毒症发生率为2.3%，2组无脓毒症发生率。在第1组中，1.2%的患者因血尿需要输血。两组双侧结石清除率相似（60.0 vs 47.7%, p = 0.194）。结论同坐位双侧逆行肾内手术治疗老年患者，安全性可接受，双侧结石清除率良好。
{"title":"Resultados de la cirugía retrógrada intrarrenal bilateral simultánea en el tratamiento de la litiasis renal en pacientes mayores de 70 años","authors":"C. Giulioni , V. de Stefano , O. Traxer , D. Ragoori , N. Gadzhiev , Y. Tanidir , T. Inoue , E. Emiliani , S. Bin Hamri , M.A. Lakmichi , C.M. Vaddi , C.T. Heng , B. Soebhali , S. More , V. Sridharan , M.I. Gökce , A.N. Tursunkulov , A. Ganpule , G.M. Pirola , A. Naselli , D. Castellani","doi":"10.1016/j.acuro.2025.501716","DOIUrl":"10.1016/j.acuro.2025.501716","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate outcomes of same sitting bilateral retrograde intrarenal surgery for kidney stone in patients aged<!--> <!-->≥<!--> <!-->70 years.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed patients with bilateral kidney stones who underwent same sitting bilateral retrograde intrarenal surgery in 21 centers (January 2015-June 2022). Inclusion criteria: patients aged<!--> <!-->≥<!--> <!-->70 years, bilateral kidney stones diagnosed due to either unilateral or bilateral symptomatic presentation. Patients were divided into 2 groups: group 1, patients aged 70-74 years, group 2, patients aged<!--> <!-->≥<!--> <!-->75 years.</div></div><div><h3>Results</h3><div>There were 86 patients in group 1 and 60 patients in group 2. There was no difference between the groups for gender, ASA score, BMI, comorbidities, presenting symptoms, and positive preoperative urine culture. Group 2 had a significantly higher proportion of recurrent stone formers (54.7 vs. 35.0%, p<!--> <!-->=<!--> <!-->0.03), and a higher proportion of bilaterally pre-stented patients were present in group 2 (37.9 vs. 18.6%). There was no difference in total operation time and rate of post-operative uni- and bilateral stent positioning. Surgery was discontinued in 15.1% and 18.3% of cases in groups 1 and 2, respectively (p<!--> <!-->=<!--> <!-->0.773). Median length of postoperative stay was 2 days in both groups. The most frequent complication was fever requiring antibiotics and prolonged admission (10.5% in group 1 and 11.7% in group 2, p<!--> <!-->><!--> <!-->0.99). Sepsis rate was 2.3% patients in group 1 and none in group 2. In group 1, 1.2% required a blood transfusion due to hematuria. Bilateral stone-free rate was similar (60.0 vs. 47.7%, p<!--> <!-->=<!--> <!-->0.194) in both groups.</div></div><div><h3>Conclusions</h3><div>Same sitting bilateral retrograde intrarenal surgery in elderly patients demonstrated an acceptable safety profile with good bilateral stone-free rate.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 5","pages":"Article 501716"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.acuro.2025.501693
C. Ramírez Sevilla , M. Puyol Pallàs , D.H. Llanos Manzano , Y. Zboromirskyy Pronuk
{"title":"Carcinoma embrionario puro de testículo: presentación de un nuevo caso y revisión de la literatura","authors":"C. Ramírez Sevilla , M. Puyol Pallàs , D.H. Llanos Manzano , Y. Zboromirskyy Pronuk","doi":"10.1016/j.acuro.2025.501693","DOIUrl":"10.1016/j.acuro.2025.501693","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 5","pages":"Article 501693"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.acuro.2025.501754
H.A. García-Perdomo
{"title":"Respuesta del autor sobre el comentario referente a los aspectos metodológicos de «Relación entre varicocele e hipogonadismo o disfunción eréctil: revisión sistemática y metaanálisis»","authors":"H.A. García-Perdomo","doi":"10.1016/j.acuro.2025.501754","DOIUrl":"10.1016/j.acuro.2025.501754","url":null,"abstract":"","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 5","pages":"Article 501754"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.acuro.2025.501687
J. Palou, M. Casadevall, O. Rodríguez Faba, J.M. Gaya, A. Breda
Introduction
Testicular cancer accounts for 5% of urological tumors, with an incidence of 5.6 cases per 100,000 men per year in Europe. Salvage retroperitoneal lymphadenectomy is the standard surgery for persistent retroperitoneal masses after chemotherapy. The advent of minimally invasive surgery is changing the therapeutic approach. The objective is to present our initial experience with the transmesocolic robotic approach for the surgical management of these masses.
Methods
We report the perioperative and oncological outcomes of four patients affected by non-seminomatous germ cell tumors who were treated with transmesocolic robotic left para-aortic retroperitoneal lymphadenectomy.
Results
The surgical time for the first case was 220 minutes, and the average surgical time for the remaining cases was 120 minutes (SD: 15). Estimated blood loss was 82.5 ml (SD: 79.3). No intraoperative or postoperative complications were observed. Pathological anatomy revealed post-pubertal teratoma (30%) and necrosis (70%) in case 1, necrosis with reactive adenitis in case 2, extensive fibrosis in case 3 and post-pubertal teratoma in case 4. Currently, all patients are disease-free.
Conclusions
Robotic retroperitoneal lymphadenectomy is a safe and precise technique that offers favorable oncological and functional outcomes. The transmesocolic approach represents a feasible option in selected cases, ensuring rapid retroperitoneal access and reduced surgical time.
睾丸癌占泌尿系统肿瘤的5%，在欧洲每年每10万男性中有5.6例的发病率。挽救性腹膜后淋巴结切除术是化疗后持续性腹膜后肿物的标准手术。微创手术的出现正在改变治疗方法。目的是介绍我们的初步经验，经肠系膜机器人入路手术处理这些肿块。方法报告4例非半原性生殖细胞肿瘤患者行经结肠左腹主动脉旁机器人腹膜后淋巴结切除术的围手术期及肿瘤预后。结果1例手术时间为220分钟，其余病例平均手术时间为120分钟（SD: 15）。估计失血量82.5 ml （SD: 79.3）。术中、术后均无并发症。病理解剖显示：病例1为青春期后畸胎瘤（30%）和坏死（70%），病例2为坏死伴反应性腺炎，病例3为广泛纤维化，病例4为青春期后畸胎瘤。目前，所有患者均无疾病。结论机器人腹膜后淋巴结切除术是一种安全、精确的技术，具有良好的肿瘤和功能预后。经结肠入路在特定病例中是一种可行的选择，可确保快速进入腹膜后并缩短手术时间。
{"title":"Linfadenectomía retroperitoneal robótica transmesocólica en tumores germinales de testículo no seminomatosos: un abordaje prometedor","authors":"J. Palou, M. Casadevall, O. Rodríguez Faba, J.M. Gaya, A. Breda","doi":"10.1016/j.acuro.2025.501687","DOIUrl":"10.1016/j.acuro.2025.501687","url":null,"abstract":"<div><h3>Introduction</h3><div>Testicular cancer accounts for 5% of urological tumors, with an incidence of 5.6 cases per 100,000 men per year in Europe. Salvage retroperitoneal lymphadenectomy is the standard surgery for persistent retroperitoneal masses after chemotherapy. The advent of minimally invasive surgery is changing the therapeutic approach. The objective is to present our initial experience with the transmesocolic robotic approach for the surgical management of these masses.</div></div><div><h3>Methods</h3><div>We report the perioperative and oncological outcomes of four patients affected by non-seminomatous germ cell tumors who were treated with transmesocolic robotic left para-aortic retroperitoneal lymphadenectomy.</div></div><div><h3>Results</h3><div>The surgical time for the first case was 220<!--> <!-->minutes, and the average surgical time for the remaining cases was 120<!--> <!-->minutes (SD: 15). Estimated blood loss was 82.5<!--> <!-->ml (SD: 79.3). No intraoperative or postoperative complications were observed. Pathological anatomy revealed post-pubertal teratoma (30%) and necrosis (70%) in case<!--> <!-->1, necrosis with reactive adenitis in case<!--> <!-->2, extensive fibrosis in case<!--> <!-->3 and post-pubertal teratoma in case<!--> <!-->4. Currently, all patients are disease-free.</div></div><div><h3>Conclusions</h3><div>Robotic retroperitoneal lymphadenectomy is a safe and precise technique that offers favorable oncological and functional outcomes. The transmesocolic approach represents a feasible option in selected cases, ensuring rapid retroperitoneal access and reduced surgical time.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 5","pages":"Article 501687"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.acuro.2025.501749
S. Mancon , A. Matsukawa , A. Cadenar , I. Tsuboi , M. Miszczyk , M.K. Parizi , T. Fazekas , R.J. Schulz , A. Cormio , E. Laukhtina , A. Gallioli , P. Diana , R. Contieri , F. Soria , B. Pradere , G. Lughezzani , T. Kimura , A. Territo , A. Breda , N.M. Buffi , D. D’Andrea
Introduction
Opium is used recreationally and for pain relief in certain regions and has been classified as a human carcinogen by the IARC. While its use is rare in Europe and Oceania, it remains a major public health issue in other parts of the world. This study evaluates the risk of bladder cancer among opium users compared to non-users.
Methods
A comprehensive search of MEDLINE, Scopus, and Web of Science was conducted up to July 2024 to identify studies examining the link between opium use and bladder cancer. A meta-analysis was performed to calculate the pooled risk ratio with 95% confidence intervals (CI) (PROSPERO: CRD42024562623).
Results
A total of 15 studies (n = 60,149) were included. The analysis showed that opium users had a significantly higher risk of developing bladder cancer than non-users (risk ratio: 2.36; 95% CI: 1.92-2.90; P < 0.001). The risk increased with the amount of opium consumed, regardless of type or method of use.
Conclusions
Opium consumption increase the risk of developing bladder cancer by more than twofold among users. Awareness of its carcinogenic potential and public health implications is crucial. Our findings underscore the need for global prevention strategies and further research into opium-related bladder cancer risks.
鸦片在某些地区用于娱乐和止痛，被国际癌症研究机构列为人类致癌物。虽然在欧洲和大洋洲很少使用，但在世界其他地区，它仍然是一个重大的公共卫生问题。这项研究评估了鸦片使用者与非使用者之间膀胱癌的风险。方法对截至2024年7月的MEDLINE、Scopus和Web of Science进行综合检索，以确定有关鸦片使用与膀胱癌之间关系的研究。进行meta分析以95%置信区间（CI）计算合并风险比（PROSPERO: CRD42024562623）。结果共纳入15项研究（n = 60149）。分析显示，鸦片使用者患膀胱癌的风险明显高于非使用者(风险比：2.36；95% ci: 1.92-2.90；P & lt;0.001)。风险随着鸦片消费量的增加而增加，无论使用类型或方法如何。结论磺胺类药物使用者膀胱癌发病风险增加2倍以上。对其潜在致癌性和公共卫生影响的认识至关重要。我们的研究结果强调了制定全球预防策略和进一步研究鸦片相关膀胱癌风险的必要性。
{"title":"Impacto del opio en la incidencia del cáncer de vejiga: revisión sistemática y metaanálisis","authors":"S. Mancon , A. Matsukawa , A. Cadenar , I. Tsuboi , M. Miszczyk , M.K. Parizi , T. Fazekas , R.J. Schulz , A. Cormio , E. Laukhtina , A. Gallioli , P. Diana , R. Contieri , F. Soria , B. Pradere , G. Lughezzani , T. Kimura , A. Territo , A. Breda , N.M. Buffi , D. D’Andrea","doi":"10.1016/j.acuro.2025.501749","DOIUrl":"10.1016/j.acuro.2025.501749","url":null,"abstract":"<div><h3>Introduction</h3><div>Opium is used recreationally and for pain relief in certain regions and has been classified as a human carcinogen by the IARC. While its use is rare in Europe and Oceania, it remains a major public health issue in other parts of the world. This study evaluates the risk of bladder cancer among opium users compared to non-users.</div></div><div><h3>Methods</h3><div>A comprehensive search of MEDLINE, Scopus, and Web of Science was conducted up to July 2024 to identify studies examining the link between opium use and bladder cancer. A meta-analysis was performed to calculate the pooled risk ratio with 95% confidence intervals (CI) (PROSPERO: CRD42024562623).</div></div><div><h3>Results</h3><div>A total of 15 studies (n<!--> <!-->=<!--> <!-->60,149) were included. The analysis showed that opium users had a significantly higher risk of developing bladder cancer than non-users (risk ratio: 2.36; 95% CI: 1.92-2.90; <em>P</em> <!--><<!--> <!-->0.001). The risk increased with the amount of opium consumed, regardless of type or method of use.</div></div><div><h3>Conclusions</h3><div>Opium consumption increase the risk of developing bladder cancer by more than twofold among users. Awareness of its carcinogenic potential and public health implications is crucial. Our findings underscore the need for global prevention strategies and further research into opium-related bladder cancer risks.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 5","pages":"Article 501749"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.acuro.2025.501719
R. Pichler , N.C.H. van Creij , J.D. Subiela , A. Cimadamore , J. Caño-Velasco , K.H. Tully , K. Mori , R. Contieri , L. Afferi , A. Mari , F. Soria , F. Del Giudice , C. D‘Elia , R. Mayr , L.S. Mertens , N. Pyrgidis , M. Moschini , A. Gallioli , Asociación Europea de Urología-Jóvenes Urólogos Académicos (EAU-YAU): Grupo de Trabajo de Carcinoma Urotelial
FGFR3 mutations are among the most frequent genomic alterations in urothelial cancer (UC) being mainly associated with the luminal papillary (LumP) subtype. With the establishment of fibroblast growth factor receptor (FGFR) inhibitors, the treatment of UC is now shifting more and more towards personalized medicine. A systematic review using Medline and scientific meeting records was carried out according to the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines to assess the potential role of FGFR inhibitors in combination with additional therapies for the management of UC. Ongoing trials were identified via a systematic search on ClinicalTrials.gov. A total of 11 full-text papers, 10 congress abstracts, and 5 trials on ClinicalTrials.gov were identified. Following the BLC2001 and THOR study, erdafitinib is the only approved FGFR1-4 inhibitor for metastatic UC with susceptible FGFR2/3 alterations following platinum-based chemotherapy. According to the THOR data of cohort 2, erdafitinib should not be recommended in patients who are eligible for and have not received prior immune checkpoint inhibitors (ICIs). One phase 3 trial is currently evaluating the intravesical device system (TAR210) in FGFR-altered intermediate non-muscle invasive bladder cancer (MoonRISe-1). Preclinical evidence suggests that combination-based approaches could be considered to improve the efficacy of FGFR inhibitors in patients with UC. Nine phase 1b/2 trials are focusing on the combination of FGFR inhibitors with ICIs, chemotherapy, or enfortumab vedotin. In metastatic disease, some preliminary analyses have reported promising results from these combinations (e.g. NORSE and FORT-2 trial). However, no phase 3 trial is terminated, so there is currently no level 1 evidence with long-term outcomes to support the combination of FGFR inhibitors with ICIs, chemotherapy, or targeted therapies. A better understanding of the different mechanisms of action to inhibit FGFR signaling pathways, optimal patient selection and treatment approaches is still needed.
{"title":"Implicaciones biológicas y terapéuticas de las alteraciones del receptor del factor de crecimiento de fibroblastos (FGFR) en el cáncer urotelial: una revisión sistemática desde la enfermedad no musculoinvasiva a la metastásica","authors":"R. Pichler , N.C.H. van Creij , J.D. Subiela , A. Cimadamore , J. Caño-Velasco , K.H. Tully , K. Mori , R. Contieri , L. Afferi , A. Mari , F. Soria , F. Del Giudice , C. D‘Elia , R. Mayr , L.S. Mertens , N. Pyrgidis , M. Moschini , A. Gallioli , Asociación Europea de Urología-Jóvenes Urólogos Académicos (EAU-YAU): Grupo de Trabajo de Carcinoma Urotelial","doi":"10.1016/j.acuro.2025.501719","DOIUrl":"10.1016/j.acuro.2025.501719","url":null,"abstract":"<div><div>FGFR3 mutations are among the most frequent genomic alterations in urothelial cancer (UC) being mainly associated with the luminal papillary (LumP) subtype. With the establishment of fibroblast growth factor receptor (FGFR) inhibitors, the treatment of UC is now shifting more and more towards personalized medicine. A systematic review using Medline and scientific meeting records was carried out according to the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines to assess the potential role of FGFR inhibitors in combination with additional therapies for the management of UC. Ongoing trials were identified via a systematic search on ClinicalTrials.gov. A total of 11<!--> <!-->full-text papers, 10<!--> <!-->congress abstracts, and 5 trials on ClinicalTrials.gov were identified. Following the BLC2001 and THOR study, erdafitinib is the only approved FGFR1-4 inhibitor for metastatic UC with susceptible FGFR2/3 alterations following platinum-based chemotherapy. According to the THOR data of cohort 2, erdafitinib should not be recommended in patients who are eligible for and have not received prior immune checkpoint inhibitors (ICIs). One phase 3 trial is currently evaluating the intravesical device system (TAR210) in FGFR-altered intermediate non-muscle invasive bladder cancer (MoonRISe-1). Preclinical evidence suggests that combination-based approaches could be considered to improve the efficacy of FGFR inhibitors in patients with UC. Nine phase 1b/2 trials are focusing on the combination of FGFR inhibitors with ICIs, chemotherapy, or enfortumab vedotin. In metastatic disease, some preliminary analyses have reported promising results from these combinations (e.g. NORSE and FORT-2 trial). However, no phase 3 trial is terminated, so there is currently no level 1 evidence with long-term outcomes to support the combination of FGFR inhibitors with ICIs, chemotherapy, or targeted therapies. A better understanding of the different mechanisms of action to inhibit FGFR signaling pathways, optimal patient selection and treatment approaches is still needed.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 5","pages":"Article 501719"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.acuro.2025.501718
E. Albers Acosta , L. Pelari-Mici , G. Celada Luis , C. Velasco Balanza , A. Zapatero , N. Romero-Laorden , P. Toquero Diez , J. Caño-Velasco , F. Guerrero-Ramos , M. Moschini , W. Krajewski , F. Del Giudice , F. Soria , E. Laukhtina , L. Mertens , R. Pichler , K. Mori , D. D’Andrea , A. Mari , G. Marcq , L. San José Manso
Introduction and objectives
Urothelial carcinoma is a challenging disease that requires a comprehensive approach. Multidisciplinary tumor committees are essential to bring specialists together, optimize treatment, ensure individualized care, and promote evidence-based decision making. This study aims to collect evidence and explore the impact of multidisciplinary tumor committees in the management of urothelial carcinoma.
Materials and methods
A systematic review was performed following PRISMA guidelines. We searched PubMed/Medline, Embase, Scopus and Cochrane databases for relevant studies on the role of multidisciplinary committees in the management of urothelial carcinoma, including bladder cancer, upper tract urothelial carcinoma and urethral carcinoma. Given the limited and heterogeneous evidence, a systematic review with narrative synthesis was performed.
Results
Multidisciplinary tumor committees had a significant impact on the diagnosis and treatment of urothelial neoplasms, especially bladder cancer. Consistent findings showed that these committees produced substantial changes in treatment, improved adherence to clinical guidelines, and demonstrated a potential to improve patient outcomes. In addition, multidisciplinary committees increased the likelihood of curative treatments and were associated with reduced mortality rates, enhanced clinical decision making, and improved patient care, particularly in bladder and upper tract urothelial carcinoma.
Conclusions
This review highlights the essential role of multidisciplinary tumor committees in improving the management of urothelial carcinoma of the bladder and upper urinary tract. However, further research using standardized approaches is needed. The absence of studies on urethral carcinoma underlines the urgent need to investigate the potential benefits of multidisciplinary tumor committees. Future studies should cover a wider range of tumor types and follow standardized methodologies to provide a more complete and generalizable picture.
{"title":"El impacto del enfoque multidisciplinar en la elección del tratamiento y los resultados del carcinoma urotelial: una revisión sistemática","authors":"E. Albers Acosta , L. Pelari-Mici , G. Celada Luis , C. Velasco Balanza , A. Zapatero , N. Romero-Laorden , P. Toquero Diez , J. Caño-Velasco , F. Guerrero-Ramos , M. Moschini , W. Krajewski , F. Del Giudice , F. Soria , E. Laukhtina , L. Mertens , R. Pichler , K. Mori , D. D’Andrea , A. Mari , G. Marcq , L. San José Manso","doi":"10.1016/j.acuro.2025.501718","DOIUrl":"10.1016/j.acuro.2025.501718","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Urothelial carcinoma is a challenging disease that requires a comprehensive approach. Multidisciplinary tumor committees are essential to bring specialists together, optimize treatment, ensure individualized care, and promote evidence-based decision making. This study aims to collect evidence and explore the impact of multidisciplinary tumor committees in the management of urothelial carcinoma.</div></div><div><h3>Materials and methods</h3><div>A systematic review was performed following PRISMA guidelines. We searched PubMed/Medline, Embase, Scopus and Cochrane databases for relevant studies on the role of multidisciplinary committees in the management of urothelial carcinoma, including bladder cancer, upper tract urothelial carcinoma and urethral carcinoma. Given the limited and heterogeneous evidence, a systematic review with narrative synthesis was performed.</div></div><div><h3>Results</h3><div>Multidisciplinary tumor committees had a significant impact on the diagnosis and treatment of urothelial neoplasms, especially bladder cancer. Consistent findings showed that these committees produced substantial changes in treatment, improved adherence to clinical guidelines, and demonstrated a potential to improve patient outcomes. In addition, multidisciplinary committees increased the likelihood of curative treatments and were associated with reduced mortality rates, enhanced clinical decision making, and improved patient care, particularly in bladder and upper tract urothelial carcinoma.</div></div><div><h3>Conclusions</h3><div>This review highlights the essential role of multidisciplinary tumor committees in improving the management of urothelial carcinoma of the bladder and upper urinary tract. However, further research using standardized approaches is needed. The absence of studies on urethral carcinoma underlines the urgent need to investigate the potential benefits of multidisciplinary tumor committees. Future studies should cover a wider range of tumor types and follow standardized methodologies to provide a more complete and generalizable picture.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 5","pages":"Article 501718"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.acuro.2025.501746
S. Mero , K. Oberneder , J. Weiss , E. Grobet-Jeandin , A. Grégoris , P. Sèbe , S. Shariat , D. D’Andrea
Objectives
Patients with non-muscle invasive bladder cancer (NMIBC) face a high risk of recurrence and progression after transurethral resection, making adjuvant therapies necessary. Intravesical device-assisted therapies, such as radiofrequency-induced thermochemotherapy (RITE), have shown promise in enhancing the effectiveness of intravesical chemotherapies. This study aimed to evaluate oncological outcomes in patients with NMIBC treated with RITE in a real-world setting, encompassing those unresponsive to prior Bacillus Calmette-Guérin (BCG) or intravesical chemotherapy, as well as those who declined or were ineligible for BCG or radical cystectomy (RC).
Methods
A retrospective multicenter analysis of patients treated with RITE for NMIBC between 2015 and 2024 was performed. Co-primary endpoints of the study were intravesical recurrence free survival (RFS) and high-grade intravesical recurrence free survival (HG-RFS). Secondary endpoints included radical cystectomy-free survival (RC-FS), overall survival (OS), cancer-specific survival (CSS), and adverse events (AEs).
Results
Fifty-nine consecutive patients were included in the final analyses. Overall, 12 (20%) and 45 (76%) patients failed previous intravesical chemotherapy, and immunotherapy with BCG, respectively. The 24-months RFS and HG-RFS following RITE were 68.6% (95% CI: 0.568, 0.828) and 74.8% (95% CI: 0.632, 0.885). RC-FS at 24 months was 93.8% (95% CI: 0.872, 1.000). The OS probability at 24 months was 91%, with a CSS of 97.8%. Most common AEs were dysuria and urgency in 27 (45.7%) patients, treatment limiting bladder spasms in 11 (19%) patients, low bladder compliance in 11 (19%) patients and urethral strictures in 5 (8%) patients.
Conclusions
In our analyses, RITE resulted in notable antitumor activity and allows for the avoidance of more aggressive and quality-of-life-limiting therapies, such as radical cystectomy. RITE might be considered as a second-line bladder-sparing option in patients failing previous intravesical therapies. Long-term follow-up and larger-scale data are required to validate our findings.
{"title":"Hipertermia inducida por radiofrecuencia en el cáncer de vejiga no músculo invasor: resultados oncológicos en un escenario real","authors":"S. Mero , K. Oberneder , J. Weiss , E. Grobet-Jeandin , A. Grégoris , P. Sèbe , S. Shariat , D. D’Andrea","doi":"10.1016/j.acuro.2025.501746","DOIUrl":"10.1016/j.acuro.2025.501746","url":null,"abstract":"<div><h3>Objectives</h3><div>Patients with non-muscle invasive bladder cancer (NMIBC) face a high risk of recurrence and progression after transurethral resection, making adjuvant therapies necessary. Intravesical device-assisted therapies, such as radiofrequency-induced thermochemotherapy (RITE), have shown promise in enhancing the effectiveness of intravesical chemotherapies. This study aimed to evaluate oncological outcomes in patients with NMIBC treated with RITE in a real-world setting, encompassing those unresponsive to prior Bacillus Calmette-Guérin (BCG) or intravesical chemotherapy, as well as those who declined or were ineligible for BCG or radical cystectomy (RC).</div></div><div><h3>Methods</h3><div>A retrospective multicenter analysis of patients treated with RITE for NMIBC between 2015 and 2024 was performed. Co-primary endpoints of the study were intravesical recurrence free survival (RFS) and high-grade intravesical recurrence free survival (HG-RFS). Secondary endpoints included radical cystectomy-free survival (RC-FS), overall survival (OS), cancer-specific survival (CSS), and adverse events (AEs).</div></div><div><h3>Results</h3><div>Fifty-nine consecutive patients were included in the final analyses. Overall, 12 (20%) and 45 (76%) patients failed previous intravesical chemotherapy, and immunotherapy with BCG, respectively. The 24-months RFS and HG-RFS following RITE were 68.6% (95% CI: 0.568, 0.828) and 74.8% (95% CI: 0.632, 0.885). RC-FS at 24 months was 93.8% (95% CI: 0.872, 1.000). The OS probability at 24 months was 91%, with a CSS of 97.8%. Most common AEs were dysuria and urgency in 27 (45.7%) patients, treatment limiting bladder spasms in 11 (19%) patients, low bladder compliance in 11 (19%) patients and urethral strictures in 5 (8%) patients.</div></div><div><h3>Conclusions</h3><div>In our analyses, RITE resulted in notable antitumor activity and allows for the avoidance of more aggressive and quality-of-life-limiting therapies, such as radical cystectomy. RITE might be considered as a second-line bladder-sparing option in patients failing previous intravesical therapies. Long-term follow-up and larger-scale data are required to validate our findings.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 5","pages":"Article 501746"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-01DOI: 10.1016/j.acuro.2025.501742
M. Hassi Roman , K. Mate , P. de Pablos-RodrIguez , Á. Zamora Horcajada , A. Guijarro Cascales , Á. Sanchís Bonet , A. Vilaseca , D. Vázquez-Martul Pazos , E. Linares Espinós , J. Muñoz Rodríguez , J.M. de la Morena Gallego , J.R. Alemán , J. Gómez Rivas , L. Formisano , M.J. Juan Fita , M. Costa Planells , M. Domínguez Esteban , M. Pérez Márquez , M. García Sanz , N. García Expósito , M. Ramírez Backhaus
Introduction
Apalutamide has shown significantly increases in radiographic progression-free survival (rPFS) and overall survival (OS) in metastatic hormone-sensitive prostate cancer (mHSPC) patients diagnosed by conventional imaging (CI). However, there is scarce knowledge on the use of apalutamide in mHSPC population diagnosed by NGI.
Methods
Retrospective multicenter study of mHSPC patients treated with apalutamide from May 2018 to September 2023 registered in the Real-World Evidence APA (RWE-APA). CI and NGI group were defined, according to the diagnostic tool of metastatic disease. Primary objective was rPFS at 24 months in CI vs NGI group. Secondary objectives were OS in CI vs NGI group and rPFS in synchronic/metachronic, low volume (LV)/high volume (HV) in CI and NGI groups and risk of developing new metastasis according to the imaging technique, metastasis volume and location of the metastasis.
Results
772 mHSPC patients were included. 47% (359) of patients were diagnosed with CI and 53% (413) of patients with NGI. rPFS at 24 months was 80% in the CI group vs 84% in the NGI group (Hazard ratio (HR): 0.57 (0.35 – 0.92) 95% Confidence Interval [CI], p = 0.023). OS at 24 months was 89.5% in the CI group and 95.8% in the NGI group (HR 0.35; 95% CI, 0.16 – 0.75, p = 0.007). In the multivariable analysis, only HV was significantly associated with metastatic progression (HR 0.33 (0.18-0.59) 95% CI; p ‹ 0.001).
Conclusion
mHSPC patients treated with apalutamide and NGI-diagnosed exhibited superior rPFS and OS in comparison with CI-diagnosed patients.
{"title":"Uso de apalutamida en pacientes con cáncer de próstata hormonosensible metastásico diagnosticados mediante pruebas de imagen convencionales y de nueva generación. Datos reales de 772 pacientes","authors":"M. Hassi Roman , K. Mate , P. de Pablos-RodrIguez , Á. Zamora Horcajada , A. Guijarro Cascales , Á. Sanchís Bonet , A. Vilaseca , D. Vázquez-Martul Pazos , E. Linares Espinós , J. Muñoz Rodríguez , J.M. de la Morena Gallego , J.R. Alemán , J. Gómez Rivas , L. Formisano , M.J. Juan Fita , M. Costa Planells , M. Domínguez Esteban , M. Pérez Márquez , M. García Sanz , N. García Expósito , M. Ramírez Backhaus","doi":"10.1016/j.acuro.2025.501742","DOIUrl":"10.1016/j.acuro.2025.501742","url":null,"abstract":"<div><h3>Introduction</h3><div>Apalutamide has shown significantly increases in radiographic progression-free survival (rPFS) and overall survival (OS) in metastatic hormone-sensitive prostate cancer (mHSPC) patients diagnosed by conventional imaging (CI). However, there is scarce knowledge on the use of apalutamide in mHSPC population diagnosed by NGI.</div></div><div><h3>Methods</h3><div>Retrospective multicenter study of mHSPC patients treated with apalutamide from May 2018 to September 2023 registered in the Real-World Evidence APA (RWE-APA). CI and NGI group were defined, according to the diagnostic tool of metastatic disease. Primary objective was rPFS at 24 months in CI vs NGI group. Secondary objectives were OS in CI vs NGI group and rPFS in synchronic/metachronic, low volume (LV)/high volume (HV) in CI and NGI groups and risk of developing new metastasis according to the imaging technique, metastasis volume and location of the metastasis.</div></div><div><h3>Results</h3><div>772 mHSPC patients were included. 47% (359) of patients were diagnosed with CI and 53% (413) of patients with NGI. rPFS at 24 months was 80% in the CI group vs 84% in the NGI group (Hazard ratio (HR): 0.57 (0.35 – 0.92) 95% Confidence Interval [CI], p<!--> <!-->=<!--> <!-->0.023). OS at 24 months was 89.5% in the CI group and 95.8% in the NGI group (HR 0.35; 95% CI, 0.16 – 0.75, p<!--> <!-->=<!--> <!-->0.007). In the multivariable analysis, only HV was significantly associated with metastatic progression (HR 0.33 (0.18-0.59) 95% CI; p<!--> <!-->‹<!--> <!-->0.001).</div></div><div><h3>Conclusion</h3><div>mHSPC patients treated with apalutamide and NGI-diagnosed exhibited superior rPFS and OS in comparison with CI-diagnosed patients.</div></div>","PeriodicalId":7145,"journal":{"name":"Actas urologicas espanolas","volume":"49 5","pages":"Article 501742"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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