Katya Hanessian, Ali Albaghli, Ruben Crew, Grant Sajdak, Ala'a Farkouh, Sikai Song, Daniel Jhang, Zham Okhunov, D. Duane Baldwin
Objective
This study aims to explore risk factors related to positive single and multi-organism stone cultures and their association with postoperative complications in patients undergoing percutaneous nephrolithotomy (PCNL).
Subjects/Patients and Methods
A retrospective review was performed on 293 PCNL patients with stone cultures at a single academic institution between January 2017 and March 2023. Data collection encompassed demographics, comorbidities, operative details and postoperative outcomes. Chi-square and ANOVA with Tukey B post hoc tests were employed. Multivariable logistic regression identified independent outcomes. Significance was set at p < 0.05.
Results
Positive stone cultures were seen in 56% of patients and cultures with multiple organisms were seen in 25% of patients. Female sex (p = 0.007), preoperative nephrostomy tubes (p < 0.001) and longer surgical durations (p < 0.001) were more likely to have positive cultures. Significant associations were observed between positive cultures and postoperative fever (p = 0.007), readmissions (p = 0.020), stone recurrence (p = 0.002) and multidrug resistance (p = 0.016) with no difference between single- and multi-organism culture groups. Positive cultures were independently associated with higher odds of readmission (OR = 4.31; p = 0.03) and stone recurrence (OR = 2.89; p = 0.005). Additionally, calcium phosphate and struvite stones were associated with positive cultures (p < 0.001).
Conclusion
Positive stone cultures (single or multi-organism) predicted adverse postoperative outcomes including fever, readmission and recurrence. Patients with multi-organism stone cultures were more likely to have stone recurrences within 6 months, suggesting the need for closer follow-up and more comprehensive antibiotic therapy. These findings emphasize the role of stone culture status in guiding risk stratification and tailored prophylactic strategies, particularly in patients with multi-organism stone cultures who have multidrug resistance.
{"title":"The effect of negative, single and multi-organism positive cultures on outcomes following PCNL","authors":"Katya Hanessian, Ali Albaghli, Ruben Crew, Grant Sajdak, Ala'a Farkouh, Sikai Song, Daniel Jhang, Zham Okhunov, D. Duane Baldwin","doi":"10.1002/bco2.70150","DOIUrl":"https://doi.org/10.1002/bco2.70150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to explore risk factors related to positive single and multi-organism stone cultures and their association with postoperative complications in patients undergoing percutaneous nephrolithotomy (PCNL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects/Patients and Methods</h3>\u0000 \u0000 <p>A retrospective review was performed on 293 PCNL patients with stone cultures at a single academic institution between January 2017 and March 2023. Data collection encompassed demographics, comorbidities, operative details and postoperative outcomes. Chi-square and ANOVA with Tukey B post hoc tests were employed. Multivariable logistic regression identified independent outcomes. Significance was set at <i>p</i> < 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Positive stone cultures were seen in 56% of patients and cultures with multiple organisms were seen in 25% of patients. Female sex (<i>p</i> = 0.007), preoperative nephrostomy tubes (<i>p</i> < 0.001) and longer surgical durations (<i>p</i> < 0.001) were more likely to have positive cultures. Significant associations were observed between positive cultures and postoperative fever (<i>p</i> = 0.007), readmissions (<i>p</i> = 0.020), stone recurrence (<i>p</i> = 0.002) and multidrug resistance (<i>p</i> = 0.016) with no difference between single- and multi-organism culture groups. Positive cultures were independently associated with higher odds of readmission (OR = 4.31; <i>p</i> = 0.03) and stone recurrence (OR = 2.89; <i>p</i> = 0.005). Additionally, calcium phosphate and struvite stones were associated with positive cultures (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Positive stone cultures (single or multi-organism) predicted adverse postoperative outcomes including fever, readmission and recurrence. Patients with multi-organism stone cultures were more likely to have stone recurrences within 6 months, suggesting the need for closer follow-up and more comprehensive antibiotic therapy. These findings emphasize the role of stone culture status in guiding risk stratification and tailored prophylactic strategies, particularly in patients with multi-organism stone cultures who have multidrug resistance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bjui-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145891514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tarik Almdalal, Maja Fahlén, Ulrika Harmenberg, Börje Ljungberg, Magnus Lindskog
Objectives
This study aimed to identify clinical and socioeconomic factors associated with treatment selection and survival in patients diagnosed with synchronous metastatic renal cell carcinoma (mRCC).
Patients and Methods
The Renal Cell Cancer Database Sweden (RCCBaSe2.0), linking the National Swedish Kidney Cancer Register with other national quality registers, was used to identify all patients with synchronous mRCC diagnosed 1 January 2014–1 July 2019 (n = 951); thus, it was performed during the tyrosine kinase inhibitor era. Logistic and Cox regression were used to evaluate associations with treatment selection, overall survival (OS) and cancer-specific survival (CSS).
Results
Upfront cytoreductive nephrectomy (uCN) was the primary treatment in 56% of patients and was associated with larger primaries and treatment at university hospitals. Immediate systemic treatment (IST) was chosen in 32% and associated with multidisciplinary team (MDT) discussions, cN1 disease, more metastatic sites and higher comorbidity index. Gender, income, education level or marital status were not associated with upfront treatment. Patients selected for uCN had longer OS and CSS compared with those allocated to IST. This association remained when adjusting for selection factors. Socioeconomic factors were not linked to survival. Limitations include the retrospective design and the lack of detailed data on the International mRCC Database Consortium risk factors.
Conclusion
Tumour-related factors had significant effects on the choice to perform uCN or not. Patients with more advanced disease, higher comorbidity index and those discussed at MDT were more likely to be offered immediate systemic treatment. Socioeconomic status did not affect treatment allocation or survival, indicating equal healthcare access for Swedish mRCC patients.
{"title":"Real-world drivers of treatment choices in synchronous metastatic renal cell carcinoma","authors":"Tarik Almdalal, Maja Fahlén, Ulrika Harmenberg, Börje Ljungberg, Magnus Lindskog","doi":"10.1002/bco2.70149","DOIUrl":"10.1002/bco2.70149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to identify clinical and socioeconomic factors associated with treatment selection and survival in patients diagnosed with synchronous metastatic renal cell carcinoma (mRCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>The Renal Cell Cancer Database Sweden (RCCBaSe2.0), linking the National Swedish Kidney Cancer Register with other national quality registers, was used to identify all patients with synchronous mRCC diagnosed 1 January 2014–1 July 2019 (<i>n</i> = 951); thus, it was performed during the tyrosine kinase inhibitor era. Logistic and Cox regression were used to evaluate associations with treatment selection, overall survival (OS) and cancer-specific survival (CSS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Upfront cytoreductive nephrectomy (uCN) was the primary treatment in 56% of patients and was associated with larger primaries and treatment at university hospitals. Immediate systemic treatment (IST) was chosen in 32% and associated with multidisciplinary team (MDT) discussions, cN1 disease, more metastatic sites and higher comorbidity index. Gender, income, education level or marital status were not associated with upfront treatment. Patients selected for uCN had longer OS and CSS compared with those allocated to IST. This association remained when adjusting for selection factors. Socioeconomic factors were not linked to survival. Limitations include the retrospective design and the lack of detailed data on the International mRCC Database Consortium risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tumour-related factors had significant effects on the choice to perform uCN or not. Patients with more advanced disease, higher comorbidity index and those discussed at MDT were more likely to be offered immediate systemic treatment. Socioeconomic status did not affect treatment allocation or survival, indicating equal healthcare access for Swedish mRCC patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to determine the association between appendicular muscle-to-fat ratio (aMFR) and the risk of urinary incontinence (UI) in women.
Methods
A total of 4393 participants recruited from the National Health and Nutrition Examination Database (NHANES) from 2011 to 2018 were included in this study. We screened variables using least absolute shrinkage and selection regression, multivariate logistic regression, dose–response curve and nomogram to estimate the relationship between aMFR and UI. The accuracy and discrimination of the nomogram were validated using calibration, receiver operating characteristic (ROC), and decision curve analysis (DCA) curves.
Results
Participants with UI had a lower aMFR than those without (I [0.57, interquartile range [IQR]: 0.49, 0.69] vs 0.63, IQR: 0.54, 0.77, P < 0.05). Dose–response curves and multivariate logistic regression showed a negative correlation between the aMFR and the risk of developing UI [adjusted odds ratio (aOR) = 0.35, 95% confidence interval (CI) = 0.226–0.537, P < 0.001]. Validation of the calibration curves, ROC curves and DCA curves revealed the good predictive ability of the UI nomogram, and the area under the ROC curve in the predictive model was 0.668 (95% CI = 0.641–0.695) in the training set and 0.660 (95% CI = 0.633–0.687) in the testing set, which demonstrated the good performance of the model.
Conclusion
A low aMFR was significantly associated with an increased risk of UI in women in the US and could be included in risk prediction models for female UI.
{"title":"Low muscle, high leak? The aMFR wake-up call for women's bladders!","authors":"Jingyi Zhou, Donghai Zhang, Ruomeng Bi, Lei Xia, Zengyuan Zhou, Qian Zhou, Yongsheng Yu, Qingmiao Ge, Runtao Zhang","doi":"10.1002/bco2.70132","DOIUrl":"10.1002/bco2.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to determine the association between appendicular muscle-to-fat ratio (aMFR) and the risk of urinary incontinence (UI) in women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 4393 participants recruited from the National Health and Nutrition Examination Database (NHANES) from 2011 to 2018 were included in this study. We screened variables using least absolute shrinkage and selection regression, multivariate logistic regression, dose–response curve and nomogram to estimate the relationship between aMFR and UI. The accuracy and discrimination of the nomogram were validated using calibration, receiver operating characteristic (ROC), and decision curve analysis (DCA) curves.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants with UI had a lower aMFR than those without (I [0.57, interquartile range [IQR]: 0.49, 0.69] vs 0.63, IQR: 0.54, 0.77, <i>P</i> < 0.05). Dose–response curves and multivariate logistic regression showed a negative correlation between the aMFR and the risk of developing UI [adjusted odds ratio (aOR) = 0.35, 95% confidence interval (CI) = 0.226–0.537, <i>P</i> < 0.001]. Validation of the calibration curves, ROC curves and DCA curves revealed the good predictive ability of the UI nomogram, and the area under the ROC curve in the predictive model was 0.668 (95% CI = 0.641–0.695) in the training set and 0.660 (95% CI = 0.633–0.687) in the testing set, which demonstrated the good performance of the model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A low aMFR was significantly associated with an increased risk of UI in women in the US and could be included in risk prediction models for female UI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vineet Gauhar, Bhaskar Somani, Steffi Kar-Kei Yuen, Kemal Sarica, Marek Zawadzki, Abhishek Singh, Khi Yung Fong, Angelo Cormio, Wei Zhu, Jaisukh Kalathia, Nariman Gadzhiev, Vigen Malkhasyan, Yadgar Shwani, Oriol Angerri Feu, Ben H. Chew, Guohua Zheng, Thomas R. W. Herrmann, Daniele Castellani
Objective
We aim to evaluate the association between sheath size and outcomes in suction mini-percutaneous nephrolithotomy (SM-PCNL).
Materials and Methods
A prospective, multicentre study enrolled 1534 patients undergoing SM-PCNL from March to November 2024 across 30 centres. Patients were stratified into three groups: Group 1 (14–15 Fr, n = 780), Group 2 (16–18 Fr, n = 388), and Group 3 (20–22 Fr, n = 366). Primary outcome was 30-day stone-free rate (SFR) determined by non-contrast CT. Secondary outcomes included complications, operative times and hospital stay.
Results
Group 3 achieved the highest zero residual fragment rate (92.6%) compared to Groups 2 (80.7%) and 1 (79.5%) (p < 0.001). Operative times were shortest in Group 3 (36 min) and longest in Group 2 (65 min). Larger sheaths were associated with significantly higher overall complication rates: Group 1 (7.6%), Group 2 (14.4%) and Group 3 (14.8%) (p < 0.001). Transfusion requirements increased with sheath size: 0% (Group 1), 1.5% (Group 2) and 3.3% (Group 3). Group 3 had exclusive pleural injuries requiring chest tubes (2.7%) and highest pelvicalyceal perforation rates (4.1% vs 1.3% in Group 2, 0% in Group 1). Larger sheath (16/18 Fr: OR 1.82; 21/22 Fr: OR 4.14) and single step dilation (OR 3.84) were associated with higher odds of zero residual fragments. Sheath size 21/22 Fr (OR 2.12) and increasing Guys stone score (score 2: OR 1.94; score 3: OR 3.51; score 4: OR 2.63 95% CI) were factors significantly associated with higher odds of overall complications.
Conclusions
Sheath selection in SM-PCNL requires balancing efficacy against safety. Larger sheaths (20–22 Fr) optimize stone clearance but increase complications. Smaller sheaths (14–15 Fr) offer superior safety for simple cases. Intermediate sizes (16–18 Fr) may represent an optimal compromise for moderately complex stones.
目的：探讨吸式微型经皮肾镜取石术（SM-PCNL）中肾鞘大小与预后的关系。材料和方法：一项前瞻性多中心研究，于2024年3月至11月在30个中心招募了1534名接受SM-PCNL的患者。患者被分为三组：1组（14-15 Fr, n = 780）， 2组（16-18 Fr, n = 388）， 3组（20-22 Fr, n = 366）。主要终点是通过非对比CT测定的30天无结石率（SFR）。次要结局包括并发症、手术时间和住院时间。结果：与2组（80.7%）和1组（79.5%）相比，3组获得了最高的零残余碎片率（92.6%）（p p）。结论：SM-PCNL鞘鞘选择需要平衡疗效和安全性。较大的鞘（20- 22fr）可优化结石清除，但增加并发症。较小的护套（14-15 Fr）为简单的情况提供了优越的安全性。中等大小（16-18 Fr）可能是中等复杂结石的最佳选择。
{"title":"Influence of sheath size on suction mini-PCNL outcomes: An observational study from the EAU endourology section and the global suction in mini-PCNL collaborative study group","authors":"Vineet Gauhar, Bhaskar Somani, Steffi Kar-Kei Yuen, Kemal Sarica, Marek Zawadzki, Abhishek Singh, Khi Yung Fong, Angelo Cormio, Wei Zhu, Jaisukh Kalathia, Nariman Gadzhiev, Vigen Malkhasyan, Yadgar Shwani, Oriol Angerri Feu, Ben H. Chew, Guohua Zheng, Thomas R. W. Herrmann, Daniele Castellani","doi":"10.1002/bco2.70134","DOIUrl":"10.1002/bco2.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aim to evaluate the association between sheath size and outcomes in suction mini-percutaneous nephrolithotomy (SM-PCNL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A prospective, multicentre study enrolled 1534 patients undergoing SM-PCNL from March to November 2024 across 30 centres. Patients were stratified into three groups: Group 1 (14–15 Fr, <i>n</i> = 780), Group 2 (16–18 Fr, <i>n</i> = 388), and Group 3 (20–22 Fr, <i>n</i> = 366). Primary outcome was 30-day stone-free rate (SFR) determined by non-contrast CT. Secondary outcomes included complications, operative times and hospital stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Group 3 achieved the highest zero residual fragment rate (92.6%) compared to Groups 2 (80.7%) and 1 (79.5%) (<i>p</i> < 0.001). Operative times were shortest in Group 3 (36 min) and longest in Group 2 (65 min). Larger sheaths were associated with significantly higher overall complication rates: Group 1 (7.6%), Group 2 (14.4%) and Group 3 (14.8%) (<i>p</i> < 0.001). Transfusion requirements increased with sheath size: 0% (Group 1), 1.5% (Group 2) and 3.3% (Group 3). Group 3 had exclusive pleural injuries requiring chest tubes (2.7%) and highest pelvicalyceal perforation rates (4.1% vs 1.3% in Group 2, 0% in Group 1). Larger sheath (16/18 Fr: OR 1.82; 21/22 Fr: OR 4.14) and single step dilation (OR 3.84) were associated with higher odds of zero residual fragments. Sheath size 21/22 Fr (OR 2.12) and increasing Guys stone score (score 2: OR 1.94; score 3: OR 3.51; score 4: OR 2.63 95% CI) were factors significantly associated with higher odds of overall complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Sheath selection in SM-PCNL requires balancing efficacy against safety. Larger sheaths (20–22 Fr) optimize stone clearance but increase complications. Smaller sheaths (14–15 Fr) offer superior safety for simple cases. Intermediate sizes (16–18 Fr) may represent an optimal compromise for moderately complex stones.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"7 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel Weng, Tran Anh Thu Phung, Robert Bell, Lars Dyrskjøt, Ewan A. Gibb
Background
To evaluate whether long non-coding RNA (lncRNA) expression patterns can improve molecular stratification and outcome prediction in high-risk non-muscle-invasive bladder cancer (NMIBC).
Methods
RNA sequencing data from high-grade Ta (TaHG) and T1 (n = 212) tumours from the UROMOL consortium (Lindskrog et al., Nature Communications 2021) were analysed. Unsupervised consensus clustering based on lncRNA expression patterns identified distinct patient subgroups, which were characterized using gene expression patterns and gene signatures. A single-sample classifier was trained using elastic net logistic regression on UROMOL lncRNA expression profiles and applied to the Knowles cohort for independent validation. Recurrence-free survival (RFS) and progression-free survival (PFS) were evaluated using Kaplan–Meier (KM) plots, univariate and multivariate analyses.
Results
LncRNA expression patterns identified three distinct clusters of TaHG and T1 tumours (LC1, LC2, LC3). Of these, the LC1 subgroup (n = 47) had significantly better RFS (p = 0.04) and PFS (p = 0.002). The LC1 subgroup was characterized by downregulation of genes associated with proliferation (i.e., FOXM1, MKI67) and lower G2M and E2F gene signatures, suggesting reduced rates of tumour growth. A transcriptomic classifier trained on UROMOL lncRNA profiles successfully stratified recurrence risk in an independent validation cohort (Knowles, n = 120), where predicted high-risk cases (LC2/3) demonstrated significantly poorer recurrence-free survival (p < 0.001). While these findings highlight lncRNA expression as a potential stratification tool, limitations include the retrospective design, treatment heterogeneity and the need for external validation.
Conclusion
LncRNA-based clustering demonstrates significant potential for improving patient stratification in high-risk NMIBC, identifying less aggressive tumours in an otherwise high-risk setting. A transcriptomic classifier trained on these findings was successfully validated in an independent cohort, supporting its potential clinical utility in refining risk assessment and guiding treatment decisions. Prospective studies are needed to further validate and refine this approach.
{"title":"Long non-coding RNAs define favourable biology in high-risk non-muscle-invasive bladder cancer","authors":"Rachel Weng, Tran Anh Thu Phung, Robert Bell, Lars Dyrskjøt, Ewan A. Gibb","doi":"10.1002/bco2.70131","DOIUrl":"10.1002/bco2.70131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To evaluate whether long non-coding RNA (lncRNA) expression patterns can improve molecular stratification and outcome prediction in high-risk non-muscle-invasive bladder cancer (NMIBC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>RNA sequencing data from high-grade Ta (TaHG) and T1 (n = 212) tumours from the UROMOL consortium (Lindskrog et al., Nature Communications 2021) were analysed. Unsupervised consensus clustering based on lncRNA expression patterns identified distinct patient subgroups, which were characterized using gene expression patterns and gene signatures. A single-sample classifier was trained using elastic net logistic regression on UROMOL lncRNA expression profiles and applied to the Knowles cohort for independent validation. Recurrence-free survival (RFS) and progression-free survival (PFS) were evaluated using Kaplan–Meier (KM) plots, univariate and multivariate analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LncRNA expression patterns identified three distinct clusters of TaHG and T1 tumours (LC1, LC2, LC3). Of these, the LC1 subgroup (n = 47) had significantly better RFS (p = 0.04) and PFS (p = 0.002). The LC1 subgroup was characterized by downregulation of genes associated with proliferation (i.e., <i>FOXM1</i>, <i>MKI67</i>) and lower G2M and E2F gene signatures, suggesting reduced rates of tumour growth. A transcriptomic classifier trained on UROMOL lncRNA profiles successfully stratified recurrence risk in an independent validation cohort (Knowles, n = 120), where predicted high-risk cases (LC2/3) demonstrated significantly poorer recurrence-free survival (p < 0.001). While these findings highlight lncRNA expression as a potential stratification tool, limitations include the retrospective design, treatment heterogeneity and the need for external validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LncRNA-based clustering demonstrates significant potential for improving patient stratification in high-risk NMIBC, identifying less aggressive tumours in an otherwise high-risk setting. A transcriptomic classifier trained on these findings was successfully validated in an independent cohort, supporting its potential clinical utility in refining risk assessment and guiding treatment decisions. Prospective studies are needed to further validate and refine this approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexandrine Martel, Lucas Raue, Patrice Hodonou Avogbe, Jennifer Raisch, Claudio Jeldres, Thorsten Ecke, Emmanuel Vian, Md Ismail Hosen, Anja Rabien, Florence Le Calvez-Kelm, Francois-Michel Boisvert
Background and Objective
Bladder cancer (BC), a prevalent malignancy, poses significant diagnostic and surveillance challenges due to its high recurrence rates and reliance on cystoscopy, an invasive procedure for diagnosis and monitoring. While urine-based genomic and proteomic biomarkers offer promising non-invasive alternatives, their clinical implementation remains limited. This review synthesizes evidence from multicentric studies on urinary biomarkers for BC and evaluates their potential in reducing unnecessary invasive cystoscopies.
Methods
A comprehensive review of literature was conducted searching for multicentric studies on urine-based genomic and proteomic biomarkers for BC detection and/or surveillance. MEDLINE/Pubmed, Embase and Scopus databases and BJUI, UroToday and European Urology Oncology registries were searched using National Library of Medicine Medical Subject Headings (MeSH) terms. Emphasis was placed on the comparative performance of diagnostic platforms across different research and clinical settings.
Key Findings and Limitations
The literature search yielded 51 reports that were included for analysis. Multicentre studies enhance the generalizability of findings by addressing inter-laboratory variability and population diversity. This review underscores the importance of standardization, comparative performance analyses that these studies provide, and the potential for cost-effective non-invasive diagnostic tools. However, despite FDA approvals, no biomarker has replaced cystoscopy in clinical settings due to an inconsistent and insufficient combination of sensitivity, specificity and cost-effectiveness parameters. The performance of AssureMDX and Enhanced CxBladder tests showed the most promise, but further large-scale, standardized validation is still necessary.
Conclusions and Clinical Implications
Urine-based biomarkers have the potential to improve early BC detection and surveillance while reducing reliance on invasive procedures and costs related to the disease. Future efforts should prioritize cost-effective, large-scale multicentric studies to facilitate the adoption of these biomarkers into routine practice.
{"title":"Urinary biomarkers in multicentric studies: Shaping the future of bladder cancer diagnosis and follow-up","authors":"Alexandrine Martel, Lucas Raue, Patrice Hodonou Avogbe, Jennifer Raisch, Claudio Jeldres, Thorsten Ecke, Emmanuel Vian, Md Ismail Hosen, Anja Rabien, Florence Le Calvez-Kelm, Francois-Michel Boisvert","doi":"10.1002/bco2.70124","DOIUrl":"10.1002/bco2.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Bladder cancer (BC), a prevalent malignancy, poses significant diagnostic and surveillance challenges due to its high recurrence rates and reliance on cystoscopy, an invasive procedure for diagnosis and monitoring. While urine-based genomic and proteomic biomarkers offer promising non-invasive alternatives, their clinical implementation remains limited. This review synthesizes evidence from multicentric studies on urinary biomarkers for BC and evaluates their potential in reducing unnecessary invasive cystoscopies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive review of literature was conducted searching for multicentric studies on urine-based genomic and proteomic biomarkers for BC detection and/or surveillance. MEDLINE/Pubmed, Embase and Scopus databases and BJUI, UroToday and European Urology Oncology registries were searched using National Library of Medicine Medical Subject Headings (MeSH) terms. Emphasis was placed on the comparative performance of diagnostic platforms across different research and clinical settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Findings and Limitations</h3>\u0000 \u0000 <p>The literature search yielded 51 reports that were included for analysis. Multicentre studies enhance the generalizability of findings by addressing inter-laboratory variability and population diversity. This review underscores the importance of standardization, comparative performance analyses that these studies provide, and the potential for cost-effective non-invasive diagnostic tools. However, despite FDA approvals, no biomarker has replaced cystoscopy in clinical settings due to an inconsistent and insufficient combination of sensitivity, specificity and cost-effectiveness parameters. The performance of AssureMDX and Enhanced CxBladder tests showed the most promise, but further large-scale, standardized validation is still necessary.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Clinical Implications</h3>\u0000 \u0000 <p>Urine-based biomarkers have the potential to improve early BC detection and surveillance while reducing reliance on invasive procedures and costs related to the disease. Future efforts should prioritize cost-effective, large-scale multicentric studies to facilitate the adoption of these biomarkers into routine practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer M. Slota, Rose E. Darcy, Kathryn Fink, Ridwan Alam, Nicole Handa, Sai Kumar, Clayton Neill, Yutai Li, Hiten D. Patel, Kent T. Perry Jr, Vinayak Rohan, Satish Nadig, Ashley E. Ross, Dylan Isaacson
Introduction
We aim to evaluate the perioperative, oncologic, and survival outcomes of RARP in kidney transplant recipients (KTRs) and compare to propensity-matched controls.
Patients and Methods
This was a single-institution retrospective cohort study using the Northwestern Enterprise Data Warehouse. We identified eight KTRs who underwent RARP from January 2018–September 2024 and propensity matched them 1:4 with non-KTR controls using age, body mass index, and pathologic Gleason score. Outcomes were assessed using Wilcoxon rank sum and Fisher's exact tests. Overall survival was analysed using Kaplan–Meier and univariable Cox proportional hazards models.
Results
All RARPs in KTRs were completed robotically. Median time from kidney transplant to RARP was 11.1 years (8.9–15.1). KTRs had higher Charlson Comorbidity Index (9.5 vs 4; p < 0.001) but similar operative time (198.5 vs 201; p = 0.8), estimated blood loss (125 vs 90 ml; p = 0.7), and length of hospital stay (1 midnight in both; p = 0.2). KTRs experienced no major complications, graft injuries, episodes of acute kidney injury, or 90-day readmissions. The 30-day urinary tract infection rate was higher in KTRs (25% vs 0%; p = 0.036), who had a median catheterization duration of 11 days (8–12.5). Surgical margin positivity (29% vs 19%, p = 0.6) and biochemical recurrence rates (13% vs 6.3%, p = 0.5) did not differ. Median follow-up time was 3.2 years in KTRs vs 1.7 years in controls (p = 0.13). Allograft function remained stable at 12 months. One KTR died from renal failure 44 months after RARP; none developed metastases or died of PCa.
Conclusion
RARP in kidney transplant recipients is feasible and safe for experienced surgeons, with comparable surgical and oncologic outcomes as compared to matched controls. Higher UTI rates suggest modified catheter removal strategies could be considered.
我们的目的是评估肾移植受者（KTRs） RARP的围手术期、肿瘤学和生存结果，并与倾向匹配的对照组进行比较。患者和方法：这是一项使用西北企业数据仓库的单机构回顾性队列研究。我们确定了2018年1月至2024年9月期间接受RARP治疗的8名ktr患者，并使用年龄、体重指数和病理格里森评分将他们与非ktr对照组进行1:4的倾向匹配。使用Wilcoxon秩和和和Fisher精确检验评估结果。采用Kaplan-Meier和单变量Cox比例风险模型分析总生存率。结果：KTRs的所有rarp都是机器人完成的。从肾移植到RARP的中位时间为11.1年（8.9-15.1年）。ktr患者的Charlson共病指数（9.5 vs 4, p = 0.8）、估计失血量（125 vs 90 ml, p = 0.7）和住院时间（两者均为1个午夜，p = 0.2）较高。ktr患者无重大并发症、移植物损伤、急性肾损伤发作或90天再入院。ktr患者30天尿路感染率较高（25% vs 0%; p = 0.036），中位置管时间为11天（8-12.5天）。手术切缘阳性（29% vs 19%, p = 0.6）和生化复发率（13% vs 6.3%, p = 0.5）无差异。ktr组中位随访时间为3.2年，对照组为1.7年（p = 0.13）。同种异体移植物功能在12个月时保持稳定。1例KTR患者在RARP术后44个月死于肾功能衰竭；没有发生转移或死于前列腺癌。结论：对于经验丰富的外科医生来说，肾移植受者的RARP是可行和安全的，与匹配的对照组相比，其手术和肿瘤预后相当。较高的尿路感染率提示可以考虑改良的导管拔除策略。
{"title":"Robotic radical prostatectomy in kidney transplant recipients: A propensity-matched cohort study","authors":"Jennifer M. Slota, Rose E. Darcy, Kathryn Fink, Ridwan Alam, Nicole Handa, Sai Kumar, Clayton Neill, Yutai Li, Hiten D. Patel, Kent T. Perry Jr, Vinayak Rohan, Satish Nadig, Ashley E. Ross, Dylan Isaacson","doi":"10.1002/bco2.70128","DOIUrl":"10.1002/bco2.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We aim to evaluate the perioperative, oncologic, and survival outcomes of RARP in kidney transplant recipients (KTRs) and compare to propensity-matched controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This was a single-institution retrospective cohort study using the Northwestern Enterprise Data Warehouse. We identified eight KTRs who underwent RARP from January 2018–September 2024 and propensity matched them 1:4 with non-KTR controls using age, body mass index, and pathologic Gleason score. Outcomes were assessed using Wilcoxon rank sum and Fisher's exact tests. Overall survival was analysed using Kaplan–Meier and univariable Cox proportional hazards models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All RARPs in KTRs were completed robotically. Median time from kidney transplant to RARP was 11.1 years (8.9–15.1). KTRs had higher Charlson Comorbidity Index (9.5 vs 4; <i>p</i> < 0.001) but similar operative time (198.5 vs 201; <i>p</i> = 0.8), estimated blood loss (125 vs 90 ml; <i>p</i> = 0.7), and length of hospital stay (1 midnight in both; <i>p</i> = 0.2). KTRs experienced no major complications, graft injuries, episodes of acute kidney injury, or 90-day readmissions. The 30-day urinary tract infection rate was higher in KTRs (25% vs 0%; <i>p</i> = 0.036), who had a median catheterization duration of 11 days (8–12.5). Surgical margin positivity (29% vs 19%, <i>p</i> = 0.6) and biochemical recurrence rates (13% vs 6.3%, <i>p</i> = 0.5) did not differ. Median follow-up time was 3.2 years in KTRs vs 1.7 years in controls (<i>p</i> = 0.13). Allograft function remained stable at 12 months. One KTR died from renal failure 44 months after RARP; none developed metastases or died of PCa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RARP in kidney transplant recipients is feasible and safe for experienced surgeons, with comparable surgical and oncologic outcomes as compared to matched controls. Higher UTI rates suggest modified catheter removal strategies could be considered.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12713085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Cosenza, Francesco Barletta, Leonardo Quarta, Michele Brancaccio, Giorgio Gandaglia, Francesco Montorsi, Alberto Briganti, Armando Stabile
<p>Prostate cancer (PCa) is most commonly diagnosed in its localized stage, with radical treatments such as prostatectomy or radiotherapy offering high rates of cancer control.<span><sup>1</sup></span> However, these curative options are frequently associated with significant adverse effects, including erectile dysfunction and urinary incontinence, which can negatively impact patients' quality of life.<span><sup>2</sup></span> In response, interest in organ-sparing approaches has increased, particularly for patients with low-risk disease where overtreatment remains a pressing concern. Focal therapies (FTs) aim to treat only the cancerous portion of the prostate identified by targeted biopsy and multiparametric MRI, thereby reducing the burden of treatment-related morbidity while maintaining oncological safety.</p><p>Among available FT modalities, vascular-targeted photodynamic therapy (VTP) using TOOKAD® Soluble (WST-11) has emerged as a promising option. VTP induces localized ablation of prostate tissue through the photochemical activation of a photosensitizer with near-infrared laser light, resulting in vascular occlusion and subsequent tumour necrosis.<span><sup>3</sup></span> While encouraging short-term oncological outcomes have been reported, long-term data remain limited.<span><sup>4</sup></span></p><p>Here, we report 5-year clinical outcomes of patients with low-risk PCa treated with VTP at our tertiary referral centre.</p><p>Between 2018 and 2020, a total of 13 patients underwent VTP at San Raffaele Hospital. Eligibility criteria included unilateral ISUP Grade Group 1 disease on biopsy, PSA < 10 ng/mL and clinical stage cT1. All procedures were performed by a single experienced urologist. Data were prospectively collected and approved by the Institutional Review Board. Primary outcomes were technical feasibility, defined as the absence of Grades 4 and 5 adverse events, and PCa recurrence or progression necessitating radical treatment.</p><p>At treatment, median patient age was 65 years (IQR: 62–68), and median PSA was 6 ng/mL (IQR: 4–8). Multiparametric prostate MRI was available in 11 (85%) patients. Suspicious lesions were categorized as PI-RADS 2–4 in 2 (18%), 3 (27%) and 6 (55%) patients, respectively, and showed concordance with biopsy-identified cancer locations. Median prostate volume, measured via MRI or transrectal ultrasound, was 52 cc (IQR: 31–81). The median number of biopsy cores was 15 (IQR: 13–16), with three positive cores (IQR: 2–4). Time from biopsy to treatment was 6 months (IQR: 3–14).</p><p>All patients were discharged the day after the procedure. No serious (Grades 4 and 5) adverse events were recorded. One patient (7.7%) experienced acute urinary retention, while three (23%) had transient haematuria, all classified as Grade ≤3 events.</p><p>After a median follow-up of 70 months (IQR: 52–72), five patients (38%) experienced recurrence. In Kaplan–Meier analysis, the 5-year PCa recurrence-free survival was 64% (95%
{"title":"Five-year outcomes of TOOKAD® (WST-11) vascular-targeted photodynamic therapy for low-risk prostate cancer patients: Insights from a tertiary referral centre","authors":"Andrea Cosenza, Francesco Barletta, Leonardo Quarta, Michele Brancaccio, Giorgio Gandaglia, Francesco Montorsi, Alberto Briganti, Armando Stabile","doi":"10.1002/bco2.70106","DOIUrl":"10.1002/bco2.70106","url":null,"abstract":"<p>Prostate cancer (PCa) is most commonly diagnosed in its localized stage, with radical treatments such as prostatectomy or radiotherapy offering high rates of cancer control.<span><sup>1</sup></span> However, these curative options are frequently associated with significant adverse effects, including erectile dysfunction and urinary incontinence, which can negatively impact patients' quality of life.<span><sup>2</sup></span> In response, interest in organ-sparing approaches has increased, particularly for patients with low-risk disease where overtreatment remains a pressing concern. Focal therapies (FTs) aim to treat only the cancerous portion of the prostate identified by targeted biopsy and multiparametric MRI, thereby reducing the burden of treatment-related morbidity while maintaining oncological safety.</p><p>Among available FT modalities, vascular-targeted photodynamic therapy (VTP) using TOOKAD® Soluble (WST-11) has emerged as a promising option. VTP induces localized ablation of prostate tissue through the photochemical activation of a photosensitizer with near-infrared laser light, resulting in vascular occlusion and subsequent tumour necrosis.<span><sup>3</sup></span> While encouraging short-term oncological outcomes have been reported, long-term data remain limited.<span><sup>4</sup></span></p><p>Here, we report 5-year clinical outcomes of patients with low-risk PCa treated with VTP at our tertiary referral centre.</p><p>Between 2018 and 2020, a total of 13 patients underwent VTP at San Raffaele Hospital. Eligibility criteria included unilateral ISUP Grade Group 1 disease on biopsy, PSA < 10 ng/mL and clinical stage cT1. All procedures were performed by a single experienced urologist. Data were prospectively collected and approved by the Institutional Review Board. Primary outcomes were technical feasibility, defined as the absence of Grades 4 and 5 adverse events, and PCa recurrence or progression necessitating radical treatment.</p><p>At treatment, median patient age was 65 years (IQR: 62–68), and median PSA was 6 ng/mL (IQR: 4–8). Multiparametric prostate MRI was available in 11 (85%) patients. Suspicious lesions were categorized as PI-RADS 2–4 in 2 (18%), 3 (27%) and 6 (55%) patients, respectively, and showed concordance with biopsy-identified cancer locations. Median prostate volume, measured via MRI or transrectal ultrasound, was 52 cc (IQR: 31–81). The median number of biopsy cores was 15 (IQR: 13–16), with three positive cores (IQR: 2–4). Time from biopsy to treatment was 6 months (IQR: 3–14).</p><p>All patients were discharged the day after the procedure. No serious (Grades 4 and 5) adverse events were recorded. One patient (7.7%) experienced acute urinary retention, while three (23%) had transient haematuria, all classified as Grade ≤3 events.</p><p>After a median follow-up of 70 months (IQR: 52–72), five patients (38%) experienced recurrence. In Kaplan–Meier analysis, the 5-year PCa recurrence-free survival was 64% (95%","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joshua Tran, Yeagyeong Hwang, Mai Xuan Nguyen, Gillian Mendoza, Erica Huang, Linda Huynh, Rafael Gevorkyan, Catherine Fung, Robert Wilson, Sheldon Greenfield, Thomas Ahlering
Objectives
To assess the relationship of intermittent adverse cardiovascular events (ACE) in men undergoing androgen deprivation therapy (ADT) post radical prostatectomy (RP), since ACE are severe complications associated with ADT following a biochemical recurrence (BCR) post-RP for the treatment of prostate cancer (PC).
Patients and Methods
Retrospective review of prospectively collected data of patients who underwent robot-assisted radical prostatectomy (RARP) with a BCR (n = 407). A total of 308 men with adequate follow-up data included for analysis. A total of 189/308 men in the “treatment group” (TG) were managed with ADT. The comparator group consisted of 119/308 men with no treatment (NT). Regression and Kaplan Meier (KM) analyses were performed to assess predictors of ACE.
Results
At baseline, patients in the treatment group had higher risk characteristics for PC (preoperative PSA, pathological stage and Gleason grade). Univariate analysis of ACE showed significant predators were age, Charlson comorbidity index (CCI), body mass index (BMI), treatment status and smoking status. In multivariate analysis, treatment status was trending towards significance (p = 0.10) with CCI (p < 0.001) and BMI (p = 0.003) being significant predictors of ACE. In 15-year KM, we observed a significant increase in ACEs (TG 54.4% and NT 41.8%, p = 0.02). Limitations include retrospective design and limited analysis of NT, TG or ADT effects on cardiovascular mortality.
Conclusion
ADT, in our experience, is associated with an increased risk of ACE. We also noted the importance of CCI and BMI as a prognosticating tool for ACE.
目的探讨男性根治性前列腺切除术（RP）后接受雄激素剥夺治疗（ADT）的男性间歇性心血管不良事件（ACE）的关系，因为ACE是前列腺癌（PC）根治性前列腺切除术（RP）后生化复发（BCR）与ADT相关的严重并发症。患者和方法对前瞻性收集的接受机器人辅助根治性前列腺切除术（RARP）的BCR患者（n = 407）的数据进行回顾性分析。共有308名男性接受了足够的随访数据进行分析。“治疗组”（TG）共有189/308名男性接受ADT治疗。比较组包括119/308名未接受治疗的男性（NT）。采用回归分析和Kaplan Meier （KM）分析评估ACE的预测因素。结果在基线时，治疗组患者具有更高的PC风险特征（术前PSA、病理分期和Gleason分级）。ACE单因素分析显示，年龄、Charlson合并症指数（CCI）、体重指数（BMI）、治疗状况和吸烟状况是显著的“捕食者”。在多因素分析中，治疗状态趋于显著（p = 0.10）， CCI （p < 0.001）和BMI （p = 0.003）是ACE的显著预测因子。在15年KM中，我们观察到ace显著增加（TG 54.4%, NT 41.8%, p = 0.02）。局限性包括回顾性设计和NT、TG或ADT对心血管死亡率影响的有限分析。结论：根据我们的经验，ADT与ACE风险增加有关。我们也注意到CCI和BMI作为ACE预测工具的重要性。
{"title":"Long-term assessment of adverse cardiovascular events in men receiving intermittent androgen deprivation therapy following radical prostatectomy","authors":"Joshua Tran, Yeagyeong Hwang, Mai Xuan Nguyen, Gillian Mendoza, Erica Huang, Linda Huynh, Rafael Gevorkyan, Catherine Fung, Robert Wilson, Sheldon Greenfield, Thomas Ahlering","doi":"10.1002/bco2.70127","DOIUrl":"https://doi.org/10.1002/bco2.70127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the relationship of intermittent adverse cardiovascular events (ACE) in men undergoing androgen deprivation therapy (ADT) post radical prostatectomy (RP), since ACE are severe complications associated with ADT following a biochemical recurrence (BCR) post-RP for the treatment of prostate cancer (PC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Retrospective review of prospectively collected data of patients who underwent robot-assisted radical prostatectomy (RARP) with a BCR (n = 407). A total of 308 men with adequate follow-up data included for analysis. A total of 189/308 men in the “treatment group” (TG) were managed with ADT. The comparator group consisted of 119/308 men with no treatment (NT). Regression and Kaplan Meier (KM) analyses were performed to assess predictors of ACE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At baseline, patients in the treatment group had higher risk characteristics for PC (preoperative PSA, pathological stage and Gleason grade). Univariate analysis of ACE showed significant predators were age, Charlson comorbidity index (CCI), body mass index (BMI), treatment status and smoking status. In multivariate analysis, treatment status was trending towards significance (p = 0.10) with CCI (p < 0.001) and BMI (p = 0.003) being significant predictors of ACE. In 15-year KM, we observed a significant increase in ACEs (TG 54.4% and NT 41.8%, p = 0.02). Limitations include retrospective design and limited analysis of NT, TG or ADT effects on cardiovascular mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ADT, in our experience, is associated with an increased risk of ACE. We also noted the importance of CCI and BMI as a prognosticating tool for ACE.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bjui-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Antti Nummi, Pertti Nurminen, Olli Kesti, Mikael Högerman, Otto Ettala, Peter J. Boström, Antti Kaipia, Jukka Sairanen, Riikka Järvinen
Objective
This study aims to determine whether asymptomatic bacteriuria (ABU) increases the risk of infective complications requiring hospitalisation in patients undergoing Bacillus Calmette-Guérin (BCG) instillations and consequently evaluate the need to screen asymptomatic patients for bacteriuria prior to BCG administration.
Subjects/patients and methods
We analysed retrospectively all patients who received ≥1 BCG instillations as treatment of NMIBC in Helsinki University Hospital and Turku University Hospital during 2009–2018. Patients submitted urine specimens 1–7 days prior to every BCG instillation. Urine culture results and possible antibiotic prophylaxis prior to BCG administration were recorded. ABU was classified as having a positive urine culture but no dysuria or fever. All hospital admissions because of urinary tract infections and other BCG-related adverse effects within 2 weeks of BCG administration were recorded.
Results
We analysed 802 patients and 12 968 BCG instillations. ABU was recorded prior to 2428 (19%) instillations among which antibiotics were used in 527 (22%). Hospital admission was recorded after 9 (0,3%) and 39 (0,4%) instillations in the ABU and in the sterile urine groups, respectively (P = 0.9). Antibiotic prophylaxis did not affect the hospital admission rate (P = 0.2).
Conclusion
BCG instillation with ABU is safe, and the results do not support routine screening of asymptomatic patients for bacteriuria prior to intravesical BCG immunotherapy.
{"title":"Time to abandon routine urine analysis prior to Bacillus Calmette–Guérin administration in asymptomatic patients","authors":"Antti Nummi, Pertti Nurminen, Olli Kesti, Mikael Högerman, Otto Ettala, Peter J. Boström, Antti Kaipia, Jukka Sairanen, Riikka Järvinen","doi":"10.1002/bco2.70117","DOIUrl":"https://doi.org/10.1002/bco2.70117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to determine whether asymptomatic bacteriuria (ABU) increases the risk of infective complications requiring hospitalisation in patients undergoing Bacillus Calmette-Guérin (BCG) instillations and consequently evaluate the need to screen asymptomatic patients for bacteriuria prior to BCG administration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects/patients and methods</h3>\u0000 \u0000 <p>We analysed retrospectively all patients who received ≥1 BCG instillations as treatment of NMIBC in Helsinki University Hospital and Turku University Hospital during 2009–2018. Patients submitted urine specimens 1–7 days prior to every BCG instillation. Urine culture results and possible antibiotic prophylaxis prior to BCG administration were recorded. ABU was classified as having a positive urine culture but no dysuria or fever. All hospital admissions because of urinary tract infections and other BCG-related adverse effects within 2 weeks of BCG administration were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We analysed 802 patients and 12 968 BCG instillations. ABU was recorded prior to 2428 (19%) instillations among which antibiotics were used in 527 (22%). Hospital admission was recorded after 9 (0,3%) and 39 (0,4%) instillations in the ABU and in the sterile urine groups, respectively (<i>P</i> = 0.9). Antibiotic prophylaxis did not affect the hospital admission rate (<i>P</i> = 0.2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BCG instillation with ABU is safe, and the results do not support routine screening of asymptomatic patients for bacteriuria prior to intravesical BCG immunotherapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72420,"journal":{"name":"BJUI compass","volume":"6 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bjui-journals.onlinelibrary.wiley.com/doi/epdf/10.1002/bco2.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145750927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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