Andrea Marmiroli,Francesco Di Bello,Natali Rodriguez Peñaranda,Mattia Longoni,Quynh Chi Le,Fabian Falkenbach,Michele Nicolazzini,Calogero Catanzaro,Zhe Tian,Jordan A Goyal,Stefano Luzzago,Francesco Alessandro Mistretta,Mattia Piccinelli,Fred Saad,Shahrokh F Shariat,Alberto Briganti,Felix K H Chun,Salvatore Micali,Nicola Longo,Markus Graefen,Carlotta Palumbo,Riccardo Schiavina,Gennaro Musi,Pierre I Karakiewicz
{"title":"Response to comments on 'Adverse in-hospital outcomes in patients with paraplegia who undergo radical prostatectomy'.","authors":"Andrea Marmiroli,Francesco Di Bello,Natali Rodriguez Peñaranda,Mattia Longoni,Quynh Chi Le,Fabian Falkenbach,Michele Nicolazzini,Calogero Catanzaro,Zhe Tian,Jordan A Goyal,Stefano Luzzago,Francesco Alessandro Mistretta,Mattia Piccinelli,Fred Saad,Shahrokh F Shariat,Alberto Briganti,Felix K H Chun,Salvatore Micali,Nicola Longo,Markus Graefen,Carlotta Palumbo,Riccardo Schiavina,Gennaro Musi,Pierre I Karakiewicz","doi":"10.1111/bju.70210","DOIUrl":"https://doi.org/10.1111/bju.70210","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"66 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147368393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Like most journals, BJUI relies on the hard work and dedication of its peer reviewers and we are grateful to them all. Each month the Editorial Team nominates peer reviewers whose reviews have stood out for their quality and timeliness and those selected as the best are highlighted on this page in recognition of their exceptional work.</p> <p><b>Francesca Ambrosini</b></p> <div>Dr. Francesca Ambrosini is a consultant urologist based in Genoa, Italy, working in a high-volume academic and clinical setting. She completed her medical degree and urology training in Italy, with a strong focus on oncological urology. Her main clinical and research interest is prostate cancer. <figure> <div><picture> <source media="(min-width: 1650px)" srcset="/cms/asset/5e9b2747-d7e3-4745-ba25-1a03e72ddbf7/bju70222-gra-0001-m.jpg"/><img alt="image" data-lg-src="/cms/asset/5e9b2747-d7e3-4745-ba25-1a03e72ddbf7/bju70222-gra-0001-m.jpg" loading="lazy" src="/cms/asset/03e5af1f-df8c-4263-be32-36c164c6f64f/bju70222-gra-0001-m.png" title="image"/></picture><p></p> </div> </figure> </div> <p>She further strengthened her academic background through a 9-month research fellowship at the Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf (UKE), Germany, a leading international referral centre for prostate cancer. During this period, she was actively involved in clinical research projects focusing on prostate cancer.</p> <p>Dr. Francesca Ambrosini is actively involved in peer review for international urological journals. She is an associate member of the EAU Young Academic Urologists (YAU) Prostate Cancer Working Group and is actively engaged in collaborative research and academic activities within the international urological community.</p> <p><b>Marilyn Ashley</b></p> <div>Dr. Marilyn Ashley is a postdoctoral research associate with the Sexual Health Research Lab at Queen's University and a Part-Time Professor in Psychology at the University of Ottawa. She earned her bachelor's degree in Psychology, with a minor in Women's and Gender Studies, at Carleton University, completing her honours thesis under Dr. Anne Bowker. She then completed her PhD in Experimental Psychology at the University of Ottawa under Dr. Krystelle Shaughnessy. Dr. Ashley has published widely on sexual communication, digital intimacy, psychometric measurement, and 2SLGBTQ+ health. Her current projects with Dr. Caroline Pukall include a randomised controlled trial of an online pelvic health program for women with vulvodynia, clinical validation of a sexual self-concept scale, and a four-year longitudinal study on post-SSRI/SNRI sexual dysfunction focused on symptom trajectories, predictors, and bio-psycho-sexual outcomes. Across all projects, Dr. Ashley takes a person-centred approach, critically evaluating whether widely used theories and measurement tools are valid for marginalised populations and adapting them when they are not. Her work aims to centre minoritised voices and develo
{"title":"April's reviewers of the month","authors":"","doi":"10.1111/bju.70222","DOIUrl":"https://doi.org/10.1111/bju.70222","url":null,"abstract":"<p>Like most journals, BJUI relies on the hard work and dedication of its peer reviewers and we are grateful to them all. Each month the Editorial Team nominates peer reviewers whose reviews have stood out for their quality and timeliness and those selected as the best are highlighted on this page in recognition of their exceptional work.</p>\u0000<p><b>Francesca Ambrosini</b></p>\u0000<div>Dr. Francesca Ambrosini is a consultant urologist based in Genoa, Italy, working in a high-volume academic and clinical setting. She completed her medical degree and urology training in Italy, with a strong focus on oncological urology. Her main clinical and research interest is prostate cancer. <figure>\u0000<div><picture>\u0000<source media=\"(min-width: 1650px)\" srcset=\"/cms/asset/5e9b2747-d7e3-4745-ba25-1a03e72ddbf7/bju70222-gra-0001-m.jpg\"/><img alt=\"image\" data-lg-src=\"/cms/asset/5e9b2747-d7e3-4745-ba25-1a03e72ddbf7/bju70222-gra-0001-m.jpg\" loading=\"lazy\" src=\"/cms/asset/03e5af1f-df8c-4263-be32-36c164c6f64f/bju70222-gra-0001-m.png\" title=\"image\"/></picture><p></p>\u0000</div>\u0000</figure>\u0000</div>\u0000<p>She further strengthened her academic background through a 9-month research fellowship at the Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf (UKE), Germany, a leading international referral centre for prostate cancer. During this period, she was actively involved in clinical research projects focusing on prostate cancer.</p>\u0000<p>Dr. Francesca Ambrosini is actively involved in peer review for international urological journals. She is an associate member of the EAU Young Academic Urologists (YAU) Prostate Cancer Working Group and is actively engaged in collaborative research and academic activities within the international urological community.</p>\u0000<p><b>Marilyn Ashley</b></p>\u0000<div>Dr. Marilyn Ashley is a postdoctoral research associate with the Sexual Health Research Lab at Queen's University and a Part-Time Professor in Psychology at the University of Ottawa. She earned her bachelor's degree in Psychology, with a minor in Women's and Gender Studies, at Carleton University, completing her honours thesis under Dr. Anne Bowker. She then completed her PhD in Experimental Psychology at the University of Ottawa under Dr. Krystelle Shaughnessy. Dr. Ashley has published widely on sexual communication, digital intimacy, psychometric measurement, and 2SLGBTQ+ health. Her current projects with Dr. Caroline Pukall include a randomised controlled trial of an online pelvic health program for women with vulvodynia, clinical validation of a sexual self-concept scale, and a four-year longitudinal study on post-SSRI/SNRI sexual dysfunction focused on symptom trajectories, predictors, and bio-psycho-sexual outcomes. Across all projects, Dr. Ashley takes a person-centred approach, critically evaluating whether widely used theories and measurement tools are valid for marginalised populations and adapting them when they are not. Her work aims to centre minoritised voices and develo","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"32 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147368494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karin Andersen,Janni Søvsø Hjelmager,Thomas Emil Andersen,Kristian Stærk
{"title":"Response to: Bridging research and patient experience in chronic urinary tract infection.","authors":"Karin Andersen,Janni Søvsø Hjelmager,Thomas Emil Andersen,Kristian Stærk","doi":"10.1111/bju.70186","DOIUrl":"https://doi.org/10.1111/bju.70186","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"16 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147351099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frederik K Palshof,Lina S Mørch,Klaus Brasso,Niels Kroman,Signe Benzon Larsen,Andreas Røder,Hein V Stroomberg
OBJECTIVETo assess the prostate-specific antigen (PSA) testing and prostate cancer-related outcomes in a national, publicly funded healthcare setting, with recommendations against testing of asymptomatic men.SUBJECTS AND METHODSAll men born between 1920 and 1970, alive and residing in Denmark on 1 January 2014, were quarried in the national health registries. Age-standardised rates (ASR) per 100 000 men for men aged >50 years and cumulative incidence at 100 years by Aalen Johansen estimator with delayed entry were estimated for PSA testing, prostate histology, biopsy, prostate cancer diagnosis, and prostate cancer-specific death.RESULTSAmong 1 371 099 eligible men, the ASR of PSA testing in 2023 was 14 659 tests per 100 000 men (95% confidence interval [CI] 14 585-14 733), and 21 828 tests per 100 000 men (95% CI 21 646-22 111) in men aged 70-79 years. Cumulative incidence at 100 years of a PSA test was 84% (95% CI 84-84%), prostate histology 20% (95% CI 20-20%), biopsy 15% (95% CI 15-15%), prostate cancer diagnosis 12% (95% CI 11-12%), and prostate cancer-specific death 5.0% (95% CI 5.0-5.1%). The median (interquartile range [IQR]) age at initial PSA test was 60 (52-67) years, 70 (64-76) years at prostate histology and biopsy, 72 (66-78) years at prostate cancer diagnosis, and 84 (78-89) years at prostate cancer-specific death.CONCLUSIONSIn Denmark PSA testing rates are high and prevalent in older ages, despite restrictive national guidelines and active training against PSA testing for general practitioners. The findings support the discussion of whether the availability of the PSA test should be reconsidered to minimise the harms associated with unnecessary testing.
目的评估前列腺特异性抗原（PSA）检测和前列腺癌相关结果在国家公共资助的医疗机构，并建议不检测无症状的男性。研究对象和方法所有出生于1920年至1970年，2014年1月1日居住在丹麦的男性都在国家健康登记处进行了采集。通过延迟进入的Aalen Johansen估计器，对年龄在50岁至50岁之间的每10万名男性的年龄标准化率（ASR）和100岁时的累积发病率进行了PSA检测、前列腺组织学、活检、前列腺癌诊断和前列腺癌特异性死亡的估计。结果在1 371 099名符合条件的男性中，2023年PSA检测的ASR为每10万名男性14 659例（95%可信区间[CI] 14 585-14 733）， 70-79岁男性的ASR为每10万名男性21 828例（95% CI 21 646-22 111）。100年PSA检测累积发病率为84% (95% CI 84-84%)，前列腺组织学20% (95% CI 20-20%)，活检15% (95% CI 15-15%)，前列腺癌诊断12% (95% CI 11-12%)，前列腺癌特异性死亡5.0% （95% CI 5.0-5.1%）。首次PSA检测的中位年龄（四分位间距[IQR]）为60（52-67）岁，前列腺组织学和活检的中位年龄为70（64-76）岁，前列腺癌诊断的中位年龄为72（66-78）岁，前列腺癌特异性死亡的中位年龄为84（78-89）岁。结论在丹麦，尽管有严格的国家指南和针对全科医生PSA检测的积极培训，但PSA检测率高且在老年人中普遍存在。研究结果支持是否应该重新考虑PSA检测的可用性，以尽量减少不必要检测带来的危害的讨论。
{"title":"Prostate-specific antigen testing and prostate cancer-related outcomes: a Danish nationwide study.","authors":"Frederik K Palshof,Lina S Mørch,Klaus Brasso,Niels Kroman,Signe Benzon Larsen,Andreas Røder,Hein V Stroomberg","doi":"10.1111/bju.70208","DOIUrl":"https://doi.org/10.1111/bju.70208","url":null,"abstract":"OBJECTIVETo assess the prostate-specific antigen (PSA) testing and prostate cancer-related outcomes in a national, publicly funded healthcare setting, with recommendations against testing of asymptomatic men.SUBJECTS AND METHODSAll men born between 1920 and 1970, alive and residing in Denmark on 1 January 2014, were quarried in the national health registries. Age-standardised rates (ASR) per 100 000 men for men aged >50 years and cumulative incidence at 100 years by Aalen Johansen estimator with delayed entry were estimated for PSA testing, prostate histology, biopsy, prostate cancer diagnosis, and prostate cancer-specific death.RESULTSAmong 1 371 099 eligible men, the ASR of PSA testing in 2023 was 14 659 tests per 100 000 men (95% confidence interval [CI] 14 585-14 733), and 21 828 tests per 100 000 men (95% CI 21 646-22 111) in men aged 70-79 years. Cumulative incidence at 100 years of a PSA test was 84% (95% CI 84-84%), prostate histology 20% (95% CI 20-20%), biopsy 15% (95% CI 15-15%), prostate cancer diagnosis 12% (95% CI 11-12%), and prostate cancer-specific death 5.0% (95% CI 5.0-5.1%). The median (interquartile range [IQR]) age at initial PSA test was 60 (52-67) years, 70 (64-76) years at prostate histology and biopsy, 72 (66-78) years at prostate cancer diagnosis, and 84 (78-89) years at prostate cancer-specific death.CONCLUSIONSIn Denmark PSA testing rates are high and prevalent in older ages, despite restrictive national guidelines and active training against PSA testing for general practitioners. The findings support the discussion of whether the availability of the PSA test should be reconsidered to minimise the harms associated with unnecessary testing.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"8 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The nascent role of circulating tumour DNA in the management of non-muscle-invasive bladder cancer.","authors":"Richard T Bryan,Keval Patel,Douglas G Ward","doi":"10.1111/bju.70217","DOIUrl":"https://doi.org/10.1111/bju.70217","url":null,"abstract":"","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"37 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147329509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marta Pezzoli,Mattia Lo Re,Valeria Pizziconi,Marco Falcone,Mirko Preto,Marco Capece,Michele Rizzo,Guglielmo Mantica,Francesco Chierigo,Malte Vetterlein,Patrizio Vicini,François-Xavier Madec,Paul Neuville,Wai Gin Don Lee,Francesca Vedovo,Saskia Morgenstern,Marjan Waterloos,Miroslav Djordjevic,Wesley Verla,Lukasz Bialek,Juan Diego Tinajero,Jordán Scherñuk,Tim Ludwig,Silke Riechardt,Lisa Szyper,Maren Wenk,Jochen Heß,Julia Bohr,Andrea Minervini,Andrea Cocci,
OBJECTIVETo achieve an international expert consensus among surgeons on the indications, contraindications, and perioperative management of feminising genital surgery (FGS) for assigned-male-at-birth (AMAB) individuals, using a Delphi process.METHODSA two-round on-line Delphi survey (May-July 2025) followed by a final consensus meeting (September 2025) was conducted among 27 urological surgeons specialised in gender-affirming genital surgery. The survey explored eligibility criteria, risk factors, hormone therapy, counselling, and perioperative care. Consensus was defined a priori as ≥75% agreement or disagreement, with descriptive statistics summarising results.RESULTSIn all, 26 experts (96%) completed Round 1, and 24 (89%) completed Round 2. Consensus was achieved on 63 of 68 statements. Advanced age alone was not a contraindication but should be evaluated alongside comorbidities. Body mass index >24.9 kg/m2, diabetes, smoking, and cardiovascular disease were identified as significant risk factors for postoperative complications. Major psychiatric disorders and spinal cord injury were relative contraindications for FGS. Previous pelvic surgery or radiotherapy, as well as Charlson Comorbidity Index ≥3, were considered relative contraindications for vaginoplasty only. No consensus was reached on the timing of hormone therapy interruption or re-initiation. Preoperative counselling was essential for adherence to wound care and dilation protocols and for addressing complications such as infection, thromboembolism, bleeding, and bowel injury. Experts recommended genital hair removal, enoxaparin prophylaxis, postoperative dressings and catheterization for 3-5 days, and pelvic rehabilitation before and after surgery. A dilation protocol of three daily 30-min sessions was advised. FGS improved quality of life even in older or comorbid patients, although healing and function may be less optimal.CONCLUSIONThis study presents the first international Delphi consensus on indications and perioperative management of FGS in AMAB individuals, emphasising individualised, comorbidity-based assessment, structured counselling, and multidisciplinary care. Unresolved issues regarding hormone therapy require further study.
{"title":"International Delphi consensus on feminising genital surgery in assigned-male-at-birth individuals.","authors":"Marta Pezzoli,Mattia Lo Re,Valeria Pizziconi,Marco Falcone,Mirko Preto,Marco Capece,Michele Rizzo,Guglielmo Mantica,Francesco Chierigo,Malte Vetterlein,Patrizio Vicini,François-Xavier Madec,Paul Neuville,Wai Gin Don Lee,Francesca Vedovo,Saskia Morgenstern,Marjan Waterloos,Miroslav Djordjevic,Wesley Verla,Lukasz Bialek,Juan Diego Tinajero,Jordán Scherñuk,Tim Ludwig,Silke Riechardt,Lisa Szyper,Maren Wenk,Jochen Heß,Julia Bohr,Andrea Minervini,Andrea Cocci, ","doi":"10.1111/bju.70196","DOIUrl":"https://doi.org/10.1111/bju.70196","url":null,"abstract":"OBJECTIVETo achieve an international expert consensus among surgeons on the indications, contraindications, and perioperative management of feminising genital surgery (FGS) for assigned-male-at-birth (AMAB) individuals, using a Delphi process.METHODSA two-round on-line Delphi survey (May-July 2025) followed by a final consensus meeting (September 2025) was conducted among 27 urological surgeons specialised in gender-affirming genital surgery. The survey explored eligibility criteria, risk factors, hormone therapy, counselling, and perioperative care. Consensus was defined a priori as ≥75% agreement or disagreement, with descriptive statistics summarising results.RESULTSIn all, 26 experts (96%) completed Round 1, and 24 (89%) completed Round 2. Consensus was achieved on 63 of 68 statements. Advanced age alone was not a contraindication but should be evaluated alongside comorbidities. Body mass index >24.9 kg/m2, diabetes, smoking, and cardiovascular disease were identified as significant risk factors for postoperative complications. Major psychiatric disorders and spinal cord injury were relative contraindications for FGS. Previous pelvic surgery or radiotherapy, as well as Charlson Comorbidity Index ≥3, were considered relative contraindications for vaginoplasty only. No consensus was reached on the timing of hormone therapy interruption or re-initiation. Preoperative counselling was essential for adherence to wound care and dilation protocols and for addressing complications such as infection, thromboembolism, bleeding, and bowel injury. Experts recommended genital hair removal, enoxaparin prophylaxis, postoperative dressings and catheterization for 3-5 days, and pelvic rehabilitation before and after surgery. A dilation protocol of three daily 30-min sessions was advised. FGS improved quality of life even in older or comorbid patients, although healing and function may be less optimal.CONCLUSIONThis study presents the first international Delphi consensus on indications and perioperative management of FGS in AMAB individuals, emphasising individualised, comorbidity-based assessment, structured counselling, and multidisciplinary care. Unresolved issues regarding hormone therapy require further study.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"43 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana Fernández-Mardomingo,Jose Daniel Subiela,Alberto Artiles Medina,Wojciech Krajewski,Renate Pichler,Nils C H van Creij,María de la Palma de la Estella Lucena,Irene de la Parra,Cesar Mínguez Ojeda,Almudena Coloma,Luis Crespo Martínez,Pedro Del Olmo Durán,Daniel A González-Padilla,Felipe Villacampa,Júlia Aumatell,Pietro Scilipoti,Mattia Longoni,Marco Moschini,Mario de Angelis,Jorge Caño-Velasco,Roberto Contieri,Andrea Gallioli,David D'Andrea,Eduardo Albers Acosta,Tarek Ajami,Elisabeth Grobet-Jeandin,Francesco Del Giudice,Valerio Santarelli,Aleksander Ślusarczyk,Simone Albisinni,Francesco Soria,Laura S Mertens,Karl Tully,Andrea Mari,Félix Guerrero-Ramos,Mario Alvarez-Maestro,Franklin Anagua Melendres,Oscar Buisan,Luca Afferi,Pablo Gajate,Patricia Guerrero,Ana Saiz,Benjamin Pradere,Francisco Javier Burgos Revilla,
OBJECTIVETo evaluate the prognostic impact of T-stage at re-transurethral resection of bladder (TURB) and its utility for refining risk stratification across European Association of Urology 2021 (EAU21) risk groups in patients with T1 high-grade (HG) non-muscle-invasive bladder cancer (NMIBC) treated with adequate Bacillus Calmette-Guérin (BCG).PATIENTS AND METHODSRetrospective multicentre study including patients with primary or secondary T1HG NMIBC treated with TURB, re-TURB, and adequate BCG between 2007 and 2020 across 28 European academic centres. Patients were stratified according to re-TURB pathological stage (T0, Ta, Tis, T1) and EAU21 risk groups. Kaplan-Meier, Cox regression, and competing-risk methods were used to evaluate recurrence-free survival (RFS), HG-RFS, progression-free survival (PFS), and cancer-specific mortality (CSM). A mixture cure model estimated statistical cure fractions for the overall cohort.RESULTSAmong 1403 patients, residual disease at re-TURB was identified in 38.8%, including 17.7% with persistent T1. Residual T1 was consistently associated with worse outcomes. Compared with T0/Ta, persistent T1 at re-TURB showed substantially lower 5-year HG-RFS and PFS, with high-grade recurrence in over half of patients and 5-year progression up to 48% in high- and very high-risk groups. The 5-year CSM rose from 6-7% (T0/Ta) to 23% (T1). On multivariable analysis, residual T1 was independently associated with worse HG-RFS (hazard ratio 2.40), PFS (hazard ratio 3.10), and CSM (hazard ratio 3.00). Cure modelling showed lower cure fractions for residual T1 compared with T0/Ta.CONCLUSIONResidual T1 at re-TURB is strongly associated with adverse long-term oncological outcomes in BCG-treated T1HG NMIBC and markedly reduces the likelihood of statistical cure. High- and very high-risk patients with persistent T1 represent a biologically adverse subgroup in whom standard BCG may be insufficient.
{"title":"Impact of re-transurethral resection of bladder staging on risk stratification of high-grade T1 non-muscle-invasive bladder cancer across European Association of Urology 2021 risk groups.","authors":"Ana Fernández-Mardomingo,Jose Daniel Subiela,Alberto Artiles Medina,Wojciech Krajewski,Renate Pichler,Nils C H van Creij,María de la Palma de la Estella Lucena,Irene de la Parra,Cesar Mínguez Ojeda,Almudena Coloma,Luis Crespo Martínez,Pedro Del Olmo Durán,Daniel A González-Padilla,Felipe Villacampa,Júlia Aumatell,Pietro Scilipoti,Mattia Longoni,Marco Moschini,Mario de Angelis,Jorge Caño-Velasco,Roberto Contieri,Andrea Gallioli,David D'Andrea,Eduardo Albers Acosta,Tarek Ajami,Elisabeth Grobet-Jeandin,Francesco Del Giudice,Valerio Santarelli,Aleksander Ślusarczyk,Simone Albisinni,Francesco Soria,Laura S Mertens,Karl Tully,Andrea Mari,Félix Guerrero-Ramos,Mario Alvarez-Maestro,Franklin Anagua Melendres,Oscar Buisan,Luca Afferi,Pablo Gajate,Patricia Guerrero,Ana Saiz,Benjamin Pradere,Francisco Javier Burgos Revilla, ","doi":"10.1111/bju.70207","DOIUrl":"https://doi.org/10.1111/bju.70207","url":null,"abstract":"OBJECTIVETo evaluate the prognostic impact of T-stage at re-transurethral resection of bladder (TURB) and its utility for refining risk stratification across European Association of Urology 2021 (EAU21) risk groups in patients with T1 high-grade (HG) non-muscle-invasive bladder cancer (NMIBC) treated with adequate Bacillus Calmette-Guérin (BCG).PATIENTS AND METHODSRetrospective multicentre study including patients with primary or secondary T1HG NMIBC treated with TURB, re-TURB, and adequate BCG between 2007 and 2020 across 28 European academic centres. Patients were stratified according to re-TURB pathological stage (T0, Ta, Tis, T1) and EAU21 risk groups. Kaplan-Meier, Cox regression, and competing-risk methods were used to evaluate recurrence-free survival (RFS), HG-RFS, progression-free survival (PFS), and cancer-specific mortality (CSM). A mixture cure model estimated statistical cure fractions for the overall cohort.RESULTSAmong 1403 patients, residual disease at re-TURB was identified in 38.8%, including 17.7% with persistent T1. Residual T1 was consistently associated with worse outcomes. Compared with T0/Ta, persistent T1 at re-TURB showed substantially lower 5-year HG-RFS and PFS, with high-grade recurrence in over half of patients and 5-year progression up to 48% in high- and very high-risk groups. The 5-year CSM rose from 6-7% (T0/Ta) to 23% (T1). On multivariable analysis, residual T1 was independently associated with worse HG-RFS (hazard ratio 2.40), PFS (hazard ratio 3.10), and CSM (hazard ratio 3.00). Cure modelling showed lower cure fractions for residual T1 compared with T0/Ta.CONCLUSIONResidual T1 at re-TURB is strongly associated with adverse long-term oncological outcomes in BCG-treated T1HG NMIBC and markedly reduces the likelihood of statistical cure. High- and very high-risk patients with persistent T1 represent a biologically adverse subgroup in whom standard BCG may be insufficient.","PeriodicalId":8985,"journal":{"name":"BJU International","volume":"99 1","pages":""},"PeriodicalIF":4.5,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147329510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ankur Malpani, Jonathan T Ryan, Hui Yu, Nachiketh Soodana-Prakash, Archan Khandekar, Tarek Ajami, Adam Williams, Zoe Szczotka, Mohammed Alshalalfa, Yangyang Hao, Elai Davicioni, Sanjaya Swain, Oleksandr Kryvenko, Alan Dal Pra, Radka Stoyanova, Sandra Gaston, Alan Pollack, Brandon A Mahal, Matthew Abramowitz, Bruno Nahar, Chad R Ritch, Bruce Kava, Mark L Gonzalgo, Dipen J Parekh, Sanoj Punnen
Objectives: To evaluate basal-luminal cell of origin subtyping using Prediction Analysis of Microarray of 50 genes (PAM50) genomic classification profiles for predicting disease progression in men undergoing active surveillance (AS) for prostate cancer (PCa).
Patients and methods: In the prospective Miami Active Surveillance Trial (MAST) trial, 205 men undergoing AS received serial multiparametric magnetic resonance imaging (MRI) and biopsies, including MRI-targeted and systematic sampling. The highest-grade core from each biopsy was sent for expression profiling using Decipher, a clinical-grade transcriptome assay (Veracyte Inc., San Diego, CA, USA). Basal-luminal subtyping was evaluated using PAM50 molecular subtype models. PCa grade progression was compared across subtypes, as were gene mutation signatures, prognostic indices, and pathway activities. Kaplan-Meier curves, log-rank test, and multivariable Cox regression were used to assess association between PAM50 and grade progression. Heatmaps and volcano plots were rendered to illustrate potential mechanistical differences between PAM50 subtypes.
Results: Of the 205 patients, 128 had transcriptome data for baseline basal-luminal classification. PAM50 identified 46 Luminal A (LA), 26 Luminal B (LB), and 56 Basal subtypes. Decipher scores were lowest in LA, followed by Basal, and highest in LB. Grade progression-free survival was worse in patients with the LB subtype (median 1.7 years) compared to those with LA and Basal subtypes (median 2.9 years; log-rank P = 0.005); LB patients had grade progression-free survival of 34% by 24 months of AS, compared to 63% for Basal or 68% for LA. Transcriptome analysis showed distinct enrichment profiles for each subtype, with LB strongly associated with SPOP and CHD1 mutations. Limitations include small sample size and single-institution setting.
Conclusion: The PAM50 basal-luminal subtyping shows promise as a molecular classification tool for predicting progression risk in PCa. This is one of the only prospective studies evaluating PAM50 subtyping for predicting cancer progression in a cohort of men undergoing AS for PCa.
目的：利用50基因微阵列预测分析（PAM50）基因组分类谱来评估基底腔细胞起源亚型，以预测前列腺癌（PCa）主动监测（AS）男性的疾病进展。患者和方法：在前瞻性迈阿密主动监测试验（MAST）中，205名患有AS的男性接受了一系列多参数磁共振成像（MRI）和活检，包括MRI靶向和系统取样。每个活检中最高级别的核心被送去使用Decipher进行表达谱分析，这是一种临床级转录组测定（Veracyte Inc., San Diego， CA， USA）。采用PAM50分子亚型模型评估基底腔亚型。比较了不同亚型的PCa分级进展，以及基因突变特征、预后指标和途径活性。采用Kaplan-Meier曲线、log-rank检验和多变量Cox回归评估PAM50与年级进展的相关性。绘制了热图和火山图，以说明PAM50亚型之间潜在的机械差异。结果：205例患者中，128例具有基线基底腔分类的转录组数据。PAM50鉴定出46个Luminal A （LA）、26个Luminal B （LB）和56个Basal亚型。破译评分在LA患者中最低，其次是基础亚型，在LB患者中最高。与LA和基础亚型患者（中位2.9年，log-rank P = 0.005）相比，LB亚型患者的分级无进展生存期（中位1.7年）更差；到24个月AS时，LB患者的无进展生存率为34%，而基础组为63%，LA组为68%。转录组分析显示，每种亚型都有不同的富集谱，其中LB与SPOP和CHD1突变密切相关。局限性包括样本量小和单一机构设置。结论：PAM50基底腔分型有望作为预测前列腺癌进展风险的分子分类工具。这是唯一一项评估PAM50亚型在前列腺癌患者中预测癌症进展的前瞻性研究。
{"title":"Prediction Analysis of Microarray of 50 genes (PAM50) classifier validated for predicting prostate cancer progression in active surveillance: Miami Active Surveillance Trial (MAST).","authors":"Ankur Malpani, Jonathan T Ryan, Hui Yu, Nachiketh Soodana-Prakash, Archan Khandekar, Tarek Ajami, Adam Williams, Zoe Szczotka, Mohammed Alshalalfa, Yangyang Hao, Elai Davicioni, Sanjaya Swain, Oleksandr Kryvenko, Alan Dal Pra, Radka Stoyanova, Sandra Gaston, Alan Pollack, Brandon A Mahal, Matthew Abramowitz, Bruno Nahar, Chad R Ritch, Bruce Kava, Mark L Gonzalgo, Dipen J Parekh, Sanoj Punnen","doi":"10.1111/bju.70202","DOIUrl":"https://doi.org/10.1111/bju.70202","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate basal-luminal cell of origin subtyping using Prediction Analysis of Microarray of 50 genes (PAM50) genomic classification profiles for predicting disease progression in men undergoing active surveillance (AS) for prostate cancer (PCa).</p><p><strong>Patients and methods: </strong>In the prospective Miami Active Surveillance Trial (MAST) trial, 205 men undergoing AS received serial multiparametric magnetic resonance imaging (MRI) and biopsies, including MRI-targeted and systematic sampling. The highest-grade core from each biopsy was sent for expression profiling using Decipher, a clinical-grade transcriptome assay (Veracyte Inc., San Diego, CA, USA). Basal-luminal subtyping was evaluated using PAM50 molecular subtype models. PCa grade progression was compared across subtypes, as were gene mutation signatures, prognostic indices, and pathway activities. Kaplan-Meier curves, log-rank test, and multivariable Cox regression were used to assess association between PAM50 and grade progression. Heatmaps and volcano plots were rendered to illustrate potential mechanistical differences between PAM50 subtypes.</p><p><strong>Results: </strong>Of the 205 patients, 128 had transcriptome data for baseline basal-luminal classification. PAM50 identified 46 Luminal A (LA), 26 Luminal B (LB), and 56 Basal subtypes. Decipher scores were lowest in LA, followed by Basal, and highest in LB. Grade progression-free survival was worse in patients with the LB subtype (median 1.7 years) compared to those with LA and Basal subtypes (median 2.9 years; log-rank P = 0.005); LB patients had grade progression-free survival of 34% by 24 months of AS, compared to 63% for Basal or 68% for LA. Transcriptome analysis showed distinct enrichment profiles for each subtype, with LB strongly associated with SPOP and CHD1 mutations. Limitations include small sample size and single-institution setting.</p><p><strong>Conclusion: </strong>The PAM50 basal-luminal subtyping shows promise as a molecular classification tool for predicting progression risk in PCa. This is one of the only prospective studies evaluating PAM50 subtyping for predicting cancer progression in a cohort of men undergoing AS for PCa.</p>","PeriodicalId":8985,"journal":{"name":"BJU International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147302158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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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