Actas urologicas espanolas最新文献_第9页

Surgical competencies in Urology: Agreement between the perceptions of trainees and practicing professionals in a Latin American country 泌尿外科手术能力：拉丁美洲国家培训生和执业专业人员之间的共识。

Actas urologicas espanolas

Pub Date : 2025-09-01 DOI: 10.1016/j.acuroe.2025.501794

J. Scherñuk, M.G. Dorsemaine, J.K. Toapanta Ortega, D. Zimmermann, I.P. Tobia, D. Santillán

Introduction

Consensus remains lacking on which surgeries should be deemed essential for general urologists and which should be reserved for subspecialists. This study aims to compare the perceptions of urology trainees (Trainees) and practicing urologists (PractUrol) regarding the relevance of surgeries for independent practice and subspecialist training.

Methods

Cross-sectional comparative study on Trainees and PractUrol from a Latin-American country. Participants completed a Google Forms® questionnaire on 56 urological surgeries in September–October 2023, categorizing each as Essential Index (E-index), Supervised Index (Sup-index), or Subspecialty (Subspec). Statistical comparisons were performed using Chi-square or Fisher’s exact tests with Bonferroni correction.

Results

Among 138 participants (109 PractUrol, 29 Trainees), 78.6% (44/56) of surgeries showed agreement between groups, with 13 surgeries achieving over 75% concordance. Disagreements were noted for 21.4% (12/56) of surgeries: (1) Microvaricocelectomy, penectomy, DVIU, ureteral reimplantation, and vesicovaginal fistula repair were more often classified as Subspec by Trainees but as E-index by PractUrol. (2) Radical cystectomy with orthotopic diversion and Boari Flap were classified as Subspec by Trainees but as Sup-index by PractUrol. (3) Partial cystectomy, pelvic, and inguinal lymphadenectomy were more frequently deemed Subspec by Trainees. (4) Flexible ureteroscopy was considered E-index by Trainees but Sup-index by PractUrol. (5) Artificial urinary sphincter placement was more often classified as Sup-index by PractUrol.

Conclusion

There is substantial agreement on the relevance of urological surgeries between PractUrol and Trainees, including 13 surgeries deemed essential by over 75% of participants. However, differing opinions on 12 surgeries highlight areas for further discussion.

引言：对于哪些手术应该被认为是普通泌尿科医生必需的，哪些应该被保留给专科医生，共识仍然缺乏。本研究旨在比较泌尿外科培训生（受训者）和执业泌尿科医生（PractUrol）对独立执业和专科培训手术相关性的看法。方法：对来自拉美某国的实习生和PractUrol进行横断面比较研究。参与者于2023年9月至10月完成了56例泌尿外科手术的谷歌Forms®问卷调查，并将其分类为基本指数（E-index）、监督指数（Sup-index）或亚专科（Subspec）。统计学比较采用卡方检验或Fisher精确检验，并进行Bonferroni校正。结果：138例患者（109例PractUrol， 29例实习生）中，78.6%（44/56）例手术组间一致性，其中13例手术一致性达到75%以上。21.4%（12/56）的手术存在差异：(1)微精索静脉曲张切除术、阴茎切除术、DVIU、输尿管再植和膀胱阴道瘘修补术被练习者分类为Subspec，而被PractUrol分类为E-index。(2)根治性膀胱切除术伴原位转流和Boari皮瓣被学员归为Subspec， PractUrol归为Sup-index。(3)部分膀胱切除术、盆腔和腹股沟淋巴结切除术更常被学员视为亚规范。(4)柔性输尿管镜被学员认为是E-index，而PractUrol认为是Sup-index。(5) PractUrol多将人工尿道括约肌置入术分类为supi -index。结论：PractUrol和受训者对泌尿外科手术的相关性有实质性的一致意见，包括75%以上的参与者认为必要的13种手术。然而，对12种手术的不同意见突出了进一步讨论的领域。

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引用次数: 0

Mapping regional disparities in testicular cancer mortality across Spain (2004–2023) 绘制西班牙睾丸癌死亡率的区域差异（2004-2023年）。

Actas urologicas espanolas

Pub Date : 2025-09-01 DOI: 10.1016/j.acuroe.2025.501800

L. Cayuela , S. Cabrera Fernández , R. Roldán Testillano , M. Ortega Calvo , A. Cayuela

Introduction

This study investigates testicular cancer (TC) mortality trends and spatial patterns in Spain, utilizing provincial-level spatial analysis to identify high-risk clusters.

Methods

An ecological study was conducted using TC mortality data (ICD-10 code C62) from the Spanish National Institute of Statistics (2004–2023). Age-standardized mortality rates (ASMRs) were calculated using the direct method. Temporal trends were analyzed with joinpoint regression. Spatial patterns were assessed using standardized mortality ratios (SMR), smoothed relative risk (RR), and posterior probabilities (PP) through Bayesian hierarchical models. Spatial clustering was examined with Tango’s test and Kulldorff’s likelihood ratio test.

Results

A total of 909 TC deaths were recorded, with ASMRs ranging from 0.14 to 0.26 per 1,000,000 inhabitants. No significant temporal trends were observed. Age-specific mortality showed a bimodal distribution, peaking at ages 35–39 and 85+. The highest SMRs were found in Zamora (2.58), Segovia (2.64), and Soria (2.39), while the lowest were in Madrid (0.66) and Barcelona (0.55). Bayesian spatial analysis identified elevated relative risk in Badajoz (RR 1.6), Huelva (RR 1.47), and Sevilla (RR 1.4). Kulldorff’s analysis revealed a high-mortality cluster in southwestern Spain (Huelva, Sevilla, Badajoz), with a secondary cluster extending to neighbouring provinces.

Conclusions

While TC mortality in Spain remained stable, significant regional disparities exist. High-risk provinces and mortality clusters highlight potential inequalities in healthcare access, socioeconomic conditions, and environmental exposures.

前言：本研究调查了西班牙睾丸癌（TC）死亡率趋势和空间格局，利用省级空间分析来确定高危集群。方法：采用西班牙国家统计局（2004-2023）的TC死亡率数据（ICD-10代码C62）进行生态学研究。采用直接法计算年龄标准化死亡率（ASMRs）。用关节点回归分析时间趋势。通过贝叶斯层次模型，采用标准化死亡率（SMR）、平滑相对风险（RR）和后验概率（PP）评估空间格局。空间聚类分析采用Tango检验和Kulldorff似然比检验。结果：共记录了909例TC死亡，asmr范围为每100万居民0.14至0.26。没有观察到明显的时间趋势。按年龄划分的死亡率呈双峰分布，在35-39岁和85岁以上达到高峰。smr最高的是萨莫拉（2.58）、塞戈维亚（2.64）和索里亚（2.39），最低的是马德里（0.66）和巴塞罗那（0.55）。贝叶斯空间分析发现巴达霍斯（RR 1.6）、韦尔瓦（RR 1.47）和塞维利亚（RR 1.4）的相对风险升高。Kulldorff的分析显示，西班牙西南部（韦尔瓦、塞维利亚、巴达霍斯）有一个高死亡率聚集群，第二个聚集群延伸到邻近省份。结论：西班牙的TC死亡率保持稳定，但存在显著的地区差异。高风险省份和死亡率集群突出了医疗保健获取、社会经济条件和环境暴露方面的潜在不平等。

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引用次数: 0

Clinical profile and risk factors identified in patients with renal cancer in Mexican population 墨西哥人群肾癌患者的临床概况和危险因素

Actas urologicas espanolas

Pub Date : 2025-09-01 DOI: 10.1016/j.acuroe.2025.501814

G. Sánchez-Villaseñor , E.A. Pérez-Du Pond , I. Jasso-García , S.J. Vázquez-Sánchez , R.C. García-Romero , J.P. Gómez-Sierra , M.G. Castillo-Cardiel , A.S. Álvarez-Villaseñor , G. Cervantes-Guevara , E. Cervantes-Pérez , S. Ramírez-Ochoa , A. González-Ojeda , C. Fuentes-Orozco

Introduction

Renal cell carcinoma, ranked 14th in global incidence, is more common in men. Its incidence rates increase with age, peaking in individuals older than 75 years. The classic triad is present in only 17% of cases. Surgical management involves total or partial nephrectomy, both associated with potential complications.

Objective

To identify the clinical profile and risk factors in patients with renal cell carcinoma.

Methodology

An observational, cross-sectional, and analytical study was conducted on patients with renal cell carcinoma treated surgically in the Urology Department from January 2020 to June 2023. Demographic and clinical characteristics were analyzed in relation to TNM staging, histologic subtype, and morbidity and mortality.

Results

Among 83 patients, 48 (57%) were men, with a mean age of 59.2 years (SD 10.5). Hypertension (HTN) and obesity were the most frequent comorbidities, each affecting 37 patients (44.6%). Flank pain (37 patients, 44.6%) and hematuria (23 patients, 27.7%) were the most common manifestations. Age >50 years was associated with advanced stages (p = 0.003, OR 5.744, 95% CI 1.698–19.424), while obesity was associated with a lower risk of advanced stages (p = 0.0042, OR 0.220, 95% CI 0.075–0.648). Complications of open nephrectomy included bleeding in 26 patients (38.8%) and organ injury in 2 patients (2.9%). Mortality was reported in 1 patient.

Conclusion

Age >50 years is a risk factor for advanced stages, while obesity is associated with a lower risk. Hematuria and flank pain were common, whereas abdominal mass was rarely reported.

导读：肾细胞癌在全球发病率中排名第14位，多见于男性。其发病率随着年龄的增长而增加，在75岁以上的人群中达到高峰。典型的三联征只出现在17%的病例中。手术治疗包括全部或部分肾切除术，两者都有潜在的并发症。目的：探讨肾细胞癌患者的临床特点及危险因素。方法：对2020年1月至2023年6月泌尿外科手术治疗的肾细胞癌患者进行观察性、横断面性和分析性研究。分析人口统计学和临床特征与TNM分期、组织学亚型、发病率和死亡率的关系。结果：83例患者中，男性48例（57%），平均年龄59.2岁（SD 10.5）。高血压（HTN）和肥胖是最常见的合并症，各影响37例（44.6%）。腹部疼痛（37例，44.6%）和血尿（23例，27.7%）是最常见的表现。年龄50岁与晚期相关（p = 0.003, OR 5.744, 95% CI 1.698-19.424），而肥胖与晚期风险较低相关（p = 0.0042, OR 0.220, 95% CI 0.075-0.648）。开放性肾切除术并发症为出血26例（38.8%），脏器损伤2例（2.9%）。死亡1例。结论：年龄在50岁之间是晚期糖尿病的危险因素，而肥胖的风险较低。血尿和腹部疼痛是常见的，而腹部肿块很少报道。

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引用次数: 0

Is it truly necessary to achieve complete stone-free status in cases of staghorn calculi? 鹿角型结石真的有必要完全清除结石吗？

Actas urologicas espanolas

Pub Date : 2025-09-01 DOI: 10.1016/j.acuroe.2025.501812

G. Freschi , D.P. Resuto , R.H. Astolfi , W.R. Molina , A. Meller

Introduction and objectives

To evaluate long-term outcomes in staghorn stone patients with residual fragments following surgical treatment.

Materials and methods

A retrospective study of patients who underwent percutaneous nephrolithotripsy for staghorn stones and long term follow up were divided into two groups: residual stones versus non-residual stones. The occurrence of new stones or fragment growth, infectious events, and renal function were evaluated. Patients with a follow-up period of less than one year were excluded.

Results

A total of 87 patients (75.9% female) were included in the study. Of these, 21.8% were stone-free, while 78.2% exhibited residual fragments with a median size of 7 mm (3.5–11.5 mm). The average follow-up period was 27 months (21–36 months). Only 24.1% experienced recurrence or growth of residual fragments, with a median growth of 10 mm (6−12 mm). Additionally, 14.9% of patients developed urinary infections during the follow-up period. No significant differences were observed between stone-free patients and those with residual fragments in terms of recurrence, residual fragments growth, infectious events, or deterioration in renal function. Similarly, no differences were noted when comparing patients with positive or negative cultures.

Conclusions

The incidence of recurrence, growth of residual fragments, infectious events, and deterioration of renal function was comparable between patients with and without residual stones. Furthermore, the presence of positive preoperative or intraoperative cultures did not influence these outcomes.

前言和目的：评价手术治疗后有残留碎片的鹿角结石患者的长期预后。材料与方法：回顾性研究经皮肾镜碎石术治疗鹿角结石的患者，并进行长期随访，分为残留结石组和非残留结石组。评估新结石或碎片生长情况、感染事件和肾功能。随访期少于一年的患者被排除在外。结果：共纳入87例患者，其中女性75.9%。其中，21.8%无结石，78.2%残留碎片，中位尺寸为7 mm （3.5-11.5 mm）。平均随访27个月（21 ~ 36个月）。仅有24.1%复发或残存碎片生长，中位生长10 mm （6-12 mm）。此外，14.9%的患者在随访期间发生尿路感染。无结石患者与残留碎片患者在复发、残留碎片生长、感染事件或肾功能恶化方面无显著差异。同样，当比较阳性或阴性培养的患者时，也没有发现差异。结论：有和没有残留结石的患者的复发、残留碎片生长、感染事件和肾功能恶化的发生率是相当的。此外，术前或术中培养阳性并不影响这些结果。

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引用次数: 0

Infrared spectroscopic analysis of urinary stone composition 尿路结石成分的红外光谱分析。

Actas urologicas espanolas

Pub Date : 2025-09-01 DOI: 10.1016/j.acuroe.2025.501810

X. Han , Z. Zhang , P. Yao , X. Yang

Objective

To assess the composition of urinary stones in Lanzhou area and provide a reference basis for its clinical prevention and treatment.

Methods

A total of 1284 patients with urinary stones were included in the study. The differences in the distribution of stone components among different genders and ages were then analyzed.

Results

The overall male-to-female ratio of the cases was 3.2:1. The average age of the patients was 45.1 ± 14.0 years old. The ratio between upper and lower urinary tract stones was 7.13:1. Mixed stone composition accounted for the majority, 79.0% (1014/1284), with calcium oxalate monohydrate + calcium oxalate dihydrate + carbonate apatite being the most prevalent at 35% (449/1284), and calcium oxalate monohydrate stones being the most prevalent of the single components at 17.8% (228/1284). Apatite carbonate 62.2% (191/307) and magnesium ammonium phosphate hexahydrate 9.8% (30/307) were significantly higher in female patients compared to apatite carbonate 55.2% (539/977) and 2.8% (27/977) in male patients. Calcium oxalate was significantly more prevalent in patients aged 18–60 years than in patients <18 and ≥60 years. The proportion of patients over the age of 60 with urinary stones (10.4%) was significantly higher than patients in other age groups.

Conclusion

Urological stones in Lanzhou area are mainly of mixed type, calcium oxalate monohydrate + calcium oxalate dihydrate + carbonate apatite is the most; with the increase of patient's age, the proportion of uric acid stones increases; the distribution of urinary stone components has significant differences with different genders of patients and different age groups, which is of great significance for clinical prevention and treatment.

目的：了解兰州地区泌尿系结石的组成，为其临床防治提供参考依据。方法：共纳入1284例泌尿系结石患者。然后分析了不同性别和年龄的石质成分分布的差异。结果：全部病例的男女比例为3.2:1。患者平均年龄45.1±14.0岁。上、下尿路结石的比例为7.13:1。混合石成分占多数，占79.0%(1014/1284)，其中一水草酸钙+二水草酸钙+碳酸盐磷灰石最普遍，占35%(449/1284)，一水草酸钙结石是单一成分中最普遍的，占17.8%（228/1284）。女性患者碳酸磷灰石阳性率62.2%（191/307）、六水磷酸铵镁阳性率9.8%（30/307）显著高于男性患者碳酸磷灰石阳性率55.2%（539/977）、2.8%（27/977）。结论：兰州地区泌尿系结石以混合型为主，以一水草酸钙+二水草酸钙+碳酸钙磷灰石居多；随着患者年龄的增加，尿酸结石的比例增加；尿石成分的分布在不同性别、不同年龄段的患者中存在显著差异，对临床防治具有重要意义。

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引用次数: 0

New insights and emerging approaches in bladder-sparing treatment for muscle-invasive bladder cancer 肌肉浸润性膀胱癌保膀胱治疗的新见解和新方法。

Actas urologicas espanolas

Pub Date : 2025-09-01 DOI: 10.1016/j.acuroe.2025.501758

J.D. Subiela , F. Guerrero-Ramos , Ó. Rodríguez-Faba , J. Aumatell , P. Gajate , F. López-Campos , E. Sevillano , M. Hernández-Arroyo , E. García-Rojo , A. Artiles Medina , D. Sáenz-Calzada , C. Gómez-Cañizo , J. Romero-Otero , Felipe Couñago

Introducction and objective

Muscle-invasive bladder cancer (MIBC) poses significant challenges, traditionally treated with radical cystectomy, a procedure with considerable morbidity and impact on quality of life. Bladder-sparing approaches aim to preserve the bladder while maintaining oncological efficacy. This review explores emerging perspectives in bladder-sparing strategies for MIBC, focusing on patient selection criteria, molecular characterization, non-invasive treatment response assessment, systemic therapies, radiation techniques, and the role of intravesical devices.

Methods

A comprehensive narrative review provides insights into novel perspectives in bladder-sparing strategies for treating MIBC.

Results

Patient selection criteria for bladder preservation remain challenging. While the traditional approach focuses on selecting candidates with MIBC with fewer clinicopathological risk characteristics, some studies suggest that histological variants and the presence of hydronephrosis may not be absolute exclusion criteria. Molecular classification data shows promise but lacks sufficient evidence, while immune cell infiltration may provide insights into potential treatment response. MRI and radiomics offer the potential for non-invasive treatment response assessment. Ongoing trials investigate new systemic therapies, radiation therapy approaches, and the role of intravesical devices in bladder preservation, with some preliminary data appearing promising.

Conclusion

Bladder-sparing strategies for MIBC are currently experiencing substantial evolution. Achieving optimal patient selection may entail the integration of clinical, radiological, histopathological, and molecular data. It is likely that shortly, multimodal approaches incorporating neoadjuvant systemic therapy, radiotherapy, intravesical devices, and possibly maintenance or adjuvant regimens guided by biomarker-driven strategies will become standard practice.

简介和目的：肌肉浸润性膀胱癌（MIBC）提出了重大挑战，传统上采用根治性膀胱切除术治疗，这一手术具有相当高的发病率和对生活质量的影响。保留膀胱入路的目的是在保持肿瘤疗效的同时保护膀胱。本综述探讨了MIBC保膀胱策略的新兴观点，重点关注患者选择标准、分子特征、非侵入性治疗反应评估、全身治疗、放射技术和膀胱内装置的作用。方法：通过全面的叙述综述，为治疗MIBC的保膀胱策略提供了新的视角。结果：膀胱保留患者的选择标准仍然具有挑战性。虽然传统的方法侧重于选择具有较少临床病理风险特征的MIBC候选人，但一些研究表明，组织学变异和肾积水的存在可能不是绝对的排除标准。分子分类数据显示有希望，但缺乏足够的证据，而免疫细胞浸润可能提供潜在治疗反应的见解。MRI和放射组学为非侵入性治疗反应评估提供了可能。正在进行的试验研究了新的全身治疗方法、放射治疗方法和膀胱内装置在膀胱保存中的作用，一些初步数据看起来很有希望。结论：MIBC的膀胱保留策略目前正在经历实质性的演变。实现最佳的患者选择可能需要整合临床、放射学、组织病理学和分子数据。可能在不久的将来，结合新辅助全身治疗、放疗、膀胱内装置以及可能由生物标志物驱动的策略指导的维持或辅助方案的多模式方法将成为标准做法。

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引用次数: 0

Managing hypospadias failure: A comprehensive review of strategies and outcomes 尿道下裂失败的处理：策略和结果的综合回顾。

Actas urologicas espanolas

Pub Date : 2025-09-01 DOI: 10.1016/j.acuroe.2025.501809

L.E. Jesus , J.L. Pippi-Salle

Introduction

Hypospadias surgery has a failure rate ranging from 10% for distal cases to over 30% for proximal cases. However, real-world outcomes may be worse, as some complications emerge late in puberty or are underreported. The expectations for surgical success have evolved, shifting from basic urinary and sexual functionality to achieving a normal penile appearance. Bias in research favors retrospective studies with short follow-ups, and qualitative research remains scarce. This review describes complications following hypospadias surgery, their management, and prognosis.

Methodology

A non-systematic critical review of existing literature on hypospadias complications and surgical management was conducted.

Results

Common complications include urethrocutaneous fistulae (UCF), glans dehiscence (GD), urethral stenosis (US), urethral diverticulae (UD), urine spraying, and recurrent curvature (RC). UCF is the most frequently reported complication, treated through multilayer closure with vascularized flap coverage. GD occurs more frequently in proximal hypospadias, requiring glans reformatting and tissue augmentation. US often manifests as meatal stenosis or neourethral strictures, requiring meatoplasty or staged urethroplasty. UD arises from loose urethral segments subjected to high urinary flow resistance and is managed via excision or remodeling. Urine spraying is linked to insufficient glans fusion or meatal irregularities, sometimes requiring surgical correction. RC is a significant complication impacting sexual function, requiring individualized correction through dorsal plication or ventral lengthening.

Conclusion

Hypospadias complications require individualized assessment and surgical planning. Late complications, often underrecognized, should be considered in long-term follow-up. Proper surgical technique selection and postoperative evaluation help mitigate recurrence and improve patient outcomes.

简介：尿道下裂手术的失败率从远端10%到近端30%以上不等。然而，现实世界的结果可能更糟，因为一些并发症出现在青春期后期或被低估。对手术成功的期望已经发生了变化，从基本的泌尿和性功能转移到实现正常的阴茎外观。研究偏向于短期随访的回顾性研究，而定性研究仍然很少。本文综述了尿道下裂手术后的并发症、处理方法和预后。方法：对现有的关于尿道下裂并发症和手术治疗的文献进行非系统的批判性回顾。结果：常见的并发症包括尿道瘘（UCF）、龟头裂（GD）、尿道狭窄（US）、尿道憩室（UD）、尿喷、复发曲度（RC）。UCF是最常见的并发症，通过带血管瓣覆盖的多层闭合治疗。GD多发生在尿道下裂近端，需要龟头重构和组织增大。美国经常表现为金属狭窄或神经尿道狭窄，需要肉成形术或分期尿道成形术。尿路障碍是由于尿道段松动引起的，尿道段受到高尿流阻力，通过切除或重塑来治疗。尿喷与龟头融合不足或金属不规则有关，有时需要手术矫正。RC是影响性功能的重要并发症，需要通过背侧延伸或腹侧延长进行个体化矫正。结论：尿道下裂并发症需要个体化评估和手术计划。晚期并发症常被忽视，应在长期随访中予以考虑。正确的手术技术选择和术后评估有助于减轻复发和改善患者预后。

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引用次数: 0

Duration of androgen deprivation therapy with salvage radiotherapy in patients with prostate cancer and biochemical recurrence after surgery: Initial recruitment data in the phase III URONCOR 06-24 trial 前列腺癌术后生化复发患者雄激素剥夺治疗加补救性放疗的持续时间：URONCOR 06-24 III期试验的初始招募数据

Actas urologicas espanolas

Pub Date : 2025-09-01 DOI: 10.1016/j.acuroe.2025.501823

C. González San Segundo , F. López-Campos , A. Gómez Iturriaga , M. Santos , A. Ocanto , L. Montezuma , A.M. Boladeras-Inglada , L. Glaria , S. Guardado , A. Rodríguez , I. Henríquez , J. Olivera , V. Duque-Santana , J. Garre , S. Moreno , J. Valero , A.J. Conde , A. Doval , G. Sancho , P. Martin Nieto , F. Couñago

Introduction

URONCOR 06-24 (NCT05781217) is a prospective, multicenter, randomized, open-label, phase III trial evaluating the impact on distant metastasis-free survival (MFS) of short-term (6 months) versus long-term (24 months) androgen deprivation therapy (ADT) in combination with salvage radiotherapy in high- and intermediate-risk patients after biochemical recurrence (BCR).

Material and method

A total of 534 men will be randomized to receive either 6 or 24 months of ADT. Stratification is based on risk group (intermediate vs high) and nodal status (pN0 vs pNx).

Results

From March 2023 to November 2024, 122 patients have been enrolled: 34 (28%) with intermediate risk and 88 (72%) with high risk. Fifty-five patients (45%) are pNx. The mean time from surgery to BCR is 25.4 months, and the PSA at inclusion was 0.55 ng/ml. Restaging was performed in 89 patients, 75 of whom underwent PET/CT (97%, PSMA PET/CT). Hypofractionation was used in 68% of cases, and elective pelvic irradiation in 33%. At the time of analysis, all patients had PSA normalization. No severe ADT-related toxicity has been reported.

Conclusion

URONCOR 06-24 is the first clinical trial comparing long- versus short-term ADT in the setting of BCR after prostatectomy, with stratification by risk group. Initial recruitment data show a balanced distribution of prognostic factors between both arms and no serious adverse events related to ADT.

URONCOR 06-24 （NCT05781217）是一项前瞻性，多中心，随机，开放标签的III期试验，评估短期（6个月）与长期（24个月）雄激素剥夺治疗（ADT）联合补补性放疗对生化复发（BCR）后中高危患者远处无转移生存（MFS）的影响。材料和方法：共有534名男性随机接受6个月或24个月的ADT治疗。分层是基于风险组（中等vs高）和淋巴结状态（pN0 vs pNx）。结果：2023年3月至2024年11月共入组122例患者，其中中危34例（28%），高危88例（72%）。55例（45%）为pNx。从手术到BCR平均时间为25.4个月，纳入时PSA为0.55 ng/ml。89例患者进行了重新分期，其中75例接受了PET/CT（97%为PSMA PET/CT）。68%的病例采用低分割术，33%的病例采用选择性骨盆照射。分析时，所有患者PSA均恢复正常。结论：URONCOR 06-24是第一个比较前列腺切除术后BCR情况下长期和短期ADT的临床试验，并按风险组分层。最初的招募数据显示两组预后因素分布平衡，没有与ADT相关的严重不良事件。

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引用次数: 0

Can we use intense intravesical neoadjuvant chemotherapy to treat recurrent LG-IR NMIBC and avoid TURBT? 我们是否可以使用高强度膀胱内新辅助化疗来治疗复发性lgir NMIBC并避免TURBT？

Actas urologicas espanolas

Pub Date : 2025-08-07 DOI: 10.1016/j.acuroe.2025.501829

G Villoldo, A Kamat, G Fernández Candia

引用次数: 0

Comment on "Clinical profile and risk factors identified in patients with renal cancer in Mexican population". 评论“墨西哥人群肾癌患者的临床特征和危险因素”。

Actas urologicas espanolas

Pub Date : 2025-08-04 DOI: 10.1016/j.acuroe.2025.501833

R Mehta, R Sah

引用次数: 0