Predicting the indication for adjuvant radiation therapy according to EAU guidelines among patients with high-risk prostate cancer: a novel multivariable model.

Background: To develop a novel model for preoperatively predicting the indication for adjuvant radiation therapy after radical prostatectomy according to current guideline recommendations of the European Association of Urology (EAU) based on patient and clinical tumor characteristics in high-risk prostate cancer patients.

Methods: Within a high-volume center database (01/2010-08/2024), we identified high-risk prostate cancer patients. Univariable logistic regression models addressed indication for adjuvant radiation therapy.

Upper urinary tract urothelial carcinoma diagnosis effect on life expectancy relative to population-based controls: a retrospective analysis.

Purpose: To exam five-year overall survival (OS) of upper urinary tract urothelial carcinoma (UTUC) patients versus age- and sex-matched population-based controls.

Methods: Within Surveillance, Epidemiology, and End Results database (2004-2020), we identified newly diagnosed (2004-2015) UTUC patients. Relying on Social Security Administration Life Tables (2004-2020) age- and sex- matched population-based controls were simulated (Monte Carlo simulation).

The perks of combining extension and Gleason score of positive surgical margins after robot-assisted radical prostatectomy.

Background: The role of positive surgical margins' (PSM) features in terms of cancer control outcomes is unclear. We aimed to test the association between PSM extension combined to highest Gleason score (GS) at margin and PSA persistence, biochemical recurrence (BCR) and clinical recurrence (CR) in prostate cancer (PCa) patients undergone robot-assisted radical prostatectomy (RARP).

Materials And Methods: 2617 PCa patients treated with RARP at six European centers were stratified according to the PSM status and features, as follows): (a) negative SM; (b) focal PSM-GS 3; (c) extensive PSM-GS 3; (d) focal PSM-GS 4-5; (d) extensive PSM-GS 4-5.

Perioperative Complications and In-Hospital Mortality After Radical Prostatectomy in Prostate Cancer Patients with a History of Heart Valve Replacement.

To test for in-hospital mortality and complication rates in a population-based group of patients with vs. without a history of heart valve replacement undergoing radical prostatectomy (RP). Relying on the National Inpatient Sample (2000-2019), prostate cancer patients undergoing RP were stratified according to the presence or absence of heart-valve replacement.

Temporal Trends and Differences in Inpatient Palliative Care Use in Metastatic Penile Cancer Patients.

: To quantify inpatient palliative care use over time and to test whether patient or hospital characteristics represent determinants of inpatient palliative care use in patients with metastatic penile cancer. : Relying on the National Inpatient Sample database (2006-2019), we identified 1017 metastatic penile cancer patients. Estimated annual percentage change analyses and multivariable logistic regression models addressing inpatient palliative care use were fitted.

Does Race/Ethnicity Affect Secondary Bladder and Rectal Cancer Rates After Prostate Cancer Radiation? Results from a Population-Based Study.

Background: It is unknown whether race/ethnicity affects the risk of secondary bladder cancer (BCa) or rectal cancer (RCa) after external beam radiation therapy (EBRT) or brachytherapy (BT) for prostate cancer (PCa).

Materials And Methods: Within the Surveillance, Epidemiology, and End Results database (2004-2020), we focused on Caucasians, Hispanics, African Americans (AAs), and Asian/Pacific Islanders (APIs). Cumulative incidence plots and competing risks regression (CRR) models were fitted.

The effect of race/ethnicity on systemic chemotherapy in urothelial carcinoma patients exposed to radiotherapy.

Introduction: Based on prospective trials' result, it is unknown whether race/ethnicity affects the magnitude of cancer-specific survival differences after trimodal therapy (TMT) versus external beam radiation therapy alone (EBRT) for urothelial carcinoma for urinary bladder (UCUB). We addressed this knowledge gap.

Materials And Methods: Within the Surveillance, Epidemiology, and End Results database (2004-2020), we identified patients with cT2-T4aN0M0 UCUB treated with either TMT or EBRT.

Perioperative outcomes in testicular cancer patients treated with retroperitoneal lymph node dissection.

Objective: No large-scale population-based studies quantified perioperative outcomes in testicular cancer (TC) patients treated with retroperitoneal lymph node dissection (RPLND), especially in non-metastatic and metastatic stages. Moreover, no previous studies compared outcomes in centers of excellence (Indiana University School of Medicine, Memorial Sloan Kettering Cancer Center, and MD Anderson Cancer Center) vs. large-scale population-based databases.

Radical Prostatectomy Versus Radiotherapy for Prostate Cancer: Stage-, Age-, and Frailty-Specific Cancer-Control Outcomes of 2600 Patients.

Background: Both radical prostatectomy (RP) and radiotherapy (RT) are recommended as standard treatments for prostate cancer. The prospective comparisons available to date provide only limited information.

Methods: We used data from the database of our university cancer center to compare the metastasis-free (MFS), cancer-specific (CSS) and overall survival (OS) of all patients with prostate cancer who underwent either RP or RT in the period 2014-2024.

Ultralow Prostate-specific Antigen Nadir After Apalutamide: Outcomes in Synchronous Versus Metachronous Metastatic Hormone-sensitive Prostate Cancer.

Unlabelled: As an ultralow prostate-specific antigen (PSA) nadir (≤0.02 ng/ml) after apalutamide treatment for metastatic hormone-sensitive prostate cancer (mHSPC) was associated with the best oncological outcomes, the question arises as to whether this holds true for both synchronous and metachronous mHSPC. We addressed this knowledge gap using data from the FRAMCAP (Frankfurt Metastatic Cancer of the Prostate) database.

Radical Prostatectomy Versus Radiation Therapy for Locally Advanced and Clinically Nodal Positive Prostate Cancer.

Introduction: Radical prostatectomy (RP) and radiation therapy (RT) are both recommended as standard-of-care for advanced prostate cancer (aPCa). However, data on comparisons for aPCa are scant.

Patients And Methods: We relied on the University Cancer Center database to investigate outcomes in metastasis-free (MFS), cancer-specific (CSS) and overall survival (OS) of cT3-4 and cN1 RP versus RT-treated patients between 2014 and 2024.

Influence of Concomitant Androgen Deprivation Therapy and Its Duration for Salvage Radiation After Radical Prostatectomy: A Systematic Review and Network Meta-analysis According to Published Data.

Background And Objective: Recently published data comparing the impact and duration of androgen deprivation therapy (ADT) on metastasis-free survival (MFS), progression-free survival (PFS), and overall survival (OS) in patients undergoing salvage radiation therapy (sRT) after radical prostatectomy have not been compared directly; this study aims to address this knowledge gap.

Methods: We performed a systematic review and network meta-analysis (NMA) on MFS, PFS, and OS using data from the RADICALS-HD, NRG/RTOG 9601, RTOG 0534, and GETUG-AFU 16 trials, as well as three trials from the ARTISTIC meta-analysis (GETUG-AFU 17, RADICALS-RT, and RAVES) on adjuvant versus salvage radiotherapy. The primary outcome was MFS; the secondary outcomes were PFS and OS.

Perioperative Complications and In-hospital Mortality After Cystectomy for Nonbladder Cancer Conditions Versus Radical Cystectomy for Bladder Cancer.

Objective: This study was designed to test for perioperative complications, mortality, and length of stay after cystectomy for nonbladder cancer (non-BCa) v radical cystectomy (RC) for bladder cancer (BCa).

Methods: Patients were identified within the National Inpatient Sample (2000-2019). Multivariable logistic and Poisson regression models were fitted.

Real world comparison of adjuvant vs. salvage radiation therapy on cancer-control outcomes after radical prostatectomy.

Purpose: Outcomes of adjuvant (aRT) or salvage radiation therapy (sRT) after radical prostatectomy are under investigation regarding cancer-control outcomes.

Methods: Relying on the University Cancer Center database elaborating differences in metastasis-free (MFS), cancer-specific (CSS) and overall survival (OS) of aRT vs. sRT-treated patients between 2014-2024.

Effect of chemotherapy on cancer specific mortality in female locally advanced urethral cancer.

Objective: To quantify the effect of chemotherapy (CHT) in locally advanced female primary urethral cancer (fPUC).

Methods: In the Surveillance, Epidemiology and Ends Results (SEER) database (2000-2021), we identified 295 fPUC patients with locally advanced stage treated with local therapy (surgery or radiation or both) with or without CHT. Multivariable Cox regression models addressed cancer specific mortality free survival (CSM).

Local Tumor Destruction Versus Partial Penectomy for T1a Squamous Cell Carcinoma of the Penis.

Background: Local tumor destruction (LTD) represents a relatively novel approach for the management of early-stage squamous cell carcinoma of the penis (SCCP). Its cancer control efficacy has never been tested in large-scale epidemiologic studies. We addressed this knowledge gap and tested for differences in cancer-specific mortality (CSM) between LTD versus partial penectomy (PP) in T1aN0M0 SCCP.

Endoscopic ablation versus nephroureterectomy in localized low-grade upper tract urothelial carcinoma: a comparison in terms of cancer-specific and other-cause mortality.

Purpose: Guidelines recommend endoscopic ablation in select upper urinary tract urothelial carcinoma (UTUC) patients. To test for differences in cancer-specific mortality (CSM) and other-cause mortality (OCM) in localized non-invasive low-grade UTUC with tumor size < 2 cm treated with endoscopic ablation vs. radical nephroureterectomy.

Cancer-control outcomes of Radium- 223-pretreated lutetium- 177-PSMA Radioligand vs. Radium- 223-naïve mCRPC patients.

Purpose: Radium- 223 and Lutetium- 177 prostate-specific membrane antigen radioligand therapy (Lu- 177-PSMA) are approved for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC). Data on cancer-control outcomes of sequential therapy of Lu- 177-PSMA after radium- 223 are rare.

Methods: Using the Frankfurt Metastatic Cancer database of the Prostate (FRAMCAP) database, we analyzed progression-free (PFS) and overall (OS) survival of patients after radium- 223 pretreatment vs.

Bladder cuff excision at radical nephroureterectomy improved survival in upper tract urothelial carcinoma.

Objective: To test for survival differences after radical nephroureterectomy (RNU) in pT1-T3N0 upper tract urothelial carcinoma (UTUC) patients according to bladder cuff excision (BCE) status.

Methods: Within the Surveillance, Epidemiology, and End Results database (2004-2020), we identified RNU patients and documented BCE status. Prior and after propensity score matching (ratio 1:1), cumulative incidence plots and competing risk regression (CRR) models addressed cancer specific mortality (CSM) and other-cause mortality (OCM).

[Certified continuing education curriculum of the German Society for Urology (WECU) : WECU status report and implications of the new continuing education regulations in clinical practice].

The core points of the German education curriculum in urology (WECU) are high-quality professional training and close cooperation between inpatient and outpatient medicine in order to continue to generate well-trained urological young talent in the future. In a modular system, the program includes rotations in the outpatient area and optionally in other specialist disciplines or other clinics with different focuses. Integrated into the training period are 5 module seminars and a series of webinars with regular learning success checks, in which the entire learning content listed in the training regulations is presented in interactive presentations.

Lymphovascular Invasion Predicts Cancer-specific Mortality in Penile Localized Squamous Cell Carcinoma.

Introduction: Lymphovascular invasion (LVI) is a predictor of unfavorable stage at presentation in squamous cell carcinoma of the penis (SCCP). However, it is unknown if LVI may also predict cancer-specific mortality (CSM), especially in patients with localized SCCP in whom important differences in the treated natural history may exist. We addressed this knowledge gap in localized (T1b-T2N0M0) SCCP patients treated with penectomy.

Cancer-control outcomes with [Lu]Lu-PSMA Radioligand Therapy in elderly, frail or comorbid mCRPC patients.

[Lu]Lutetium prostate-specific membrane antigen radioligand therapy ([Lu]Lu-PSMA) is EMA-approved for certain indications in metastatic castration resistant prostate cancer (mCRPC). However, cancer-control outcomes in specific and trial-underrepresented subgroups are scant. We relied on the FRAMCAP database to elaborate progression-free (PFS) and overall (OS) survival in elderly (≥75 yrs), frail (ECOG status ≥1) mCRPC patients or those with cardiovascular disease (CVD) treated with [Lu]Lu-PSMA.

Sex-related differences in response to neoadjuvant and adjuvant chemotherapy in urothelial carcinoma of urinary bladder treated with radical cystectomy.

Introduction: It is unknown whether sex-related differences in response to neoadjuvant (NAC) or adjuvant chemotherapy (ADJ) exist in urothelial carcinoma patients treated with radical cystectomy (RC). We addressed these knowledge gaps.

Material And Methods: Within the Surveillance, Epidemiology, and End Results database (2007-2020), we identified NAC candidates (T2-T4N0M0) and ADJ candidates (T3-T4 and/or N1-3).

The association between the interval from biopsy to radical prostatectomy and biochemical recurrence in patients with intermediate- and high-risk prostate cancer.

Objective: To investigate the association between the interval from biopsy to radical prostatectomy (RP) and biochemical recurrence (BCR) in prostate cancer patients.

Methods: Within a tertiary-care database (01/2014 to 06/2023), D'Amico intermediate- and high-risk prostate cancer patients were stratified according to interval from biopsy to RP (≤3 vs. >3-≤6 months).

Association between frailty and specific comorbidities on oncological outcomes in metastatic hormone-sensitive and castration resistant prostate cancer.

Objective: Demographic changes will lead to higher proportions of metastatic hormone-sensitive (mHSPC) and castration resistant metastatic prostate cancer (mCRPC) patients with higher frailty index and multiple comorbidities.

Materials And Methods: We relied on an institutional tertiary-care database to explore the effect of frailty (Eastern Cooperative Oncology Group [ECOG]), as well as cardiovascular (CVD) and secondary malignancy (SecCa) comorbidities on overall survival (OS) and time to mCRPC in mHSPC and OS in mCRPC patients with Kaplan-Meyer estimates and Cox regression models.

Results: Of 802 mHSPC patients, 61% were ECOG0 vs.