Defining statistical cure in patients with T1 high-grade non-muscle-invasive bladder carcinoma treated with BCG immunotherapy.

Objective: To assess cure fraction and conditional survival probabilities for oncological outcomes in patients with T1 high-grade (T1HG) non-muscle-invasive bladder carcinoma (NMIBC) treated with adequate Bacillus Calmette-Guérin (BCG) immunotherapy.

Patients And Methods: This multi-institutional retrospective cohort study included 1403 patients with T1HG NMIBC treated between 2007 and 2020, adhering to modern guidelines including mandatory second transurethral resection of bladder tumour and adequate BCG, defined as at least five of six induction doses and at least two of three maintenance doses. Cure fraction, defined as the proportion of patients who will never experience the event of interest, was calculated for recurrence-free survival (RFS), progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS) using a mixture cure model.

Delayed vs. Concomitant Urethrectomy for Non-Metastatic Urothelial Carcinoma of the Urinary Bladder Undergoing Radical Cystectomy: Perioperative and Survival Outcomes from a Single Tertiary Centre in the United Kingdom.

The role of urethrectomy at the time of Robotic-Assisted or Open Radical Cystectomy (RARC, ORC) is controversial. Whether urethrectomy should be performed at the time of RARC/ORC or delayed up to a 3-6 month interval is unclear. We performed a retrospective cohort analysis of perioperative and survival outcomes in patients with high-risk NMIBCs or non-metastatic MIBCs at our institution who underwent either concomitant or deferred urethrectomy after RC.

Liquid biopsy testing in urological cancers: Focus on urine.

Liquid biopsy has significantly transformed the management of patients with urological cancers. In particular, alternative sources of tumor nucleic acids and analytes beyond blood have taken on a crucial role in these malignancies. In this context, urine represents a valuable alternative to blood and should be considered within an expanded concept of liquid biopsy.

Artificial intelligence and radiomics applications in adrenal lesions: a systematic review.

Background: Adrenal lesions, often incidentally detected, present diagnostic challenges in distinguishing benign from malignant or hormonally active lesions. Conventional imaging (computed tomography/magnetic resonance imaging (CT/MRI)) has limitations, driving interest in artificial intelligence (AI) and radiomics for enhanced accuracy.

Objectives: To systematically evaluate AI and radiomics applications in adrenal lesion characterization, focusing on diagnostic performance, methodologies, and clinical utility.

Comparative Assessment of Chemotherapy Followed by Consolidative Radical Cystectomy Versus Chemoradiation for Clinically Node-Positive Urothelial Carcinoma of the Bladder.

Context: Patients with bladder cancer and clinically positive pelvic lymph nodes (cN+) have poor prognosis, and the optimal definitive treatment method remains controversial.

Objective: To compare survival outcomes between chemotherapy followed by radical cystectomy (RC) and chemoradiation (CRT) in patients with cN+ bladder cancer.

Methods: We queried the Surveillance, Epidemiology, and End Results (2000-2021) database to identify patients with cN+ bladder cancer treated with CRT or chemotherapy and RC.

Acute kidney injury causes chronic kidney disease progression after partial nephrectomy: A retrospective study identifying patients at risk.

Introduction To assess parameters predicting acute kidney injury (AKI) and chronic kidney disease progression (CKDP) after partial nephrectomy (PN). Methods The Data of 785 patients were retrospectively reviewed. Follow-up (FU) eGFR was assessed in 542 patients.

FGFR1/3 Signaling as an Achilles' Heel of Phenotypic Diversity in Urothelial Carcinoma.

FGFR inhibitors are a new therapeutic option for urothelial carcinoma (UC) with FGFR2/3 alterations. In this study, we analyzed genetic alterations, co-regulation, and differential expression for 45 genes encoding FGF, FGFR, or FGF-binding proteins (FGFBPs) in five published UC cohorts (n = 3939 MIBC) and 39 UC cell lines (DepMap portal). Network analyses identified FGFR1/3 genes as critical oncogenic hubs, co-regulated with their ligands and co-receptors, and abundantly expressed at protein level in the HPA immunohistochemistry data set.

Liquid Biopsy: Current advancements in clinical practice for bladder cancer.

Bladder cancer is the ninth most common malignancy worldwide, with two clinically distinct forms: non-muscle-invasive disease, characterized by high recurrence and excellent long-term survival, and muscle-invasive disease, associated with poorer outcomes. Current surveillance-cystoscopy and urine cytology-offers high specificity but is invasive, costly, and insensitive to low-grade tumors, underscoring the need for reliable, non-invasive biomarkers. Liquid biopsy approaches in urine and blood have demonstrated promise for real-time assessment of tumor burden, molecular heterogeneity, and early recurrence.

Impact of timing of computed tomography staging and patient factors on the detection of 'true' cN+ bladder cancer.

Objectives: To evaluate whether computed tomography (CT) scans should be performed before or after transurethral resection of bladder tumour (TURBT) for accurate lymph node staging in clinically lymph node-positive bladder cancer (BCa). Additionally, to identify patient factors that can aid in predicting lymph node metastasis.

Patients And Methods: In this retrospective, multicentre study, we analysed patients with cN+ M0 BCa staged by CT and treated with upfront radical cystectomy (RC) and pelvic lymph node dissection.

Current status of single port robotic-assisted reconstructive urology: a systematic review, meta-analysis and structured summary of the available literature.

Single Port (SP) surgery is the most relevant surgical innovation of the past six years. Few data are available on the advantages and disadvantages of SP Robotic-Assisted reconstructive urology. In the present systematic review, we summarize the results of available literature exploring the feasibility of SP reconstructive urological procedures and comparing the SP and Multi Port (MP) approaches.

Blood and urine-based biomarkers in prostate cancer: Current advances, clinical applications, and future directions.

Prostate cancer (PCa) is one of the most prevalent malignancies in men, characterized by high clinical and molecular heterogeneity. Despite the widespread use of prostate-specific antigen (PSA) for diagnosis and monitoring, its limited specificity and sensitivity necessitate the development of more accurate biomarkers. This review provides a comprehensive overview of current and emerging diagnostic, prognostic, and predictive biomarkers in PCa, highlighting their clinical applications and future perspectives.

Prognostic Implications of Patients With Clinically Node Positive Bladder Cancer Undergoing Radical Cystectomy.

Introduction And Objectives: Patients with clinically node-positive (cN+) bladder cancer (BCa) form a biologically and prognostically diverse group. As systemic therapy reshapes management in this setting, this study examines oncological outcomes after radical cystectomy (RC) with or without perioperative systemic therapy.

Materials And Methods: We utilized a multicenter, retrospectively collected database of 1067 patients diagnosed with cTanyN+M0 BCa who underwent RC with lymphadenectomy with or without perioperative systemic treatment.

Long-term Oncological Outcomes for Patients with Non-muscle-invasive Bladder Cancer Treated with Bacillus Calmette-Guérin (BCG): A Comparative Analysis of Adequate Versus Inadequate BCG Treatment.

Background And Objective: Intravesical bacillus Calmette-Guérin (BCG) instillation is recommended for intermediate-risk (IR) and high-risk (HiR) non-muscle-invasive bladder cancer (NMIBC). There are limited comparisons of long-term outcomes between adequate and inadequate BCG.

Methods: We analyzed data from a multicenter European database (2010-2024) for 1558 patients diagnosed with IR- or HiR-NMIBC who underwent BCG treatment and received at least five BCG instillations.

Circulating miRNAs in genitourinary cancer: pioneering advances in early detection and diagnosis.

MicroRNAs (miRNAs) are noncoding, single-stranded RNAs molecules modulating gene expression thanks to their ability to bind mRNAs. Indeed, they regulate key processes for the proper functioning of the organism and affect the course of human pathologies. Altered expression of individual miRNAs has been shown in most human cancers, endowed with oncogenic or suppressor potential.

Contemporary Practice in Adrenal Surgery: A Review of Multiport versus Single-port and Transperitoneal versus Retroperitoneal Approaches.

Robotic adrenalectomy has emerged as the preferred approach for adrenal gland surgery because of its greater precision, better ergonomics, good safety profile, and minimally invasive nature. There is ongoing debate over the optimal surgical approach, specifically regarding multiport versus single-port platforms, and transperitoneal versus retroperitoneal access. Multiport robotic adrenalectomy remains the standard because of its familiarity and wider surgical exposure, whereas single-port surgery offers the advantage of better cosmesis and lower incision-related morbidity despite a more challenging learning curve.

Clinical significance of detectable blood lead and cadmium in the Sarno river basin population: results from the PREVES-STOP study.

Objectives: The Sarno river basin (Italy) is a region characterized by significant environmental pollution, raising concerns about heavy metal exposure in residents. The PREVES-STOP Initiative aims to address these concerns. This study investigates the prevalence of detectable blood lead (Pb) and cadmium (Cd) in a cohort of adults from this area and examines associations with key health indicators.

Contemporary Trends and Predictors Associated with Adverse Pathological Upstaging Among Non-Metastatic Localized Clinical T2 Muscle-Invasive Bladder Cancers Undergoing Radical Cystectomy: Outcomes from a Single Tertiary Centre in the United Kingdom.

: Radical cystectomy (RC) is the gold standard for urothelial cT2-4a, N0, M0 muscle-invasive bladder cancer (MIBC). However, bladder-sparing strategies (BSS) such as Trimodality Therapy (TMT) have emerged as alternative treatments for a select group of localized muscle-confined (cT2) urothelial bladder cancers. Accordingly, reliable preoperative staging and a reliable risk factor assessment linked to pathological upstaging play a key role in adequate counselling and patient selection for BSS.

The Role of Salvage Cystectomy After Prior Trimodality Therapy: A Multinational Match-paired Analysis.

Background And Objective: Trimodality therapy (TMT) with transurethral resection followed by radiation of the urinary bladder and chemotherapy is associated with similar long-term survival rates to radical cystectomy (RC) for well-selected patients. Nevertheless, salvage RC may become necessary in 10% of patients receiving TMT. We aimed to assess the perioperative and long-term outcomes of salvage RC after prior TMT through a large multinational cohort study.

Cardiovascular events after kidney cancer surgery: insights from a comprehensive national database.

Background: The aim of this study is to compare the occurrence of major cardiovascular events (MCEs) after partial nephrectomy (PN) and radical nephrectomy (RN), and to identify risk factors for their development, including the impact of social determinants of health (SDOH).

Methods: We used the PearlDiver™ Mariner database (Pearl-Diver Technologies, Colorado Springs, CO, USA) for this analysis. At 1- and 5-year after surgery, the following MCEs were described by using proper ICD-9/10 diagnostic codes: myocardial infarction, cerebrovascular diseases, congestive heart failure, and peripheral vascular diseases.

Which Surrogate Marker of Insulin Resistance Among Those Proposed in the Literature Better Predicts the Presence of Non-Metastatic Bladder Cancer?

: Recent evidence has shown that insulin resistance (IR), a hallmark of nonalcoholic fatty liver disease, predicts bladder cancer (BC) presence. However, the best surrogate marker of IR in predicting BC is still unclear. This study examined the relationships among ten surrogate markers of IR and the presence of BC.

A Single Port (SP) Approach Reduces the Risk of Postoperative Complications in Elderly Patients Undergoing Robotic-Assisted Partial Nephrectomy (RAPN).

Introduction: In recent years, due to the increasing life expectancy and the growing popularity of nephron sparing strategies (NSS), more elderly and frail patients are undergoing Robotic-Assisted Partial Nephrectomy (RAPN) for the treatment of localized Renal Cell Carcinoma (RCC). A Single Port Approach has demonstrated itself to reduce estimated blood loss (EBL), complication rates, and length of stay (LOS). In the present study, we aim to compare perioperative and postoperative outcomes of SP RAPN and Multi Port (MP) RAPN, with a focus on elderly patients.

The impact of heavy metals exposure on male fertility: a scoping review of human studies.

Introduction: Male infertility is a critical global health issue, with environmental and occupational exposure to heavy metals, such as lead (Pb), cadmium (Cd), mercury (Hg), and arsenic (As), impacting male reproductive health. This scoping review aims to evaluate the effects of heavy metal exposure on semen parameters.

Content: This study adhered to the 2020 PRISMA framework.

Impact of Histological Subtypes/Divergent Differentiation on Clinicopathological and Oncological Outcomes for Patients with Upper Tract Urothelial Carcinoma Treated with Radical Nephroureterectomy: A Comprehensive Updated Systematic Review and Meta-analysis.

Background And Objective: Upper tract urothelial carcinoma (UTUC) is associated with poor survival. Recent studies have evaluated whether the presence of histological subtypes or divergent differentiation (HS/DD) is associated with worse UTUC prognosis. Our aim was to assess the relationship between HS/DD and clinicopathological features and oncological outcomes for patients with UTUC undergoing radical nephroureterectomy (RNU) without investigating causal pathways.

Oncological Outcomes in Bacillus Calmette-Guérin-naïve High-risk Non-muscle-invasive Bladder Cancer Patients: A Systematic Review on Current Treatment Strategies and Future Perspectives.

Background And Objective: Bacillus Calmette-Guérin (BCG) is the standard treatment in patients harboring high-risk (HR) non-muscle-invasive bladder cancer (NMIBC). However, BCG therapy faces frequent adverse events (AEs), limited efficacy, and ongoing shortages, leading to a low completion rate, access challenges, and high recurrence. In consequence, there is a growing interest in exploring alternative treatments, including immune checkpoint inhibitors, chemotherapy combinations, and novel intravesical therapies.

Comparison of extended and standard lymph node dissection in radical cystectomy for urothelial bladder cancer: a systematic review and meta-analysis.

Purpose: Lymph node dissection (LND) is an essential part of radical cystectomy (RC) performed with curative intent for invasive urothelial bladder cancer (UBC). This meta-analysis synthesizes evidence from randomized controlled trials (RCTs) comparing outcomes of extended and standard LND during RC.

Methods: Systematic searches of PubMed, Scopus, and Web of Science, conducted on November 10, 2024, identified RCTs that compared outcomes of standard (removal of pelvic lymph nodes [LNs]) versus extended LND (removal of pelvic and retroperitoneal LNs) during RC.