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.

The Evolving Landscape of Systemic Immunotherapy for Bacillus Calmette-Guérin-naïve High-risk Non-muscle-invasive Bladder Cancer: At the Edge of a Tsunami?

Background And Objective: Treatment options for high-risk (HR) non-muscle-invasive bladder cancer (NMIBC) are still limited. The addition of systemic immunotherapy to intravesical bacillus Calmette-Guérin (BCG) instillations is currently being explored as an initial strategy for BCG-naïve HR NMIBC patients to enhance treatment effectiveness and decrease the risk of BCG failure.

Methods: A collaborative narrative review of the literature by the Cancer Committee of the French Association of Urology (CC-AFU) was carried out to describe ongoing studies assessing systemic immunotherapy in BCG-naïve HR NMIBC patients, focus on the different study designs, and evaluate the clinical pertinence of the endpoints.

Bladder cancer prevalence and diagnostic test accuracy: French results from the IDENTIFY study.

Introduction: The IDENTIFY study aimed to assess the international prevalence of bladder cancer in patients referred to urologists for evaluation of haematuria or suspicion of bladder cancer. The primary objective of this analysis was to report the French data from IDENTIFY: prevalence, diagnostic performance of urologists during cystoscopy, and diagnostic performance of the initial evaluation with ultrasound and CT scan.

Materials And Methods: A prospective study was conducted in 6 French centers from December 2017 to December 2018.

Effect of Sex Differences on Cancer Outcomes After Chemo-Radiation for Muscle-Invasive Bladder Cancer: A Retrospective Multicenter Cohort Study.

Objective: To examine whether the well demonstrated sex-based differences in bladder cancer management and outcomes are similarly observed for those treated with chemo-radiation for muscle invasive bladder cancer (MIBC).

Methods: This retrospective, multicenter study reports on patients who underwent curative intent radiotherapy, with concurrent chemotherapy, for MIBC across 10 academic centers in Canada. The primary outcome was cancer specific survival (CSS) and secondary outcomes included complete response and overall survival (OS).

Contemporary outcomes in non-muscle-invasive bladder cancer: a large European multicentre study.

Objective: To report real-world rates of non-muscle-invasive bladder cancer (NMIBC) recurrence and progression within a European multicentre cohort with detailed information on intravesical instillation courses, as contemporary data on oncological outcomes in NMIBC are limited.

Patients And Methods: A total of 1918 patients with NMIBC treated with transurethral resection of bladder tumour (TURBT) were retrospectively identified from six tertiary-referral European centres (2015-2022). Patients were stratified according to European Association of Urology 2021 criteria into low- (LR), intermediate- (IR), high- (HR) and very high-risk (VHR) categories.

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.

Bricker ileal conduit diversion with ICG technique in 10 steps.

The Bricker ileal conduit is a widely used incontinent urinary diversion, commonly performed after pelvic exenteration. Described by Bricker in 1950 (Bricker, 1950), it remains popular due to low complication rates and surgical simplicity (Martínez-Gómez et al., 2021).

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.

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.

Renal Mass Biopsy Prior to Surgical Excision: Practice, Diagnostic Performance, and Impact on Management in the UroCCR Registry (Ancillary Study No. 118).

Background And Objective: A renal mass biopsy (RMB) is not systematically recommended before surgical excision of a renal mass, although it has demonstrated elevated accuracy in determining renal masses with low morbidity. Our aim was to determine the diagnostic accuracy of an RMB, the clinical and tumoral factors associated with RMB practice, and the impact of an RMB on renal cell carcinoma management in a contemporary prospective national registry-UroCCR (2010-2021).

Methods: We identified all patients with a single renal mass (pT1-4 N0-2 M0 or benign) who were treated surgically and stratified them according to the performance of a prior RMB.

Outcomes of BCG vs upfront radical cystectomy for high-risk non-muscle-invasive bladder cancer.

Objective: To assess the oncological outcomes of patients with high-risk (HR) and very high-risk (VHR) non-muscle-invasive bladder cancer (NMIBC) treated with upfront radical cystectomy (RC) vs Bacillus Calmette-Guérin (BCG) instillations from a contemporary European multicentre cohort.

Patients And Methods: We conducted a retrospective analysis of 1491 patients diagnosed with HR- or VHR-NMIBC from a European multicentre database between 2015 and 2024. Patients were included if they received either upfront RC or at least five doses of BCG.

Oncologic Outcomes of Endoscopic Management of Upper Tract Urothelial Carcinoma: A Systematic Review and Pooled Analysis from the EAU-YAU Urothelial Working Group.

Background And Objective: Data about the mid- and long-term oncologic outcomes of endoscopic kidney-sparing surgery (eKSS) for upper tract urothelial carcinoma (UTUC) are scarce. Therefore, we aimed to summarize the current evidence on the oncologic outcomes of eKSS for UTUC.

Methods: A literature search was conducted to identify reports published until May 2024.

The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY study.

Objectives: To assess the contemporary malignancy rate in isolated de novo red patches in the bladder and associated risk factors for better selection of red patch biopsy.

Patients: Patients from the IDENTIFY dataset; Patients referred to secondary care with suspected urinary tract cancer and found to have isolated de novo red patches on cystoscopy.

Methods: We reported the unadjusted cancer prevalence in isolated de novo red patches that were biopsied; multivariable logistic regression was used to explore cancer-associated risk factors including age, sex, smoking, type of haematuria, LUTS, UTIs and a suspicious-looking red patch (as reported by the cystoscopist).

Gemcitabine and docetaxel for high-risk non-muscle-invasive bladder cancer: EuroGemDoce group results.

Objective: To evaluate the oncological efficacy and safety of sequential intravesical gemcitabine/docetaxel (Gem/Doce) therapy in a European cohort of patients with high-risk and very-high-risk non-muscle-invasive bladder cancer (NMIBC) after previous Bacillus Calmette-Guérin (BCG) treatment.

Materials And Methods: Data were retrospectively collected from 95 patients with NMIBC, treated with Gem/Doce at 12 European centres between 2021 and 2024. Patients previously treated with BCG who had completed a full induction course and received at least one follow-up evaluation were included.

French AFU Cancer Committee Guidelines - Update 2024-2026: Upper urinary tract urothelial cancer (UTUC).

Introduction: The purpose of this study was to propose an update of the French guidelines from the national committee ccAFU on upper tract urothelial carcinomas (UTUC).

Methods: A systematic Medline search for epidemiology, risk factors, diagnosis, prognosis, treatment options and follow-up of UTUC was performed between 2022 and 2024 to evaluate available references and their levels of evidence.

Results: UTUC is a rare malignancy with specific risk factors, including exposure to aristolochic acid and Lynch syndrome.

French AFU Cancer Committee Guidelines - Update 2024-2026: Non-muscle invasive bladder cancer (NMIBC).

Objective: To update the CCAFU recommendations for the management of non-muscle invasive bladder cancer (NMIBC).

Methods: A systematic review (Medline) of the literature from 20222024 was performed, taking into account the elements of diagnosis, treatment options and monitoring of NMIBC and evaluating references with their level of evidence.

Results: The diagnosis of NMIBC (Ta, T1, or CIS) is made after complete and deep tumour resection.

French AFU Cancer Committee Guidelines - Update 2024-2026: Muscle-invasive bladder cancer (MIBC).

Objective: To update the CCAFU recommendations for the management of muscle-invasive bladder cancer (MIBC).

Methods: A systematic review (Medline) of the literature from 2022 to 2024 was carried out, taking into account the elements of the diagnosis, the treatment options and the monitoring of NMIBC and MIBC, evaluating the references with their level of evidence.

Results: MIBC is diagosed after the must complete tumor resection possible .

Adjuvant Immune Checkpoint Inhibitors for Muscle-Invasive Urothelial Carcinoma: An Updated Systematic Review, Meta-analysis, and Network Meta-analysis.

Context: Adjuvant immune checkpoint inhibitors (ICIs) have recently emerged as guideline-recommended treatments of high-risk muscle-invasive urothelial carcinoma (MIUC). However, there is limited evidence regarding the optimal candidates and the differential efficacy of adjuvant ICI regimens.

Objective: To synthesize and compare the efficacy and safety of adjuvant ICIs for high-risk MIUC using updated data from phase III randomized controlled trials.

Benefit of Whole-Pelvis Radiation for Patients With Muscle-Invasive Bladder Cancer: An Inverse Probability Treatment Weighted Analysis.

Purpose: The value of pelvic lymph node irradiation is debated for patients with muscle-invasive bladder cancer (MIBC) undergoing curative-intent radiation therapy (RT). We sought to compare the oncologic outcomes between bladder-only (BO)-RT and whole-pelvis (WP)-RT using a large Canadian multicenter collaborative database.

Patients And Methods: The study cohort consisted of 809 patients with MIBC (cT2-4aN0-2M0) who underwent curative RT at academic centers across Canada.

Tissue-based Biomarkers Steering Clinical Decisions in Patients with Urothelial Cancer.

The European Association of Urology (EAU), National Comprehensive Cancer Network, and European Society for Medical Oncology guidelines recommend PD-L1 and FGFR testing for patients with locally advanced bladder cancer or upper tract urothelial cancer (UTUC) according to specific eligibility criteria; positive results indicate therapy with immune checkpoint inhibitors or erdafitinib, respectively. The EAU guidelines recommend PD-L1 testing for subsequent adjuvant therapy in high-risk UC, and germline DNA sequencing in patients with UTUC positive for DNA mismatch repair alterations.

Effect of Complete Transurethral Resection on Oncologic Outcomes After Radiation Therapy for Muscle-Invasive Bladder Cancer.

Purpose: To compare the oncologic outcomes of patients with nonmetastatic muscle-invasive bladder cancer (MIBC) undergoing complete versus incomplete transurethral tumor resection (TURBT) before radiation therapy.

Methods And Materials: Patients with nonmetastatic MIBC who underwent curative-intent radiation therapy between 2002 and 2018 at 10 Canadian institutions were retrospectively evaluated. Inverse probability of treatment weighting was performed using baseline characteristics.

The Impact of Histologic Subtypes on Clinical Outcomes After Radiation-Based Therapy for Muscle-Invasive Bladder Cancer.

Purpose: Outcomes of radiation-based therapy (RT) for muscle-invasive bladder cancer (MIBC) with histologic subtypes of urothelial cancer (HS-UC) are lacking. Our objective was to compare survival outcomes of pure urothelial carcinoma (PUC) to HS-UC after RT.

Materials And Methods: A multicenter retrospective study of 864 patients with MIBC who underwent curative-intent RT to the bladder for MIBC (clinical T2-T4aN0-2M0) between 2001 and 2018 was conducted.

Thromboprophylaxis during neoadjuvant chemotherapy for bladder cancer reduces thromboembolism and bleeding.

Objectives: To assess the risk of venous thromboembolic events (VTEs) and bleeding with or without thromboprophylaxis during neoadjuvant chemotherapy in bladder cancer patients scheduled for radical cystectomy.

Materials And Methods: We conducted a retrospective cohort study in 4886 patients with non-metastatic bladder cancer undergoing cystectomy across 28 centres in 13 countries between 1990 and 2021. Inverse probability weighting analyses were performed to estimate the effect of thromboprophylaxis on VTE and bleeding.