Automated Kidney Tumor Segmentation in CT Images Using Deep Learning: A Multi-Stage Approach.

Rationale And Objectives: Computed tomography (CT) remains the primary modality for assessing renal tumors; however, tumor identification and segmentation rely heavily on manual interpretation by clinicians, which is time-consuming and subject to inter-observer variability. The heterogeneity of tumor appearance and indistinct margins further complicate accurate delineation, impacting histopathological classification, treatment planning, and prognostic assessment. There is a pressing clinical need for an automated segmentation tool to enhance diagnostic workflows and support clinical decision-making with results that are reliable, accurate, and reproducible.

Cytoreductive nephroureterectomy for treatment of upper urinary tract urothelial carcinoma initially diagnosed as node-positive.

Urothelial carcinomas of the upper urinary tract (UTUC) are rare tumors with a high malignancy degree. Radical nephroureterectomy (RNU) with bladder cuff excision remains one of the standard treatments in clinically localized or locally advanced UTUCs. However, the role of cytoreductive RNU in treating clinically lymph node-positive (N+) UTUCs remains unclear.

The Influence of Chronic Kidney Disease on the Management of Upper Urinary Tract Cancer Following Radical Nephroureterectomy: A Nationwide Multi-Institutional Study.

Background: This study aimed to investigate the impact of chronic kidney disease (CKD) on oncological outcomes in patients with upper tract urothelial cancer (UTUC) undergoing radical nephroureterectomy (RNU) in Taiwan.

Methods: We conducted a retrospective cohort study using data from the Taiwan UTUC Collaboration database. 1590 patients who underwent RNU for UTUC were included in the analysis.

Predicting hemorrhagic complications in robotic-assisted partial nephrectomy for renal tumors: simplifying risk assessment with tumor diameter and depth.

Purpose: Robotic-assisted partial nephrectomy has emerged as the standard surgical procedure for managing localized kidney cancers, with bleeding risk being a primary clinical consideration. This investigation seeks to establish simple predictive indicators for hemorrhage-related adverse events.

Materials And Methods: We performed a retrospective review of sequential patients undergoing robotic-assisted partial nephrectomy at a single tertiary medical center.

First validation of the Prostatype® P-score in an Asian cohort: Improving risk stratification for prostate cancer.

Objectives: To evaluate the prognostic performance of the Prostatype® score (P-score) in the Asian prostate cancer (PCa) cohort and to assess its ability to refine risk stratification compared to the National Comprehensive Cancer Network (NCCN) guidelines. This study aimed to determine whether the P-score, previously validated in European populations, maintains its predictive accuracy in a genetically and clinically distinct high-risk Asian cohort, where late-stage diagnosis is more common.

Patients And Methods: This retrospective study included 148 PCa patients diagnosed at Taiwan Chang Gung Memorial Hospital between 2012 and 2017.

Development and validation of a prediction model for early recurrence in upper tract urothelial carcinoma treated with radical nephroureterectomy.

Background: Most cases of upper tract urothelial carcinoma (UTUC) exhibit recurrence within the first year following surgery. The time from surgery to recurrence significantly impacts cancer-specific survival. In this study, we analyzed patients with localized UTUC (pTis-3N0/xcM0) who experienced postoperative recurrence to identify an appropriate early recurrence time point and the associated risk factors.

Dual SOT Switching Modes in a Single Device Geometry for Neuromorphic Computing.

Neuromorphic computing aims to replicate the brain's efficient processing through artificial neurons and synapses, requiring binary and multilevel switching. We present a PtMn/(Co/Pd)/Ta device that uniquely enables dual spin-orbit torque (SOT) switching modes─binary and multilevel (analog)─within the same geometry and stack structure, eliminating the need for device modifications. Binary SOT switching is achieved via domain wall nucleation and propagation at moderate current levels (∼65 mA), while multilevel switching occurs via domain nucleation mode without significant propagation after a high-current treatment (∼85 mA).

Effects of an app-assisted self-management intervention for urinary incontinence on self-efficacy and related outcomes in men with prostate cancer: A randomized controlled feasibility trial.

Purpose: To assess the feasibility, acceptability, and effectiveness of an app-assisted self-management intervention for urinary incontinence (App-SMI-UI) in men with prostate cancer.

Methods: We recruited men (n = 85) who had been diagnosed with prostate cancer and experienced urinary incontinence following radical prostatectomy. Participants were randomly assigned to the self-management group (n = 43) or the attrition control group (n = 42).

Preoperative ECOG performance status as a predictor of outcomes in upper tract urothelial cancer surgery.

Eastern Cooperative Oncology Group performance status (ECOG-PS) is a widely used functional status measure in oncology, yet its prognostic value in upper tract urothelial carcinoma remains unclear. In this multicenter study of 2473 patients undergoing radical nephroureterectomy, ECOG-PS ≥ 2 was independently associated with worse overall survival (hazard ratio [HR] 2.53, p < 0.

Psychological Resilience in Newly Diagnosed Prostate Cancer Survivors: A Longitudinal Study.

Background: Psychological resilience is considered a dynamic process or outcome. Most studies that have examined the psychological resilience of prostate cancer survivors have used cross-sectional designs, limiting the understanding of changes in psychological resilience across different stages of the disease.

Objectives: To investigate changes in psychological resilience and demoralization among newly diagnosed prostate cancer survivors from before treatment to 1 year after treatment initiation as well as the associated influencing factors.

Cystopexy following anterior-approach robot-assisted radical prostatectomy enhances early continence recovery.

To evaluate the effect of cystopexy on continence recovery after anterior-approach transperitoneal robot-assisted radical prostatectomy (RaRP). We retrospectively analyzed continence recovery of patients with prostate cancer receiving RaRP in a transperitoneal anterior-approach manner with or without cystopexy. Continence recovery is defined as complete intact continence without safety pad utility.

Using deep learning to differentiate among histology renal tumor types in computed tomography scans.

Background: This study employed a convolutional neural network (CNN) to analyze computed tomography (CT) scans with the aim of differentiating among renal tumors according to histologic sub-type.

Methods: Contrast-enhanced CT images were collected from patients with renal tumors. The patient cohort was randomly split to create a training dataset (90%) and a testing dataset (10%).

Repurposing of Metformin to Improve Survival Outcomes in Patients With Upper Tract Urothelial Carcinoma.

Purpose: Upper tract urothelial carcinoma (UTUC) presents a higher incidence rate in Taiwan compared to Western societies. The aim of this study is to investigate the potential of metformin in improving survival outcomes for patients with UTUC in Taiwan.

Material And Methods: This retrospective study included 940 patients with UTUC and type 2 diabetes from the Taiwan UTUC Collaboration Group, spanning 21 hospitals from July 1988 to September 2023.

Selective treatment de-escalation in advanced prostate cancer: have we come full circle?

Compelling evidence has solidified the notion of early treatment intensification in managing patients with metastatic hormone-sensitive prostate cancer (mHSPC). Landmark trials have provided Level 1 evidence for the survival benefits achieved by combining multiple agents. The efficacy of combined therapy relies not only on how treatment is intensified but also on how it is de-escalated.

Predicting Bleeding Related Events in Robotic-Assisted Partial Nephrectomy for Angiomyolipoma: Simplifying Risk Assessment with Tumor Diameter and Depth, A Retrospective Study.

Background: Evaluating risk factors for bleeding events in robot-assisted partial nephrectomy (RAPN) for renal angiomyolipoma (RAML) is essential for improving surgical outcomes.

Methods: We performed a retrospective analysis of patients who underwent RAPN for renal masses between May 2019 and June 2023 at a single medical center, categorizing them into AML and non-AML groups. We assessed demographic data, perioperative complications, and postoperative outcomes.

Impact of Obesity on Clinical Presentation and Surgical Outcomes in Patients with Benign Prostate Hyperplasia Receiving Greenlight Laser Prostatectomy.

Objective: To investigate the impact of body mass index (BMI) on preoperative characteristics, lower urinary tract symptoms (LUTS), intraoperative variables, surgical outcomes and postoperative complications.

Methods: This is a retrospective observational study including 891 benign prostate hyperplasia (BPH) patients who underwent GreenLight Laser photoselective vaporization of the prostate (PVP) between 2014 and 2020. Clinical characteristics, uroflowmetry parameters, and surgery related parameters were extracted from electronic health records.

Nomogram Analysis for Predicting Response to Androgen-Receptor-Axis-Targeted Therapies in Patients With Metastatic Castration-Resistant Prostate Cancer.

Background: This study aimed to identify the clinical predictors for the response of patients with mCRPC to ARATs.

Materials And Methods: We retrospectively collected data on consecutive patients who were diagnosed with mCRPC and underwent ARAT treatment during this stage of the disease. Clinical parameters were obtained through medical chart reviews.

Aristolochic acid-related renal cell carcinoma exhibits a distinct tumor-immune microenvironment favoring response to immune checkpoint blockade.

Immune checkpoint blockade (ICB) is currently the standard of care for metastatic renal cell carcinoma (RCC), but treatment responses remain unpredictable. Aristolochic acid (AA), a prevalent supplement additive in Taiwan, has been associated with RCC and induces signature mutations, although its effect on the tumor-immune microenvironment (TIME) is unclear. We aimed to investigate the immune profile of AA-positive RCCs and explore its potential role as a susceptible candidate for ICB.

Lesion size may affect diagnostic capabilities of MRI-guided ultrasound fusion biopsy and cognitive targeted biopsy for clinically significant prostate cancer.

MRI-guided targeted biopsy (MRGB) was recommended as part of biopsy paradigm of prostate cancers by current guidelines. This study aimed to analyze the diagnostic efficacy of MRGB and systemic biopsy (SB), and to compare diagnostic capabilities within subgroups of MRGB: MRI-cognitive biopsy (MRCB) and MRI-fusion biopsy (MRFB). We retrospectively enrolled patients who underwent MRGB for suspicious malignant lesion(s) identified on MRI in a single tertiary center, sample size was 74 patients.

AP-2α gene deregulation is associated with renal cell carcinoma patient survival.

Background: Renal cell carcinoma (RCC), one of the most fatal urologic tumors, accounts for approximately 3% of all adult cancers and exhibits a high metastatic index at diagnosis and a high rate of relapse. Radical or partial nephrectomy is a curative option for nonmetastatic RCCs. Targeted therapy has been shown to improve the survival of patients with metastatic RCCs.

No difference in oncological outcomes and perioperative complications between patients with ESRD with unilateral and bilateral UTUC receiving radical nephroureterectomy.

Patients with end stage renal disease (ESRD) are at high risk of developing upper tract urothelial carcinoma (UTUC). Due to high recurrence rate of UTUC in contralateral kidney and ureter, and high risk of complications related to surgery and anesthesia, whether it's necessary to remove both kineys and ureters at one time remains in debate. We utilized Taiwanese UTUC Registry Database to valuate the difference of oncological outcomes and perioperative complications between patients with ESRD with unilateral and bilateral UTUC receiving surgical resection.

Prognostic factors of intravesical recurrence after radical nephroureterectomy for upper tract urothelial carcinoma.

Purpose: To evaluate predictive factors of increasing intravesical recurrence (IVR) rate in patients with upper tract urothelial carcinoma (UTUC) after receiving radical nephroureterectomy (RNUx) with bladder cuff excision (BCE).

Materials And Methods: A total of 2114 patients were included from the updated data of the Taiwan UTUC Collaboration Group. It was divided into two groups: IVR-free and IVR after RNUx, with 1527 and 587 patients, respectively.