Exploring the metastatic potential of isolated tumour cells and clusters-cords patterns of ISUP Grade 5 acinar adenocarcinoma of the prostate: a comprehensive morphological analysis.

Gleason pattern 5 (GP5) prostatic adenocarcinoma (PC) includes distinct morphologies: undifferentiated solid pattern (US), solid and cribriform with necrosis (CN), clusters and cords (CC), and isolated single tumour cells (ISTC). The role of these patterns in the metastatic setting is still poorly understood. We conducted a case-control retrospective histological characterization of two cohorts of ISUP Grade Group 5 PC, one with nodal metastases (N1) and one without (N0), comparing GP5 sub-patterns distribution, from robot-assisted radical prostatectomies with extended lymphadenectomy diagnosed between January 2013 and February 2023.

The current role of photodynamic diagnosis (PDD) in the management of non-muscle invasive bladder cancer: the Italian Society of Urology (SIU) Position Paper.

Photodynamic diagnosis (PDD) significantly enhances the detection of bladder cancer (BCa) and is able to reduce the risk of disease recurrence, although it may not affect disease progression and mortality rates. Despite its advantages, widespread adoption of PDD is limited by cost considerations and the absence of unified guidelines on its application, highlighting the need for continued evaluation of its cost-effectiveness across different healthcare settings. To date, no specific recommendations for PDD in non-muscle invasive bladder cancer (NMIBC) management have been provided by the Italian Society of Urology (Società Italiana di Urologia, SIU).

Machine learning driven diagnostic pathway for clinically significant prostate cancer: the role of micro-ultrasound.

Introduction & Objectives: Detecting clinically significant prostate cancer (csPCa) remains a top priority in delivering high-quality care, yet consensus on an optimal diagnostic pathway is constantly evolving. In this study, we present an innovative diagnostic approach, leveraging a machine learning model tailored to the emerging role of prostate micro-ultrasound (micro-US) in the setting of csPCa diagnosis.

Materials & Methods: We queried our prospective database for patients who underwent Micro-US for a clinical suspicious of prostate cancer.

Assessing oncological outcomes of bladder-sparing treatments in patients with BCG-unresponsive and BCG-exposed non-muscle-invasive bladder cancer.

Background: A subset of non-muscle invasive bladder cancer (NMIBC) patients falls between BCG-naïve and BCG-unresponsive, leading to the introduction of the 'BCG-exposed' category. We assessed oncological outcomes in BCG-unresponsive and BCG-exposed patients undergoing bladder-sparing treatments (BST).

Methods: This retrospective study included BCG-unresponsive and BCG-exposed patients who underwent BST with BCG or a shift to different intravesical chemotherapy.

The role of primary tumour site surgery in metastatic UTUC: a systematic review and meta-analysis.

Objective: To assess the impact of primary tumour surgery on survival outcomes in patients with metastatic upper urinary tract urothelial carcinoma (mUTUC) by conducting a systematic review and meta-analysis.

Methods: A systematic search was conducted using the PubMed/Medline, Embase, Web of Science, and Cochrane Library databases for studies published up to January 2025, using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Eligible studies included adult patients (≥18 years) diagnosed with mUTUC (cM+ excluding cN + M0).

An Evaluation of the Diagnostic Accuracy of [68Ga]Ga-PSMA-11 vs. [18F]F-PSMA-1007 PET/CT for Lymph Node Staging in Patient Candidates for Radical Prostatectomy and Lymph Node Dissection: A Single Institutional Analysis.

: This study evaluates and compares the diagnostic accuracy of [68Ga]Ga-PSMA-11 and [18F]F-PSMA-1007 for lymph node staging in patients with prostate cancer (PCa) scheduled for robot-assisted radical prostatectomy (RARP) and lymphadenectomy (LND). : We retrospectively reviewed prospectively collected data on patients referred to our hospital from October 2020 to January 2023. We included all patients who underwent [68Ga]Ga-PSMA-11 or [18F]F-PSMA-1007 PET/CT for primary staging and subsequently had RARP with concomitant LND.

Enhanced prognostic value of four-tier hybrid grading system in Ta non-muscle-invasive bladder cancer.

Objectives: To compare the predictive performance of the World Health Organization (WHO) 1973, WHO 2004/2022, the three-tier (low grade [LG]/Grade 1 [G1]-G2, high grade [HG]/G2, and HG/G3), and four-tier (LG/G1, LG/G2, HG/G2, and HG/G3) hybrid grading systems in Ta non-muscle-invasive bladder cancer (NMIBC), by evaluating recurrence-free survival (RFS) and progression-free survival (PFS).

Patients And Methods: This retrospective multicentre study included 1233 patients with pTa NMIBC treated with transurethral resection of bladder tumour, eventually followed by intravesical instillations as determined by their physicians, between 2010 and 2023, across 18 Italian hospitals. Pathologists graded resected tissues using the WHO 1973, WHO 2004/2022 classifications, and hybrid three-tier (LG, HG/G2, HG/G3) and four-tier (LG/G1, LG/G2, HG/G2, HG/G3) systems.

Reliability of the da Vinci robotic surgical system: a systematic review and pooled analysis of technical failures.

Purpose: Millions of patients undergo robot-assisted surgery. This technology carries potential risks to perioperative safety. Despite the widespread adoption of robotic platforms, data on the frequency of system malfunctions remain limited.

Towards Defining Follow-up Strategies for Patients with Primary Intermediate-risk Non-muscle-invasive Bladder Cancer.

Background And Objective: The current European Association of Urology (EAU) guidelines on non-muscle-invasive bladder cancer (NMIBC) categorize patients into four risk groups. In 2024, a specific follow-up schedule was introduced for intermediate-risk (IR) disease. However, recommendations are based on expert opinion and restricted to patients with IR-NMIBC who have primary low-grade or high-grade/grade 2 disease.

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.

Enhanced diagnostic accuracy of micro-ultrasound in prostate cancer detection: An updated series from a single-center prospective study.

Introduction: Multiparametric (mp) magnetic resonance imaging (MRI) is essential for prostate cancer (PCa) detection but is limited by availability, cost, and complexity. Micro-ultrasound (microUS) offers real-time, high-resolution imaging and may enhance clinically significant (cs) prostate cancer (PCa) detection when used with mpMRI. This study updates the diagnostic performance of microUS compared to mpMRI in a large prospective cohort.

Association of energy source with outcomes in en bloc TURB: secondary analysis of a randomized trial.

Purpose: To comprehensively evaluate the efficacy of different energy sources used for en-bloc transurethral resection of bladder tumors (ERBT) on perioperative outcomes.

Methods: This sub-analysis derived from a prospective randomized study that enrolled patients undergoing ERBT vs conventional transurethral resection of the bladder (cTURB) from January 2019 to January 2022 (NCT03718754). Endpoints were pathological specimen quality and perioperative outcomes after either monopolar (m-ERBT) or bipolar (b-ERBT) or laser (l-ERBT) ERBT.

Impact of prostate cancer screening in European ancestry un-affected men with germline DNA repair pathogenic variants.

Background And Objective: Prostate cancer (PCa) is a significant global health concern, ranking as the second most prevalent cancer among men worldwide. Genetic factors, particularly germline pathogenic variants (PVs) in DNA repair genes (DRGs), play a crucial role in PCa predisposition. Our study aimed to assess patients' adherence to a targeted PCa screening program targeting high-risk individuals with DRG PVs and evaluate the potential reduction in biopsy and MRI rates by employing our screening protocol.

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.

Optimizing Prostate Cancer Diagnostic Work-Up Through Micro-Ultrasound: Minimizing Unnecessary Procedures and Reducing Overdiagnoses.

Introduction: We aim to critically assess Microultrasound (mUS) clinical performance in an outpatient setting, focusing on its ability to reduce unnecessary diagnostic procedures, potentially reshape prostate cancer (PCa) diagnostic protocols, and increase the ability to rule out clinically significant (Gleason Score ≥ 3 + 4) PCa (csPCa).

Materials And Methods: Between November 2018 and April 2022, we conducted a prospective study involving men who underwent mUS examination due to clinical symptoms, PSA elevation, or opportunistic early detection of PCa. Experienced urologists performed mUS assessments in an outpatient setting using the prostate risk identification using micro-ultrasound (PRI-MUS) protocol to identify lesions suspicious of csPCa (PRI-MUS score ≥ 3).

Xpert Bladder Cancer Detection in Emergency Setting Assessment (XESA Project): A Prospective, Single-centre Trial.

Background And Objective: Bladder cancer (BC) represents a significant health care challenge and is frequently detected during evaluations for haematuria in emergency departments (EDs). Our aim was to evaluate the clinical performance and economic implications of the Xpert BC Detection (BCD) test for patients presenting to the ED with haematuria to address the pressing need for more efficient and accurate diagnostic tools in this setting.

Methods: We conducted a prospective single-centre observational study in the ED of a tertiary university hospital.

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.