Comparative outcomes of radical nephroureterectomy and kidney-sparing surgery in the treatment of high-grade upper tract urothelial carcinoma.

Purpose: Upper tract urothelial carcinoma (UTUC) can be managed via radical nephroureterectomy or kidney-sparing surgery. Unfortunately, there is a paucity of data comparing radical vs. kidney-sparing management for high-grade UTUC.

Tolerability and efficacy of induction Bacillus Calmette-Guérin for non-muscle invasive bladder cancer.

Background: Intravesical Bacillus Calmette-Guérin (BCG) is the standard treatment for intermediate-risk, high-grade, and high-risk non-muscle invasive bladder cancer (NMIBC). However, it is associated with adverse effects, potentially causing treatment interruptions or discontinuation.

Objectives: This study analyzed the tolerability and efficacy of induction BCG, with associated patient- and disease-related factors.

Extended Outcomes of Intravesical Valrubicin and Docetaxel as a Secondary Salvage Treatment for Recalcitrant High-risk Non-muscle-invasive Bladder Cancer.

Background And Objective: After multiple treatment failures, clinical practice guidelines recommend that patients with high-risk non-muscle-invasive bladder cancer (HR-NMIBC) undergo radical cystectomy (RC). However, since many patients will be either unfit or averse to radical surgery, additional bladder-sparing therapies are needed. Herein, we report the efficacy of sequential intravesical valrubicin and docetaxel (Val/Doce) as a salvage therapy for patients with recurrent HR-NMIBC.

Avelumab and taxol chemotherapy in platinum-refractory or ineligible metastatic urothelial carcinoma (AVETAX trial).

Background And Objective: This study investigates the role of taxanes and immunotherapy for inoperable advanced or metastatic urothelial carcinoma in patients unable to tolerate or refractory to platinum-based regimens. We aimed to determine the safety and estimate the efficacy of a combination of avelumab and docetaxel in treating advanced or metastatic urothelial carcinoma.

Methods: This phase 1b, single-arm, open-label clinical trial involved adults with advanced or metastatic urothelial carcinoma, progressing during or after platinum-containing chemotherapy, within 12 months of neoadjuvant or adjuvant platinum-containing chemotherapy, or ineligible for platinum regimens.

The role of blue light cystoscopy and additional operative evaluations during first surveillance after induction therapy for high-risk NMIBC.

Background: During surveillance of high-risk non-muscle invasive bladder cancer (HR-NMIBC), occult disease can be missed by standard cystoscopy.

Objective: To determine the utility of enhanced restaging procedures.

Methods: We retrospectively reviewed 297 patients with HR-NMIBC who underwent enhanced restaging procedures during the first surveillance following induction intravesical therapy between 2010-2021.

Bladder-sparing management for high grade noninvasive urothelial carcinoma of the prostate.

Objectives: To characterize the oncologic outcomes in patients with high-grade noninvasive urothelial carcinoma of the prostate (NMIUC-P) treated with intravesical therapy and assess for clinicopathologic features associated with response.

Subjects And Methods: Patients with high-grade NMIUC-P treated with intravesical Bacillus Calmette-Guerin (BCG) or chemotherapy between 2005 and 2021 were retrospectively analyzed. Survival probabilities were estimated using the Kaplan-Meier method.

Presence of an Artificial Intelligence-powered Predictive Biomarker Is Associated with a Poor Response to Intravesical Bacillus Calmette-Guerin but Not to Intravesical Sequential Gemcitabine/Docetaxel in Patients with High-grade Non-muscle-invasive Bladder Cancer.

Intravesical bacillus Calmette-Guerin (BCG) is considered first-line adjuvant therapy for high-risk or high-grade non-muscle-invasive bladder cancer (NMIBC). Recently, sequential intravesical gemcitabine and docetaxel (Gem/Doce) has emerged as a promising alternative to intravesical BCG. Biomarkers to select the optimal treatment regimen could facilitate clinical decision-making.

Transperineal prostate biopsy without routine antibiotics demonstrates decreased infection risk.

Introduction: Infections are the most feared complication of transrectal prostate biopsies, along with growing concerns of antibiotic resistance. Our institution transitioned to a transperineal approach without use of perioperative antibiotics or bowel preparations. We aimed to compare the safety outcomes associated with transperineal and transrectal prostate biopsy techniques.

Impact of Tumor Stage on Oncologic Outcomes of High-grade Bacillus Calmette-Guérin Unresponsive Non-muscle-invasive Bladder Cancer Undergoing Bladder-sparing Therapies.

Background And Objective: Current data on bacillus Calmette-Guérin (BCG)-unresponsive non-muscle-invasive bladder cancer (NMIBC) do not differentiate outcomes by clinical stage. The purpose of this study is to investigate the role of tumor stage in oncologic outcomes in BCG-unresponsive NMIBC undergoing bladder-sparing therapies.

Methods: Demographic and outcome data for patients with BCG-unresponsive NMIBC were reviewed at ten institutions.

Rethinking the definition of stage III disease in adrenocortical carcinoma: Assessing the impact of clinical lymph node positive disease.

Introduction: Stage III adrenocortical carcinoma encompasses both lymph node positive (TanyN1M0) and negative (T3-4N0M0) disease. Given the disease's rarity, the current staging paradigm's estimates of survival are supported by limited evidence. Consequently, we examined the impact of clinical lymph node positivity on survival outcomes in the context of the current staging of advanced adrenocortical carcinoma.

Sequential Endoluminal Doxorubicin and Gemcitabine Alternating Weekly with Sequential Mitomycin and Docetaxel for Recurrent Non-Muscle Invasive Urothelial Carcinoma.

After first-line treatment failure, patients with non-muscle invasive urothelial carcinoma (NMIUC) are recommended to undergo radical cystectomy. However, those unable to pursue radical surgery or desiring bladder preservation require effective salvage therapies. Multi-agent treatment regimens are particularly useful for targeting the complex resistance mechanisms of recurrent UC.

Landscape and prognostic significance of oncogene drivers in metastatic castration sensitive prostate cancer.

Background: Tumor suppressors are well known drivers of cancer invasion and metastasis in metastatic castration sensitive prostate cancer (mCSPC). However, oncogenes are also known to be altered in this state, however the frequency and prognosis of these alterations are unclear. Thus, we aimed to study the spectrum of oncogene mutations in mCSPC and study the significance of these alteration on outcomes.

Bladder sparing management for muscle-invasive bladder cancer after a complete clinical response: ready for prime time?-a narrative review.

Background And Objective: A standard of care for muscle-invasive bladder cancer (MIBC) is cisplatin-based neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC). Given recent improvements in NAC and the morbidity associated with RC, bladder-sparing therapy has been investigated as a promising treatment for patients with MIBC who experience a complete clinical response (CCR) to systemic therapy. However, clinical staging is unreliable, making it challenging to determine ideal candidates for bladder-sparing therapy.

Oncologic Outcomes of Sequential Intravesical Gemcitabine and Docetaxel Compared with Bacillus Calmette-Guérin in Patients with Bacillus Calmette-Guérin-Unresponsive Non-Muscle Invasive Bladder Cancer.

Background And Objective: Non-muscle-invasive bladder cancer (NMIBC) patients treated with additional bacillus Calmette-Guérin (BCG) may become unresponsive to BCG. Recently, sequential intravesical gemcitabine and docetaxel (gem/doce) are being used for NMIBC. This study aims to compare oncologic outcomes between sequential intravesical gem/doce versus additional BCG in patients with BCG-unresponsive NMIBC.

The efficacy of sequential intravesical gemcitabine and docetaxel versus BCG for the treatment of European association of urology very-high risk non-muscle invasive bladder cancer.

Background: The European Association of Urology (EAU) recommends early radical cystectomy (RC) for very-high-risk (VHR) nonmuscle invasive bladder cancer (NMIBC), in part due to suboptimal efficacy from BCG in this setting. Effective bladder-sparing alternatives are needed. We compared the oncological outcomes of Gemcitabine/Docetaxel (Gem/Doce) to BCG therapy in patients with VHR NMIBC.

A pilot intervention trial to reduce the use of post-procedural antimicrobials after common endourologic surgeries.

Objective: Post-procedural antimicrobial prophylaxis is not recommended by professional guidelines but is commonly prescribed. We sought to reduce use of post-procedural antimicrobials after common endoscopic urologic procedures.

Design: A before-after, quasi-experimental trial with a baseline (July 2020-June 2022), an implementation (July 2022), and an intervention period (August 2022-July 2023).

Omission of intraoperative drain placement during robotic partial nephrectomy and robotic radical prostatectomy is safe: an analysis of 18,000 patients.

Purpose: Placement of a drain during robotic assisted partial nephrectomy (RAPN) and robotic assisted radical prostatectomy (RARP) is standard practice for many urologists and can aid in assessment and management of complications such as urine leak, lymphocele, or bleeding. However, drain placement can cause discomfort and delay patient discharge, with questionable benefit. We aim to assess the correlation between drain placement with post operative complications.

The role of radical cystectomy and lymphadenectomy in the management of bladder cancer with clinically positive lymph node involvement.

Purpose Of Review: The role of radical cystectomy and pelvic lymph node dissection in muscle-invasive bladder cancer (MIBC) with clinically positive lymph nodes is debated. This review examines the role of surgery in treating patients with clinical N1 and more advanced nodal involvement (N2-N3) within a multimodal treatment approach.

Recent Findings: For clinical N1 disease, guidelines typically recommend neoadjuvant chemotherapy followed by surgery.