Proposed tripartite classification of T1 renal cell carcinoma: Comparison with current binary system.

Objective: Outcomes of stage 1 renal cell carcinoma (RCC) are heterogeneous and vary widely. We sought to investigate whether tripartite reclassification of current binary T1 RCC would lead to more rational consolidation of similar outcomes that may improve predictive ability.

Methods: We performed a retrospective multicenter analysis of patients undergoing radical (RN) or partial nephrectomy (PN) for clinical T1N0M0 RCC.

Urine Glycosaminoglycan Scores for Surveillance of Recurrence in Intermediate- and High-risk Nonmetastatic Clear Cell Renal Cell Carcinoma-An Observational Prospective Multicentre Diagnostic Test Cohort Study.

Background And Objective: Nonmetastatic (M0) clear cell renal cell carcinoma (ccRCC) recurs in ∼20% of patients within 5 yr after surgery. With no biomarkers available, recurrence detection relies on radiological imaging. Urine glycosaminoglycan profiles (GAGomes) were previously associated with M0 ccRCC recurrence.

Development of a Health-related Quality of Life Questionnaire for Patients with Metastatic or Localized Renal Cell Carcinoma.

Background And Objective: Despite significant advances in treatments for renal cell carcinoma (RCC) over the past decade, health-related quality of life (HRQOL) assessments have not been updated to reflect these developments. The aim of our study was to refine assessment of HRQOL for patients with localized or metastatic RCC.

Methods: We conducted a four-phase international study (August 2022-October 2024).

Developing biomarkers and methods of risk stratification: Consensus statements from the International Kidney Cancer Symposium North America 2024 Think Tank.

Accurate prognostication and personalized treatment selection remain major challenges in kidney cancer. This consensus initiative aimed to provide actionable expert guidance on the development and clinical integration of prognostic and predictive biomarkers and risk stratification tools to improve patient care and guide future research. A modified Delphi method was employed to develop consensus statements among a multidisciplinary panel of experts in urologic oncology, medical oncology, radiation oncology, pathology, molecular biology, radiology, outcomes research, biostatistics, industry, and patient advocacy.

Risk Factors for First-Year Recurrence in Patients With Synchronous Metastatic Renal Cell Carcinoma Undergoing Cytoreductive Nephrectomy and Complete Metastasectomy.

Purpose: Patients with metastatic renal cell carcinoma (mRCC) with oligometastatic disease can achieve radiographic disease-free (M1 NED) status after cytoreductive nephrectomy and concurrent complete metastasectomy. This study aimed to evaluate outcomes and identify risk factors associated with metastatic recurrence and overall survival in patients with mRCC M1 NED.

Materials And Methods: Patients with synchronous mRCC who were M1 NED after cytoreductive nephrectomy and concurrent complete metastasectomy from 4 institutions (2010-2020) were identified.

Phase 3 Trial of Dose-Escalated Radiation Therapy and Standard Androgen Deprivation Therapy Versus Dose-Escalated Radiation Therapy and Enhanced Androgen Deprivation Therapy With Orteronel for Men With High-Risk Prostate Cancer (NRG/RTOG 1115).

Purpose: NRG/RTOG 1115 was a phase 3 trial evaluating the addition of orteronel, a CYP17A1 inhibitor, to radiation therapy (RT) plus androgen deprivation therapy (ADT) in men with high-risk prostate cancer.

Methods And Materials: The study was designed to evaluate overall survival for 900 men with high-risk prostate cancer (Gleason 9-10, prostate specific antigen (PSA) > 20, or clinical stage T2 or higher with Gleason ≥ 8). Patients were randomized 1:1 to standard of care (SOC) therapy (RT plus 2 years of ADT) or SOC plus 2 years of orteronel.

Concordance between clinical and pathologic staging of larger (cT2a-b) and more invasive (cT3a) renal cell carcinoma.

Introduction And Objectives: Among patients with renal cell carcinoma (RCC), 5%-23% of those with cT1 and smaller cT2 tumors may be upstaged to pT3a disease after surgery. The pathologic restaging rate of larger or clinically more invasive tumors is understudied and has implications for perioperative systemic therapy clinical trial enrollment. We examined rates of pathologic restaging for cT2a-b and cT3a RCC after surgery.

Association of Elevated Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte, and De Ritis Ratios With Major Complications After Surgery for Renal Cell Carcinoma: A Pathway to Optimize Charlson Comorbidity Index and Preoperative Predictive Modeling.

Objective: To evaluate the predictive value of De Ritis ratio (DRR), Neutrophil-to-Lymphocyte Ratio (NLR), and Platelet-to-Lymphocyte Ratio (PLR) for major post-operative complications following Renal Cell Carcinoma (RCC) surgery, and to assess their predictive utility in addition to Charlson Comorbidity Index (CCI).

Methods: We conducted a multicenter retrospective analysis of patients who underwent surgery for M0 RCC. Primary outcome was the occurrence of major complication (Clavien-Dindo >2).

Opioid Use in Patients With Testicular Cancer: Patterns and Risk Factors.

Introduction: Prescription opioid use is a gateway to chronic dependence and associated morbidity and mortality. Research has demonstrated that men receiving narcotics after urologic surgery are at increased risk of persistent opioid use. However, factors associated with persistent use in testicular cancer patients specifically are poorly understood.

UNIK (Urologic Non-Neoplastic Investigation of Kidneys): a machine learning approach to decode benign lesion.

Purpose: Predicting the likelihood of benign neoplasia in patients with suspected renal cell carcinoma (RCC) is a cornerstone of presurgical planning. We sought to create and validate U.N.

Primary penile mesenchymal tumors: A clinicopathologic analysis of 48 cases.

Introduction: While the vast majority of penile malignancies are of epithelial origin, most commonly squamous cell carcinoma, mesenchymal tumors of the penis, though rare, represent an important and diagnostically diverse group of neoplasms with variable clinical behavior.

Materials And Methods: We retrieved cases of primary penile mesenchymal tumors diagnosed or treated at our institution over a 24-year period. Histologic diagnoses were confirmed through systematic review of archived hematoxylin and eosin and immunohistochemical slides.

A Spatial Metabolomics Annotation Workflow Leveraging Cyclic Ion Mobility and Machine Learning-Predicted Collision Cross Sections.

In nontargeted spatial metabolomics, accurate annotation is crucial for understanding metabolites' biological roles and spatial patterns. MS mass spectrometry imaging (MSI) coverage is often incomplete or nonexistent, resulting in many unknown features that represent an untapped source of biological information. Ion mobility-derived collision cross sections (CCS) have been leveraged as valuable descriptors for confirming putative metabolite annotations, distinguishing isomers, and aiding in unknown structural elucidation.

Prospective evaluation of comprehensive geriatric assessments in multidisciplinary bladder cancer care and implications for personalized vulnerability phenotyping.

Purpose: Frailty predicts adverse outcomes in bladder cancer (BC). Current guidelines endorse completion of Comprehensive Geriatric Assessments (CGAs) in older adults prior to treatment election to objectively measure frailty, however, these are rarely performed in urologic practice due to inadequate resources. We hypothesized CGA implementation would be feasible and identify multifaceted vulnerabilities beyond standard risk assessments in a multidisciplinary BC clinic and developed a novel method to visualize "vulnerability phenotypes" to guide supportive interventions.

Thromboembolic Events in Castration-Resistant Prostate Cancer Patients With and Without Cardiovascular Comorbidities Receiving Oral Androgen Receptor Pathway Inhibitors.

Background: This study investigates the association between thromboembolic events (TE) and castration-resistant prostate cancer (CRPC) patients receiving oral androgen receptor pathway inhibitors (ARPi) compared to those undergoing chemotherapy, both with and without a pre-existing history of cardiovascular disease (CVD).

Methods: A total of 2779 men diagnosed with CRPC were identified using the Surveillance, Epidemiology, and End Results (SEER) Medicare Linked Database from 2012 to 2016. Patients were stratified based on their CVD history.

Propensity Score-Matched Analysis of Radical and Partial Nephrectomy in pT3aN0M0 Renal Cell Carcinoma.

Background: We sought to evaluate oncological and functional outcomes of patients treated with partial nephrectomy (PN) and radical nephrectomy (RN) in pT3aN0M0 renal cell carcinoma (RCC).

Patients And Methods: We conducted a retrospective analysis of surgically treated pT3aN0M0 RCC patients. Primary outcome was all-cause mortality/overall survival (ACM/OS).

Paraneoplastic and symptomatic score (PRIMAL) for prediction of overall and cancer-specific survival after surgery in patients with renal cell carcinoma.

Purpose: To develop the PRIMAL (Prognostic Risk stratification for Integrating Manifestations of symptoms and Abnormal Labs) score to predict prognosis in renal cell carcinoma (RCC) by integrating clinical presentation, paraneoplastic syndromes (PNS), and abnormal laboratory values at diagnosis.

Materials And Methods: 5256 T1-T4, N0/1, M0/1 RCC surgical patients from 4 institutions were analyzed retrospectively. Preoperative variables included hematuria, visceral pain, nausea/vomiting, thrombocytopenia (<100 × 10/L), hypoalbuminemia (<3.

Incidence of New Mental Health Diagnosis in Testicular Cancer Survivors.

Objective: To evaluate incidence of mental health disorder (MHD) diagnosis after orchiectomy in testicular cancer patients and identify factors associated with MHD.

Methods: Using claims from the IBM Marketscan database, we identified patients 18 years or older diagnosed with testicular cancer between 2009 and 2021 who underwent orchiectomy, had no prior MHD diagnoses, and maintained insurance coverage spanning 6months before and 12months after diagnosis. Chemotherapy and RPLND were defined as advanced treatments.

Integrating Botanicals into Oncology Care: Consideration of FDA Regulation of Botanical Products and Botanical Clinical Trials.

Modern cancer pharmacotherapy consists of contributions from natural products, their structural analogues, and chemotherapies. Interest in natural products is being revitalized in oncology. Natural products may be classified as food, dietary supplements, drugs, or cosmetics depending on their intended use.

Neoadjuvant cabozantinib for locally advanced nonmetastatic clear cell renal cell carcinoma: a phase 2 trial.

Cabozantinib is an oral multikinase inhibitor approved for treatment in metastatic renal cell carcinoma (RCC). We conducted a phase 2, nonrandomized, single-arm clinical trial (NCT04022343) of cabozantinib treatment for 12 weeks in 17 patients with locally advanced, biopsy-proven, nonmetastatic clear cell RCC before surgical resection. The primary end point was the objective response rate (complete and partial responses) at week 12 and secondary end points included safety, tolerability, clinical and surgical outcomes, and quality of life.

Treatment switching between Enzalutamide and Abiraterone Acetate and time to oral opioid initiation in castration-resistant prostate cancer patients.

Background And Aims: Enzalutamide (ENZ) and Abiraterone Acetate (AA) are both first-line treatments for castration-resistant prostate cancer (CRPC). CRPC patients may switch from ENZ to AA or from AA to ENZ, if they do not respond well to the treatment, or experience intolerable side effects. This study examine treatment switching from ENZ to AA or from AA to ENZ, while investigating death as a competing risk.

Association of baseline inflammatory biomarkers and clinical outcomes in patients with advanced renal cell carcinoma treated with immune checkpoint inhibitors.

Background: Immune checkpoint inhibitors (ICIs) have become the mainstay treatment of metastatic kidney cancer, demonstrating enhanced outcomes and durable responses in select patient subgroups. However, identifying reliable prognostic biomarkers for treatment outcomes remains challenging.

Objectives: This study aimed to assess the correlation between baseline inflammatory markers and overall survival (OS), progression-free survival (PFS), and clinical benefit (CB) in metastatic kidney cancer patients receiving ICIs.

A Call for a Neoadjuvant Kidney Cancer Consortium: Lessons Learned from Other Cancer Types.

Neoadjuvant systemic treatment strategies have improved outcomes in several solid tumour types. This success has not yet been replicated in renal cell carcinoma (RCC). A consensus and international collaboration are urgently needed for the development of adaptive perioperative immunotherapy strategies for patients with RCC at high risk of recurrence.

Real-World Outcomes in Patients with Advanced Penile Squamous Cell Carcinoma Receiving Immune Checkpoint Inhibitors: A Single Institution Experience.

Introduction: Advanced penile squamous cell carcinoma (pSCC) is a rare and aggressive malignancy with a poor prognosis and an unmet need for biomarkers. We performed a retrospective evaluation of real-world efficacy, safety outcomes, and baseline inflammatory biomarkers in patients with advanced pSCC treated with immune checkpoint inhibitors (ICIs).

Methods: We performed a retrospective review of patients with advanced pSCC who received ICIs from 2012 to 2023 at the Winship Cancer Institute of Emory University in Atlanta, GA.

Development and validation of nomograms and integrated software incorporating preoperative C-reactive protein level for prognostic prediction of nonmetastatic clear cell renal cell carcinoma: Results from the International Marker Consortium for Renal Cancer (INMARC) Registry.

Purpose: Preoperative C-reactive protein (CRP) is a valuable prognostic biomarker in nonmetastatic clear cell renal cell carcinoma (nmccRCC). Incorporation of CRP into prognostic models may improve the prediction of oncologic outcomes. Herein, we aimed to develop and validate prognostic nomograms and an integrated software incorporating preoperative CRP level in nmccRCC.

Racial disparity in preoperative C-reactive protein level for predicting prognosis of patients with non-metastatic clear cell renal cell carcinoma: INMARC study.

Background: C-reactive protein (CRP) is a prognostic biomarker for clear cell renal cell carcinoma (ccRCC). However, there may be potential racial heterogeneity in distribution and prognostic impact of CRP level. We investigated potential racial differences in distribution and prognostic impact of preoperative CRP among Asian (AS), African American (AA), and Caucasian (CAUC) patients with non-metastatic ccRCC (nmccRCC).