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World Journal of Hepatology 2024年第4期16卷 490-493页

作者： Mohamed Wishahi Department of urology Theodor Bilharz Research InstituteCairo 12411Egypt

Cancer immunotherapy is administered for first-line,second-line,neoadjuvant,or adjuvant treatment of advanced,metastatic,and recurrent cancer in the liver,gastrointestinal tract,and genitourinary tract,and other solid tumors.Erdafitinib is a fibroblast growth factor receptor(FGFR)inhibitor,and it is an adenosine triphosphate competitive inhibitor of FGFR1,FGFR2,FGFR3,and FGFR4.Immune checkpoint inhibitors are monoclonal antibodies that block programmed cell death protein 1(PD-1)and its ligand that exert intrinsic antitumor mechanisms.The promising results of first-line treatment of advanced and metastatic urothelial carcinoma with PD-1 blockades with single or combined agents,indicate a new concept in the treatment of advanced,metastatic,and recurrent hepatic and gastrointestinal carcinomas.Cancer immunotherapy as first-line treatment will improve overall survival and provide better quality of life.Debate is arising as to whether to apply the cancer immunotherapy as first-line treatment in invasive carcinomas,or as second-line treatment in recurrent or metastatic carcinoma following the standard chemotherapy.The literature in the field is not definite,and so far,there has been no consensus on the best approach in this situation.At present,as it is described in this editorial,the decision is applied on a case-by-case basis.

关键词： Programmed cell death protein-ligand 1 Erdafitinib Liver cancer Fibroblast growth factor receptor inhibitors Checkpoint inhibitors Bladder cancer Metastases

Treatment-induced neuroendocrine prostate cancer and de novo neuroendocrine prostate cancer:Identification,prognosis and survival,genetic and epigenetic factors

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World Journal of Clinical Cases 2024年第13期12卷 2143-2146页

作者： Mohamed Wishahi Department of urology Theodor Bilharz Research InstituteCairo 12411Egypt

Neuroendocrine prostate cancer(NEPC)shows an aggressive behavior compared to prostate cancer(PCa),also known as prostate adenocarcinoma.Scanty foci in PCa can harbor genetic alternation that can arise in a heterogeneity of prostate cancer.NEPC may arise de novo or develop following androgen deprivation therapy(ADT).NEPC that arise following ADT has the nomenclature“treatmentemerging/induced NEPC(t-NEPC)”.t-NEPC would be anticipated in castration resistant prostate cancer(CRPC)and metastatic PCa.t-NEPC is characterized by low or absent androgen receptor(AR)expression,independence of AR signaling,and gain of neuroendocrine phenotype.t-NEPC is an aggressive metastatic tumor,develops from PCa in response to drug induced ADT,and shows very short response to conventional therapy.t-NEPC occurs in 10%-17%of patients with CRPC.De novo NEPC is rare and is accounting for less than 2%of all PCa.The molecular mechanisms underlying the trans-differentiation from CRPC to t-NEPC are not fully elucidated.Sphingosine kinase 1 plays a significant role in t-NEPC development.Although neuroendocrine markers:Synaptophysin,chromogranin A,and insulinoma associated protein 1(INSM1)are expressed in t-NEPC,they are non-specific for diagnosis,prognosis,and follow-up of therapy.t-NEPC shows enriched genomic alteration in tumor protein P53(TP53)and retinoblastoma 1(RB1).There are evidences suggest that t-NEPC might develop through epigenetic evolution.There are genomic,epigenetic,and transcriptional alterations that are reported to be involved in development of t-NEPC.Knock-outs of TP53 and RB1 were found to contribute in development of t-NEPC.PCa is resistant to immunotherapy,and at present there are running trials to approach immunotherapy for PCa,CRPC,and t-NEPC.

关键词： Prostate cancer Neuroendocrine carcinoma Treatment induced neuroendocrine prostate cancer Androgen deprivation therapy Genetic and epigenetic factors Castration resistant prostate cancer De novo neuroendocrine prostate cancer

Tumor deposits in axillary adipose tissue in patients with breast cancer:Do they matter?

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World Journal of Clinical Cases 2024年第6期12卷 1045-1049页

作者： Muhammed Mubarak Rahma Rashid Shaheera Shakeel Department of Histopathology Sindh Institute of Urology and TransplantationKarachi 74200SindhPakistan

Tumor deposits(TDs)are defined as discrete,irregular clusters of tumor cells lying in the soft tissue adjacent to but separate from the primary tumor,and are usually found in the lymphatic drainage area of the primary tumor.By definition,no residual lymph node structure should be identified in these tumor masses.At present,TDs are mainly reported in colorectal cancer,with a few reports in gastric cancer.There are very few reports on breast cancer(BC).For TDs,current dominant theories suggest that these are the result of lymph node metastasis of the tumor with complete destruction of the lymph nodes by the tumor tissue.Even some pathologists classify a TD as two lymph node metastases for calculation.Some pathologists also believe that TDs belong to the category of disseminated metastasis.Therefore,regardless of the origin,TDs are an indicator of poor prognosis.Moreover,for BC,sentinel lymph node biopsy is generally used at present.Whether radical axillary lymph node dissection should be adopted for BC with TDs in axillary lymph nodes is still inconclusive.The present commentary of this clinical issue has certain guiding significance.It is aimed to increase the awareness of the scientific community towards this under-recognized problem in BC pathology.

关键词： Breast cancer Tumor deposits Lymph node metastasis Staging

Antioxidant treatment foroligoasthenoteratozoospermia and varicocele:aDBPC trial to evaluate the impact of age and bodymass index

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Asian Journal of Andrology 2024年第3期26卷 239-244页

作者： Gian Maria Busetto Bernarde F Rodrigues Ashraf Virmani Andrea Checchia Antonella Ninivaggi Anna Ricapito Giovanni Barbieri Piero Fischetti Ugo G Falagario Pasquale Annese Nicola d’Altilia Vito Mancini Matteo Ferro Felice Crocetto Angelo Porreca Carlo Bettocchi Luigi Cormio Ashok Agarwal Giuseppe Carrieri University of Foggia Foggia 71122Italy Department of urology and Renal Transplantation Policlinico of FoggiaFoggia 71122Italy Department of urology HumanReproduction SectionFederal University of Sao PauloSao Paulo 05403-000Brazil Alfasigma Healthscience Utrecht 3528 BGThe Netherlands urology Unit “G.Tatarella”HospitalCerignola 71042Italy urology Unit European Institute of Oncology(IEO)IRCCSMilan 20142Italy University of Naples Federico II Naples80126Italy Department of Oncological urology Veneto Institute of Oncology(IOV)IRCCSPadua 35039Italy urology Unit “L.Bonomo”HospitalAndria 70031Italy Global Andrology Forum Moreland HillsOH 44022USA

Oxidative stress is one of the main mechanisms responsible for male infertility.Various conditions such as varicocele,obesity,advanced age,and lifestyle can lead to an increase in reactive oxygen species,causing an oxidative imbalance in the reproductiveenvironment.Spermatozoa are sensitive to reactive oxygen species and require energy to carry out their main function of fertilizingthe egg.Excessive reactive oxygen species can affect sperm metabolism,leading to immobility,impaired acrosome reaction,and celldeath,thereby impairing reproductive success.This double-blind randomized study evaluated the effect of supplementation withL-carnitine,acetyl-L-carnitine,vitamins,and other nutrients on semen quality in 104 infertile patients with or without varicocele,while also investigating the impact of factors such as obesity and advanced age on treatment.Sperm concentration significantlyincreased in the supplemented group compared to the placebo group(P=0.0186).Total sperm count also significantly increasedin the supplemented group(P=0.0117),as did sperm motility(P=0.0120).The treatment had a positive effect on patients upto 35 years of age in terms of sperm concentration(P=0.0352),while a body mass index(BMI)above 25 kg m−2 had a negativeeffect on sperm concentration(P=0.0110).Results were not showing a net benefit in stratifying patients in accordance withtheir BMI since sperm quality increase was not affected by this parameter.In conclusion,antioxidant supplementation may bebeneficial for infertile patients and has a more positive effect on younger patients with a normal weight.

关键词： aging antioxidants body mass index oligoasthenoteratozoospermia varicocele

Incidence of urinary incontinence followingendoscopic laser enucleation of the prostate byen-bloc and non-en-bloc techniques:a multicenter,real-world experience of 5068 patients

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Asian Journal of Andrology 2024年第3期26卷 233-238页

作者： Daniele Castellani Vineet Gauhar Khi Yung Fong Mario Sofer Moisés Rodríguez Socarrás Azimdjon N Tursunkulov Lie Kwok Ying Sarvajit Biligere Ho Yee Tiong Dean Elterman Abhay Mahajan Mark Taratkin Sorokin Nikolai Ivanovich Tanuj Pal Bhatia Dmitry Enikeev Nariman Gadzhiev Mohammed Taif Bendigeri Jeremy Yuen-Chun Teoh Marco Dellabella Fernando Gómez Sancha Bhaskar Kumar Somani Thomas Reinhard William Herrmann urology Unit IRCCS INRCAAncona 60127Italy urology Unit Marche University HospitalLe Marche Polytechnic UniversityAncona 60126Italy Departmentof urology Ng Teng Fong General HospitalSingapore 609606Singapore Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore Department of urology Tel Aviv Sourasky Medical CenterAffiliated to the Sackler School of MedicineTel Aviv UniversityTel Aviv 6423906Israel Department of urology and Robotic Surgery ICUA-Clínica CEMTROMadrid 28701Spain urology Division AkfaMedline HospitalTashkent 100211Uzbekistan Advanced urology Gleneagles HospitalSingapore 258499Singapore Department of urology National University HospitalSingapore 119228Singapore Divisionof urology Department of SurgeryUniversity of TorontoOntarioToronto M5G 2C4Canada Department of urology Mahatma Gandhi Mission’s Medical College andHospitalAurangabad 431003India institute for urology and Reproductive Health Sechenov UniversityMoscow119435Russian Federation Department of urologyand Andrology Lomonosov Moscow State UniversityMoscow 119992Russian Federation Department of urology Sarvodaya Hospital and Research CentreFaridabadHaryana 121006India Department of urology Medical University of ViennaVienna 1090Austria Department of urology Saint-Petersburg State University HospitalSaint-Petersburg 199034Russian Federation Department of urology Asian Institute of Nephrology and UrologyHyderabad 500082India S.H.Ho urologyCentre Department of SurgeryFaculty of MedicineThe Chinese University of Hong KongHong Kong 96H2+Q9China Department of urology University HospitalsSouthampton NHS TrustSouthampton SO166YDUnited Kingdom Department of urology Cantonal Hospital Thurgau AGFraunfeld 8500Switzerland.

We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate(EEP)comparing en-bloc(Group 1)versus 2-lobe/3-lobe techniques(Group 2).We performed a retrospective review of patients undergoing EEP for benign prostaticenlargement in 12 centers between January 2020 and January 2022.Data were presented as median and interquartile range(IQR).Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence(SUI)and mixed urinary incontinence(MUI).There were 1711 patients in Group 1 and 3357 patients in Group 2.Patients in Group 2were significantly younger(68[62–73]years vs 69[63–74]years,P=0.002).Median(interquartile range)prostate volume(PV)wassimilar between the groups(70[52–92]ml in Group 1 vs 70[54–90]ml in Group 2,P=0.774).There was no difference in preoperativeInternational Prostate Symptom Score,quality of life,or maximum flow rate.Enucleation,morcellation,and total surgical time weresignificantly shorter in Group 1.Within 1 month,overall incontinence rate was 6.3%in Group 1 versus 5.3%in Group 2(P=0.12),and urge incontinence was significantly higher in Group 1(55.1%vs 37.3%in Group 2,P<0.001).After 3 months,the overall rate ofincontinence was 1.7%in Group 1 versus 2.3%in Group 2(P=0.06),and SUI was significantly higher in Group 2(55.6%vs 24.1%in Group 1,P=0.002).At multivariable analysis,PV and IPSS were factors significantly associated with higher odds of transient SUI/MUI.PV,surgical time,and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.

关键词： benign prostatic hyperplasia en-bloc enucleation endoscopic enucleation of the prostate laser therapy stress urinaryincontinence urge urinary incontinence

A systematic review of cytoreductive prostatectomy outcomes and complications in oligometastatic disease

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Asian Journal of urology 2024年第2期11卷 208-220页

作者： Andrey Morozov Leonid Chuvalov Mark Taratkin Mikhail Enikeev Leonid Rapoport Nirmish Singla Eric Barret Elena Poddubskaya Maria Borodina Georg Salomon Juan Gomez Rivas Dmitry Enikeev institute for urology and Reproductive Health Sechenov UniversityMoscowRussia Young Academic Urologists EAUthe Netherlands Department of urology James Buchanan Brady Urological InstituteThe Johns Hopkins University School of MedicineBaltimoreUSA Department of urology Institut Mutualiste MontsourisParisFrance Sechenov University MoscowRussia Hertsen Moscow Oncology Research InstituteMoscowRussia Hertsen Moscow Oncology Research institute MoscowRussia Martini Clinic University Medical Center Hamburg-EppendorfHamburgGermany Department of urology Clinico San Carlos University HospitalMadridSpain Department of urology Medical University of ViennaViennaAustria

Objective: To analyze outcomes and complications of cytoreductive prostatectomy (CRP) for oligometastatic prostate cancer (PCa) in order to elucidate its role in this space.Methods: We performed a systematic literature search using three databases (Medline, Scopus, and Web of Science). The primary endpoints were oncologic outcomes. The secondary endpoints were complication rates and functional results.Results: In all studies, overall survival was better or at least comparable variable in the groups with CRP compared to no local treatment. The greatest benefit from CRP in 5-year overall survival in one study was 67.4% for CRP versus 22.5% for no local treatment. Cancer-specific survival (CSS) showed the same trend. Several authors found significant benefits from CSS in the CRP group: from 79% vs. 46% to 100% vs. 61%. CRP was a predictor of better CSS (hazard ratio 0.264, p=0.004). Positive surgical margin rates differed widely from 28.6% to 100.0%. Urinary continence in CRP versus RP for localized PCa was significantly lower (57.4% vs. 90.8%, p<0.0001). Severe incontinence occurred seldom (2.5%-18.6%). Total complication rates after CRP differed widely, from 7.0% to 43.6%. Rates of grades 1 and 2 events prevailed. Patients on ADT alone also showed a considerable number of complications varying from 5.9% to 57.7%.Conclusion: CRP improves medium-term cancer control in patients with oligometastatic PCa. The morbidity and complication rates of this surgery are comparable with other approaches, but postoperative incontinence rate is higher compared with RP for localized disease.

关键词： Systematicreview Prostatecancer Oligometastatic Bone metastases Cytoreductive prostatectomy

Robotic assisted laparoscopic simple suprapubic prostatectomy--The Smith institute for urology experience with an evolving technique

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Asian Journal of urology 2014年第1期1卷 55-59页

作者： Sammy E.Elsamra Nikhil Gupta Haris Ahmed David Leavitt Jessica Kreshover Louis Kavoussi Lee Richstone The Smith institute for urology New Hyde ParkNYUSA

Objective:Despite a multitude of minimally invasive surgical options available for benign prostatic enlargement,open simple prostatectomy(OSP)remains the standard for large prostates(typically greater than 100 g).OSP,however,is associated with significant morbidity.Recently,a few reports touting robotic application to simple prostatectomy have been published.Herein,we reviewed our series of robotic assisted laparoscopic simple suprapubic prostatectomy(RALSSP)and detailed modifications in our technique as our experience increased.Methods:All RALSSP cases performed between January 2013 and January 2014 were reviewed for demographics,pre-operative features,and perioperative outcomes.All parameters were tabulated and mean values were calculated.Student’s t-test was utilized with p<0.05 deemed significant.Details regarding surgical technique were reviewed and highlighted.Results:Fifteen patients underwent RALSSP during this period.Mean age of these men was 68.7 years.Mean body mass index(BMI)was 28.5 kg/m^2.American Society of Anesthesiologists(ASA)score was on average 2.6.Average International Prostate Symptom Score(IPSS)was 16.2 with the majority of men experiencing some adverse clinical sequela of such benign prostatic hyperplasia(BPH).For those patients not in retention,preoperative post-void residual(PVR)was 428 mL.All patients underwent successful RALSSP without need for conversion or need for blood transfusion.Mean estimated blood loss(EBL)was 290 mL.Five patients underwent other concurrent procedures(e.g.,cystolithotomy).Mean length of hospital stay(LOS)was 2.4 days and only five patients required continuous bladder irrigation(CBI)postoperatively.Postoperative PVR improved to a mean of 33 mL and IPSS improved to 4.5(p<0.001).No major complications were identified.Adaptation of low transverse cystotomy,utilization of a robotic tenaculum in the#3 arm with its control by a surgeon on a second console,and the utilization of mucosal advancement have all subjectively aided in performance of RALSSP and perioperative

关键词： Robotic assisted laparoscopic simple suprapubic prostatectomy Benign prostatic hyperplasia Blood loss Hospital stay

Defining minimal invasive surgical therapy for benign prostatic obstruction surgery: Perspectives from a global knowledge, attitude, and practice survey

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Asian Journal of urology 2024年第1期11卷 55-64页

作者： Bryan Kwun-Chung Cheng Steffi Kar-Kei Yuen Daniele Castellani Marcelo Langer Wroclawski Hongda Zhao Mallikarjuna Chiruvella Wei-Jin Chua Ho-Yee Tiong Yiloren Tanidir Jean de la Rosette Enrique Rijo Vincent Misrai Amy Krambeck Dean S.Elterman Bhaskar K.Somani Jeremy Yuen-Chun Teoh Vineet Gauhar Department of Surgery United Christian HospitalHong KongChina S.H.Ho urology Centre Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongHong KongChina Department of urology University Hospital“Ospedali Riuniti”and Polytechnic University of Marche RegionAnconaItaly Hospital Israelita Albert Einstein Sao PauloSPBrazil BP—A Beneficencia Portuguesa de Sao Paulo Sao PauloSPBrazil Faculdade de Medicina do ABC Santo AndreSPBrazil Department of urology Asian Institute of Nephrology and UrologyHyderabadTGIndia Department of urology National University HospitalSingapore Department of urology Marmara University School of MedicineIstanbulTurkey Department of urology Medipol Mega University HospitalIstanbul Medipol UniversityIstanbulTurkey Department of urology Hospital Quiron BarcelonaBarcelonaSpain Department of urology Clinique PasteurToulouseFrance Department of urology Indiana University School of MedicineIndianapolisINUSA Division of urology Department of SurgeryUniversity Health NetworkUniversity of TorontoTorontoCanada Department of urology University Hospital Southampton NHS TrustSouthamptonUK Department of urology Ng Teng Fong General HospitalNUHSSingapore

Objective:To scrutinize the definitions of minimal invasive surgical therapy(MIST)and to investigate urologists’knowledge,attitudes,and practices for benign prostatic obstruction surgeries.Methods:A 36-item survey was developed with a Delphi method.Questions on definitions of MIST and attitudes and practices of benign prostatic obstruction surgeries were included.Urologists were invited globally to complete the online survey.Consensus was achieved when more than or equal to 70%responses were“agree or strongly agree”and less than or equal to 15%responses were“disagree or strongly disagree”(consensus agree),or when more than or equal to 70%responses were“disagree or strongly disagree”and less than or equal to 15%responses were“agree or strongly agree”(consensus disagree).Results:The top three qualities for defining MIST were minimal blood loss(n=466,80.3%),fast post-operative recovery(n=431,74.3%),and short hospital stay(n=425,73.3%).The top three surgeries that were regarded as MIST were Urolift®(n=361,62.2%),Rezum®(n=351,60.5%),and endoscopic enucleation of the prostate(EEP)(n=332,57.2%).Consensus in the knowledge section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,day surgery feasibility,and post-operative continence.Consensus in the attitudes section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,and day surgery feasibility.Consensus on both sections was achieved for EEP as the option with the better symptoms and flow improvement,lower retreatment rate,and better suitable for prostate more than 80 mL.Conclusion:Minimal blood loss,fast post-operative recovery,and short hospital stay were the most important qualities for defining MIST.Urolift®,Rezum®,and EEP were regarded as MIST by most urologists.

关键词： Benignprostate hyperplasia Minimalinvasive surgical therapy Surgery Bladderoutlet obstruction

Minimally invasive surgical therapies(MISTs)for lower urinary tract symptoms(LUTS):promise or panacea?

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Asian Journal of Andrology 2024年第2期26卷 135-143页

作者： Gian Maria Busetto Andrea Checchia Marco Recchia Edoardo Tocci Ugo G Falagario Gennaro Annunziata Pasquale Annese Nicola d'Altilia Vito Mancini Matteo Ferro Felice Crocetto Octavian Sabin Tataru Luca Di Gianfrancesco Angelo Porreca Francesco Del Giudice Ettore De Berardinis Carlo Bettocchi Luigi Cormio Giuseppe Carrieri University of Foggia Foggia 71122Italy Department of urology and Renal Transplantation Policlinico of FoggiaFoggia 71122Italy urology Unit "G.Tatarlla"HospitalCerignola 71042Italy urology Unit European Institute of Oncology(IE0)IRCcSMilan 20141Italy University of Naples Federico Il Naples 80126Italy G.E.Palade University of Medicine PharmacyScienceand Technology of Targu MuresTargu Mures 540142Romania Department of Oncological urology Veneto Institute of Oncology(IOv)IRccSPadua 35128Italy Department of Maternal-Infant and Urological Sciences Sapienza Rome UniversityRoma 00161Italy urology Unit "L.Bonomo"HospitalAndria 76123Italy

The increasing importance of treatment of lower urinary tract symptoms(LUTS),while avoiding side effects and maintaining sexual function,has allowed for the development of minimally invasive surgical therapies(MiSTs).Recently,the European Association of urology guidelines reported a paradigm shift from the management of benign prostatic hyperplasia(BPH)to the management of nonneurogenic male LUTS.The aim of the present review was to evaluate the efficacy and safety of the most commonly used MisTs:ablative techniques such as aquablation,prostatic artery embolization,water vapor energy,and transperineal prostate laser ablation,and nonablative techniques such as prostatic urethral lift and temporarily implanted nitinol device(iTIND).MiSTs are becoming a new promise,even if clinical trials with longer follow-up are still lacking.Most of them are still under investigation and,to date,only a few options have been given as a recommendation for use.They cannot be considered as standard of care and are not suitable for all patients.Advantages and disadvantages should be underlined,without forgetting our objective:treatment of LUTS and re-treatment avoidance.

关键词： aquablation iTIND prostatic artery embolization prostatic urethral lift transperineal prostate laser ablation water vapor energy

A multicenter uroflowmetry study of healthy women in China

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中华医学杂志(英文版) 2024年第10期137卷 1225-1227页

作者： Liu Xiaodong Meng Lingfeng Wang Jiawen Ma Tianming Shi Benkang Huang Hai Wang Qingwei Chen Min Liao Limin Shen Hong Wei Zhongqing Xiao Yuansong Pan Tiejun Ren Jian Zhang Peng Tian Xiaojun Zhang Yaoguang Department of urology The Second Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu China Department of urology General Hospital of Southern Theatre Command Guangzhou Guangdong China Department of urology General Hospital of Central Theatre Command Wuhan Hubei China Department of urology China-Japan Friendship Hospital Beijing China Department of urology Beijing Chao-Yang Hospital Beijing China Department of urology Peking University Third Hospital Beijing China Department of urology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences &amp Peking Union Medical College Beijing China Graduate School of Peking Union Medical College Beijing China Department of urology Qilu Hospital Shandong University Jinan Shandong China Department of urology SUN YAT-SEN Memorial Hospital Guangzhou Guangdong China Department of urology The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan China Department of urology Tongji Hospital Tongji Medical College of Huazhong University of Science and Technology Wuhan Hubei China Department of urology China Rehabilitation Research Center Beijing China Department of urology West China Hospital Chengdu Sichuan China