Subjects -> MEDICAL SCIENCES (Total: 8196 journals)
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    - UROLOGY, NEPHROLOGY AND ANDROLOGY (151 journals)

UROLOGY, NEPHROLOGY AND ANDROLOGY (151 journals)                     

Showing 1 - 144 of 144 Journals sorted alphabetically
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 1)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Advances in Chronic Kidney Disease     Hybrid Journal   (Followers: 15)
Advances in Urology     Open Access   (Followers: 13)
African Journal of Nephrology     Open Access   (Followers: 1)
African Journal of Urology     Open Access   (Followers: 7)
AJP Renal Physiology     Hybrid Journal   (Followers: 8)
Aktuelle Urologie     Hybrid Journal   (Followers: 4)
American Journal of Kidney Diseases     Hybrid Journal   (Followers: 53)
American Journal of Men's Health     Open Access   (Followers: 9)
American Journal of Nephrology     Full-text available via subscription   (Followers: 31)
Andrologia     Hybrid Journal   (Followers: 3)
Andrology     Hybrid Journal   (Followers: 5)
Andrology & Gynecology : Current Research     Hybrid Journal   (Followers: 4)
Andrology and Genital Surgery     Open Access   (Followers: 8)
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 2)
Arab Journal of Urology     Open Access   (Followers: 7)
Archives of Clinical Nephrology     Open Access   (Followers: 2)
Archivio Italiano di Urologia e Andrologia     Open Access   (Followers: 1)
Archivos Españoles de Urología     Open Access   (Followers: 1)
Asian Journal of Andrology     Open Access   (Followers: 1)
Asian Journal of Urology     Open Access   (Followers: 3)
Asian Pediatric Nephrology Association     Open Access   (Followers: 3)
Bangladesh Journal of Urology     Open Access   (Followers: 5)
Basic and Clinical Andrology     Open Access  
BJU International     Hybrid Journal   (Followers: 19)
BJUI Compass     Open Access   (Followers: 1)
BMC Nephrology     Open Access   (Followers: 9)
BMC Urology     Open Access   (Followers: 13)
Canadian Journal of Kidney Health and Disease     Open Access   (Followers: 7)
Canadian Urological Association Journal     Open Access   (Followers: 1)
Cancer Urology     Open Access   (Followers: 1)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Case Reports in Nephrology     Open Access   (Followers: 6)
Case Reports in Nephrology and Dialysis     Open Access   (Followers: 8)
Case Reports in Urology     Open Access   (Followers: 11)
Clinical and Experimental Nephrology     Hybrid Journal   (Followers: 5)
Clinical Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 24)
Clinical Kidney Journal     Open Access   (Followers: 5)
Clinical Medicine Insights : Urology     Open Access   (Followers: 3)
Clinical Nephrology     Full-text available via subscription   (Followers: 8)
Cuadernos de Cirugía     Open Access  
Current Opinion in Nephrology & Hypertension     Hybrid Journal   (Followers: 12)
Current Opinion in Urology     Hybrid Journal   (Followers: 11)
Current Urology     Open Access   (Followers: 10)
Current Urology Reports     Hybrid Journal   (Followers: 5)
Der Nephrologe     Hybrid Journal  
Der Urologe     Hybrid Journal   (Followers: 1)
Diabetic Nephropathy     Open Access  
EMC - Urología     Full-text available via subscription  
Enfermería Nefrológica     Open Access   (Followers: 1)
European Urology     Hybrid Journal   (Followers: 23)
European Urology Focus     Hybrid Journal   (Followers: 4)
European Urology Oncology     Hybrid Journal  
European Urology Open Science     Open Access   (Followers: 8)
Forum Nefrologiczne     Full-text available via subscription  
Geriatric Nephrology and Urology     Hybrid Journal   (Followers: 7)
Giornale di Clinica Nefrologica e Dialisi     Open Access  
Hellenic Urology     Open Access   (Followers: 3)
IJU Case Reports     Open Access  
Indian Journal of Nephrology     Open Access   (Followers: 2)
Indian Journal of Urology     Open Access   (Followers: 5)
International Brazilian Journal of Urology     Open Access   (Followers: 5)
International Journal of Nephrology     Open Access   (Followers: 2)
International Journal of Nephrology and Renovascular Disease     Open Access   (Followers: 2)
International Journal of Urology     Hybrid Journal   (Followers: 10)
International Urology and Nephrology     Hybrid Journal   (Followers: 6)
Journal für Urologie und Urogynäkologie/Österreich     Hybrid Journal  
Journal of Clinical Nephrology     Open Access   (Followers: 1)
Journal of Clinical Urology     Hybrid Journal   (Followers: 12)
Journal of Endoluminal Endourology     Open Access  
Journal of Endourology     Hybrid Journal   (Followers: 2)
Journal of Endourology Case Reports     Hybrid Journal  
Journal of Genital System & Disorders     Hybrid Journal   (Followers: 1)
Journal of Integrative Nephrology and Andrology     Open Access   (Followers: 2)
Journal of Kidney Cancer and VHL     Open Access  
Journal of Lower Genital Tract Disease     Hybrid Journal  
Journal of Nephrology     Hybrid Journal   (Followers: 5)
Journal of Nephrology Research     Open Access   (Followers: 2)
Journal of Pediatric Nephrology     Open Access   (Followers: 3)
Journal of Renal Care     Hybrid Journal   (Followers: 8)
Journal of Renal Nursing     Full-text available via subscription   (Followers: 8)
Journal of Renal Nutrition     Hybrid Journal   (Followers: 28)
Journal of Renal Nutrition and Metabolism     Open Access   (Followers: 2)
Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 38)
Journal of The Egyptian Society of Nephrology and Transplantation     Open Access  
Journal of Urology & Nephrology     Open Access  
Kidney Diseases     Open Access   (Followers: 3)
Kidney International     Hybrid Journal   (Followers: 52)
Kidney International Reports     Open Access   (Followers: 6)
Kidney Medicine     Open Access   (Followers: 1)
Kidney Research Journal     Open Access   (Followers: 6)
Kidneys (Počki)     Open Access  
Nature Reviews Nephrology     Full-text available via subscription   (Followers: 29)
Nature Reviews Urology     Full-text available via subscription   (Followers: 9)
Nefrología     Open Access  
Nefrología (English Edition)     Open Access  
Nephro-Urology Monthly     Open Access   (Followers: 1)
Nephrology     Hybrid Journal   (Followers: 13)
Nephrology Dialysis Transplantation     Hybrid Journal   (Followers: 26)
Nephron     Hybrid Journal   (Followers: 3)
Nephron Clinical Practice     Full-text available via subscription   (Followers: 3)
Nephron Experimental Nephrology     Full-text available via subscription   (Followers: 4)
Nephron Extra     Open Access   (Followers: 1)
Nephron Physiology     Full-text available via subscription   (Followers: 4)
Neurourology and Urodynamics     Hybrid Journal   (Followers: 1)
OA Nephrology     Open Access   (Followers: 2)
Open Access Journal of Urology     Open Access   (Followers: 6)
Open Journal of Nephrology     Open Access   (Followers: 4)
Open Journal of Urology     Open Access   (Followers: 6)
Open Urology & Nephrology Journal     Open Access  
Paediatric Nephrology Journal of Bangladesh     Open Access   (Followers: 4)
Portuguese Journal of Nephrology & Hypertension     Open Access   (Followers: 1)
Progrès en Urologie     Full-text available via subscription  
Progrès en Urologie - FMC     Full-text available via subscription  
Prostate Cancer and Prostatic Diseases     Hybrid Journal   (Followers: 4)
Renal Failure     Open Access   (Followers: 11)
Renal Replacement Therapy     Open Access   (Followers: 3)
Research and Reports in Urology     Open Access   (Followers: 4)
Revista de Nefrología, Diálisis y Trasplante     Open Access   (Followers: 1)
Revista Mexicana de Urología     Open Access  
Revista Urologia Colombiana     Open Access  
Scandinavian Journal of Urology     Hybrid Journal   (Followers: 6)
Seminars in Nephrology     Hybrid Journal   (Followers: 11)
The Prostate     Hybrid Journal   (Followers: 6)
Therapeutic Advances in Urology     Open Access   (Followers: 3)
Translational Research in Urology     Open Access   (Followers: 1)
Trends in Urology & Men's Health     Partially Free   (Followers: 1)
Urine     Open Access  
Uro-News     Hybrid Journal  
Urolithiasis     Hybrid Journal   (Followers: 1)
Urologia Internationalis     Full-text available via subscription   (Followers: 1)
Urologia Journal     Hybrid Journal  
Urologic Clinics of North America     Full-text available via subscription   (Followers: 3)
Urologic Nursing     Full-text available via subscription   (Followers: 3)
Urological Science     Open Access  
Urologicheskie Vedomosti     Open Access  
Urologie in der Praxis     Hybrid Journal  
Urology     Hybrid Journal   (Followers: 26)
Urology Case Reports     Open Access   (Followers: 3)
Urology Times     Free   (Followers: 3)
Urology Video Journal     Open Access  
World Journal of Nephrology and Urology     Open Access   (Followers: 5)
World Journal of Urology     Hybrid Journal   (Followers: 10)

           

Similar Journals
Journal Cover
Current Opinion in Urology
Journal Prestige (SJR): 0.949
Citation Impact (citeScore): 2
Number of Followers: 11  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0963-0643 - ISSN (Online) 1473-6586
Published by LWW Wolters Kluwer Homepage  [297 journals]
  • Editorial introductions

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      Abstract: imageNo abstract available
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Editorial: genetics in urology

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      Authors: Hassler; Melanie R.; Lawrentschuk, Nathan
      Abstract: No abstract available
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • The role of prophylactic prostatectomy as a primary prevention strategy in
           high-risk germline mutation carriers

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      Authors: Tiwari; Raj; Clark, Roderick; Fleshner, Neil
      Abstract: imagePurpose of review Men with high-risk germline mutations are at significantly higher risk of developing and dying from prostate cancer. Current screening and treatment paradigms may lead to missed opportunities for cure. Herein we review the current literature on prevention, screening and treatment of these carriers and explore the potential role of prophylactic prostatectomy in primary prevention of prostate cancer mortality.Recent findings Prostate-specific antigen (PSA)-based screening has demonstrated marginal benefits in prostate cancer (PCa) survival and uncertainty remains on its true benefit among high-risk carriers. Recent results indicate that PCa in BRCA 2 carriers occurs at a higher incidence, younger age and progresses more rapidly compared with noncarriers. An intensified screening protocol of MRI and PSA in young carriers demonstrated how using PSA values alone may be insufficient. Current evidence indicates that high-risk carriers have worse survival outcomes after undergoing radical treatment for screening detected disease when compared with noncarriers.Summary Prophylactic prostatectomy within the context of a clinical trial is a reasonable primary prevention option for discussion with high-risk carriers, especially BRCA2 carriers during the shared decision-making process. Limitations exist in the current strategies of early PSA screening followed by radical treatment in this group.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Molecular uropathology and cancer genetics for the urologist: key findings
           for classification and diagnosis

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      Authors: Compérat; Eva; Oszwald, André; Wasinger, Gabriel; Kläger, Johannes; Hassler, Melanie R.; Shariat, Shahrokh F.
      Abstract: imagePurpose of review To highlight the latest changes in prostate cancer (PCa), urothelial carcinoma, upper tract urothelial carcinoma (UTUC) and renal cell carcinoma (RCC) diagnosis and the impact of genetics in this field.Recent findings Breast cancer1/2 mutations start to play a major role in PCa treatment with regard to personalized medicine. In urothelial carcinoma an overlap between histological pathological and molecular findings exists, fibroblast growth factor receptor alteration are starting to play a major role, programmed death-ligand 1 although problematic is still important in the treatment setting. UTUC is rare, but genetically different from urothelial carcinoma. In the development of RCC, different genetic pathways such as Von Hippel–Lindau, but also tuberous sclerosis 1/2 and others play a major role in tumor development.Summary Over the last years, genetics has become increasingly important role in the diagnosis and the treatment of patients with urological malignancies. The upcoming 5th edition (1) of the WHO still considers conventional surgical pathology as the diagnostic gold standard, but molecular pathology is gaining importance not only for diagnosis, but also in personalized treatment, of prostate, kidney cancer and urothelial carcinomas. Therefore, a close collaboration between surgical urology, pathology and oncology departments is mandatory. In this review, we will discuss the latest evolutions in PCa, urothelial carcinoma, upper urinary tract carcinomas and RCC s in the field of genetics in urology.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Novel germline mutations for active surveillance and imaging strategies in
           prostate cancer

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      Authors: Mondschein; Romy; Taylor, Renea; Thorne, Heather; Bolton, Damien
      Abstract: imagePurpose of review This review highlights the emerging role of genetics-lead medicine (GLM) in prostate cancer. We describe the benefits of GLM integration into prostate cancer screening, diagnosis and management. Imaging techniques enhancing prostate cancer detection are advancing concurrently, facilitating strategic active surveillance protocols for appropriately selected patients. We aim to improve clinician awareness of the role of GLM in current and future practice.Recent findings We explore recent literature advancing the role of GLM in prostate cancer detection and management, particularly as this coexists with the development of imaging technology. Our current understanding of germline mutations implicated in familial prostate cancer development is summarized. We describe how these developments are being utilized to inform screening, surveillance and the development of novel therapies. We summarize current guidelines and explore factors inhibiting optimal implementation of recommendations in clinical practice.Summary Integration and further development of genetics-lead medicine in the detection, surveillance and management of prostate cancer will improve clinical outcomes for men at risk of aggressive disease as a result of familial predispositions to prostate cancer. This review summarizes the pertinent developments in the field including improving clinician awareness to facilitate implantation of these strategies into current clinical practice.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Genetics of neuroendocrine prostate cancer: recent progress in genetic
           understanding is translating into therapeutic opportunities

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      Authors: Rinott Mizrahi; Gal; Williams, Isabella; Azad, Arun; Lawrentschuk, Nathan
      Abstract: imagePurpose of review Neuroendocrine prostate cancer (NEPC) is a rare histologic subtype of prostate cancer with extremely aggressive clinical behaviour and very limited data regarding treatment options. This review is intended to relay new research advances in the understanding of the genetic and epigenetic aberrations underlying NEPC development and to review new targeted therapeutic options developed based on NEPC genetics.Recent findings Multiple genomic alterations and epigenetic regulators have been identified in NEPC development. Among these are amplifications of oncogenic transcriptional factors, changes in expression of cell surface markers and epigenetic alterations. This in turn has facilitated a number of new targeted therapies for NEPC that act via different mechanisms including catalytic inhibitors, immune-modulators and epigenetic modifiers. These targeted therapies are now being studied in different phases of clinical trials with some preliminary results showing efficacy.Summary NEPC is a highly aggressive malignancy with currently lack of effective treatments. Considerable challenges still remains to improve clinical outcomes in NEPC; however, ongoing trials exploiting novel genetic and epigenetic alterations hold promise for patients suffering from this aggressive disease.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Polygenic risk score in prostate cancer

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      Authors: Oh; Jong Jin; Hong, Sung Kyu
      Abstract: imagePurpose of review This study was conducted in order to review the outcomes regarding polygenic risk score (PRS) in prediction of prostate cancer (PCa). With the increasing proficiency of genetic analysis, assessment of PRS for prediction of PCa has been performed in numerous studies. Genetic risk prediction models for PCa that include hundreds to thousands of independent risk-associated variants are under development. For estimation of additive effect of multiple variants, the number of risk alleles carried by an individual is summed, and each variant is weighted according to its estimated effect size for generation of a PRS.Recent findings Currently, regarding the accuracy of PRS alone, PCa detection rate ranged from 0.56 to 0.67. A higher rate of accuracy of 0.866–0.880 was observed for other models combining PRS with established clinical markers. The results of PRS from Asian populations showed a level of accuracy that is somewhat low compared with values from Western populations (0.63–0.67); however, recent results from Asian cohorts were similar to that of Western counterparts. Here, we review current PRS literature and examine the clinical utility of PRS for prediction of PCa.Summary Emerging data from several studies regarding PRS in PCa could be the solution to adding predictive value to PCa risk estimation. Although commercial markers are available, development of a large-scale, well validated PRS model should be undertaken in the near future, in order to translate hypothetical scenarios to actual clinical practice.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • New approaches to targeting epigenetic regulation in prostate cancer

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      Authors: Thompson; Daryl; Choo, Nicholas; Bolton, Damien M.; Lawrentschuk, Nathan; Risbridger, Gail P.; Lawrence, Mitchell G.; Taylor, Renea A.
      Abstract: imagePurpose of review Many clinical trials are currently underway to target the epigenome of castration-resistant prostate cancer. In this review, we summarize the major epigenetic alterations that occur during prostate cancer progression, describe their biological consequences, and highlight potential of therapies that target epigenetic regulators for use in patients.Recent findings Epigenetic alterations frequently occur in tumour suppressor genes, DNA repair genes, and genes that regulate cell proliferation and differentiation. Unlike genetic alterations, epigenetic changes are reversible, making them promising targets for cancer therapy. Epigenetic regulators can be divided into three broad groups: writers, readers, and erasers, each with specific drug targets that are being assessed in phase I and II clinical trials for prostate cancer. CBP/p300, and BRD4 are coregulators of the androgen receptor and inhibit androgen signalling, making bromodomain extra-terminal inhibitors and CBP/p300 inhibitors attractive targets in prostate cancer. Enhancer of zeste homolog 2, a histone methyltransferase, is also a potential target in castrate-resistant prostate cancer. An emerging direction is to combine epigenetic inhibitors with other compounds to enhance their efficacy.Summary Preclinical studies indicate that the epigenome is a potential target in prostate cancer, and clinical trials are testing multiple agents that target the epigenome in different ways. However, the process of translating these therapies into the clinic is ongoing and none have yet been approved for castrate-resistant prostate cancer.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Genetics of testicular cancer: a review

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      Authors: Martin; Felicity C.; Conduit, Ciara; Loveland, Kate L.; Thomas, Benjamin; Lewin, Jeremy; Tran, Ben
      Abstract: imagePurpose of review Testicular germ cell tumours (TGCTs) are the most common solid malignant cancer diagnosed in young males and the incidence is increasing. Understanding the genetic basis of this disease will help us to navigate the challenges of early detection, diagnosis, treatment, surveillance, and long-term outcomes for patients.Recent findings TGCTs are highly heritable. Current understanding of germline risk includes the identification of one moderate-penetrance predisposition gene, checkpoint kinase 2 (CHEK2), and 78 low-to-moderate-risk single nucleotide polymorphisms identified in genome-wide-associated studies, which account for 44% of familial risk. Biomarker research in TGCTs has been challenging for multiple reasons: oncogenesis is complex, actionable mutations are uncommon, clonal evolution unpredictable and tumours can be histologically and molecularly heterogeneous. Three somatic mutations have thus far been identified by DNA exome sequencing, exclusively in seminomas: KIT, KRAS and NRAS. Several genetic markers appear to be associated with risk of TGCT and treatment resistance. TP53 mutations appear to be associated with platinum resistance. MicroRNA expression may be a useful biomarker of residual disease and relapse in future.Summary The biology of testicular germ cells tumours is complex, and further research is needed to fully explain the high heritability of these cancers, as well as the molecular signatures which may drive their biological behaviour.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Major heritable renal cell carcinoma syndromes: novel treatment options
           and future perspectives

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      Authors: Naidoo; Vishen; Perera, Marlon; Adam, Ahmed
      Abstract: imagePurpose of review To provide an overview of diagnosis, genetic abnormalities, clinical signs and treatment options for the major heritable renal cell carcinoma (RCC) syndromes.Recent findings RCC in major hereditary syndromes are disorders which are typically autosomal dominant. They predispose patients to early onset of RCC and may exhibit other extrarenal manifestations. Early recognition of these diseases allows correct screening at appropriate ages as well as early detection of RCC. Moreover, expedient identification may optimize the management of extra renal manifestations as well as allow for genetic testing and screening of at-risk relatives.Summary The risk of RCC in these major heritable syndromes is higher than sporadic disease. They occur at earlier age groups and can be multifocal or bilateral. Tumours are observed until at least 3 cm before any intervention, while nephron sparing surgery is widely considered as the treatment of choice except for hereditary leiomyomatosis with renal cell cancer, of which radical nephrectomy is treatment of choice. Intervention should be timeous as there is a highly reported incidence of early metastasis. Molecular therapies have been used in the setting of patients with metastasis, some of which show favourable outcomes.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • The past, present, and future of pT0 in bladder cancer clinical trials

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      Authors: Schober; Jared P.; Plimack, Elizabeth; Geynisman, Daniel; Zibelman, Matthew
      Abstract: imagePurpose of review Since the establishment of neoadjuvant chemotherapy as the standard of care for patients with muscle invasive bladder cancer, the pathologic absence of disease, denoted pT0, was found to be predictive of improved overall survival. Accordingly, it has been used in clinical trials as an optimal surrogate outcome measure, even in contemporary nonchemotherapeutic interventions. We review the role of pT0 as a catalyst for change in trial design and its suitability to facilitate more efficient and timely results. In addition, we explore the present and future of cT0, the clinical absence of disease, in defining treatment response and enabling bladder-sparing management options.Recent findings The use of pT0 as a surrogate has provided initial results for the efficacy of immunotherapy in the neoadjuvant space. In combination with molecular markers, pT0 has improved our ability to identify treatment responders and its clinical counterpart, cT0, has been integrated into multiple trials to redefine postneoadjuvant chemotherapy management algorithms.Summary The use of pT0 as a surrogate endpoint in bladder cancer trials has improved clinical trial design, defined efficacy of emerging therapeutics, and has the potential to redefine the postneoadjuvant treatment management for patients seeking bladder-sparing options.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Progression-free survival is an adequate endpoint for clinical trials of
           locally advanced and metastatic urothelial carcinoma

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      Authors: Martini; Alberto; Fallara, Giuseppe; Ploussard, Guillaume; Pradere, Benjamin
      Abstract: imagePurpose of review To evaluate intermediate clinical endpoints that have been proposed as potential surrogates for overall survival amongst patients with locally advanced and metastatic urothelial carcinoma.Recent findings Several endpoints have been proposed as potential surrogates for overall survival. They are: pathologic downstaging or complete response after neoadjuvant treatments and progression-free survival in the adjuvant setting and metastatic setting. Formal surrogacy, as per Prentice, has not been established among any of the aforementioned intermediate clinical endpoints and overall survival. Despite that, regulatory agencies have recently approved adjuvant nivolumab for patients with high-risk muscle invasive bladder cancer, based on the results of a trial that had disease-free survival as primary endpoint.Summary Despite the lack of proven surrogacy between progression-free survival and overall survival, this endpoint seems adequate for trial design and medication approval, as the recent case of adjuvant nivolumab demonstrates.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Micropapillary bladder cancer: an evolving biology

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      Authors: Lonati; Chiara; Simeone, Claudio; Suardi, Nazareno; Briganti, Alberto; Montorsi, Francesco; Moschini, Marco
      Abstract: imagePurpose of review To summarize a comprehensive overview of more recent evidence on micropapillary bladder cancer (MPBC), focusing on actual incidence, clinical features, therapeutic strategies, and prognosis.Recent findings MPBC generally exhibits an aggressive behaviour compared with pure urothelial carcinoma (pUC) with advances in tumour stage and nodal and distant spread at diagnosis. Due to its rarity and presence of only small sample size and retrospective studies, no consensus currently exists regarding the most effective therapeutic strategy to be performed among nonmuscle-invasive (conservative treatment versus immediate radical cystectomy) and muscle-invasive MPBC (neoadjuvant therapy versus upfront radical cystectomy versus adjuvant chemotherapy).Summary The incidence of MPBC is recently increased according to latter literature, ranging from 2.9 to 7.6% of all bladder cancer. Despite its aggressive behaviour at time of presentation, more recent evidence fails to demonstrate a significant association between MPBC and worse outcomes compared with pUC when adjusted for clinical and pathological features. According to latter evidence, MPBC pathological response to NAC appears to be unsatisfactory compared with pUC patients while neoadjuvant immunotherapy with Pembrolizumab may represent an effective treatment among MPBC patients, based on PD-L1 and TMB expression.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Brief update of the new WHO classification for urothelial carcinoma

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      Authors: Compérat; Eva; Wasinger, Gabriel; Oszwald, André; Shariat, Shahrokh F.
      Abstract: imagePurpose of review Six years after the release of the 4th edition of the WHO classification on male and genitourinary tumors in 2016, the upcoming 5th edition will be released in 2022. This review will discuss significant changes in the new WHO classification for urothelial carcinoma.Recent findings Substantial progress has been made during the last 6 years, especially in the molecular definition of bladder cancer, but also in treatment approaches. The authors have incorporated these and other changes relating to surgical pathology and made relevant changes to provide a more logical and consistent structure in separating chapters.Summary As the WHO bluebook is intended to be used worldwide, the authors believe that the impact of these changes will be considerable.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Clinical and biological markers for risk-stratification of T1 high-grade
           non-muscle invasive bladder cancer

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      Authors: Soria; Francesco; Dutto, Daniele; Gontero, Paolo
      Abstract: imagePurpose of review To summarize the prognostic and predictive role of current clinical and biological markers in patients with T1 high-grade (T1HG) nonmuscle invasive bladder cancer (NMIBC).Recent findings Classical clinico-pathologic markers such as age, tumor size, focality, and location as well as the presence of concomitant carcinoma in situ, lymphovascular invasion, and histological variants at the time of transurethral resection (TUR) should be used in the risk-stratification of T1HG to improve patients’ selection for early aggressive treatment. pathological T1 substaging has shown to predict disease progression and response to intravesical therapy, and should therefore be reported in the pathological assessment to improve clinical decision-making. Urinary inducible cytokines measured at different time points during Bacillus Calmette-Guerin therapy may be used to predict response to treatment, while urinary mRNA-based biomarkers may be of value to select patients for repeated TUR (reTUR). The advent of genomic classification in NMIBC and that of immune markers may improve current risk-stratification tools and pave the way toward personalized treatment.Summary The role of clinico-pathologic variables in the risk-stratification of T1HG NMIBC remains unaltered, despite insufficient. Urinary biomarkers and tissue-based immune markers hold the promise to revolutionize the paradigm of risk-stratification due to their potential role in predicting response to intravesical and systemic immunotherapy. However, to date, none of the investigated biomarkers is used in clinical practice to risk-stratify T1HG patients due to the lack of external and/or prospective validations.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • RNA-based urinary assays for non-muscle invasive bladder cancer

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      Authors: Pijpers; Olga M.; de Jong, Joep J.; Zuiverloon, Tahlita C.M.; Boormans, Joost L.
      Abstract: imagePurpose of review To provide an overview of the recent literature on RNA-based molecular urine assays for the diagnosis and surveillance of non-muscle invasive bladder cancer (NMIBC).Recent findings Articles were eligible for inclusion if performance metrics sensitivity, specificity, and negative-predictive value (NPV) were reported or could be calculated. Only prospective studies published between 2020–2022 were included. Five out of fourteen studies addressed the primary diagnostic setting; the proportion of gross hematuria patients in all study populations was>50%. Only one study reported performance metrics within a microscopic hematuria subgroup. This study evaluated Xpert Bladder and reported a sensitivity: 73%, specificity: 84%, NPV: 99%, and PPV: 12%. Ten studies assessed test performance during surveillance for NMIBC. For the detection of high-grade (HG) and high-risk (HR) NMIBC, sensitivity, specificity, NPV, and PPV varied between 78–100%, 64–89%, 97.0–99.7%, and 9.2–39%.Summary Multiple RNA-based urine assays have been investigated for the detection of urothelial cancer in the primary or surveillance setting. However, studies included within this review have important limitations, hampering the interpretation of study results. As such, performance metrics should be interpreted with caution and further research is required to evaluate the clinical impact of RNA-based urine assays in daily practice.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Drug instillation in the management of urinary tract urothelial carcinoma

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      Authors: Kim; Sung Han; Lerner, Seth P.
      Abstract: imagePurpose of review This article aimed to investigate the efficacy of drug instillation therapy in preventing the recurrence of postsurgical upper urinary tract urothelial carcinoma (UTUC) by reviewing recently published research articles.Recent findings Several clinical trials have shown new potential forms of postsurgical intracavitary and intravesical drug instillation methodologies with better efficacy and less toxicity for use in UTUC. With the improvement of endoscopic imaging techniques and laser sciences, diverse attempts in drug instillation have shown an improved recurrence rate after kidney-sparing surgery in low-grade, low-tumor burden cancers in the upper urinary tract. A gel-form type of mitomycin-C in intracavitary instillation further reduced recurrence rates in UTUC. Other studies have compared different drug instillation methodologies with varying initiation times and timed instillation. They have shown that early instillation with multiple rounds resulted in better protective effects for recurrence rates before, during, and after surgery.Summary A new gel-form of intracavitary instillation of mitomycin-C, the timing of drug instillation, and refining techniques can result in better recurrence-free survival of patients with UTUC after surgery. Further large-scale prospective clinical trials are needed to validate these new forms of drugs and methodologies to change the therapeutic guidelines of UTUC.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • The use of MRI in urothelial carcinoma

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      Authors: Messina; Emanuele; Pisciotti, Martina Lucia; Pecoraro, Martina; Borrelli, Antonella; Del Giudice, Francesco; Panebianco, Valeria
      Abstract: imagePurpose of review To conduct a nonsystematic review of the existing literature to investigate the role of Magnetic Resonance Imaging (MRI) in urothelial carcinomas (UCs).Recent findings Imaging is becoming progressively more crucial in local and distant staging of UCs, especially in cases of bladder cancer (BCa). The primary objective of imaging in patients with BCa is to detect lesions and distinguish T1 from T2 stages, since the treatment varies significantly.Summary The applicability of MRI in the management of UCs has been investigated, particularly focusing on the new evidence on multiparametric MRI (mpMRI) of the bladder and Vesical Imaging-Reporting And Data System score for the description of BCa and discussing the possible utility of MRI for upper tract urothelial carcinomas . Imaging modalities, in particular CT and MRI, are essential tools for the local and distant staging of UCs. MpMRI of the bladder and VI-RADS score accurately define the risk of muscle invasiveness, promoting tailored therapeutic planning. Moreover, mpMRI has also been included in patients’ follow-up and in the assessment of response to systematic therapy. MRI utility and possible application in upper tract urothelial carcinomas cases are yet to be discovered.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Radical cystectomy and women's sexual health – can we do better'

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      Authors: Escott; Megan; Avulova, Svetlana; Bree, Kelly K.; Westerman, Mary E.
      Abstract: imagePurpose of review Female sexual function after radical cystectomy is a crucial, but historically overlooked component of bladder cancer survivorship. This review focuses on recent studies, which have investigated pelvic health and sexual function after radical cystectomy. We discuss modifiable factors, which may contribute to decreased sexual function after radical cystectomy and techniques, which may lead to improved outcomes.Recent findings Sexual function is important to women and there is a significant desire (and unmet need) for more perioperative counseling and discussion regarding sexual function changes and quality of life impacts. Sexual function may be altered due to a combination of hormonal changes from ovarian removal, anatomic changes from vaginal alteration, and sensation changes due to damage to the neurovascular bundle. Techniques to preserve these structures have been developed.Summary Sexual function is an important component of survivorship and increasing attention is being focused on this area. Long term studies with objective measures are needed for to compare various techniques and ensure oncologic safety. Ovarian preservation, anterior vaginal wall preservation, and vaginal estrogen replacement should be carefully considered for most patients.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Comparative performance of the different orthotopic urinary diversions

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      Authors: Sheybaee Moghaddam; Farshad; Ghoreifi, Alireza; Djaladat, Hooman
      Abstract: imagePurpose of review Majority of patients undergoing radical cystectomy are suitable for orthotopic urinary diversion. The effect of different techniques of neobladder reconstruction on early and long-term postoperative complications is still being determined. Additionally, it is unclear which type of neobladder provides the best patient satisfaction. The purpose of this article is to review the outcomes of different orthotopic urinary diversions following radical cystectomy.Recent findings Ileal neobladder is the preferred type of orthotopic urinary diversion following radical cystectomy. Hautmann and Studer, which are the most common orthotopic diversion techniques, provide daytime continence rate up to 87% and 92%, respectively. However, nighttime continence is achieved in about 50% of patients. High-level evidence supports the long-term safety of orthotopic neobladder in terms of renal function, even in patients with a glomerular filtration rate
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Molecular biomarkers to help select neoadjuvant systemic therapy for
           urothelial carcinoma of the bladder

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      Authors: Laukhtina; Ekaterina; Pradere, Benjamin; Lemberger, Ursula; Karakiewicz, Pierre I.; Fajkovic, Harun; Shariat, Shahrokh F.
      Abstract: imagePurpose of review In this review, we aimed to summarize the available evidence on pretreatment molecular biomarkers that may help to predict oncologic and pathologic outcomes in patients treated with neoadjuvant systemic therapy (NAST) for urothelial carcinoma of the bladder (UCB).Recent findings Several readily available and easily measurable blood-based biomarkers (e.g., neutrophil to lymphocyte or platelet–lymphocyte ratios) seems to help improve the selection of UCB patients who are most likely to benefit from NAST. Recent evidence suggests liquid biopsy including circulating tumor DNA (ctDNA) to be a promising tool to guide the administration of NAST in UCB patients. Pretreatment molecular and genetic characterization of transurethral resection of the bladder tumor samples may also help understand the tumor biology as luminal and basal tumor subtypes seems to be more responsive to NAST, while claudin-low and luminal-infiltrated tumor subtypes are less. In the context of neoadjuvant immunotherapy, programmed death-ligand 1 (PD-L1) status and ctDNA remain the only biomarker with possible value as the clinical utility of tumor mutational burden remains controversial/poor.Summary Biomarker approach is a necessary step to usher the age of precision/personalized medicine for muscle-invasive UCB with the overarching good to prevent both over- and under-therapy. The present review may offer a robust framework to compare and assess current and future molecular biomarkers for the selection of NAST in muscle-invasive UCB.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Active surveillance for non-muscle-invasive bladder cancer: fallacy or
           opportunity'

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      Authors: von Deimling; Markus; Pallauf, Maximilian; Bianchi, Alberto; Laukhtina, Ekaterina; Karakiewicz, Pierre I.; Rink, Michael; Shariat, Shahrokh F.; Pradere, Benjamin
      Abstract: imagePurpose of review This review aims to analyze the current place of active surveillance (AS) in non-muscle-invasive bladder cancer (NMIBC).Recent findings A growing body of evidence suggests that AS protocols for pTa low-grade (TaLG) NMIBC are safe and feasible. However, current guidelines have not implemented AS due to a lack of high-quality data. Available studies included pTa tumors, with only one study excluding pT1-NMIBC. Inclusion/exclusion criteria were heterogeneously defined based on tumor volume, number of tumors, carcinoma in situ (CIS), or high-grade (HG) NMIBC. Tumor volume
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
  • Device-assisted intravesical chemotherapy treatment for nonmuscle invasive
           bladder cancer: 2022 update

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      Authors: Vartolomei; Mihai Dorin; Ferro, Matteo; Roth, Beat; Teoh, Jeremy Yuen-Chun; Gontero, Paolo; Shariat, Shahrokh F.
      Abstract: imagePurpose of review To critically analyze the oncological outcomes and safety profile of device-assisted intravesical chemotherapy studies reported in 2021. Studies were considered eligible if they included patients with nonmuscle invasive blood cancer (NMIBC), had a prospective or retrospective design, included at least 10 patients, were published in 2021, and assessed the oncological impact of device-assisted intravesical chemotherapy and/or reported standardized adverse effects (AEs).Recent findings Eight new studies reported oncological outcomes after hyperthermic intravesical chemotherapy (HIVEC). In Bacillus Calmette-Guérin (BCG) naive patients, the reported 2-yr. recurrence-free survival (RFS) ranged from 70.7% to 82.4%, with one study reporting 2 yr. progression free survival (PFS) of 92%. In both BCG naive and BCG refractory patients, the reported 1-yr. RFS ranged from 60.5% to 70% and PFS was 94% in one study. For radiofrequency-induced HIVEC, the reported 5-yr. estimates were 38%for RFS and 91.5%for PFS. Regarding AEs, 10.2% of patients had severe AEs. Six studies reported AEs after HIVEC; the majorities were grade 1–2 AEs.Summary Data coming from the studies published in the last years provides support for a consolidating role of device-assisted intravesical chemotherapy as a safe and effective alternative first- or second-line adjuvant treatment of patients with NMIBC.
      PubDate: Thu, 01 Sep 2022 00:00:00 GMT-
       
 
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