Language：English   Publisher：International Journal of Clinical Oncology  

Background: Treatment-related skin reactions (TRSRs) induced by enfortumab vedotin (EV) targeting nectin-4 are among the most common adverse events. However, their association with survival and treatment response is poorly understood. Methods: We retrospectively identified patients who received EV from December 2021 to April 2023 at Nagoya University Hospital and its affiliated facilities and extracted clinical data from their medical records. We evaluated cancer-specific survival (CSS) and progression-free survival (PFS) as survival outcomes and overall response rate (ORR) and disease control rate (DCR) as treatment responses between patients with and without TRSRs. Results: In total, 67 eligible patients were identified. Thirty-four patients experienced TRSRs, and the remaining 33 did not experience TRSRs. The median follow-up period was 8 months. Patients in the TRSRs group demonstrated significantly longer median CSS (15 vs. 8 months; p = 0.003) and median PFS (10 vs. 5 months; p < 0.001) than the non-TRSRs. Regarding treatment response, the patients in the TRSRs group showed a favorable, albeit nonsignificant, treatment response trend compared with those in the non-TRSRs group (ORR, 73.5% vs. 51.5%; p = 0.107; DCR, 91.2 % vs. 81.8%; p = 0.444). Conclusions: Patients with TRSRs demonstrated more prolonged survival and superior treatment responses to EV treatment. The role of TRSR as a surrogate marker of EV’s efficacy should be further explored in prospective and sufficiently powered studies.

DOI： 10.1007/s10147-024-02672-3

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PubMed

Publisher：Journal of Cancer Research and Therapeutics  

Introduction: There is no established predictor of the neoadjuvant chemotherapy (NAC) response in patients with muscle-invasive bladder cancer (MIBC) treated via radical cystectomy (RC). We assessed the predictive utility of the pretreatment C-reactive protein (CRP) level in terms of the response to NAC in patients with MIBC treated with RC. Patients and Methods: This retrospective study enrolled patients with MIBC treated via RC following NAC at Nagoya University Hospital and affiliated hospitals from January 2004 to December 2020. An elevated CRP was defined as a CRP level ≥1 mg/dL. The association between the response to NAC and the pretreatment CRP level was investigated. Results: We retrospectively identified 192 patients of whom 101 (52.6%) were NAC nonresponders (pathological ≥T2 or node-positive). Nonresponders exhibited poorer 5-year disease-free survival (DFS) (82.5% vs. 42.7%, P < 0.01) and overall survival (OS) (95.3% vs. 48.8%, P < 0.01) than responders. Thirty patients (15.6%) showed elevated CRP levels that correlated with poorer 5 year DFS (66.7% vs. 33.0%, P < 0.01) and OS (74.6% vs. 48.3%, P < 0.01) than others. In multivariate analyses, an elevated CRP level was significantly associated with poorer 5-year DFS [hazard ratio (HR) 3.35, 95% confidence interval (CI) 1.88-5.97, P < 0.01)], OS (HR 2.13, 95% CI 1.13-4.03, P = 0.02), and nonresponder status (odds ratio 3.83, 95% CI 1.4-10.3, P < 0.01). Conclusion: An elevated CRP level may predict NAC nonresponder status and poorer oncological outcome. Upfront RC should be considered for patients with an elevated CRP level.

DOI： 10.4103/jcrt.jcrt_1773_23

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Language：English   Publisher：International Journal of Clinical Oncology  

Background: This study aimed to compare the efficacy of robot-assisted partial nephrectomy for completely endophytic renal tumors with the reported outcomes of conventional laparoscopic partial nephrectomy and investigate the transition of renal function after robot-assisted partial nephrectomy. Methods: We conducted a prospective, multicenter, single-arm, open-label trial across 17 academic centers in Japan. Patients with endophytic renal tumors classified as cT1, cN0, cM0 were included and underwent robot-assisted partial nephrectomy. We defined two primary outcomes to assess functional and oncological aspects of the procedure, which were represented by the warm ischemic time and positive surgical margin, respectively. Comparisons were made using control values previously reported in laparoscopic partial nephrectomy studies. In the historical control group, the warm ischemia time was 25.2, and the positive surgical margin was 13%. Results: Our per-protocol analysis included 98 participants. The mean warm ischemic time was 20.3 min (99% confidence interval 18.3–22.3; p < 0.0001 vs. 25.2). None of the 98 participants had a positive surgical margin (99% confidence interval 0–5.3%; p < 0.0001 vs. 13.0%). The renal function ratio of eGFR before and after protocol treatment multiplied by splits was 0.70 (95% confidence interval: 0.66–0.75). Factors such as preoperative eGFR, resected weight, and warm ischemic time influenced the functional loss of the partially nephrectomized kidney after robot-assisted partial nephrectomy. Conclusions: Robot-assisted partial nephrectomy for completely endophytic renal tumors offers a shorter warm ischemia time and comparable positive surgical margin rate compared with conventional laparoscopic partial nephrectomy.

DOI： 10.1007/s10147-024-02599-9

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Language：English   Publisher：Urology journal  

PURPOSE: It is unclear if robotic radical cystectomy with extracorporeal urinary diversion (eRARC) provides additional benefit when performed along with enhanced recovery after surgery (ERAS). We assessed the additional efficacy of eRARC in terms of perioperative outcomes. MATERIALS AND METHODS: We retrospectively assessed 143 patients undergoing radical cystectomy with urinary diversion between June 2010 and December 2021 at a single center. The patients were assigned to three groups: open radical cystectomy (ORC) with conventional recovery after surgery (CRAS) [Group A], ORC with ERAS [Group B], and eRARC with ERAS [Group C]. A propensity score-matched analysis was performed to evaluate how ERAS and eRARC affected outcomes respectively. Meanwhile, multivariable analysis was used to detect the predictors of prolonged length of hospital stay (LOS). RESULTS: The median LOS was shorter after ERAS and eRARC. In the propensity score-matched analysis, ERAS was linked to a significantly shorter median LOS (28.0 vs. 20.0 days, P < .001), but eRARC was not associated with a shorter LOS (19.0 vs. 17.5 days, P = .21). Neither ERAS nor eRARC were connected with a reduce in complication rate. Following multivariable analysis, ERAS was found to be independently associated with shorter LOS (OR=0.23, P < .001), but eRARC demonstrated no such correlation (OR=0.29, P = .096). CONCLUSION: ERAS had strong association with shorter LOS, although eRARC did not contribute to additional efficacy. Neither ERAS nor eRARC decreased the complication rate.

DOI： 10.22037/uj.v20i.7752

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PubMed

Language：English   Publisher：International Journal of Urology  

Intraductal carcinoma of the prostate, a unique histopathologic entity that is often observed (especially in advanced prostate cancer), is characterized by the proliferation of malignant cells within normal acini or ducts surrounded by a basement membrane. Intraductal carcinoma of the prostate is almost invariably associated with an adjacent high-grade carcinoma and is occasionally observed as an isolated subtype. Intraductal carcinoma of the prostate has been demonstrated to be an independent poor prognostic factor for all stages of cancer, whether localized, de novo metastatic, or castration-resistant. It also has a characteristic genetic profile, including high genomic instability. Recognizing and differentiating it from other pathologies is therefore important in patient management, and morphological diagnostic criteria for intraductal carcinoma of the prostate have been established. This review summarizes and outlines the clinical and pathological features, differential diagnosis, molecular aspects, and management of intraductal carcinoma of the prostate, as described in previous studies. We also present a discussion and future perspectives regarding intraductal carcinoma of the prostate.

DOI： 10.1111/iju.15299

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PubMed

Presentation type：Oral presentation (general)  

Presentation type：Symposium, workshop panel (nominated)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)  

Presentation type：Oral presentation (general)