Journal Reviews
Malignant upper urinary tract obstruction: emergency presentations and long-term outcomes
Malignant upper urinary tract obstruction (MUUTO) is a frequent emergency urological referral, often necessitating kidney drainage to preserve renal function. However, many patients have advanced cancer with limited life expectancy, raising questions about intervention benefits. While percutaneous nephrostomy (PCN) or...
Oncological benefits of extended pelvic lymph node dissection
Touijer and colleagues present extended follow-up results from a large randomised trial comparing limited pelvic lymph node dissection (l-PLND) and extended PLND (e-PLND) in prostate cancer patients undergoing radical prostatectomy. The study aimed to assess whether e-PLND, which includes external...
Anti-VEGF and PD-1 combinations in renal cell carcinoma
Over the past decade, vascular endothelial growth factor (VEGF) tyrosine kinase inhibitors (TKIs) have been central to treating renal cell carcinoma (RCC), with oncologists refining dosing strategies to balance treatment efficacy with quality of life (QoL). Recently, the introduction of...
Defining adjuvant, consolidative, and salvage treatment after RP
The most common oncologic outcome following radical prostatectomy (RP) for localised prostate cancer is achieving undetectable prostate-specific antigen (PSA) levels (<0.1 ng/ml), indicating an absence of detectable disease. However, the landscape of RP is shifting as active surveillance becomes the...
Intravesical instillation of chemotherapy before radical surgery for upper UTUC
Upper urinary tract urothelial carcinoma (UTUC) is a rare but increasingly prevalent form of urothelial cancer, accounting for 5–10% of cases, with an annual incidence of two to three cases per 100,000 individuals in Western Europe. Radical nephroureterectomy (RNU) with...
The future of bladder-sparing therapy is bright
Trimodal therapy (TMT), combining optimal transurethral resection of bladder tumour (TURBT) and concurrent chemoradiotherapy, has garnered significant attention for managing muscle-invasive bladder cancer (MIBC). This approach offers the potential for bladder preservation while delivering oncological outcomes comparable to radical cystectomy....
Tissue-based biomarkers steering clinical decisions in patients with urothelial cancer
Biomarkers play an essential role in the diagnosis and treatment of urothelial cancer (UC), with PD-L1, FGFR, and MMR proteins being the most clinically established. These biomarkers, derived from histological specimens, guide therapeutic decisions for bladder cancer (BCa) and upper...
Are standard repeat biopsies during active surveillance for prostate cancer still necessary?
Active surveillance (AS) has emerged as a key strategy for managing low-risk prostate cancer (PCa), offering an alternative to immediate treatment. Initially, AS relied on prostate specific antigen (PSA) testing, digital rectal examinations (DRE), and systematic biopsies. Early studies using...
Cost effectiveness of prostate cancer screening in Europe
Prostate cancer (PCa) stands as the most prevalent cancer and the third leading cause of cancer-related deaths among men in Europe. According to data from the European Commission, in 2020, PCa represented a staggering 23.2% of all new cancer cases...
First and second-line treatments in metastatic renal cell carcinoma
Over the past two decades, the treatment landscape for metastatic renal cell carcinoma (mRCC) has evolved significantly, leading to a quadrupling of patient survival rates. Modern systemic treatments include combinations of anti-PD-1 antibodies with either anti-CTLA-4 antibodies or antiangiogenic tyrosine...
PSA screening in limbo: how low should we go?
One may wonder how the management of prostate cancer could have evolved differently if it had followed a path similar to breast cancer. In breast cancer, early detection in the 1970s relied heavily on imaging because no reliable circulating biomarker...
Treatment options for renal cell carcinoma
In this issue of European Urology, experts review advancements and challenges in treating renal cell carcinoma (RCC), emphasising the complexity of managing a disease with an expanding array of therapeutic options. Despite significant progress, critical questions remain about treatment sequencing,...
