Objective: To assess the impact of vas deferens invasion (VDI) on prognosis, as well as clinical and pathological outcomes in patients with pT3b prostate cancer. Materials and Methods: Patients reported as pT3b between 2010 and 2020 were included in the study. Patients were divided into two groups: Group 1 (VDI-) and Group 2 (VDI+). Biochemical recurrence-free survival (BCRFS) was compared using the Kaplan-Meier method with the log-rank test. Univariate and multivariate regression models were used to investigate the relationship between VDI and the risk of BCR. Results: The study included 199 patients with seminal vesicle invasion (SVI) on radical prostatectomy (RP) pathology. VDI was detected in 95 patients (47.7%). No differences was found between the two groups with respect to clinical and perioperative factors, including age, preoperative prostate-specific antigen (PSA), prostate volume, PSA density, biopsy International Society of Urological Pathology (ISUP) grade, clinical N stage, preoperative European Association of Urology risk group, surgery type (open or robotic), nerve-sparing approach, surgical margin status, number of resected lymph nodes (LN), and pathological LN positivity rates. The VDI+ group exhibited higher rates of extraprostatic extension and bilateral SVI, and a more advanced ISUP grade in RP pathology (p<0.05). The number of patients who received adjuvant hormone therapy was higher in the VDI+ group. Sixth-week PSA values were higher in the VDI+ group (p<0.05). No significant difference in BCRFS was observed (log-rank test; p=0.127). In multivariate logistic regression analysis, pN+ and RP ISUP grade were found to be significant predictors of BCR (p<0.05). Conclusion: Although the current study found that patients with VDI had lower BCRFS, the difference was not statistically significant. This condition may result from disparities in adjuvant treatments and other clinicopathological variables. Since the effect of VDI on prognosis in pT3b patients is not known, the results should be interpreted with caution. Patients with T3b prostate cancer may exhibit heterogeneous survival rates. Therefore, the indication of VDI in the pathology report appears to be an important consideration that can guide patient management.
Objective: This study aims to identify the maximum standardized uptake value (SUVmax) value that predicts the presence of oligometastatic and high-risk prostate cancer and forecasts disease behavior. Materials and Methods: In this retrospective analysis, patients who underwent 12-quadrant transrectal prostate biopsy in our clinic were evaluated in the study. D’Amico risk scoring was performed. Data of non-metastasis, oligometastatic and multimetastatic patients were recorded using imaging methods. Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) SUVmax values, prostate-specific antigen (PSA) and pathology parameters were recorded. PSA and SUVmax values were compared between oligometastatic/multimetastatic and D’Amico risk groups. By performing receiver operating characteristic analyses, SUVmax values in predicting oligometastatic and high-risk disease were tried to be predicted. Results: According to the D’Amico risk scoring, there was no significant difference in SUVmax values between the low-risk group and the intermediate-risk group (p=0.18). However, a significant difference was observed between the intermediate-risk group and the high-risk group (p=0.006). According to the D’Amico risk classification, the best SUVmax cut-off value that distinguishes medium risk from high risk was 7.95, and the sensitivity for this value was found to be 73% and the specificity was 86%. The cut-off SUVmax value in distinguishing between oligometastatic and multimetastasis was found to be 12.65, and its sensitivity was 77% and specificity was 68%. The area under the curve was found to be 0.735. Conclusion: PSMA-PET should be considered as a factor guiding treatment in prostate cancer. The SUVmax value of 7.95 in the distinction of high-risk prostate cancer and the SUVmax value of 12.65 in the distinction of multimetastatic prostate cancer are safe parameters that can be used in daily practice. It will achieve more successful results with more standardized studies conducted on larger populations and will be used in a more standardized way in planning treatment.
Radiotherapy, applied to the lower abdomen and pelvis may result in urological complications due to damage to surrounding healthy tissues. A seventy-year-old male patient who underwent radical prostatectomy and who received 35 fractions of radiotherapy (2 Gy per fraction, total of 70 Gy) to the prostate bed using an intensity-modulated radiotherapy technique for biochemical recurrence presented to our clinic with haematuria. Cystoscopy revealed perforation in the left lateral wall of the bladder.
Objective: To evaluate the predictive value of demographic, preoperative, and postoperative clinical parameters for detecting incidental prostate cancer (iPCa) in patients undergoing holmium laser enucleation of the prostate (HoLEP). Materials and Methods: Clinical records of male patients who underwent HoLEP for BPH between 01.01.2023 and 01.01.2024 were retrospectively reviewed. Demographic, preoperative, and postoperative data, including total prostate-specific antigen (PSA), free PSA, and PSA density (PSAd), were analysed. The role of these measurements and data in predicting the likelihood of iPCa in patients whose pathology results revealed iPCa were evaluated. Results: A total of 112 patients underwent HoLEP,including 96 with BPH (85.7%) (group 1) and 16 with iPCa (Group 2) (14.3%). Median age was 66.5 years. Demographic data and PSA levels were comparable between groups. PSAd was significantly higher in Group 2 (0.06 vs. 0.04 ng/mL/cc, p=0.008), and PSAd >= 0.15 was more frequent in Group 2 (25% vs. 5.2%, p=0.023). Pathology revealed 68.7% Gleason grade group 1, all under active surveillance, and 31.3% grade group 2-5, treated with radiotherapy +/- hormonal therapy. Multivariate analysis identified PSAd as the only independent predictor of iPCa (odds ratio: 9.09, 95% confidence interval: 1.12-73.8, p=0.01). Receiver operating characteristic analysis showed moderate diagnostic performance for PSAd (AUC: 0.71), with a 0.08 ng/mL/cc threshold yielding 75% sensitivity and 69.7% specificity. Conclusion: iPCa after HoLEP is relatively common but mostly low-grade, with favourable oncological outcomes. Preoperative PSAd was identified as a significant predictor of iPCa. These findings may aid in preoperative patient counselling and risk-stratified management. Active surveillance appears safe and effective for low-grade iPCa.
Objective: To investigate the association between preoperative computed tomography (CT)-based abdominal muscle-fat composition and length of hospital stay, post-operative complications and cancer-specific survival in patients with bladder cancer undergoing radical cystectomy. Materials and Methods: Preoperative CT scans of 128 patients undergoing radical cystectomy for bladder cancer between 2013-2018 were reviewed. Densitometric quantification of total, visceral (VFA), subcutaneous (SFA) and inter-muscular fat-area (IMFA), mean muscle density (between-29HU and 150HU) (MD150) and muscle area (between-29HU and 150HU) (MA150) measurements were performed retrospectively on an axial CT image at the level of L3 vertebra. The length of hospital stays and Clavien-Dindo score was noted. In the survival analysis, 12-and 30-months were taken as the threshold values. The primary outcome measure was cancer-specific survival. Results: A total of 96 patients (92 men and 4 women, mean age 66 years, age range 49-86 years) were included. Patients with length of hospital stay more than 10 days had significantly higher VFA/SFA ratio (p=0.03) and higher IMFA (p=0.01). In the cohort, 74% of patients had low Clavien-Dindo scores (<= 2) with significantly higher MA150 (p=0.02), MD150 (p<0.01) and lower IMFA (p=0.01) compared to group with high scores. In the survival analysis, MA150 and MD150 values were significantly higher (p=0.01 and p<0.01, respectively) in survivors more than 12 months. Only MD 150 value was significantly higher in survivors more than 30 months (p<0.01). Conclusion: Preoperative CT-based body composition parameters, particularly MD150 and MA150, can be used as non-invasive prognostic markers in patients undergoing radical cystectomy. These muscle-related parameters are strongly correlated with fewer surgical complications and longer cancer-specific survival, suggesting a promising role in preoperative risk stratification and patient support.
Objective: Prostate-specific antigen density (PSAd) has gained traction as a superior diagnostic marker, compared with PSA alone, for predicting clinically significant prostate cancer (csPCa). However, prostate gland volume may affect the diagnostic accuracy of PSAd. To evaluate how prostate volume influences the diagnostic performance of PSAd for detecting csPCa in patients with Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions. Materials and Methods: We retrospectively analyzed 576 patients with PI-RADS 3 lesions who underwent PSA testing, multiparametric magnetic resonance imaging (MRI), and cognitive-and fusion-guided transrectal prostate biopsies between 2017 and 2025. PSAd was calculated as serum PSA divided by MRI-measured prostate volume. Patients were stratified into three groups according to prostate volume: <= 30 mL, 31-50 mL, and >= 51 mL. csPCa was defined as International Society of Urological Pathology grade >= 2. Diagnostic performance of PSAd was assessed using receiver operating characteristic (ROC) curve analysis with volume-specific cut-offs. Results: The overall csPCa detection rate was significantly higher in patients with prostates <= 30 mL (p<0.001). Across all volume groups, csPCa detection remained <5% when PSAd <0.10 ng/mL/mL. For glands <= 30 mL, csPCa rates rose sharply above this threshold. ROC analysis revealed that small prostates had a slightly higher diagnostic accuracy [area under the curve (AUC) 0.668] compared with intermediate (AUC 0.599) and large (AUC 0.633) glands. Optimal PSAd cut-offs were narrowly distributed (0.1058-0.1531), but diagnostic sensitivity varied with volume. Conclusion: The findings indicate that the diagnostic performance of PSAd in predicting csPCa is influenced by prostate volume. Instead of proposing definitive universal cut-off values, our results suggest that lower PSAd thresholds may be considered in patients with larger prostate volumes, particularly in borderline cases such as PI-RADS 3 lesions. Incorporating prostate volume into PSAd interpretation may improve risk stratification and contribute to more individualized biopsy decision-making.
Objective: Surgical management of renal tumors has shifted toward partial nephrectomy (PN), even in larger or more complex cases. This study aimed to evaluate how clinical practice patterns, surgical approaches, and outcomes of PN evolved over the last decade. Materials and Methods: Using the Turkish Urooncology Association REDCap database, we retrospectively reviewed 3,482 patients who underwent PN for renal cell carcinoma between 1997 and 2024. Patients were stratified into earlier (before 2014) and later (after 2014) groups. Demographic, surgical, perioperative, and oncologic parameters were compared. Subgroup analyses assessed open, laparoscopic, and robot-assisted PN. Statistical analyses were performed using t-tests and chi-square tests with significance set at p<0.05. Results: Patients in the last decade were older (56.9 vs. 54.9 years; p<0.001). Hospital stay, blood loss, and ischemia time were significantly reduced (all p<0.001). The use of minimally invasive PN increased significantly, with robotic procedures comprising 12.2% of cases after 2014 (p<0.001). Intraoperative complications declined from 3.5% to 1.5% (p=0.001), and postoperative complications declined from 14.1% to 6.5% (p<0.001). Recurrence decreased from 8.7% to 3.5% (p<0.001), while positive margin rates remained stable at 9.1% in both groups. Subgroup analyses confirmed reductions in complications and in recurrence for both open and laparoscopic PN. Conclusion: PN has evolved toward wider use in older patients and with minimally invasive techniques. Despite comparable tumor sizes, perioperative complications and recurrence rates declined significantly over time, supporting PN as a safe and effective treatment for complex renal tumors.
Objective: This study aimed to evaluate the prognostic impact of intraductal carcinoma of the prostate (IDC-P) in patients with metastatic prostate cancer treated with enzalutamide or abiraterone acetate. Materials and Methods: We retrospectively analyzed data from patients with metastatic prostate cancer who received abiraterone acetate or enzalutamide. The primary outcome was overall survival (OS). Secondary outcomes were prostate-specific antigen (PSA) progression-free survival (PFS) and radiologic PFS. Results: A total of 94 men were enrolled in the study. Among them, 30 patients (31.9%) received androgen receptor pathway inhibitors for metastatic hormone-sensitive prostate cancer (mHSPC), and 64 patients (68.1%) were treated for metastatic castration-resistant prostate cancer (mCRPC). The presence of IDC-P was associated with significantly shorter OS than in patients without IDC-P (35.38 months vs. 55.59 months, respectively; p=0.011). In mCRPC, median OS was significantly shorter in patients with IDC-P (35.38-55.59 months), while the difference was not significant in the mHSPC cohort [35.48 months vs. not reached (NR)]. Multivariate Cox regression analysis identified IDC-P as an independent adverse prognostic factor for OS (hazard ratio 3.16, 95% confidence interval 1.56-6.41; p=0.001). Similarly, median PSA-PFS was significantly shorter in patients with IDC-P than in those without IDC-P (15.87 vs. 31.11 months, p=0.020). In mCRPC, median PSA-PFS was significantly shorter in patients with IDC-P (15.9 vs. 28.4 months), whereas the difference was not significant in the mHSPC cohort (18.3 months vs. NR). Conclusion: The presence of IDC-P is associated with poorer PSA-PFS and OS in patients with metastatic prostate cancer treated with abiraterone acetate or enzalutamide.
Renal metastasis from small cell lung cancer (SCLC) is highly uncommon. A 60-year-old woman received chemotherapy and radiotherapy for metastatic SCLC. The patient remained in remission for 18 months on adjuvant atezolizumab. Follow-up radiological staging revealed a solitary renal mass. Then she underwent laparoscopic nephrectomy. The pathological examination confirmed SCLC metastasis. This case report suggested that isolated renal metastasis can be seen in patients with SCLC even under maintenance immunotherapy.
Objective: Cribriform architecture has increasingly been recognized as an adverse morphological feature in prostate adenocarcinoma. The present study aimed to describe a novel histopathological subtype of cribriform architecture, termed conglomerated cribriform morphology (CCM), and to investigate its association with clinicopathological parameters and oncological outcomes. Materials and Methods: Radical prostatectomy specimens with Gleason score 7 and cribriform architecture were retrospectively reviewed. All cases were re-evaluated and categorized into two morphological groups: basic cribriform morphology and CCM. Clinicopathological variables and survival outcomes were compared between these groups. Results: A total of 151 patients were included in the study, with a mean age of 67.6 years. CCM was detected in 21.2% of cases. This pattern was significantly associated with higher prostate-specific antigen levels, extraprostatic extension, lymph node metastasis, biochemical recurrence, and distant metastasis. Multivariate Cox regression analysis revealed tertiary Gleason pattern, lymphovascular invasion, and CCM as independent predictors of biochemical recurrence. Patients with CCM had significantly shorter biochemical recurrence-free survival. Conclusion: Cribriform architecture is widely considered an unfavorable feature in prostate cancer. The newly described conglomerated cribriform subtype appears to be a particularly aggressive variant. Recognition of this morphology may contribute to improved prognostic stratification and influence clinical management strategies.
Objective: The purpose of study was to identify the clinical utility of preoperative systemic immune-inflammation index (SII) in predicting biochemical recurrence (BCR) after robot-assisted radical prostatectomy (RARP). Materials and Methods: A retrospective analysis was performed using data from our robotic surgery database, which included 531 patients with localized prostate cancer (PCa) who received RARP from March 2015 through June 2021. Patients' characteristics and outcomes were recorded. The preoperative SII of each patient was calculated. Patients with and without BCR were confronted. The predictive ability of the SII was determined by receiver operating characteristic (ROC) curve analysis. Results: After applying the exclusion criteria, the study included 400 patients. Among them, 90 patients (22.5%) experienced BCR. Analysis of the relationship between BCR and preoperative variables demonstrated that prostate-specific antigen, biopsy International Society of Urological Pathology (ISUP) grade, clinical stage, and D'Amico classification statistically significant. Although the SII was higher in patients with BCR, the difference was not statistically significant (p=0.198). Previously reported pathological factors, such as ISUP grade at prostatectomy, pathological stage, lymphovascular invasion, perineural invasion, extraprostatic extension, seminal vesicle invasion, and positive surgical margin, were associated with BCR. The ROC curve for the SII demonstrated poor predictive ability for BCR (95% confidence interval: 0.412-0.545; p=0.532). Conclusion: SII did not appear to be a prognostic indicator for BCR after RARP in localized PCa patients.
Objective: The Mayo adhesive probability (MAP) score is used to predict the presence of adherent perinephric fat. The study aimed to assess the impact of MAP score on intra-and postoperative outcomes in partial nephrectomy (PN). Materials and Methods: This retrospective analysis encompassed 130 patients treated with either open or laparoscopic PN. MAP scores were calculated, and their relevance to intra-and postoperative characteristics was evaluated. Results: Cases were seperated into 2 groups according to MAP scores [group 1: MAP score <= 2 (n=86 (66.15%) and group 2: MAP score >= 3 (n=44 (33.85%)]. No significant differences were observed in age, tumor size, body mass index, PN laterality, or radius, exophytic/endophytic, nearness, anterior/posterior location, and preoperative aspects and dimensions used for an anatomical nephrometry scores. Male patients, as well as those with higher American Society of Anesthesiologists scores (>= 2) and Charlson comorbidity index (>= 4), demonstrated significantly elevated MAP scores (p<0.001, p=0.046, p=0.022). Median operation time was longer [135 (interquartile range (IQR): 120-180) vs 160 (IQR: 140-180) min] in group 2 (p=0.014). Although duration of WIT [28 (IQR: 19.5-37.5) vs 33.5 (IQR: 21.75-41.25) min] and intraoperative bleeding [400 (IQR: 200-700) vs 500 (IQR: 200-900) mL] were higher in group 2, no statistically significant difference was observed (p=0.262, p=0.352). No significant differences were observed regarding intra-and postoperative transfusion requirements or hospital length of stay. Conclusion: Elevated MAP scores are linked to longer operative times, while having a minimal effect on intra-and postoperative complications and outcomes.
Objectives: The study investigates whether multiparametric magnetic resonance imaging (mpMRI) targeted biopsy (MRI-TB) is necessary in the setting of prostate-specific antigen (PSA) 20-100 ng/mL and normal digital rectal examination (DRE). Materials and Methods: Patients undergoing MRI-TB and concomitant systematic biopsies (SB) with a PSA 20-100 ng/mL and normal DRE were retrospectively reviewed in Prostate Cancer Database of Turkish Urooncology Association. Pathological data of MRI-TB was compared to the SB data. All patients underwent mpMRI followed by transrectal/transperineal MRI-TB of any Prostate Imaging Reporting and Data System lesion and 12-core SB. The prostate cancer (PCa) and clinically significant PCa (csPCa) (grade group >= 2) detection on MRI-TB, SB and MRI-TB+SB were determined for all patients. A subgroup analysis of combined (MRI-TB+SB) group was also performed to identify performances of MRI-TB alone, SB alone and combination of MRI-TB+SB for the prediction of final pathology at radical prostatectomy (RP). Statistically significance was set at p<0.05. Results: In the study 65 patients were evaluated. Among them, 35 have PCa and 32 of them were csPCa. The detection rate of PCa for MRI-TB+SB, MRI-TB and SB were 53%, 46% and 36%, respectively, and csPCa detection rates were 49%, 41% and 33%, respectively. TB added 31.4% of any grade PCa and 31.25% csPCa detection over SB. csPCa detection rate improved with increased PSA density for TB. Among 15 patients who underwent RP,6 patients were found to have csPCa on final pathology which went undetected or undergraded with SB biopsy initially. Conclusion: MRI-TB based on mpMRI presents a valuable addition to SB in patients with PSA 20-100 ng/mL and normal DRE.
Testicular neoplasms represent an uncommon subset of urogenital malignancies, with lymphomatous involvement being an even more infrequent clinical presentation. Fournier's gangrene, a fulminant necrotizing fasciitis affecting the perineal region, is characterized by a polymicrobial pathogenesis. The therapeutic management of this condition is predicated upon three critical interventional strategies: Expeditious and comprehensive surgical debridement, targeted antimicrobial pharmacotherapy, and robust hemodynamic stabilization.We report a rare case of recurrent testicular diffuse large B-cell lymphoma in an 85-year-old diabetic man complicated by Fournier's gangrene, a severe infectious complication.
Objective: For eligible patients with muscle-invasive bladder cancer, the current standard of care is neoadjuvant chemotherapy (NAC) using cisplatinbased regimens followed by radical cystectomy (RC) with pelvic lymph node dissection. We evaluated the role of NAC in the pathological T-staging of tumors in patients who underwent RC and the effect of pathological T-stage regression on disease-free survival (DFS) and overall survival (OS). Materials and Methods: We evaluated 29 patients who underwent RC following NAC between 2015 and 2023 at our hospital. Eligible participants had histologically confirmed urothelial carcinoma of the bladder with stage cT2-T4a N0-N2 M0 disease and had received cisplatin-based NAC. The primary endpoint was the effect of NAC on pathological T-stage regression, DFS, and OS. The secondary endpoint was to determine the factors affecting DFS following RC. Results: Cystectomy pN0 rate, in patients with T regression, was significantly higher than that in the other group (86.7% vs. 42.9%, p=0.021). The rate of lymphovascular invasion following cystectomy was significantly lower in the T regression group (57.1%) compared to the non-T regression group (93.3%; p=0.023). T2 pathology to RC time (hazard ratio=1.620, 95% confidence interval: 1.004-2.613, p<0.048) was the only independent predictor for DFS following RC in the multivariate analysis. Conclusion: Detection of pathological tumor regression in cystectomy pathology after NAC is associated with better DFS and OS. T2 pathology to RC time was an independent predictor of DFS.
Angiomyolipoma with epithelial cyst (AMLEC) is a rare variant of angiomyolipoma (AML). Hereby, we report a unique case which is the largest size of AMLEC ever reported, the patient being the youngest one ever recorded, and the first case of AMLEC associated with tuberous sclerosis complex reported from India. The patient was a 19-year-old woman who presented with hematuria. Contrast-enhanced computed tomography (CT) and positron emission tomography-CT detected a large complex cystic lesion, which was reported to be AML with a less likely possibility of cystic renal cell carcinoma. The patient underwent radical nephrectomy. Histopathology and immuno-histochemistry identified the tumor to be AMLEC. On further evaluation, the patient was found to satisfy clinical criteria of tuberous sclerosis complex. Rare forms of renal tumor like AMLEC need to be kept in mind whenever we encounter complex cystic lesions in the kidney.
Objective: To evaluate the learning curve of a single surgeon performing 72 laparoscopic radical prostatectomy (LRP) cases without mentorship, following a two-month advanced laparoscopy observership. Materials and Methods: The urologist, without prior LRP experience, underwent observership in a high-volume center before independently performing 72 LRP procedures over three years. Cases were divided into two groups: group A (first 36 cases) and group B (subsequent 36 cases). Data on demographics, operative parameters, complications, and surgical outcomes were analyzed. Crucial parameters, including total operation time, lymphadenectomy time, and urethrovesical anastomosis time, were compared between groups. Results: Group B showed significant improvements in total operation time (p=0.008), lymphadenectomy time (p=0.001), and urethrovesical anastomosis time (p<0.001). However, group B, significantly influenced by high-risk cases and a rectal injury complication, had longer hospital stays and urinary catheter durations. Despite a higher rate of high-risk cases in group B, there was no significant difference in overall complication rates or positive surgical margins. One case required conversion to open surgery due to rectal injury. Conclusions: Significant improvements in operative times were observed; however, complication rates and positive surgical margins did not differ significantly between groups, likely influenced by the higher proportion of high-risk patients in the second group. While these findings suggest that LRP can be performed without direct mentorship, the study's single-surgeon experience and limited sample size restrict generalizability. Longer follow-up and larger studies are needed to assess oncological and functional outcomes and to further optimize the learning curve.
Objective: Bacillus Calmette-Gu & eacute;rin (BCG) therapy continues to be a fundamental component in the treatment of non-muscle invasive bladder cancer. The objective of this study was to assess the relationship between granuloma formation resulting from BCG therapy and histopathological and clinical parameters. Materials and Methods: This study encompassed 96 patients who underwent intravesical BCG therapy from 1990 to 2003. Post-treatment biopsy specimens were re-evaluated for the presence of granulomas. Cases demonstrating any number of granulomas were classified as positive for granulomatous response. The presence of granulomas was analyzed in relation to various factors including age, sex, pathological tumor stage, tumor grade, and the status of tumor recurrence and progression. Results: The mean age of the cases was 64.13 +/- 10.34 years. The cases were predominantly male (85.4%, n=82) compared to those who were female (14.6%, n=14). Granuloma formation was identified in 39 cases (40.6%). Recurrence occurred in 48 cases (50%). Progression was observed in 11 patients (11.5%). The distribution of pathological stages was as follows: non-invasive tumors (pTa) in 70 cases (72.9%) and pT1 in 26 cases (27.1%). Tumor grading revealed 38 grade 1 cases (39.6%), 45 grade 2 cases (46.9%), and 13 grade 3 cases (13.5%). Statistical analysis revealed no significant differences between cases with and without granuloma in terms of age (p=0.703), gender (p=0.052), recurrence (p=0.301), progression (p=0.761), time to recurrence (p=0.186), survival (p=0.367) or tumor grade (p=0.353). However, a significant difference was observed in the distribution of pathological stages and the frequency of granulomas was higher in cases with pT1 (p=0.011). Conclusion: The study revealed a higher prevalence of stage pTa in patients without granulomas, suggesting that granuloma formation might be more likely in tumors that exhibit invasion. This could reflect differences in immune response elicited by BCG therapy or in biological/molecular characteristics of the tumor itself. The presence of granulomas doesn't strongly correlate with the overall prognosis. These results emphasize the need for further research to explore the mechanisms behind granuloma formation and its potential implications for treatment efficacy and patient management in more standardized case series.
Objective: This bibliometric analysis examines the evolution of prostate cancer (PCa) research and evaluates the impact of machine learning and artificial intelligence (AI) on its diagnosis, classification, and treatment. Materials and Methods: Articles published between 1997 and 2025 were analysed using the Web of Science Core Collection database. VOSviewer and Bibliometrix software was utilized for bibliometric analysis. Terms such as "PCa", "machine learning (ML)", "deep learning" and "AI" were included in the search strategy. The number of publications, the most cited studies, author collaborations and country collaborations, thematic trends, and citation networks were visualised. Results: A total of 3,277 articles were analysed. The in augural article was published in 1997. Over the past five years, there has been a significant increase in the number of articles published. The United States and China are the countries with the highest number of publications, and the most influential authors and institutions are concentrated in these countries. A marked upward trend has been observed in ML applications for PCa diagnosis, risk stratification, and treatment planning. Conclusion: The use of AI and ML in PCa research has grown significantly over the last 20 years. However, most of the existing models have been tested with retrospective data, and more multicenter and prospective studies are needed for clinical applications. Comprehensive clinical validation is essential before AI-based systems can be reliably implemented.
Objective: This study aimed to investigate the relationship between preoperative systemic immune-inflammation index (SII) and postoperative tumor stage in patients with seminomatous testicular germ cell tumors. Materials and Methods: A total of 33 patients who underwent radical orchiectomy and were histopathologically diagnosed with seminoma were included in the study. Patients with tumors localized to the testis were designated as group 1, while those with extratesticular spread (advanced-stage tumors) were classified as group 2. Each group was then compared based on preoperative SII levels. Results: Group 1 consisted of 22 patients. The mean ages of groups 1 and 2 were 36.14 and 35.09 years, respectively, with no statistically significant difference between the groups (p>0.05). However, SII levels in group 2 were significantly higher than those in group 1, with a reported value of 924.70 (p=0.002). Moreover, a 10-unit increase in SII was found to increase the likelihood of advanced-stage tumors, with extratesticular spread, by approximately 6% (odds ratio =1.006). Conclusion: This study demonstrated that high preoperative SII is significantly associated with advanced tumor stage in patients with seminoma.
