This research analyzes the global landscape of clinical trials focusing on therapies targeting the Nectin cell adhesion molecule 4 (Nectin-4) across various malignancies, using data from the Trialtrove database. Analysis of 136 interventional trials reveals a rapidly expanding field dominated by antibody-drug conjugates, particularly in urothelial carcinoma, with significant activity in combination regimens and diverse therapeutic modalities under exploration. These findings emphasize the substantial translational potential of Nectin-4 and highlight key trends shaping its future clinical development.

Objective:To preliminarily investigate the safety and feasibility of domestic Jingfeng MP1000 multi-port robotic surgical system-assisted laparoscopic radical nephrectomy with venous tumor thrombectomy.Methods:Clinical data of 15 patients with renal cell carcinoma(RCC)and venous tumor thrombus who underwent Jingfeng MP1000 robot-assisted laparoscopic radical nephrectomy with venous tumor thrombectomy at the Department of Urology,Peking University Third Hospital from June 2024 to January 2026 were retrospectively analyzed.The primary outcomes were the success rate of the robotic procedure,overall complication rate,and major complication rate(Clavien-Dindo≥grade Ⅲ).Secondary outcomes included operative time,estimated blood loss,and length of hospital stay.Baseline characteristics,perioperative outcomes,pathological results,and postoperative complications were col-lected and analyzed using descriptive statistical methods.Results:All the 15 procedures were successful-ly completed with robotic assistance,with no conversions to open surgery.The success rate of robotic-assisted surgery was 100％.The median patient age was 60 years,and the median body mass index was 25.6 kg/m2.Ten patients had right-sided and 5 had left-sided tumors,with a median tumor diameter of 9.1 cm.According to the Mayo classification,there were 5 cases of grade 0,4 of grade Ⅰ,5 of grade Ⅱ,and 1 of grade Ⅲ thrombus.The median operative time was 233.0 min,the median estimated blood loss was 250.0 mL,and 5 patients(33.3％)received blood transfusions.The median postoperative hos-pital stay was 6 days.Only one patient(6.7％)experienced a Clavien-Dindo grade Ⅱ complication(lymphatic leakage),with no grade≥Ⅲ severe complications or perioperative mortality.Postoperative pathology revealed clear cell renal cell carcinoma in 12 cases,and venous wall invasion was confirmed in 8 patients(53.3％).After a median follow-up of 4.4 months,one patient developed duodenal metasta-sis 10 months postoperatively.Conclusion:The domestic Jingfeng MP1000 multi-port robotic system-assisted laparoscopic radical nephrectomy with venous tumor thrombectomy is technically safe and feasi-ble,with favorable perioperative outcomes and a low complication rate.Its long-term oncological efficacy requires further validation through large-scale,prospective studies.

BACKGROUND:The aim of this study was to evaluate the feasibility and safety of radical nephrectomy with thrombectomy for geriatric renal cell carcinoma (RCC) patients with venous tumor thrombus (VTT). METHODS:The retrospective analysis included 542 patients with RCC and VTT between 2014 and 2024. Patients were stratified into geriatric (≥70 years, N.=88) and younger groups (<70 years, N.=454). Propensity score matching (PSM, 1:1) balanced baseline variables, including Mayo classification, TNM stage, surgical approach, and comorbidities. Perioperative outcomes (operative time, blood loss, complications) and 1-year survival rates were compared. RESULTS:Geriatric patients exhibited higher comorbidity rates (82.95% vs. 64.54%, P=0.001) and ≥3 ASA scores portion (26.14% vs. 14.10%, P=0.004) but shorter tumor diameter (7.9 cm vs. 8.8 cm, P=0.007). After PSM, perioperative outcomes showed no significant difference: operative time (271 vs. 290 min, P=0.14), blood loss (400 vs. 600 mL, P=0.23), complications (37.50% vs. 40.97%, P=0.53) or severe complications (8.0% vs. 9.2%, P=0.67). 1-year overall survival was similar between two groups (94.6% vs. 94.1%, HR=1.04, P=0.90), as was cancer-specific survival (HR=0.98, P=0.96). For the inferior vena cava VTT and M0 stage subgroups, the outcomes were consistent with the above. CONCLUSIONS:This study demonstrates comparable perioperative safety and equivalent short-term survival benefits between geriatric and younger patients undergoing radical nephrectomy with thrombectomy, regardless of VTT complexity and distant metastasis. Age alone should not preclude surgical intervention when supported by comprehensive multidisciplinary assessment.

BackgroundAnaplastic lymphoma kinase (ALK)–rearranged renal cell carcinoma (ALK-RCC) is a rare provisional entity characterized by fusion of the ALK gene with various fusion partner genes, resulting in oncogenic activation.Case presentationWe report a case of a 39-year-old Chinese man with ALK-RCC who underwent partial nephrectomy for a left renal tumor measuring 2.8 × 2.7× 2.6 cm. Histopathological examination revealed a renal epithelial tumor with atypical morphology. Immunohistochemistry demonstrated the occurrence of renal epithelial differentiation and excluded other entities. Next-generation sequencing confirmed a KIF5B-ALK gene fusion.ConclusionThis case presents the clinical data, morphology, immunohistochemistry, and molecular characteristics of a rare subtype of ALK–rearranged renal cell carcinoma with KIF5B-ALK fusion. The findings may enhance the clinical and pathological understanding of ALK-RCC among clinicians and pathologists. Managing ALK-RCC is challenging due to its rarity and limited treatment options. Targeted therapies directed at the ALK gene may have a role in patients with ALK-RCC.

Background: Benign prostatic hyperplasia (BPH) is a common condition that causes lower urinary tract symptoms (LUTS) in middle-aged and elderly men. Existing bladder function monitoring methods, such as ultrasound and urodynamic studies (UDS), have limitations including invasiveness, lack of dynamic capability, poor portability, and susceptibility to psychological interference. Electrical impedance tomography (EIT) technology, with its potential for non-invasiveness, non-ionizing during monitoring, portability, and real-time dynamic imaging, offers a new approach to address this clinical challenge. Methods: This study aims to evaluate whether an intelligent wearable EIT device can achieve clinically acceptable agreement with standard uroflowmetry for dynamic monitoring of bladder volume and urinary flow rate in patients with BPH. This is a single-centre, self-controlled diagnostic consistency study. We plan to enroll 40 eligible patients with BPH. All participants will undergo simultaneous monitoring with the EIT wearable device and a conventional uroflowmeter during voiding. The primary outcomes are maximum flow rate (Qmax), average flow rate (Qave), and voided volume (VV) measured by both methods. Clinically acceptable agreement will be evaluated primarily by Bland-Altman analysis with 95% limits of agreement, with intraclass correlation coefficient (ICC) used as a supplementary measure of consistency; curve similarity will be explored using dynamic time warping (DTW) distance and Pearson correlation. Secondary outcomes include the device's capability for real-time dynamic bladder volume monitoring during filling and voiding, and the development of an artificial intelligence (AI)-enhanced analytical framework for future home-based telemedicine applications. Discussion: This trial will systematically validate whether EIT-based wearable technology can achieve non-invasive, accurate, and dynamic monitoring of voiding function in patients with BPH. If successful, it may provide a practical alternative to traditional uroflowmetry by enabling continuous physiological assessment in a near-natural state, and ultimately support long-term home-based self-management and remote urological care. Trial Registration: This trial was registered with ClinicalTrials.gov on 12 January 2026 with the trial ID NCT07357012, accessible athttps://clinicaltrials.gov.

ABSTRACT Background The adoption of robotic partial nephrectomy has grown significantly over the past decade, prompting a debate on the merits of transperitoneal versus retroperitoneal surgical access. This study evaluated the association between surgical route (transperitoneal, TRPN; retroperitoneal, RRPN) and pentafecta achievement using a detailed location classification. Methods We retrospectively analyzed 368 patients who underwent RPN. Tumor location was classified into four main categories (anteromedial, AM; anterolateral, AL; posteromedial, PM; posterolateral, PL). Inverse probability of treatment weighting (IPTW) with covariate balancing propensity score (CBPS) balanced baseline covariates. Weighted logistic regression assessed the interaction between surgical approach and location on pentafecta achievement. Statistical methods employed included the binomial test, chi‐square test, and Mann–Whitney U test. Results After IPTW, all covariates were balanced (SMD < 0.1). Compared with RRPN, TRPN significantly reduced pentafecta odds for PL (OR = 0.03, 95% CI 0.005–0.13, p < 0.001) and PM tumors (OR = 0.08, 95% CI 0.015–0.39, p = 0.002), but significantly increased odds for AL tumors (OR = 10.45, 95% CI 2.91–37.48, p < 0.001). No significant difference was found for AM tumors (OR = 0.13, p = 0.053). Low R.E.N.A.L. complexity independently predicted higher pentafecta odds (OR = 3.67, p = 0.034). Conclusions A location‐guided strategy is supported: TRPN is superior for AL tumors, while RRPN achieves better pentafecta rates for PL and PM tumors. Individualized approach selection based on detailed tumor anatomy is essential. Prospective multicenter studies are warranted to validate these findings.

Objective To explore the applicability of the new media platform "Urological Surgery Learning Notes"in the continuing education of urology specialists. Methods In December 2024, 390 subjects were recruited. Educational content, questions, and interactive materials related to the diagnosis, treatment, and surgery of urological diseases were disseminated via the WeChat public platform "Urological Surgery Learning Notes."Post-instruction surveys were conducted to assess knowledge acquisition, attitudes, and educational outcomes. Results Among the 390 subjects, 313 (80.26%) used the platform's educational resource library more than once per week. 270 participants (69.23%) showed greater interest in learning content related to surgical techniques and precautions, while 340 (87.18%) preferred the video tutorial format offered by the platform. Regarding comprehension of different urological teaching content, 84.6% participants found the resource library's content understandable. 88.19% participants believed it was effective or highly effective in improving urological surgical skills or clinical decision-making abilities. However, only 11.3% participants reported applying content from this resource library to more than 20 cases in their clinical practice. Conclusion The use of the WeChat public platform-based educational resource library for continuing education of urology specialists demonstrated high acceptance, recognition, and applicability, proving to be feasible. However, its application process requires further enhancement based on the actual case mix and clinical realities of different hospitals.

BACKGROUND:The management of complex ureteral strictures remains a significant urologic challenge. Although metallic stents offer an alternative to traditional polymer stents, long-term data on their efficacy, particularly for newer devices, are limited. This study evaluates the safety and efficacy of a novel, domestically produced thermally expanding nickel-titanium alloy stent (Fulbright®) in treating various ureteral strictures. METHODS:A prospective, single-center study was conducted between August 2024 and September 2025. Consecutive patients with ureteral strictures of diverse etiologies (e.g., stone-related, postradiation, iatrogenic, idiopathic) were enrolled. All participants underwent implantation of the thermally expanding nickel-titanium alloy stent (Fulbright). Primary outcomes included technical success, stent patency, and changes in renal function parameters (serum creatinine, estimated glomerular filtration rate (eGFR), hydronephrosis volume) assessed during follow-up. RESULTS:A total of 21 patients (representing 23 ureteral units) were included. The cohort presented with complex strictures of varied etiology: urolithiasis (39.1%, n = 9), radiation-induced (21.7%, n = 5), iatrogenic (17.4%, n = 4), idiopathic (13.0%, n = 3), and tumor extrinsic compression (8.7%, n = 2). The primary endpoint of an effective decompression was achieved in 87.0% of cases over a median follow-up of 5.0 months (interquartile range [IQR] 2.0-6.0). Postoperative renal function improved significantly, with serum creatinine levels decreasing from a median of 95.0 μmol/L (IQR 73.0-126.0) to 84.0 μmol/L (IQR 68.0-115.0) (p < 0.001). Concurrently, the eGFR increased significantly from 64.8 ± 23.3 mL/min/1.73 m2 to 73.1 ± 22.1 mL/min/w1.73 m2 (p = 0.001). A marked reduction in hydronephrosis volume was also observed, from a median of 57.9 cm³ (IQR 27.7-109.8) to 12.9 cm³ (IQR 5.7-38.4) (p < 0.001). Stent migration was the predominant complication, occurring in 17.4% (4/23) of cases, one of which was effectively managed endoscopically. CONCLUSIONS:The novel thermally expanding nickel-titanium alloy stent (Fulbright) represents a promising, safe, and effective minimally invasive therapeutic option for managing both benign and malignant ureteral strictures.

Forecasting postoperative complications in patients with renal cell carcinoma and tumor thrombus is clinically important but mathematically challenging, because the available data are limited, temporally unstable, and strongly affected by epistemic uncertainty. To address this problem, this paper proposes an uncertain logistic regression model with an uncertain disturbance term. The model parameters are estimated by uncertain maximum likelihood, and the residual is further analyzed through uncertain Bayesian rule and uncertain hypothesis testing. A retrospective cohort of 491 patients is used for the case study, including 418 patients from 2023 and earlier as the training set and 73 patients from 2024 as the temporal test set. Seven clinically meaningful risk factors are identified, including age, body mass index, tumor thrombus grade, venous-wall adherence, tumor diameter, lymph-node status, and metastasis status. Compared with the probabilistic logistic regression benchmark, the proposed method reduces the maximum forecast deviation from 0.1537 to 0.1350 and decreases the misjudgment ratio from 0.1644 to 0.1507. For the 90% uncertain interval, the empirical coverage obtained by uncertainty theory is 87%, whereas the corresponding probabilistic interval covers only 25% of the residuals. These results suggest that the proposed model is useful for conservative retrospective risk analysis under epistemic uncertainty, but they should not be interpreted as evidence of confirmed clinical decision support value. Further external and prospective validation is still required before any clinical deployment.

BackgroundRenal tubulocystic oncocytoma (RTO) is an exceptionally rare variant of renal oncocytoma (RO) with poorly understood genetic underpinnings. This study aimed to characterize the clinicopathological features and genomic landscape of RTO to enhance diagnostic precision and elucidate its molecular profile.MethodsWhole-exome sequencing (WES) was performed on a pathologically confirmed case of RTO to identify somatic mutations. Bioinformatics filtering identified single-nucleotide variants (SNVs) and insertions/deletions (INDELs), which were screened against databases such as the Cancer Gene Census (CGC) to identify potential driver and predisposing genes. Findings were validated via Sanger sequencing. Immunohistochemistry (IHC) was utilized for diagnostic marker assessment and tumor microenvironment (TME) characterization. Furthermore, a literature-based analysis of reported RTO cases was conducted across multiple databases, including PubMed, Ovid, Google Scholar, EMBASE, and Scopus.ResultsWES analysis identified 399 somatic SNVs and 91 INDELs, as well as mutations in 14 candidate predisposing genes and 27 candidate driver genes, including mutations in 3 predisposing genes (COL7A1, CSF3R, and MKL1) and 11 driver genes (ZFHX3, TSC2, NFATC2, TCF7L2, TLR4, RANBP17, ITK, NEB [Chr2:152499355], NUP214, FBN2, and NEB [Chr2:152544903]). Drug-target prediction and resistance analysis identified several variants with potential therapeutic relevance. IHC staining confirmed positive expression of CD117, EMA, and E-cadherin, supporting the differential diagnosis. TME profiling revealed an “immune-cold” phenotype characterized by low densities of CD4+, CD8+, and FOXP3+ T cells, CD19+ and CD20+ B cells, CD56+ and CD57+ NK cells, and CD163+ tumor-associated macrophages, alongside minimal checkpoint activity and focal fibroblast activation. A comparative analysis with eight previously reported cases further contextualized these clinicopathological and immunophenotypic findings.ConclusionsThis study provides a comprehensive genomic characterization of RTO. The integration of molecular profiling, histopathology, and literature-based comparison broadens the understanding of RTO’s molecular and immunophenotypic landscape, providing a foundation for future hypothesis-driven research.

ABSTRACT Objectives To compare the perioperative and postoperative outcomes of transperitoneal and retroperitoneal robotic partial nephrectomy (RPN) and develop a prediction model for reference to select the approach. Materials and Methods We retrospectively reviewed our single‐institutional RPN database. The patients were divided into training and validation sets. In training set, transperitoneal and retroperitoneal cases were matched using propensity score matching to balance confounding factors. The intraoperative and postoperative outcomes of both approaches were compared. A prediction model was constructed to predict the probability of the retroperitoneal approach. The model was then externally validated using the data from the validation set. Results A total of 318 patients were included in the training set, and after propensity score matching, 200 cases were left. Additionally, 92 patients were included in the validation set. The estimated blood loss ( p = 0.021) and the hemoglobin change ( p = 0.016) were greater in the transperitoneal group. There was no significant difference in operative time ( p = 0.539), warm ischemia time ( p = 0.678), hospitalization time ( p = 0.673), extubation time ( p = 0.621), creatinine change ( p = 0.623), negative margin ( p = 1), local recurrence ( p = 1), postoperative complication ( p = 0.229), long‐term creatinine ( p = 0.158), and overall survival ( p = 0.671) between the two groups. Tumor diameter, anteroposterior location, longitudinal location, and accessory renal artery were employed as variables to construct the prediction model, resulting in area under the curve values of 0.84 and 0.77, respectively, during internal and external validation. Conclusions Retroperitoneal and transperitoneal approaches of RPN showed no difference in perioperative outcomes except estimated blood loss and hemoglobin change. The retroperitoneal approach is recommended for smaller tumors located in the upper pole or posterior and the presence of an accessory renal artery. Our model is available to predict the probability of the retroperitoneal approach.

Objective To explore the application effectiveness of the “Urology surgery learning notes” new media teaching resource library in the standardized training of surgical learning for urology residency. Methods In this study, 30 residents undergoing standardized training received new media-based teaching (experimental group), while 30 others received traditional teaching (control group). The learning outcomes of the two groups were compared. Results The examination scores of the experimental and control groups were 89.10 ± 3.10 and 69.81 ± 3.31, respectively (P = 0.012). The experimental group outperformed the control group in foundational theoretical knowledge, essay questions, and case analysis. After the teaching intervention, satisfaction surveys on teaching content, methodology, and competency development were conducted. The experimental group showed significantly higher satisfaction (P < 0.05). Conclusion The new media teaching resource library demonstrates superior effectiveness in urological surgical education, better motivates students' autonomous learning, and holds potential for broader application.

Kidney transplant recipients (KTRs) exhibit a higher incidence of neoplasms compared to the general population, primarily due to the prolonged administration of immunosuppressive agents and viral infections. In China, the primary type of tumor among KTRs is urothelial carcinoma (UC), which lacks specific clinical manifestations. Accurate diagnosis necessitates the integration of multiple diagnostic modalities, while therapeutic approaches must judiciously balance oncological control with the preservation of renal function, thereby presenting a considerable challenge to the health of KTRs. This article provides a comprehensive review of the epidemiological characteristics, risk factors, diagnostic methodologies, and therapeutic strategies associated with urothelial carcinoma post kidney transplantation (KT), aiming to enhance healthcare professionals’ understanding of this condition and improve patient management.

Background:Presurgical molecular therapy (PMT) including tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) showed various outcomes for renal cell carcinoma (RCC) with tumor thrombus (TT). We aimed to evaluate the impact of PMT on Mayo level or TT height and the treatment-related adverse events (AEs). Methods:A systematic literature search was conducted in PubMed, Embase, Cochrane Library, and Web of Science up to June 2023 to identify relevant studies investigating the impact of PMT on RCC patients with TT. The literature investigating the impact of PMT on RCC patients with venous TT, whether followed by surgery or not, was included. Results:Overall, 184 patients were enrolled in this study. 30.7% (95% CI, 17.6-43.8%, I2 = 79%, p<0.01) patients experienced a decrease in TT levels after receiving PMT, while only 1.5% (95% CI, 0-0.044%, I2 = 0%, p=0.98) exhibited an increase in TT levels. An average decrease of 15.2mm (95% CI, 22.4-8.0, I2 = 77%, p<0.01) of TT in 117 patients was observed after PMT. The most common AEs was hypertension (49.9%, 95% CI, 27.1-77.7, I2 = 88%, p<0.01), diarrhea (20.2%, 95% CI, 2.7-37.6, I2 = 83%, p<0.01), fatigue (25.3%, 95% CI, 6.1-44.4, I2 = 84%, p<0.01) and hand-foot syndrome (25.5%, 95% CI, 5.6-45.5, I2 = 86%, p<0.01). Conclusion:PMT is available to assist in lowering the TT level in RCC patients aiming to simply the surgical procedures, particularly in patients with Mayo grade 3/4. The frequency and severity of AEs during PMT are tolerable. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier CRD420234399128.

Background Chronic kidney disease (CKD) represents a significant global public health challenge and is often underestimated in those over 60. Understanding its impact on the elderly individuals is crucial for proper healthcare resource allocation. Methods The Global Burden of Disease Study 1990–2021 data was analysed to assess CKD incidence, prevalence, mortality, and disability-adjusted life years (DALYs) in individuals aged 60 and older. Health disparities were evaluated via the slope index of inequality and the concentration index, whereas frontier analysis was used to predict outcomes on the basis of development levels. Decomposition analysis identified factors affecting disease burden changes, Joinpoint regression was used to analyse temporal trends, and the Bayesian age-period-cohort (BAPC) model was used to project future disease burden trends. Results From 1990 to 2021, the incidence, mortality, and DALY rates of CKD in the global elderly population showed an increasing trend, whereas the prevalence rate exhibited a decreasing trend. The age-standardized incidence rate (ASIR) was highest in high-social development Index (SDI) regions, while the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) were highest in low-SDI regions. In China, the age-standardized prevalence rates (ASPR), ASMR, and ASDR have been on a decline, yet the ASIR has been on the rise. The ASPR and ASIR are slightly higher in women than in men, whereas the ASMR and ASDR are higher in men than in women. By 2050, the global disease burden of CKD among the elderly population is projected to continue increasing, with the trend becoming more pronounced with advancing age. High blood sugar, hypertension, obesity, and low intake of fruits and vegetables are the primary risk factors associated with CKD-related DALYs among elderly individuals. Conclusions In 2021, the global burden of CKD in older adults showed a decline in the ASPR but an increase in the ASIR, ASMR, and ASDR, which are projected to increase over the next 30 years. Key risk factors include high blood sugar, hypertension, obesity, and low fruit and vegetable intake.

BackgroundRenal cell carcinoma (RCC) with venous tumor thrombus (VTT) is great burden over world. Radical nephrectomy (RN) with thrombectomy seems to be its gold standard operation, which might cause reduction of renal function. The aim of this systematic review was to provide evidence about the incidence, risk factors, possible reasons and influence of renal insufficiency in RCC patients undergoing RN with thrombectomy.MethodsA systematic search using PubMed, Embase, Web of Science, the Cochrane Library and European Urology databases was conducted. Study selection followed the PRISMA guidelines. After screening, eleven articles and abstracted fully compatible with the PICOS were included in this systematic review. The study was registered with PROSPERO, CRD42024516596.ResultsOverall, a total of 1,668 patients who were diagnosed with RCC and VTT and underwent RN (open/laparoscopic/robotic) with thrombectomy were analyzed. The postoperative renal insufficiency was present from 0.7 to 53.9%. Relevant risk factors of postoperative renal insufficiency could be summarized into three aspects: baseline characteristics (male gender, tumor thrombus level), intraoperative procedure (surgical method and inferior vena cava clamping time) and other factors (development of the times). The reason of renal insufficiency could be depletion of circulation volume, alteration in renal hemodynamics and condition of solitary kidney. The overall survival (OS) ranged from 2 months to 98 months. A clear association between survival and renal function could not be established because of the oncological risk on survival. Necessary managements like supplying blood volume, diuretic therapy and renal replacement therapy should be applied.ConclusionsThe present incidence of postoperative renal insufficiency was underestimated. More possible risk factors should be explored. Large cohort, multi-center, prospective, and well-designed studies would be necessary to corroborate these results and provide high-grade recommendation for clinical practice.

Background: Radical surgery can achieve remarkable improvements in the survival of patients with renal cell carcinoma (RCC) and inferior vena cava tumor thrombus (IVCTT); however, not all patients can obtain the desired results. Therefore, identifying patients with poor survival after surgery is crucial for guiding follow-up adjuvant therapies and patient counseling. Objective: To evaluate the impact of primary tumor score based on tumor necrosis and tumor thrombus morphology on overall survival (OS), and create a postoperative prognostic model for patients with RCC and IVCTT. Methods: This retrospective study included 182 patients with RCC and IVCTT who underwent radical nephrectomy and thrombectomy (RNTE). Preoperative contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), ultrasound imaging, and clinical records were collected. Kaplan-Meier analysis was used to evaluate the overall survival (OS). Prognostic factors for OS were identified by univariate and multivariate analyses using the Cox proportional hazards regression model. A nomogram was developed and internally calibrated using the bootstrap resampling method. Results: The mean follow-up time was 24.1 months (1-84.5 months), and 34.1% (62 of 182) of the patients died of all causes. The primary tumor score possesses a superior prognostic value for the primary tumor compared with the level of IVCTT and tumor size. Multivariate Cox regression analysis showed that primary tumor score, distant metastasis, nonclear cell subtype, sarcomatoid degeneration, preoperative anemia grade, and ASA level were independent prognostic factors. Based on these factors, a nomogram was built; the concordance index was 0.77, and the AUC for predicting 1-3 years OS were 0.80, 0.81, and 0.78, respectively. Conclusions: Primary tumor score is a independent prognostic factors for patients with RCC and IVCTT. Combined with 5 easily acquired prognostic factors, a postoperative nomogram was developed and internally validated, and can be used to select patients who may benefit from adjuvant therapy or aggressive surveillance regimens. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

To analyze and summarize the clinical and pathological characteristics and prognosis of percutaneous kidney-sparing surgery (PCKSS) for the treatment of upper tract urothelial carcinoma (UTUC). A retrospective analysis was conducted on the clinical data and oncological characteristics of 16 cases of UTUC with PCKSS admitted to the Urology Department of Peking University Third Hospital from July 2015 to December 2023, and postoperative follow-up was conducted on the patients. All cases were discussed at a multi-disciplinary treatment group and underwent PCKSS by the same surgeon. As a result, all 16 cases of PCKSS surgery were successfully completed, with 3 cases having multiple tumors. The median surgical time is 150 (75–216) minutes, and the median intraoperative bleeding volume is 150 (20–800) ml. Postoperative pathological diagnosis showed 11 cases of high-grade urothelial carcinoma and 10 cases in pTa. The average postoperative hospitalization time is 7.2 ± 2.2 days. During a median follow-up of 22 (2–93) months, 7 cases of recurrence and 2 cases of death due to tumors. PCKSS is a minimally invasive surgical method for the treatment of UTUC, which avoids serious complications caused by radical surgery. However, it is necessary to carefully select suitable patients before surgery, and strict and regular follow-up is required after surgery.

OBJECTIVE:To investigate the effect of different surgical timing on the surgical treatment of renal angiomyolipoma (RAML) with rupture and hemorrhage. METHODS:The demographic data and perioperative data of 31 patients with rupture and hemorrhage of RAML admitted to our medical center from June 2013 to February 2023 were collected. The surgery within 7 days after hemorrhage was defined as a short-term surgery group, the surgery between 7 days and 6 months after hemorrhage was defined as a medium-term surgery group, and the surgery beyond 6 months after hemorrhage was defined as a long-term surgery group. The perioperative related indicators among the three groups were compared. RESULTS:This study collected 31 patients who underwent surgical treatment for RAML rupture and hemorrhage, of whom 13 were males and 18 were females, with an average age of (46.2±11.3) years. The short-term surgery group included 7 patients, the medium-term surgery group included 12 patients and the long-term surgery group included 12 patients. In terms of tumor diameter, the patients in the long-term surgery group were significantly lower than those in the recent surgery group [(6.6±2.4) cm vs. (10.0±3.0) cm, P=0.039]. In terms of operation time, the long-term surgery group was significantly shorter than the mid-term surgery group [(157.5±56.8) min vs. (254.8±80.1) min, P=0.006], and there was no significant difference between other groups. In terms of estimated blood loss during surgery, the long-term surgery group was significantly lower than the mid-term surgery group [35 (10, 100) mL vs. 650 (300, 1 200) mL, P < 0.001], and there was no significant difference between other groups. In terms of intraoperative blood transfusion, the long-term surgery group was significantly lower than the mid-term surgery group [0 (0, 0) mL vs. 200 (0, 700) mL, P=0.014], and there was no significant difference between other groups. In terms of postoperative hospitalization days, the long-term surgery group was significantly lower than the mid-term surgery group [5 (4, 7) d vs. 7 (6, 10) d, P=0.011], and there was no significant difference between other groups. CONCLUSION:We believe that for patients with RAML rupture and hemorrhage, reoperation for more than 6 months is a relatively safe time range, with minimal intraoperative bleeding. Therefore, it is more recommended to undergo surgical treatment after the hematoma is systematized through conservative treatment.