Robot-assisted surgery has become an important component of modern urologic practice, and the emergence of alternative robotic platforms has accelerated platform diversification beyond the conventional da Vinci multiport ecosystem. However, the global research landscape and evidence evolution of emerging robotic platforms in urology remain incompletely characterized. Publications related to emerging robotic platforms in urology were retrieved from the Web of Science Core Collection from inception to May 15, 2026. After screening, 264 articles and reviews were included. CiteSpace and bibliometrix were used to analyze publication trends, geographic and institutional contributions, collaboration networks, co-cited references, journals, keyword evolution, burst terms, and thematic structure. Annual output remained limited before 2021 but increased rapidly thereafter, reaching the highest levels in 2024 and 2025. Italy, China, and Japan were the most productive countries, whereas the United States showed the highest betweenness centrality in the country collaboration network. Research activity was concentrated in several high-volume institutions, including Catholic University of the Sacred Heart, IRCCS Policlinico Gemelli, Kobe University, and Peking University. Co-cited references were mainly published after 2022, indicating a recently formed and rapidly evolving knowledge base. Keyword analyses showed that current research is centered on robotic surgery, radical prostatectomy, prostate cancer, outcomes, complications, Hugo RAS, learning curve, and partial nephrectomy. The evidence structure was uneven across procedures: robot-assisted radical prostatectomy represented the most mature application area, whereas partial nephrectomy, cystectomy, adrenalectomy, pyeloplasty, and reconstructive procedures remained largely supported by feasibility studies or early clinical cohorts. Emerging topics such as artificial intelligence, telesurgery, and virtual reality appeared as niche themes, suggesting future directions for digitally integrated robotic surgery. Overall, research on emerging robotic platforms in urology is transitioning from early feasibility reporting toward outcome assessment and platform-specific comparison, but multicenter validation, long-term follow-up, learning-curve assessment, and cost-effectiveness evidence remain insufficient.

Robot-assisted urologic surgery attenuates the tactile and kinesthetic information normally generated by tissue contact, but the organization and scope of the related literature remain unclear. We mapped publication activity, collaboration, citation structure, and thematic change in research involving haptic feedback and force information. Web of Science Core Collection was searched on 24 July 2026 using a proximity-based robotic-urology block combined with terms for tactile or kinesthetic feedback, force sensing or estimation, force control, and sensory substitution. Seventy-four English-language articles and reviews published in 2001–2025 were analyzed with bibliometrix/Biblioshiny and CiteSpace. The corpus comprised 50 journals, 442 authors, 222 author keywords, and 2,335 cited references; 13 papers were published in 2025. The United States led output and network brokerage, and author participation was dispersed, with 89.59

Acute kidney injury (AKI) lacks disease-modifying therapies, partly because cell type–specific injury programs remain incompletely resolved and tissue mechanisms are not readily translated into clinically accessible biomarkers. We constructed a cross-scale, multi-omics atlas to prioritize candidate regulator linking renal injury circuitry with urine-detectable signals. Human single-cell, bulk, and spatial transcriptomics were integrated with mouse renal ischemia–reperfusion injury (RIRI) kidney proteomics and clinical urine proteomics. Overlap of differentially expressed genes and differentially abundant proteins nominated candidates, which were ranked by a random forest model. Immune remodeling was assessed by deconvolution and pathway enrichment, with spatial localization supported by reference-based deconvolution. Therapeutic tractability was explored by structure-based virtual screening, molecular docking, molecular dynamics simulation, and cellular thermal shift assay (CETSA). TRIM28 was evaluated in HK-2 hypoxia/reoxygenation (H/R) and mouse RIRI models using genetic perturbation, expression validation, and in vitro pharmacologic evaluation. Integration converged on five genes (TRIM28, HNRNPH1, ARHGEF10L, C1RL, and UCHL3), with TRIM28 showing the highest feature importance and links to inflammatory, immune, metabolic, and proliferative programs. AKI exhibited intensified intercellular communication and an innate-skewed immune landscape. TRIM28 was robustly upregulated in HK-2 H/R and mouse RIRI kidneys and was also directly detected in the human urine proteome. In HK-2 cells, TRIM28 knockdown dampened, whereas overexpression amplified, IL-17–linked inflammatory signaling and apoptotic responses. Docking-prioritized HY-N10592 improved viability, reduced H/R-associated TRIM28 induction, IL-17–linked output, and apoptotic marker activation, and showed CETSA-supported cellular engagement of TRIM28. This integrative framework prioritizes TRIM28 as a candidate regulator linking tubular injury mechanisms with clinically relevant urinary signals and nominates HY-N10592 as a candidate chemical tool with CETSA-supported cellular target engagement for further mechanistic and in vivo evaluation in AKI.

Robot-assisted retroperitoneal tumor resection has emerged as an important minimally invasive surgical approach; however, the overall research landscape and developmental trends in this field remain insufficiently characterized. This bibliometric study systematically evaluates research patterns using publications, which were retrieved from the Web of Science Core Collection (SCI-Expanded) database from inception to December 31, 2025, limited to English-language articles and reviews. A total of 415 publications were included, and data were analyzed using CiteSpace, VOSviewer, Bibliometrix, and GraphPad Prism. Annual outputs exhibited consistent growth, particularly from 2019 onward, indicating growing scholarly attention. Research output was highest from the United States and China, while the most prominent institutions were in North America, with notable contributions from Asia and Europe. Co-cited reference analysis indicated that current research is largely based on comparative clinical studies and multicenter investigations, suggesting a transition toward evidence-based evaluation. Keyword analysis revealed that research hotspots focus mainly on surgical techniques, oncological indications, and perioperative outcomes, while recent trends highlight a growing focus on minimally invasive approaches, robotic surgical procedures, and single-port techniques. As a bibliometric analysis based on metadata, it does not assess study quality, clinical outcomes, or risk of bias; trends reflect research activity rather than validated clinical efficacy. Future investigations should employ rigorously designed multicenter trials, evaluate long-term outcomes, and incorporate patient-centered assessments to better determine the clinical impact of robot-assisted retroperitoneal tumor excision.

IntroductionWith the rapid development of 16S rRNA sequencing and metagenomic technologies, the traditional concept of sterile urine has been completely overturned, and a diverse urinary microbiome has been identified even in healthy individuals. Increasing evidence indicates that dysbiosis of the urinary microbiome is closely associated with the onset and progression of various non-infectious urological diseases.MethodsThis review systematically summarizes recent advances in the role of the urinary microbiome in non-infectious urological diseases, including bladder cancer, benign prostatic hyperplasia, prostate cancer, nephrolithiasis, interstitial cystitis/bladder pain syndrome, and urinary incontinence, with a focus on microbial dysbiosis, pathogenic mechanisms, and clinical applications.ResultsStudies have shown that alterations in the composition and diversity of the urinary microbiome are closely related to chronic inflammation, immune dysregulation, metabolic disturbances, and changes in the local microenvironment. These alterations may contribute to disease pathogenesis through mechanisms such as persistent low-grade inflammation, abnormal metabolic activity, and biofilm formation. In recent years, non-invasive detection based on urinary microbial profiles has shown promising potential in the early diagnosis of bladder and prostate cancers, with some machine learning models achieving diagnostic accuracies above 80 percent. Furthermore, the urinary microbiome may influence the efficacy of immunotherapy, offering new insights for personalized precision medicine.ConclusionsThis review summarizes the mechanisms, research status, and clinical prospects of the urinary microbiome in non-infectious urological diseases, emphasizing the importance of methodological standardization and highlighting its potential applications in early screening, diagnostic stratification, and microbiome-targeted interventions.

Fluorescence-guided imaging has increasingly been integrated into robot-assisted urologic surgery to improve intraoperative visualization of vascular anatomy, tissue perfusion, lymphatic drainage, tumor-related landmarks, and reconstructive anatomy. However, the global research landscape, collaborative structure, intellectual foundation, and thematic evolution of fluorescence-guided robot-assisted urologic surgery have not been systematically characterized. In this study, publications related to fluorescence-guided robot-assisted urologic surgery were retrieved from the Web of Science Core Collection from 1998 to May 16, 2026. After screening, 457 English-language articles and reviews were included. CiteSpace, VOSviewer, and the bibliometrix package in R were used to analyze annual publication trends, countries/regions, institutions, authors, journals, cited journals, co-cited references, keyword co-occurrence, burst terms, trend topics, and thematic evolution. Publication output remained limited before 2011, increased gradually thereafter, and expanded more rapidly after 2018, with peak outputs in 2024 and 2025. The United States, Italy, and the Netherlands were the leading contributors, while Leiden University, Leiden University Medical Center, the Netherlands Cancer Institute, and Cleveland Clinic Foundation represented major institutional hubs. Co-cited references and keyword analyses showed that the knowledge base of this field is mainly organized around indocyanine green-guided robotic partial nephrectomy, fluorescence-enhanced radical prostatectomy, sentinel lymph node mapping, and robot-assisted ureteral reconstruction. “Indocyanine green,” “robotic surgery,” “prostate cancer,” “image-guided surgery,” “partial nephrectomy,” “radical prostatectomy,” and “augmented reality” were major conceptual themes. Recent hotspots included near-infrared fluorescence, ureteral stricture, lymph node dissection, positive surgical margins, artificial intelligence, and navigation. Overall, fluorescence-guided robot-assisted urologic surgery is evolving from early feasibility exploration toward procedure-specific clinical application, reconstructive precision, oncologic safety assessment, and digitally integrated surgical navigation. Future studies should emphasize standardized fluorescence protocols, quantitative imaging assessment, prospective multicenter validation, long-term clinical outcomes, and integration with artificial intelligence, augmented reality, and molecular imaging. Because bibliometric indicators reflect research activity and citation relationships rather than direct clinical efficacy or patient benefit, these findings should be interpreted as a map of research development and evidence gaps rather than as evidence supporting the superiority of fluorescence-guided robotic surgery.

Robot-assisted surgery has emerged as a pivotal minimally invasive technique in urology and has demonstrated accelerated development in the field of kidney transplantation in recent years. Compared with traditional open surgery, robot-assisted kidney transplantation (RAKT) offers several advantages, including precise and stable robotic arm manipulation, high-resolution three-dimensional visualization, and reduced surgical trauma. Collectively, these features contribute to enhanced perioperative safety and improved postoperative recovery. In this study, a comprehensive literature search was conducted using three core databases, Web of Science Core Collection (WoSCC) PubMed and Scopus. A total of 1,168 English-language publications were ultimately included for analysis. CiteSpace was employed to visualize global research trends, institutional collaboration networks, and author contributions within the field of RAKT. The results reveal a sustained and steady increase in the number of publications related to RAKT. The United States, Italy, and Spain emerged as the leading contributors to this research domain. Among all institutions, the University of Illinois Chicago was identified as the most prolific. Campi, Riccardo and Breda, Alberto were recognized as the most active and influential authors. From a temporal perspective, early investigations primarily focused on technical feasibility and procedural exploration. This phase was followed by a period characterized by clinical standardization and multicenter validation. More recently, research has advanced toward addressing complex clinical scenarios, such as obesity and multiple vascular anastomoses, as well as evaluating long-term prognostic outcomes. Current emerging trends are predominantly centered on advancements in robotic technological platforms and the preliminary development of intelligent and automated systems. Overall, this bibliometric analysis objectively demonstrates that RAKT has evolved into a field with a well-structured knowledge framework and a mature research ecosystem. The findings provide valuable macro-level insights and evidence-based support for researchers aiming to comprehend developmental trajectories, identify emerging research frontiers, and explore potential collaborative opportunities in this rapidly evolving domain.

Background: Renal ischemia-reperfusion injury (RIRI) is a major cause of acute kidney injury (AKI) and contributes to delayed graft function and progression toward chronic kidney disease. In addition to oxidative stress and inflammation, RIRI induces profound metabolic derangements, particularly suppression of tubular fatty-acid β-oxidation (FAO), leading to energetic stress, lipid accumulation, and maladaptive repair. Peroxisome proliferator-activated receptor-α (PPARα) is a key regulator of tubular FAO, but whether Schisandrin B (Sch B) mitigates RIRI through restoration of a PPARα-associated metabolic program remains unclear. Objective: To determine whether Sch B alleviates RIRI in association with restoration of tubular FAO and attenuation of lipid accumulation and fibrotic remodeling. Methods: A unilateral murine renal I/R model and an HK-2 hypoxia/reoxygenation (H/R) model were used. Mice received Sch B (20 or 40 mg/kg/day) before I/R, and a subset was co-treated with the PPARα antagonist GW6471. Renal function, tubular injury, fibrosis, lipid accumulation, and FAO-related proteins were assessed by serum biochemistry, histopathology, Oil Red O staining, transmission electron microscopy, immunohistochemistry, immunofluorescence, and Western blotting. Bulk RNA-seq and public single-cell RNA-seq datasets were integrated to characterize metabolic pathway remodeling and cell-type-associated PPARα changes. Molecular docking and molecular dynamics simulations were performed to explore the potential interaction between Sch B and PPARα. Results: Sch B significantly improved renal function, reduced tubular injury, and attenuated interstitial collagen deposition after I/R. Sch B also reduced lipid droplet accumulation, preserved mitochondrial ultrastructure, and restored the expression of FAO-related proteins, including CPT1A, CPT2, and ACADM. In vivo and in vitro, Sch B decreased α-SMA, COL1A1, and vimentin expression, indicating attenuation of EMT-associated/profibrotic remodeling. Integrated transcriptomic analyses supported marked metabolic reprogramming after I/R, with enrichment of FAO- and PPAR-related pathways and reduced PPARα expression predominantly in tubular compartments. Sch B was associated with restoration of tubular PPARα expression, while docking and molecular dynamics analyses supported a plausible Sch B-PPARα interaction in silico. GW6471 blunted the beneficial effects of Sch B on fibrosis-related and FAO-related readouts. Conclusions: Sch B alleviates RIRI and limits subsequent fibrotic remodeling in association with restoration of a PPARα-related tubular FAO program, reduced lipid accumulation, and preservation of tubular metabolic homeostasis. These findings identify metabolic reprogramming as an important component of Sch B-mediated renoprotection, although the precise mode by which Sch B regulates PPARα requires further investigation.

Robot-assisted ureteral reconstruction has evolved from bowel substitution to free oral mucosal grafts and vascularized appendiceal techniques, yet the intellectual structure and clinical maturity of these autologous tissue strategies remain unclear. PubMed and the Web of Science Core Collection were searched from inception through 2 August 2026. Records were merged, deduplicated, screened, and linked to OpenAlex for bibliometric enrichment. Publication trends, institutional contributions, co-citation patterns, thematic evolution, evidence maturity, and outcome reporting were assessed. Among 201 unique records screened, 74 publications were included in the bibliometric corpus and 66 primary clinical or technical reports formed the evidence-maturity subset. Bowel segments were the largest category (28/74), followed by buccal mucosa (22/74), appendix (12/74), lingual/labial mucosa (11/74), and mixed tissue (1/74). Thirty-six publications appeared during 2024–2026, and co-citation analysis identified distinct mucosal-graft and bowel-substitution foundations. Of the 66 primary reports, 24 were classified as E1, 8 as E2, 10 as E3, 22 as E4, and 2 as E5. Outcome reporting remained heterogeneous, device-free status was not explicitly detectable, while patient-reported outcomes appeared in only 4–17

Robot-assisted ureteral reimplantation (RAUR) has emerged as an important minimally invasive technique in reconstructive urology, yet the global research landscape of this field remains incompletely characterized. This study aimed to systematically evaluate the development trends, knowledge structure, and research hotspots of RAUR through bibliometric and visualization analyses. Publications were retrieved from the Web of Science Core Collection database, covering the period from database inception to December 31, 2025. A total of 380 articles and reviews were included. Bibliometric analyses were performed using CiteSpace, VOSviewer, Bibliometrix, and Microsoft Excel to assess publication trends, collaborative networks, co-citation relationships, and keyword evolution. The results demonstrated a sustained increase in annual publications, with a marked acceleration after 2019, reflecting growing academic interest in RAUR. The United States dominated global research output and institutional contributions, while European countries exhibited relatively stronger international collaboration. Core authors and highly cited researchers were concentrated in North America and Europe, indicating a geographically centralized knowledge structure. Journal analysis showed that publications were mainly distributed in specialized urology and minimally invasive surgery journals, with a limited number of high-impact journals exerting substantial academic influence. Co-citation analysis indicated that the field has progressed from early feasibility studies to comparative outcome research and, more recently, to multicenter studies. Keyword analysis further demonstrated a shift in research focus from initial clinical experience toward outcome evaluation, complication-related issues, and minimally invasive approaches, particularly in pediatric populations. In conclusion, RAUR research has evolved from an exploratory stage to a more clinically oriented phase, with increasing emphasis on outcome evaluation and evidence accumulation. This work offers a structured analysis of worldwide scientific activity in this field and identifies emerging trends, providing useful insights for future studies.

Transcription factor E3-rearranged renal cell carcinoma (TFE3-rRCC) is a rare, fusion-driven malignancy characterized by marked biological heterogeneity, diagnostic complexity, and suboptimal clinical outcomes under standard RCC therapies. Although several molecular studies have highlighted the importance of fusion partner diversity, these findings remain fragmented and incompletely integrated into clinical practice. In this review, We conducted a comprehensive review of genomic, transcriptomic, proteomic, and clinical studies on TFE3-rRCC. We synthesized evidence from retrospective cohorts, multi-omics analyses, and preclinical models to elucidate the molecular structure of recurrent diseases, protein-level signaling pathways, tumor microenvironment status, and emerging modalities of treatment response. We found that TFE3-rRCC is a fusion-defined disease family with suggest substantially more structural variations than point mutations. The coding features of fusion partners result in functionally distinct modules that reshape transcriptional regulation, RNA processing, protein homeostasis, and mitochondrial quality control, resulting in reproducible protein-level subtypes and immune-vascular "fingerprints". These features support diagnostic and therapeutic hypotheses based on fusion partner regulation, including varying sensitivities to angiogenesis-targeting and immune-targeting strategies. Further, we suggest a combined diagnostic pathway with respect to pathology, molecular tests, computational techniques, and a partner-guided clinical trial framework for future validation. Taken together, this review formalizes a fusion partner-informed framework that links molecular mechanism with clinical investigation. By defining evidentiary boundaries and validation pathways, it provides a roadmap for translating mechanistic insight into rigorous evidence-based management of TFE3-rRCC.

Kidney transplantation remains the treatment of choice for patients with end-stage renal disease, yet its long-term success continues to face major challenges, including organ shortage, rejection, and drug toxicity. With the advancement of genetic testing technologies, transplant management is progressively shifting from empirical practice toward precision medicine. This review systematically outlines four core applications of genetic testing in kidney transplantation: from pre-transplant precision donor-recipient matching and risk stratification, to peri-operative pharmacogenomics-guided immunosuppression, and finally post-transplant noninvasive rejection monitoring and infection management. By integrating high-resolution HLA typing, epitope mismatch analysis, donor-derived cell-free DNA monitoring, urinary biomarker detection, genotyping of drug-metabolizing genes such as CYP3A5, and assessment of host susceptibility variants, genetic technologies have significantly improved transplant outcomes. Despite persistent challenges in standardization, clinical translation, and ethical considerations, emerging innovations including microfluidics, nanopore sequencing, and organoid modeling are expected to further accelerate the transition of kidney transplantation into a new era of comprehensive precision management.

Learning curves are critical to the safe adoption and standardized training of robot-assisted urological surgery, yet the evolution of proficiency assessment from technical experience toward surgical safety and functional recovery remains unclear. Records indexed in the Web of Science Core Collection were quantitatively mapped to examine publication dynamics, research partnerships, the underlying knowledge base, and shifts in major topics over time. A total of 346 publications, including 252 articles and 94 reviews, were analyzed. Scientific output increased markedly, with an annual growth rate of 21.33

Aristolochic acids (AAs) are a class of well-known nephrotoxic compounds; however, the molecular mechanisms underlying AA-induced kidney injury remain incompletely understood. This study aimed to identify potential molecular targets and explore the mechanisms involved in AA-induced kidney injury, with particular emphasis on prostaglandin-endoperoxide synthase 2 (PTGS2). An integrated computational and experimental approach was applied. Candidate targets associated with AA exposure and kidney injury were identified through database mining, followed by enrichment and network analyses to determine key regulatory genes. Molecular docking and molecular dynamics simulations were performed to evaluate AA-target interactions, and the association between PTGS2 and kidney injury was further assessed using two-sample Mendelian randomization based on genome-wide association study data. Experimental validation was conducted in an acute AAI-induced C57BL/6 mouse model through evaluation of renal function, histopathology, and PTGS2 expression. PTGS2 was identified as a central candidate gene associated with AA-induced kidney injury and exhibited stable binding with AA in silico. In vivo, AAI exposure caused renal dysfunction and histopathological alterations accompanied by reduced PTGS2 expression. These findings identified PTGS2 as a candidate molecular target involved in AA-induced kidney injury and provided a foundation for further mechanistic research.

Robot-assisted partial nephrectomy (RAPN) is an important nephron-sparing approach for renal tumors, with increasing emphasis on postoperative renal functional preservation. Preservation of renal function is clinically relevant in patients with reduced renal reserve or factors associated with future renal decline. However, the global research landscape and emerging trends in this field remain unclear. This study performed a bibliometric analysis of publications related to robot-assisted partial nephrectomy and renal function preservation, with emphasis on functional outcomes and CKD-related concepts identified within the literature. Publications from 2008 to 2026 were retrieved from the Web of Science Core Collection on May 10, 2026. Only English-language articles and reviews were included. Data were analyzed using Excel, VOSviewer, CiteSpace, Charticulator, and Scimago Graphica. A total of 276 publications were included, comprising 245 articles and 31 reviews. Publication output showed steady growth, with peaks in 2017 and 2022. Urology and nephrology were the dominant category. The United States led in publications, citations, and H-index, followed by Italy and China, with collaboration centered mainly on the United States and Italy. Cleveland Clinic and Temple University were leading institutions. Keyword analysis identified partial nephrectomy, ischemia, warm ischemia time, eGFR, small renal mass, and trifecta as major themes. The field has evolved from technical exploration toward ischemia reduction, nephron preservation, standardized outcome reporting, and individualized risk stratification. Future studies should prioritize prospective multicenter designs and standardized renal functional endpoints.

Background: Acute kidney injury (AKI) is a severe clinical syndrome characterized by metabolic stress and profound inflammation. However, the landscape of lactylation-associated molecular alterations and their potential relevance in AKI remain incompletely understood. Methods: Bulk transcriptomes (GSE30718) were analyzed using the limma package, weighted gene co-expression network analysis (WGCNA), and consensus clustering to characterize AKI-associated molecular patterns linked to lactylation-associated signatures. Hub genes, prioritized through least absolute shrinkage and selection operator (LASSO) regression and the random forest algorithm, were integrated into a diagnostic nomogram and evaluated in an external cohort (GSE139061). Immune infiltration analysis was performed, and single-cell RNA sequencing data (GSE183276) were used to resolve cell-type-specific expression patterns of the hub genes. A cisplatin-induced murine AKI model validated global protein lactylation and hub gene expression by immunohistochemistry and Western blot. Results: Three hub genes (CKLF, ACLY, and SLC13A3) reliably discriminated AKI from controls (training AUC = 0.897). Their diagnostic performance varied in the external validation cohort. These genes correlated significantly with diverse immune infiltrates. Single-cell analysis localized CKLF predominantly to immune cells, ACLY broadly across renal populations, and SLC13A3 to proximal tubules. In vivo validation demonstrated increased global protein lysine lactylation levels in injured kidneys and confirmed expression alterations of CKLF, ACLY, and SLC13A3 consistent with transcriptomic observations. Conclusions: Integrating transcriptomic analysis with in vivo experimental validation, this study identified CKLF, ACLY, and SLC13A3 as candidate lactylation-associated signatures linked to immune and metabolic alterations in AKI.

Purpose:Renal solitary fibrous tumor is a rare mesenchymal neoplasm with heterogeneous biological behavior. This review summarizes current evidence regarding its epidemiology, diagnosis, treatment, and clinical outcomes to support clinical management. Methods:PubMed and Web of Science were searched from database inception to September 10, 2025, for studies involving renal solitary fibrous tumors. Eligible studies included case reports, case series, and original articles providing patient-level data on clinically and histologically confirmed primary renal solitary fibrous tumors. Results:Renal solitary fibrous tumors commonly originate from the renal capsule or sinus and are frequently asymptomatic, although flank pain and hematuria may occasionally be present. Diagnostically, imaging typically reveals a well-circumscribed mass with variable enhancement patterns; however, histopathological examination remains essential for definitive diagnosis, characterized by spindle-cell proliferation and diffuse nuclear expression of STAT6. Therapeutically, complete surgical excision with negative margins constitutes the mainstay of treatment and is associated with favorable outcomes in the majority of patients. Nevertheless, approximately 10-15% of cases may develop recurrence or distant metastasis, underscoring the necessity of long-term surveillance. In the setting of advanced disease, limited data suggest that metastasectomy and selected targeted or anti-angiogenic agents may offer therapeutic benefit. Conclusion:Accurate diagnosis requires integrated clinical, radiologic, and pathologic evaluation. Complete resection remains the cornerstone of treatment, while prolonged follow-up is recommended because of the potential for delayed recurrence. Further molecular studies and collaborative investigations are needed to optimize risk stratification and therapeutic strategies.

TRIM47 is an emerging E3 ubiquitin ligase of the tripartite motif family that has been increasingly implicated in inflammation, tissue injury, fibrosis, and cancer. Rather than acting as a disease-specific factor, TRIM47 appears to function as a context-dependent organizer of ubiquitin signaling, in which substrate selection and ubiquitin-chain topology shape distinct pathological outputs. Through K48-linked ubiquitination, TRIM47 promotes degradation of inhibitory or protective proteins, including CYLD, SIRT1, PPM1A, FBP1, CDO1, p53, Smad4, and XAF1, whereas through K63-linked ubiquitination it enhances signaling activity of mediators such as NEMO and PARP1. These substrate- and chain-dependent actions converge on a limited set of recurrent mechanisms, including inflammatory amplification, profibrotic remodeling, metabolic reprogramming, ferroptosis resistance, apoptosis escape, and DNA repair rewiring. This framework helps explain the repeated involvement of TRIM47 across innate immune dysregulation, organ injury, fibrogenesis, tumor progression, and treatment response. Notably, TRIM47 may also act as a double-edged regulator of therapy, promoting resistance to platinum-, taxane-, and endocrine-based treatments while potentially increasing vulnerability to PARP inhibition in selected homologous recombination-deficient settings. Although these observations support TRIM47 as a promising biomarker and therapeutic target, major gaps remain, including incomplete substrate and ubiquitin-site mapping, limited cell type-specific in vivo validation, insufficient structural and interactome data, and the lack of TRIM47-selective inhibitors. A mechanism-centered understanding of TRIM47 will be essential for improving disease stratification and developing rational TRIM47-directed therapies.