【一周新资讯--泌尿系统肿瘤 322】2024 W4401

主要研究结果：

• 共纳入17项符合标准的研究

• 两组12和24个月复发以及和12个月进展率无统计学显著性差异

• 整块切除术(ERBT)与存在更高的肌层浸润(DM)显著相关性(RR=1.10，P=0.02)

• 两组再次经尿道膀胱肿瘤切除术(reTURBT)中残留肿瘤和黏膜肌层(MM)的可检测性方面无统计学显著性差异

• 整块切除术与更低风险的膀胱穿孔(P=0.002)和闭孔神经反射(p < 0.001)显著相关

• 整块切除术与手术时间较长、导尿时间较短和住院时间较短显著相关

参考文献：

Basile G, Uleri A, Leni R, Cannoletta D, Afferi L, Baboudjian M, Diana P, D'Andrea D, Teoh J, Pradere B, Subiela JD, Laukhtina E, Seisen T, Rouprêt M, Briganti A, Montorsi F, Moschini M, Breda A, Gallioli A; European Association of Urology—Young Academic Urologists (EAU-YAU): Urothelial Carcinoma Working Group. En Bloc Versus Conventional Transurethral Resection of Bladder Tumors: A Systematic Review and Meta-analysis of Oncological, Histopathological, and Surgical Outcomes. Eur Urol Oncol. 2024 Oct 19:S2588-9311(24)00232-3. doi: 10.1016/j.euo.2024.10.004. Epub ahead of print. PMID: 39428278.

主要研究结果：

• 共有62名阅读者对四个欧洲中心的400次mpMRI进行检查，先后评估了bpMRI与mpMRI，分配病灶特异性PI-RADS评分(3-5)和患者级别的怀疑评分(0-100)

• CSPC的患病率为33%(133/400)

• bpMRI和mpMRI的AUROC相似，分别为0.853和0.859，非劣效性差异为-0.6%(95%CI:-1.2%-+0.1%，P<0.001)，证实了非劣效性

• PI-RADS≥3：bpMRI和mpMRI的敏感性分别为88.6%和89.4%，非劣效性差异为-0.9%(95%CI:-1.7%-0.0%, P<0.001)，特异性分别为58.6%和57.7%，非劣效性差异为0.9%(95%CI:0.0-1.8%, P<0.001)，证实了非劣效性

• 替代风险阈值：mpMRI以降低特异性为代价提高了敏感性

• 决策曲线分析(DCA)：在癌症厌恶情景下，mpMRI路径具有最高的净收益；而在活检厌恶情景下，bpMRI路径显示出更大的益处

参考文献：

Twilt JJ, Saha A, Bosma JS, van Ginneken B, Bjartell A, Padhani AR, Bonekamp D, Villeirs G, Salomon G, Giannarini G, Kalpathy-Cramer J, Barentsz J, Maier-Hein KH, Rusu M, Rouvière O, van den Bergh R, Panebianco V, Kasivisvanathan V, Obuchowski NA, Yakar D, Elschot M, Veltman J, Fütterer JJ, Huisman H, de Rooij M; PI-CAI Consortium. Evaluating Biparametric Versus Multiparametric Magnetic Resonance Imaging for Diagnosing Clinically Significant Prostate Cancer: An International, Paired, Noninferiority, Confirmatory Observer Study. Eur Urol. 2024 Oct 21:S0302-2838(24)02640-X. doi: 10.1016/j.eururo.2024.09.035. Epub ahead of print. PMID: 39438187.

主要研究结果：

• 共纳入1203例男性：仅前列腺切除1082例，早期RT(<12个月)57例，晚期RT(≥12个月)64例

• 全组中位年龄60.5岁，白人1075例，中位随访85.6个月

• 相比于单纯前列腺切除，术后RT在性、失禁和尿路刺激征方面的HRQOL有显著更大的降低

• 前列腺切除后的RT时机与任何HRQOL域的长期降低无关

• 早期RT较晚期RT改善了性、失禁和尿路刺激征方面的评分

• 前列腺切除后RT开始前，早期组与晚期组分别有39.3%与73.4%无需护垫

• RT后六个月访视，早期组与晚期组分别有67.4%与47.6%无需护垫

参考文献：

Patel SA, Patil D, Smith J, Saigal CS, Litwin MS, Hu JC, Cooperberg MR, Carroll PR, Klein EA, Kibel AS, Andriole GL, Han M, Michalski JM, Wood DP, Hembroff LA, Spratt DE, Wei JT, Sandler HM, Hamstra DA, Pisters L, Kuban D, Regan MM, Wagner A, Crociani CM, Kaplan I, Sanda MG, Chang P; PROST-QA/RP2 Consortium. Postprostatectomy Radiotherapy Timing and Long-Term Health-Related Quality of Life. JAMA Netw Open. 2024 Oct 1;7(10):e2440747. doi: 10.1001/jamanetworkopen.2024.40747. PMID: 39446326.