UroStream

For most prostate cancer patients, resistance to androgen deprivation therapy (ADT) inevitably develops within 18-36 months, progressing to castration-resistant prostate cancer (CRPC). This transition not only increases mortality risk but also poses a serious challenge to survival outcomes. The European Society for Medical Oncology (ESMO) Annual Meeting 2024, held from September 13 to 17 in Barcelona, Spain, showcased numerous studies on metastatic castration-resistant prostate cancer (mCRPC). Oncology Frontier - Urology Insight invited Dr. Xiaojie Bian from Fudan University Shanghai Cancer Center to share the latest advances.

Surgical treatment is a crucial approach for prostate cancer, with radical prostatectomy being the gold standard. Even for intermediate and advanced prostate cancer, surgery can offer the possibility of clinical cure. For rare subtypes and complex cases, decisions often require multidisciplinary team (MDT) discussions and thorough communication with the patient. During the recent CSCO Annual Meeting, Urology Frontier invited Dr. Jianming Guo from Zhongshan Hospital, Fudan University, to share insights on the current state of prostate cancer diagnosis and treatment in China, recent research results, the standardized development of MDT, and the future directions for the urology team.

Radical nephroureterectomy (RNU) remains the gold standard treatment for upper tract urothelial carcinoma (UTUC). However, some patients with a solitary kidney or insufficient renal reserve may require alternative approaches to preserve kidney function. In recent years, advancements in systemic drug therapy and various endoscopic focal treatment techniques have provided kidney-sparing options for such patients. Nonetheless, large-scale case reports or prospective studies remain scarce. At the 31st Urology Academic Conference (CUA 2024), organized by the Chinese Medical Association and the Chinese Urological Association, Dr. Qiang Wei and  Yige Bao from West China Hospital, Sichuan University, presented their report on multimodal kidney-sparing treatment in 62 patients with high-risk localized UTUC.

Radical nephrectomy combined with venous tumor thrombus resection is the preferred treatment for renal cell carcinoma (RCC) with inferior vena cava tumor thrombus (IVC-TT) and can significantly improve patient prognosis. Preoperative neoadjuvant therapy aimed at reducing tumor thrombus level and grade is of great importance in reducing perioperative risks. Recently, the NEOTAX study, led by Academician Xu Zhang, Professor Xin Ma, and Professor Liangyou Gu from the Chinese People's Liberation Army General Hospital, was presented at the ESMO Congress (1701P). The study demonstrated that the neoadjuvant regimen of toripalimab combined with axitinib reduced tumor thrombus levels in 96.0% of RCC patients with IVC-TT and achieved thrombus downstaging in 44% of patients, thereby simplifying the surgical process. The study results were published in the Nature sub-journal Signal Transduction and Targeted Therapy (IF: 40.8). The combined treatment showed significant efficacy in reducing IVC-TT and improving surgical feasibility, offering a new direction for improving the prognosis of such patients. Below are the study details.

Surgery is a fundamental treatment for renal cancer, particularly for patients with stage I and II cancers, where surgery can cure the majority of cases and ensure long-term survival. At the 2024 CSCO Annual Meeting, Urology Frontier invited Dr. Pei Dong from Sun Yat-sen University Cancer Center to discuss this year’s key updates in the CSCO guidelines for surgical treatment of renal cancer, comparisons between single-port and traditional laparoscopic nephrectomy, and the role of neoadjuvant therapy in enhancing surgical outcomes.

Prostate cancer is a common malignant tumor in elderly men. However, with continuous advancements in diagnostic and treatment strategies, patient survival rates have improved, and patient-centered care has become a key focus in oncology. During the recent CUA Annual Meeting, Urology Frontier invited Dr. Eamonn Rogers from the National University of Ireland to share his thoughts on the future of prostate cancer research, the importance of patient-reported outcomes (PROs), and evolving models of care to meet modern medical challenges.

Bladder cancer is one of the most common malignant tumors among the Chinese population, with 75% of cases classified as non-muscle invasive bladder cancer (NMIBC), which has a high postoperative recurrence rate. What are the unmet diagnostic and treatment needs of NMIBC patients? Which research findings may change future clinical practice for NMIBC? During the recent CUA Annual Meeting, Urology Frontier invited Dr. Jeremy Teoh from The Chinese University of Hong Kong to discuss the current unmet needs in NMIBC, the factors influencing recurrence, and the latest research developments that could potentially change clinical practice.

The 2024 European Society for Medical Oncology (ESMO) Annual Meeting is being held from September 13-17 in Barcelona, Spain. Several key studies in the field of urologic cancers have attracted significant attention at the conference. Urology Frontier invited Dr. Fufu Zheng from the Department of Urology at The First Affiliated Hospital , Sun Yat-sen University to provide in-depth analysis of the major research findings presented at the conference. Professor Zheng shared his team’s latest breakthroughs in the field of urology, particularly regarding the frontier advancements in combination therapies for advanced renal cell carcinoma (RCC), while also offering insights into the promising future of RCC treatment.

Research has shown that nearly 50% of patients with muscle-invasive urothelial carcinoma (MIUC) will experience recurrence with distant metastases. Therefore, exploring perioperative treatments for muscle-invasive bladder cancer (MIBC) is crucial to improving patient outcomes. The 2024 European Society for Medical Oncology (ESMO) Congress, held from September 13 to 17 in Barcelona, Spain, highlighted several advances in perioperative immunotherapy and combination immunotherapy for MIUC patients. Dr. Wei Yu and Dr. Qi Tang from Peking University First Hospital shared their insights on this important topic.

Younger, low-risk prostate cancer patients often prioritize quality of life, particularly urinary control and sexual function, leading to ongoing clinical exploration for treatment strategies that meet these demands. From September 19 to 22, 2024, the 31st Urology Academic Conference was held at the National Convention Center in Tianjin. After the conference, Urology Frontier invited Dr. Shancheng Ren from The Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital) to discuss the advantages of extraperitoneal single-port robotic surgery, mastering surgical techniques, and the team's exploration of cutting-edge topics in urology.