With the rapid advancements in the field of urologic oncology in China, an increasing number of Chinese studies are making their mark on the global stage. At the recent 39th European Association of Urology Annual Meeting (EAU24) held in Paris, France, Professor Gong Kan‘s team from Peking University First Hospital presented several new research findings. At the event, Dr. Zhang Zedan and Dr. Deng Ruiyi from Professor Gong’s team were invited by the journal “Oncology Frontier” to share their latest studies.
Oncology Frontier : Please introduce the latest research findings your team presented at this conference.
Dr. Zhang Zedan, from Professor Gong Kan’s team: At the EAU meeting, I reported on a study regarding early screening for hereditary renal cancer, primarily utilizing metabolite analysis to screen for key biomarkers in a broad population of patients with genetic predispositions to renal cancer, thus establishing a more precise diagnostic model. Specific changes in blood plasma metabolites such as glycerophospholipids and L-malate, related to VHL gene mutation types, and plasma levels of N2,N2-dimethylguanosine can independently predict the onset of RCC in these patients. These discoveries have advanced our understanding of the disease mechanisms of VHL-RCC and provided significant scientific evidence for the early diagnosis, risk assessment, and development of personalized treatment strategies for VHL syndrome-related renal cancer. Optimizing the diagnostic model is expected to significantly reduce the rates of missed or incorrect diagnoses, thereby improving treatment outcomes and quality of life for patients, which is of great clinical significance for the management and treatment of rare diseases.
Dr. Deng Ruiyi, from Professor Gong Kan’s team: At the conference, I reported on a study concerning upper tract urothelial carcinoma (UTUC), utilizing data from the American SEER database covering patients diagnosed with organ-confined (T1-2N0M0) UTUC from 2004 to 2020. For patients with UTUC, radical nephroureterectomy (RNU) has long been considered the “gold standard” treatment. However, our clinical observations indicate that although RNU can achieve good tumor control, it is not suitable for all patients due to significant surgical trauma, potential severe complications such as bleeding, and the possible resultant postoperative renal impairment from removing a kidney. With the development of various surgical techniques in urology, nephron-sparing surgery (NSS) has been increasingly applied in cases of organ-confined UTUC. This study included 1,969 patients with organ-confined UTUC, most of whom were in stage T1, and about one-third were in stage T2. We used propensity score weighting to balance the baseline data between the groups. Survival analysis showed that there was no significant difference in overall survival (OS) and cancer-specific survival (CSS) between patients undergoing RNU and NSS before and after propensity score weighting. Further univariate and multivariate Cox analyses indicated that factors such as age, T stage, and pathological grade were major determinants of patient prognosis. Based on these risk factors, we constructed a nomogram to predict patient outcomes, which was evaluated using the c-index, calibration curves, and Kaplan-Meier analysis, showing good predictive accuracy and risk stratification capabilities. This study suggests that selected patients with organ-confined UTUC, especially those with severe comorbidities, poor overall health, chronic renal impairment, a solitary kidney, or bilateral kidney tumors, could be considered for NSS under stringent criteria.
Oncology Frontier: Which hot topics at the conference left a strong impression on you?
Dr. Zhang Zedan, from Professor Gong Kan’s team: Our team is primarily focused on urologic oncology, especially in areas such as molecular biomarkers and the integration of medical diagnostics with artificial intelligence (AI) for screening purposes. As is well known, effective molecular biomarkers are crucial for disease screening, diagnosis, and prognosis prediction. At this EAU conference, Dr. Brian Chapin from the USA delved deeply into whether biomarkers can provide additional value. Dr. Chapin advocates conducting prospective clinical trials to test current and new biomarkers and to proactively assess their clinical value. I strongly agree with his perspective. As more high-quality molecular biomarkers are discovered, we need further practice to validate their true clinical value. This year’s EAU conference also featured a special session on AI. I was particularly impressed by the significant achievements of Professor Guo Jianming’s team from the Urology Department at Fudan University Zhongshan Hospital in utilizing AI technology to aid in the diagnosis of renal tumors. Their research not only paves new pathways for early diagnosis and treatment of renal tumors but also brings innovative inspiration to the field of urologic surgery research.
Dr. Deng Ruiyi, from Professor Gong Kan’s team: This EAU conference featured many hot topics, and our team was particularly interested in the advances in renal and prostate cancer. For instance, the management of small renal masses—whether to opt for active surveillance, more aggressive approaches like renal biopsy, or even surgical intervention—is a topic worthy of further study. Additionally, with the recent advancements in various urological techniques, the application of non-surgical local treatments, such as radiofrequency ablation, is increasing. For patients with benign kidney tumors, small renal masses, or those who cannot tolerate major surgical trauma, local non-surgical treatments are viable alternative options. However, the efficacy of local non-surgical treatments for kidney tumors and their impact on patient outcomes currently lack high-quality prospective research, so more clinical evidence is needed in the future to demonstrate their therapeutic value. There has also been progress in prostate biopsy research, such as optimizing reduced-needle biopsy protocols and comparing different biopsy approaches. Although there is substantial retrospective data to support these, high-quality prospective data is still lacking. Moreover, we are also paying attention to the advancements in AI-assisted diagnostics for prostate cancer. Recently, the application of AI in imaging diagnostics for prostate cancer has been increasing. Although AI has shown potential in retrospective studies to assist in diagnosing prostate cancer, many AI models developed by researchers still have limitations in generalizability and applicability. Currently, few studies integrate AI into clinical practice, and more prospective research is needed to validate the value of AI in medical clinical practice.
Professor Gong Kan
Vice Director of the Urological Research Institute at Peking University
Chief Physician, Professor, and Doctoral Supervisor
Selected for the third batch of the “National High-level Talents Special Support Plan (Ten Thousand Talents Plan)” by the Organization Department of the Central Committee
Vice Chairman of the Urology Branch of the China Medical Promotion Association
Member of the Oncology Group of the Urology Branch of the Chinese Medical Association
Member of the Rare Diseases Branch of the Chinese Medical Association
Member of the Urologic Oncology Committee of the Chinese Medical Doctor Association
Editorial Board Member of the “Chinese Urological Diseases Diagnosis and Treatment Guidelines—Prostate Cancer”
Dr. Zhang Zedan
Ph.D. candidate in Urology at Peking University First Hospital
Visiting Scholar at Stanford University, USA. To date, he has published 25 papers in international journals, including 9 as first/co-first author and 5 in Q1 journals. He has participated in 7 national and provincial natural science projects, and has made several oral presentations and poster displays at the European Association of Urology Congress and the Chinese Urological Association meetings; he has won the Best Poster Award at the first session of the Rare Diseases Branch of the Chinese Medical Association. He has also received the Graduate National Scholarship and been honored as an Outstanding Student at Peking University.
Dr. Deng Ruiyi
Ph.D. candidate in Urology at Peking University First Hospital
He has published 11 academic papers to date, including 7 as the first or co-first author in SCI-indexed journals. He is the principal investigator of one project under the Beijing Natural Science Foundation “Qiyuan” Program. He delivered an oral presentation at the 2024 European Association of Urology Congress (EAU24). He has received awards such as the National Scholarship and has been recognized as a Model Outstanding Student at Peking University.
