IJU this issue

Abstract

This issue contains 13 original articles, four urological notes, and eight editorial comments. New diagnostic techniques called liquid biopsy have advanced a great deal recently. Liquid biopsy is also known as a good biomarker for survival. Two original articles on liquid biopsy as a predictive biomarker appear in this issue. Koh et al. (Osaka, Japan) investigated circulating tumor DNA (ctDNA) in 14 patients with metastatic renal cell carcinoma who were treated with immune checkpoint inhibitors. Using next-generation sequencing, nine of 14 patients had ctDNA with a total of 20 mutations of which VHL (30.0%) was the most frequently mutated gene, followed by TP53 (20.0%). Interestingly, cases with decreasing mutant ctDNA allele frequency had better progression-free survival (P = 0.0441). Yang et al. (Shanghai, China) reported a study on circulating tumor cell (CTC). They analyzed CD133 expression in CTC, an antigen expressed on the surface of both stem cells and cancer stem cells associated with neuroendocrine differentiation. In their study, 89 of 104 cases with metastatic castration-sensitive prostate cancer were CTC positive, of which 44 were CD133 positive. After median follow-up period of 24 months, progression-free survival was better in cases with CTC+ and CD133+, compared with CTC− or CD133−. Multivariate analyses also showed that the CTC+ and CD133+ is one of three significant variables affecting time to castration-resistant prostate cancer. Mirabegron may be useful for erectile dysfunction (ED). In this issue, Elbaz et al. (Mansoura, Egypt) conducted a randomized controlled trial. In all, 55 men with lower urinary tract symptoms (LUTS) with concomitant ED were randomly assigned to receive either mirabegron plus doxazosin (n = 28) or tolterodine plus doxazosin as a control (n = 27). There was a significant difference of the International Index of Erectile Function-15 total score which was improved in 91.7% in the mirabegron group compared with 26.1% in the tolterodine group (P < 0.001), while both groups showed a significant improvement of the International Prostate Symptom Score, quality of life, and post-voiding residual, compared with baseline. Four original articles and one urological note on prostate cancer appear in this issue. Kohada et al. (Sendai, Japan) assessed the impact of patients' interest in sex on the overall satisfaction after robot-assisted radical prostatectomy (RARP) analyzing 101 cases. The impact of urinary and sexual functions and bothers on patients' overall satisfaction differed between patients with preoperative high interest and low interest in sex. They clearly demonstrated the importance of preoperative sexual interest evaluating overall satisfaction after RARP. Blas et al. (Fukuoka, Japan) validated several models predicting lymph node involvement, using 331 Japanese cases treated with RARP plus extended pelvic node dissection. They found that the Memorial Sloan Kettering Cancer Center web calculator (AUC 0.78) and the updated Briganti nomogram of 2017 (0.76) were the most accurate performing models. Lee et al. (Hwaseong, Korea) compared oncological outcomes of radical prostatectomy (n = 45) with radiation therapy plus androgen deprivation therapy (n = 107) in men with clinical T3a prostate cancer. They concluded that cancer-specific survival was significantly longer in men who underwent radical prostatectomy. As is pointed in the editorial comment, it should be noted that sample size is very small with only 48 cases of propensity score-matched population. Medical treatment is essential for metastatic cases. Nagumo et al. (Tsukuba, Japan) retrospectively analyzed the 2048 cases with metastatic hormone-sensitive prostate cancer patients who were treated with androgen deprivation therapy at 30 institutions in Japan. In the high-burden group, combined androgen blockade with a first-generation anti-androgen resulted in superior progression-free survival compared with castration monotherapy. Tanaka et al. (Aomori, Japan) reviewed 298 cases with metastatic castration-sensitive prostate cancer who had high-tumor-burden disease. The castration-resistant prostate cancer-free survival and overall survival of cases treated with upfront DTX, ABI, APA, or ENZ (upfront group, n = 179) was better than that of cases treated with androgen deprivation therapy alone or plus bicalutamide (vintage group, n = 119). None declared.