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Purpose To compare Cancer-specific mortality (CSM) in patients with Squamous cell carcinoma (SCC) vs. non-SCC penile cancer, since survival outcomes may differ between histological subtypes. Methods Within the Surveillance, Epidemiology and End Results database (2004–2016), penile cancer patients of all stages were identified. Temporal trend analyses, cumulative incidence and Kaplan–Meier plots, multivariable Cox regression and Fine and Gray competing-risks regression analyses tested for CSM differences between non-SCC vs. SCC penile cancer patients. Results Of 4,120 eligible penile cancer patients, 123 (3%) harbored non-SCC vs. 4,027 (97%) SCC. Of all non-SCC patients, 51 (41%) harbored melanomas, 42 (34%) basal cell carcinomas, 10 (8%) adenocarcinomas, eight (6.5%) skin appendage malignancies, six (5%) epithelial cell neoplasms, two (1.5%) neuroendocrine tumors, two (1.5%) lymphomas, two (1.5%) sarcomas. Stage at presentation differed between non-SCC vs. SCC. In temporal trend analyses, non-SCC diagnoses neither decreased nor increased over time ( p  > 0.05). After stratification according to localized, locally advanced, and metastatic stage, no CSM differences were observed between non-SCC vs. SCC, with 5-year survival rates of 11 vs 11% ( p  = 0.9) for localized, 33 vs. 37% ( p  = 0.4) for locally advanced, and 1-year survival rates of 37 vs. 53% ( p  = 0.9) for metastatic penile cancer, respectively. After propensity score matching for patient and tumor characteristics and additional multivariable adjustment, no CSM differences between non-SCC vs. SCC were observed. Conclusion Non-SCC penile cancer is rare. Although exceptions exist, on average, non-SCC penile cancer has comparable CSM as SCC penile cancer patients, after stratification for localized, locally invasive, and metastatic disease.

AimsTo compare the 1973 WHO and the 2004/2016 WHO grading systems in patients with urothelial carcinoma of urinary bladder (UCUB), since no consensus has been made which classification should supersede the other and since both are recommended in clinical practice.MethodsNewly diagnosed patients with Ta UCUB treated with transurethral resection of bladder tumour were abstracted from the Surveillance, Epidemiology and End Results database (2010–2016). Kaplan-Meier plots and multivariable Cox regression models (CRMs) tested cancer-specific mortality (CSM), according to 1973 WHO (G1 vs G2 vs G3) and to 2004/2016 WHO (low-grade vs high-grade) grading systems.ResultsOf 35 986 patients, according to 1973 WHO grading system, 8165 (22.7%) were G1, 17 136 (47.6%) were G2 and 10 685 (29.7%) were G3. According to 2004/2016 WHO grading system, 24 961 (69.4%) were low-grade versus 11 025 (30.6%) high-grade. In multivariable CRMs, G3 (HR: 2.05, p<0.001), relative to G1, and high-grade(HR: 2.13, p<0.001), relative to low-grade, predicted higher CSM. Conversely, G2 (p=0.8) was not an independent predictor. The multivariable models without consideration of either grading system were 74% accurate in predicting 5-year CSM. After addition of 1973 WHO or 2004/2016 WHO grade, the accuracy increased to 76% and 77%, respectively.ConclusionsFrom a statistical standpoint, it appears that the 2004/2016 WHO grading system holds a small, although measurable advantage over the 1973 WHO grading system. Other considerations, such as intraobserver and interobserver variability may represent an additional matric to consider in deciding which grading system is better.

BackgroundWe hypothesized that the residency status (rural area [RA] vs urban clusters [UC] vs urban areas [UA]) affects stage and cancer-specific mortality (CSM) in contemporary newly diagnosed prostate cancer (PCa) patients of all stages, regardless of treatment.MethodsNewly diagnosed PCa patients with available residency status were abstracted from the Surveillance, Epidemiology, and End Results database (2004–2016). Propensity-score (PS) matching, cumulative incidence plots, multivariate competing-risks regression (CRR) models were used.ResultsOf 531,468 PCa patients of all stages, 6653 (1.3%) resided in RA, 50,932 (9.6%) in UC and 473,883 (89.2%) in UA. No statistically significant or clinically meaningful differences in stage at presentation or CSM were recorded. Conversely, 10-year other cause-mortality (OCM) rates were 27.2% vs 23.7% vs 18.9% (p < 0.001) in RA vs UC vs UA patients, respectively. In CRR models, RA (subhazard ratio [SHR] 1.38; p < 0.001) and UC (SHR 1.18; p < 0.001) were independent predictors for higher OCM relative to UA. These differences remained statistically significant in fully PS-adjusted multivariate CRR models.ConclusionRA, and to a lesser extent UC, PCa patients are at higher risk of OCM than UA patients. Higher OCM may indicate shorter life expectancy and should be considered in treatment decision making.

In recent years, vaccines and immunotherapy have become two of the most promising and effective tools in the fight against a wide range of diseases, from the common cold to cancer [...].In recent years, vaccines and immunotherapy have become two of the most promising and effective tools in the fight against a wide range of diseases, from the common cold to cancer [...].

Background/Objective: The grade of recommendation for renal cell carcinoma (RCC) salvage treatment options is weak. The aim of the current study is to summarize available evidence about the surgical, oncological, and functional outcomes of salvage renal options after previous treatments for RCC. Methods: A systematic search (PROSPERO: CRD42024618629) was performed according to the PRISMA statement. A pooled analysis was performed to quantify the effect size (ES) for an overall postoperative Clavien–Dindo (CD) grade ≥ III and postoperative and intraoperative complications for either partial or radical nephrectomy (PN or RN) subgroups. Results: Overall, 11 studies involving 331 patients were included in the final analysis. The median age ranged from 44 to 75 years. Primary treatments for RCC included 267 (80.6%) PNs, 40 (12.0%) radiofrequency ablations (RFAs), 23 (6.9%) cryotherapies, and 1 (0.3%) stereotactic radiotherapy. Overall, the median time of local recurrence for RCC patients was from 25 to 99 months for PNs, 13 months for RFA and cryotherapy, and 6 months for stereotactic radiotherapy. The overall pooled analysis was associated with an ES of 0.28 for overall postoperative complications and of 0.11 for CD ≥ III postoperative complications (all p < 0.001). Within subgroup analyses, RN was invariably associated with less complications (the ES ranged from 0.05 to 0.17). Conclusions: The profile of oncological safety as well as the morbidity and mortality of salvage treatment options for RCC may justify considering such procedures in a salvage setting.

The Prostate Imaging Reporting and Data System (PI-RADS) classification is based on a scale of values from 1 to 5. The value is assigned according to the probability that a finding is a malignant tumor (prostate carcinoma) and is calculated by evaluating the signal behavior in morphological, diffusion, and post-contrastographic sequences. A PI-RADS score of 3 is recognized as the equivocal likelihood of clinically significant prostate cancer, making its diagnosis very challenging. While PI-RADS values of 4 and 5 make biopsy necessary, it is very hard to establish whether to perform a biopsy or not in patients with a PI-RADS score 3. In recent years, machine learning algorithms have been proposed for a wide range of applications in medical fields, thanks to their ability to extract hidden information and to learn from a set of data without previous specific programming. In this paper, we evaluate machine learning approaches in detecting prostate cancer in patients with PI-RADS score 3 lesions via considering clinical-radiological characteristics. A total of 109 patients were included in this study. We collected data on body mass index (BMI), location of suspicious PI-RADS 3 lesions, serum prostate-specific antigen (PSA) level, prostate volume, PSA density, and histopathology results. The implemented classifiers exploit a patient’s clinical and radiological information to generate a probability of malignancy that could help the physicians in diagnostic decisions, including the need for a biopsy.

Background: Familial prostate cancer (PCa) accounts for nearly 20% of all PCa cases and is associated with increased genetic susceptibility and earlier disease onset. However, early detection and risk stratification in genetically predisposed individuals remain challenging. Circulating cell-free DNA (cfDNA) provides a minimally invasive source of tumor-derived genomic and epigenomic information. Integrating multi-omic cfDNA analyses may enhance the discovery of biomarkers relevant to familial PCa biology. Methods: We conducted a pilot feasibility study employing whole-genome, strand-specific sequencing of cfDNA from eight patients with familial PCa. A unified analytical pipeline was used to jointly profile genomic alterations and epigenomic features. Variant calling, methylation mapping, and allele-specific methylation (ASM) analysis were performed to identify somatic mutations, characterize epigenetic dysregulation, and explore potential interactions between genetic and epigenetic mechanisms. Results: Sequencing revealed 18,878 genetic variants, including 2276 potentially pathogenic alterations. We identified 26 recurrent high-impact mutations, such as stop-gain and start-loss variants, in genes including MUC4, MCM9, and SKA3. Epigenomic profiling demonstrated widespread gene-specific hypermethylation, consistent with transcriptional repression in these loci. ASM events were detected in TTC22, TEX51, WDR89, LAIR2, and SKA3, suggesting coordinated interactions between somatic variation and epigenetic regulation in familial PCa. Conclusions: This proof-of-concept study highlights the feasibility and potential of integrating whole-genome and epigenome profiling of cfDNA to decode the molecular architecture of familial prostate cancer. By jointly capturing genomic alterations and epigenetic signatures, including allele-specific methylation, this multi-omic liquid biopsy approach supports a high-resolution exploration of biologically relevant molecular features. Moreover, this integrated profiling strategy provides a minimally invasive and clinically scalable tool that may substantially improve risk assessment. These findings offer a promising foundation for future validation studies in larger cohorts, with the aim of advancing multi-omic cfDNA analysis as a next-generation technology in the field of precision oncologic epigenetics.

The management of patients with oligometastatic urothelial carcinoma (UC) represents an evolving field in uro-oncology, and the role of metastasis-directed therapies, including metastasectomy and metastasis-directed radiation therapy (MDRT), is gaining increasing attention. Herein, we summarize available evidence about the role of MDRT with consolidative intent in oligometastatic UC patients. A systematic review was performed in December 2021. Six studies involving 158 patients were identified. Most patients (n = 120, 90.2%) had a history of bladder cancer and the most frequent sites of metastases were lymph nodes (n = 61, 52.1%) followed by the lungs (n = 34, 29%). Overall, 144 metastases were treated with MDRT. Median follow-up ranged from 17.2 to 25 months. Local control rates ranged from 57% to 100%. Median Overall Survival (OS) ranged from 14.9 to 51.0 months and median progression-free survival ranged from 2.9 to 10.1 months. Rates of OS at one and two years ranged from 78.9% to 96% and from 26% to 63%, respectively. Treatment-related toxicity was recorded in few patients and in most cases a low-grade toxicity was evident. MDRT with consolidative intent represents a potential treatment option for selected patients with oligometastatic UC.

PurposeTo assess the effect of race/ethnicity in cancer-specific mortality (CSM) adjusted for other-cause mortality (OCM) in metastatic prostate cancer patients (mPCa) treated with external beam radiotherapy (EBRT) to the prostate.MethodsWe relied on the Surveillance, Epidemiology, and End Results (SEER) database to identify Caucasian, African-American, Hispanic/Latino and Asian mPCa patients treated by EBRT between 2004 and 2016. Cumulative incidence plots displayed CSM after adjustment for OCM according to race/ethnicity. Propensity score matching accounted for patient age, prostate-specific antigen, clinical T and N stages, Gleason Grade Groups and M1 substages. OCM adjusted multivariable analyses tested for differences in CSM in African-Americans, Hispanic/Latinos and Asians relative to Cauacasians.ResultsAfter 3:1 propensity score matching and OCM adjustment, Asians exhibited lower CSM at 60 and 120 months (48.2 and 60.0%, respectively) compared to Caucasians (66.7 and 79.4%, respectively, p < 0.001). In OCM adjusted multivariable analyses, Asian race/ethnicity was associated with lower CSM (HR 0.66, CI 0.52–0.83, p < 0.001). Conversely, African-American and Hispanic/Latino race/ethnicity did not affect CSM. OCM rates were comparable between examined races/ethnicities.ConclusionIn the setting of mPCa treated with EBRT, Asians exhibit lower CSM than Caucasians, African-Americans and Hispanic/Latinos. This observation may warrant consideration in prognostic stratification schemes for newly diagnosed mPCa patients.

Background Social media platforms, initially developed for recreational use, have evolved into major sources for disseminating information, including medical information for patients and healthcare providers in many disciplines. This study aimed to evaluate the educational potential of YouTube® videos in teaching tracheal intubation to first-year anesthesiology residents. Methods This study was approved by the Ethical Committee of “University Federico II-AORN A. Cardarelli” (protocol no. 00010735). We analyzed the first 10 YouTube videos identified via the search term “tracheal intubation.” Each video was evaluated for misinformation and informational completeness via a 5-item Likert scale. After providing written consent, fifty-seven first-year anesthesiology residents watched these videos and completed a 22-item questionnaire before and after viewing. Each correct answer received one point, whereas incorrect answers received 0 points, allowing for comparisons of knowledge acquisition. Results The videos exhibited moderate quality (median score, 3; range, 1–5) and low informational completeness (median score, 1.432; range, 1.000–2.046). Residents’ scores increased modestly by one point after viewing (from 13 to 14; p  < 0.001). Misinformation was positively correlated with the number of followers (beta coefficient: 0.00002, p  < 0.001), video duration (beta coefficient: 0.0042, p  < 0.05), and linking ratio (beta coefficient: 0.242, p  < 0.05). Conversely, informational completeness was inversely correlated with video duration (beta coefficient: − 0.001121, p  < 0.05) and the thumbs-up/view ratio (beta coefficient: − 67.4697, p  < 0.05). Conclusions While YouTube® has potential as an accessible educational tool, current video selection offers limited improvement in residents’ understanding of tracheal intubation. Our findings highlight the need for greater curation and better-quality control of medical educational content on YouTube® to optimize its effectiveness and provide accurate information. Institutions could play a key role in producing reliable, guideline-based videos that better support learning objectives in anesthesiology training.