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Objective: The objective of the study was to describe the surgical outcome of robot‐assisted radical cystectomy and predictive factors for major complications in real‐world clinical practice at a single institution in Japan. Methods: We retrospectively analyzed 208 consecutive patients undergoing robot‐assisted radical cystectomy at our institution between 2019 and 2023. Patient and disease characteristics, intraoperative details, and perioperative outcomes were reviewed. Postoperative complications were defined as minor complications (Clavien–Dindo grades 1–2) or major complications (grades 3–5). Predictors of complications were examined using multivariable logistic analysis. Results: Overall, 147 men and 61 women, median age 70 years (interquartile range, 62–77), were included in this study. Median operative time and estimated blood loss were 8.4 h and 185 mL, respectively; 11 patients (5%) received intraoperative blood transfusions. For urinary diversions, ileal conduit, neobladder, and cutaneous ureterostomy were performed in 153 (74%), 49 (24%), and 6 (3%) patients, respectively. Urinary diversions were primarily performed with extracorporeal urinary diversion. In total, 140 complications occurred in 111 patients (53%) within 30 days. Of these patients, 31 major complications occurred in 28 patients, and one perioperative death (0.5%) with a postoperative cardiovascular event. Multivariable analysis showed only prolonged operative time (odds ratio: 4.34, 95% confidence interval: 1.82–10.35, p < 0.01) was the independent risk factor for major complications. Conclusions: This study reports surgical outcomes at our single institution. Prolonged operative time was a significant prognostic factor for major complications. As far as we know, this study reports the largest number of robot‐assisted radical cystectomy cases at a single center in Japan. [ABSTRACT FROM AUTHOR]

The pseudoaneurysm in Case 4 was confirmed to have regressed spontaneously by CECT at 4 months after surgery. gl As shown in Figure 1a, DUS as a screening test identified four cases of asymptomatic RAP. Abbreviations and Acronyms CECT contrast-enhanced computed tomography DUS Doppler ultrasonography DVT deep venous thrombosis PN partial nephrectomy POD postoperative day RAP renal artery pseudoaneurysm Where technically feasible, partial nephrectomy (PN) is increasingly considered the gold standard for localized renal cell carcinomas. Doppler ultrasonography as a screening test for the detection of asymptomatic renal artery pseudoaneurysms following partial nephrectomy: A 15-year single-institution experience. [Extracted from the article]

Objectives: To investigate the tumor shrinkage patterns of patients with metastatic renal cell carcinoma treated with nivolumab monotherapy. Methods: Forty‐four consecutive patients with metastatic renal cell carcinoma treated with nivolumab monotherapy (81 metastatic and four primary lesions) between September 2013 and December 2020 were retrospectively analyzed. The tumor shrinkage rate of individual visceral and lymph node metastatic lesions and the primary site lesions treated with nivolumab monotherapy, as well as the association between overall survival and pretreatment tumor size, were statistically assessed. Results: Pretreatment tumor size for the total and individual target lesions, which included kidneys, lungs, pancreas, and lymph nodes, were not correlated with tumor shrinkage rate. The tumor shrinkage rate was found to have no significant association with pretreatment tumor size between any organ. In addition, there is no significant difference in tumor shrinkage rate between larger (>median value) and smaller (

Objectives: To evaluate the efficacy and safety profiles of first‐line etoposide, ifosfamide and cisplatin and primary prophylaxis with pegfilgrastim as first‐line chemotherapy for disseminated germ cell cancer. Methods: This study reviewed 154 consecutive patients with previously untreated disseminated germ cell cancer who received first‐line etoposide, ifosfamide and cisplatin between 1995 and 2020. Of these, 54 patients were managed with primary prophylaxis using pegfilgrastim (primary prophylaxis group), and 100 were managed with the therapeutic use of short‐acting granulocyte colony‐stimulating factor (non‐primary prophylaxis group). Results: The International Germ Cell Cancer Collaborative Group classification identified 90 (58%)/40 (26%)/24 (16%) patients with good/intermediate/poor prognosis, respectively. Overall, 139 patients (90%) were disease free after etoposide, ifosfamide and cisplatin with/without post‐chemotherapy surgery. The median relative dose intensity of etoposide, ifosfamide and cisplatin was 96%, and there was a significant difference between the primary prophylaxis and non‐primary prophylaxis groups (100% vs 90%, P < 0.01). The 5‐year salvage treatment‐free and overall survival rates were 83% and 94%, respectively. In total, 138 patients (90%) developed grade 4 hematological toxicities, and there were no treatment‐related deaths due to myelosuppression. Grade 4 neutropenia was less commonly observed in the primary prophylaxis group compared with the non‐primary prophylaxis group (80% vs 95%, P < 0.01). Conclusions: This is the largest study of first‐line etoposide, ifosfamide and cisplatin, and its sufficient efficacy and safety profiles are confirmed in current clinical practice. Primary prophylaxis using pegfilgrastim might further improve the feasibility of etoposide, ifosfamide and cisplatin. [ABSTRACT FROM AUTHOR]