Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Disitamab vedotin with or without PD-1 inhibitors in pretreated patients with locally advanced or metastatic urothelial carcinoma: Identifying patients who derive additional benefit from immune combination therapy","authors":"Mengnan Qu ,&nbsp;Jinchang Wei ,&nbsp;Jiazhi Mo ,&nbsp;Jiayuan Chen ,&nbsp;Xiaowen Wu ,&nbsp;Huayan Xu ,&nbsp;Li Zhou ,&nbsp;Juan Li ,&nbsp;Xieqiao Yan ,&nbsp;Chuanliang Cui ,&nbsp;Lu Si ,&nbsp;Zhihong Chi ,&nbsp;Jun Guo ,&nbsp;Xinan Sheng","doi":"10.1016/j.urolonc.2025.12.006","DOIUrl":"10.1016/j.urolonc.2025.12.006","url":null,"abstract":"<div><h3>Background</h3><div>The relative clinical value of disitamab vedotin (RC48) monotherapy versus its combination with a programmed cell death protein 1 (PD-1) inhibitor remains unclear in previously treated patients with locally advanced or metastatic urothelial carcinoma (LA/mUC). Identifying patients who truly benefit from immunotherapy intensification is therefore critical to guide personalized treatment and avoid overtreatment.</div></div><div><h3>Patients and Methods</h3><div>We conducted a retrospective analysis to compare the clinical outcomes of RC48 monotherapy versus its combination with a PD-1 inhibitor in pretreated patients with LA/mUC. To address potential confounders, multiple imputation and inverse probability of treatment weighting (IPTW) were employed. The primary endpoint was overall survival (OS); secondary endpoints included progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and safety assessment.</div></div><div><h3>Results</h3><div>The median follow-up for the 195 patients was 10.3 months. No significant difference in OS was observed between combination therapy and monotherapy (median OS, 16.7 vs. 22.0 months; HR 1.09; 95% confidence intervals [95% CI], 0.67–1.78; <em>P</em> = 0.73). PFS, ORR, and DCR did not differ significantly between groups. In exploratory analyses, patients with HER2-positive and PD-L1–negative tumors showed improved outcomes with combination therapy (OS HR 0.28; 95% CI, 0.09–0.86; <em>P</em> = 0.03; PFS HR 0.46; 95% CI, 0.24–0.89; <em>P</em> = 0.02). PFS benefit was also observed in those with nondivergently differentiated histology (HR 0.66; 95% CI, 0.44–0.98; <em>P</em> = 0.04).</div></div><div><h3>Conclusion</h3><div>While RC48 combined with a PD-1 inhibitor did not confer survival advantage in the overall population, patients with HER2-positive and PD-L1-negative tumors, as well as those without divergent histologic differentiation, may derive additional benefit from combination therapy. Safety findings were consistent with prior experience.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 3","pages":"Article 110970"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate cancer-related genetic counseling in a safety-net healthcare setting","authors":"Prisca Mbonu ,&nbsp;Jacqueline Mersch M.S., C.G.C. ,&nbsp;Jana Heady M.S., C.G.C. ,&nbsp;Samuel Newman M.S. ,&nbsp;Jolonda C. Bullock O.D.S-C. ,&nbsp;Kyle Seymour ,&nbsp;David E. Gerber M.D. ,&nbsp;Kalyani Narra M.D.","doi":"10.1016/j.urolonc.2025.12.003","DOIUrl":"10.1016/j.urolonc.2025.12.003","url":null,"abstract":"<div><h3>Background</h3><div>Germline genetic testing and genetic counseling have become integral aspects of prostate cancer management. In 2018, the National Comprehensive Cancer Network (NCCN) broadened testing recommendations to identify more at-risk individuals based on tumor characteristics and family cancer history. We assessed genetic counseling referrals and outcomes in relation to this expansion in a large safety-net population.</div></div><div><h3>Methods</h3><div>We analyzed cases of prostate adenocarcinoma diagnosed in 2016 to 2023 at JPS Health Network (JPS), a safety-net provider in Texas. Demographic and clinical data including genetic counseling referrals and testing results were obtained from cancer registries and electronic health records. Statistical analysis was performed using logistic regression model.</div></div><div><h3>Results</h3><div>Among 543 patients, 46% were Black, 27% were Hispanic, and 40% had metastatic disease. Overall, 132 patients (24%) were referred for genetic counseling, of whom 102 (77%) completed the visits. Rates of referrals increased from 4% in 2017 to 9% in 2019 to 28% in 2023. A multivariate logistic regression determined that patients with stage 3 or 4 cancers were more likely than stage 1 to be referred (<em>P</em> = 0.02 and <em>P</em> &lt; 0.01 respectively). Genetic testing was completed for 78 patients (76%) with 8 (10%) having 9 positive results in <em>BRCA1</em> (<em>n</em> = 1), <em>BRCA2</em> (<em>n</em> = 1), <em>CHEK2</em> (<em>n</em> = 3), <em>MSH2</em> (<em>n</em> = 2), <em>PALB2</em> (<em>n</em> = 1), and <em>PMS2</em> (<em>n</em> = 1).</div></div><div><h3>Conclusion</h3><div>Following guideline changes, genetic testing referrals for patients with prostate cancer increased approximately 7-fold in a safety-net setting. Over three-fourths of referred patients completed testing and 10% had positive results, demonstrating the feasibility and importance of genetic testing in underserved populations.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 3","pages":"Article 110967"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in diagnostic, prognostic, and predictive genomic biomarkers for prostate cancer: Ready for prime time?","authors":"Andrey Bazarkin ,&nbsp;Mark Taratkin Ph.D. ,&nbsp;Stanislav Vovdenko Ph.D. ,&nbsp;Aleksandr Androsov ,&nbsp;Maria Balashova Ph.D. ,&nbsp;Andrey Morozov Ph.D. ,&nbsp;Alina Itskevich ,&nbsp;Ekaterina Laukhtina ,&nbsp;Evgenii Bezrukov M.Sc. ,&nbsp;Nirmish Singla M.Sc. ,&nbsp;Leonid Rapoport D.Sc. ,&nbsp;Evgenii Shpot D.Sc. ,&nbsp;Petr Glybochko D.Sc.","doi":"10.1016/j.urolonc.2025.12.001","DOIUrl":"10.1016/j.urolonc.2025.12.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Until recently, the widespread use of genetic markers in prostate cancer (PCa) has been limited by the complexities and cost of genomic data analysis. Artificial intelligence (AI), due to its ability to process large volumes of unstructured data, holds the potential to play a transformative role in the future of medical genetics.</div></div><div><h3>Methods</h3><div>We conducted a systematic literature review using the Medline citation database and the Google Scholar search engine to evaluate the feasibility of AI applications in PCa diagnostics and disease progression prediction. We selected articles that presented data on the use of AI to identify genetic markers and/or their association with clinical data in patients with confirmed or suspected prostate cancer, without applying any time restriction. In total, 15 articles were included in the final analysis.</div></div><div><h3>Results</h3><div>Studies investigating the application of AI in prostate cancer diagnosis have demonstrated that machine learning (ML) methods can be effectively used to identify novel cancer-related genes from genetic databases. Additionally, ML algorithms have shown potential in predicting clinical risk in PCa. By analyzing miRNAs, mRNAs, lncRNAs, and patterns of gene upregulation and alteration, AI has been able to predict adverse clinical outcomes such as metastatic progression, biochemical recurrence following radical prostatectomy, reduced survival, and elevated serum PSA levels. Moreover, AI tools have been utilized to predict genitourinary complications after radiation therapy through genome-wide data analysis, to identify cell line phenotypes resistant to antiandrogen therapy and to detect novel signaling pathways that may be targeted by emerging systemic treatments.</div></div><div><h3>Conclusion</h3><div>AI-based methods appear to be promising tools for the identification of new genetic biomarkers in PCa, offering potential for improvements in disease detection, prognosis, and prediction of treatment response, including the identification of actionable therapeutic targets. However, their clinical implementation remains limited due to a lack of clinical validation and practical benefit uncertainties.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 3","pages":"Article 110965"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of omitting pelvic imaging in patients with stage I germ cell tumor (GCT) on surveillance: A multi-institutional study","authors":"Hamed Ahmadi ,&nbsp;Tarik Benidir ,&nbsp;Alon Lazarovich ,&nbsp;Lynn Anson-Cartwright ,&nbsp;Martin O’Malley ,&nbsp;Scott E. Eggener ,&nbsp;Robert J. Hamilton ,&nbsp;Siamak Daneshmand","doi":"10.1016/j.urolonc.2025.12.002","DOIUrl":"10.1016/j.urolonc.2025.12.002","url":null,"abstract":"<div><h3>Background and Objective</h3><div>The preferred management of clinical stage I (CS1) germ cell tumor (GCT) is surveillance. Standard surveillance imaging protocols expose young patients to potential radiation-related consequences and have financial implications. We evaluated the safety of omitting routine pelvic imaging.</div></div><div><h3>Methods</h3><div>Patients with CS1 GCT electing surveillance at 3 major referral centers were included. “Pelvis only” recurrence was defined as those detectable solely on pelvic imaging below the bifurcation of common iliac vessels. Any inguinal recurrence detected on pelvic imaging was considered an “inguinal recurrence.” Standard surveillance imaging protocols were used to estimate radiation dose reduction and cost saving per patient.</div></div><div><h3>Results</h3><div>A total of 285 patients were included. Forty-three patients (15%) had pelvic/inguinal nodal recurrence and 16/43 (37%) were detectable by imaging alone. However, in 11/16 (69%), pelvic/inguinal nodal disease was either visible on CT abdomen cuts (3) or there was simultaneous retroperitoneal recurrence (8). Only 5/285 (1.7%) patients had pelvis/inguinal recurrence only detectable on CT pelvis. Only 3/220 (1.3%) patients with no prior cryptorchidism or inguinal/scrotal surgery had pelvis only recurrence. The estimated reduction in radiation dose ranged between 2.31 and 3.46 mSv over 5 years with cost savings of 700 to 800 USD per patient. A limitation of the study includes variability in imaging protocols amongst the centers.</div></div><div><h3>Conclusion</h3><div>Isolated pelvic/inguinal recurrence in CS1 GCT is rare and routine pelvic imaging appears to have limited value. Omitting CT pelvis could also reduce radiation exposure and offers cost-saving.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 3","pages":"Article 110966"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate cancer deaths will decrease by 2050","authors":"Nicholas N. Brutus M.D. ,&nbsp;Maximilian J. Rabil M.D. ,&nbsp;Isaac Y. Kim M.D., Ph.D., M.B.A., F.A.C.S.","doi":"10.1016/j.urolonc.2025.12.007","DOIUrl":"10.1016/j.urolonc.2025.12.007","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 3","pages":"Article 110971"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate cancer deaths in 2050-quo vadimus?","authors":"Kevin R. Loughlin M.D., M.B.A.","doi":"10.1016/j.urolonc.2025.06.014","DOIUrl":"10.1016/j.urolonc.2025.06.014","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 3","pages":"Article 110818"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Location matters: Reduced detection of csPCa in transition zone versus peripheral zone PI-RADS lesions","authors":"Andrew M. Wood M.D. ,&nbsp;Sabrina L. Noyes B.S. ,&nbsp;Jennifer Bullen M.S. ,&nbsp;Anna Johnson M.S. ,&nbsp;Prajit Khooblall M.D. ,&nbsp;Andrew Moriarity M.D. ,&nbsp;Tarik Benidir M.D. ,&nbsp;Jane K. Nguyen M.D., Ph.D. ,&nbsp;Ruben Olivares M.D. ,&nbsp;Zeyad Schwen M.D. ,&nbsp;Samuel Haywood M.D. ,&nbsp;Eric Klein M.D. ,&nbsp;Ryan D. Ward M.D. ,&nbsp;Matthew S. Davenport M.D. ,&nbsp;Andrei S. Purysko M.D. ,&nbsp;Christopher J. Weight M.D. ,&nbsp;Brian R. Lane M.D., Ph.D.","doi":"10.1016/j.urolonc.2025.12.011","DOIUrl":"10.1016/j.urolonc.2025.12.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Fusion prostate biopsy of prostate imaging report and data system lesions has become an integral part of diagnosis of prostate cancer. Though the scoring system is slightly different between peripheral zone and transition zone located lesions, a score of 4 or 5, regardless of lesion location is associated with a high or very high chance of clinically significant prostate cancer. Our goal is to examine whether lesion location impacts detection of clinically significant prostate cancer, defined as International Society of Urological Pathology grade group ≥2.</div></div><div><h3>Materials and Methods</h3><div>Multi-institutional retrospective review of patients who underwent MRI fusion biopsy at 3 tertiary care medical centers between 2017 and 2022. Lesion level review was performed to compare targeted biopsy results for PI-RADS 4 and 5 lesions located in the transition zone and peripheral zone. Primary outcome of interest was detection of clinically significant prostate cancer. Multivariable logistic regression analyses were performed to assess for predictors of clinically significant prostate cancer detection.</div></div><div><h3>Results and Conclusions</h3><div>Two thousand one hundred twenty eight lesions from 1,635 patients were included. On multivariate analysis, lesions located in the transition zone were independently associated with decreased detection of clinically significant prostate cancer (OR 0.55, <em>P</em> &lt; 0.001). Similarly, detection of grade group 3 or higher prostate cancer was also lower for lesions in the transition zone (adjusted OR: 0.37; 95% CI: 0.26–0.54; <em>P</em> &lt; 0.001). These differences have implications for further workup in patients with negative or low-grade pathology on MRI-TBx of PI-RADS 5 lesions and suggest a needs for reworking of the PI-RADS system.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 3","pages":"Article 110975"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of periurethral structural reinforcement technique on early urinary continence recovery following laparoscopic radical prostatectomy: A retrospective study","authors":"Chenxu Ma B.SC. ,&nbsp;Lili Chen B.SC. ,&nbsp;Yongxiang Li M.D. ,&nbsp;Liang Qiao M.D. ,&nbsp;Yadong Sun M.D.","doi":"10.1016/j.urolonc.2025.12.012","DOIUrl":"10.1016/j.urolonc.2025.12.012","url":null,"abstract":"<div><h3>Purpose</h3><div>This retrospective comparative study aims to evaluate the safety and efficacy of a novel periurethral structural reinforcement (PSR) technique for enhancing early urinary continence recovery after laparoscopic radical prostatectomy (LRP).</div></div><div><h3>Methods</h3><div>Clinical records of 140 prostate cancer patients undergoing LRP between March 2022 to August 2023 were reviewed. Participants were divided into modified (PSR) and conventional (standard anastomosis) groups. The PSR technique augments standard posterior reconstruction by incorporating circumferential support sutures, aimed at reconstructing key surgical-damaged periurethral supports. Continence status (≤1 pad/day) were analyzed at catheter removal, 1, 2 4, and 12 weeks following surgery. Operative time, complications and pathologic characteristics were compared between 2 groups.</div></div><div><h3>Results</h3><div>Baseline characteristics were comparable among 2 groups. The modified group maintained superior continence recovery at all time intervals: 16.0% vs. 0% (immediate, <em>P</em> &lt; 0.001), 20.0% vs. 6.7% (1 week, <em>P</em> = 0.018), 52.0% vs. 27.8% (4 weeks, <em>P</em> = 0.004), and 82.0% vs. 52.2% (12 weeks, <em>P</em> &lt; 0.001), respectively. Complication rates showed no significant difference (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>The PSR technique is a safe and simple technique to accelerate early urinary continence recovery following LRP. Nevertheless, the generalizability of these outcomes require rigorous validation through a large-scale multicenter randomized controlled trial.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 3","pages":"Article 110976"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Beyond tunnel vision—Reconsidering real-world evidence on staging in intermediate-risk prostate cancer","authors":"Felix Preisser MD ,&nbsp;Tobias Maurer MD","doi":"10.1016/j.urolonc.2025.11.015","DOIUrl":"10.1016/j.urolonc.2025.11.015","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 3","pages":"Article 110961"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of insurance status on testicular cancer outcomes: A single-institution, dual-site study","authors":"Ifeanyi Chidera Ibezue ,&nbsp;Zine-Eddine Khene ,&nbsp;Raj Bhanvadia ,&nbsp;Yair Lotan ,&nbsp;Vitaly Margulis ,&nbsp;Solomon Woldu ,&nbsp;Xiaosong Meng ,&nbsp;Aditya Bagrodia ,&nbsp;Waddah Arafat ,&nbsp;Jue Wang ,&nbsp;Farrukh Awan ,&nbsp;Kris Gaston ,&nbsp;Isamu Tachibana","doi":"10.1016/j.urolonc.2025.12.005","DOIUrl":"10.1016/j.urolonc.2025.12.005","url":null,"abstract":"<div><h3>Background</h3><div>Our aim was to examine a diverse patient population to identify any sociodemographic factors, specifically lack of health care coverage, that may worsen aggressiveness of disease on presentation and negatively impact outcomes in testicular germ cell tumors (TGCT).</div></div><div><h3>Methods</h3><div>Patients who were diagnosed and treated for TGCT at both a SNH (Safety-Net Hospital) and TCH (Tertiary Care Hospital) covered by the same institution and physicians were retrospectively reviewed to assess any disparities in outcomes. We evaluated whether insurance coverage affected the severity of disease on presentation based on International Germ Cell Collaborative Group (IGCCCG) prognostic classification.</div></div><div><h3>Results</h3><div>Between January 2009 and December 2020, 144 patients were considered underinsured compared to 82 patients that were fully insured. Underinsured patients were more likely to be treated at SNH (85.4% vs. 7.3% <em>P</em> &lt; 0.01), more likely to be Hispanic (73.6% vs. 17.1%, <em>P</em> &lt; 0.01) and more likely to present with advanced disease (<em>P</em> = 0.01). IGCCG risk at presentation was worse for underinsured vs. insured including 19 patients (23.8%) vs. 3 patients (8.1%) with intermediate risk disease and 22 patients (27.5%) vs. 5 patients (13.5%) with poor risk disease (<em>P</em> &lt; 0.01). Although recurrence after first line chemotherapy was similar between underinsured and insured (<em>P</em> = 0.38), the CSS outcomes were worse in those patients without insurance (<em>P</em> = 0.02). Patients with worse presentation of disease (IGCCCG risk group) also demonstrated worse CSS outcomes (<em>P</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Insurance status can be associated with a worse prognostic disease presentation of TGCT and may have implications on treatment options and survival. These findings underscore the necessity of community outreach and educational interventions targeting populations in SNHs to improve earlier access to care or increase availability of salvage options in rare cases to mitigate these disparities.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"44 3","pages":"Article 110969"},"PeriodicalIF":2.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}