Abbreviations & Acronyms BMI = body mass index CT = computed tomography eGFR = estimated glomerular filtration rate IQR = interquartile range OPN = open partial nephrectomy PN = partial nephrectomy PSM = positive surgical margin RAPN = robot-assisted partial nephrectomy RCC = renal cell carcinoma SSI = surgical site infection TAE = transarterial embolization WIT = warm ischemic timeObjectives: To assess the perioperative outcomes of robot-assisted partial nephrectomy without renorrhaphy for cT1b renal tumors compared with cT1a. Methods: From February 2015 to May 2018, 100 robot-assisted partial nephrectomy patients who underwent robot-assisted partial nephrectomy without renorrhaphy for renal tumors were included. We retrospectively reviewed the medical records, and compared the perioperative outcomes of 66 and 34 patients for cT1a and cT1b tumors, respectively. Inner suture was carried out in the opened collecting system or renal sinus, whereas parenchymal renorrhaphy was not. For hemostasis, the soft-coagulation system was used, and absorbable hemostats were placed on the resection bed. Results: The median tumor size and RENAL nephrometry score were significantly different between the two groups (cT1a vs cT1b: 23.5 vs 45 mm, P < 0.001, 6 vs 8, P < 0.001). The median operating time and warm ischemic time were significantly longer in the cT1b group than in the cT1a group (154 vs 184 min, P < 0.001; 14 vs 21 min, P < 0.001). The median blood loss was not significantly different (2.5 vs 50 mL, P = 0.109). The positive surgical margin rate was 4.5% versus 11.7% (P = 0.22). Postoperative complications classified as Clavien-Dindo grade III or higher were port-site herniation (one patient), acute cholecystitis (one patient) and pseudoaneurysm (one patient) in the cT1b group. Urinary leakage was not observed in the two groups. Conclusions: Robot-assisted partial nephrectomy without renorrhaphy using the softcoagulation system and absorbable hemostats appears to be feasible for renal or cT1b tumors. However, longer warm ischemic time and a high rate of complications can be expected compared with cT1a tumors.

Background The Paris System (TPS) for reporting urinary cytology differs from conventional systems (CS) in that it focuses on the diagnosis of high-grade urothelial carcinoma (HGUC). This study investigated the impact of TPS implementation on the diagnostic accuracy of HGUC by comparing it with our institutional CS. Methods A total of 649 patients who underwent transurethral resection of bladder tumor (TURBT) between January 2009 and December 2020 were included in this study. Our institution adopted TPS to report urinary cytology in February 2020. The diagnostic accuracy of HGUC in preoperative urinary cytology was compared with the presence or absence of HGUC in resected specimens of TURBT before and after TPS implementation. Results After implementing TPS in urinary cytology, 89 patients were reviewed and compared with 560 patients whose urinary cytology was diagnosed by CS. TPS and CS for detecting HGUC had 56.0% and 58.2% sensitivity, 97.8% and 91.2% specificity, and 93.3% and 87.9% positive predictive values, respectively. There were no significant differences between TPS and CS in terms of sensitivity, specificity, and positive predictive value for HGUC (P = 0.83, 0.21, 1.00). On the other hand, the negative predictive value for HGUC using TPS was 80.0%, which was significantly higher than that of CS (66.4%, P = 0.04) The multivariate logistic regression analysis indicated that not using TPS was one of the independent predictive factors associated with false-negative results for HGUC (odds ratio, 2.26; 95% confidence interval, 1.08–4.77; P = 0.03). Conclusion In instances where urinary cytology is reported as negative for HGUC by TPS, there is a low probability of HGUC, indicating that TPS has a potential diagnostic benefit.

Abbreviations & Acronyms BC = bladder cancer BCG = bacillus Calmette-Gu erin CI = confidence interval CIS = carcinoma in situ DM = detrusor muscle EORTC = European Organisation for Research and Treatment of Cancer HR = hazard ratio MIBC = muscle-invasive bladder cancer MMC = mitomycin C NMIBC = non-muscleinvasive bladder cancer OR = odds ratio RFS = recurrence-free survival SC = surgical checklist THP = pirarubicin TUR = transurethral resection UTUC = upper urinary tract urothelial cancer

No abstract

Criteria for Adverse Events DRESS = drug rash with eosinophilia and systemic symptoms HE = hematoxylin-eosin mCSPC = metastatic castration-sensitive prostate cancer nmCRPC = non-metastatic castration-resistant prostate cancer SAEs = severe adverse events SJS = Stevens-Johnson syndrome TEN = toxic epidermal necrolysis