Background: In the treatment of advanced urothelial (aUC) and renal cell carcinoma (aRCC), biomarkers such as PD-1 and PD-L1 are not robust prognostic markers for immunotherapy (IO) response. Previously, a significant association between IO and a change in splenic volume (SV) was described for several tumour entities. To the best of our knowledge, this study presents the first correlation of SV to IO in aUC and aRCC. Methods: All patients with aUC (05/2017–10/2021) and aRCC (01/2012–05/2022) treated with IO at our academic centre were included. SV was measured at baseline, 3 and 9 months after initiation of IO using an in-house developed convolutional neural network-based spleen segmentation method. Uni- and multivariate Cox regression models for overall survival (OS) and progression-free survival (PFS) were used. Results: In total, 35 patients with aUC and 30 patients with aRCC were included in the analysis. Lower SV at the three-month follow-up was significantly associated with improved OS in the aRCC group. Conclusions: We describe a new, innovative artificial intelligence-based approach of a radiological surrogate marker for IO response in aUC and aRCC which presents a promising new predictive imaging marker. The data presented implicate improved OS with lower follow-up SV in patients with aRCC.

Amygdalin is purported to exhibit anti-cancer properties when hydrolyzed to hydrogen cyanide (HCN). However, knowledge about amygdalin efficacy is limited. A questionnaire evaluating the efficacy, treatment, and dosing protocols, reasons for use, HCN levels, and toxicity was distributed to physicians and healers in Germany, providing amygdalin as an anti-cancer drug. Physicians (20) and healers (18) provided amygdalin over 8 (average) years to nearly 80 annually treated patients/providers. Information about amygdalin was predominantly obtained from colleagues (55%). Amygdalin was administered both intravenously (100%) and orally (32%). Intravenous application was considered to maximally delay disease progression (90%) and relieve symptoms (55%). Dosing was based on recommendations from colleagues (71%) or personal experience (47%). If limited success became apparent after an initial 3g/infusion, infusions were increased to 27g/infusion. Treatment response was primarily monitored with established (26%) and non-established tumor markers (19%). 90% did not monitor HCN levels. Negative effects were restricted to a few dizzy spells and nausea. Only 58% were willing to participate in clinical trials or contribute data for analysis (34%). Amygdalin infusions are commonly administered by healers and physicians with few side effects. The absence of standardized treatment calls for guidelines. Since intravenous application bypasses metabolization, re-evaluation of its mode of action is required.

Background Radical cystectomy (RC) is marked by a tremendous potential for short and long-term complications. By introduction of Enhanced Recovery After Surgery (ERAS) protocols serious endeavors have been made in order to reduce postoperative morbidity in favor of a fast-track recovery. In this study, we investigated the impact of our in-house ERAS protocol on postoperative complications and hospital stay. Methods We identified 106 patients who received standard care of treatment post-surgery (non-ERAS group). After implementation of our ERAS protocol, we prospectively recorded data from 53 patients (ERAS group) up to 90 days post-surgery. Non-ERAS patients were matched with ERAS patients with respect to preoperative clinical characteristics. Statistical analysis was conducted by matched-pair analysis and Wilcoxon-Mann-Whitney-Test. Results Altogether 51 patients were matched. Considering patients with a hospital stay of ≤ 30 and ≤ 20 days we noticed a significant difference in favor of ERAS protocol (p = 0.043, p = 0.004) with regards to hospital stay. Removal of single-J stents occurred on day 11 (8–17) in the non-ERAS group and on day 8 (8–15) in the ERAS group post-surgery (p < 0.001). No difference could be identified in overall and 90-day complication rate (p = 0.443). Conclusion Adherence to ERAS protocol achieved a significantly shorter hospital stay in patients with a hospital stay of ≤ 30 and ≤ 20 days with no increase in complication rates. Furthermore, early removal of single-J stents did not result in higher rates of postoperative complications and hospital readmission.