Background: Among the novel robotic platforms, the Hugo RAS system is the second most studied platform, next to the da Vinci system, and we aim to address our experiences in radical prostatectomy (RP) with the Hugo RAS system.Methods: We recorded our first 12 cases of prostate cancer undergoing RP with the Hugo RAS system. The median console time was 145 min and median hospital stay was 7 days. Hedge’ g was applied to search for the cut‐off case in four parameters in surgeries.Results: Pre‐console preparation was significantly improved after the first seven cases, and the console time was remarkably shortened after the first two cases. The intraoperative pause for trouble shooting was remarkably shortened after the first three cases.Conclusions: We found that RP with the Hugo RAS system was feasible, and the learning curve was short as surgeons may benefit from the previous experience with the da Vinci system.

Adjacent segment disease (ASD) is troublesome condition that has proved to be highly related to spinal malalignment after spinal surgery. Hence, we aimed to evaluate the morphological changes after anterior lumbar interbody fusion (ALIF) and oblique LIF (OLIF) to establish the differences between the two surgical methods in terms of possible ASD avoidance. Fifty patients, half of whom received ALIF while the other half received OLIF, were analyzed with image studies and functional outcomes during the pre-operative and post-operative periods, and 2 years after surgery. Image measurements obtained included spinal-pelvic parameters, index lordosis (IL), segmental lordosis (SL), anterior disc height (ADH), posterior disc height (PDH) and adjacent segment disc angle (ASDA). The ADH and PDH in the adjacent segment decreased in the two groups while OLIF showed greater decrease without radiological ASD noted at 2-year follow-up. Both groups showed an increase in IL after surgery while ALIF showed greater improvement. No statistical difference was identified in functional outcomes between LIFs. We suggest that both ALIF and OLIF can restore adequate lordosis and prevent ASD after surgery. However, it should be noted that patient selection remains crucial when making any decision involving which of the two methods to use.

Immune checkpoint inhibitors (ICIs) targeting programmed cell death protein 1 (PD-1) and programmed death-ligand 1 (PD-L1) have changed the treatment of advanced bladder cancer, but only a minority of patients benefit. We asked whether expression of PD-1 pathway genes carries prognostic information in bladder cancer. Sixty-eight genes annotated to the PD-1 signaling, CD28 co-stimulation, and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitory signaling pathways in Reactome were examined in The Cancer Genome Atlas bladder urothelial carcinoma cohort (TCGA-BLCA). Genes differentially expressed between tumor and normal tissue were entered into a least absolute shrinkage and selection operator (LASSO) Cox model, yielding a seven-gene risk score (FYN, GRAP2, TRIB3, MAP3K8, AKT3, CD274, and CD80). In TCGA-BLCA (n = 404), the risk score was associated with overall survival independently of age, sex, and stage (hazard ratio [HR] per standard deviation 1.24, 95% confidence interval [CI] 1.11–1.39) and modestly improved discrimination over clinical variables (concordance index [C-index] 0.630 to 0.664). With coefficients and standardization fixed in advance, the score was not associated with cancer-specific survival in GSE13507 (n = 165; HR per standard deviation 1.21, 95% CI 0.83–1.77) or with outcome in four further independent cohorts, including an atezolizumab-treated cohort; in a second, smaller ICI-treated cohort it was associated with shorter survival. Gene selection was unstable under bootstrap resampling, and the signature’s associations with transcriptome-inferred immune indices were limited. This PD-1 pathway-derived signature should therefore be regarded as exploratory; its prognostic value outside TCGA-BLCA is not supported by the available evidence.