Randomized clinical trials (RCTs) are the building blocks of an evidence-based approach to medicine and surgery. These trials are used as trusted sources of evidence when designing clinical practice guidelines. It is therefore expected that their results are trustworthy and that their conclusions can be verified. Randomized clinical trial data sharing (ie, sharing statistical codes, study protocols, and individual participant data) holds promise for enhancing transparency and maximizing the value of research.¹ Data sharing is supported by patients who also want to share their data in a responsible and secure manner.² In 2018, the International Committee of Medical Journal Editors (ICMJE) required that manuscripts submitted to ICMJE journals as of July 1, 2018, must contain a data sharing statement if they are reporting the results of an RCT. If a trial began enrolling participants on or after January 1, 2019, the article must also include a data sharing plan in the trial’s registration.³ The ICMJE considers that “it is an ethical obligation to responsibly share data generated by interventional clinical trials because participants have put themselves at risk.”⁴

Deregulation of the PI3K-Akt-mTOR pathway plays a critical role in the development and progression of many cancers. In prostate cancer, evidence suggests that it is mainly driven by PTEN loss of function. For many years, the development of selective Akt inhibitors has been challenging. In recent phase II and III clinical trials, Ipatasertib and Capivasertib associated with androgen deprivation therapies showed promising outcomes in patients with metastatic castration-resistant prostate cancer and PTEN-loss. Ongoing trials are currently assessing several Akt inhibitors in prostate cancer with different combinations, at different stages of the disease.

Radical cystectomy is the gold standard technique for muscle-invasive bladder cancer and resistant non muscle-invasive bladder cancer. This surgery presents a high rate of complications despite the advance of robotic surgery. The aim of this study is to compare the complications according to the presence of ureteral stents or not. Two hundred consecutive patients who underwent robotic radical cystectomy for bladder cancer at our center between 2012 and 2022 were included in this retrospective study. Cessation of upper tract drainage was introduced prospectively in February 2021, without any selection bias. Patients were divided into 2 groups: ureteral stents (US) or no ureteral stents (NUS). All complications were analyzed during 3 postoperative months. Urinary diversion-specific complications were analyzed during 12 postoperative months. Over the 200 included patients, 58 did not have any ureteral stents (29%). The overall postoperative complication rate was nearly identical between the NUS group at 48% and the US group at 53% (P=0.56). The rate of severe complications≥Clavien3a seemed lower in the NUS group at 15% versus 24% in the US group (Chi²: 1.73, P=0.19), as were the rates of infectious complications: NUS 29% versus US 38% (Chi²: 1.20, P=0.27). These results were the same in subgroup analyses. Complications on the urinary diversion at 12 months were 12% for the NUS group and 20% for the US group (Chi²: 1.67, P=0.196). Going against all dogmas, the absence of upper urinary tract drainage for cystectomy does not increase the risk of early and late complications, and even seems to limit infectious and late complications such as stenosis.