Clear cell renal cell carcinoma (ccRCC) is the most common histological subtype of renal cancer. Cuproptosis is suggested to be a novel therapy target for cancer treatment. However, the function of cuproptosis and its key regulator FDX1 in ccRCC remains unclear. In this study, we adequately explored the prognostic factors, clinicopathological characteristics, and function of FDX1 in ccRCC. We found that the expression of FDX1 was significantly downregulated in ccRCC samples. Patients with a higher FDX1 expression had a significantly better prognosis, including overall survival (OS) (Hazard ratio (HR): 2.54, 95% confidence interval (CI): 1.82–3.53, p < 0.001), disease-specific survival (DSS) (HR: 3.04, 95% CI: 2.04–4.54, p < 0.001), and progression-free survival (PFS) (HR: 2.54, 95% CI: 1.82–3.53, p < 0.001). FDX1 was a clinical predictor to stratify patients into the high or low risk of poor survival, independent of conventional clinical features, with the area under the ROC curve (AUC) of 0.658, 0.677, and 0.656 for predicting the 5-year OS, DSS, and PFS. The nomogram model based on FDX1 had greater predictive power than other individual prognostic parameters. FDX1 mainly participated in the oxidative-related process and mitochondrial respiration-related processes but was not associated with immune infiltration levels. In conclusion, the cuproptosis key regulator FDX1 could serve as a potential novel prognostic biomarker for ccRCC patients.

Purpose: To compare the peri-operative outcomes of females undergoing laparoscopic intracorporeal urinary diversions (ICUD) and extracorporeal urinary diversions (ECUD) after laparoscopic radical cystectomies (LRC).Patients and methods: Thirty-eight females who underwent LRCs and urinary diversions from February 2008 to October 2018 were divided into two groups: the ECUD group (19 patients) and the ICUD group (19 patients). We retrospectively analysed the patients in terms of patients’ demographics, peri-operative outcomes, and oncological follow-ups.Results: There were significant differences in the mean operative times between ECUDs and ICUDs (364.6 vs. 297.1 min,p = 0.007), transfusion rates (37% vs. 5%,p = 0.042), time to flatus (5 vs. 3 days,p = 0.020), time to ambulation (2 vs. 1 days,p = 0.022), and duration of postoperative hospital stays (22 vs. 13 days,p = 0.002). The mean lymph node yield was 12.9 in the ECUD group and 18.6 in the ICUD group (p = 0.140). Seven out of 19 patients (37%) in the ECUD group and 6 out of 19 patients (32%) in the ICUD group had positive lymph nodes (p > 0.9). Two out of 19 ECUD patients (11%) and 4 of 19 ICUD patients (21%) had positive surgical margins (p = 0.660). Although there were no differences in major complications at 30 days and in all complications at 90 days, the Clavien grade II complications were significantly different at 30 days (ECUD 8, ICUD 2;p = 0.026). The mean follow-up times were 48.7 months (ECUD group) and 26.4 months (ICUD group). There were no statistically significant differences in estimated glomerular filtration rates postoperatively (p = 0.516). Seven patients had disease metastases (ECUD 2 out of 19, ICUD 5 out of 19;p = 0.405) and 5 died (ECUD 3 out of 19, ICUD 2 out of 19;p > 0.9).Conclusions: ICUDs benefit females by having smaller incisions, faster recoveries, and decreased complication rates.

Background The traditional surgical treatment for upper urinary tract urothelial carcinoma (UTUC) is time-consuming owing to changing the surgical position and larger surgical trauma because of open surgery in handling the distal ureter. Therefore, we created a new surgical technique of combination retroperitoneal with transperitoneal (CRT) laparoscopic nephroureterectomy (LNU) in a single position and to reported our early outcomes. Methods From January 2017 to October 2018, a total of 45 patients underwent LNU by a single surgeon at our department, of whom 25 patients underwent standard technique and 20 patients underwent CRT technique. Relevant clinical data were collected including each patient’s characteristics, surgical outcomes, and follow-up results. A comparative analysis between standard LNU cases and CRT LNU cases was performed. Results LNU was performed successfully on all 45 patients. There was no significant difference in patients’ characteristics. Compared to standard group, patients in CRT group had shorter operative time, less estimated blood loss (EBL), lower visual analogue scale (VAS) pain score and less scar ( P <0.001). The mean time of surgical drain stay decreased from 4.2d to 2.8d and median hospital stay after surgery decreased from 5d to 3d ( P <0.001). The complication rates did not show statistic difference between the two groups within the first 30 days postoperatively ( P =0.258). For the long-term complications, the incidence of abdomen bulge or incisional hernia in CRT group was less than that in the standard group ( P <0.001). Conclusion The CRT technique, which combines both the advantages of retroperitoneal and transperitoneal approaches, is a more minimally invasive, simplified and effective way to perform the LNU.