Antegrade flexible URSL is a minimal invasive option for treating distal ureteral stones in patient after urinary diversion.

Background and Objective: Adding belzutifan to adjuvant pembrolizumab improved disease-free survival (DFS) in LITESPARK-022, but its durability beyond the 1-year treatment is unknown. Methods: Following a registered plan, we reconstructed individual patient data from published Kaplan-Meier curves of ten phase 3 adjuvant renal cell carcinoma trials. Within each trial, we estimated restricted mean survival time differences (ΔRMST), hazard ratios (HRs) before and after planned treatment ended, and DFS differences. Key Findings and Limitations: In LITESPARK-022 (central review), the 24-month ΔRMST was 1.34 months (95% confidence interval 0.73–1.95), and the belzutifan arm remained ahead after month 12 (ΔRMST increment 0.74 months/yr, 0.32–1.19). The HR was 0.55 (0.43–0.71) before month 12 and 1.16 (0.87–1.54) afterwards (post/pre ratio 2.10); investigator assessment showed similar attenuation. Similar ratios occurred in KEYNOTE-564 at its first interim analysis (2.02), whose benefit persisted, and in SORCE and PROTECT (2.09, 2.59), whose benefit faded. From months 12 to 30 (post hoc), the DFS difference changed by −3.7 percentage points (−8.1 to 0.8) with central review and 0.6 (−4.0 to 5.0) with investigator assessment. Data were reconstructed, and follow-up was short. Conclusions and Clinical Implications: Relative hazard reductions with belzutifan were greater before month 12; durability of the absolute DFS advantage is uncertain and assessment-dependent, so single-HR projections should be avoided. Patient Summary: In a trial after kidney cancer surgery, adding belzutifan to pembrolizumab increased the average time without cancer returning by about 6 weeks over 2 years, but caused more serious side effects. Whether this advantage lasts after treatment ends is not yet clear.

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.

Inguinal herniation of urinary bladder is a rare condition which might associated with significant complication. Exact pre-operative diagnosis is extremely important. We reported a case of huge inguinoscrotal bladder hernia, associated with bilateral hydronephrosis and kidney injuries, managed by laparoscopy technique.