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European Urology[JOURNAL]

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Diagnosis and Staging of Patients with Prostate Cancer: Report from the 2025 Advanced Prostate Cancer Consensus Conference (APCCC) Diagnostics.

Fanti S, Turco F, Tombal B … +59 more , Walz J, Hofman MS, Hadaschik B, Emmett L, Tilki D, Pecoraro G, Salfi G, Attard G, Beltran H, Bjartell A, Briganti A, Burger IA, Castro E, Cerci JJ, Chiti A, Cooperberg M, Fizazi K, Fossati N, Gafita A, Gallina A, Goffin K, Horvath LG, Hugosson J, Iagaru A, James ND, Kasivisvanathan V, Koh DM, Kristiansen G, Kumar R, Lecouvet F, Loeb S, McKay RR, Morris MJ, Murphy DG, Murthy V, Naoun N, Oprea-Lager DE, Ost P, O'Sullivan J, Padhani AR, Palapattu G, Paone G, Petralia G, Roobol MJ, Sartor OA, Sathekge M, Schuster DM, Seibert TM, Spratt DE, Tempany C, Tunariu N, Vargas HA, Vogl UM, Wyatt AW, Zilli T, Lin HM, Omlin A, Gillessen S, Herrmann K

Eur Urol · 2026 Jul · PMID 42399196 · Publisher ↗

BACKGROUND: For over a decade the Advanced Prostate Cancer Consensus Conference (APCCC) covers a variety of topics that greatly impact daily practice. In 2025, a dedicated event was organised to discuss key questions in... BACKGROUND: For over a decade the Advanced Prostate Cancer Consensus Conference (APCCC) covers a variety of topics that greatly impact daily practice. In 2025, a dedicated event was organised to discuss key questions in clinical management of patients with prostate cancer (PC) related to diagnostic tools (APCCC Diagnostics). Here we present the voting results of the APCCC Diagnostics questions. OBJECTIVE; DESIGN, SETTING, AND PARTECIPANTS: APCCC Diagnostics 2025 is a pilot project. The scientific committee for APCCC Diagnostics 2025 developed 88 multiple-choice consensus questions on six different topics. Prior to the conference, the panel members (''panellists'') voted on these questions via a web-based survey. Consensus was defined as ≥75% agreement, with strong consensus defined as ≥90% agreement. OUTCOMES MEASUREMENTS AND STATISTICAL ANALYSIS: Consensus was only reached on 17 of 88 questions (19%), of which six (7%) received a strong consensus. Specifically, consensus was reached for two of 17 questions (14%) in "how to diagnose PC"; seven of 16 (44%) in "how to stage PC"; three of 14 (21%) in "Biochemical Recurrence Scenario"; two of 11 (18%) in "metastatic disease: what to do?"; zero of 18 (0%) in "monitoring metastatic PC"; and three of 12 (25%) in "radioligand therapy and imaging." CONCLUSIONS: The voting results and their discussion may assist physicians in navigating controversial areas of clinical management related to diagnosis, staging, and restaging in the different clinical settings for PC, particularly where high-level evidence is scarce or conflicting. The findings can also help funders and policymakers in prioritising areas for future research.
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Re: Twelve-month Results from the CISTO Study Comparing Radical Cystectomy Versus Bladder-sparing Therapy for Recurrent High-grade Non-muscle-invasive Bladder Cancer: Recurrent High-risk NMIBC: One Bladder, Choose Wisely.

Contieri R, van der Heijden AG, Mertens LS

Eur Urol · 2026 Jul · PMID 42392908 · Publisher ↗

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Re: Dries Develtere, Riccardo Bertolo. Cumulative Genitourinary Toxicity After Prostate Radiotherapy: High-Level Long-Term Randomized Evidence. J Clin Oncol. Online ahead of print. http://dx.doi.org/10.1200/JCO-26-00436.

Persson AE, Adrian G

Eur Urol · 2026 Jul · PMID 42392907 · Publisher ↗

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In Memory of Paul Mitrofanoff (1934-2025).

François-Xavier M, Bernard B, Agnès L

Eur Urol · 2026 Jul · PMID 42391644 · Publisher ↗

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Re: McKay RR, Pal S, Xie W, et al. Advanced Urologic Cancer Consensus Conference (AUC3) 2025: Expert Consensus on the Management of Renal Cell and Urinary Tract Cancers. CA Cancer J Clin 2026;76:e70052.

Lorenzo GD, Maio MD

Eur Urol · 2026 Jul · PMID 42386399 · Publisher ↗

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Re: Ultra-hypofractionated Stereotactic Ablative Body Radiotherapy for Primary Renal Cell Carcinoma: 5-year Outcomes from a Pooled Analysis of the FASTRACK Trials.

Liu T, Zhu C, Yan Z

Eur Urol · 2026 Jun · PMID 42379927 · Publisher ↗

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Re: Alexander D. Sherry, Van To, Criselle D'souza, et al. Metastasis-directed Therapy With or Without Pembrolizumab for Oligometastatic Clear Cell Renal Cell Carcinoma: Pooled Analysis of Two Prospective Single-arm Phase 2 Trials. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2026.03.024.

Cigliola A, Necchi A, Capitanio U

Eur Urol · 2026 Jun · PMID 42379926 · Publisher ↗

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Re: Hormone Therapy Use and Duration with Postoperative Radiotherapy for Recurrent Prostate Cancer: an Individual Patient Data Meta-analysis.

Viti A, Scuderi S, Cucchiara V … +3 more , Gandaglia G, Briganti A, Montorsi F

Eur Urol · 2026 Jun · PMID 42373361 · Publisher ↗

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Re: Nguyen DD, Tadayon Najafabadi B, Lin L, et al. Effect of Prostate Cancer Screening with Prostate-specific Antigen Testing on Long-term Prostate Cancer-specific Mortality: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2026.04.005.

Takahashi T

Eur Urol · 2026 Jun · PMID 42373360 · Publisher ↗

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Histological Subtypes and Divergent Differentiation of Urothelial Carcinoma: Histology, Genomics, and Management Implications.

Aydogdu C, Bukavina L, Cheng L … +15 more , Al-Ahmadie HA, Alhalabi O, Brown JR, Lopez-Beltran A, Grivas P, Hwang C, Grass GD, Kamat AM, Chatzkel J, Mian O, Necchi A, Ross J, Apolo AB, Spiess PE, Li R

Eur Urol · 2026 Jun · PMID 42362411 · Publisher ↗

BACKGROUND AND OBJECTIVE: Histological subtypes and divergent differentiation are common in bladder cancer. Each subtype has distinct biology and clinical features. We aim to summarize pathology, molecular features, and... BACKGROUND AND OBJECTIVE: Histological subtypes and divergent differentiation are common in bladder cancer. Each subtype has distinct biology and clinical features. We aim to summarize pathology, molecular features, and outcomes of the most common bladder cancer subtypes to guide management. METHODS: We performed a narrative review of cohort studies, clinical trials, and population-based analyses assessing morphology, immunophenotype, genomic alterations, and outcomes following various localized and systemic therapies in patients with bladder cancer subtypes. KEY FINDINGS AND LIMITATIONS: Histological subtypes are often understaged on transurethral resection of bladder tumor and commonly demonstrate lymph node metastasis, supporting early radical cystectomy (RC) even for certain clinically non-muscle-invasive bladder cancers. Small cell urothelial carcinoma (UC) consistently benefits from platinum/etoposide-based chemotherapy regimens, whereas predominant squamous, plasmacytoid, sarcomatoid, and micropapillary tumors demonstrate variable response rates to systemic therapies used in conventional UC. Trimodality therapy may approximate RC in locoregional control for small cell UC and appears inferior in cases with predominant squamous and adenocarcinoma. Genomic profiling highlights actionable alterations, albeit with unclear clinical implications. Immune checkpoint blockade and antibody-drug conjugates have been used sparingly against subtype bladder cancers and have anecdotally demonstrated activity across several subtypes. CONCLUSIONS AND CLINICAL IMPLICATIONS: Histological subtypes and divergent differentiation of UC represent high-risk yet biologically distinct disease phenotypes that may not conform to the current "one-size-fits-all" treatment paradigm. More in-depth clinical and translational analyses with robust, adequately powered cohorts are required to further understand the clinical behavior of each unique bladder cancer subtype and to customize the optimal therapeutic strategies.
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Re: Fecal Microbiota Transplantation plus Immunotherapy in Metastatic Renal Cell Carcinoma: The Phase 1 PERFORM Trial.

Yao Y, Liu Y, Li Y … +4 more , Lu B, Lyu D, Cui X, Pan X

Eur Urol · 2026 Jun · PMID 42350167 · Publisher ↗

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Reply to Vallée M, Stangl FP, Wagenlehner F et al's Letter to the Editor re: Tikkinen KAO, Najafabadi BT, Hajebrahimi S, et al. A Multicenter Randomized Controlled Trial of Antimicrobial Prophylaxis to Prevent Urinary Tract Infections After Shockwave Lithotripsy for Urolithiasis: The APPEAL Trial. Eur Urol 2025;88(6):543-51.

Tikkinen KAO, Tondroanamag F, Parpia S … +3 more , Guyatt GH, Violette PD, APPEAL Trial Investigators

Eur Urol · 2026 Jun · PMID 42350166 · Publisher ↗

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Re: Desai AC, Maalouf NM, Harper JD, et al. Prevention of Urinary Stones with Hydration: A Randomised Clinical Trial of an Adherence Intervention.

Scilipoti P, Panthier F, Villa L … +2 more , Traxer O, Ventimiglia E

Eur Urol · 2026 Jun · PMID 42350165 · Publisher ↗

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Re: Xenotransplantation of a Porcine Kidney for End-stage Kidney Disease.

Yamamoto S, Yamanaka S, Yokoo T … +2 more , Kimura T, Egawa S

Eur Urol · 2026 Jun · PMID 42350164 · Publisher ↗

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Beyond the Primary Tumour: Rethinking Biomarker Strategies in Recurrent Renal Cell Carcinoma.

Tippu Z, Au L, Turajlić S

Eur Urol · 2026 Jun · PMID 42350163 · Publisher ↗

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Re: Circulating Kidney Injury Molecule-1 (KIM-1) and Association with Outcome to Adjuvant Immunotherapy in Renal Cell Carcinoma.

Flippot R, Roca L, Calabrese M … +2 more , Escudier B, Albiges L

Eur Urol · 2026 Jun · PMID 42342548 · Publisher ↗

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Reply to Andrew R. A. Godtman et al.'s Letter to the Editor re: The PROSA Trial: Some Prosaic Comments. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2026.03.036.

Messina E, Borrelli A, Panebianco V

Eur Urol · 2026 Jun · PMID 42342547 · Publisher ↗

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Re: Multicenter, Randomized, Phase II Trial of Olaparib Plus Radium-223 Versus Radium-223 in Men with Castration-Resistant Prostate Cancer with Bone Metastases (COMRADE).

Ma H, Zhang L

Eur Urol · 2026 Jun · PMID 42336727 · Publisher ↗

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Re: Impact of Circulating Tumor DNA and Copy-number Alterations on Clinical Outcome in Relapsed/Refractory Germ Cell Tumors Treated with Salvage High-dose Chemotherapy: BLOG TITLE: Value of ctDNA in Advanced Germ Cell Tumors.

Holland L, Eggener S

Eur Urol · 2026 Jun · PMID 42323244 · Publisher ↗

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Re: Aldo Brassetti, Gabriele Tuderti, Umberto Anceschi, et al. Sutureless Purely Off-clamp Robotic Partial Nephrectomy: Evidence from a Randomized Controlled Noninferiority Trial. Eur Urol. In press. http://dx.doi.org/10.1016/j.eururo.2026.04.019.

Giannarini G, Amodeo A, Porreca A … +1 more , Crestani A

Eur Urol · 2026 Jun · PMID 42323243 · Publisher ↗

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