Renal cell carcinoma (RCC) is one of the most common tumors of the urinary system, which is a serious threat to human health. The diagnosis and treatment of RCC are still urgent problems. As a unique biomarker of renal cell carcinoma, especially clear cell renal cell carcinoma, CD70 has a wide range of applications from diagnosis to treatment. This paper will focus on the clinical translation and application of CD70 in the diagnosis and treatment for renal cell cancer, and pay close attention to new technologies and therapies related to clinical work, as well as speculate the possible application direction in the near future.

With the rapid development of minimally invasive technology in the medical field, especially in Urology, nephron sparing surgery has become the "gold standard" for the treatment of renal tumors, and its indications are gradually expanding. Compared with radical nephrectomy, nephron sparing surgery has significant advantages in renal parenchyma and postoperative renal function preservation, but it also has complications such as bleeding, urinary fistula, renal insufficiency, and positive margin. At present, there are many advances in the preoperative localization evaluation, the improvement of surgical methods and techniques, and the treatment of postoperative complications of nephron sparing surgery. In this paper, the application of nephron sparing surgery for renal tumors is reviewed based on recent research reports.

Renal pelvis cancer is the most common malignant tumor originating from the upper urinary tract epithelium. Since its treatment approach differs significantly from benign and malignant tumors of renal cell origin, accurate imaging diagnosis before treatment is extremely important. This review provides a comprehensive overview of the imaging methods for renal pelvis cancer, their advantages and limitations, CT/MRI imaging characteristics, and differential diagnosis from renal cell carcinoma and Renal infectious diseases. It also briefly introduces applications aimed at reducing radiation dose through split contrast agent injection, dual-energy CT utilization, and artificial intelligence applications designed to improve image quality and predict tumor response to treatment. The aim is to provide strategies for selecting appropriate imaging methods in clinical practice, improve the diagnostic accuracy of imaging for this disease, and learn about future trends in imaging advancements of this disease.

Locally advanced renal cell carcinoma (la-RCC) encompasses patients with TNM staging (AJCC 2017 edition) of T_1-2N₁M₀, T₃N_0-1M₀, and T₄ cases with localized disease and without distant metastasis. These patients face a high risk of postoperative recurrence and metastasis. The current primary treatment approach involves surgical resection combined with perioperative therapy. However, the optimal perioperative treatment strategy remains undefined, and refining these strategies is critical to improving patient outcomes. In recent years, immune checkpoint inhibitors (ICIs) have demonstrated significant advancements in the neoadjuvant and adjuvant treatment of renal cell carcinoma. This article reviews recent progress in perioperative immunotherapy for la-RCC, including findings from studies on preoperative neoadjuvant immunotherapy and postoperative adjuvant immunotherapy, to provide insights for clinical practitioners.

To compare the clinical efficacy and safety of Shurui single-port robotic system (Shanghai Shurui Medical Technology Co., Ltd., China) versus Mindray laparoscopic system (China) in nephron-sparing partial nephrectomy.

From February to August 2022, 20 patients undergoing nephron-sparing partial nephrectomy at the First Affiliated Hospital of Zhejiang University School of Medicine, were randomly assigned to the Shurui single-port robotic group (n=10) or the Mindray laparoscopic control group (n=10). Demographic data (age, BMI, R.E.N.A.L. score, surgical approach, gender, hypertension, diabetes, cardiovascular and cerebrovascular diseases) and perioperative outcomes (operative time, blood loss, warm ischemia time, hospital stay, postoperative pathology, preoperative and postoperative creatinine levels, and visual analogue scale pain scores) were collected. Statistical analysis was performed using Chi-square test, Fisher’s exact test, t-test, and Mann-Whitney U test.

There were no statistically significant differences between the two groups of patients in terms of age, BMI, gender distribution, R.E.N.A.L. score, preoperative creatinine level, hypertension, diabetes, cardiovascular and cerebrovascular diseases (P>0.05). The robotic group had longer operative time [198(83-264)] min vs 143(83-245) min, P=0.044] but lower blood loss [(15(2-50) mL vs 50 (10-200) mL, P=0.005]. Postoperative creatinine levels differed significantly only on postoperative day 1 [(74.0±19.6) μmol/L vs (94.1±23.5) μmol/L, P=0.030]. No statistically significant differences were observed between the two groups in terms of warm ischemia time during surgery, blood creatinine levels before discharge and one month after surgery, VAS scores at different time points after surgery, length of hospital stay, and the incidence of postoperative complications (P>0.05).

Shurui single-port robotic surgery demonstrated superior outcomes in reducing intraoperative blood loss and minimizing short-term renal function impairment compared to Mindray laparoscopy, with comparable safety profiles between the two approaches.

To compare the clinical efficacy of modified Byars staged urethroplasty versus traditional procedure in pediatric patients with severe hypospadias.

A retrospective analysis was conducted on clinical data of 82 pediatric patients with severe hypospadias admitted to the First Affiliated Hospital of Sun Yat-sen University from January 2012 to December 2023. Patients were divided into traditional group (31 cases, underwent traditional Byars procedure) and modified group (51 cases, underwent modified Byars procedure) according to surgical approaches. Based on the traditional procedure, the modified Byars technique added glansplasty in stage I and employed Y-shaped flap combined with glans tunnel technique for urethroplasty in stage II. Perioperative indicators, postoperative complication rates, and follow-up outcomes were compared between the two groups.

There were no significant differences between the two groups in preoperative baseline characteristics, operative time, blood loss, and incidence of postoperative complications including urethrocutaneous fistula, urethral stricture, urethral diverticulum, and penile curvature (P>0.05). The incidence of coronal fistula and glanular dehiscence in the modified group were both 0%, significantly lower than 12.90% in the traditional group (P=0.008). The rate of orthotopic urethral orifice in the modified group was 100%, significantly higher than 83.9% in the traditional group (P=0.003). The Hypospadias Objective Penile Evaluation (HOPE) score for penile appearance satisfaction in the modified group was (8.75±0.15), significantly higher than (7.94±0.30) in the traditional group (P=0.010). The modified group achieved normal urethral orifice position with natural slit-like configuration and near-normal penile appearance.

Compared with traditional Byars staged procedure, the modified technique significantly reduces the risk of coronal fistula and glanular dehiscence, improves the rate of orthotopic urethral orifice and penile appearance satisfaction, representing an effective surgical approach for treating severe hypospadias in pediatric patients.

To explore the safety of circumcision and perioperative management in children with hemophilia A, providing evidence for developing targeted treatment protocols.

A retrospective analysis was conducted on clinical data of 9 children with hemophilia A and phimosis treated in the Department of Urology, the First People's Hospital of Kashgar Region from January 2020 to April 2023.

Among the 9 children, 6 underwent Shang-ring circumcision and 3 received conventional circumcision, all successfully completed. Empirical factor VIII supplementation was administered preoperatively: 500 IU q8h for 3-4 days in moderate hemophilia, and 250 IU q12h for 2 days in mild hemophilia. Preoperative activated partial thromboplastin time (APTT) was controlled below 45 seconds. Postoperative factor VIII supplementation discontinuation criteria included APTT <45 s combined with evaluation of local clinical signs. One child in the conventional group developed mild oozing and local swelling on postoperative day 1, which resolved after 2 days of intensified factor VIII replacement. No surgery-related complications were observed during 12-38 months of follow-up.

Circumcision is safe and feasible for children with hemophilia A and phimosis or redundant prepuce when aggressive perioperative factor VIII supplementation is implemented.

To investigate the diagnostic value of ¹⁸F-prostate-specific membrane antigen (PSMA)-1007 PET/CT for postoperative upgrading in patients with biopsy International Society of Urological Pathology (ISUP) grade 1-2 prostate cancer.

Clinical and pathologic information were retrospectively collected from October 2020 to August 2023 for 73 patients with biopsy ISUP grade 1-2 prostate cancer who underwent radical prostatectomy (RP) at the First Affiliated Hospital of Xi'an Jiaotong University. Differences in ¹⁸F-PSMA-1007 PET/CT and clinical parameters were compared between the ISUP upgrading and ISUP non-upgrading groups. Univariate and multivariate logistic regression analyses were used to select the predictors of ¹⁸F-PSMA-1007 PET/CT and clinical parameters for predicting postoperative pathologic upgrading. A diagnostic prediction nomogram was constructed. Receiver operating characteristic (ROC) curve and decision curve were plotted to evaluate the predictive performance and clinical benefit of the model.

Among 73 included prostate cancer patients, ISUP upgrading occurred in 44(60.3%) cases. Serum prostate-specific antigen (PSA) level, the maximum standardized uptake values (SUV_max) and mean standardized uptake values (SUV_mean) were significantly higher in the ISUP upgrading group than those in the ISUP non-upgrading group (all P<0.05). Age, metabolic tumor volume (MTV), and total lesion uptake (TLU) had no statistically significant differences between the two groups (all P>0.05). The univariate logistic regression analysis showed that PSA level, biopsy ISUP grade group, and SUV_mean could influence the postoperative upgrading. And the multivariate logistic regression analysis indicated that biopsy ISUP grade group and SUV_mean were independent predictors of ISUP upgrading in postoperative prostate cancer. The combined model for predicting postoperative ISUP upgrading was higher than that of biopsy ISUP grading group and SUV_mean (0.851 vs 0.623, 0.728, P=0.008, P=0.210), but there was no significantly statistical difference in the latter. Decision curve analysis showed that when the threshold probability was greater than 47%, the combined model was beneficial in clinical application.

¹⁸F-PSMA-1007 PET/CT is promising for diagnosing postoperative pathologic upgrading in patients with biopsy ISUP grade 1-2 prostate cancer.

To explore the clinical efficacy of complete retained bladder neck technique in single-site laparoendoscopic radical prostatectomy via extraperitoneal approach.

Patients who underwent extraperitoneal single-site laparoendoscopic radical prostatectomy in our hospital from June 2021 to October 2022 were enrolled in the study, total 74 patients were included. The patients were classified into the control group (n=40) who did not retain the bladder neck and the observation group (n=34) that retained it completely. The perioperative indexes and postoperative urodynamics, such as bladder compliance (BC), post-void residual urine (PVR), maximum detrusor pressure (Pdet_max) and maximum urinary flow rate (Q_max), were compared between the two groups. The patients were followed up for 3 months after operation. The urinary continence of the two groups was compared at 1 month and 3 months after operation. The international index of erectile function (IIEF) score was used to evaluate the erectile function of the patients 3 months after operation. The incidence of postoperative complications was compared between the two groups.

There was no significant difference in intraoperative blood loss and operation time between the two groups (P>0.05). The indwelling time of urinary catheter and pelvic drainage tube, and hospitalization time in the observation group were shorter than those in the control group (P<0.05). The BC, PVR, Pdet_max, Q_max, IIEF of patients in the observation group were better than those in the control group. The urinary continence of the observation group was better than that in the control group at 1 week, 1 month and 3 months after operation (P<0.05). The incidence of postoperative complications in the observation group was (14.71%) lower than that in the control group (35.00%) (P<0.05). Meanwhile, no significant difference of the positive rate of postoperative margin was found between the observation group (17.65%) and the control group (17.50%).

Complete bladder neck method can effectively improve the bladder compliance and the urinary control, and reduce negative impacts on erectile function as well as postoperative complications.

To analyse the predictive value of dynamic changes of prostate specific antigen (PSA), fPSA and f/tPSA on the prognosis of prostate cancer (PCa) patients after androgen deprivation therapy (ADT).

A total of 519 patients diagnosed with PCa by prostate biopsy were selected from the database of Henan Provincial People's Hospital. All patients received ADT treatment and had not received any other form of prostate cancer-related treatment previously, with regular follow-up conducted. Finally, 78 patients progressed to castration-resistant prostate cancer (CRPC). The relationship between PSA nadir (PSAn), time from ADT to PSA nadir (TTPN), bone metastasis score, fPSA nadir (fPSAn) and CRPC was calculated by COX analysis, and the optimal cut-off value was calculated by receiver operating characteristic curve, and finally its feasibility was verified by K-M analysis.

Bone metastasis score, TTPN, PSAn and whether PSA decreased to undetectable levels, fPSAn, TTFPN, f/tPSA before treatment and f/tPSA peak time were independent risk factors for PCa patients to progress to CRPC. The smaller the PSAn, the longer the TTPN, TTFPN, the peak time of f/tPSA, the longer the patient's progression to CRPC, and the optimal cut-off value obtained by ROC curve was PSAn: 0.214 ng/mL, TTPN: 14.5 months, fPSAn: 0.04 ng/mL, TTFPN: 10.5 months, and f/tPSA peak time: 19 months.

Dynamic changes in prostate-specific antigen can effectively predict the risk of progression to castration-resistant prostate cancer in prostate cancer patients after androgen deprivation therapy, providing evidence for clinical prognosis assessment.

To investigate the predictive value of urinary Tamm-Horsfall protein (THP) and 24-hour urine osmotic pressure in patients with calcium oxalate stones.

A retrospective analysis was conducted on the clinical data of 120 patients hospitalized for upper urinary tract stones in Songjiang Hospital Affiliated to Shanghai Jiaotong University school of Medicine from January 2020 to December 2021. The patients were divided into a recurrence group (53 cases) and a non-recurrence group (67 cases) based on whether stone recurrence occurred during follow-up. The levels of urinary THP and 24-hour urine osmotic pressure were compared between the two groups, and ROC curves were used to evaluate the predictive value of urinary THP and 24-hour urine osmotic pressure for stone recurrence.

The urinary THP and 24-hour urine osmotic pressure were significantly higher in the recurrence group than in the non-recurrence group (P<0.05). The ROC curve showed that the optimal cut-off points for predicting stone recurrence were ≥27.01 mg/L for urinary THP and ≥577.69 mOsm/(kg·H₂O) for 24-hour urine osmotic pressure. The accuracy, sensitivity, and negative predictive value of 24-hour urine osmotic pressure and urinary THP alone for predicting kidney stone recurrence were significantly lower than those of their combined detection (P<0.05).

Urinary THP and 24-hour urine osmotic pressure are higher in patients with recurrent calcium oxalate stones. Combined detection of the two methods has good predictive value for stone recurrence.

To investigate the effect of the upper infundibulopelvic angle (UIPA) on the treatment of mature ampullary upper ureter calculi by ureteroscopic holmium laser lithotripsy.

The clinical data of 58 patients with upper ureteral calculi treated with hard ureteroscope in First Hospital of Shanxi Medical University from January 2019 to January 2021 were retrospectively analyzed. There were 17 males and 41 females, aged 34-71 years, with an average age of (42±11) years. All the included patients had unilateral upper ureteral calculi with a diameter of 0.8 cm-2.1 cm, an average of (1.3±0.8) cm. Preoperative non-enhanced CT and intravenous pyelography were performed to confirm the type of renal pelvis and the UIPA. Among them, 39 cases had UIPA <20°, 15 cases had UIPA between 21° and 30°, and 4 cases had UIPA >30°.

All the 58 patients were mature renal pelvis, and 5 patients was converted to flexible ureteroscopy. All five patients were males. Four had a UIPA of over 30°, and one had a UIPA between 21° and 30°. The success rate of one-time stone fragmentation using rigid ureteroscopy was 91.4% (53/58). The operation time of the 53 patients was (48±21) min. The postoperative hospitalization was (1.4±1.0) days. Double J tubes were removed 1-3 months after the operation, followed up for 1-3 months. During the follow-up, plain films of the urinary system were performed to confirm the stone clearance, and the stone clearance rate was 88.7%(47/53).

UIPA can preliminarily determine whether a rigid ureteroscope can enter the upper calyx and complete the lithotripsy. Combined with preoperative imaging analysis, UIPA can be used for upper ureteral stones to reduce the use of flexible ureteroscopes and the economic burden of patients.

To explore the safety and effectiveness of non-fornix puncture during percutaneous nephrolithotomy (PCNL) guided by ultrasound.

A retrospective study was conducted on 110 patients with nephrolithiasis treated with PCNL in Yangjiang People's Hospital Affiliated to Guangdong Medical University from September 2021 to March 2023. There were 82 cases in the fornix group and 28 cases in the non-fornix group. The patient's preoperative general information, stone clearance rate, hemoglobin, white blood cells, intraoperative bleeding and complication rate were collected.

All 110 surgeries were successfully performed, with no conversion to open surgery. There was no significant difference in hemoglobin, white blood cells before and after surgery between the fornix group and the non-fornix group (P>0.05). There was no significant difference in whether massive hemorrhage occurred during the operation, operation time, postoperative hemoglobin decline, nephrostomy tube removal time, stone clearance rate and complication rate between the two groups (P>0.05).

Non-fornix puncture during percutaneous nephrolithotomy under ultrasound guidance is a safe and feasible alternative and is worthy of clinical promotion.

To investigate the predictive value of SSIGN grading combined with gamma-glutamyl transpeptidase (GGT) in postoperative recurrence of high-risk non-metastatic renal carcinoma.

Data of 80 patients with high-risk non-metastatic renal cancer admitted to the Central Hospital Affiliated to Chongqing University of Technology from January 2020 to January 2022 were retrospectively analyzed. All patients underwent SSIGN grading before surgery, serum GGT level was detected, and postoperative regular outpatient visit and telephone follow-up were conducted to analyze postoperative tumor recurrence. Kaplan-Meier survival analysis was conducted for relapse-free survival of high-risk non-metastatic renal cancer patients with different SSIGN grades and GGT levels. Univariate and multivariate Cox regression analysis was conducted for factors influencing postoperative recurrence of high-risk non-metastatic renal cancer patients. Receiver operating characteristic (ROC) curve analysis of the value of SSIGN grading combined with GGT in predicting postoperative recurrence in high-risk non-metastatic renal cancer patients.

The median follow-up was 19(12-36) months. During the follow-up, 18 cases relapsed, with a recurrence rate of 22.50%. pT₂, tumor diameter ≥5 cm, Fuhrman nuclear grade 3-4, lymphovascular infiltration, tumor necrosis ratio and serum GGT level in the recurrence group were higher than those in the non-recurrence group (P<0.05), and the difference in SSIGN grade between the two groups was statistically significant (P<0.05). The relapse-free survival rate of different SSIGN grades was statistically significant (P<0.05), and the relapse-free survival rate of high GGT group was lower than that of low GGT group (P<0.05). Multivariate Cox regression results showed that high risk of pT₂ and SSIGN grading and high GGT were risk factors for postoperative recurrence in high-risk non-metastatic renal cancer patients (P<0.05). The area under the curve predicted by SSIGN grade and GGT for postoperative recurrence of high-risk non-metastatic renal cancer was 0.847 and 0.705, respectively, and the area under the curve predicted by combined SSIGN grade with GGT was 0.955, which was higher than that predicted by alone (P<0.05).

High SSIGN risk ratio and serum GGT level before operation are associated with low relapse-free survival rate in high-risk non-metastatic renal cancer patients with postoperative recurrence. Combined SSIGN grade and GGT can help to predict the risk of postoperative recurrence of high-risk non-metastatic renal cancer.

To analyze the expression and clinical significance of mast cell immunoglobulin like receptor 1 (MILR1) in clear cell renal cell carcinoma (ccRCC) using bioinformatics combined with clinical samples.

Multiple public databases were applied to analyze the expression of MILR1 and its role on patient prognosis and the immune microenvironment of ccRCC. Constructing a nomogram based on MILR1. The MILR1 protein expression was detected and its clinical significance using human ccRCC tissue microarray.

The mRNA and protein expression of MILR1 were elevated in ccRCC, which indicates poor prognosis and serves as a risk factor. A nomogram based on MILR1 can accurately predict the prognosis of patients. High expression of MILR1 is associated with the inhibitory immune microenvironment of ccRCC.

High expression of MILR1 in ccRCC indicates poor prognosis in patients, which is associated with inhibitory immune microenvironment.

To investigate the correlation between triglyceride glucose (TyG) index and the prognosis of postoperative renal cell carcinoma patients.

A retrospective analysis was conducted on the clinical data of 108 patients with renal cell carcinoma who underwent surgical treatment at the Second People's Hospital of Huai'an City from January 2019 to January 2022. Kaplan-Meier method and Cox proportional hazards regression model were used to analyze the prognosis of the patients. Calculate the TyG index, obtain patient prognosis information through follow-up, and use Pearson correlation analysis to examine the relationship between TyG index and overall survival(OS) of patients.

The differences in fasting blood glucose (FBG), triglycerides (TG), insulin levels (INS), creatinine (Cr), and other parameters among patients with different TyG index levels were statistically significant (P<0.05). After a follow-up of 49(35, 60) months postoperatively, 28 out of 108 patients with renal cell carcinoma died (25.93%), survived (74.07%), and had a median OS of 48 (34, 60) months. The low TyG group died in 6 cases (11.76%), survived in 45 cases (88.24%), had a median OS of 45 (33, 58) months, the medium TyG group died in 10 cases (25.64%), survived in 29 cases (74.36%), had a median OS of 40 (30, 56) months, the high TyG group died in 12 cases (66.67%), survived in 6 cases (33.33%), and had a median OS of 37 (28, 55) months. The difference in group OS was statistically significant (P<0.05). Cox regression analysis showed that high FBG, TG, INS, HOMA-IR, and Cr were all risk factors for postoperative prognosis in patients with renal cell carcinoma (P<0.05). The Pearson correlation analysis results showed that the TyG index was positively correlated with FBG, TG, INS, HOMA-IR, Cr and other indicators (r=0.825, 0.932, 0.841, 0.585, 0.855), and the correlation was significant (P<0.05).

The TyG index is closely related to the postoperative prognosis of patients with renal cell carcinoma, and patients with high TyG index have worse postoperative prognosis.

To establish an animal model of urogenic sepsis and simulating acute kidney injury (AKI) caused by acute ureteral obstruction and infection. To explore the mechanism of action of glycyrrhizic acid (GA) on acute kidney injury related to urinary sepsis.

Twenty male healthy New Zealand rabbits were divided into four groups with five rabbits in each group: control group, sham operation group, sepsis group, sepsis + glycyrrhizin group. Control group did not receive any treatment, only with free diet. In the sham operation group, the left upper middle segment of the ureter was exposed, and no other treatment was done. In the sepsis group, E. coli (ATCC 25922) at a concentration of 10⁸ cfu/mLwas injected into the left ureter of rabbits at the rate of 0.5 mL/kg, and then the distal end of the ureter was ligated with silk suture to replicate the model of urogenic sepsis caused by acute ureteral obstruction and infection. In sepsis + glycyrrhizic acid group, on the basis of sepsis group, glycyrrhizic acid solution of 5 mg/kg was injected through ear vein for 3 consecutive days. At 72 h after operation, peripheral blood white blood cell count, neutrophil count, C-reactive protein, serum creatinine and urea nitrogen were detected. The contents of high mobility group box 1 (HMGB1), TNF-α, IL-1β and IL-6 in serum were determined by ELISA. Renal tissue of each group was stained with HE to evaluate inflammatory infiltration and renal tubular injury. The expression of HMGB1, Toll-like receptor 4 (TLR4), nuclear factor-κB P65 (NF-κB P65) and other related signaling pathways were detected by RT-PCR, Western-blot and IHC.

There was no significant difference in the expression of serum leukocyte count, neutrophil count and C-reactive protein between sham operation group and control group (P>0.05). Serum leukocyte count, neutrophil count and C-reactive protein level in sepsis group were significantly higher than those in sham operation group (P<0.05). GA treatment for 72 h significantly decreased the levels of leukocytes, neutrophils and C-reactive protein in serum of rabbits in sepsis group (P<0.05). The serum creatinine and urea nitrogen levels of rabbits in sepsis group were significantly higher than those in sham operation group (P<0.05). GA treatment for 72 h reduced the serum creatinine and urea nitrogen levels of rabbits in sepsis group (P<0.05). Serum levels of HMGB1, TNF-α, IL-1β and IL-6 in sepsis group were significantly higher than those in sham operation group (P<0.05). GA treatment for 72 h reduced the serum levels of HMGB1, TNF-α, IL-1β and IL-6 of rabbits in sepsis group (P<0.05). The levels of TLR4 and NF-κB p65 in renal tissue of rabbits with sepsis were significantly increased. GA treatment significantly inhibited the activation of TLR4/NF-κB signaling pathway.

Glycyrrhizic acid has certain therapeutic value for AKI related to urogenic sepsis, Glycyrrhizic acid may reduce AKI associated with urogenic sepsis by regulating the HMGB1/TLR4/NF-κB signaling pathway.

Prostate cancer is one of the most common malignancies in men and the current standard treatment for metastatic prostate cancer is androgen deprivation therapy. However, the patients treated with androgen deprivation therapy eventually develop metastatic castration-resistant prostate cancer. Immunotherapy has shown promising results in a variety of tumors, but in prostate cancer, the results have been less than satisfactory. Single-cell sequencing technology enables high-resolution analysis of cells at the single-cell level, which is of great value for studying immunotherapy for prostate cancer. This article reviews the research status and future development of single-cell sequencing technology in the immunotherapy of prostate cancer.

Patients with malignant tumors of the urinary system often exhibit insufficient preoperative cardiopulmonary function and muscle reserve due to their own physiological and psychological factors. This diminished reserve capacity weakens their adaptive response to surgical stress, thereby consequently affecting the postoperative recovery process. As a beneficial supplement of enhanced recovery after surgery(ERAS), prehabilitation emphasizes taking the preoperative stage as the intervention opportunity, and adopts single or multiple intervention measures to optimize the preoperative organ function of patients, improve the tolerance and adaptation of surgical trauma, and change the postoperative outcome. This article reviewed the necessity, contents and effects of prehabilitation in patients with urological malignancies, and provided reference for further promotion of prehabilitation in China.

Partial nephrectomy has been recommended by various guidelines as the preferred surgical procedure for T1a stage renal tumors. However, due to its special anatomical location near renal blood vessels and the renal collecting system, partial nephrectomy for renal portal tumors has always been recognized as a challenging surgery in Urology. This article summarizes the surgical techniques and experience of this procedure, and believes that through comprehensive preoperative evaluation, appropriate surgical approach selection, improved tumor resection and wound reconstruction techniques, the surgery can be safely and effectively completed, achieving the "three consecutive victories" goal of negative margins, shortened ischemia time, and reduced perioperative complications.

This paper reports a male case of Castleman's disease in renal sinus, with painless gross hematuria as the main clinical manifestation. CTU showed a round-shaped tumor in the right renal pelvis, which was obviously enhanced. The initial diagnosis was renal pelvis tumor. The patient underwent a total nephroureterectomy via laparoscopic retroperitoneal approach under general anesthesia, and postoperative pathology confirmed Castleman disease in the renal sinus.

This article presents a case of renal cell carcinoma with inferior vena cava tumor thrombus and iliac vessel thrombosis (RCC-TT). The patient was admitted to the Urology Department of Jieyang People's Hospital in Guangdong Province. PET-CT and enhanced CT indicated a huge tumor in the right kidney, along with the formation of tumor thrombus in the inferior vena cava and right renal vein. Pathological examination of the right renal tumor biopsy suggested clear cell renal cell carcinoma. Through a multidisciplinary consultation on difficult cases in Guangdong Urological Association, we formulated a treatment plan combining targeted therapy with immunotherapy and regularly assessed its efficacy. The patient has completed seven courses of axitinib combined with tislelizumab and seven courses of lenvatinib mesylate combined with toripalimab treatment, with close follow-up during this period. Although mild adverse reactions such as skin itchiness and hematuria occurred, the follow-up CT imaging showed that the inferior vena cava tumor thrombus had decreased compared to before, and the iliac vessel tumor thrombus had disappeared. The subsequent surgical intervention will be performed after risk assessment at major domestic medical center. Currently, due to the lack of high-quality clinical research evidence, there is still controversy regarding the systemic treatment of renal cancer with tumor thrombus. This case affirms the positive role of targeted therapy combined with immunotherapy in reducing tumor thrombus and improving the quality of life in renal cell carcinoma with inferior vena cava tumor thrombus, which effectiveness, feasibility and safety are worth further research and exploration.