Upper tract urothelial carcinoma (UTUC) is a relatively rare malignant tumor in the urinary system, characterized by a latent onset, strong invasiveness, and high recurrence rate. Radical nephroureterectomy has been the standard treatment for this condition for several decades, effectively preventing tumor recurrence or distant metastasis. However, for elderly patients, solitary kidneys, bilateral tumors, and those with renal insufficiency, postoperative renal function significantly declines, limiting the application of platinum-based chemotherapy. In recent years, with the development of imaging diagnosis, endoscopic techniques, and robotic surgery, nephron-sparing treatment has shown promising application prospects in specific patient groups. This article reviews the research progress of nephron-sparing treatment for UTUC based on updated international guidelines and the latest clinical research evidence.

The treatment of metastatic hormone-sensitive prostate cancer (mHSPC) has made significant progress in recent years. Androgen deprivation therapy (ADT) alone is gradually being phased out and replaced by doublet or triplet intensified therapies combining ADT with novel androgen receptor pathway inhibitors (ARPIs) and/or docetaxel. In addition, for patients with low-volume or oligometastatic disease, local radiotherapy or cytoreductive surgery of the primary prostate tumor has shown the potential to improve survival. With the continuous enrichment of treatment modalities, risk stratification based on tumor volume and timing of metastasis is crucial for making individualized treatment decisions. In the future, precision targeted therapies for DNA damage repair defects and the PI3K/AKT pathway, as well as radioligand therapies (such as Lu-PSMA), are expected to further improve the prognosis of mHSPC patients. This article reviews the latest drug therapies, local therapies, risk-stratified treatment strategies, and future perspectives for mHSPC, aiming to provide a reference for clinical practice.

The clinical incidence of T₁ stage renal cell carcinoma is increasing year by year. Partial nephrectomy, as the core surgical method recommended by domestic and international guidelines for preserving renal units, has been widely practiced in clinic. The Robot-assisted retroperitoneal laparoscopic partial nephrectomy, which combines the advantages of laparoscopic minimally invasive surgery and the three-dimensional high-definition vision and precise operation characteristics of the robotic system, shows significant advantages in the treatment of complex renal tumors. Based on the clinical experience of our clinical center, this article summarizes the techniques and insights of robot-assisted retroperitoneal laparoscopic partial nephrectomy in clinical application.

To build a convolutional neural network model to predict tumor necrosis on whole-slide images (WSI) in clear cell renal cell carcinoma, and to assess the performance of the model.

25 WSIs of clear cell renal cell carcinoma with tumor necrosis are downloaded from TCGA database, and 100 pathological slides of clear cell renal cell carcinoma from the First Affiliated Hospital of Sun Yat-sen University are scanned. Tumor and necrosis region are annotated in WSIs under the guidance of pathologists. The WSIs from TCGA are then cropped into 21 411 patches (2 556 necrosis and 18 855 non-necrosis), training the convolutional neural network DenseNet201 to establish a deep learning model for detecting tumor and necrotic patches. 3 855 patches from our center are used for external testing. Based on the classification results and location information of patches, tumor necrosis-prediction maps are generated. The quantile threshold method is used to analyze the performance of the model to detect tumor necrosis at the whole slide level.

In the external testing group, the accuracy, sensitivity, specificity and AUC of the model at patch-wise are 0.909, 0.890, 0.943, and 0.973 for tumor and non-tumor classification. The accuracy, sensitivity, specificity and AUC are 0.717, 0.958, 0.657 and 0.920 respectively for necrotic and non-necrotic classification. The AUC, sensitivity, specificity and accuracy of tumor necrosis at slide-wise are 0.903, 0.760, 0.933, and 0.890. Based on the classification results of patches, prediction maps of tumor necrosis are generated and the percentage of tumor necrosis is calculated.

The classification model based on convolutional neural network algorithm can be used as an assistant diagnostic tool to help pathologists detect tumor necrosis clear cell renal cell carcinoma and quantitatively evaluate the extent of necrosis.

Cystoscopy is an essential diagnostic procedure for bladder tumors. However, the effectiveness of the examination is greatly influenced by the characteristics of the lesion and the proficiency of the examiner, leading to possible misdiagnosis and missed diagnosis. The application of deep learning models can help improve the identification of tumors under cystoscopy. This study explores the performance of deep learning models in segmenting tumors of different sizes and clarity under cystoscopy.

A retrospective study included 198 patients who underwent transurethral bladder tumor resection in Peking Union Medical College Hospital, Beijing Sixth Hospital, and Beijing Longfu Hospital from June 1, 2022, to June 1, 2024. Semantic segmentation models Mask2Former and DeepLabV3+ were used to identify bladder tumors. Video data from 171 patients and 27 patients were used as the training set and test set, respectively. Observational indicators included intersection over union (IOU), accuracy, recall rate, and mean Dice coefficient. Analysis was performed using R 4.0.2 software, and all count data were expressed as numbers or percentages.

The DeepLabV3+ model (with 21.75 Mparameters) achieved an accuracy and recall of 83.3% for segmenting low-clarity bladder tumors. The Mask2Former model (with 197 M parameters) achieved an accuracy and recall rate of 92.1% and 88.9%, respectively, for low-clarity bladder tumors. Both models achieved an accuracy and recall rate of over 98.0% for high-clarity bladder tumors. When applying the Mask2Former model, as the number of cases in the training set increased from 10 to 171, the model's accuracy rate for segmenting bladder tumors increased from 94.0% to 97.7%, recall rate increased from 73.3% to 93.5%, and mDice increased from 62.3% to 85.5%, with a particularly noticeable improvement in the low-clarity group. When using the Mask2Former model to segment bladder tumors of different sizes, the accuracy rate for tumors occupying less than 0.02 of the screen and more than 0.1 was 90.9% and 98.1%, respectively; the recall rate was 83.3% and 99.8%, respectively.

The deep learning model Mask2Former demonstrates excellent performance in the segmentation of bladder tumors under cystoscopy, particularly exhibiting robust segmentation capabilities for low-clarity images and tumors occupying a significant portion of the visual field.

To analyze the expression of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) in patients with benign prostatic hyperplasia and type 2 diabetes, and to explore the clinical significance.

The clinical data of 74 patients who underwent transurethral prostatectomy in our hospital from January 2020 to May 2024 were analyzed. According to whether they had type 2 diabetes, the patients were divided into two groups, the prostatic hyperplasia group (control group, n=37) and type 2 diabetes with prostatic hyperplasia group (observation group, n=37). The expression of HIF-1α and VEGF in prostate hyperplasia tissues of two groups of patients was detected by immunofluorescence immunohistochemical staining, and statistical analysis was performed.

The expression of HIF-1α in the observation group of benign prostatic hyperplasia tissue was significantly higher than that in the control group (Z=2.046, P=0.041). The expression of VEGF in the observation group of benign prostatic hyperplasia tissue was also significantly higher than that in the control group (Z=2.496, P=0.013). The expression of VEGF was positively correlated with HIF-1α in the observation group (r=0.327, P=0.049).

The activation of HIF-1α/VEGF pathway may be related to benign prostatic hyperplasia in type 2 diabetes patients.

To explore the safety and efficacy of domestic Jinfeng single-port robot-assisted radical prostatectomy (SP-RARP) in the treatment of patients with intermediate-high risk prostate cancer (PCa).

The clinical data of patients who underwent Jinfeng SP-RARP in the First Affiliated Hospital of Anhui Medical University from March 2025 to September 2025 were collected, and the intraoperative and postoperative conditions of patients were analyzed.

A total of 53 patients were included in this study. The median age was 68.4 (55.0, 82.0) years, the median body mass index (BMI) was 23.48 (16.76, 32.14) kg/m², the median prostate-specific antigen (PSA) level was 11.82 (2.00, 52.70) ng/mL, and the median prostate volume was 32.83 (12.38, 96.59) mL, among them, there were 42 patients with intermediate-risk prostate cancer and 11 patients with high-risk prostate cancer. All surgeries were performed successfully without changing the surgical approach during the operation. The median operation time was 135 ( 82, 230) min, and the median blood loss was 48 (10, 530) mL. No intraoperative blood transfusion was required for any patient. The median postoperative hospital stay was 4.1 (3.0, 9.0) days. No severe complications (Clavien grade ≥Ⅲ) occurred during or after the operation. Positive surgical margins were observed in 15 patients (28.30%). The urinary continence rate was 77.35% (41/53) at the 1-month postoperative follow-up and 81.13% (43/53) at the 3-month postoperative follow-up.

The domestic Jinfeng single-port robot can be safely used for the treatment of intermediate-high risk PCa with good efficacy, and this surgical method has advantages such as minimal trauma and rapid recovery.

To investigate the risk factors for retrograde ureteral stenting failure in the treatment of malignant external ureteral obstruction.

The clinical data of patients with malignant ureteral obstruction caused by compression or invasion of non-urological cancers and who underwent retrograde ureteral stenting in the Sixth Affiliated Hospital of Sun Yat-sen University from January 2021 to January 2024 were retrospectively collected. Patients were divided into two groups according to whether retrograde ureteral stenting failure. Univariate and multivariate Logistic regression analysis were used to analyze the correlation between retrograde ureteral stenting failure and preoperative predictors such as age, BMI, and nephrostomy status, primary cancer type, nature, previous treatment history, preoperative hemoglobin value, albumin value, serum creatinine level, tumor marker level, urine leukocytes, urinary occult blood, urine culture, ureteral lateralization (left, right, bilateral), ureteral obstruction level (abdominal segment, pelvic segment, bladder wall segment, bladder invasion), grade of hydronephrosis, pelvic wall invasion, abdominal wall invasion, urinary fistula, intestinal fistula and so on.

Among the 80 cases of MEUO that underwent RUS, 26 cases (32.5%) failed. Univariate Logistic regression analysis showed that the risk factors for RUS failure were the primary cancer simultaneously invading the bladder, bladder wall segment, and pelvic segment, the presence of pelvic radiation inflammation, preoperative serum albumin value of less than 35 g/L, and preoperative urine leukocyte positive (P<0.05). The multivariate Logistic regression analysis indicated that the primary cancer simultaneously invading the bladder, bladder wall segment, and pelvic segment (P=0.016, OR=3.818, 95%CI: 1.279-11.398), the presence of pelvic radiation inflammation (P=0.044, OR=3.004, 95%CI: 1.030-8.760) would increase the risk of RUS failure.

The primary cancer simultaneously invades the bladder, bladder wall segment, and pelvic segment, and the presence of pelvic radiation inflammation were independent risk factors for predicting the failure of RUS in patients with MEUO.

To investigate the safety and efficacy differences between prone and lateral positions for retroperitoneal robotic-assisted partial nephrectomy (rRAPN) in the treatment of cT₁ posterior renal hilar tumors, and to summarize the clinical experiences of prone position technique.

The clinical data of 51 patients with cT₁ posterior renal hilar tumors between January 2023 and January 2025 in our hospital were retrospectively analyzed. All patients underwent rRAPN by Da Vinci robotic system. The patients were divided into two groups based on surgical position: the prone position group (n=28) and the lateral position group (n=23). There were no significant differences between the two groups in terms of preoperative baseline characteristics, including age, gender, affected kidney side, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, age-adjusted Charlson Comorbidity Index (aCCI), preoperative hemoglobin (Hb), chronic kidney disease (CKD) staging, tumor diameter, R.E.N.A.L. score, and PADUA score (P>0.05). Perioperative outcomes and complications were compared between the two groups.

All patients successfully completed surgery without conversion to open surgery, secondary procedures, or radical nephrectomy. Negative surgical margins were achieved in all cases. The prone position group had significantly shorter robotic docking time [(14.1±3.1) vs (17.3±2.7) min, P<0.001], operation time [(58.2±21.0) vs (82.6±33.6) min, P=0.004], renal artery dissection time [(6.2±3.0) vs (15.7±8.9) min, P<0.001], warm ischemia time [(25.9±8.8) vs (33.6±14.8) min, P=0.035], suturing time [(13.8±5.4) vs (20.1±10.2) min, P=0.011], and reduced estimated intraoperative blood loss [50.0 (27.5, 57.5) vs 100.0 (50.0, 200.0) mL, P=0.040] compared to the lateral position group. No significant differences were observed between the two groups in terms of postoperative 30 d changes in eGFR, 6-month changes in eGFR, postoperative hospital stay, 30 dcomplication rate, or "trifecta" achievement rate (P>0.05).

rRAPN in the prone position for cT₁ posterior renal hilar tumors is safe and effective. Compared with the traditional lateral position, the prone retroperitoneal approach is associated with shorter robotic docking time, operation time, renal artery dissection time, warm ischemia time, and suturing time, as well as alleviated intraoperative blood loss and surgical difficulty.

To analyze the distribution of pathogenic bacteria and changes in antibiotic resistance among Urology patients in Lingnan Hospital, the Third Affiliated Hospital of Sun Yat-sen University to provide a theoretical basis for guiding rational clinical drug use.

WHONET 5.6 software analyzed non-duplicate bacterial isolates and antimicrobial susceptibility data from Urology patients from 2014 to 2024.

From 2014 to 2024, pathogens were detected in 2035 Urology patients, with 51.84% male and 48.16% female. Pathogen detection rates varied slightly among age groups. The primary source of pathogen specimens was urine samples (90.37%), followed by drainage fluid (2.53%), sputum (2.46%) and blood (1.17%). A total of 2,566 non-duplicate isolates were isolated from urology patients. The detection rate of gram-negative bacilli exhibited a downward trend, with the top five detected bacteria being Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, and Acinetobacter baumannii. Conversely, the detection rate of gram-positive bacteria increased, with the top five being Enterococcus faecalis, Streptococcus agalactiae, Staphylococcus haemolyticus, Enterococcus faecium, and Streptococcus mitis/streptococcus oralis. Similarly, the detection rate of fungi also increased, with the top three being Candida albicans, Candida glabrata, and Candida tropicalis. No Escherichia coli resistant to tigecycline was detected. The resistance rates of Escherichia coli to imipenem, meropenem, cefoperazone/sulbactam, nitrofurantoin, ertapenem, amikacin, piperacillin/tazobactam, and cefoxitin were low (<10%). The resistance rates of Klebsiella pneumoniae to tigecycline, amikacin, imipenem, meropenem, and ertapenem were also low (<10%). For Proteus mirabilis, the resistance rates to meropenem, ertapenem, piperacillin/tazobactam, cefoperazone/sulbactam, cefoxitin, amikacin, ceftazidime, and amoxicillin/clavulanate were low (<10%). Regarding Pseudomonas aeruginosa, the resistance rates to amikacin, meropenem, imipenem, piperacillin/tazobactam, cefepime, ceftazidime, gentamicin, and tobramycin were low (<10%). Enterococcus faecalis exhibits low resistance rates (<5%) to vancomycin, nitrofurantoin, ampicillin, penicillin, and linezolid. No Streptococcus agalactiae isolates have shown resistance to vancomycin, linezolid, ampicillin, ceftriaxone, or cefotaxime. No vancomycin-, linezolid-, or nitrofurantoin-resistant Staphylococcus haemolyticus isolates were identified. Enterococcus faecium exhibited low resistance rates to linezolid and vancomycin (1.4% and 4.3%, respectively). No linezolid- or vancomycin-resistant Streptococcus mitis/oralis group strains were detected, with chloramphenicol resistance observed in only 3.5% of isolates.

In the urology department, the patient population was predominantly male, with urine specimens constituting the majority of samples. Gram-negative bacteria remained the primary pathogens, however, increasing detection rates of gram-positive bacteria and fungi warrant heightened clinical vigilance. Escherichia coli was the most prevalent isolate, demonstrating stable or declining resistance rates to most antimicrobial agents. Notably, the top five gram-negative bacilli exhibited low resistance to carbapenems, while the leading five gram-positive species showed minimal resistance to vancomycin and linezolid. These findings suggest that standardized antimicrobial stewardship practices have effectively mitigated the escalation of bacterial drug resistance.

To investigate the method and efficacy of robot-assisted modified antegrade inguinal lymphadenectomy guided by indocyanine green (ICG) fluorescence imaging in patients with penile cancer.

The clinical data of 4 patients with penile cancer from June 2022 to July 2024 were retrospectively analyzed. The median age of the 4 patients was 61.5 years, ranging from 52 to 72 years. Clinical stage: 4 cases were T₁ (subcutaneous connective tissue invasion), preoperative physical examination and auxiliary examination showed inguinal lymph node enlargement, of which 1 case showed left pelvic lymph node enlargement, including 2 cases of N₁ stage, 1 case of N₂ stage and 1 case of N₃ stage. No distant metastasis was observed. Surgical methods: the patient was placed in the supine position, and ICG was injected into the root of the penis before operation. Precise inguinal lymphadenectomy and pelvic lymphadenectomy were performed under the guidance of ICG.

All operations were successfully completed without conversion to open surgery and without the need for mobile robotic arm system. In one case, the original cannula position was used to enter the abdominal cavity, and pelvic lymphadenectomy was performed at the same time. A total of 8 operations and 1 pelvic lymphadenectomy were performed in 4 patients. The median operation time of each side was 60 min, ranging from 50 to 70 min. The intraoperative blood loss was less than 10 ml on each side. The median number of left lymph nodes dissected was 4, ranging from 3 to 14. The median number of right lymph nodes dissected was 4, ranging from 2 to 9. Stitchings were removed in all the 4 cases within 10 days after operation, and no complications such as skin necrosis, delayed wound healing, and cellulitis occurred. The drainage tube removal time of 4 cases ranged from 5 to 40 days, with a median time of 11 days. One of them had lymphatic leakage in the inguinal region and delayed removal of the tube. All patients were followed up for 5-25 months, and no tumor recurrence or metastasis was found in the primary tumor, inguinal and pelvic lymph nodes.

Robot-assisted modified anterograde inguinal lymphadenectomy under the guidance of ICG fluorescence can accurately distinguish the location of lymph nodes and separate them from the surrounding tissues, significantly improve the efficacy of inguinal lymph node dissection and reduce the incidence of postoperative complications.

To investigate the role of SHOX2 in lymph node metastasis (LNM) and poor prognosis of pT1 non-clear cell renal cell carcinoma (nccRCC), and to evaluate its potential as a risk stratification biomarker.

Clinical data of 528 pT₁ renal cell carcinoma (RCC) patients who underwent robot-assisted partial nephrectomy at a single center were retrospectively analyzed, including 96 patients of nccRCC and 432 patients of clear cell renal cell carcinoma (ccRCC). LNM rates and prognosis were compared between the two groups. Transcriptomic data of nccRCC (n=355) were obtained from the TCGA database to screen differentially expressed genes between positive lymph nodes (LN+) and negative lymph nodes (LN-) groups, followed by survival analysis and pathway enrichment analysis. SHOX2 immunohistochemistry (IHC) was performed on paraffin-embedded specimens from 20 pT₁ nccRCC patients, and protein expression levels were compared between the two groups.

In the clinical cohort, the LNM rate was higher in nccRCC than in ccRCC (5.21% vs 0.46%, P=0.001), and LNM independently predicted poor prognosis (HR=36.44, 95%CI: 4.67-284.47, P<0.001). In the TCGA cohort, SHOX2 was the most upregulated gene in LN+ tumors (log₂FC=6.01, P<0.001), and high SHOX2 mRNA expression was associated with shorter disease-free survival (HR=2.896, 95%CI: 1.329-6.310, P=0.007). Functional enrichment linked SHOX2 to extracellular matrix (ECM) remodeling (r=0.401) and epithelial-mesenchymal transition (EMT) activation (r=0.381) (both P<0.001). Preliminary IHC analysis showed higher SHOX2 protein expression in LN+ than in LN- specimens (Mann-Whitney U=9.500, P=0.002).

SHOX2 may drive lymphatic metastasis in pT₁ nccRCC through the ECM-EMT axis and serve as a potential prognostic biomarker. Future studies could explore the value of combining SHOX2 expression with its methylation detection for risk stratification in high-risk nccRCC, though multicenter prospective validation is required.

To analyze the clinical and imaging features of a case of intraparenchymal renal artery aneurysm (IPRAA), aiming to improve the clinical diagnosis and treatment of this rare disease.

A retrospective analysis was conducted on a case of IPRAA treated at the Third Affiliated Hospital of Sun Yat-sen University in September 2025. The clinical diagnosis and treatment process were reviewed, and relevant literature was summarized.

The IPRAA showed no typical clinical manifestations. On non-enhanced CT, a well-defined mass with slightly higher density was observed. After contrast enhancement, the mass showed heterogeneous enhancement in the corticomedullary phase, homogeneous in the nephrographic phase. The patient underwent robot-assisted partial nephrectomy, intraoperative ultrasound localization revealed blood flow turbulence within the tumor, and the turbulence ceased after renal artery occlusion. The lesion was considered as renal artery aneurysm, and the lesion was completely resected along the boundary of the tumor. Pathology confirmed the diagnosis of renal artery aneurysm.

IPRAA is a rare arterial malformation that is easily misdiagnosed as a renal malignancy. Performing a biopsy on such a mass may result in uncontrollable bleeding. Contrast-enhanced CT alone is often insufficient for a definitive diagnosis, but Doppler ultrasound showing the characteristic of blood turbulence flow pattern can help clarify the diagnosis. Additionally, robot-assisted partial nephrectomy provides a reliable method for complete removal of the aneurysm, and the patient’s prognosis is favorable.

Ureteral stricture (US) is a common urinary system disease that seriously affects the quality of life of patients. Traditional surgical procedures involve greater trauma, more postoperative complications, and carry a higher risk with certain limitations. In recent years, endoscopic treatment has received widespread attention as a new treatment method. This article provides a review of the research progress on intracavitary treatment of US, summarizing the advantages and limitations of intracavitary treatment in treating US. The aim is to provide guidance and inspiration for research and clinical applications in this field.

As a morphological alteration of the prostate, intravesical prostatic protrusion (IPP) is conventionally utilized to assess lower urinary tract symptoms, particularly in benign prostatic hyperplasia (BPH). However, a growing body of recent evidence indicates that IPP exerts a significant influence on the diagnosis and treatment of prostate cancer (PCa). Diagnostically, IPP may serve as an auxiliary indicator for PCa detection. Therapeutically, IPP can impact the efficacy of radical prostatectomy, modulate postoperative complication rates, and consequently affect long-term prognosis. Therefore, it is imperative for surgeons to conduct precise preoperative assessments of IPP and formulate individualized surgical strategies to mitigate adverse outcomes and harness the clinical utility of IPP in the management of PCa.

Urological diseases commonly cause dysuria, local pain and other symptoms, and conventional drug treatment has certain limitations. With the advantages of minimal invasiveness, safety and adjustability, electrophysiological techniques have been widely used in various clinical departments. This article systematically reviews the application status and research progress of electrophysiological monitoring, electrophysiological therapy, combined therapies and novel electrophysiological technologies in urology. Electrophysiological monitoring can be applied to preoperative functional evaluation and intraoperative nerve protection, which effectively reduces the risk of surgical complications. Therapies including spinal cord stimulation and transcutaneous electrical nerve stimulation have achieved satisfactory effects on overactive bladder, urinary incontinence, chronic prostatitis, and male diseases, as well as postoperative rehabilitation. The combination of electrophysiological techniques with western medicine, traditional Chinese medicine and acupuncture can further improve the therapeutic efficacy. In addition, new technologies such as visualized precise electrophysiology, novel electrode materials and deep brain stimulation are under continuous exploration. At present, there are still some challenges in this field, including unclear action mechanisms, lack of unified treatment protocols and insufficient positioning accuracy. Further researches focusing on action mechanisms, optimization of stimulation parameters, development of electrode materials and targeted precise therapy are required in the future, so as to promote the standardized and precise clinical application of electrophysiological techniques in urology.

This article reports a case of posterior left retroperitoneal Ewing sarcoma complicated by renal vein and inferior vena cava tumor thrombus.The patient was admitted due to "left-sided abdominal pain for one month". PET-CT scan revealed a large mass in the left adrenal region, the left adrenal gland was indistinct, and the tumor boundaries with the gastric fundus, pancreatic tail, and upper pole of the left kidney were unclear; tumor thrombus formation was suspected in the left renal vein and inferior vena cava, pulmonary artery tumor thrombus was suspected in the main trunk of the right pulmonary artery, right middle pulmonary artery, and right lower pulmonary artery. After discussion by the multidisciplinary team at Nanfang Hospital, Southern Medical University, a combined thoracoabdominal left retroperitoneal mass resection, renal vein and inferior vena cava tumor thrombus removal, and pulmonary artery tumor thrombus removal were performed. Postoperative pathology results indicated Ewing sarcoma. After a multidisciplinary consultation of difficult cases in Guangdong Urological Association, It was ultimately determined to administer adjuvant chemotherapy first postoperatively, with a regimen of VDC/IE (vincristine + doxorubicin + cyclophosphamide alternating with ifosfamide + etoposide). Retroperitoneal masses complicated by renal vein and inferior vena cava tumor thrombus present significant surgical challenges and high risks, as tumor thrombus detachment can lead to serious complications such as pulmonary artery embolism. These patients require multidisciplinary discussion before surgery, thorough preoperative preparation, multidisciplinary collaboration during surgery, and individualized postoperative adjuvant treatment.