Purpose: This study aimed to report the real-world outcomes of intravesical gemcitabine for bacillus Calmette–Guérin (BCG)–unresponsive, high-risk, non–muscle-invasive bladder cancer (HR-NMIBC) in Korean patients who were unable or unwilling to undergo radical cystectomy (RC). Materials and Methods: This retrospective study included 131 patients (median age, 69 years; 88.5% men) treated with intravesical gemcitabine for BCG-unresponsive HR-NMIBC at nine centers between May 2019 and April 2022. The primary endpoint was 1-year recurrence-free survival (RFS). The secondary endpoints included factors influencing RFS, progression-free survival (PFS), cystectomy- free survival, cancer-specific survival (CSS), overall survival (OS), and safety. Survival analysis was performed using the Kaplan-Meier method, and risk factors for recurrence were assessed using Cox regression models. Results: Patients were followed up for a median duration of 25 months, with carcinoma in situ (CIS) in 41.9% of the patients. The 1-year and 2-year RFS rates were 68% and 42%, while the 1-year and 2-year PFS rates were 87% and 77%, respectively. No significant factors influencing RFS were identified. Seventeen patients underwent RC during a median follow-up of 16 months, with the condition in three patients progressing to muscle-invasive disease on final pathological analysis. The 2-year CSS and OS rates were 98% and 97%, respectively. Intravesical gemcitabine was well-tolerated, with only seven patients (5.3%) unable to complete the full induction course. Conclusion Our research highlights the potential of intravesical gemcitabine as a viable bladder-sparing treatment option for BCG-unresponsive HR-NMIBC, providing real-world evidence on its safety, efficacy, and tolerability.

Snapping sensations in fingers commonly lead to diagnoses of trigger finger, usually attributed to A1 pulley pathology. However, less common etiologies can present challenges in accurate diagnosis and management. Here, we present a 70-year-old woman with right middle finger snapping, initially diagnosed as trigger finger but unresponsive to corticosteroid injection at the A1 pulley. Physical examination revealed snapping during right third proximal interphalangeal joint flexion. Ultrasound imaging revealed the lateral band’s anomalous movement during flexion, confirming the diagnosis. Conservative management was chosen due to the patient’s preference and mild symptoms. This case highlights the importance of considering uncommon causes of finger snapping and underscores the value of ultrasound in diagnosis, contributing to enhanced clinical recognition and utility of ultrasound for such rare pathologies.

Snapping sensations in fingers commonly lead to diagnoses of trigger finger, usually attributed to A1 pulley pathology. However, less common etiologies can present challenges in accurate diagnosis and management. Here, we present a 70-year-old woman with right middle finger snapping, initially diagnosed as trigger finger but unresponsive to corticosteroid injection at the A1 pulley. Physical examination revealed snapping during right third proximal interphalangeal joint flexion. Ultrasound imaging revealed the lateral band’s anomalous movement during flexion, confirming the diagnosis. Conservative management was chosen due to the patient’s preference and mild symptoms. This case highlights the importance of considering uncommon causes of finger snapping and underscores the value of ultrasound in diagnosis, contributing to enhanced clinical recognition and utility of ultrasound for such rare pathologies.

Snapping sensations in fingers commonly lead to diagnoses of trigger finger, usually attributed to A1 pulley pathology. However, less common etiologies can present challenges in accurate diagnosis and management. Here, we present a 70-year-old woman with right middle finger snapping, initially diagnosed as trigger finger but unresponsive to corticosteroid injection at the A1 pulley. Physical examination revealed snapping during right third proximal interphalangeal joint flexion. Ultrasound imaging revealed the lateral band’s anomalous movement during flexion, confirming the diagnosis. Conservative management was chosen due to the patient’s preference and mild symptoms. This case highlights the importance of considering uncommon causes of finger snapping and underscores the value of ultrasound in diagnosis, contributing to enhanced clinical recognition and utility of ultrasound for such rare pathologies.

Snapping sensations in fingers commonly lead to diagnoses of trigger finger, usually attributed to A1 pulley pathology. However, less common etiologies can present challenges in accurate diagnosis and management. Here, we present a 70-year-old woman with right middle finger snapping, initially diagnosed as trigger finger but unresponsive to corticosteroid injection at the A1 pulley. Physical examination revealed snapping during right third proximal interphalangeal joint flexion. Ultrasound imaging revealed the lateral band’s anomalous movement during flexion, confirming the diagnosis. Conservative management was chosen due to the patient’s preference and mild symptoms. This case highlights the importance of considering uncommon causes of finger snapping and underscores the value of ultrasound in diagnosis, contributing to enhanced clinical recognition and utility of ultrasound for such rare pathologies.

This review examines the evolution, clinical efficacy, and future directions of trimodal therapy (TMT) as a bladder-preserving treatment option for muscle-invasive bladder cancer. A nonsystematic literature search was conducted on PubMed in October 2024 using the following keywords: “muscle invasive bladder cancer,” “bladder preservation,” “trimodal therapy,” “chemoradiotherapy,” and “radiation therapy.” Papers published between 2000 and 2024 were included, and original articles, reviews, and editorials written in English were selected. Relevant studies were organized and cited in the analysis. TMT, which consists of transurethral resection of the bladder tumor, chemotherapy, and radiotherapy, demonstrated comparable oncologic outcomes to radical cystectomy (RC) in terms of 5-year overall survival (36%–74%) and cancer-specific survival (50%–82%). Long-term data from multiple studies indicate that TMT can preserve bladder function while maintaining acceptable survival rates. The recent integration of immune checkpoint inhibitors with TMT shows promise, further improving tumor control and expanding the eligible patient population. However, standardized protocols and long-term follow-up data are still lacking. TMT serves as an effective alternative to RC in selected patients, offering similar oncologic outcomes while preserving quality of life. Further research is needed to establish standardized protocols and to refine patient selection criteria to optimize treatment outcomes.

This review examines the evolution, clinical efficacy, and future directions of trimodal therapy (TMT) as a bladder-preserving treatment option for muscle-invasive bladder cancer. A nonsystematic literature search was conducted on PubMed in October 2024 using the following keywords: “muscle invasive bladder cancer,” “bladder preservation,” “trimodal therapy,” “chemoradiotherapy,” and “radiation therapy.” Papers published between 2000 and 2024 were included, and original articles, reviews, and editorials written in English were selected. Relevant studies were organized and cited in the analysis. TMT, which consists of transurethral resection of the bladder tumor, chemotherapy, and radiotherapy, demonstrated comparable oncologic outcomes to radical cystectomy (RC) in terms of 5-year overall survival (36%–74%) and cancer-specific survival (50%–82%). Long-term data from multiple studies indicate that TMT can preserve bladder function while maintaining acceptable survival rates. The recent integration of immune checkpoint inhibitors with TMT shows promise, further improving tumor control and expanding the eligible patient population. However, standardized protocols and long-term follow-up data are still lacking. TMT serves as an effective alternative to RC in selected patients, offering similar oncologic outcomes while preserving quality of life. Further research is needed to establish standardized protocols and to refine patient selection criteria to optimize treatment outcomes.

Purpose: The use of gallium-68 prostate-specific membrane antigen-11 positron emission tomography/computed tomography (Ga-68 PSMA-11 PET/CT) is becoming increasingly common among men with prostate cancer (PCa). However, it remains uncertain which patients will derive the most benefit, and there is a scarcity of real-world data regarding its impact on altering treatment plans. This study investigated which patients would most benefit from Ga-68 PSMA-11 PET/CT, focusing on detection rates and changes in treatment strategies, drawing from a single-center experience. Materials and Methods: In total, 230 men with PCa who underwent Ga-68 PSMA-11 PET/CT between November 2021 and August 2022 were included in this retrospective study. The patients were classified into 5 groups based on their disease status: group 1, further work-up for high-risk localized PCa; group 2, de novo metastatic PCa; group 3, biochemical recurrence after definitive treatment; group 4, castration-resistant PCa; group 5, others. The positivity rate, positive lesions, predictive value of lymph node metastases, comparison with conventional images, and treatment changes after Ga-68 PSMA-11 PET/CT were analyzed in each group. Results: Of the 230 patients, 40 (17.4%), 20 (8.7%), 77 (33.5%), 76 (33.0%), and 17 (7.4%) were classified into groups 1–5, respectively. Ga-68 PSMA-11 PET/CT showed lesions in 74.8% of patients, and the optimal cutoff value for PSA was 1.99 ng/mL. Lesions not observed on conventional imaging were found in 62 patients (33.2%). In 38 patients (13.5%), treatment was changed due to Ga-68 PSMA-11 PET/CT. Conclusions These real-world data suggest that Ga-68 PSMA-11 PET/CT may be clinically useful for various disease conditions, as substantial stage migration and subsequent treatment changes occur in men with PCa. However, the prognostic impact of this modality remains unclear; thus, a well-designed prospective study is needed to address this issue.

This review examines the evolution, clinical efficacy, and future directions of trimodal therapy (TMT) as a bladder-preserving treatment option for muscle-invasive bladder cancer. A nonsystematic literature search was conducted on PubMed in October 2024 using the following keywords: “muscle invasive bladder cancer,” “bladder preservation,” “trimodal therapy,” “chemoradiotherapy,” and “radiation therapy.” Papers published between 2000 and 2024 were included, and original articles, reviews, and editorials written in English were selected. Relevant studies were organized and cited in the analysis. TMT, which consists of transurethral resection of the bladder tumor, chemotherapy, and radiotherapy, demonstrated comparable oncologic outcomes to radical cystectomy (RC) in terms of 5-year overall survival (36%–74%) and cancer-specific survival (50%–82%). Long-term data from multiple studies indicate that TMT can preserve bladder function while maintaining acceptable survival rates. The recent integration of immune checkpoint inhibitors with TMT shows promise, further improving tumor control and expanding the eligible patient population. However, standardized protocols and long-term follow-up data are still lacking. TMT serves as an effective alternative to RC in selected patients, offering similar oncologic outcomes while preserving quality of life. Further research is needed to establish standardized protocols and to refine patient selection criteria to optimize treatment outcomes.

Purpose: The Korean Renal Cancer Study Group (KRoCS) provides consensus recommendations on the role of cytoreductive nephrectomy (CRN) in patients with metastatic renal cell carcinoma (mRCC). Materials and Methods: A group of mRCC experts from the Korean Urological Oncology Society convened at the 2021 KRoCS meeting on CRN for mRCC. Results: The consensus document was developed to address 4 questions related that were judged to be the most relevant to patient care: (1) Is there a role for CRN in patients planning targeted therapy? (2) Is there a role for CRN in patients planning immuno-oncology agents? (3) When is the optimal time of CRN in patients planning systemic treatment? (4) What is the ideal patient selection for CRN? The panelists have come up with following consensus. For mRCC patients, CRN should be considered only in those with IMDC (International Metastatic Renal Cell Carcinoma Database Consortium) favorable and intermediate risk disease, regardless of the systemic treatment plans. Timing of CRN should consider the risk group as well as the number of risk factors, but is generally recommended for after assessing the degree of response to initial systemic treatment. Patients with good performance status, limited metastatic burden on top of resectable primary tumor are candidates recommended for CRN with or without metastasectomy with priority. Conclusions In conclusion, there is still a role for CRN in the multimodality treatment of mRCC. Careful patient selection is of paramount importance. As the treatment landscape of mRCC continues to change, the role of CRN in the current immuno-oncology era will require more exploration.