T-cell therapy,as an emerging strategy for bladder cancer treatment,primarily includes tumor-infiltrating lymphocyte(TIL)therapy,T cell receptor-engineered T-cell(TCR-T)therapy,and chimeric antigen receptor T-cell(CAR-T)therapy.TIL therapy involves extracting,expanding,and reinfusing tumor-infiltrating T cells,aiming to promote tumor regression,which has achieved initial progress in the field of bladder cancer.TCR-T therapy involves genetically modifying T cells to specifically recognize tumor antigens presented by MHC,with clinical trials targeting NY-ESO-1 and other targets progressing in an orderly manner.CAR-T therapy utilizes artificially designed CAR molecules to target bladder cancer-highly expressed antigens such as prostate-specific membrane antigen(PSMA)and human epidermal growth factor receptor 2(HER2),with multiple studies confirming its potent cytotoxic effects.This article systematically summarizes the existing research,advantages and limitations of T-cell therapy in bladder cancer,so as to provide reference for exploring new options for the next-generation immunotherapy strategies of bladder cancer.

This article highlights the limitations of traditional treatment methods for non-muscle-invasive bladder cancer and the multi-dimensional exploration of emerging strategies.It firsty reviews the history and challenges of BCG immunotherapy,pointing out its bottlenecks in efficacy,tolerance,and supply,and focuses on its chemicobiological modifications,such as the optimization of nanoparticle drug delivery systems and immune-active components.Subsequently,it summarizes the development of various new treatment approaches,including gene therapy,photodynamic/sonodynamic therapy,chemodynamic therapy,and proteolysis-targeting chimeras for targeted protein degradation strategies.It particularly emphasizes the enhancement of drug delivery efficiency and targeting in the bladder through nanotechnology,aptamer-mediated systems,and biomimetic carriers.The treatment of bladder cancer is gradually transforming from local and single-mode to precise,synergistic,and low-toxicity directions,with chemicobiological means playing a core role in driving this transformation.Interdisciplinary integration provides a broad space and new hope for the treatment of bladder cancer.

High-risk non-muscle invasive bladder cancer (HR-NMIBC) is associated with a higher risk of recurrence and progression. The standard treatment involves intravesical Bacillus Calmette-Guérin (BCG) instillation following transurethral resection of the bladder cancer. However, in cases of BCG unresponsiveness, radical cystectomy is typically recommended. Due to the high complication rates and significant impact on quality of life associated with this procedure, bladder-preserving treatment (BPT) strategies have emerged as an alternative. This review summarizes recent advances in BPT, including combined chemoradiotherapy, immune checkpoint inhibitors, targeted therapies, localized precision treatments, and novel immunomodulators. With ongoing technological and therapeutic innovations, BPT has become an effective alternative for patients who are unable or unwilling to undergo surgery, reshaping the treatment landscape of HR-NMIBC.

En bloc resection of bladder tumor(ERBT),as an innovative procedure for conventional transurethral resection of bladder tumor(cTURBT),has become an important treatment option for non-muscle invasive bladder cancer(NMIBC).Although ERBT has been recommended by international guidelines,its technical standardization,verification of long-term survival benefits and stratification of indications are still the focus of future research.This article first provides an overview of the surgical techniques of ERBT,and then elaborates on the advantages and disadvantages of the three energy sources of ERBT,namely,electrocautery,laser,and Hybridknife.In terms of pathological assessment,current research suggests that the detection of detrusor muscle in surgical specimens can reflect the quality of the surgery.The integrity of pathological specimens and diagnostic consistency have promoted the progress of sub-staging of T1 bladder cancer and have also driven more research on microscopic indicators related to prognosis.Finally,this article reviews whether repeated transurethral resection can be avoided to help optimize individualized treatment for bladder tumor.

T-cell therapy,as an emerging strategy for bladder cancer treatment,primarily includes tumor-infiltrating lymphocyte(TIL)therapy,T cell receptor-engineered T-cell(TCR-T)therapy,and chimeric antigen receptor T-cell(CAR-T)therapy.TIL therapy involves extracting,expanding,and reinfusing tumor-infiltrating T cells,aiming to promote tumor regression,which has achieved initial progress in the field of bladder cancer.TCR-T therapy involves genetically modifying T cells to specifically recognize tumor antigens presented by MHC,with clinical trials targeting NY-ESO-1 and other targets progressing in an orderly manner.CAR-T therapy utilizes artificially designed CAR molecules to target bladder cancer-highly expressed antigens such as prostate-specific membrane antigen(PSMA)and human epidermal growth factor receptor 2(HER2),with multiple studies confirming its potent cytotoxic effects.This article systematically summarizes the existing research,advantages and limitations of T-cell therapy in bladder cancer,so as to provide reference for exploring new options for the next-generation immunotherapy strategies of bladder cancer.

This article highlights the limitations of traditional treatment methods for non-muscle-invasive bladder cancer and the multi-dimensional exploration of emerging strategies.It firsty reviews the history and challenges of BCG immunotherapy,pointing out its bottlenecks in efficacy,tolerance,and supply,and focuses on its chemicobiological modifications,such as the optimization of nanoparticle drug delivery systems and immune-active components.Subsequently,it summarizes the development of various new treatment approaches,including gene therapy,photodynamic/sonodynamic therapy,chemodynamic therapy,and proteolysis-targeting chimeras for targeted protein degradation strategies.It particularly emphasizes the enhancement of drug delivery efficiency and targeting in the bladder through nanotechnology,aptamer-mediated systems,and biomimetic carriers.The treatment of bladder cancer is gradually transforming from local and single-mode to precise,synergistic,and low-toxicity directions,with chemicobiological means playing a core role in driving this transformation.Interdisciplinary integration provides a broad space and new hope for the treatment of bladder cancer.

Objective To investigate the diagnostic efficacy of targeted biopsy(TB)combined with ipsilateral hemiglandular systematic biopsy(SB)of the dominant lesion,so as to explore a novel reduced-core biopsy strategy.Methods A retrospective analysis was conducted on the clinical data of 299 patients treated in our hospital during Sep.1,2022,and Feb.28,2023,who had a Prostate Imaging Reporting and Data System(PI-RADS)score ≥3 and underwent combined TB and SB.The dominant lesion was defined as the lesion with the highest PI-RADS score on multi-parametric magnetic resonance imaging(mpMRI);in cases of identical scores,the largest was designated as the dominant.SB was categorized as ipsilateral(ipsi-SB)or contralateral(contra-SB)to the dominant lesion.The consistency in detecting clinically significant prostate cancer(csPCa)was compared between TB with ipsi-SB(TB+ipsi-SB),TB with contra-SB(TB+contra-SB),and TB with SB(TB+SB).Subgroup analyses were performed based on PI-RADS score,prostate-specific antigen(PSA)level,prostate volume(PV),and mpMRI lesion distribution to evaluate csPCa detection rates across different variables.Results TB+ipsi-SB demonstrated comparable detection rate to TB+SB(46.2％vs.46.8％).The K values for TB+ipsi-SB and TB+contra-SB relative to TB+SB were 0.987(95％CI:0.969-1.000,P＜0.01)and 0.933(95％CI:0.892-0.974,P＜0.01),respectively.Across all subgroups,TB+ipsi-SB showed the highest agreement with TB+SB.Notably,in subgroups with PI-RADS 3 and 5,PSA＞0-20 ng/mL,PV＜25 mL,bilateral or multiple mpMRI lesions,TB+ipsi-SB achieved complete concordance with TB+SB in csPCa detection[K=1.000(95％CI:1.000-1.000),P＜0.01].Conclusion For patients with PI-RADS score ≥3,TB+ipsi-SB exhibits near-perfect consistency with TB+SB in csPCa detection while requiring fewer biopsy cores.TB+ipsi-SB represents a promising refinement of the TB+SB approach.

In recent years,patient-derived tumor organoid(PDTO)models have rapidly emerged as important tools in cancer research,thanks to their unique ability to preserve the characteristics of primary tumors.These models provide a reliable preclinical research platform for screening individualized chemotherapy and targeted therapies for patients.However,traditional PDTOs lack immune cells and cannot replicate the tumor immune microenvironment,which restricts their utility in evaluating immunotherapies.To address this challenge,researchers have developed composite models that incorporate both tumor cells and immune cells,known as patient-derived immunocompetent tumor organoids(PDITOs).PDITOs have shown excellent performance in the preclinical evaluation of immunotherapies,particularly with PD-1/PD-L1 immune checkpoint inhibitors,with some studies reporting up to 100％accuracy in predicting patient responses to immunotherapy.As a common malignancy of the urinary system,bladder cancer has benefited from the application of PDITOs in drug screening and personalized immunotherapy evaluation,demonstrating significant potential.This paper aims to review the rise and development of PDITOs,and compare the advantages and limitations of using different methods to construct PDITOs,so as to explore their application in the treatment of bladder cancer.

En bloc resection of bladder tumor(ERBT),as an innovative procedure for conventional transurethral resection of bladder tumor(cTURBT),has become an important treatment option for non-muscle invasive bladder cancer(NMIBC).Although ERBT has been recommended by international guidelines,its technical standardization,verification of long-term survival benefits and stratification of indications are still the focus of future research.This article first provides an overview of the surgical techniques of ERBT,and then elaborates on the advantages and disadvantages of the three energy sources of ERBT,namely,electrocautery,laser,and Hybridknife.In terms of pathological assessment,current research suggests that the detection of detrusor muscle in surgical specimens can reflect the quality of the surgery.The integrity of pathological specimens and diagnostic consistency have promoted the progress of sub-staging of T1 bladder cancer and have also driven more research on microscopic indicators related to prognosis.Finally,this article reviews whether repeated transurethral resection can be avoided to help optimize individualized treatment for bladder tumor.

Objective To investigate the impact of body mass index(BMI)on the perioperative outcomes and prognosis in patients with clear cell renal cell carcinoma(ccRCC)undergoing robot-assisted partial nephrectomy(RAPN),so as to provide reference for optimizing clinical management strategies.Methods The clinical data of 745 ccRCC patients undergoing RAPN at our hospital during 2014 and 2023 were retrospectively analyzed.Patients were categorized into three groups according to preoperative BMI:normal weight(18＜BMI＜24,n=202),overweight(24＜BMI＜28,n=428),and obese(BMI≥28,n=115).Baseline characteristics,surgical parameters,postoperative complications,pre-and post-operative estimated glomerular filtration rate(eGFR),and overall survival(OS)were compared among the groups.Multivariate regression analyses were performed to adjust potential confounders.Results Among baseline characteristics,only the gender distribution differed significantly among the three groups(P=0.009).Multivariate analysis showed that gender had no significant effects on reoperation,transfusion,operation time,intraoperative blood loss,or postoperative renal function.The median follow-up was 32(12,55)months.Compared with the normal-weight group,the obese group had longer operation time[140.0(115.0,170.0)min vs.160.0(125.0,190.0)min,P=0.009]and greater intraoperative blood loss[50.0(50.0,100.0)mL vs.100.0(50.0,150.0)mL,P=0.003].No statistically significant differences were observed among the three groups in pre-and post-operative eGFR,overall complication rate,long-term follow-up eGFR,or OS(P＞0.05).Conclusion RAPN provides comparable surgical benefits across BMI categories in patients with ccRCC;however,obese patients may experience increased operation time and blood loss.