Objective To evaluate the clinical characteristics, diagnostic reasoning, and therapeutic strategies of prostatic paraganglioma (PPG) to provide an evidence-based foundation for early diagnosis and precision treatment of this rare malignancy. Methods The clinical data of a patient with PPG admitted to our hospital were retrospectively analyzed. Concurrently, a systematic search was conducted across domestic and international databases, including PubMed, CNKI, and Wanfang.Clinical manifestations, laboratory tests, pathological features, therapeutic modalities, and prognostic data of 24 cases reported between 1979 and 2025 were pooled with the institutional case for a comprehensive analysis (n=25). Results Epidemiological features: the age at onset ranged from 8 to 76 years, with a mean age of (44.6±15.2) years, predominantly affecting young and middle-aged adults (30-50 years).Notably, 20.0% (5/25) of the patients exhibited characteristic micturition-associated catecholamine release symptoms (e.g., post-micturition palpitations, transient hypertension).Laboratory findings: among the 19 patients who underwent catecholamine metabolite testing, 14 (73.7%) showed significant elevation in serum or urinary norepinephrine and methoxyadrenaline levels.Pathological and immunohistochemical features: the positivity rate for neuroendocrine markers (chromogranin A, synaptophysin, and neuron-specific enolase) was 100%, while the negativity rate for prostate-specific markers (prostate-specific antigen and prostate-specific acid phosphatase) was also 100%.Treatment and prognosis: surgical intervention was performed in 96.0% (24/25) of the patients, including radical prostatectomy (37.5%), precision tumor excision (25.0%), and transurethral resection (12.5%).Favorable outcomes without recurrence were observed in 89.5% (17/19) of the total cohort. Conclusion PPG is clinically exceedingly rare.The disease should be highly suspected in patients presenting with a prostatic mass, normal prostate-specific antigen level, and micturition-associated cardiovascular symptoms.Testing for catecholamine metabolites is the key screening tool.Robot-assisted surgery facilitates precise tumor excision while ensuring optimal functional preservation.Given the malignant potential and genetic correlations of PPG, lifelong follow-up is recommended.

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.

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 explore the efficacy of focal radiofrequency ablation (RFA) in the treatment of low-to-intermediate risk localized prostate cancer and its impact on postoperative urinary control and sexual function recovery，in order to explore the feasibility of minimally invasive methods for the treatment of localized prostate cancer. Methods: Clinical data of 28 patients with low-to-intermediate risk localized prostate cancer who underwent RFA in Nanjing Drum Tower Hospital，Affiliated Hospital of Medical School during Jun.2017 and Feb.2021 were retrospectively analyzed.The 5-year failure-free survival (FFS) rate，surgery related complications，postoperative urinary control and sexual function were collected.The differences between the survival curves of patients in the low-risk and intermediate-risk subgroups were assessed with log-rank test and Breslow test. Results: All surgeries were successfully completed under local anesthesia.During the median follow-up of 43 (40-49) months，the 5-year FFS rate predicted by Kaplan-Meier method was 78.57%; 25 patients (89.29%) did not experience surgery-related complications; 27 patients (96.43%) were able to control urination; 1 patient developed new-onset sexual dysfunction.There was no significant difference in the survival curves between patients in the low-risk and intermediate-risk groups (P>0.05). Conclusion: RFA for patients with low-to-intermediate risk localized prostate cancer has good clinical efficacy，little impact on urinary control and sexual function recovery，and few postoperative complications，which can be used as one of the treatment options for these patients.

Objective: To explore the diagnosis, treatment and prognosis of primary prostatic signet ring cell carcinoma (SRCC), so as to provide reference for the clinical diagnosis and treatment. Methods: A retrospective analysis was conducted on the clinical data of 6 patients with primary prostatic SRCC treated in Nanjing Drum Tower Hospital during Nov.2020 and Sep.2024.The clinical manifestations, imaging features, treatment methods, histological characteristics and prognosis were summarized. Results: The average age of the patients was (72.00±4.28) years.Varying degrees of dysuria occurred in 4 patients. All patients underwent multi-parametric magnetic resonance imaging (mpMRI) examination before surgery, and the results indicated typical prostate cancer.Preoperative biopsies showed high-grade (Gleason 8-10) prostate acinar adenocarcinoma.Postoperative pathological diagnoses were mixed types of prostate acinar adenocarcinoma and SRCC, and no metastasis was found in the pelvic lymph nodes.All patients were followed up for 1 to 46 months after surgery and are currently alive.Robot-assisted laparoscopic radical prostatectomy only was performed in 3 cases; apalutamide and leuprolide/triptorelin was administered after surgery in 2 cases; bicalutamide + goserelin was administered after surgery in 1 case, who developed bladder metastasis of prostate cancer 24 months later, and the serum prostate-specific antigen (PSA) concentration decreased to a safe level (<0.2 ng/mL) after the use of darolutamide with radiotherapy.No recurrence or metastasis was found in the remaining patients. Conclusion: Primary prostatic SRCC is a rare and highly aggressive malignant tumor of the prostate.The diagnosis depends on pathological examinations due to lack of specific imaging features and clinical manifestations.The prognosis is poor, and there is currently no standardized treatment.The combined use of surgery, hormonotherapy and radiotherapy can help improve the survival rate of patients.

Objective: To investigate the clinical efficacy of en bloc resection of ureteral orifice in the treatment of tumors around ureteral orifice. Methods: Clinical data of 43 patients treated at our hospital during Jul.2018 and Jun.2023 were retrospectively analyzed，including 34 male and 9 female patients.Prior to surgical intervention，all patients were diagnosed with bladder masses via imaging or cystoscopy，and no concurrent upper urinary tract tumors were detected.The initial surgical procedure was transurethral resection of bladder tumor，which removed the tumors around ureteral orifice.Subsequently，electrocoagulation was employed for hemostasis，followed by the placement of a double-J tube into the affected ureter.Tumor recurrence and hydronephrosis were observed after operation. Results: All operations were successful without conversion to open surgery.The operation time was (61±25) min.The postoperative pathological results showed 28 cases of Ta stage tumors，14 cases of T1 stage tumors，and 1 case of T2 stage tumor.During the follow-up of (17±11) months，8 patients (19%) had tumor recurrence，among whom 4 (9%) had recurrent tumor involving the ureteral orifice，and 1 (2%) had transient hydronephrosis after removal of double-J tube. Conclusion: The en bloc resection of the ureteral orifice with placement of a double-J tube is safe and effective for the treatment of tumors around the ureteral orifice，with low recurrence rate.It is an optional procedure for early stage patients.

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.