Uro-oncología en H. U. i P. La Fe y andrología en Quirón Valencia, FEBU, Doctorando en último año.
Valencia, España
Joined April 2012
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Javier Pérez Ardavín retweeted
Histologic diversity in #BladderCancer is stage-dependent: rare in pTa (<2%) and pT1 (<5%), but common in MIBC/mUC (~35% variants/divergent). Squamous differentiation dominates (~90% of divergent cases), with basal-like biology and distinct therapeutic targets.
#GUPath #UrothelialCancer
🌶️🌡️Summary of my uropathology for urologists and oncologists series! 👉check it out! and retweet if you like!
@urotoday @OncoAlert @Uroweb @EAUYAUrology @EAU_YAUroTech @EauPatient @niklas_kluemper @onkowissen
xitter.cf/Markuseckstein3/status…
Javier Pérez Ardavín retweeted
🚨 PSMA-guided RT intensification for #ProstateCancer 🚨
@EuropeanUrology
👥 262 randomized (253 treated), 4 strata: salvage post-RP, high-risk, oligomet, salvage post-RT
📊 Phase 2 RCT, SOC RT vs PSMA-PET-guided RT to all detected sites
⏱️ Median f/u 66 mo
⚠️ Primary 5-yr failure-free survival 66% vs 62%, HR 0.80, p=0.14 (not met)
✅ BCFS favored PSMAgRT: 72% vs 65% (sHR 0.70, p=0.048)
✅ High-risk 81% vs 66%; post-RP 80% vs 68% (sHR 0.54, p=0.037)
🎯 Seeing more w/ PSMA doesn't mean treating more helps everyone.
-High-risk & post-RP pts look like the target group
-Pending phase 3 PATRON.
🔗 doi.org/10.1016/j.eururo.202…
@AmerUrological @UroOnc @PCFnews @AmarUKishan @UrologyTimes @urotoday @SbrtSean @PCF_Science
Javier Pérez Ardavín retweeted
🤖 IA en Urología: coincidir no es acertar.
Asistentes tipo ChatGPT en comités de tumores (UroMDT, Motril, Verona): coinciden con la decisión final en el 56–67% de los casos (kappa 0,44–0,48). Acuerdo moderado, y los desacuerdos se acumulan en los casos complejos. 🧵👇
Javier Pérez Ardavín retweeted
🌄 Monday Morning Mention!
✍ BRIEF REPORT: Gemcitabine-Cisplatin Chemotherapy Induces Nectin-4 Downregulation and Enfortumab Vedotin Resistance in Bladder Cancer by Christoph Nössing...Bernhard Englinger et al
💡 Link to full article: buff.ly/altXSPr
👏 Thank you to the authors for trusting EUO to publish your work!
@uroweb
@mroupret
@GPloussard
@jteoh_hk
@Ric_Campi
@CaPsurvivorship
@LauraMarandino
@DaveDandrea
@RenuEapen
@Ecastromarcos
@OncoAlert
@Sciencedirect
Javier Pérez Ardavín retweeted
Urinary diversion for severe pelvic radiation injury significantly enhances bowel-related quality of life. Urologists should consider this intervention for patients with debilitating post-radiation complications. tinyurl.com/26to34nz
Javier Pérez Ardavín retweeted
📢 Irradiate the whole pelvis in clinically node-negative high-risk localized prostate cancer yes/no?
New systematic review and meta-analysis, evaluated 5 available phase III randomized trials, including 5,172 patients, comparing whole-pelvic radiotherapy (WPRT) versus prostate-only radiotherapy (PORT).
🔹 No overall survival benefit was observed with WPRT: HR 1.07 (95% CI 0.94–1.21).
🔹 The apparent benefit in biochemical/progression-free and metastasis-free survival was largely driven by the POP-RT trial and was no longer evident when this study was excluded.
🔹 WPRT was associated with a modest increase in late grade ≥2 GU/GI toxicity, without a meaningful excess of severe events with modern radiotherapy techniques.
👉 Key message: current randomized evidence does not support routine elective pelvic irradiation for all cN0 high-risk patients.
“Alone we can do so little; together, we can do so much” congratulations to all the team 💪
#ProstateCancer
@josedsh @fcounago @PedrodePablos1
sciencedirect.com/science/ar…
Javier Pérez Ardavín retweeted
Apical dissection during radical prostatectomy by Dr. Jochen Walz @ERUSrobotics
1- blunt and cold cut dissection (avoid diathermy)
2- cut DVC, then stitch (stitching DVC before may trap the anterior sphincter)
3- stitch DVC before dissecting urethra for better visualization
Javier Pérez Ardavín retweeted
🚨 Retzius-sparing RARP: better early continence, worse long-term cancer control in the first randomized trial 10-yr readout 🚨
@EurUrolOncol, post hoc analysis of an RCT
👥 120 men, NCCN low/intermediate risk PCa, randomized 1:1 RS vs anterior RARP
⏱️ Median f/u 77 mo, 20 progression events (BCR and/or any additional tx)
✅ 5-yr PFS: 80.2% RS vs 91.1% anterior (p=0.01)
✅ 10-yr PFS: 50.5% vs 82.0%
✅ Adjusted for CAPRA-S: HR 2.64 for progression w/ RS (95% CI 1.01 to 6.91)
⚠️ Signal held in negative-margin pts only: 5-yr 81.1% vs 96.1% (p=0.042), so not just a margin story
⚠️ RS arm had more pT3 (45% vs 23%) and numerically more PSMs (25% vs 13%)
⚠️ Small trial, oncology not the original endpoint, only 9 pts at risk at 10 yr, and the 2 surgeons had done just 60 RS cases total. Expert series suggest ~100 to flatten the learning curve
🎯 First randomized long-term evidence that the oncologic equivalence of RS RARP cannot be assumed.
👉Not a final verdict on RS in high-volume hands
🔗 doi.org/10.1016/j.euo.2026.0…
@AmerUrological @UroOnc @SUO_YUO @PCF_Science @PCFnews @UrologyTimes @urotoday
Javier Pérez Ardavín retweeted
🚨 Exercise improved QoL for patients on ADT for #prostatecancer & it costs less per QALY than most cancer drugs the NHS funds 🚨
🏋️♂️@TheLancetOncol STAMINA trial:
👥 700 men on ADT, median age 71.6, 34% metastatic, 19% on ARPI or chemo
📊 Randomized 5:4 vs an ACTIVE comparator: optimised usual care w/ clinician training and behavioural prompts
💊 12 mo supervised aerobic + resistance exercise in community gyms, dietary advice, behavioural support, free membership
✅ FACT-P +4.5 (p=0.0004), FACT-G +3.7, above the >3 point clinically important threshold
✅ Fatigue (FACIT-F) +1.9 (p=0.0068)
✅ £13,920 to £19,077 per QALY. Median ICER for NICE-approved oncology drugs: £30,000
⚠️ Open label PROs, 97% of pts White, fatigue effect at the edge of MCID, physical outcomes unchanged
⚠️ 3 intervention-related SAEs, all recovered
🎯 This beat an already-enhanced control, in a population including metastatic pts, delivered through community gyms at scale.
👉I think many of us have been telling patients for years to exercise while on ADT to reduce side effects, now we have trial-grade data!
*The figure in this post is not from the paper, based on tabular data!!!
🔗 doi.org/10.1016/S1470-2045(2…
@AmerUrological @UroOnc @SUO_YUO @PCFnews @urotoday @UrologyTimes @CaPsurvivorship
Javier Pérez Ardavín retweeted
Important change in the 2026 @AmerUrological NMIBC Guidelines: all high-grade Ta tumors are now classified as high-risk.
This reduces a long-standing source of heterogeneity in the intermediate-risk group and should improve risk-appropriate treatment for patients, while creating cleaner, more meaningful populations for clinical trials.
Great to see the evidence translate into practice. @IBCG_BladderCA @UrogerliMD @pjhensley11 @AmirHorowitz @mouwlab @spsutkaMD @shilpaonc @AndreaNecchi @LAUrology_NL @karima_oualla @PGrivasMDPhD @marigfern @SpiessPhilippe @UroCancerMD
Time to revisit something I’ve been saying for years: TaHG bladder cancer is not intermediate risk. The clinical outcomes, molecular biology ... all point in the same direction.
Yet some frameworks allow < 3cm TaHG tumors to be downgraded into “intermediate risk” alongside low-grade disease.
That classification has real consequences for patients:
• undertreatment
• less rigorous surveillance
• in some studies, these patients are even placed on observation as a supposedly appropriate “control arm.”
TaHG is high risk. 🧵 @BladderCancerUS @WorldBladderCan @IBCG_BladderCA
Javier Pérez Ardavín retweeted
🚨 Referring men w/ #ProstateCancer on ADT to a cardiologist lowered cholesterol, not heart attacks 🚨
🖊️@JAMAInternalMed, RADICAL PC-2:
👥 2,487 men w/ PCa starting ADT, 55 sites
📊 RCT: usual care vs routine cardiology/internist referral w/ statin for all
⏱️ Median f/u 5.8 yrs
✅ Cholesterol lower in treatment group
⚠️ CV death, MI, stroke, HF: sHR 1.08 (0.79 to 1.49). No difference
⚠️ The price: ~1,240 new specialist referrals, plus years of f/u visits, to move a lab value a statin script could have moved on day 1
🎯 Advice from this paper, skip the referral, just start the statin🤷
🔗 doi.org/10.1001/jamainternme…
@AmerUrological @UroOnc @SUO_YUO @urotoday @UrologyTimes @PCF_Science @PCFnews @ManuMysore2
Javier Pérez Ardavín retweeted
Testosterone therapy in men on active surveillance for prostate cancer is not associated with increased risk of disease progression auajournals.org/doi/10.1097/…
Javier Pérez Ardavín retweeted
🚨 MRI-first screening w/o contrast finds more ≥GG2 #ProstateCancer 🚨
@EurUrol
👥 759 pts randomized
📊 Biparametric MRI first vs MRI only if PSA ≥3
⏱️ 15 min scan, no contrast
✅ csPCa detected: 4.6% vs 1.8% (RR 2.6, 95% CI 1.1-6.1)
✅ Several csPCa found in pts w/ normal PSA
⚠️ More biopsies in MRI-first arm (10.8% vs 5.2%)
🎯 A FAST⚡️ contrast-free MRI up front catches significant PCa a PSA screen might miss
@PCF_Science @PCFnews @urotoday @UrologyTimes @UroOnc
🔗shorturl.at/NUI1i
Javier Pérez Ardavín retweeted
Generally assumed population-based PSA screening = increased overdiagnosis. But already lots of PSA testing going on. In a modeling study, we show organized screening would reduce PSA tests, overdiagnosis compared to current disorganized approach
onlinelibrary.wiley.com/doi/…
Javier Pérez Ardavín retweeted
Point-Counterpoint: Does #PROTEUS represents a new standard of care?
Dr. David Morris @UA_Nashville at #USPCC26 says YES—for carefully selected patients planning RP.
Key arguments:
✅ PSMA PET is now routine practice—MFS by PSMA PET reflects real-world staging
✅ Perioperative apalutamide delayed next therapy by ~3 years (NNT ~10 at 5 yrs)
✅ ~3× higher odds of organ-confined disease; pCR may convert some to surgical candidates
✅ 77–80% recover testosterone >150 ng/dL by 1 year with proactive AE management
Bottom line: For high-risk/node+ patients accepting upfront toxicity to delay progression, PROTEUS supports perioperative intensified therapy as "a" new SOC.
Written coverage by @zklaassen_md @GACancerCenter > bit.ly/4yPazul
Javier Pérez Ardavín retweeted
➡️ Monday Morning Mention!
➡️ Risk-adapted Omission of Systematic Cores in PI-RADS 3 Lesions Based on Prostate-specific Antigen Density, Biopsy Route, and Targeted Core Number: A Multicentre Cohort Study by Bogdan Adrian Buhas ...Guillaume Ploussard et al
➡️ buff.ly/E6iWTHn
➡️ We thank the authors for trusting EUO with your work!
@uroweb
@mroupret
@GPloussard
@jteoh_hk
@Ric_Campi
@CaPsurvivorship
@LauraMarandino
@RenuEapen
@Ecastromarcos
@OncoAlert
@Sciencedirect
Javier Pérez Ardavín retweeted
What if bladder preservation became biomarker-guided? @AlanTanMD outlined his hope for a future where ctDNA, utDNA, HER2, FGFR, and Nectin-4 determine who can safely avoid cystectomy and who needs treatment intensification.
🚩Less "bladder preservation for all."
🚩More "the right bladder preservation strategy for the right patient."
That's where the field should be headed
#BCANTT26 @UroToday @BladderCancerUS
Javier Pérez Ardavín retweeted
#BCANTT26 Can AI identify which #MIBC patients actually benefit from NAC?
Dr. Chappidi highlighted a major unmet need:
🔹 20–30% of patients derive little benefit from cisplatin-based NAC
🔹 Nonresponders face toxicity, treatment delays, and worse oncologic outcomes
Using a single routine TURBT H&E slide, an AI histopathology biomarker predicted pathologic response with:
🔹 AUC 0.76
🔹 Accuracy 72.8%
🔹 PPV 78.5%
Perhaps most importantly, this represents a scalable pathology-based approach that does not require costly molecular profiling.
However, the most important finding may be the challenge of generalizability:
🔹 Internal CV AUC: 0.64–0.70
🔹 External validation AUC: 0.42–0.70
@UroToday @BladderCancerUS
Javier Pérez Ardavín retweeted
🚨active surveillance, for #prostatecancer, now with a 25-year horizon🚨
@EUplatinum
📊 GÖTEBORG-1, screen-detected low- and intermediate-risk PCa, f/u up to 25 yrs
✅ extended data continue to support AS as safe for well-selected pts over the very long term
⚠️ intermediate-risk selection and adherence to follow-up still matter, this is screen-detected disease
⭐️PCa-specific survival at 25 yrs was 94%
-99% for VLR
-92% for LR
-85% for Int Risk
🎯 bottom line: when we tell a pt w/with low-risk PCa that surveillance is safe, we can now point to a quarter century of trial follow-up.
🔗 shorturl.at/H2a6x
#pcsm @AmerUrological @UroOnc @GGiannarini @PCFnews @PCF_Science @GabeCanales @ASPI_INTL
