Abstract:According to Global Cancer Statistics 2020，bladder cancer is the tenth most commonly diagnosed cancer worldwide，which is the sixth most common cancer and the ninth leading cause of cancer-related death in men. Although the exact pathogenesis of bladder cancer is unclear，certain factors have been demonstrated to be associated with an increased risk of bladder cancer，such as smoking，chemical exposure，age，sex，genetic factors，and environmental factors. Bladder cancer can cause pain，urinary tract infection，urinary incontinence，and death，which can impose a huge health and economic burden on patients. To better prevent and treat bladder cancer，the detection of biomarkers can help monitor or predict the development，progression，or treatment of bladder cancer. In recent years，studies have shown that the development of bladder cancer is closely related to various mechanisms including inflammation，pyroptosis，and ferroptosis，and these molecular mechanisms-related biomarkers have been increasingly applied in the research of bladder cancer. This review focuses on the value of these novel biomarkers in the diagnosis，treatment，and prognosis of bladder cancer，which can be potential targets at different treatment stages of bladder cancer for controlling the disease，prolonging disease-free interval，and inhibiting tumor recurrence and metastasis.

Abstract:Objective To investigate the clinical significance of tumor-associated fibroblast as a biomarker in predicting postoperative recurrence of non-muscle invasive bladder cancer（NMIBC）.Methods Transcriptomic data were downloaded from the Gene Expression Omnibus database along with corresponding clinical information to analyze the differences in ACTA2 expression in primary and recurrent bladder cancer samples. Immunohistochemistry（IHC） was used to determine α-smooth muscle actin（α-SMA） expression in 56 bladder cancer samples. Recurrence-free survival（RFS） curves and time-dependent receiver operating characteristic（tdROC） curves were plotted. Univariate and multivariate Cox proportional hazard regression models were used to analyze the feasibility of α-SMA as a predictor of postoperative recurrence of bladder cancer.Results The expression of ACTA2 was significantly higher in the recurrence group than in the primary group in the GSE13507，GSE120739，and GSE128959 datasets（P<0.05）. IHC results showed that α-SMA protein was localized in the tumor stoma，and the percentage of positive/strongly positive α-SMA was 56.52% in the recurrence group and 16.13% in the primary group，with a significant difference between the two groups（P<0.001）. There was no significant correlation between α-SMA protein expression and age，gender，pathological stage，grade，tumor number，and size. Postoperative RFS was significantly shorter in patients with high α-SMA expression than in those with low α-SMA expression [hazard ratio（HR）=2.76，95% confidence interval（CI）=1.21~6.30，P=0.016]. Multivariate Cox analysis showed that α-SMA protein expression level was an independent risk factor for postoperative RFS in patients（HR=2.47，95%CI=1.02~5.97，P=0.045）. tdROC curves suggested that α-SMA was a better predictor of recurrence than other clinical factors.Conclusion α-SMA protein expression level in the tumor stroma is closely related to the recurrence of bladder cancer and can be used as a clinical marker to predict postoperative recurrence of NMIBC.

Abstract:Objective To explore an effective adjuvant therapy for patients with muscle invasive bladder cancer who cannot accept radical surgery，radiotherapy，and chemotherapy.Methods A retrospective analysis was conducted on patients with muscle invasive bladder cancer discharged from the Department of Urology of Guang’anmen Hospital in the past 10 years. The treatment methods and bladder retention time were analyzed.Results Of patients treated with bladder tumor interventional embolization combined with transurethral bladder tumor resection and traditional Chinese medicine，61.90% patients achieved a treatment effect of retaining the bladder for more than 3 years.Conclusion The application of integrated traditional Chinese and Western medicine may help prolong the bladder retention time of patients with muscle invasive bladder cancer and improve the prognosis and quality of life of patients.

Abstract:Objective To investigate the value of inflammatory biomarkers in predicting the efficacy of neoadjuvant therapy in patients with muscle-invasive bladder cancer.Methods A retrospective analysis was performed for the clinical data of patients with muscle-invasive bladder cancer who attended Department of Urology，The First Affiliated Hospital of Chongqing Medical University，from January 2020 to February 2023 and received neoadjuvant therapy. The influence of related inflammatory biomarkers on the efficacy of neoadjuvant therapy was analyzed，including neutrophil-to-lymphocyte ratio（NLR），derived neutrophil-to-lymphocyte ratio（dNLR），and systemic immune-inflammation index（SII），and the receiver operating characteristic（ROC） curve was used to determine the optimal cut-off values. Then the patients were divided into high and low inflammatory biomarker subgroups to investigate the differences in clinicopathological parameters and the efficacy of neoadjuvant therapy. Finally，a comparative analysis was performed to investigate the influence of inflammatory biomarkers on the outcome of patients receiving neoadjuvant therapy.Results There were no significant differences in clinicopathological parameters between the high and low inflammatory biomarker subgroups（P>0.05）. There were significant differences in objective response rate（ORR） and disease control rate（DCR） after neoadjuvant therapy between the high and low inflammatory biomarker subgroups（P<0.05），and higher levels of inflammatory biomarker were associated with a less favorable therapeutic outcome. In addition，there were no significant differences in ORR and DCR between the four neoadjuvant treatment regimens（P>0.05）.Conclusion The peripheral blood inflammatory biomarkers NLR，dNLR，and SII before neoadjuvant therapy can be used as potential indicators to judge the efficacy of neoadjuvant therapy.

Abstract:Objective To explore the correlation between the expression level of L-type amino acid transporter 1（LAT1） and the risk of postoperative relapse in patients with non-muscle-invasive bladder cancer（NMIBC）.Methods A total of 108 patients with NMIBC who received surgical treatment in Yongchuan Hospital Affiliated to Chongqing Medical University from February 2021 to February 2022 were selected as subjects. LAT1 expression levels in the bladder cancer tissue （from the sites where tumor was identified） and paracancerous tissue（from adjacent normal areas） were measured by reverse transcriptase polymerase chain reaction，and the expression levels of LAT1 in the two types of tissue were compared. Meanwhile，all patients were divided into high expression group and low expression group according to the second quantile of LAT1 expression in the bladder cancer tissue，and the clinicopathological parameters of the two groups were compared. The two groups were observed and followed up for 12 months for postoperative relapse. The Kaplan-Meier curve was used to analyze and compare the risk of postoperative relapse between the two groups. The multivariate Cox proportional hazards regression model was used to determine the influencing factors for postoperative relapse.Results The LAT1 expression level in the bladder cancer tissue（1.80±0.35） was significantly higher than that in the paired paracancerous tissue（1.05±0.17）（P<0.05）. The proportion of patients with a smoking history and clinical stage T₁ was significantly higher in the high LAT1 expression group than in the low LAT1 expression group（P<0.05）. The mean follow-up time of 108 patients with bladder tumor was （10.84±1.94） months. Among these patients，33 had a relapse，with a relapse rate of 30.56%. The Kaplan-Meier curve showed that the overall relapse rate was significantly higher in patients with high LAT1 expression than in those with low LAT1 expression（log rank χ2=4.382，P=0.036）；the multivariate Cox regression analysis showed that smoking history [hazard ratio（HR）=6.539，95%CI=2.439-17.531]，clinical stage T₁（HR=3.658，95%CI=1.808-7.398），and high LAT1 expression（HR=3.425，95%CI=1.631-7.191） were risk factors for postoperative relapse of patients with NMIBC P<0.05）.Conclusion The LAT1 expression level is high in the bladder cancer tissue，and high LAT1 expression levels may be correlated with an increased risk of postoperative relapse in patients with bladder cancer.

Abstract:Objective To investigate the effect of intravesical infusion of Nocardia rubra cell wall skeleton（N-CWS） versus bacille Calmette-Guérin（BCG） on the treatment outcome and quality of life of patients with non-muscle invasive bladder cancer（NMIBC）.Methods A total of 86 patients with intermediate- to high-risk NMIBC who were admitted to the urology department of Sichuan Provincial People's Hospital from April 2016 to April 2021 were enrolled，and all the patients underwent surgical treatment and had complete clinical and follow-up data. According to the drug used for intravesical infusion，the patients were divided into N-CWS group（n=41） and BCG group（n=45）. After two years of follow-up，the two groups were compared in terms of quality of life，clinical outcome，and adverse reactions.Results Compared with the BCG group，the N-CWS group had lower 6-month recurrence rate（4.88% vs. 6.67%，χ²=0.125，P=0.723），1-year recurrence rate（9.76% vs. 17.78%，χ²=1.150，P=0.284），and 2-year recurrence rate（21.95% vs. 28.89%，χ²=3.268，P=0.071）. Compared with the BCG group at 6 months after intravesical infusion，the N-CWS group had significantly higher role function，emotional function，and overall function（P<0.05） and significantly lower scores of pain，urinary system symptoms，and problems caused by treatment（P<0.05）. At 1 year after intravesical infusion，compared with the BCG group，the N-CWS group had significantly higher role function，emotional function，and overall function（P<0.05） and significantly lower scores of pain，urinary system symptoms，and problems caused by treatment（P<0.05）. At 2 years after intravesical infusion，the N-CWS group had a significantly higher emotional function than the BCG group（P<0.05），and there were no significant differences in the other scores between the two groups. Compared with the BCG group，the N-CWS group had significantly lower incidence rates of the adverse events such as urinary tract irritation，hematuria，joint pain，and pyrexia（P<0.05）.Conclusion N-CWS has a comparable clinical effect to BCG in the intravesical infusion treatment of NMIBC after surgery and can effectively improve quality of life with a favorable safety profile，and therefore，it holds promise for clinical application.

Abstract:Objective To investigate the safety and efficacy of transurethral submucosal dissection of bladder tumor combined with intraoperative bladder submucosal injection of gemcitabine in the treatment of non-muscle invasive urothelial bladder cancer（NMIBC）.Methods A retrospective analysis was performed for the clinical data of seven patients with solitary NMIBC who were admitted to our department from June 2021 to September 2022. Bladder tumor-endoscopic submucosal dissection（BT-ESD） was performed after the formation of local edema by injection of gemcitabine（20 mg/mL） at the base of the tumor via cystoscopy using a special bladder mucosal injection needle. Time of operation，length of postoperative hospital stay，postoperative pathological findings，and postoperative complications were recorded，and intraoperative blood loss was estimated. Cystoscopy was performed at 3 months and 1 year after surgery，and recurrence rate was calculated.Results All seven patients underwent successful BT-ESD，with no patients converted to open surgery or other surgical regimens. There was no unscheduled postoperative reoperation for hemostasis，traumatic bladder perforation or intraoperative blood transfusion. Of all seven patients，there were five male patients and two female patients，and the maximum tumor diameter ranged from 0.7 to 2.0 cm，with a mean diameter of （0.9±0.4） cm；all tumors were cauliflower-shaped and pedicled and were located in the lateral wall of the bladder in two patients，in the right ureteral ridge in two patients，in the left ureteral ridge in two patients，and in the trigone in one patient. The time of operation was 20-40 minutes，with a mean time of （31.40±2.67） minutes. The volume of intraoperative blood loss was 1-5 mL，with a mean volume of （2.24±1.46） mL. The length of postoperative hospital stay was 1-2 days. Postoperative pathological findings showed low-risk NMIBC with negative surgical margins. Cystoscopy was performed at 3 months and 1 year after surgery and showed no recurrence or progression.Conclusion The submucosal injection of gemcitabine into the bladder during BT-ESD is safe，reliable，and effective in the treatment of NMICB.

Abstract:Objective To explore the correlation between serum recombinant Kruppel factor 5（KLF5） content and positive lymph node ratio and its predictive value for the prognosis of patients with bladder cancer after radical operation.Methods Ninety-two patients in Department of Urinary Surgery，Xinxiang Central Hospital and The First Affiliated Hospital of Zhengzhou University with bladder cancer treated by radical cystectomy from June 2019 to September 2022 were selected for the study，and they were divided into effective and ineffective groups according to their efficacy. The expression level of serum KLF5 was obtained by enzyme-linked immunosorbent assay. The correlation between serum KLF5 content and positive lymph node ratio and its predictive value for prognosis were analyzed.Results The expression level of serum KLF5 in patients in the effective group was significantly lower than that in the ineffective group（P<0.05）； the positive lymph node ratio in patients in the effective group was significantly different compared with that in the ineffective group（P<0.05）. Pearson analysis showed that a positive correlation was found between serum KLF5 and positive lymph node ratio（odds ratio=0.607；P=0.000）. Multivariate logistic regression analysis showed that serum KLF5（OR=2.751，95%CI=1.777-4.260，P=0.000） and positive lymph node ratio（OR=2.751，95%CI=1.389-7.342，P=0.006） were independent risk factors affecting the prognosis of patients undergoing radical cystectomy（P<0.05）. The receiver operating characteristic curve results showed that the areas under the curve（AUCs） of serum KLF5 and positive lymph node ratio were 0.909 and 0.748，respectively，for predicting the prognosis of patients undergoing radical cystectomy. The corresponding sensitivity was 80.71% and 93.26%，and the specificity was 91.24% and 92.50%，respectively. The AUC for the combined diagnosis of the two indicators was 0.929，with a sensitivity and specificity of 92.30% and 92.50%，respectively.Conclusion Serum KLF5 and positive lymph node ratio are independent risk factors for the prognosis of patients undergoing radical cystectomy，and KLF5 is positively correlated with positive lymph node ratio in patients undergoing radical cystectomy. Therefore，in the process of predicting the prognosis of patients undergoing radical cystectomy，dynamic detection of changes in related influencing factors can provide a basis for clinicians to diagnose the disease.

Abstract:Objective To investigate the feasibility of chymotrypsin-like proteasome（CLP） activity as a biomarker for prostate cancer.Methods Proteasome activity was determined in vitro and in vivo. We also measured the expression of inhibitory protein α of nuclear factor κB（IκB-α），Bcl-2 associated X protein（Bax），and cyclin-dependent kinase inhibitor（p27）.Results CLP activity was elevated by 70% in vitro and 23% in vivo，and the expression levels of the proteasome substrate proteins IκB-α，Bax，and p27 decreased in prostate cancer cells and prostate tumor xenografts compared with normal prostate epithelial cells and control mouse prostate tissue.Conclusion CLP activity is a potential biomarker for prostate cancer and may be used to supplement prostate-specific antigen in clinical diagnosis of prostate cancer.

Abstract:Objective To explore the effects of miR-520a-5p on the proliferation and docetaxel resistance of prostate cancer cells and the potential mechanisms.Methods The expression levels of miR-520a-5p in prostate cancer cells（PC-3/DU145） and normal prostate epithelial cells（RWPE-1） were measured by RT-qPCR. Western blot was used to determine whether miR-520a-5p regulated the expression of the key glycolytic enzymes hexokinase 2（HK2） and phosphofructokinase（PFKM）. The effects of miR-520a-5p on the proliferation and docetaxel resistance of prostate cancer cells were determined using cell counting kit-8. Glucose consumption and lactic acid production in the culture supernatant were assessed by enzyme-linked immunosorbent assay. According to the transfection， all cells were divided into 4 groups： minic group，minic NC group，inhibitor group and inhibitor NC group.Results miR-520a-5p was significantly down-regulated in prostate cancer cells（P<0.001）. Compared with the mimic NC group，the mimic group showed significant decreases in the proliferative ability（P<0.001），half-maximal inhibitory concentration（IC₅₀） of docetaxel，glucose consumption level，and lactic acid production level（P<0.001） of PC-3 and DU145 prostate cancer cells. Compared with the inhibitor NC group，the inhibitor group showed significantly increased proliferative ability（P<0.001） and glucose consumption and lactic acid production levels（P<0.001） of PC-3 and DU145 prostate cancer cells. Starbase database analysis indicated that there were binding sites between miR-520a-5p and HK2 and PFKM. Western blot results showed that miR-520a-5p negatively regulated the expression of HK2 and PFKM. Inhibiting the glycolysis of prostate cancer cells by 2-DG could recover the effect of miR-520a-5p on the proliferative ability of prostate cancer.Conclusion The low expression of miR-520a-5p in prostate cancer may up-regulate the key glycolytic enzymes HK2 and PFKM to enhance aerobic glycolysis，thereby inducing resistance to docetaxel in prostate cancer cells.

Abstract:Objective To investigate the correlations of serum transforming growth factor（TGF）-β1，prostate-specific antigen（PSA），and alkaline phosphatase（ALP） with the occurrence of metastatic castration-resistant prostate cancer（mCRPC） in patients with prostate cancer bone metastases.Methods Using the method of retrospective study，patients diagnosed with bone metastasis of prostate cancer in Guangdong Provincial Hospital of Chinese Medicine from January 2022 to February 2023 were selected and divided into CRPC group（26 cases） and non-CRPC group（29 cases）. The general information of patients was collected，and the levels of serum TGF-β1，ALP，and PSA were measured using enzyme-linked immunosorbent assay.Results Univariate analysis was performed between the two groups. The difference in serum PSA was not significant（P>0.05），while the differences in serum TGF-β1 and ALP were statistically significant（P<0.05）. Binary logistic regression analysis showed that TGF-β1 was an independent risk factor for the occurrence of mCRPC. Spearman correlation analysis showed a positive correlation between serum TGF-β1 and ALP in patients with mCRPC.Conclusion TGF-β1 and ALP levels are closely related to the invasion and progression of prostate cancer bone metastases. Our results may provide a basis for evaluating the treatment and prognosis of patients with prostate cancer bone metastases.

Abstract:Objective To compare the difference in the detection rate of prostate cancer（PCa） between ultrasound-guided transrectal prostate systematic biopsy（TR-SB） and magnetic resonance/ultrasound-guided transperineal prostate targeted biopsy（TP-TB），and to evaluate the diagnostic value of both methods.Methods A retrospective analysis was conducted on 310 patients who underwent transrectal and transperineal prostate biopsies in the First Affiliated Hospital of Chongqing Medical University from December 2020 to May 2022. The patients were divided into TR-SB group and TP-TB group based on the biopsy methods. The two biopsies were compared for the differences in the detection rates of PCa and clinically significant prostate cancer（CSPCa），as well as the incidence of complications.Results There was no significant difference in the detection rates of PCa and CSPCa between the TR-SB and TP-TB groups in patients with a total prostate-specific antigen（tPSA） level of 4-50 ng/mL（P>0.05）. The detection rates of PCa and CSPCa were significantly higher in the TP-TB group than in the TR-SB group when the tPSA level was between 4-<10 ng/mL or 10-<20 ng/mL and the free/total prostate-specific antigen（f/tPSA） level was less than 0.16（P<0.05）. The detection rate of CSPCa was significantly higher in the TP-TB group than in the TR-SB group when the tPSA level was between 10-<20 ng/mL（P<0.05）. There was no significant difference in the overall incidence of complications between the two groups（P>0.05）. The risk of postoperative fever and infections was significantly higher in the TR-SB group than in the TP-TB group（P<0.05）.Conclusion TS-TB has a higher detection rate for PCa and CSPCa in patients with a tPSA level of 4-<10 ng/mL or 10-<20 ng/mL and an f/tPSA level of less than 0.16. For patients with a tPSA level of 10-<20 ng/mL，especially accompanied by an f/tPSA level of less than 0.16，TP-TB has a higher detection rate for highly invasive CSPCa and has a lower risk of postoperative infections，making it an efficient and safer biopsy method in clinical practice.

Abstract:Objective To investigate the efficacy and safety of enzalutamide as the first-line therapy for metastatic castration-resistant prostate cancer（mCRPC） and as the second-line therapy after abiraterone resistance in the real-world setting.Methods A retrospective analysis was performed for the clinical data of 26 patients with mCRPC who were admitted to The First Affiliated Hospital of Army Medical University from December 2019 to March 2023. Based on the biochemical parameters including serum prostate-specific antigen（PSA），imaging reexamination results，and follow-up records during treatment，the patients were analyzed in terms of PSA response，PSA progression，and radiographic progression，and adverse events during treatment were reported.Results A total of 26 patients with mCRPC received enzalutamide treatment，among whom 13 patients received enzalutamide as the first-line therapy for mCRPC and 13 patients who developed resistance to abiraterone acetate received enzalutamide as the second-line therapy for mCRPC. The patients had a median follow-up time of 14（4，23） months，and the patients receiving first-line therapy had a significantly higher PSA response rate than those receiving second-line therapy（100% vs. 53.8%，χ²=7.800，P=0.005）. The patients receiving the first-line therapy for mCRPC had a median PSA progression-free survival time of 18.6 months and a median radiographic progression-free survival time of 20.5 months，while the patients receiving the second-line therapy for mCRPC had a median PSA progression-free survival time of 17.4 months and a median radiographic progression-free survival time of 19.5 months. The main adverse reactions observed in the patients receiving enzalutamide included fatigue（17/26），hot flashes（3/26），and drug-induced liver injury（1/26），which had good overall tolerability in patients.Conclusion Enzalutamide treatment in mCRPC patients can effectively achieve PSA response and delay tumor progression. Enzalutamide as the first-line therapy has better overall efficacy than it as the second-line therapy after abiraterone resistance，with tolerable drug-related adverse events.

Abstract:Objective To explore the clinical characteristics of bone metastasis and its correlation with clinicopathological factors in patients with prostate cancer with prostate specific antigen（PSA） ≤20 ng/mL.Methods This study retrospectively analyzed the clinical and pathological data of patients who were newly diagnosed with prostate cancer with PSA ≤20 ng/mL in Nanfang Hospital，Zhujiang Hospital，and General Hospital of Southern Theater Command from January 2011 to December 2017. The patients were divided into two groups according to with or without bone metastasis. Differences in age，PSA，complexed PSA（cPSA），free PSA（fPSA），Gleason score（GS），and T and N stages were analyzed between the two groups，and the correlation of these factors with bone metastasis was analyzed. A further subgroup analysis was performed based on PSA levels（≤10 ng/mL and 10.01-20 ng/mL），GS（GS ≤ 6 and GS ≥ 7），T stages（T_1-2 and T_3-4），and N stages（N₀ and N₁） to explore the characteristics of bone metastasis between subgroups. Finally，univariate and multivariate logistic regression analyses were used to identify risk factors for bone metastasis.Results Of all 237 patients involved in this study，42（17.7%） patients showed bone metastases，and the incidence rates of bone metastasis in patients with PSA <4 ng/mL，patients with PSA≤10 ng/mL，and patients with PSA of 10.01-20 ng/mL were 7.5%，12.1%，and 24.8%，respectively. There were significant differences in PSA，cPSA，and fPSA levels，GS，and T and N stages between the patients with and without bone metastasis（P<0.05）. There was no significant difference in age between the two groups（P>0.05）. The subgroup analysis further revealed that with the increases in PSA level and GS，the incidence of bone metastasis was consistently increased，and bone metastasis was more frequent in patients with stage T_3-4 and N₁ disease ［odds ratio（OR）=2.372，95%CI=1.148-4.901，P=0.020；OR=6.458，95%CI=2.435-17.131，P<0.001］. logistic regression analyses showed that PSA level，GS，and T and N stages were closely related to bone metastasis in patients with prostate cancer with PSA ≤20 ng/mL，and PSA level，GS，and N stage were independent risk factors for bone metastasis（P<0.05）. There was no significant association between age and bone metastasis（P>0.05）.Conclusion More tumor aggressiveness is found in patients with GS ≥7 and stage T_3-4 and N₁ disease among patients with prostate cancer with PSA ≤20 ng/mL. PSA level，GS，and N stage are independent risk factors for bone metastasis in patients with prostate cancer with PSA ≤20 ng/mL.

Abstract:Objective To investigate the causal relationship between thyroid dysfunction and prostate cancer by using the two-sample Mendelian randomization method.Methods Relevant genome-wide association study（GWAS） data were collected. The exposure factor was thyroid dysfunction（including hyperthyroidism，hypothyroidism），and the outcome variable was prostate cancer. We performed Mendelian randomization analysis using the inverse-variance weighted method（IVW），weighted median，and Mendelian randomization-Egger method. The heterogeneity test，sensitivity analysis，and pleiotropic analysis were also carried out.Results There was a negative causal relationship between hyperthyroidism and prostate cancer（IVW：OR=0.015，95%CI=0~0.436） and a positive causal relationship between congenital hypothyroidism and prostate cancer（IVW：OR=1.088，95%CI=1.003~1.180）. No causal relationship was found between the other types of hypothyroidism and prostate cancer. No results had pleiotropy. Leave-one-out cross-validation suggested that the results were robust.Conclusion Thyroid dysfunction is causally linked to prostate cancer，and low levels of thyroid hormones may be related to an increased risk of prostate cancer，which need further verification through Mendelian randomization studies using larger-size GWAS data.

Abstract:Objective To compare the efficacy of robot-assisted vs. laparoscopic radical prostatectomy.Methods A retrospective analysis was performed on the clinical data of patients with prostate cancer（253 patients undergoing robot-assisted radical prostatectomy and 148 patients undergoing laparoscopic radical prostatectomy） in the Department of Urology in The First Affiliated Hospital of Chongqing Medical University between January 2017 and December 2022. The two groups were compared for positive surgical margins，length of hospital stay，and hospital fees after the baseline characteristics of the two groups had been matched and balanced using propensity scores.Results Multivariate logistic analyses showed that the odds ratio（OR） of positive surgical margins for robot-assisted surgery（compared with laparoscopic surgery） was 1.17（OR=1.17，95%CI=0.61-2.25，P=0.640）. The length of hospital stay was 13.5（10，17） days in the robot-assisted group and 13（10，18） days in the laparoscopic group，showing no significant difference between the two groups（P=0.927）. The total hospital fee was 72 695（65 479，78 623） Yuan in the robot-assisted group and 46 045（40 367，63 149） Yuan in the laparoscopic group，showing a significant difference（P<0.001）.Conclusion In comparison to laparoscopic radical prostatectomy，robot-assisted surgery does not offer any advantage in reducing patients’ length of hospital stay and incidence of positive surgical margins while adding extra medical expenses.

Abstract:Objective To analyze the influencing factors for positive perineural invasion in pathological specimens after laparoscopic radical prostatectomy.Methods The clinical data of 104 patients who underwent laparoscopic radical prostatectomy in the Department of Urology of the Affiliated Hospital of North Sichuan Medical College from January 2018 to March 2023 were retrospectively analyzed. The patient’s age，smoking history，drinking history，preoperative total prostate-specific antigen（TPSA），ratio of preoperative free prostate-specific antigen/TPSA（F/T ratio），postoperative pathological Gleason score，capsular invasion，perineural invasion，resection margin，seminal vesicle invasion，and pathological T stage were collected. According to the postoperative pathological results，the patients were divided into two groups： positive perineural invasion group and negative perineural invasion group. The age，smoking history，drinking history，preoperative TPSA，preoperative F/T ratio，postoperative pathological Gleason score，capsular invasion，resection margin，seminal vesicle invasion，and pathological T stage were compared between the two groups. The chi-square test and multivariate logistic regression analysis were used to analyze the variables to explore the influencing factors for positive perineural invasion.Results A total of 104 patients were included in this study，including 30 patients with positive perineural invasion（28.85%） and 74 patients with negative perineural invasion（71.15%）. All patients were confirmed to have prostate cancer by postoperative pathological results. Univariate analysis showed that there were significant differences in age，F/T ratio，Gleason score，capsular invasion，positive resection margin，seminal vesicle invasion，and pathological T stage（P<0.05），and that there were no significant differences in smoking history，drinking history，and preoperative TPSA（P>0.05）. The statistically significant indices were included in multivariate logistic regression analysis，and the results showed that age <70 years and positive resection margin were independent influencing factors for positive perineural invasion after laparoscopic radical prostatectomy（P<0.05）.Conclusion Age，F/T ratio，Gleason score，capsular invasion，positive resection margin，seminal vesicle invasion，and pathological T stage are significantly related to positive perineural invasion after laparoscopic radical prostatectomy. Among them，age <70 years and positive resection margin are independent risk factors for positive perineural invasion after laparoscopic radical prostatectomy.

Abstract:Objective To evaluate the prostate-specific antigen（PSA） response rates in patients with metastatic hormone-sensitive prostate cancer（mHSPC） who received androgen deprivation therapy（ADT） combined with apalutamide in Chengdu，Sichuan Province，China.Methods A retrospective analysis was performed on the clinical data of patients with mHSPC who were treated with apalutamide combined with ADT in the Department of Urological Surgery of four grade A tertiary hospitals in Chengdu from January 2021 to March 2022. The main outcomes were the response rates of PSA50 and PSA90 and the incidence of adverse reactions after 1 month and 3 months of treatment.Results A total of 81 patients with mHSPC were included in this study. After 1 month of treatment，the response rates of PSA50 and PSA90 were 81.48% and 48.15%，respectively，and PSA≤0.2 ng/mL was found in 3 patients（3.7%）. After 3 months of treatment，the response rates of PSA50 and PSA90 were 97.53% and 86.42%，respectively，and PSA≤0.2 ng/mL was found in 35 patients（43.21%）. Frequently reported adverse reactions included rash（28.40%），fatigue（23.46%），diarrhea（6.17%），and hypertension（2.47%）. The adverse events of grade 3 or higher were rash（4.93%） and fatigue（2.47%）.Conclusion The real-world data of patients with mHSPC in Chengdu show that ADT combined with apalutamide yield favorable PSA response rates and are well-tolerated，making it suitable to be used as one of the treatment options for patients with mHSPC in China.

Abstract:Objective To investigate the diagnosis and treatment strategies for retroperitoneal vascular leiomyosarcoma which is a rare disease in clinical practice.Methods Related data were collected from 12 patients with retroperitoneal vascular leiomyosarcoma who were treated from July 2018 to April 2023，among whom there were 3 male patients and 9 female patients，with a mean age of 55.2 （32.0，69.0） years. The lesion was located in the right side for all patients，and clinical symptoms included abdominal discomfort，lower limb numbness，lower limb，and ascites. Among these patients，4 patients were misdiagnosed with adrenocortical carcinoma or paraganglioma，and 1 patient did not undergo surgery. Among the 11 patients undergoing surgery，4 underwent laparoscopy surgery，among whom 1 was converted to open surgery； 5 underwent open surgery； 2 underwent robot-assisted laparoscopy. All patients required the operation for the inferior vena cava（IVC） during surgery，including right renal vein repair by clamping the IVC in 1 patient，simple suture of the IVC in 3 patients，partial resection of the IVC wall and simple repair in 2 patients，biological patch repair of the IVC wall in 2 patients，transection and anastomosis of the IVC in 1 patient，and segmental resection of the IVC in 2 patients.Results The 12 patients had a mean tumor size of 10.6（4.2，22.0） cm，a mean time of operation of 268（151，467） minutes，and a mean blood loss of 715（20，1 550） mL. 8 patients received intraoperative blood transfusion，5 received right nephrectomy，1 had positive surgical margin，and 2 experienced delayed retroperitoneal hemorrhage after surgery. It was confirmed that 1 patient had leiomyosarcoma originating from the adrenal vein，2 had leiomyosarcoma originating from the renal vein，and 9 had leiomyosarcoma originating from the IVC. Tumor thrombus in the IVC was observed in 6 patients. Pathological examination showed that the tumor was composed of spindle cells，with mitotic figures observed. Immunohistochemistry showed positive SMA in all patients and positive Desmin in 8 patients，and the positive expression rate of Ki-67 was 20%-80%. The mean follow-up time was 21.6（1.0，54.0） months. Among these patients，3 died during follow-up，4 survived with postoperative recurrence，and 5 had no recurrence，among whom 3 were followed up for more than 2 years.Conclusion Retroperitoneal vascular leiomyosarcoma is easily misdiagnosed before surgery，and the operation for the IVC is required during surgery. The surgery is challenging，and surgical procedures should be used according to the actual situation. Open surgery is the preferred choice，and retroperitoneal laparoscopy should be selected with caution. The tumor is highly malignant with a high recurrence rate.

Abstract:Objective To investigate the influence of ubiquitin-conjugating enzyme 2C（UBE2C） on malignant rhabdoid tumor of the kidney（MRTK） and its mechanism of action.Methods Western blot and immunofluorescence assay were used to verify the expression of UBE2C in MRTK clinical specimens and G401 cells. Gene expression data of MRTK were downloaded from the TARGET database for validation，and the Kaplan-Meier method was used to assess the association between UBE2C and prognosis. Small interfering RNA（siRNA） was used to inhibit the expression of UBE2C in G401 cells. CCK-8 assay was used to observe the proliferation of G401 cells after transfection，flow cytometry was used to observe cell apoptosis，and scratch assay and Transwell assay were used to observe the changes in cell migration and invasion abilities. Gene Set Enrichment Analysis（GSEA） was used to explore the pathways regulated by UBE2C，and Western blot was used to verify the expression of pathway proteins.Results The expression of UBE2C in MRTK clinical specimens was 3.189±1.900 times that in adjacent control samples（P=0.033）. The expression of UBE2C in G401 cells was 2.092±0.231 times that in HEK293 cells（P=0.000）. The Kaplan-Meier survival analysis showed that the patients with high UBE2C expression tended to have a worse prognosis（P=0.019），and the patients with stage 4 MRTK had a significantly higher expression of UBE2C than the patients in the early stage（680.9±167.7 vs. 560.5±166.9，P=0.021）. Our research group successfully knocked down the expression of UBE2C to 0.446±0.058 folds（P=0.000） by using siRNA，and it was found that UBE2C knockdown inhibited the proliferation，invasion，and migration of G401 cells and promoted the apoptosis of G401 cells（P=0.000）. GSEA enrichment analysis revealed that UBE2C was associated with the Wnt/β-catenin signaling pathway（P=0.000），and UBE2C knockdown inhibited the Wnt/β-catenin signaling pathway and epithelial-mesenchymal transition（EMT）（P=0.000）.Conclusion The high expression of UBE2C in MRTK is associated with poor prognosis and is involved in the regulation of the Wnt/β-catenin signaling pathway，and inhibition of UBE2C can inhibit proliferation，migration，invasion，and EMT and promote apoptosis in MRTK.

Abstract:Objective To explore the value of peripheral blood neutrophil-to-lymphocyte ratio（NLR） and platelet-to-lymphocyte ratio（PLR） in predicting the outcome after immunotherapy for advanced urothelial carcinoma.Methods We retrospectively analyzed the clinical data of patients with advanced urothelial carcinoma treated with immune checkpoint inhibitors from September 2019 to July 2022. The patients were grouped according to the cut-off value derived from the area under the curve（AUC）. The Kaplan-Meier method was used to compare the survival of the groups. A multivariable Cox model was used to determine independent predictive factors.Results A total of 57 patients were included. After three cycles of immunotherapy，NLR was significantly decreased（pre-treatment 2.40±1.08 vs. post-treatment 3.05±1.07，P<0.001）. There was no significant change in PLR（pre-treatment 226.41±111.70 vs. post-treatment 246.97±113.17，P=0.402）. The AUC values of pre-NLR，post-NLR，pre-PLR，post-PLR，and delta-NLR（change in NLR） were 0.829 1（P=0.004），0.889 6（P<0.001），0.743 6（P=0.003），0.740 4（P<0.001），and 0.798 4（P<0.001），respectively. The survival analysis showed that pre-NLR ≥3.17（3.5 months vs. not achieved，P<0.001），pre-PLR≥284.40（5.7 months vs. 9.5 months，P=0.011），post-NLR ≥2.41（4.8 months vs. 9.9 months，P<0.001），and delta-NLR<19.8%（5.8 months vs. 9.5 months，P=0.004） were significantly associated with a poorer PFS；first-line immunotherapy combined with chemotherapy produced a better PFS（9.3 months vs. 6.0 months，P=0.006），and NLR change was significantly greater in patients with combined treatment（P=0.034）. The multivariable Cox analysis showed that pre-NLR，delta-NLR，and whether chemotherapy was combined were independent predictors of PFS after immunotherapy in advanced urothelial carcinoma（P<0.05）.Conclusion High levels of NLR and PLR before treatment indicate a poor prognosis. First-line immunotherapy combined with chemotherapy can reduce NLR and prolonging patients’ PFS. NLR and its change are independent predictors of outcome after immunotherapy in advanced urothelial carcinoma.

Abstract:Objective To explore the clinicopathological characteristics and perioperative clinical characteristics of patients with pheochromocytoma of different ages，and to provide more theoretical bases for individualized treatment of patients with pheochromocytoma in clinical practice.Methods The clinicopathological and perioperative data of 213 patients with pheochromocytoma who were pathologically confirmed and surgically treated in our hospital from 2012 to 2022 were retrospectively analyzed，and the patients were divided into three groups according to age： youth，middle-aged，and elderly groups. The clinicopathological indices and perioperative characteristics of patients with pheochromocytoma in the three groups were compared and analyzed.Results There were significant differences in lesion size，intraoperative blood loss，body mass index，preoperative complications，admission symptoms，intraoperative blood pressure fluctuation，and pathological characteristics among the three groups（P<0.05）. The elderly group had the largest lesion diameter，the highest proportion of positive NSE in postoperative biopsy pathology，and the highest incidence of postoperative nutrition-related complications. The youth group had the highest positive rate of Ki-67，the highest proportion of pheochromocytoma-related symptoms on admission，and the highest incidence of hypertension crisis and intraoperative bleeding. The middle-aged group had the highest incidence of intraoperative blood pressure fluctuation，but shorter total length of hospital stay.Conclusion Pheochromocytoma patients of different age groups have variability in postoperative complications，admission symptoms，and intraoperative blood pressure fluctuations，so treatment should be individualized for patients of different ages.

Abstract:Objective To analyze the factors affecting the outcome of partial nephrectomy（PN） in patients with stage T₁ renal cancer.Methods A retrospective analysis was conducted on the data of 219 patients with stage T₁ renal cancer who underwent PN in the First Affiliated Hospital of Chongqing Medical University from September 2020 to May 2022. Patients were divided into two groups according to tumor stage：T_1a group and T_1b group. Patients’ general data，tumor characteristics，intraoperative and postoperative data were analyzed. PN that simultaneously met four elements of negative surgical margins，renal warm ischemia time <30 min，no grade 3 or higher postoperative complications，and no intermediate conversion to radical nephrectomy was considered as a PN with good outcome，and with this as the observation endpoint，a logistic regression analysis was performed to analyze the factors affecting surgical outcome.Results Significant differences existed between the two groups in terms of maximum tumor diameter，RENAL score，operative time，estimated bleeding，renal warm ischemia time，number of cases with intermediate conversion to radical nephrectomy，creatinine uptake value，and number of cases meeting the four elements. The logistic regression analysis showed that RENAL score was the main factor affecting surgical outcome.Conclusion RENAL score is a key influencing factor for the outcome of PN in patients with stage T₁ renal cancer.

Abstract:Objective To compare the clinical effects of robot-assisted laparoscopic partial nephrectomy（RAPN） and laparoscopic partial nephrectomy（LPN） in patients with complex renal tumors（R.E.N.A.L score ≥7）.Methods The clinical data of patients with complex renal tumors treated by RAPN and LPN in the Department of Urology of The First Affiliated Hospital of Chongqing Medical University from January 2015 to September 2022 were collected and divided into RAPN group（n=91） and LPN group（n=92） according to different surgical methods. The clinicopathological features and perioperative results in the two groups were compared.Results All surgeries were successfully completed. There were no significant differences in operation time，percentage change in postoperative serum creatinine，blood transfusion rate，and resection margin positive rate between the RAPN group and the LPN group（P>0.05）. The total length of hospital stay[（11.3±4.3） d vs. （14.3±4.2） d]，postoperative length of hospital stay[（5.0±2.6） d vs. （7.4±2.9） d]，intraoperative blood loss[（193.0±103.2） mL vs. （231.6±105.0） mL]，and warm ischemia time[（23.9±6.0） min vs. （28.1±6.6） min] were significantly lower in the RAPN group than in the LPN group（P<0.05）.Conclusion The robot-assisted surgery system provides a three-dimensional high-definition field of vision and has a flexible robotic arm，which makes the operation more precise and accurate. RAPN can shorten warm ischemia time，reduce intraoperative blood loss，and shorten length of hospital stay in the treatment of complex renal tumors.

Abstract:Objective To establish a nomogram model for evaluating the prognosis of papillary renal cell carcinoma（PRCC）.Methods Clinical data were collected from 6 028 patients with PRCC in the Surveillance，Epidemiology，and End Results（SEER） database，and they were randomly divided into the training cohort with 4 220 patients and the validation cohort with 1 808 patients. A Cox proportional-hazards regression model analysis was used to identify the clinicopathological features associated with the prognosis of PRCC. A nomogram was established based on the Cox model to predict the prognosis of patients with PRCC； the receiver operating characteristic（ROC） curve and C-index were used to evaluate the discriminatory ability of the model，and the calibration curve was used to assess the predictive accuracy of the nomogram model.Results The data of 6 028 patients with PRCC were retrieved from the SEER database. The Cox proportional-hazards regression model analysis showed that age at diagnosis，grade，tumor-node-metastasis stage（TNM，AJCC，7th edition），surgical treatment，tumor number，and marital status were significant independent prognostic variables，and all the variables were combined to establish a nomogram. The nomogram model had a C-index of 0.807（95%CI=0.779-0.834） in the training cohort and 0.800（95%CI=0.759-0.841） in the validation cohort，and AJCC TNM stage had a C-index of 0.686（95%CI=0.667-0.706） in the training cohort and 0.668（95%CI=0.638-0.697） in the validation cohort，suggesting that compared with AJCC TNM stage，the nomogram model exhibited a good predictive ability for overall survival（OS） rate in the training and validation cohorts. The calibration curve showed high consistency between the OS rate predicted by the nomogram and the actual OS rate.Conclusion The nomogram established in this study shows an excellent predictive performance and can help to evaluate the OS of patients with PRCC，thereby providing a basis for developing individualized treatment strategies.

Abstract:Objective To analyze the impact of laparoscopic nephron-sparing nephrectomy on renal function and prognosis in patients with renal cell carcinoma.Methods A total of 182 patients with renal cell carcinoma in Department of Urology，The First Affiliated Hospital of Chongqing Medical University were enrolled from January 2017 to March 2022. The patients were randomly assigned to undergo laparoscopic radical nephrectomy（control group，91 patients） or laparoscopic nephron-sparing nephrectomy（study group，91 patients）. Postoperative renal function and prognosis of the two groups were compared.Results The study group was significantly better than the control group in the length of hospital stay（P=0.011），and the control group was significantly better than the study group in intraoperative bleeding volume（P<0.001） and operation time（P=0.019）. Compared with the control group，the study group showed a significantly lower serum creatinine level 24 hours after surgery（P=0.013） and significantly higher scores of cognitive function（P=0.018），physical function（P=0.021），social function（P=0.025），emotional function（P=0.032），and overall quality of life（P=0.033） after surgery.Conclusion Laparoscopic nephron-sparing nephrectomy can lessen the impact on renal function and improve postoperative quality of life for patients with renal cell carcinoma.

Abstract:Objective To explore the preliminary efficacy of Disitamab Vedotin（RC48） as postoperative adjuvant therapy in patients with Her-2 positive locally advanced urothelial carcinoma.Methods The clinical data of 32 postoperative patients who received adjuvant therapy with RC48（RC48 group） and 104 postoperative patients who received conventional chemotherapy for locally advanced urothelial carcinoma（chemotherapy group） were retrospectively analyzed. The recurrence status of patients was followed up. The recurrence rate and adverse reaction rate of the two groups were compared.Results There were no significant differences in baseline data and preoperative/postoperative data between the two groups（P>0.05）. The recurrence rate（9.4%，1 case） of the RC48 group was significantly lower than that of the chemotherapy group（20.2%）（P=0.007）. The incidence of adverse reactions in the RC48 group（12.5%） was significantly lower than that in the chemotherapy group（20.2%）（P=0.022）.Conclusion Within 12 months of postoperative treatment，the recurrence rate and adverse reaction rate of patients in the RC48 group were lower than those in the conventional chemotherapy group，suggesting that RC48 has clinical significance in reducing the recurrence rate and delaying the progression of urothelial carcinoma in postoperative patients.

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Abstract:Objective To investigate the safety and efficacy of retroperitoneal laparoscopic adrenalectomy via the extra or intra perinephric fat approach，and to provide experience and a basis for retroperitoneal adrenalectomy.Methods Related clinical data were collected from 497 patients who underwent retroperitoneal laparoscopic adrenalectomy in The First Affiliated Hospital of Chongqing Medical University from December 2017 to March 2023，and a retrospective analysis was performed for their basic features and the changes in perioperative indicators.Results A total of 233 patients receiving the intra perinephric fat approach（IPFA） were included，among whom 224 underwent laparoscopic surgery and 9 underwent robotic surgery，and 264 patients receiving the extra perinephric fat approach（EPFA） were included，among whom 253 underwent laparoscopic surgery and 11 underwent robotic surgery. The two groups had comparable tumor size，estimated blood loss，and time of operation. The EPFA group had a tumor size of （30.47±15.83） mm，which was significantly larger than the tumor size in the IPFA group（P=0.000）. Compared with the EPFA group，the IPFA group had a significantly longer time of operation（P=0.000） and a significantly lower volume of estimated blood loss[（119.07±82.32） mL vs. （158.88±106.94） mL，P=0.000]. There were no significant differences between the two groups in blood transfusion rate and length of hospital stay.Conclusion Retroperitoneal laparoscopic adrenalectomy is a safe and effective procedure that can be performed via the extra and intra perinephric fat approaches. IPFA patients have lower estimated blood loss and postoperative blood transfusion rate than EPFA patients，while EPFA patients have a longer time of operation than IPFA patients. The selection of surgical approach mainly depends on the experience of the surgeon，the characteristics of adrenal tumor，and the nature of perirenal adipose tissue.

Abstract:Objective To summarize the current clinical treatment regimens and experience for malignant ureteral obstruction（MUO），to clarify the clinical application scope of percutaneous nephrostomy（PN） and ureteral stenting（US） in managing MUO，and to investigate the efficacy of these two operation methods in relieving renal impairment due to MUO.Methods A retrospective analysis was performed for 76 patients who were diagnosed with MUO in Department of Urology，The First Affiliated Hospital of Chongqing Medical University，from January 2021 to May 2023 and were screened according to strict inclusion and exclusion criteria，and then they were randomly divided into PN group with 22 patients and US group with 54 patients. The two groups were compared in terms of baseline characteristics，perioperative data，and half-year follow-up data，and SPSS 21.0 was used for data analysis.Results There were significant differences between the two groups in sex（P=0.017），degree of hydronephrosis at the operated side（P=0.000），urea nitrogen（P=0.002） and serum creatinine（P=0.003） 3 days before surgery，and urea nitrogen（P=0.017） and blood creatinine（P=0.005） 1 day after surgery. There was no significant difference in renal function between the two groups at 3 days and 6 months after surgery.Conclusion MUO is often observed in cervical cancer，followed by bladder cancer and colorectal cancer. US is suitable for patients with obstruction or mild hydronephrosis，chronic ureteral obstruction，and mild renal impairment，and it can be considered the preferred choice for relieving ureteral obstruction. PN is typically used for the treatment of patients with moderate to severe hydronephrosis，severe renal impairment，or acute renal insufficiency caused by MUO，and it can be used as an alternative in case of the failure of US.

Abstract:Objective To investigate the safety and practicability of the stoma incision-assisted technique （sampling specimens and performing intestinal anastomosis and ureteral anastomosis through the stoma incision） in laparoscopic radical cystectomy and ileal conduit.Methods In this study，60 patients who had an indication for radical cystectomy or ileal conduit were randomly divided into stoma incision-assisted technique group（experimental group） and traditional lower midline abdominal incision-assisted technique group（control group）. The two groups were compared for urinary diversion operation time，intraoperative blood loss，complication rate，length of postoperative hospital stay，and postoperative pain score.Results The urinary diversion operation time was significantly shorter in the experimental group than in the control group［（105.0±18.9） min vs. （117.0±17.7） min，P<0.05］. The postoperative pain score was significantly lower in the experimental group than in the control group （4.03±1.50 vs. 5.40±1.69，P<0.05）. The length of postoperative hospital stay was significantly shorter in the experimental group than in the control group［（8.27±1.86） days vs. （9.70±1.87） days，P<0.05］. There was no significant difference between the two groups in intraoperative blood loss［experimental group：（260±155） mL，control group：（271±154） mL，P=0.784］. Four cases in the experimental group experienced complications （intestinal obstruction in 2 cases，parastomal hernia in 1 case，and urinary tract infection in 1 case）. Six cases in the control group experienced complications （intestinal obstruction in 3 cases，incision infection in 2 cases，and urinary tract infection in 1 case）. There was no significant difference between the groups in overall complication rate.Conclusion It is safe and feasible to apply the stoma incision-assisted technique in laparoscopic radical cystectomy and ileal conduit，offering a promising application prospect for fast recovery after surgery.

Abstract:Objective To investigate the efficacy and safety of modified laparoscopic partial nephrectomy combined with suction in the treatment of giant cystic renal masses.Methods A total of eleven patients with giant cystic renal masses were admitted，with a maximum tumor diameter of 60-130 mm and a mean diameter of （83±23） mm，and radiological examination showed Bosniak grade Ⅲ-Ⅳ cystic renal masses. During the procedure，the renal artery was separated under the laparoscopic visual field through a retroperitoneal or intraperitoneal approach，and the exophytic portion of the cystic mass was separated as much as possible. Then，a needle-shaped suction rod was used to suck out the cystic fluid at the thin area，and the needle hole was sutured or sealed. The tumor was further isolated completely，the renal artery was blocked，and partial nephrectomy was performed. The double-layer continuous suture technique was used for the suture of renal wound. Perioperative data and postoperative follow-up data were collected.Results All patients underwent a successful surgery，with no patients converted to open surgery or receiving radical treatment. The patients had a mean time of operation of （162±42） minutes，a mean warm ischemia time of （24.0±5.3） minutes，a mean blood loss of （107±79） mL，and a mean postoperative hospital stay of （6.7±1.7） days. Pathological examination showed clear cell renal cell carcinoma in seven patients，papillary renal cell carcinoma in one patient，xanthogranulomatous pyelonephritis in one patient，and benign complex cysts in two patients. No tumor recurrence or metastasis was observed during a median follow-up time of 21 months after surgery，and the patients had good renal function.Conclusion Modified laparoscopic partial nephrectomy combined with suction is a safe and effective method for the treatment of giant cystic renal masses and is suitable for Bosniak grade Ⅲ-Ⅳ cystic masses mainly with cystic components and a few septa.