Javier Pérez Ardavín

🚀 New paper out! ARPI intensification in non-metastatic HSPC. 📄 rdcu.be/fcPvR Congrats to all co-authors 👏 Special thanks to Patricia Willisch & Beatriz Vázquez #ProstateCancer

Reviewed in journal club today 🤓. Love MRI 🧲. But I have some concerns. A 🧵 - summary slides and my thoughts

💫🌟Immunotherapy escalation in BCG-naïve NMIBC: time to pause and think A sharp editorial in European Urology Oncology calls for selectivity over enthusiasm. @EurUrolOncol @OncoAlert 1️⃣ The temptation 🟣 Early IO escalation is attractive… but are we overtreating? 2️⃣ The reality 🔵 BCG still cures a significant proportion of patients 🔵 Not all NMIBC carries the same biological risk 3️⃣ The risk 🔴 Escalation without selection → toxicity, cost, and unclear long-term benefit 💡 Take-home We are entering an era where “who” matters more than “what”. Precision must guide escalation, not excitement. 🔗 buff.ly/U6qXTYb @oncologytube @urotoday @ecancer @OncBrothers @uroweb @mroupret @GPloussard @jteoh_hk @Ric_Campi @LauraMarandino @RenuEapen @Ecastromarcos @Sciencedirect #BladderCancer #NMIBC #Immunotherapy #PrecisionOncology #UroOnc

Anemia - Differential Diagnosis #medtwitter #foamed #meded

DRIFT: A floating device for intravesical gemcitabine-docetaxel delivery. James Byrne, MD, PhD @uiowa joins @UroDocAsh @UTMDAnderson to discuss the DRIFT - Drug-Releasing Intravesical Floating Technology for sequential gemcitabine-docetaxel delivery. #WatchNow > bit.ly/3PDEYdd

@mjuanfi81 @OncoAlert @IBCG_BladderCA Great news! An additional key question is if we could predict pCR using MRI or uDNA, to safely avoid cystectomy! Always learning from you!

RWD on consolidative surgery after EV+P: ✅23 highly selected patients (2 stage II, 13 III, 8 IV) ✅45% pCR & 59% downstaging ⁉️64% complication rate; 27% grade ≥3 ☄️For mUC great responders the dilemma remains: Surgery vs FU @OncoAlert @IBCG_BladderCA doi.org/10.1016/j.urol…

Our @UrolOncol paper is live! Consolidative surgery after EVP: 1⃣Feasible for select advanced UCs 2⃣45% pCR; 59% downstaging 3⃣0 intraop complications; all margins- 4⃣Postop complications: 64% (27% HG) 5⃣Median FU 14 mo: 5 recurrences, 2 deaths 🔗authors.elsevier.com/a/1mtG53r93nkT…

🚨 EN VEZ DE VER NETFLIX ESTA NOCHE… mira esto durante 1 hora. Este curso de Claude AI te enseña a construir y automatizar casi cualquier cosa. Los que lo vean hoy despertarán mañana con una skill que la mayoría no tendrá en 2 años. Los que lo ignoren seguirán viendo Netflix el año que viene preguntándose por qué nada cambia. Tu decisión. Sígueme para más contenido así 🚀

🚨Preop MRI before radical prostatectomy isn't just for surgical planning, it predicts survival.🚨 New meta-analysis (n=24,941) in @JAMAOnc : 🔬 mrT3a (EPE): HR 2.16 for BCR, HR 10.93 for PCSS ⚠️ mrT3b (SVI): HR 2.74 for BCR, HR 5.58 for MFS 📊 PI-RADS 4/5: HR 2.15 for BCR 📏 Tumor >20mm: HR 2.35 for BCR 🌊 Low ADC (<0.9): HR 2.39 for BCR All independent of PSA, Gleason, and pathologic stage. 🧲 Your preop MRI is a prognostic biomarker. Start treating it like one! 🔗shorturl.at/yq3q9 @PCFnews @PCF_Science @UrologyTimes @urotoday

Does pretreatment MRI predict long-term outcomes after radical prostatectomy? 24,941 patients say yes. mrT3a: HR 2.16 for BCR. Independent of grade and pathology! @JAMAOnc @Uroweb @APCCC_Lugano @OncoAlert

🚨The sequel is here!! The other 👞 drops. Cribriform morphology in ProtecT — now in prostatectomy specimens #ProstateCancer #radonc #UroSoMe @UroToday @APCCC_Lugano @PCF_Science @OncoAlert 🧵1️⃣

In the EV era are we underusing local control? 🚩Among 459 patients with advanced urothelial carcinoma> just 108 received bladder-directed therapy after EV pub alert @CleClinicUro @UrolOncol 💡Cystectomy had the strongest survival signal in select pts supporting earlier multi D discussion @hjwang26 @MoningiShalini @AmandaNizamMD

3/ @dr_coops on screening with PSA and biopsy at #EAU26: x.com/dr_coops/statu…

Prompting is the worst way to use Claude. Here's what the top 1% do instead: 1. Open the Claude desktop app. 2. Click "Cowork" (not Chat). 2. Point it to a folder with your context files. 3. Create 3 files: about-me, my-voice, my-rules. 4. Use this setup guide: claude-co.work Claude now reads your brain. Every session. But here's where it gets powerful: Before you prompt, change these 2 settings: 1. Turn on "Extended Thinking" It forces Claude to think before answering. 2. Select "Opus 4.6" model. It is the best model for deep, multi-step work. Then stop writing prompts. Paste this instead: "I want to [TASK]. Read all files first. Ask me questions using AskUserQuestion before you execute. Do not guess." Claude generates clickable buttons. It executes. The secret was never the prompt. It was the setup. But to go even deeper, use my full playbook: claude-co.work

Kidney cancer care just got a major upgrade. The NICE 2026 guideline finally gives a full roadmap for RCC, from diagnosis → treatment → follow-up. ⚙️ What changes in clinic: 🔬 Biopsy matters more • Recommended for small renal masses (≤4 cm) when it impacts decisions 👀 Active surveillance is legit • Now standard option for selected small tumors + Bosniak 3 cysts 🔪 Surgery still leads • Remains gold standard for many localized cases 🔥 Non-surgical options • Ablation / SABR for patients unfit or unwilling for surgery 📊 Follow-up gets smarter • Risk-adapted imaging instead of one-size-fits-all 👨‍⚕️ Team-based care • Strong push for MDT + clinical nurse specialist access 💡 Takeaway 👉 Less overtreatment, more personalization, better structured RCC care 🔖 This will change real-world practice more than most trials. 📖 Full paper in comment ⬇️ #OncoTwitter #MedTwitter #KidneyCancer #RCC @OncoAlert @myesmo @esmo_open @asco

Extended vs limited pelvic lymph node dissection during radical prostatectomy for intermediate- and high-risk #ProstateCancer: 10 years of follow up - oncological outcomes from a randomized phase 3 trial. Presented by Matheus Ruggeri. #EAU26 written coverage by @zklaassen_md > bit.ly/40vh9q4 @Uroweb

#EAU26 Does bladder preservation really improve QoL? Dr. Gessner reviews the CISTO study (n=570) BST vs RC in recurrent high-grade NMIBC. 🔹 Physical function at 12 mo: similar between BST and RC 🔹 RC: better emotional function, ↓ anxiety/depression, ↓ financial burden 🔹 BST: better bowel & sexual outcomes 📊 Oncological outcomes: • CSS similar (99% BST vs 96% RC) • BST → higher recurrence rates • RC → higher perioperative toxicity (90-day mortality ~2.5%) @uroweb @UroToday

Prof Hugosson: Göteborg trial with 30 year outcomes! NND falls to -6-, with greatest benefit for men 50-59 at randomization. Despite no image guidance, high overdx, and suboptimal tx. Best evidence we have re: the evidence for #prostatecancer screening. Get tested! #eau26 @uroweb

#EAU26 Multiple learnings from the Brazilian RCT of RP w/ limited vs extended PLND. Negative overall, but subset analysis for GG3-5 positive. 1. In patients w/ GG3-5 disease --> bRFS benefit of ePLND @VickersBiostats 2. Progression is extremely common w/ ~75% of patients s/p RP developing BCR by 4.5 years w/ limited PLND. Even with ePLND it was ~50% at 4.5 years. 3. If effect size so large this can be shown in just 69 patients, this should be a very easy Ph3 multi-center trial to run. All trials to date have been single center and did not meet primary endpoint in overall population. Lets get some definitive data already as this is a big difference for patients. @ChapinMD @wandering_gu @EdwardSchaeffer @ASCO @declangmurphy @urotoday

Peter Albers lays out the case for early baseline PSA testing for #prostatecancer from the PROBASE study #eau26