{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T15:32:59Z","timestamp":1786635179702,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the utility of routine intra\u2010operative frozen section analysis (iFSA) of distal ureteric margins during radical cystectomy (RC) for bladder cancer (BCa), focusing on diagnostic accuracy and oncological outcomes in a high\u2010volume tertiary centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>We retrospectively identified 1081 patients with BCa treated with RC (2010\u20132024). Bilateral iFSA of the distal ureters was performed in all cases. Patients were stratified according to final distal ureteric margin status (positive vs negative); if positive, additional resections were attempted intra\u2010operatively. Diagnostic concordance between iFSA and final pathology was calculated. Kaplan\u2013Meier curves were used to assess 5\u2010year upper urinary tract recurrence (UUTR) free\u2010survival, overall survival (OS), and cancer\u2010specific survival (CSS). Univariable logistic regression and multivariable logistic regression (MLR) models identified variables associated with positive margins.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 139 patients (12.9%) had positive distal ureteric margins at iFSA. The sensitivity and specificity of FSA were 98.6% and 99.5%, respectively. In MLR models, hydronephrosis (odds ratio [OR] 1.75,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.014), T3\u2013T4 stage (OR 2.48,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003), bladder carcinoma\n                      <jats:italic>in situ<\/jats:italic>\n                      (CIS; OR 7.94,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and trigonal tumour location (OR 4.85,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) were independently associated with positive distal ureteric margins at iFSA. Positive margins were associated with increased risk of UUTR (5\u2010year UUTR\u2010free survival: 58% vs 78%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.038), worse OS (5\u2010year OS: 48% vs 67%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.039), and worse CSS (5\u2010year CSS: 60% vs 75%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0018).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study showed that iFSA of distal ureteric margins during RC for BCa provided excellent diagnostic performance and enabled cancer\u2010free anastomosis. Our findings support iFSA, especially in patients with bladder CIS, trigonal tumours, or hydronephrosis, to guide intra\u2010operative decisions and tailor postoperative surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70125","type":"journal-article","created":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T04:28:06Z","timestamp":1766809686000},"page":"659-666","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Is there still a role for ureteric frozen section analysis during radical cystectomy?"],"prefix":"10.1111","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7668-3475","authenticated-orcid":false,"given":"Attilio","family":"Barretta","sequence":"first","affiliation":[{"name":"Division of Urology IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna 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