{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:56:15Z","timestamp":1790571375155,"version":"4.1.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Distal ureter and bladder cuff dissection can be difficult during robot-assisted radical nephroureterectomy (RA-RNU) for upper tract urothelial carcinoma (UTUC), particularly in the deep pelvis where tactile feedback is limited. We evaluated cystoscopic submucosal indocyanine green (ICG) marking around the ureteral orifice as a navigation aid for this step.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adults who underwent RA-RNU with formal bladder cuff excision for clinically localized UTUC (\u2264T3, M0) at three centers between January 2019 and November 2024 were retrospectively analyzed. Outcomes were compared between submucosal ICG-guided and conventional non-ICG procedures. The primary endpoint was video-derived distal ureter and bladder cuff identification time; postoperative care-process measures were descriptive, and other perioperative and oncological outcomes were exploratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The analysis included 82 patients (43 ICG, 39 non-ICG). The ICG group was older, and the largest baseline imbalances by SMD involved age and pathological T stage. Median identification time was 9.0\u00a0min with ICG and 19.3\u00a0min without ICG (p &amp;lt; 0.001). In the primary parsimonious model, the geometric mean ratio was 0.49 (HC3 95% CI 0.45\u20130.53; p &amp;lt; 0.001). No statistically significant between-group difference was observed in Clavien\u2013Dindo grade. During exploratory follow-up, intravesical recurrence occurred in 1\/43 versus 2\/39 patients and extravesical recurrence in 3\/43 versus 8\/39; event counts were insufficient for comparative inference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Submucosal ICG marking around the ureteral orifice was associated with faster distal ureter and bladder cuff identification during RA-RNU. Prospective studies are needed to confirm reproducibility and evaluate injection-specific safety and longer-term oncological outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1957208","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:29:03Z","timestamp":1790569743000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cystoscopic submucosal indocyanine green marking in robot-assisted radical nephroureterectomy: a multicenter cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Runyi","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menghua","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Urology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haozhou","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Urology, Beijing Daxing District Hospital of Integrated Chinese and Western Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3322\/caac.21654","article-title":"Cancer statistics, 2021","volume":"71","author":"Siegel","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-020-03576-3","article-title":"Higher than expected and significantly increasing incidence of upper tract urothelial carcinoma. 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