Clinical genitourinary cancer最新文献

{"title":"A Clinicopathologic Study of 1598 Ultrasound-Guided Needle Prostate Biopsies and Trends in Prostate Cancer Over a 14-Year Period","authors":"Bahar Ebtehaj ,&nbsp;Mehdi Adhami ,&nbsp;Amir Javadi ,&nbsp;Fatemeh Hajmanoochehri","doi":"10.1016/j.clgc.2024.102272","DOIUrl":"10.1016/j.clgc.2024.102272","url":null,"abstract":"<div><h3>Background</h3><div>Prostate cancer manifests in various forms, ranging from occult and localized to metastatic disease. Analyzing prostate biopsies offers insights into histopathological characteristics, enhancing disease understanding and management.</div></div><div><h3>Methods</h3><div>This 14-year study reviewed ultrasound-guided needle prostate biopsies, collecting data via questionnaires and medical records, focusing on Gleason group, tumor involvement percentage, and predicted cancer stage. A comparative analysis across 2 distinct 7-year intervals was conducted. Statistical analyses included the Kolmogorov–Smirnov test, chi-square test, Fisher's exact test, and Analysis of Covariance, all performed using SPSS software.</div></div><div><h3>Results</h3><div>Among 1,598 biopsies, 624 cases of adenocarcinoma were identified. Malignancy incidence significantly correlated positively with age, prostate-specific antigen (PSA), and PSA density (PSAD), and inversely with prostate volume and the free-to-total PSA ratio (%fPSA). Notably, 30.8% of malignancies were classified as Gleason groups 4 or 5, displaying significantly higher PSA levels. Patients with prior transurethral resection of the prostate exhibited increased malignancy rates and higher Gleason groups. Diagnostic accuracy, measured by Area Under the Curve, was 0.719 for PSA, 0.730 for %fPSA, and 0.817 for PSAD. The later phase of the study showed higher cancer detection, lower PSA levels, and a greater incidence of higher Gleason groups despite a lower predicted stage.</div></div><div><h3>Conclusion</h3><div>The prevalence of higher Gleason groups was similar to other studies. PSAD demonstrated greater diagnostic reliability than PSA alone. Additionally, higher malignancy rates and Gleason groups were observed in patients with prior transurethral resection of the prostate. The increase in cancer detection rates during the second period likely indicates improved biopsy candidate selection.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102272"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics, Treatment, and Outcomes of Primary Urethral Cancer: A Multicenter Review Over Two Decades","authors":"Benjamin D. Hopkins ,&nbsp;David C. Qian ,&nbsp;Karen M. Xu ,&nbsp;Ashley McCook-Veal ,&nbsp;Jeffrey Switchenko ,&nbsp;Lindsey M. Hartsell ,&nbsp;Cara B. Cimmino ,&nbsp;Shreyas S. Joshi ,&nbsp;Vikram Narayan ,&nbsp;Viraj A. Master ,&nbsp;Bassel Nazha ,&nbsp;Bradley C. Carthon ,&nbsp;Mehmet A. Bilen ,&nbsp;Omer Kucuk ,&nbsp;Joseph W. Shelton ,&nbsp;Pretesh R. Patel ,&nbsp;Ashesh B. Jani ,&nbsp;Jill S. Remick ,&nbsp;Tony Y. Eng","doi":"10.1016/j.clgc.2024.102276","DOIUrl":"10.1016/j.clgc.2024.102276","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>Urethral cancers are uniquely complex and heterogeneous in their presentations and approaches to management.</div></span></li><li><span>•</span><span><div>Histology drives important differences in the behavior and treatment of urethral cancer.</div></span></li><li><span>•</span><span><div>The addition of brachytherapy to definitive external beam radiation results in superior locoregional disease control.</div></span></li><li><span>•</span><span><div>More than a third of the patients in our study required multimodality care, highlighting the importance of inter-disciplinary collaboration and comprehensive care in complex cases.</div></span></li></ul></div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102276"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cisplatin- or Carboplatin-Based Chemotherapy Plus Pembrolizumab in Advanced Urothelial Cancer: Exploratory Analysis From the Phase 3 KEYNOTE-361 Study","authors":"Thomas Powles ,&nbsp;Tibor Csőszi ,&nbsp;Yohann Loriot ,&nbsp;Nobuaki Matsubara ,&nbsp;Lajos Geczi ,&nbsp;Susanna Y-S Cheng ,&nbsp;Yves Fradet ,&nbsp;Ajjai Alva ,&nbsp;Stéphane Oudard ,&nbsp;Christof Vulsteke ,&nbsp;Rafael Morales-Barrera ,&nbsp;Aude Fléchon ,&nbsp;Seyda Gunduz ,&nbsp;Chih-Chin Liu ,&nbsp;Blanca Homet Moreno ,&nbsp;Abhishek Bavle ,&nbsp;Mustafa Özgüroğlu","doi":"10.1016/j.clgc.2024.102261","DOIUrl":"10.1016/j.clgc.2024.102261","url":null,"abstract":"<div><h3>Introduction</h3><div>KEYNOTE-361 evaluated first-line pembrolizumab with and without platinum-based chemotherapy versus chemotherapy alone in advanced or metastatic urothelial carcinoma. The primary end points of progression-free survival (PFS) or overall survival (OS) were not met. Exploratory analysis of efficacy by platinum agent (cisplatin or carboplatin) is reported.</div></div><div><h3>Patients and Methods</h3><div>Eligible patients were randomly assigned 1:1:1 to receive pembrolizumab 200 mg intravenously every 3 weeks for ≤35 cycles with or without chemotherapy (gemcitabine with investigator's choice of either cisplatin or carboplatin) or chemotherapy alone. This exploratory subset analysis evaluated PFS and objective response rate (ORR) per RECIST v1.1 by blinded independent central review and OS for cisplatin- or carboplatin-based chemotherapy with versus without pembrolizumab for patients assigned to chemotherapy-containing arms of KEYNOTE-361.</div></div><div><h3>Results</h3><div>Of 1010 patients enrolled, 703 were assigned to receive a chemotherapy-containing regimen (<em>n</em> = 312 cisplatin based; <em>n</em> = 391 carboplatin based). Median follow-up was 31.3 months. For cisplatin-based arms, with versus without pembrolizumab, median OS was 20.1 versus 16.4 months (HR 0.88, 95% CI, 0.67-1.15) and median PFS was 8.5 versus 7.1 months (HR 0.67, 0.51-0.89). ORR was 64.1% versus 48.7%, respectively. For carboplatin-based arms, with versus without pembrolizumab, median OS was 15.5 versus 12.3 months (HR 0.84, 95% CI, 0.67-1.06) and median PFS was 8.0 versus 6.7 months (HR 0.86, 0.68-1.09). ORR was 47.2% versus 41.8%, respectively. Among patients in the cisplatin-based versus carboplatin-based chemotherapy alone arms, 55.8% versus 41.8% received a subsequent antiprogrammed cell death protein 1/ligand 1 therapy. The addition of pembrolizumab did not significantly increase the incidence of adverse events reported.</div></div><div><h3>Conclusion</h3><div>Results suggest trends toward OS and PFS improvements with the addition of pembrolizumab to gemcitabine-platinum doublet over gemcitabine-platinum alone regardless of whether cisplatin or carboplatin was the chosen platinum agent. OS may have been influenced by active subsequent therapies.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102261"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Patterns and Attrition in Metastatic Renal Cell Carcinoma: Real-Life Experience from the Turkish Oncology Group Kidney Cancer Consortium (TKCC) Database","authors":"Hatice Bölek ,&nbsp;Elif Sertesen ,&nbsp;Omer Faruk Kuzu ,&nbsp;Deniz Tural ,&nbsp;Saadet Sim ,&nbsp;Mehmet Ali Nahit Şendur ,&nbsp;Gökhan Uçar ,&nbsp;Selver Işık ,&nbsp;Bekir Hacıoğlu ,&nbsp;İrfan Çiçin ,&nbsp;Çağatay Arslan ,&nbsp;Sema Sezgin Göksu ,&nbsp;Özlem Nuray Sever ,&nbsp;Cengiz Karaçin ,&nbsp;Nuri Karadurmuş ,&nbsp;Mustafa Özgüroğlu ,&nbsp;Emre Yekedüz ,&nbsp;Yüksel Ürün","doi":"10.1016/j.clgc.2024.102282","DOIUrl":"10.1016/j.clgc.2024.102282","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the rapid evolution in management of metastatic renal cell carcinoma (mRCC) over the past decade, challenges remain in accessing new therapies in some parts of the world. Despite therapeutic advancements, attrition rates remain persistently high. This study aims to assess the treatment patterns and attrition rates of patients with mRCC in oncology clinics across Turkey.</div></div><div><h3>Patients and Methods</h3><div>Patients diagnosed with mRCC between January 1, 2008, and December 31, 2022, with first-line systemic treatment data, were retrospectively evaluated using the Turkish Oncology Group Kidney Cancer Consortium (TKCC) Database.</div></div><div><h3>Results</h3><div>The final analysis included a total of 1126 patients. The percentages of patients treated in the 2nd, 3rd, 4th, and 5th lines of therapy were 62.8%, 27.4%, 8.9%, and 2.1%, respectively. The drugs that were most commonly used in the groups were tyrosine kinase inhibitors (TKIs) (52.2%) and interferon (IFN)-alpha (43.3%) for the first line, TKIs (66.3%) and immunotherapy (IO) monotherapy (25.9%) for the second line, TKI (41.4%) and mTOR inhibitors (28.8%) for the third line, TKI (44.4%) and mTOR inhibitors (29%) for the fourth line, and IO monotherapy (37.5%) and TKI (25%) for the fifth line. For the first-line treatment, the primary cause of attrition was disease progression (66.4%), followed by toxicity (16.5%), death (11.2%), and patient preference (5.9%). The primary reason for attrition across all treatment lines was disease progression. Over time, the use of TKIs in first-line treatment increased, while IFN-alpha usage declined. IOs began to be utilized in earlier lines, predominantly in second-line treatment, though use of IO-based combination therapies remains limited.</div></div><div><h3>Conclusion</h3><div>This study underscores that despite significant progress in therapeutic options, the adoption of novel agents remains slow, and attrition rates are still high. These findings indicate a disparity in systemic therapy compared to developed countries.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102282"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness Analysis of Lenvatinib plus Pembrolizumab or Everolimus as First-Line Treatment for Advanced Renal Cell Carcinoma","authors":"Huanrui Zheng ,&nbsp;Jin Zhou ,&nbsp;Yao Tong ,&nbsp;Jinhua Zhang","doi":"10.1016/j.clgc.2024.102264","DOIUrl":"10.1016/j.clgc.2024.102264","url":null,"abstract":"<div><h3>Background</h3><div>Recently, due to its promising efficacy against advanced renal cell carcinoma (RCC), the combination therapy with lenvatinib and pembrolizumab or everolimus has been approved as a first-line treatment for patients with advanced RCC in China and the United States. However, the high costs of combination therapies, especially of those new drugs, may limit their viability as clinical treatment options. Thus, our study aimed to evaluate the cost-effectiveness of using lenvatinib plus pembrolizumab or everolimus as a first-line treatment for patients with advanced RCC from the perspective of the Chinese healthcare system and US third-party payers.</div></div><div><h3>Methods</h3><div>We established a Markov model using TreeAge Pro 2022 software to estimate and compare the cost and effectiveness of the therapy with lenvatinib plus pembrolizumab or everolimus with those of sunitinib therapy for treating advanced RCC based on the clinical data derived from a phase III randomized controlled trial (CLEAR, ClinicalTrials.gov number NCT02811861). Transition probabilities and other data were calculated and obtained by using parametric survival modeling. The direct medical costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were used as economic indicators in this analysis. The robustness of the model was assessed by performing one-way and probability sensitivity analyses (PSA).</div></div><div><h3>Results</h3><div>Among the 3 treatment strategies, the sunitinib 1 was the least expensive option. All ICERs were far higher than the thresholds of $38,024 and $100,000 selected for China and the United States, respectively. The ICERs of the therapy with lenvatinib plus pembrolizumab versus sunitinib therapy were 106,749.06 US$/QALY and $414,672.19 US$/QALY in China and the United States, respectively. Thus, among these 2, the former strategy was less cost-effective than the latter. In addition, the ICERs of the lenvatinib plus everolimus treatment vs. sunitinib treatment were $44,353.18 US$/QALY and $292,653.10 US$/QALY in China and the United States, respectively. Thus, among these 2 strategies, the former was less cost-effective than the latter. The total cost of the lenvatinib plus everolimus treatment strategy was lower than that of lenvatinib plus pembrolizumab; however, the former treatment was less effective than the latter.</div></div><div><h3>Conclusion</h3><div>The treatment with lenvatinib plus pembrolizumab or everolimus is less cost-effective than the sunitinib treatment for patients with advanced RCC in China and the United States.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102264"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and Disparities in Inpatient Palliative Care Use in Metastatic Renal Cell Carcinoma Patients Receiving Critical Care Therapy","authors":"Carolin Siech ,&nbsp;Simone Morra ,&nbsp;Lukas Scheipner ,&nbsp;Andrea Baudo ,&nbsp;Mario de Angelis ,&nbsp;Letizia Maria Ippolita Jannello ,&nbsp;Nawar Touma ,&nbsp;Jordan A. Goyal ,&nbsp;Zhe Tian ,&nbsp;Fred Saad ,&nbsp;Shahrokh F. Shariat ,&nbsp;Nicola Longo ,&nbsp;Luca Carmignani ,&nbsp;Ottavio de Cobelli ,&nbsp;Sascha Ahyai ,&nbsp;Alberto Briganti ,&nbsp;Cristina Cano Garcia ,&nbsp;Luis A. Kluth ,&nbsp;Felix K.H. Chun ,&nbsp;Pierre I. Karakiewicz","doi":"10.1016/j.clgc.2024.102269","DOIUrl":"10.1016/j.clgc.2024.102269","url":null,"abstract":"<div><h3>Purpose</h3><div>Temporal trends in and predictors of inpatient palliative care use in patients with metastatic renal cell carcinoma (mRCC) undergoing critical care therapy are unknown.</div></div><div><h3>Methods</h3><div>Relying on the National Inpatient Sample (2008-2019), we identified mRCC patients undergoing critical care therapy, namely invasive mechanical ventilation, percutaneous endoscopic gastrostomy tube insertion, dialysis for acute kidney failure, total parenteral nutrition, or tracheostomy. Estimated annual percentage changes (EAPC) analyses and multivariable logistic regression models addressed inpatient palliative care use.</div></div><div><h3>Results</h3><div>Of 3802 mRCC patients undergoing critical care therapy, 817 (21.5%) received inpatient palliative care. Overall, inpatient palliative care use increased from 4.9% to 31.5% between 2008 and 2019 (EAPC +9.2%). In subgroup analyses, the highest increase in inpatient palliative care use was observed in the Midwest (EAPC: +11.9%), in the South (EAPC +10.4%), and in teaching hospitals (EAPC +9.0%; all <em>P</em> ≤ .004). In logistic regression models, teaching hospital status (odds ratio [OR] 1.41) and contemporary year interval (OR 2.12; all <em>P</em> &lt; .001) independently predicted higher inpatient palliative care rates. Conversely, hospital admission in the Northeast (OR 0.53) or in the South (OR 0.79; all <em>P</em> ≤ .03) was associated with lower inpatient palliative care rates than in the West.</div></div><div><h3>Conclusion</h3><div>In mRCC patients, inpatient palliative care rates have improved over time, with the highest increase in hospitals in the Midwest and in the South. Moreover, admission to teaching hospitals or in the West is associated with higher inpatient palliative care rates. In consequence, regional disparities, as well as differences according to teaching hospital status represent targets to achieve comprehensive inpatient palliative care coverage in mRCC patients receiving critical care therapy.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102269"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world Clinical Outcomes and Prognostic Factors in Neuroendocrine Prostate Cancer","authors":"Richard Gagnon ,&nbsp;Ealia Khosh Kish ,&nbsp;Sarah Cook ,&nbsp;Kosuke Takemura ,&nbsp;Brian Yu Chieh Cheng ,&nbsp;Kamiko Bressler ,&nbsp;Daniel Yick Chin Heng ,&nbsp;Nimira Alimohamed ,&nbsp;Dean Ruether ,&nbsp;Richard Marvin Lee-Ying ,&nbsp;Pinaki Bose ,&nbsp;Michael Paul Kolinsky ,&nbsp;Catalina Vasquez ,&nbsp;Divya Samuel ,&nbsp;John Lewis ,&nbsp;Rehan Faridi ,&nbsp;Minal Borkar ,&nbsp;Adrian Fairey ,&nbsp;Tarek Bismar ,&nbsp;Steven Yip","doi":"10.1016/j.clgc.2024.102274","DOIUrl":"10.1016/j.clgc.2024.102274","url":null,"abstract":"<div><h3>Background</h3><div>Neuroendocrine prostate cancer (NEPC) encompasses pure NEPC and tumors with mixed adenocarcinoma and neuroendocrine histology. While NEPC is thought to confer a poor prognosis, outcome data are sparse, making risk stratification and treatment decisions difficult for clinicians.</div></div><div><h3>Methods</h3><div>This retrospective study identified patients with morphological and/or immunohistochemical NEPC features on pathological review of high-grade prostate cancer cases. Median overall survival (OS) was calculated by stage and castration sensitivity. Prognostic factors were assessed via multivariate analysis. OS and progression-free survival on first-line metastatic systemic treatment were also evaluated.</div></div><div><h3>Results</h3><div>Of 135 NEPC cases, 25.9% had NEPC documented in the original pathological report. Mixed pathology was found in 91.9% of cases. Median OS from NEPC diagnosis was 59.2, 42.3, 14.3, 17.6 and 9.6 months for localized, nonmetastatic castration-sensitive, nonmetastatic castration-resistant, metastatic castration-sensitive and metastatic castration-resistant prostate cancer, respectively. Anemia (hazard ratio [HR]: 1.66; 95% CI 1.05-2.16; <em>P = .</em>031) and elevated neutrophil-lymphocyte ratio (NLR) (HR: 1.51; 95% CI 1.01-2.52; <em>P = .</em>045), were associated with increased risk of death on multivariate analysis. 67 patients received first-line metastatic treatment beyond androgen deprivation, with a median progression-free survival of 5.2 months and OS of 15 months. Of these, 50.7% received more than 1 line of systemic treatment.</div></div><div><h3>Conclusion</h3><div>We observed underdiagnosis of NEPC in pathology specimens. NEPC is associated with poorer prognosis than would be expected in pure adenocarcinoma populations, with rapid progression on first-line metastatic treatment and sharp drop-off between subsequent treatment lines. Anemia and elevated NLR were associated with poor survival.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102274"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of Prognostic Model for Metastatic Castration-Resistant Prostate Cancer Patients Treated With First-Line Abiraterone or Enzalutamide","authors":"Orazio Caffo ,&nbsp;Umberto Basso ,&nbsp;Carlo Cattrini ,&nbsp;Paola Ermacora ,&nbsp;Marco Maruzzo ,&nbsp;Martina Alberti ,&nbsp;Cecilia Anesi ,&nbsp;Davide Bimbatti ,&nbsp;Massimiliano Cani ,&nbsp;Veronica Crespi ,&nbsp;Giovanni Farinea ,&nbsp;Dzenete Kadrija ,&nbsp;Stefania Kinspergher ,&nbsp;Eleonora Lai ,&nbsp;Ludovica Lay ,&nbsp;Francesca Maines ,&nbsp;Alessia Mennitto ,&nbsp;Francesco Pierantoni ,&nbsp;Alessandro Samuelly ,&nbsp;Susanna Urban ,&nbsp;Antonello Veccia","doi":"10.1016/j.clgc.2024.102265","DOIUrl":"10.1016/j.clgc.2024.102265","url":null,"abstract":"<div><h3>Introduction</h3><div>Over the years, several prognostic models were developed in patients receiving chemotherapy for metastatic castration resistant prostate cancer (mCRPC), while data on androgen-receptor signaling inhibitors (ARSI) in a real-world setting are limited.</div></div><div><h3>Patients and methods</h3><div>We compared a consecutive series of 565 mCRPC patients receiving first-line ARSI at 4 high-volume Italian Centers (development set) to an external series of 180 patients receiving the same treatment at another Italian high-volume Center (training set), between 2011 and 2022.</div><div>Sixteen clinical and baseline laboratory variables were selected to develop a prognostic model. Patients were categorized into risk groups according to the number of independent factors positively associated with overall survival (OS).</div></div><div><h3>Results</h3><div>In the development cohort, after a median follow-up of 21.1 months, the median OS was 30.4 months (95% CI 27.5-33.4). At the multivariate analysis, 7 variables [age, prostate specific antigen (PSA) doubling time, baseline levels of hemoglobin, PSA, time to castration resistance, ECOG PS and bone metastases number) were included into the final model.</div><div>The median OS was 13.4, 25.7 and 46.4 months in poor (0-2 factors), intermediate (3-4 factors) and good (≥ 5 factors) prognosis group, respectively.</div><div>The application of the model to the validation set confirmed its ability to prognosticate for OS. The model c-indexes were 0.68 (95% CI 0.64-0.72) and 0.75 (95% CI 0.68-0.81) in the development and validation cohort, respectively.</div></div><div><h3>Conclusions</h3><div>Our model, based on clinical and laboratory variables readily assessable in clinical practice, might prognosticate the OS of mCRPC patients receiving first-line ARSI.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102265"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex Decision Making for Individual Patients With Penile Cancer: Benchmarking Divergent Practices in European High-Volume Reference Centers: Results From eUROGEN Survey","authors":"Laura Elst ,&nbsp;Darren Shilhan ,&nbsp;Michelle Battye ,&nbsp;Jure Murgić ,&nbsp;Ana Frӧbe ,&nbsp;Maarten Albersen ,&nbsp;Marija Miletić","doi":"10.1016/j.clgc.2024.102275","DOIUrl":"10.1016/j.clgc.2024.102275","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Penile cancer (PeCa) remains a challenge due to its rarity and the lack of prospective studies, leading to treatment challenges and controversies. Guidelines offer recommendations, but discrepancies with clinical practice persist. This study analyzed treatment practices among specialists managing high-risk PeCa in European reference centers.</div></div><div><h3>Methods</h3><div>A cross-sectional survey included 39 PeCa specialists from 13 European countries representing high-volume centers. Descriptive analysis assessed (neo)adjuvant therapy preferences, systemic regimen choices, immunotherapy use, and next-generation sequencing (NGS) integration.</div></div><div><h3>Key findings and limitations</h3><div>Variations in managing high-risk PeCa, especially in (neo)adjuvant therapy utilization, were noted among participants. The differences highlight the influence of professional backgrounds and variations in treatment approaches between participants. Systemic regimen preferences and immunotherapy utilization also varied. Limited NGS integration indicated gaps in precision medicine adoption. Limitations included sample size, self-reported data, and cross-sectional design.</div></div><div><h3>Conclusions and clinical implications</h3><div>This study offered insights into PeCa management by specialists in high-volume European reference centers, stressing the need for evidence-based recommendations, guideline adherence, and collaboration to enhance PeCa care.</div></div><div><h3>Patient summary</h3><div>Managing PeCa is complex due to its rarity and treatment controversies. This study examined practices among specialists in European reference centers, revealing treatment variations. The findings emphasize the importance of evidence-based care and collaboration in optimizing PeCa management.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102275"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eighty-Nine Cases of Primary Prostatic Signet Ring Cell Carcinoma—Systematic Review","authors":"Madison Boot ,&nbsp;Kenneth Keen Yip Chew ,&nbsp;Jack Archer ,&nbsp;Kirra Parks ,&nbsp;Katelyn Wilson ,&nbsp;Cameron Sowter ,&nbsp;Steven Sowter","doi":"10.1016/j.clgc.2024.102281","DOIUrl":"10.1016/j.clgc.2024.102281","url":null,"abstract":"<div><div>Signet ring cell adenocarcinoma is a rare subtype of mucinous adenocarcinoma that affects the gastrointestinal tract and the prostate. Prostatic signet ring cell carcinoma comprises 0.02% of all cases of prostate cancer and 0.4% of all signet ring cell cancers. The aim of this review was to summarize the existing literature on primary prostatic signet ring cell carcinoma by assessing patient demographics, clinical presentations, investigations, treatment methods, and survival outcomes. A systematic review was conducted in multiple databases, including 46 articles comprising 89 individual cases of primary prostatic signet ring cell carcinoma. Data was extracted and analyzed using descriptive statistics. The average age of patients with primary prostatic signet ring cell carcinoma was 68.5 years, and most cases were reported in Caucasian individuals. Clinical presentations varied, with lower urinary tract symptoms being the most common. Biochemical markers, such as prostate-specific antigen, were often elevated. Imaging modalities, including computed tomography and magnetic resonance imaging, were used for diagnosis, and it found that one-third had metastatic disease on diagnosis. Treatment options included radical prostatectomy, hormone therapy, radiation therapy, and chemotherapy. The prognosis for primary prostatic signet ring cell carcinoma was poor, with a 3-year survival rate of approximately 17%. Primary prostatic signet ring cell carcinoma is a rare and aggressive form of prostate cancer. The limited literature on this condition highlights the need for further research. These systematic review findings contribute to a better understanding of this disease and may guide future clinical management strategies.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102281"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}