Clinical genitourinary cancer最新文献

{"title":"Role of Cytoreductive Nephrectomy in Metastatic Clear Cell Renal cell Carcinoma in the Era of immunotherapy: An Analysis of the National Cancer Database","authors":"Maroun Bou Zerdan ,&nbsp;Stephanie Niforatos ,&nbsp;Swathi Arunachalam ,&nbsp;Tamara Jamaspishvili ,&nbsp;Roger Wong ,&nbsp;Gennady Bratslavsky ,&nbsp;Joseph Jacob ,&nbsp;Jeffrey Ross ,&nbsp;Oleg Shapiro ,&nbsp;Hanan Goldberg ,&nbsp;Alina Basnet","doi":"10.1016/j.clgc.2024.102193","DOIUrl":"10.1016/j.clgc.2024.102193","url":null,"abstract":"<div><h3>Background</h3><p>The effectiveness of the clinical outcome of CN (Cytoreductive Nephrectomy) in cases of mccRCC (Metastatic Clear Cell Renal cell Carcinoma) is still uncertain despite two trials, SURTIME and CARMENA. These trials, conducted with Sunitinib as the standard treatment, did not provide evidence supporting the use of CN.</p></div><div><h3>Methods</h3><p>We queried the NCDB for stage IV mccRCC patients between the years of 2004 to 2020, who received (immunotherapy) IO with or without nephrectomy. Overall survival (OS) was calculated among three groups of IO alone, IO followed by CN (IOCN), CN followed by IO (CNIO). Cox models compared OS by treatment group after adjusting for sociodemographic, health, and facility variables.</p></div><div><h3>Results</h3><p>From 1,549,101 renal cancer cases, 7983 clear and nonclear cell renal cell carcinoma cases were identified. After adjusting for sociodemographic and health covariates, patients who received IO followed by CN or CN followed by IO had a respective 64% (adjusted Hazard Ratio [aHR] = 0.36, 95% CI = 0.30-0.43, <em>P</em> = .006] and 47% (aHR = 0.53, 95% CI = 0.49-0.56, <em>P</em> = .001) mortality risk reduction respectively compared to patients who received IO alone. Compared to White adults, individuals who identified as Black exhibited 17% higher risk mortality (aHR = 1.17, 95% CI = 1.06-1.30, <em>P</em> = .002). Patients who received CN prior to IO had a 59% associated mortality risk compared to patients who received IO followed by CN who had a lower risk, 35.7% (<em>P</em> &lt; .001).</p></div><div><h3>Conclusions</h3><p>Patients receiving CN regardless of sequence with IO did better than IO alone in this national registry-based adjusted analysis for mccRCC. Presently available data indicates that the combination of CN and IO holds promise for enhancing clinical results in patients with mRCC.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102193"},"PeriodicalIF":2.3,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201809","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":"Fatigue Management in Advanced Prostate Cancer: Real-World Insights From Qualitative Interviews With Patients","authors":"Stephen J. Freedland ,&nbsp;Marty Chakoian ,&nbsp;Ted Wells ,&nbsp;Nader El-Chaar ,&nbsp;Alexandra Colon ,&nbsp;Dina Elsouda ,&nbsp;Agnes Hong","doi":"10.1016/j.clgc.2024.102209","DOIUrl":"10.1016/j.clgc.2024.102209","url":null,"abstract":"<div><h3>Background</h3><p>Patients with advanced prostate cancer (PC) commonly experience fatigue related to the disease itself and its treatment, which affects their quality of life. There are limited real-world data available on patients’ experiences of fatigue while receiving PC treatment and its management.</p></div><div><h3>Patients and Methods</h3><p>This was a cross-sectional, noninterventional qualitative study involving individual concept-elicitation interviews with patients in the United States. Patients with advanced PC aged ≥18 years who had experienced fatigue and were on androgen-deprivation therapy in combination with second-generation androgen receptor pathway inhibitors were interviewed and their experiences quantified.</p></div><div><h3>Results</h3><p>Of the 143 patients screened, 13 qualified and 11 completed the interview. Most patients used the term “fatigue” (<em>n</em> = 8) to describe their experiences of tiredness, exhaustion, lack of energy, and weakness. Most patients (<em>n</em> = 8) did not receive any form of educational support from their healthcare providers (HCPs), but some expressed an interest in receiving this support (pamphlets, <em>n</em> = 4; discussion with HCPs, <em>n</em> = 4; online resources, <em>n</em> = 3). Most patients (<em>n</em> = 9) self-discovered fatigue-management strategies over the course of their disease and treatment. Patients found that rigorous exercise (<em>n</em> = 5), regular naps (<em>n</em> = 2), increased rest (<em>n</em> = 3), and a healthy diet (<em>n</em> = 3) were the most effective approaches for managing their fatigue.</p></div><div><h3>Conclusion</h3><p>Tools are needed to support HCPs with counseling patients with PC for effective management of disease- and treatment-related fatigue.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102209"},"PeriodicalIF":2.3,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172514","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":"Paraneoplastic Syndrome Prevalence and Survival in Racially-Diverse Cohort With Renal Cell Carcinoma","authors":"Edouard H. Nicaise ,&nbsp;Benjamin N. Schmeusser ,&nbsp;Gregory Palmateer ,&nbsp;Khushali Vashi ,&nbsp;Krishna Parikh ,&nbsp;Dattatraya Patil ,&nbsp;Daniel D. Shapiro ,&nbsp;E. Jason Abel ,&nbsp;Shreyas Joshi ,&nbsp;Vikram Narayan ,&nbsp;Kenneth Ogan ,&nbsp;Viraj A. Master","doi":"10.1016/j.clgc.2024.102207","DOIUrl":"10.1016/j.clgc.2024.102207","url":null,"abstract":"<div><h3>Introduction</h3><p>The prevalence of preoperative paraneoplastic syndromes (PNS) in renal cell carcinoma (RCC) is poorly understood. Many laboratory abnormalities representative of PNS have demonstrated prognostic value when incorporated into predictive survival models in RCC. We sought to characterize the relationship between baseline prevalence of PNS with overall survival (OS) and cancer-specific survival (CSS) in RCC patients following nephrectomy.</p></div><div><h3>Methods</h3><p>Our prospectively maintained nephrectomy database was retrospectively reviewed for any stage, major histology RCC patients that underwent surgery from 2000 to 2022. Baseline laboratory values within 90 days (closest used) were required. Presence of PNS was defined according to established laboratory cutoffs. Kaplan-Meier curves estimated survival rates, and multivariable Cox proportional hazards models examined the association between PNS with OS and CSS following nephrectomy.</p></div><div><h3>Results</h3><p>2599 patients were included with listed staging: 1494 Stage I; 180 Stage II; 616 Stage III; 306 Stage IV. Proportion of patients presenting with &gt;1 PNS significantly increased from stage I (31.3%) to stage IV (74.2%) RCC (<em>P</em> &lt; .001). Elevated C-reactive protein was the most prevalent PNS (45.4%). On multivariable analysis, the presence of &gt;1 PNS was associated with higher risk of all-cause (HR 2.09; <em>P</em> &lt; .001) and cancer-specific mortality (HR 2.55; <em>P</em> &lt; .001). The 10-year OS estimates as reported: 65.2% (no PNS), 52.3% (1 PNS), 36.6% (&gt;1 PNS); and 10-year CSS estimates: 88.3% (no PNS), 79.3% (1 PNS), 61.6% (&gt;1 PNS).</p></div><div><h3>Discussion</h3><p>Increased prevalence of PNS in major histology RCC was associated with a significant increase in the risk of all-cause and cancer-specific mortality even when accounting for patient and disease characteristics.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102207"},"PeriodicalIF":2.3,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147166","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":"Quantification of Gleason Pattern 4 Metrics Identifies Pathologic Progression in Patients With Grade Group 2 Prostate Cancer on Active Surveillance","authors":"Marlon Perera ,&nbsp;Melissa Assel ,&nbsp;Sunny Nalavenkata ,&nbsp;Sari Khaleel ,&nbsp;Nicole Benfante ,&nbsp;Sigrid V. Carlsson ,&nbsp;Victor E. Reuter ,&nbsp;Vincent P. Laudone ,&nbsp;Peter T. Scardino ,&nbsp;Karim A. Touijer ,&nbsp;James A. Eastham ,&nbsp;Andrew J. Vickers ,&nbsp;Samson W. Fine ,&nbsp;Behfar Ehdaie","doi":"10.1016/j.clgc.2024.102204","DOIUrl":"10.1016/j.clgc.2024.102204","url":null,"abstract":"<div><h3>Background</h3><p>During active surveillance (AS) for Grade Group (GG) 2 prostate cancer, pathologic progression to GG3 on surveillance biopsy is a trigger for intervention. However, this ratio of GP3:GP4, may be obscured by increases of relatively indolent disease. We aimed to explore changes in GP4 quantity during AS and propose alternative definitions for progression based on GP4 changes.</p></div><div><h3>Design, Setting, and Participants</h3><p>We assessed patients enrolled on AS between November 2014 and March 2020 with GG2 disease on diagnostic biopsy and subsequent surveillance biopsy approximately 1 year later. Outcome measures included change in overall %GP4 and total length GP4 (mm).</p></div><div><h3>Results and Limitations</h3><p>61 patients met the inclusion criteria, the median change in total length of GP4 and %GP4 was -0.12 mm (IQR −0.31, 0.09) and −2.5% (IQR −8.6, 0.0), respectively. Excluding the 35 patients with no evidence of GP4 on surveillance biopsy, median change in total GP4 length and %GP4 was 0.19 mm (IQR −0.04, 0.67) and 1.2% (IQR −1.6, 6.6), respectively. Three patients progressed to GG3 disease on surveillance biopsy, one of whom had only a small increase in %GP4. Conversely, an additional 2 patients who did not meet the criterion for GG3 had a large increase (&gt; 1 mm) in total GP4 length.</p></div><div><h3>Conclusions</h3><p>Presence of GG3 disease on surveillance biopsy as a trigger for treatment in men on AS is of questionable use alone; we suggest including other measures that do not depend on a ratio, such as an increase in total GP4 length.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102204"},"PeriodicalIF":2.3,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1558767324001745/pdfft?md5=964b906d2822262977d032e605ab41b7&pid=1-s2.0-S1558767324001745-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163756","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":"Can Patients With Urogenital Cancer Rely on Artificial Intelligence Chatbots for Treatment Decisions?","authors":"Anil Erkan ,&nbsp;Akif Koc ,&nbsp;Deniz Barali ,&nbsp;Atilla Satir ,&nbsp;Salim Zengin ,&nbsp;Metin Kilic ,&nbsp;Gokce Dundar ,&nbsp;Muhammet Guzelsoy","doi":"10.1016/j.clgc.2024.102206","DOIUrl":"10.1016/j.clgc.2024.102206","url":null,"abstract":"<div><h3>Objectives</h3><p>In the era of artificial intelligence, almost half of the patients use the internet to get information about their diseases. Our study aims to demonstrate the reliability of the information provided by artificial intelligence chatbots (AICs) about urogenital cancer treatments.</p></div><div><h3>Methods</h3><p>The most frequently searched keyword about prostate, bladder, kidney, and testicular cancer treatment via Google Trends was asked to 3 different AICs (ChatGPT, Gemini, Copilot). The answers were evaluated by 5 different examiners in terms of readability, understandability, actionability, reliability, and transparency.</p></div><div><h3>Results</h3><p>The DISCERN score evaluation indicates that ChatGPT and Gemini provided moderate quality information, while Copilot's quality was low. (Total DISCERN scores; 41, 42, 35, respectively). PEMAT-P Understandability scores were low (40%) and PEMAT-P Actionability scores were moderate only for Gemini (60%) and low for the others (40%). Their readability according to the Coleman-Liau index was above the college level (16.9, 17.2, 16, respectively).</p></div><div><h3>Conclusions</h3><p>In the era of artificial intelligence, patients will inevitably use AICs due to their easy and fast accessibility. However, patients need to recognize that AICs do not provide stage-specific treatment options, but only moderate-quality, low-reliability information about the disease, as well as information that is very difficult to read.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102206"},"PeriodicalIF":2.3,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142136650","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":"Rare type of Bellini Duct Carcinoma in a Patient With Cacchi–Ricci Disease: A Case Report and Mini-Review","authors":"Antonio Franco ,&nbsp;Thomas Tailly ,&nbsp;Camille Berquin ,&nbsp;Daan De Maeseneer ,&nbsp;Alexander Decruyenaere ,&nbsp;Sofie Verbeke ,&nbsp;Pieter De Visschere ,&nbsp;Kathia De Man ,&nbsp;Laurens Hermie ,&nbsp;Ben Vanneste ,&nbsp;Charles Van Praet","doi":"10.1016/j.clgc.2024.102202","DOIUrl":"10.1016/j.clgc.2024.102202","url":null,"abstract":"<div><p>Medullary sponge kidney (MSK) is an uncommon kidney malformation, characterized by cystic dilatation of the precalyceal papillary collecting ducts. Urography and computed tomography scan represent the gold standard to detect this congenital disorder. A clear diagnosis is not always feasible, especially in the presence of a concomitant renal mass, which in turn can be difficult to detect in MSK patients. When conventional imaging is inconclusive, a renal biopsy can be considered in doubtful cases. Here, we report a unique case of a Bellini duct carcinoma in a patient with MSK and we review the literature on this complex condition.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102202"},"PeriodicalIF":2.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201661","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":"Serum Androgens as Predictive Biomarkers: Results From a Randomized Clinical Trial Comparing Enzalutamide and Abiraterone Acetate in Men With Metastatic Castration-Resistant Prostate Cancer","authors":"Klara K. Ternov ,&nbsp;Mikkel Fode ,&nbsp;Jens Sønksen ,&nbsp;Rasmus Bisbjerg ,&nbsp;Henriette Lindberg ,&nbsp;Ganesh Palapattu ,&nbsp;Ola Bratt ,&nbsp;Peter B. Østergren","doi":"10.1016/j.clgc.2024.102200","DOIUrl":"10.1016/j.clgc.2024.102200","url":null,"abstract":"<div><h3>Introduction</h3><p>The purpose of this study was to investigate the association between baseline androgen concentrations and outcomes in men with metastatic castration-resistant prostate cancer (mCRPC) treated with first-line enzalutamide or abiraterone acetate plus prednisone (AAP).</p></div><div><h3>Materials and Methods</h3><p>We previously randomized men with mCRPC to enzalutamide or AAP to compare side-effects and measured androgen concentrations. In this post-hoc analysis, patients were grouped in quartiles (Q) based on their serum androgen values. Kaplan-Meier and Cox regression were used to analyze progression-free and overall survival for baseline androgen groups, treatment subgroups and their interaction. The trial was registered at clinicaltrialsregister.eu (2017-000099-27).</p></div><div><h3>Results</h3><p>Eighty-four patients received enzalutamide and 85 AAP. Overall, higher (Q4) compared with lower (Q1) baseline serum testosterone was associated with longer progression-free survival (24.8 vs. 10.7 months, hazard ratio [HR] 0.52, 95% confidence interval [CI] 0.33; 0.84) and overall survival (52.8 vs. 31.5 months, HR 0.49, 95% CI 0.28; 0.85). The risk reduction in death seemed to be treatment dependent (treatment subgroup interaction <em>P</em> = .04). For men in the AAP subgroup, the Q4 compared with Q1 group had a significant lower risk of death (HR 0.30, 95% CI 0.13; 0.73), while no difference was found for enzalutamide (HR 0.77, 95% CI 0.35; 1.69). Similar results were found for the other androgens.</p></div><div><h3>Conclusion</h3><p>Pre-treatment serum testosterone levels may be a clinically useful biomarker for predicting mCRPC treatment responses and guiding treatment selection.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102200"},"PeriodicalIF":2.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1558767324001708/pdfft?md5=32cf6e7b4dd12572ea071af0a9ce80f7&pid=1-s2.0-S1558767324001708-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142149158","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":"Oncological and Survival Outcomes of Pelvic Lymph Node Dissection in Patients with Nonmuscle Invasive Bladder Cancer Undergoing Radical Cystectomy Using the National Cancer Database","authors":"Matthew Moldovan,&nbsp;Percival Nam,&nbsp;Yasoda Satpathy,&nbsp;Luke Wang,&nbsp;Aditya Bagrodia,&nbsp;Amirali Salmasi,&nbsp;Tyler F. Stewart,&nbsp;Ithaar Derweesh,&nbsp;Juan Javier-DesLoges","doi":"10.1016/j.clgc.2024.102197","DOIUrl":"10.1016/j.clgc.2024.102197","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the role of pelvic lymph node dissection (PLND) in patients diagnosed with high-risk nonmuscle-invasive bladder cancer (NMIBC) undergoing radical cystectomy (RC) using a national cohort of NMIBC patients.</p></div><div><h3>Methods</h3><p>A cohort of patients diagnosed with NMIBC cancer with urothelial carcinoma from the National Cancer Database (NCDB) between 2004 and 2019 was utilized. The cohort consists of patients who have not received BCG and underwent upfront radical cystectomy or pelvic exenteration. Kaplan–Meier analysis was utilized to assess overall survival (OS) outcomes. Cox regression was also utilized to identify independent predictors of OS.</p></div><div><h3>Results</h3><p>The cohort of 9399 patients was stratified by clinical T stage and then subdivided by pathological outcome. For patients with cTa, a majority received a lymph node dissection 97.74% (941/1019), amongst the entire cohort, a minority had node positive disease 3.3% (34/1019). For cTis, most patients received a lymph node dissection 94.08% (482/507), and a minority had node positive disease 5.1% (26/507). For cT1, most patients had a lymph node dissection 95.62% (6,060/6,337), and a 13.1% (832/6337) of patients had a positive lymph node. Amongst patients with cT1 disease who underwent PLND, KMA demonstrated better OS compared to patients who did not undergo PLND (<em>P</em> &lt; .001).</p></div><div><h3>Conclusion</h3><p>The data suggests an OS benefit in patients with later stage (cT1) NMIBC. Thus, our findings support the existing clinical guidelines of pelvic lymph node dissection in patients with high-risk nonmuscle invasive bladder cancer.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102197"},"PeriodicalIF":2.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142163755","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":"The Incidence of Extreme Serum Prostate Specific Antigen Levels During the COVID-19 Pandemic","authors":"Amanda E. Hird ,&nbsp;Rano Matta ,&nbsp;Refik Saskin ,&nbsp;Erind Dvorani ,&nbsp;Sarah Neu ,&nbsp;Sender Herschorn ,&nbsp;Robert K. Nam","doi":"10.1016/j.clgc.2024.102194","DOIUrl":"10.1016/j.clgc.2024.102194","url":null,"abstract":"<div><h3>Objective</h3><p>The COVID-19 pandemic resulted in decreased prostate specific antigen (PSA) testing for prostate cancer screening and its impact remains uncharacterized. Our objective was to compare incident PSA testing rates, PSA levels, and prostate cancer treatment rates before and during the pandemic after the state of emergency (SoE) was declared.</p></div><div><h3>Materials and Methods</h3><p>This was a population-based, retrospective cohort study among men 50-80 years of age in Ontario, Canada undergoing incident PSA testing from November 23, 2018 to July 9, 2021. Working backwards and forwards from the date of the province-wide SoE (March 17, 2020), 30-day time periods were constructed during which incident PSA testing rates were measured. Our primary outcome was the rate of incident PSA testing. Secondary endpoints included comparison of incident PSA levels and prostate cancer treatment rates.</p></div><div><h3>Results</h3><p>We identified 835,402 men who underwent incident PSA testing. There was a 20% decrease in PSA testing after the SoE (RR = 0.80,95% CI: 0.800.81, <em>P</em> &lt; .001). There was a higher proportion of extreme PSA levels after the SoE with a higher proportion of patients with a PSA &gt;20 ng/mL (rate ratio = 1.63,95% CI: 1.54-1.73, <em>P</em> &lt; .0001) and &gt;100 ng/mL (rate ratio = 1.98,95% CI: 1.77-2.20, <em>P</em> &lt; .0001). This effect was highest for those aged 50-59 years. More patients required active treatment (5,201,59.5% prior to the pandemic vs. 5,072,64.2%, <em>P</em> &lt; .001 after the SoE declaration).</p></div><div><h3>Conclusions</h3><p>The COVID-19 SoE resulted in patients experiencing a 2-fold increase in the risk of having an extreme PSA level and higher odds of treatment. Future studies are needed to assess the impact on the rates of advanced prostate cancer and cancer-specific mortality.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 5","pages":"Article 102194"},"PeriodicalIF":2.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141991","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":"The Impact of Radical Prostatectomy Versus Radiation Therapy on Cancer-Specific Mortality for Nonmetastatic Prostate Cancer: Analysis of an Other-Cause Mortality Matched Cohort","authors":"Marco Finati ,&nbsp;Nicholas James Corsi ,&nbsp;Alex Stephens ,&nbsp;Giuseppe Chiarelli ,&nbsp;Giuseppe Ottone Cirulli ,&nbsp;Matthew Davis ,&nbsp;Shane Tinsley ,&nbsp;Akshay Sood ,&nbsp;Nicolò Buffi ,&nbsp;Giovanni Lughezzani ,&nbsp;Andrea Salonia ,&nbsp;Alberto Briganti ,&nbsp;Francesco Montorsi ,&nbsp;Carlo Bettocchi ,&nbsp;Giuseppe Carrieri ,&nbsp;Craig Rogers ,&nbsp;Firas Abdollah","doi":"10.1016/j.clgc.2024.102201","DOIUrl":"10.1016/j.clgc.2024.102201","url":null,"abstract":"<div><h3>Introduction</h3><p>Studies comparing radical prostatectomy (RP) to radiation therapy (RT) have consistently shown that patients undergoing RT have a higher risk of other-cause mortality (OCM) compared to RP, signifying poor health status of the former patients. We aimed to evaluate the impact of RP versus RT on cancer-specific mortality (CSM) over a cohort with equivalent OCM risk.</p></div><div><h3>Patients and Methods</h3><p>The SEER database was queried to identify patients with nonmetastatic PCa between 2004 and 2009. Patients were matched based on their calculated 10-year OCM risk and further stratified for D'Amico Risk Score and Gleason Grade. A Cox-regression model was used to calculate the 10-year OCM risk. Propensity-score based on the calculated OCM risk were used to match RP and RT patients. Cumulative incidence curves and Competing-risk regression analyses were used to examine the impact of treatment on CSM in the matched cohort.</p></div><div><h3>Results</h3><p>We identified 55,106 PCa patients treated with RP and 36,674 treated with RT. After match, 6,506 patients were equally distributed for RT versus RP, with no difference in OCM rates (<em>P</em> = .2). The 10-year CSM rates were 8.8% versus 0.6% (<em>P</em> = .01) for RT versus RP in patients with unfavorable-intermediate-risk (Gleason Score 4 + 3) and 7.9% versus 3.9% (<em>P</em> = .003) for high-risk disease. There was no difference in CSM among RT and RP patients for favorable-intermediate-risk (Gleason Score 3 + 4) and low-risk disease.</p></div><div><h3>Conclusions</h3><p>In a matched cohort of PCa patients with comparable OCM between the 2 arms, RP yielded a more favorable CSM rate compared to RT only for unfavorable-intermediate- and high-risk groups.</p></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"22 6","pages":"Article 102201"},"PeriodicalIF":2.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147168","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}