Clinical genitourinary cancer最新文献

{"title":"Opioid Use in Patients With Testicular Cancer: Patterns and Risk Factors","authors":"Siddharth Marthi ,&nbsp;Gregory Palmateer ,&nbsp;Dattatraya Patil,&nbsp;Talia A. Helman,&nbsp;Edouard Nicaise,&nbsp;Taylor A. Goodstein,&nbsp;Kenneth Ogan,&nbsp;Vikram M. Narayan,&nbsp;Viraj A. Master,&nbsp;Mohammad Hajiha,&nbsp;Shreyas S. Joshi","doi":"10.1016/j.clgc.2025.102381","DOIUrl":"10.1016/j.clgc.2025.102381","url":null,"abstract":"<div><h3>Introduction</h3><div>Prescription opioid use is a gateway to chronic dependence and associated morbidity and mortality. Research has demonstrated that men receiving narcotics after urologic surgery are at increased risk of persistent opioid use. However, factors associated with persistent use in testicular cancer patients specifically are poorly understood.</div></div><div><h3>Materials and methods</h3><div>The Truven Marketscan database was queried for patients with testicular cancer who underwent orchiectomy between 2009 and 2021. Patients who were under 18 years old, lacked insurance coverage during the study period, filled opioid prescriptions 3 months prior to orchiectomy, or had prior opioid use disorder diagnoses were excluded. Subgroup analysis was performed by receipt of advanced treatment, defined as chemotherapy and/or retroperitoneal lymph node dissection (RPLND). Opioid exposure was defined as receipt of ≥ 1 opioid prescriptions within 30 days of last treatment. Among those who underwent advanced treatment, pretreatment opioid use over the cohort median in oral morphine equivalents (OME) was included in the definition of opioid exposure. Multivariable logistic regression was used to identify risk factors associated with our primary outcome: ≥ 1 filled opioid prescription between 31 to 90 days and 91 to 180 days after last treatment.</div></div><div><h3>Results</h3><div>Of 5409 total patients, 2115 (39.1%) underwent advanced treatment: 1697 (31.4%) chemotherapy, 185 (3.4%) RPLND, and 223 (4.3%) chemotherapy and RPLND (combination). Opioid exposure was associated with a filled opioid prescription at 31 to 90 (OR 4.67) and 91 to 180 days (OR 4.74, both <em>P</em> &lt; .001) after last treatment. On multivariate analysis, chemotherapy and combination therapy, but not RPLND alone, were independently associated with opioid use at 31 to 180 days post-treatment (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Testicular cancer patients who received opioid prescriptions after orchiectomy were more likely to require additional opioid prescriptions 31 to 180 days after treatment. Advanced treatment with chemotherapy alone or combined with RPLND, but not RPLND alone, increased the opioid dependence.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102381"},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337357","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":"Increased Severity of Prostate Cancer Presentation in an Appalachian Cohort Compared to National Data","authors":"Marvin A. Simpkins,&nbsp;Garrett Douglas,&nbsp;Emily Yablonsky,&nbsp;Lawrence Wyner,&nbsp;Justyn Blankenship","doi":"10.1016/j.clgc.2025.102375","DOIUrl":"10.1016/j.clgc.2025.102375","url":null,"abstract":"<div><h3>Background</h3><div>Prostate cancer is the second leading cause of cancer death among American men, with known disparities by geography, socioeconomic status, and access to care. Data on prostate cancer presentation in Appalachia are scarce.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 160 first‐time transrectal ultrasound‐guided prostate biopsies from 2022 to 2024 at a single Appalachian institution and compared them to 8776 positive biopsies from the PLCO trial. Gleason scores were grouped as 1 (≤ 6), 2/3 (7), 4 (8), and 5 (≥ 9). We used chi‐square tests to compare grade distributions and PSA categories (&lt; 4, 4-10, 10-20, &gt; 20 ng/mL), Wilcoxon rank‐sum tests for age and median PSA by grade, and sequential logistic regression (unadjusted; +age; +PSA+age) to identify independent predictors of Appalachian cohort membership.</div></div><div><h3>Results</h3><div>Appalachian patients were more likely to present with Grade 4 (19.1% vs. 7.9%) and Grade 5 disease (10.1% vs. 5.0%; χ² = 49.2, <em>P</em> &lt; .001) and had older median age (e.g., Grade 1: 66 vs. 63 years, <em>P</em> = .0033) and higher median PSA (e.g., Grade 1: 8.6 vs. 5.7 ng/mL, <em>P</em> = .0001). PSA category distribution also differed (χ² = 44.8, <em>P</em> &lt; .001). In fully adjusted models, Grade 4 (OR 2.54, <em>P</em> = .002) and Grade 5 (OR 2.80, <em>P</em> = .002) remained independent predictors of Appalachian cohort membership, while PSA was not (<em>P</em> = .280).</div></div><div><h3>Conclusions</h3><div>Appalachian patients exhibit a disproportionately high prevalence of advanced‐grade prostate cancer that persists after accounting for age and PSA. Tailored, region-specific strategies are needed to enhance early detection and reduce persistent disparities in care.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102375"},"PeriodicalIF":2.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271697","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":"Incidences of Secondary Malignancies After Androgen Deprivation Therapy for Prostate Cancer","authors":"Junghoon Lee ,&nbsp;Min Chul Cho ,&nbsp;Hyeon Jeong ,&nbsp;Hwancheol Son ,&nbsp;Sangjun Yoo","doi":"10.1016/j.clgc.2025.102379","DOIUrl":"10.1016/j.clgc.2025.102379","url":null,"abstract":"<div><h3>Purpose</h3><div>We aimed to assess the effects of ADT on the incidence of secondary malignancies in patients with prostate cancer.</div></div><div><h3>Methods</h3><div>Prostate cancer patients who initially treated with ADT from 2009 were included and followed up until 2019. We additionally included female patients, male patients without prostate cancer, and male patients with prostate cancer who did not undergo ADT to build comparison. A 1:1:1:1 match based on age was performed, and 55,865 individuals from each group were selected for analysis.</div></div><div><h3>Results</h3><div>The incidence of common cancers was compared between the groups. All cancers, except thyroid and breast cancers, were more common in men than women. All cancers were more common in men with prostate cancer than in men without prostate cancer, regardless of ADT. After ADT, the incidences of thyroid and breast cancers increased, whereas the incidences of liver and pancreatic cancers decreased. In the multivariate analysis, all types of cancer were more common in men with prostate cancer than in men without prostate cancer, regardless of ADT. Among these, the incidence of liver and pancreatic cancers significantly decreased after ADT.</div></div><div><h3>Conclusion</h3><div>The incidence of several secondary malignancies was affected not only by sex but also by prostate cancer diagnosis and ADT. Although further studies are required, these data could be important for health checkups and the management of prostate cancer survivors, especially prostate cancer patients who have been treated with ADT.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102379"},"PeriodicalIF":2.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337356","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":"Prognostic Role of Serum IL-6 Levels in Bladder Cancer Patients and Hints of its Origin","authors":"Simon U. Engelmann ,&nbsp;Christoph Pickl ,&nbsp;Maximilian Haas ,&nbsp;Felix Kasparbauer ,&nbsp;Emily Rinderknecht ,&nbsp;Sebastian Kälble ,&nbsp;Bas W.G. van Rhijn ,&nbsp;Peter J. Siska ,&nbsp;Sonja-Maria Decking ,&nbsp;Kathrin Renner ,&nbsp;Renate Pichler ,&nbsp;Maximilian Burger ,&nbsp;Miodrag Gužvić ,&nbsp;Roman Mayr","doi":"10.1016/j.clgc.2025.102378","DOIUrl":"10.1016/j.clgc.2025.102378","url":null,"abstract":"<div><h3>Background</h3><div>Interleukin-6 (IL-6) is associated with adverse clinical outcome in cancer patients. In bladder cancer (BC) patients, higher IL-6 serum levels have been linked with adverse pathologic features, worse overall survival (OS) and cancer-specific survival (CSS). IL-6 is being investigated as a therapeutic target. However, concentrations in tumor-tissue are not investigated in detail. Objective of this study is to analyze the prognostic value of IL-6 in BC patients and to investigate its concentration in tumor tissue.</div></div><div><h3>Methods</h3><div>In this single center prospective observational study, preoperative serum samples of 179 BC patients undergoing radical cystectomy were collected between September 2019 and September 2022. Tumor-tissue of additional 20 patients was collected during transurethral resection or radical cystectomy for investigation of IL-6 in tumor tissue supernatant. IL-6 concentration was measured by ELISA.</div></div><div><h3>Results</h3><div>Median serum IL-6 concentration was 5.4 pg/mL. High serum IL-6 was an independent predictor of OS (HR 1.95; 95% CI, 1.07-3.55; <em>P</em> = .03) and CSS (HR 2.31; 95% CI, 1.14-4.68; <em>P</em> = .02) in multivariate Cox regression analyses. Patients with advanced tumor stage, lymph node metastasis, and larger tumor size had significantly higher preoperative serum IL-6 concentration (all <em>P</em> &lt; .01). In tumor tissue supernatant, IL-6 concentration was higher in muscle-invasive BC, with a median of 715.4 pg/mL, as opposed to 20.7 pg/mL in pTa tumor stage (<em>P</em> &lt; .01).</div></div><div><h3>Conclusions</h3><div>Serum IL-6 is a strong predictor of poor survival rates and adverse pathologic features in BC patients. IL-6 concentrations in tumor tissue supernatant correlate with tumor stage. The role of IL-6 in theranostics of bladder cancer deserves more attention.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102378"},"PeriodicalIF":2.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295515","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":"Prognostic Implications of Patients With Clinically Node Positive Bladder Cancer Undergoing Radical Cystectomy","authors":"Pietro Scilipoti ,&nbsp;Marco Moschini ,&nbsp;Paolo Zaurito ,&nbsp;Mattia Longoni ,&nbsp;Mario De Angelis ,&nbsp;Luca Afferi ,&nbsp;Chiara Lonati ,&nbsp;Giovanni Tremolada ,&nbsp;Alessandro Viti ,&nbsp;Alfonso Santangelo ,&nbsp;Renate Pichler ,&nbsp;Andrea Necchi ,&nbsp;Francesco Montorsi ,&nbsp;Alberto Briganti ,&nbsp;Andrea Mari ,&nbsp;Wojciech Krajewski ,&nbsp;Ekaterina Laukthina ,&nbsp;Benjamin Pradere ,&nbsp;Francesco Del Giudice ,&nbsp;Laura Mertens ,&nbsp;Roberto Carando","doi":"10.1016/j.clgc.2025.102377","DOIUrl":"10.1016/j.clgc.2025.102377","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Patients with clinically node-positive (cN+) bladder cancer (BCa) form a biologically and prognostically diverse group. As systemic therapy reshapes management in this setting, this study examines oncological outcomes after radical cystectomy (RC) with or without perioperative systemic therapy.</div></div><div><h3>Materials and methods</h3><div>We utilized a multicenter, retrospectively collected database of 1067 patients diagnosed with cTanyN+M0 BCa who underwent RC with lymphadenectomy with or without perioperative systemic treatment. Patients with cN1-2 disease and treated from 2006 and 2023 were included. Three-months landmark Kaplan-Meier curves were used to estimate the overall survival (OS). Three-months landmark competing risk cumulative incidence curves were used to estimate the cancer specific mortality (CSM). Multivariable Cox regression models (MCR) were used to assess the association of treatment and pathology response (complete response [pCR], partial response [pPR] and pN0) with any cause death and cancer specific death.</div></div><div><h3>Results</h3><div>A total of 589 patients met the inclusion criteria, with 189 (32%) receiving preoperative systemic treatment (PST) and 115 (20%) undergoing RC + adjuvant therapy (AT). Median follow-up was 32 months. Three-year OS was 69% for PST + RC, 55% for RC + AT, and 55% for RC alone. PST + RC (HR: 0.67, <em>P</em> = .042) was associated with a lower risk of all-cause mortality at MCR. The 3-year CSM was 28% for PST + RC, 38% for RC + AT, and 32% for RC alone. Achieving pCR (HR: 0.31, <em>P</em> = .004), pPR (HR: 0.35, <em>P</em> &lt; .001), and pN0 (HR: 0.44, <em>P</em> &lt; .001) was associated with significantly lower risks of both all-cause and cancer-specific mortality.</div></div><div><h3>Conclusions</h3><div>Patients with cN+ BCa undergoing surgery show varied oncological outcomes. Those receiving PST and AT had longer OS, highlighting the importance of systemic therapy. The prognostic value of pCR, pPR, and pN0 supports the need for refined risk stratification to guide preoperative treatment and personalize care.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102377"},"PeriodicalIF":2.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295514","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":"Erdafitinib versus Chemotherapy in Fibroblast Growth Factor Receptor-Altered Advanced or Metastatic Urothelial Cancer After Progression on Anti-programmed Death-(Ligand) 1 Therapy: An Exploratory Analysis of the Asian Subpopulation in the THOR Phase 3 Study","authors":"Nobuaki Matsubara ,&nbsp;Yohann Loriot ,&nbsp;Earle F. Burgess ,&nbsp;Se Hoon Park ,&nbsp;Robert A. Huddart ,&nbsp;Ja Hyeon Ku ,&nbsp;Ben Tran ,&nbsp;Jian Huang ,&nbsp;Yi-Hsiu Huang ,&nbsp;Kazuo Nishimura ,&nbsp;Nobuaki Shimizu ,&nbsp;Nianzeng Xing ,&nbsp;Wei Xue ,&nbsp;Rosemary Hemaya ,&nbsp;Jianmin Zhuo ,&nbsp;Kris Deprince ,&nbsp;Spyros Triantos ,&nbsp;Arlene O. Siefker-Radtke","doi":"10.1016/j.clgc.2025.102376","DOIUrl":"10.1016/j.clgc.2025.102376","url":null,"abstract":"<div><h3>Introduction</h3><div>The randomized phase 3 THOR study showed significantly longer survival with erdafitinib (pan-fibroblast growth factor receptor [FGFR] inhibitor) over chemotherapy in adults with <em>FGFR</em>-altered locally advanced or metastatic urothelial cancer (la/mUC) who had progressed during or after anti-programmed death-(ligand) 1 (anti-PD-[L]1) therapy (Cohort 1). This exploratory post-hoc analysis was conducted to evaluate the efficacy and safety of erdafitinib in the Asian subpopulation within THOR Cohort 1.</div></div><div><h3>Patients and methods</h3><div>Eligible patients were randomized in a 1:1 ratio to receive erdafitinib (8 mg once daily with pharmacodynamically guided up-titration to 9 mg) or chemotherapy (vinflunine or docetaxel once every 3 weeks). The primary endpoint was overall survival (OS).</div></div><div><h3>Results</h3><div>Seventy-six patients were included in the Asian subpopulation: 37 were randomized to erdafitinib and 39 to docetaxel. The median follow-up for survival was 15.7 months. The median OS was longer with erdafitinib than chemotherapy (23.3 months vs.11.3 months; hazard ratio [HR], 0.47; 95% confidence interval [CI], 0.23–0.96). One patient (2.7%) in the erdafitinib arm and 5 patients (15.2%) in the chemotherapy arm had grade 3 or 4 treatment-related serious adverse events (SAEs). One patient (2.7%) in the erdafitinib arm and 4 patients (12.1%) in the chemotherapy arm discontinued treatment due to treatment-related AEs.</div></div><div><h3>Conclusions</h3><div>Erdafitinib showed improved survival compared with chemotherapy, with no new safety concerns in the Asian subpopulation. These findings were consistent with those for the overall study population in THOR Cohort 1 who received prior anti-PD-(L)1 therapy.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102376"},"PeriodicalIF":2.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251284","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 Role of Cytoreductive Nephrectomy in Contemporary Metastatic Renal Cell Carcinoma: An Other-Cause Mortality Match Population-Based Study","authors":"Marco Finati ,&nbsp;Giuseppe Ottone Cirulli ,&nbsp;Giuseppe Chiarelli ,&nbsp;Alex Stephens ,&nbsp;Shane Tinsley ,&nbsp;Chase Morrison ,&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.2025.102374","DOIUrl":"10.1016/j.clgc.2025.102374","url":null,"abstract":"<div><h3>Objective</h3><div>A post-hoc analysis of CARMENA trial revealed that cytoreductive nephrectomy (CN) might still be beneficial for selected metastatic renal cell carcinoma (mRCC) patients. However, selection bias influences the choice of patients for CN, typically favoring those in better health and with a lower risk of all-cause mortality. We aimed to evaluate the impact of CN on cancer-specific mortality (CSM), using a cohort of mRCC patients matched for other-cause mortality (OCM).</div></div><div><h3>Methods</h3><div>The SEER database was queried to identify patients diagnosed with mRCC and treated with immunotherapy between 2010 and 2017. A Cox regression model calculating OCM was used to create a propensity score match cohort. Cumulative incidence curves depicted, and competing risks multivariable regression tested, the impact of CN versus no-surgery on CSM according to number of metastasis sites.</div></div><div><h3>Results</h3><div>Our match yielded to 1148 patients equally distributed between CN and no-surgery arm, with no difference in OCM (HR: 0.88, 95% CI: 0.53-1.47, <em>P</em> = .6). When stratifying patients for number of metastases sites, nonsurgery arm was associated with higher CSM rates for patients with 1 (HR: 1.93, 95% CI: 1.54-2.41, <em>P</em> &lt; .001) or 2 sites (HR: 1.54, 95% CI: 1.27-1.86, <em>P</em> &lt; .001). Conversely, no difference in CSM were observed for 3 or more sites (HR: 1.35, 95% CI: 0.93-1.97, <em>P</em> = .1).</div></div><div><h3>Conclusions</h3><div>In a matched cohort of mRCC patients treated with immunotherapy and comparable OCM risk, CN provided a CSM advantage for patients with up to 2 metastatic sites. This advantage was not observed in case of 3 or more sites.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102374"},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295516","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":"Impact of Muscle Depletion on Prognosis in Patients Undergoing Radical Cystectomy","authors":"Xiangyu Pang,&nbsp;Lei Jiang,&nbsp;Haiyun Wang,&nbsp;Lei Luo,&nbsp;Tongpeng Liu,&nbsp;Lijiang Sun,&nbsp;Guiming Zhang","doi":"10.1016/j.clgc.2025.102373","DOIUrl":"10.1016/j.clgc.2025.102373","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the prognostic impact of preoperative muscle depletion (including sarcopenia and myosteatosis) in patients with bladder cancer (BCa) after radical cystectomy (RC).</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 185 patients undergoing RC for urothelial carcinoma. We used the computed tomography images at the L3 level of patients to get the skeletal muscle index (SMI) and skeletal muscle density (SMD). Sarcopenia is defined by the SMI while myosteatosis is defined by SMD. We used univariate Cox regression analysis to identify risk factors and included these risk factors in a multivariate Cox regression analysis to calculate the hazard ratio (<em>HR</em>) and 95% confidence interval (<em>95% CI</em>).</div></div><div><h3>Results</h3><div>In the univariate Cox analysis, sarcopenia (<em>P &lt; .</em>001) and myosteatosis (<em>P = .</em>017) were both associated with poorer overall survival (OS). Meanwhile, sarcopenia (<em>P &lt; .</em>001) and myosteatosis (<em>P = .</em>019) were both associated with poorer progression-free survival (PFS). In the multivariate Cox analysis, sarcopenia was identified as an independent risk factor for both OS (<em>P = .</em>018) and PFS (<em>P = .</em>005), whereas myosteatosis was not an independent risk factor for OS (<em>P = .</em>225) or PFS (<em>P = .</em>104).</div></div><div><h3>Conclusions</h3><div>Preoperative muscle depletion (including sarcopenia and myosteatosis) significantly correlates with poor prognosis of patients undergoing RC. Sarcopenia is an in dependent risk factor for 5-year OS and PFS. Our nomogram models demonstrated good predictive accuracy. Preoperative identification of muscle depletion and tailored interventions (exercise and nutrition) may improve postoperative outcomes.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102373"},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195743","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":"Utilization Patterns and Survival in Older Men With Metastatic Prostate Cancer Treated with Radium-223 in the United States: A SEER-Medicare Study","authors":"Bo Zhou ,&nbsp;Amit D. Raval ,&nbsp;Yifan Zhang ,&nbsp;Nethra Sambamoorthi ,&nbsp;Matthew J. Korn ,&nbsp;Niculae Constantinovici ,&nbsp;Rana McKay ,&nbsp;Usha Sambamoorthi","doi":"10.1016/j.clgc.2025.102372","DOIUrl":"10.1016/j.clgc.2025.102372","url":null,"abstract":"<div><h3>Introduction</h3><div>Previous research on Radium-223 treatment patterns in metastatic prostate cancer has been limited to select sites, oncology practices, or claims databases. Limited data exists on the use and outcomes of Radium-223 in Medicare population the largest public insurance provider for people aged 65 years and older in the United States. Therefore, this study used a nationwide population database of cancer registries linked to Medicare claims to examine Ra-223 treatment patterns, factors associated with treatment completion, and their associations with survival outcomes.</div></div><div><h3>Patients and Methods</h3><div>A retrospective cohort analysis was conducted on 1062 Medicare beneficiaries (≥ 66 years) with prostate cancer who initiated Ra-223 treatment between January 2016 and June 2020. Eligible men had 12 months of continuous Medicare Parts A/B/D enrollment prior to Ra-223 initiation and were followed for a minimum of 6 months. Primary outcomes included completion of ≥ 5 cycles of Ra-223 and overall survival. Factors influencing completion were analyzed with multivariate logistic regression, and survival was estimated using Kaplan-Meier and proportional hazards regressions.</div></div><div><h3>Results</h3><div>The cohort was 79.9% nonhispanic White, 6.8% Hispanic, and 6.1% nonhispanic Black, with a mean age of 75.6 years (SD = 6.6). Overall, 59.4% completed ≥ 5 cycles. Men receiving Ra-223 as first-line (21.1%) or second-line metastatic castration-resistant prostate cancer(mCRPC) therapy (44.1%) were more likely to complete treatment than those receiving third-line or later (aOR = 1.76,1.56, 95% CI, [1.22-2.54], [1.17-2.08]). Completing ≥ 5 cycles of Ra-223 was associated with longer survival (18.5 vs. 11.1 months, <em>P</em> &lt; .001; aHR = 0.51, 95% CI, [0.44, 0.59]), as was first- or second-line therapy use (18.4, 14.8 months vs. 13.8 months, <em>P</em> &lt; .001; aHR = 0.56,0.82; 95% CI, [0.45-0.68], [0.69-0.96]) compared to Ra-233 as third-line or later.</div></div><div><h3>Conclusion</h3><div>The majority of men received ≥ 5 cycles of Ra-223. Early initiation of Ra-223 was associated with higher completion rates and better survival outcomes, underscoring the importance of early Ra-223 use in managing mCRPC.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102372"},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227980","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":"Radical Prostatectomy Versus Radiation Therapy for Locally Advanced and Clinically Nodal Positive Prostate Cancer","authors":"Mike Wenzel ,&nbsp;Katrin Burdenski ,&nbsp;Nikolaos Tselis ,&nbsp;Claus Rödel ,&nbsp;Christian Brandts ,&nbsp;Marit Ahrens ,&nbsp;Jens Koellermann ,&nbsp;Markus Graefen ,&nbsp;Hans Heinzer ,&nbsp;Alexander Haese ,&nbsp;Clara Humke ,&nbsp;Carolin Siech ,&nbsp;Severine Banek ,&nbsp;Felix K.H. Chun ,&nbsp;Philipp Mandel","doi":"10.1016/j.clgc.2025.102370","DOIUrl":"10.1016/j.clgc.2025.102370","url":null,"abstract":"<div><h3>Introduction</h3><div>Radical prostatectomy (RP) and radiation therapy (RT) are both recommended as standard-of-care for advanced prostate cancer (aPCa). However, data on comparisons for aPCa are scant.</div></div><div><h3>Patients and Methods</h3><div>We relied on the University Cancer Center database to investigate outcomes in metastasis-free (MFS), cancer-specific (CSS) and overall survival (OS) of cT3-4 and cN1 RP versus RT-treated patients between 2014 and 2024.</div></div><div><h3>Results</h3><div>Of 1017 cT3-4 patients, 93% underwent RP, which were significantly younger (67 vs. 75 years) and harbored significantly lower PSA level (9.3 vs. 12.7 ng/ml). Moreover, significant higher rates of ISUP4-5 in RT patients were observed (51% vs. 37%, <em>P</em> = .001). Univariable MFS, CSS and OS outcomes did not differ for cT3-4 patients. In multivariable adjusted MFS, CSS and OS outcomes also no difference between RP vs. RT-treated cT3-4 patients were observed (all <em>P</em> &gt; .05). Of 239 cN1 patients, 87% underwent RP, which were also younger (66 vs. 73 years, <em>P</em> &lt; .001) and with clinically meaningful lower PSA level (15.4 vs. 29.0 ng/ml, <em>P</em> = .09), relative to RT patients. In univariable MFS analyses, RT provided better results, with no differences for CSS and OS. However, after multivariable adjustment MFS, CSS and OS analyses showed no significant differences between RP vs. RT-treated cN1 patients (all <em>P</em> &gt; .05).</div></div><div><h3>Conclusion</h3><div>Real-world evidence of currently RP vs. RT-treated locally advanced cT3-4 and clinically node-positive prostate cancer patients suggest equally efficient cancer-control outcomes such as MFS, CSS and OS when adjusting for different patient and tumor characteristics and show excellent cancer control rates in this very-high risk cohort.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102370"},"PeriodicalIF":2.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167427","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}