European urology oncology最新文献

{"title":"UncoVer: A Web-based Resource for Single-cell and Spatially Resolved Omics Data in Uro-oncology","authors":"Gwendoline C.V. Lecuyer, Aurélie Lardenois, Frédéric Chalmel, Uro-oncogenomics Viewer Group","doi":"10.1016/j.euo.2024.04.008","DOIUrl":"10.1016/j.euo.2024.04.008","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"7 6","pages":"Pages 1545-1547"},"PeriodicalIF":8.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate Magnetic Resonance Imaging Using the Prostate Imaging for Recurrence Reporting (PI-RR) Scoring System to Detect Recurrent Prostate Cancer: A Systematic Review and Meta-analysis","authors":"Felipe A. Mourato ,&nbsp;Luiza G. Schmitt ,&nbsp;Miriana Mariussi ,&nbsp;Giovanni Torri ,&nbsp;Stephan Altmayer ,&nbsp;Francesco Giganti ,&nbsp;Jorge Abreu-Gomez ,&nbsp;Nathan Perlis ,&nbsp;Alejandro Berlin ,&nbsp;Sangeet Ghai ,&nbsp;Masoom A. Haider ,&nbsp;Adriano B. Dias","doi":"10.1016/j.euo.2024.05.007","DOIUrl":"10.1016/j.euo.2024.05.007","url":null,"abstract":"<div><h3>Background and objective</h3><div>Prostate Imaging for Recurrence Reporting (PI-RR) was introduced in 2021 to standardize the interpretation and reporting of multiparametric magnetic resonance imaging (MRI) for prostate cancer following whole-gland treatment. The system scores image on a scale from 1 to 5 and has shown promising results in single-center studies. The aim of our systematic review and meta-analysis was to assess the diagnostic performance of the PI-RR system in predicting the likelihood of local recurrence after whole-gland treatment.</div></div><div><h3>Methods</h3><div>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for diagnostic test accuracy were followed. Relevant databases were searched up to December 2023. Primary studies met the eligibility criteria if they reported MRI diagnostic performance in prostate cancer recurrence using PI-RR. Diagnostic performance for MRI was assessed using two different cutoff points (≥3 or ≥4 for positivity according to the PI-RR system). A meta-analysis with a random-effects model was used to estimate pooled sensitivity and specificity values.</div></div><div><h3>Key findings and limitations</h3><div>Sixteen articles were identified for full-text reading, of which six were considered eligible, involving a total of 467 patients. Using a cutoff of PI-RR ≥3 (4 studies) for recurrent disease, the sensitivity was 77.8% (95% confidence interval [CI] 69.9–84.1%) and the specificity was 80.2% (95% CI 58.2–92.2%). Using a cutoff of PI-RR ≥4 (4 studies), the sensitivity was 61.9% (95% CI 35.6–82.7%) and the specificity was 86.6% (95% CI 75.1–93.3%). Overall, the inter-rater agreement varied from fair to excellent.</div></div><div><h3>Conclusions and clinical implications</h3><div>PI-RR is accurate in detecting local recurrence after whole-gland treatment for prostate cancer and shows fair-to-good to excellent inter-reader agreement. Overall, a PI-RR cutoff of ≥3 showed high sensitivity and specificity.</div></div><div><h3>Patient summary</h3><div>We reviewed studies that reported on how good MRI scans using a scoring system called PI-RR were in detecting recurrence of prostate cancer. We found that this system shows good performance, with fair to excellent agreement between different radiologists.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"7 6","pages":"Pages 1246-1254"},"PeriodicalIF":8.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Alireza Ghoreifi and Hooman Djaladat’s Letter to the Editor re: Yiling Chen, Chenyang Xu, Zezhong Mou, et al. Endoscopic Cryoablation Versus Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma. Eur Urol Oncol. In press. https://doi.org/10.1016/j.euo.2024.04.012","authors":"Yiling Chen ,&nbsp;Chenyang Xu ,&nbsp;Zezhong Mou ,&nbsp;Yun Hu ,&nbsp;Chen Yang ,&nbsp;Jinzhong Hu ,&nbsp;Xinan Chen ,&nbsp;Jianfeng Luo ,&nbsp;Lujia Zou ,&nbsp;Haowen Jiang","doi":"10.1016/j.euo.2024.10.007","DOIUrl":"10.1016/j.euo.2024.10.007","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"7 6","pages":"Pages 1553-1554"},"PeriodicalIF":8.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profiling Fibroblast Growth Factor Receptor 3 Expression Based on the Immune Microenvironment in Upper Tract Urothelial Carcinoma","authors":"Keisuke Shigeta ,&nbsp;Kazuhiro Matsumoto ,&nbsp;Sotaro Kitaoka ,&nbsp;Minami Omura ,&nbsp;Kota Umeda ,&nbsp;Yuki Arita ,&nbsp;Shuji Mikami ,&nbsp;Keishiro Fukumoto ,&nbsp;Yota Yasumizu ,&nbsp;Nobuyuki Tanaka ,&nbsp;Toshikazu Takeda ,&nbsp;Shinya Morita ,&nbsp;Takeo Kosaka ,&nbsp;Ryuichi Mizuno ,&nbsp;Satoshi Hara ,&nbsp;Mototsugu Oya","doi":"10.1016/j.euo.2024.01.013","DOIUrl":"10.1016/j.euo.2024.01.013","url":null,"abstract":"<div><h3>Background</h3><div>Although several studies have shown favorable outcomes in upper tract urothelial carcinoma (UTUC) with fibroblast growth factor receptor 3 (FGFR3) mutations and/or expression, the relationship between immune cell markers and FGFR3 expression remains unknown.</div></div><div><h3>Objective</h3><div>To clarify the FGFR3-based immune microenvironment and investigate biomarkers to predict the treatment response to pembrolizumab (Pem) in patients with UTUC.</div></div><div><h3>Design, setting, and participants</h3><div>We conducted immunohistochemical staining in 214 patients with UTUC. The expression levels of FGFR3, CD4, CD8, CD68, CD163, CD204, and programmed cell death ligand 1 (PD-L1) were examined.</div></div><div><h3>Intervention</h3><div>All UTUC patients underwent radical nephroureterectomy.</div></div><div><h3>Outcome measurements and statistical analysis</h3><div>We assessed the relationship between these immune markers and patient prognosis.</div></div><div><h3>Results and limitations</h3><div>A total of 109 (50.9%) patients showed high FGFR3 expressions and a favorable prognosis compared with the remaining patients. Among the six immune markers, CD8 high expression was an independent favorable factor, whereas CD204 expression was an independent prognostic factor for cancer death. From the FGFR3-based immune clustering, three immune clusters were identified. Cluster A showed low FGFR3 with tumor-associated macrophage–rich components (CD204⁺) followed by a poor prognosis due to a poor response to Pem. Cluster B showed low FGFR3 with an immune hot component (CD8⁺), followed by the most favorable prognosis owing to a good response to Pem. Cluster C showed high FGFR3 expression but an immune cold component, followed by a favorable prognosis due to the high FGFR3 expression, but a poor response was confirmed with Pem.</div></div><div><h3>Conclusions</h3><div>Although most patients exhibit a poor response to Pem, individuals with low FGFR3 expression and immune hot status may benefit clinically from Pem treatment.</div></div><div><h3>Patient summary</h3><div>We conducted immunohistochemical staining to evaluate fibroblast growth factor receptor 3 (FGFR3)-related immune microenvironment by evaluating the expressions of CD4, CD8, CD68, CD163, CD204, and PD-L1 in 214 upper tract urothelial carcinoma patients. We identified three distinct immune clusters based on FGFR3 expressions and found that patients with a low FGFR3 expression but immune hot status received the maximum benefit from an immune checkpoint inhibitor.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"7 6","pages":"Pages 1338-1349"},"PeriodicalIF":8.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-institutional Analysis of Metastasis-directed Therapy with or Without Androgen Deprivation Therapy in Oligometastatic Castration-sensitive Prostate Cancer","authors":"Matthew P. Deek ,&nbsp;Philip Sutera ,&nbsp;Yuezhou Jing ,&nbsp;Robert Gao ,&nbsp;Emily Rothman ,&nbsp;Heather Day ,&nbsp;David Chang ,&nbsp;Piet Dirix ,&nbsp;Andrew J. Armstrong ,&nbsp;Bethany Campbell ,&nbsp;Fernando Lopez Campos ,&nbsp;Miguel Berenguer ,&nbsp;Matthew Ramotar ,&nbsp;Antonio Conde-Moreno ,&nbsp;Alejandro Berlin ,&nbsp;Davide Giovanni Bosetti ,&nbsp;Niall Corcoran ,&nbsp;Bridget Koontz ,&nbsp;Carole Mercier ,&nbsp;Shankar Siva ,&nbsp;Christopher Sweeney","doi":"10.1016/j.euo.2024.03.010","DOIUrl":"10.1016/j.euo.2024.03.010","url":null,"abstract":"<div><h3>Background</h3><div>Metastasis-directed therapy (MDT) is increasingly being used in oligometastatic castration-sensitive prostate cancer (omCSPC). However, it is currently unclear how to optimally integrate MDT with the standard of care of systemic hormonal therapy.</div></div><div><h3>Objective</h3><div>To report long-term outcomes of MDT alone versus MDT and a defined course of androgen deprivation therapy (ADT) in omCSPC.</div></div><div><h3>Design, setting, and participants</h3><div>Here, a multicenter, international retrospective cohort of omCSPC as defined by conventional imaging was reported.</div></div><div><h3>Outcome measurements and statistical analysis</h3><div>Biochemical progression-free survival (bPFS), distant progression-free survival (dPFS), and combined biochemical or distant progression-free survival (cPFS) were evaluated with Kaplan-Meier and multivariable Cox proportional hazard regression models.</div></div><div><h3>Results and limitations</h3><div>A total of 263 patients were included, 105 with MDT + ADT and 158 with MDT alone. The majority of patients had metachronous disease (90.5%). Five-year bPFS, dPFS, and cPFS were, respectively, 24%, 41%, and 19% in patients treated with MDT + ADT and 11% (hazard ratio [HR] 0.48, 95% confidence interval [CI] 0.36–0.64), 29% (HR 0.56, 95% CI 0.40–0.78), and 9% (HR 0.50, 95% CI 0.38–0.67) in patients treated with MDT alone. On a multivariable analysis adjusting for pretreatment variables, the use of ADT was associated with improved bPFS (HR 0.43, <em>p</em> &lt; 0.001), dPFS (HR 0.45, <em>p</em> = 0.002), and cPFS (HR 0.44, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>In this large multi-institutional report, the addition of concurrent ADT to MDT appears to improve time to prostate-specific antigen progression and distant recurrence, noting that about 10% patients had durable control with MDT alone. Ongoing phase 3 studies will help further define treatment options for omCSPC.</div></div><div><h3>Patient summary</h3><div>Here, we report a large retrospective review evaluating the outcomes of metastasis-directed therapy with or without a limited course of androgen deprivation for patients with oligometastatic castration-sensitive prostate cancer. This international multi-institutional review demonstrates that the addition of androgen deprivation therapy to metastasis-directed therapy (MDT) improves progression-free survival. While a proportion of patients appear to have long-term disease control with MDT alone, further work in biomarker discovery is required to better identify which patients would be appropriate for de-escalated therapy.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"7 6","pages":"Pages 1403-1410"},"PeriodicalIF":8.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140790139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review and Meta-analysis of the Impact of Local Therapies on Local Event Suppression in Metastatic Hormone-sensitive Prostate Cancer","authors":"Ichiro Tsuboi ,&nbsp;Akihiro Matsukawa ,&nbsp;Mehdi Kardoust Parizi ,&nbsp;Jakob Klemm ,&nbsp;Stefano Mancon ,&nbsp;Sever Chiujdea ,&nbsp;Tamás Fazekas ,&nbsp;Marcin Miszczyk ,&nbsp;Ekaterina Laukhtina ,&nbsp;Tatsushi Kawada ,&nbsp;Satoshi Katayama ,&nbsp;Takehiro Iwata ,&nbsp;Kensuke Bekku ,&nbsp;Pierre Karakiewicz ,&nbsp;Koichiro Wada ,&nbsp;Morgan Rouprêt ,&nbsp;Motoo Araki ,&nbsp;Shahrokh F. Shariat","doi":"10.1016/j.euo.2024.03.007","DOIUrl":"10.1016/j.euo.2024.03.007","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Context&lt;/h3&gt;&lt;div&gt;It remains unclear to what extent the therapy of the primary local tumor, such as radical prostatectomy (RP) and radiation therapy (RT), improves overall survival in patients with low-volume metastatic hormone-sensitive prostate cancer (mHSPC). However, data suggest a benefit of these therapies in preventing local events secondary to local tumor progression.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To evaluate the efficacy of adding local therapy (RP or RT) to systemic therapies, including androgen deprivation therapy, docetaxel, and/or androgen receptor axis–targeted agents, in preventing local events in mHSPC patients compared with systemic therapy alone (ie, without RT of the prostate or RP).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Evidence acquisition&lt;/h3&gt;&lt;div&gt;Three databases and meeting abstracts were queried in November 2023 for studies analyzing mHSPC patients treated with local therapy. The primary outcome of interest was the prevention of overall local events (urinary tract infection, urinary tract obstruction, and gross hematuria) due to local disease progression. Subgroup analyses were conducted to assess the differential outcomes according to the type of local therapy (RP or RT).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Evidence synthesis&lt;/h3&gt;&lt;div&gt;Overall, six studies, comprising two randomized controlled trials, were included for a systematic review and meta-analysis. The overall incidence of local events was significantly lower in the local treatment plus systemic therapy group than in the systemic therapy only groups (relative risk [RR]: 0.50, 95% confidence interval [CI]: 0.28–0.88, &lt;em&gt;p&lt;/em&gt; = 0.016). RP significantly reduced the incidence of overall local events (RR: 0.24, 95% CI: 0.11–0.52) and that of local events requiring surgical intervention (RR: 0.08, 95% CI: 0.03–0.25). Although there was no statistically significant difference between the RT plus systemic therapy and systemic therapy only groups in terms of overall local events, the incidence of local events requiring surgical intervention was significantly lower in the RT plus systemic therapy group (RR: 0.70, 95% CI: 0.49–0.99); local events requiring surgical intervention of the upper urinary tract was significantly lower in local treatment groups (RR: 0.60, 95% CI: 0.37–0.98, &lt;em&gt;p&lt;/em&gt; = 0.04). However, a subgroup analysis revealed that neither RP nor RT significantly impacted the prevention of local events requiring surgical intervention of the upper urinary tract.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;In some patients with mHSPC, RP or RT of primary tumor seems to reduce the incidence of local progression and events requiring surgical intervention. Identifying which patients are most likely to benefit from local therapy, and at what time point (eg, after response of metastases), will be necessary to set up a study assessing the risk, benefits, and alternatives to therapy of the primary tumor in the mHSPC setting.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patient summary&lt;/h3&gt;&lt;div&gt;Our study suggests","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"7 6","pages":"Pages 1185-1194"},"PeriodicalIF":8.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Diagnosis of Very Low-risk Prostate Cancer in a Multihospital Health Care System","authors":"Richard Bennett 4th ,&nbsp;Eric V. Li ,&nbsp;Austin Y. Ho ,&nbsp;Jonathan Aguiar ,&nbsp;Ashorne K. Mahenthiran ,&nbsp;Chalairat Suk-ouichai ,&nbsp;Sai K. Kumar ,&nbsp;Clayton Neill ,&nbsp;Edward M. Schaeffer ,&nbsp;Anugayathri Jawahar ,&nbsp;Hiten D. Patel ,&nbsp;Ashley E. Ross","doi":"10.1016/j.euo.2024.04.015","DOIUrl":"10.1016/j.euo.2024.04.015","url":null,"abstract":"<div><div>The National Comprehensive Cancer Network (NCCN) very low risk (VLR) category for prostate cancer (PCa) represents clinically insignificant disease, and detection of VLR PCa contributes to overdiagnosis. Greater use of magnetic resonance imaging (MRI) and biomarkers before patient selection for prostate biopsy (PBx) reduces unnecessary biopsies and may reduce the diagnosis of clinically insignificant PCa. We tested a hypothesis that the proportion of VLR diagnoses has decreased with greater use of MRI-informed PBx using data from our 11-hospital system. From 2018 to 2023, 351/3197 (11%) men diagnosed with PCa met the NCCN VLR criteria. The proportion of VLR diagnoses did not change from 2018 to 2023 (<em>p</em> = 0.8) despite an increase in the use of MRI-informed PBx (from 49% to 82%; <em>p</em> &lt; 0.001). Of patients who underwent combined systematic and targeted PBx and were diagnosed with VLR disease, cancer was found in systematic PBx regions in 79% of cases and in targeted PBx regions in 31% of cases. When performing both systematic and targeted PBx, prebiopsy MRI-based risk calculators could limit VLR diagnosis by 41% using a risk threshold of &gt;5% for Gleason grade group ≥3 PCa to recommend biopsy; the reduction would be 77% if performing targeted PBx only. These findings suggest that VLR disease continues to account for a significant minority of PCa diagnoses and could be limited by targeted PBx and risk stratification calculators.</div></div><div><h3>Patient summary</h3><div>We looked at recent trends for the diagnosis of very low-risk (VLR) prostate cancer. We found that VLR cancer still seems to be frequently diagnosed despite the use of MRI (magnetic resonance imaging) scans before biopsy. The use of risk calculators to identify men who could avoid biopsy and/or biopsy only for lesions that are visible on MRI could reduce the overdiagnosis of VLR prostate cancer.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"7 6","pages":"Pages 1179-1182"},"PeriodicalIF":8.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140907920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported Outcome Measures and Experience Measures After Active Surveillance Versus Radiation Therapy Versus Radical Prostatectomy for Prostate Cancer: A Systematic Review of Prospective Comparative Studies","authors":"Andrea Alberti ,&nbsp;Rossella Nicoletti ,&nbsp;Daniele Castellani ,&nbsp;Yuhong Yuan ,&nbsp;Martina Maggi ,&nbsp;Edoardo Dibilio ,&nbsp;Giulio Raffaele Resta ,&nbsp;Pantelis Makrides ,&nbsp;Francesco Sessa ,&nbsp;Arcangelo Sebastianelli ,&nbsp;Sergio Serni ,&nbsp;Mauro Gacci ,&nbsp;Cosimo De Nunzio ,&nbsp;Jeremy Y.C. Teoh ,&nbsp;Riccardo Campi","doi":"10.1016/j.euo.2024.05.008","DOIUrl":"10.1016/j.euo.2024.05.008","url":null,"abstract":"<div><h3>Background and objective</h3><div>Current management options for localized prostate cancer (PCa) include radical prostatectomy (RP), radiotherapy (RT), and active surveillance (AS). Despite comparable oncological outcomes, there is still lack of evidence on their comparative effectiveness in terms of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs). We conducted a systematic review of studies comparing PROMs and PREMs after all recommended management options for localized PCa (RP, RT, AS).</div></div><div><h3>Methods</h3><div>A literature search was performed in the MEDLINE, EMBASE, and Cochrane CENTRAL databases in accordance with recommendations from the European Association of Urology Guidelines Office and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. All prospective clinical trials reporting PROMs and/or PREMs for comparisons of RP versus RT versus AS were included. A narrative synthesis was used to summarize the review findings. No quantitative synthesis was performed because of the heterogeneity and limitations of the studies available.</div></div><div><h3>Key findings and limitations</h3><div>Our findings reveal that RP mostly affects urinary continence and sexual function, with better results for voiding symptoms in comparison to other treatments. RT was associated with greater impairment of bowel function and voiding symptoms. None of the treatments had a significant impact on mental or physical quality of life. Only a few studies reported PREMs, with a high rate of decision regret for all modalities (up to 23%).</div></div><div><h3>Conclusions and clinical implications</h3><div>All recommended treatments for localized PCa have an impact on PROMs and PREMs, but for different domains and with differing severity. We found significant heterogeneity in PROM collection, so standardization in real-world practice and clinical trials is warranted. Only a few studies have reported PREMs, highlighting an unmet need that should be explored in future studies.</div></div><div><h3>Patient summary</h3><div>We reviewed differences in patient reports of their outcomes and experiences after surgical prostate removal, radiotherapy, or active surveillance for prostate cancer. We found differences in the effects on urinary, bowel, and sexual functions among the treatments, but no difference for mental or physical quality of life. Our results can help doctors and prostate cancer patients in shared decision-making.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"7 6","pages":"Pages 1255-1266"},"PeriodicalIF":8.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Radical Prostatectomy on Survival for Men with High-risk Nonmetastatic Prostate Cancer Features Selected According to STAMPEDE Criteria: An EMPaCT Study","authors":"Daimantas Milonas ,&nbsp;Alexander Giesen ,&nbsp;Annouschka Laenen ,&nbsp;Gaëtan Devos ,&nbsp;Alberto Briganti ,&nbsp;Paolo Gontero ,&nbsp;R. Jeffrey Karnes ,&nbsp;Piotr Chlosta ,&nbsp;Frank Claessens ,&nbsp;Gert De Meerleer ,&nbsp;Wouter Everaerts ,&nbsp;Markus Graefen ,&nbsp;Giansilvio Marchioro ,&nbsp;Rafael Sanchez-Salas ,&nbsp;Bertrand Tombal ,&nbsp;Henk Van Der Poel ,&nbsp;Hendrik Van Poppel ,&nbsp;Martin Spahn ,&nbsp;Steven Joniau ,&nbsp;for the European Multicenter Prostate Cancer Clinical and Translational Research Group (EMPaCT)","doi":"10.1016/j.euo.2024.05.016","DOIUrl":"10.1016/j.euo.2024.05.016","url":null,"abstract":"<div><h3>Background and objective</h3><div>A meta-analysis of two randomized STAMPEDE platform trials revealed that 3 yr of abiraterone acetate in addition to androgen deprivation therapy and radiation therapy significantly improved metastasis-free and overall survival (OS) in high-risk nonmetastatic prostate cancer (PCa) and should be considered a new standard of care. The aim of our study was to assess long-term cancer-specific survival (CSS) and OS for surgically treated patients with newly diagnosed nonmetastatic node-negative PCa meeting the STAMPEDE criteria for high risk.</div></div><div><h3>Methods</h3><div>This was a retrospective, multicenter cohort study of patients with European Association of Urology (EAU) high-risk PCa who underwent radical prostatectomy and extended pelvic lymph node dissection. CSS was assessed using cumulative incidence curves and the Kaplan-Meier method was used to evaluate OS. We used a Fine and Gray model to evaluate the prognostic value of STAMPEDE high-risk factors (SHRFs) for CSS, and a Cox proportional-hazards model to assess the association of SHRFs with OS.</div></div><div><h3>Key findings and limitations</h3><div>A total of 2994 patients with EAU high-risk PCa were divided into groups with 0, 1, 2, or 3 SHRFs. The 10-yr survival estimates for patients with 0–1 versus 2–3 SHRFs were 95% versus 82% for CSS and 81% versus 64% for OS (both <em>p</em> &lt; 0.0001). In comparison to patients with 0 SHRFs, hazard ratios were 1.2 (<em>p</em> = 0.5), 3.9 (<em>p</em> &lt; 0.0001), and 5.5 (<em>p</em> &lt; 0.0001) for CSS, and 1.1 (<em>p</em> = 0.4), 2.2 (<em>p</em> &lt; 0.0001), and 2.5 (<em>p</em> = 0.0004) for OS for patients with 1, 2, and 3 SHRFs, respectively.</div></div><div><h3>Conclusions and clinical implications</h3><div>Our results confirm that the STAMPEDE high-risk criteria identify a subgroup of patients with highly aggressive PCa features and adverse long-term oncological outcomes. This population is likely to benefit most from aggressive multimodal treatment. Nevertheless, we have shown for the first time that surgery remains a viable treatment option for patients with STAMPEDE high-risk PCa.</div></div><div><h3>Patient summary</h3><div>Prostate cancer that meets the high-risk definitions from the STAMPEDE trial is an aggressive type of cancer. Our results for long-term cancer control outcomes indicate that surgery is a viable option for the subgroup of patients with this type of prostate cancer.</div></div>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"7 6","pages":"Pages 1478-1486"},"PeriodicalIF":8.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141598911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Outcomes of Stereotactic Ablative Radiotherapy: There Is Room for Improvement","authors":"Riccardo Bertolo ,&nbsp;Giulio Francolini ,&nbsp;Laura Bukavina","doi":"10.1016/j.euo.2024.07.004","DOIUrl":"10.1016/j.euo.2024.07.004","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":"7 6","pages":"Pages 1159-1161"},"PeriodicalIF":8.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}