European urology oncology最新文献

{"title":"Multivitamin Use After Prostate Cancer Diagnosis Is Associated with Lower Risk of Recurrence: A Prospective Cohort Study from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE).","authors":"Kevin Shee, Benjamin E Cedars, Lufan Wang, Stacey A Kenfield, Janet E Cowan, Irina Tolstykh, Crystal S Langlais, William A Pace, Jeanette M Broering, Peter R Carroll, June M Chan, Erin L Van Blarigan","doi":"10.1016/j.euo.2025.04.014","DOIUrl":"https://doi.org/10.1016/j.euo.2025.04.014","url":null,"abstract":"<p><strong>Background and objective: </strong>Multivitamin (MV) use is common among men with prostate cancer (PC). However, data on MV use in relation to the risk of PC recurrence are limited.</p><p><strong>Methods: </strong>We conducted a longitudinal observational cohort study in 1396 men with nonmetastatic PC who underwent radical prostatectomy (RP) or radiation therapy (RT) and enrolled in the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) study between 1999 and 2018. The primary outcome was PC recurrence, defined as biochemical recurrence or initiation of secondary treatment. Postdiagnostic MV use was ascertained via a questionnaire after diagnosis and before any recurrence. Multivariable Cox proportional-hazards regression models controlled for sociodemographic factors, clinical factors, and health behaviors and were used to calculate adjusted hazards ratios (HRs) and 95% confidence intervals (CIs).</p><p><strong>Key findings and limitations: </strong>In the study cohort there were 858 (62%) current MV users, 227 (16%) past MV users, and 311 (22%) never users. We observed 119 PC recurrence events over a median follow-up of 4.7 (interquartile range 1.9-9.2) yrs after survey completion. Current MV use was associated with lower risk of PC recurrence (basic model: HR 0.52, 95% CI 0.35-0.78; adjusted model: HR 0.51, 95% CI 0.33-0.78). In stratified analyses, the inverse association between current MV use and PC recurrence was stronger for men with grade group 2 (Gleason 3 + 4) or greater PC (n = 430; HR 0.27, 95% CI 0.13-0.55; p < 0.001) and was not statistically significant for men with grade group 1 (Gleason 3 + 3) PC (n = 966).</p><p><strong>Conclusions and clinical implications: </strong>MV use after PC diagnosis was associated with lower risk of PC recurrence, particularly in patients with higher-grade disease. This finding warrants validation and further investigation.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979202","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":"Re: Rosemarijn H. Ettema, Jan-Jaap J. Mellema, Dennie Meijer, et al. Early Oncological Outcomes in Patients Who Underwent Staging Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography Compared with Conventional Imaging Before Radical Prostatectomy and Extended Pelvic Lymph Node Dissection. Eur Urol Oncol. In press. https://doi.org/10.1016/j.euo.2024.11.003.","authors":"Giacomo Gallo, Alessio Guidotti, Riccardo Lombardo, Cosimo De Nunzio","doi":"10.1016/j.euo.2025.02.016","DOIUrl":"https://doi.org/10.1016/j.euo.2025.02.016","url":null,"abstract":"","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999342","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":"Risk-based Prostate-specific Antigen Monitoring Reduces Follow-up Burden After Radical Prostatectomy.","authors":"Leonor Jane Paulino Pereira, Roderick C N van den Bergh, Michiel J P M Sedelaar, Berdine L Heesterman, Katja K H Aben, Lambertus Kiemeney, Inge van Oort, Harm H E van Melick","doi":"10.1016/j.euo.2025.02.013","DOIUrl":"https://doi.org/10.1016/j.euo.2025.02.013","url":null,"abstract":"<p><strong>Background and objective: </strong>The European Association of Urology (EAU)-recommended follow-up schedule after radical prostatectomy (RP)-biannual prostate-specific antigen (PSA) testing for 3 yr, followed by annual testing-does not take into account variations in biochemical recurrence (BCR) risk. Therefore, we propose an optimised, risk-adapted PSA monitoring schedule for the first 5 yr after RP, stratifying patients into BCR-based risk groups, to reduce unnecessary PSA testing without compromising BCR detection rates.</p><p><strong>Methods: </strong>Men were diagnosed with localised prostate cancer in 2015-2016, who underwent primary RP, with undetectable PSA levels <6 wk after RP, as identified in the nationwide Netherlands Cancer Registry. The outcome measures included BCR-free survival (BCR defined as PSA ≥0.1 ng/ml). Cox proportional hazards models were used to identify three risk groups; Kaplan-Meier curves illustrated BCR-free survival rates. The average BCR risk per PSA follow-up consultation in the current EAU schedule was used as a threshold to determine consultations needed in the revised risk-based schedule.</p><p><strong>Key findings and limitations: </strong>In total, 1043 patients were included in the study. Significant predictors for BCR included PSA at diagnosis, pT stage, pN stage, pathological International Society of Urological Pathology grade group, and positive surgical margins. Stratification (based on hazard ratio) resulted in 43% low-risk (15% BCR), 42% intermediate-risk (36% BCR), and 15% high-risk (72% BCR) patients. The overall 5-yr BCR-free survival rate was 62% (95% confidence interval 58-66). Low-risk patients required four, intermediate-risk patients required eight, and high-risk patients required ten consultations in the revised schedule over the first 5 yr, reducing 18% of consultations compared with the EAU schedule, with 3% delayed BCR detection. Study limitations include a potential bias due to informative censoring.</p><p><strong>Conclusions and clinical implications: </strong>This optimised risk-adapted PSA monitoring schedule following RP reduced the number of unnecessary PSA tests, particularly in low-risk patients, without compromising BCR detection rates.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992286","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":"Niraparib and Abiraterone Acetate plus Prednisone in Metastatic Castration-resistant Prostate Cancer: Final Overall Survival Analysis for the Phase 3 MAGNITUDE Trial.","authors":"Kim N Chi, Elena Castro, Gert Attard, Matthew R Smith, Shahneen Sandhu, Eleni Efstathiou, Guilhem Roubaud, Eric J Small, Andrea Pereira de Santana Gomes, Dana E Rathkopf, Marniza Saad, Howard Gurney, Wonho Jung, Won Kim, Shiva Dibaj, Daphne Wu, Jenny Zhang, Angela Lopez-Gitlitz, Peter Francis, David Olmos","doi":"10.1016/j.euo.2025.04.012","DOIUrl":"https://doi.org/10.1016/j.euo.2025.04.012","url":null,"abstract":"<p><strong>Background and objective: </strong>The phase 3 MAGNITUDE trial previously met its primary endpoint of an improvement in radiographic progression-free survival with niraparib + abiraterone acetate and prednisone (AAP) versus placebo + AAP in patients with metastatic castration-resistant prostate cancer (mCRPC) and alterations in genes involved in DNA homologous recombination repair (HRR⁺), particularly in BRCA1/2.</p><p><strong>Methods: </strong>Patients were prospectively screened for HRR alterations and randomized 1:1 to niraparib + AAP (n = 212) or placebo + AAP (n = 211). We report results from the prespecified, event-driven, final analysis of secondary efficacy endpoints.</p><p><strong>Key findings and limitations: </strong>Final analysis at median follow-up of 37.3 mo revealed no difference in overall survival (OS) between niraparib + AAP and placebo + AAP in the HRR⁺ population (hazard ratio [HR] 0.931, 95% confidence interval [CI] 0.720-1.203; p = 0.585) or the subgroup with BRCA1/2 alterations (HR 0.788, 95% CI 0.554-1.120; nominal p = 0.183). Prespecified multivariate analyses adjusted for baseline prognostic factors showed a trend toward longer OS with niraparib + AAP over placebo + AAP in the HRR⁺ population (HR 0.785, 95% CI 0.606-1.016; nominal p = 0.066) and the BRCA1/2 subgroup (HR 0.663, 95% CI 0.464-0.947; nominal p = 0.024). Niraparib + AAP led to a statistically significant, clinically meaningful improvement in time to symptomatic progression in both the HRR⁺ population (HR 0.547, 95% CI 0.396-0.754; p = 0.006) and the BRCA1/2 subgroup (HR 0.562, 95% CI 0.371-0.849; nominal p = 0.006), and a clinically meaningful improvement in time to cytotoxic chemotherapy in the HRR⁺ population (HR 0.688, 95% CI 0.499-0.950; p = 0.022) and the BRCA1/2 subgroup (HR 0.598, 95% CI 0.387-0.924; nominal p = 0.019) in comparison to placebo + AAP. The niraparib + AAP safety profile remains unchanged at longer follow-up; adverse events were primarily hematologic and manageable.</p><p><strong>Conclusions and clinical implications: </strong>The MAGNITUDE final analysis showed that patients with HRR⁺ mCRPC, including those with the approved indication of BRCA-altered mCRPC, generally continue to benefit from first-line treatment with niraparib + AAP in comparison to placebo + AAP.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001606","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":"Variation in Prostate Magnetic Resonance Imaging Performance: Data from the Prostate Biopsy Collaborative Group.","authors":"Sunny B Nalavenkata, Emily Vertosick, Alberto Briganti, Hashim Ahmed, David Eldred-Evans, Steven Gordon, Holly Raghallaigh, Christian Gratzke, Michael O'Callaghan, Michael Liss, Peter Chiu, Michael Müntener, John Yaxley, Cedric Poyet, Matthias Jahnen, Ants Toi, Sangeet Ghai, Daniel Margolis, Donna Ankerst, Behfar Ehdaie, Manish I Patel, Andrew J Vickers","doi":"10.1016/j.euo.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.euo.2025.02.007","url":null,"abstract":"<p><strong>Background and objective: </strong>The quality and reporting of prostate magnetic resonance imaging (MRI) are operator dependent, leading to variations in estimates such as positive predictive value across sites. This impacts patient counseling, risk modeling, and risk calculators. This study assessed variation in Prostate Imaging Reporting and Data System (PI-RADS) score classification and subsequent probability of grade group (GG) ≥2 + prostate cancer.</p><p><strong>Methods: </strong>Data from the Prostate Biopsy Collaborative Group, including multiple sites in North America, Europe, and Asia Pacific, were analyzed. Patients underwent multiparametric MRI (mpMRI) of the prostate followed by prostate biopsy during the years 2010-2023. Only those with MRI-targeted biopsy and PI-RADS score ≥3 were included. The risk of being assigned PI-RADS 4 or 5 and risk of GG ≥2 disease for these scores were estimated using logistic regression.</p><p><strong>Key findings and limitations: </strong>The cohort included 7325 biopsies from 7320 unique patients from 13 sites. A two-fold variation in the probability of PI-RADS 4 or 5 assignment across sites persisted even after adjustment for patient risk (heterogeneity p < 0.001 for both). There were significant differences in the absolute risk of GG ≥2 disease for PI-RADS 4 and 5 (heterogeneity p < 0.001 for both), varying between 23% and 68% and between 49% and 87%, respectively. The use of prostate biopsy as a reference standard has limitations but reflects typical usage of mpMRI in clinical practice.</p><p><strong>Conclusions and clinical implications: </strong>The probability of being assigned PI-RADS 4 or 5 and subsequent detection of GG ≥2 disease varies widely between institutions. This impacts counseling, risk stratification, and clinical practice, necessitating better standardization in the performance and interpretation of mpMRI.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976835","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":"Avelumab First-line Maintenance for Advanced Urothelial Carcinoma: Long-term Analyses of Patient-reported Outcomes and Quality-adjusted Time Without Symptoms or Toxicity from the JAVELIN Bladder 100 Trial.","authors":"Petros Grivas, Jeanny B Aragon-Ching, Joaquim Bellmunt, Yohann Loriot, Miguel A Climent Duran, Srikala S Sridhar, Po-Jung Su, Se Hoon Park, Evgeny Kopyltsov, Yoshiaki Yamamoto, Natalia Jacob, Jason Hoffman, Karin Tyroller, Juliane Manitz, Mairead Kearney, Michael Schlichting, Thomas Powles","doi":"10.1016/j.euo.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.euo.2025.04.004","url":null,"abstract":"<p><strong>Background and objective: </strong>In JAVELIN Bladder 100, avelumab first-line maintenance plus best supportive care (BSC) significantly prolonged overall survival versus BSC alone, with no detrimental impact on quality of life (QOL), in patients with advanced urothelial carcinoma without progression following first-line platinum-based chemotherapy. We report long-term analyses of patient-reported outcomes (PROs) in patients treated with avelumab (any duration or ≥12 mo) and a post hoc analysis comparing quality-adjusted time without symptoms or toxicity (Q-TWiST) between arms.</p><p><strong>Methods: </strong>PROs were assessed using National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy Bladder Symptom Index-18 (FBlSI-18) and EuroQol 5-level EQ-5D (EQ-5D-5L). Q-TWiST was calculated as the utility-weighted sum of mean time in three health states: time with all-cause grade 3/4 toxicity prior to progression, time without grade 3/4 toxicity or symptoms of progression, and time after progression.</p><p><strong>Key findings and limitations: </strong>In the overall avelumab plus BSC arm (n = 350) and the subgroup treated for ≥12 mo (n = 118), completion rates for PRO assessments during treatment were >80%. FBlSI-18 total and EQ-5D-5L index scores remained stable throughout 24 mo of treatment, with no clinically important changes from baseline. The mean Q-TWiST was 18.46 mo with avelumab plus BSC versus 15.13 mo with BSC alone (22% relative improvement). Limitations include open-label trial design and small patient numbers at later cycles.</p><p><strong>Conclusions and clinical implications: </strong>Patients receiving avelumab had preserved health-related QOL and control of cancer-related symptoms with manageable toxicity, further supporting avelumab first-line maintenance as the recommended treatment for advanced urothelial carcinoma not progressed after platinum-based chemotherapy.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005479","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":"Prediction of Prostate Cancer Biochemical Recurrence After Radical Prostatectomy by Collagen Models Using Multiomic Profiles.","authors":"Maria Frantzi, Piotr Tymoszuk, Stefan Salcher, Enrique Gomez-Gomez, Ana C Morillo, Felix Melchior, Ana Blanca, Harald Mischak, Antonia Vlahou, Andreas Pircher, Isabel Heidegger","doi":"10.1016/j.euo.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.euo.2025.03.016","url":null,"abstract":"<p><strong>Background and objective: </strong>The interplay between prostate cancer and the tumor microenvironment is well documented and of primary importance in disease evolution. Herein, we investigated the prognostic value of tissue and urinary collagen-related molecular signatures in predicting biochemical recurrence (BCR) after radical prostatectomy (RP).</p><p><strong>Methods: </strong>A comprehensive analysis of 55 collagen-related features was conducted using transcriptomic datasets (n = 1393), with further validation at the proteomic level (n = 69). Additionally, a distinct cohort (n = 73) underwent a urine-based peptidomic analysis, culminating in the validation of a urine-derived prognostic model. Independent prognostic significance was assessed using Cox proportional hazards modeling, while the model's predictive performance was benchmarked against established clinical metrics.</p><p><strong>Key findings and limitations: </strong>An expression analysis of 55 collagen-related transcripts identified 11 transcripts significantly associated with BCR (C-index: 0.55-0.72, p < 0.002). Multivariable models incorporating these transcripts enhanced prognostic accuracy, surpassing clinical variables (C-index: 0.66-0.89, p < 0.002). Proteomic validation confirmed five key collagen proteins, while a urine-based collagen model (C-index: 0.73, 95% confidence interval: 0.62-0.85) demonstrated a strong prognostic potential, although limited by small patient numbers. Additionally, tissue collagen-based models predicted overall survival with a significant prognostic value (C-index: 0.59-0.70, p < 0.01).</p><p><strong>Conclusions and clinical implications: </strong>Collagen-based molecular signatures in both tissue and urine emerge as robust prognostic biomarkers for predicting BCR following RP.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964194","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":"Association of Deep and Durable Prostate-specific Antigen Responses with Outcomes in Metastatic Hormone-sensitive Prostate Cancer: Insights from ARASENS and ARANOTE Trials.","authors":"Christopher J D Wallis, Sara Ekberg, Alicia K Morgans, Martin Boegemann, Noman Paracha, Elaine Gallagher, Michael J Crowther, Neal Shore","doi":"10.1016/j.euo.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.euo.2025.03.001","url":null,"abstract":"<p><strong>Background and objective: </strong>Prostate-specific antigen (PSA) is a critical biomarker in metastatic hormone-sensitive prostate cancer (mHSPC), offering insights into disease progression and treatment efficacy. An early PSA response to intensified therapy has significant prognostic implications; however, traditional methods often categorize PSA levels and focus on fixed time points, neglecting its dynamic nature. Joint models integrate longitudinal PSA trajectories and survival outcomes to provide a more comprehensive analysis. This study aims to evaluate the association between longitudinal PSA trajectories and overall survival (OS) in patients with mHSPC.</p><p><strong>Methods: </strong>We analyzed data from two phase 3 trials: ARASENS (n = 1305; androgen deprivation therapy [ADT] + docetaxel ± darolutamide) and ARANOTE (n = 669; ADT ± darolutamide). PSA trajectories were modeled using linear mixed models with restricted cubic splines, while OS was assessed using a Weibull model. Longitudinal PSA changes and OS were linked through joint modeling.</p><p><strong>Key findings and limitations: </strong>In ARASENS, each doubling of the PSA decline rate was associated with a reduction in mortality rate of 29% (hazard ratio [HR] 0.71, 95% confidence interval [CI]: 0.69, 0.74); in ARANOTE, the reduction was 25% (HR 0.75, 95% CI: 0.72, 0.78). Higher baseline PSA levels and sharper postnadir increases were linked to worse outcomes. Darolutamide-treated patients showed favorable PSA trajectories, marked by steeper declines, prolonged nadirs, and slower increases, translating into improved OS. Limitations include interim OS data in ARANOTE and influence of prior treatments on baseline PSA.</p><p><strong>Conclusions and clinical implications: </strong>Joint modeling demonstrates a strong association between PSA dynamics and OS, underscoring darolutamide's potential to positively influence PSA trajectories and improve survival in mHSPC.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989830","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":"Adjuvant Docetaxel Versus Surveillance in Intermediate- or High-risk Prostate Cancer After Radical Curative Radiotherapy: Final Survival Results from the SPCG-13 Trial.","authors":"Pirkko-Liisa Kellokumpu-Lehtinen, Ann-Sofie Fransson, Timo Marttila, Ilari Lehtinen, Teppo Huttunen, Camilla Thellenberg-Karlsson","doi":"10.1016/j.euo.2025.04.013","DOIUrl":"https://doi.org/10.1016/j.euo.2025.04.013","url":null,"abstract":"<p><p>The SPCG-13 trial investigated whether six cycles of adjuvant docetaxel (aDoc) improves survival in patients with intermediate- or high-risk prostate cancer after radical curative radiotherapy and androgen deprivation therapy. There was no difference in biochemical recurrence-free survival (primary endpoint) at 5-yr between the surveillance (SV) and aDoc arms. Here we report 10-yr survival data (planned secondary endpoint). Updated overall survival (OS) and metastasis-free survival data were available for 233 patients. There were no demographic differences between the original randomized cohort and the 10-yr survival population. Thus, this 10-yr sample is deemed representative of the original patient population. Median OS was 14.5 yr in the SV and was not reached in the aDoc arm. No significant difference in Kaplan-Meier survival emerged between the arms over time (log-rank test p = 0.154). Estimates of the 10-yr OS rate favored aDoc (77.4% vs 66.8%). Cox regression analysis revealed a trend towards worse OS for patients with a high Gleason score (GS; hazard ratio [HR] 1.925, 95% confidence interval [CI] 1.213-3.053; p = 0.005). A Cox model adjusted for GS risk revealed an OS HR of 0.776 (95% CI 0.508-1.187; p = 0.242) for aDoc versus SV. In conclusion, aDoc was associated with a slight, but not statistically significant, improvement in 10-yr OS, especially in the high-GS group. PATIENT SUMMARY: Our 10-year survival analysis for the SPCG-13 trial showed that six cycles of chemotherapy with docetaxel after radiotherapy and androgen deprivation therapy for intermediate- or high-risk localized prostate cancer did not significantly increase survival. Survival was worse for cancers with a high Gleason score, so docetaxel could be considered after a careful discussion of the benefits and harms of chemotherapy. Further trials are needed to investigate options for this group of patients.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985504","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- and Procedure-specific Risk Factors for Urinary Incontinence After Robot-assisted Radical Prostatectomy: A Nationwide, Population-based Study.","authors":"Katarina Koss Modig, Rebecka Arnsrud Godtman, Stefan Carlsson, Pär Stattin, Johan Styrke, Marianne Månsson, Johan Stranne","doi":"10.1016/j.euo.2025.03.015","DOIUrl":"https://doi.org/10.1016/j.euo.2025.03.015","url":null,"abstract":"<p><strong>Background and objective: </strong>Postprostatectomy urinary incontinence (PPI) is a common complication following robot-assisted laparoscopic radical prostatectomy (RALP), with incidence rates of 4-31%. This study examines associations between patient- and surgery-specific risk factors and PPI.</p><p><strong>Methods: </strong>We analysed data from 13 754 men who underwent RALP between 2017 and 2021, registered in the National Prostate Cancer Register of Sweden. Electronic patient-reported outcome measure (ePROM) questions were completed by 37% at 3 mo and 47% after 12 mo, including questions on pad use. PPI was defined as the use of more than one pad (primary) and any pad use (secondary). Poisson regression assessed the associations between PPI and factors such as age, comorbidity, prostate volume, nerve-sparing procedures, and surgical details.</p><p><strong>Key findings and limitations: </strong>At 12 mo, 17% (1086/6413) reported the use of more than one pad and 49% (3113/6413) reported any pad use. Significant risk factors for incontinence in a multivariable analysis (more than one pad) included age ≥75 versus <65 yr (p < 0.001; relative risk [RR] 2.03; 95% confidence interval [CI] 1.67-2.48), urethral division with margin from the apex versus maximal urethra length (p < 0.001; RR 1.95; 95% CI 1.57-2.43), non-nerve-sparing procedures (p < 0.001; RR 1.70; 95% CI 1.432.03), and prostate volume ≥90 versus <30 ml (p = 0.018; RR 1.47; 95% CI 1.07-2.01). Limitations included missing data on surgical variables and a relatively low ePROM response rate.</p><p><strong>Conclusions and clinical implications: </strong>Older age, large prostate size, and non-nerve-sparing surgery increase the risk of PPI, underscoring the importance of shared decision-making in treatment planning. However, these factors explain only a part of PPI.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960725","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}