Prostate Cancer and Prostatic Diseases最新文献

{"title":"Prostate specific membrane antigen focal ablation imaging (PSMA-FAB).","authors":"Egesta Lopci, Massimo Lazzeri, Vittorio Fasulo, Davide Maffei, Pier Paolo Avolio, Alessandro Tallari, Stefano Moretto, Ludovica Cella, Marcello Rodari, Federica Mrakic Sposta, Paolo Casale, Nicolò Maria Buffi, Giovanni Lughezzani","doi":"10.1038/s41391-025-01005-3","DOIUrl":"https://doi.org/10.1038/s41391-025-01005-3","url":null,"abstract":"<p><p>The Prostate Imaging after Focal Ablation (PI-FAB) score has been recently proposed for scoring the appearance on multiparametric magnetic resonance imaging (mpMRI) of prostate cancer after focal therapy. The progressive implementation of prostate specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) into the management of prostate cancer has revolutionized the diagnostic work-up and inspired our proposal for a dedicated PSMA Focal Ablation Imaging (PSMA-FAB) scoring system. Based on pre- and post-treatment imaging, the classification is categorized into: PSMA-FAB 1 (continue monitoring); PSMA-FAB2 (assess PSA kinetics and MRI, with biopsy to be considered in case of suspicion); and PSMA-FAB 3 (recommend biopsy). Furthermore, a combined Focal-therapy Imaging Response Evaluation Score (FIRE-SCORE) embedding PI-FAB and PSMA-FAB scores is suggested to help patient's management at follow up.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"5G-remote radical prostatectomy under novel robotic systems: a prospective comparative cohort study with local surgeries.","authors":"Sunyi Ye, Ding Peng, Lixian Zhu, Yi Zhu, Anbang He, Taile Jing, Xiaolin Yao, Shilong Wei, Qianqian Zhao, Jieyin Chen, Yanle Ye, Jingshuang Cai, Jin Zhou, Ping Wang, Zhiyang Huang, Shuo Wang, Dan Xia","doi":"10.1038/s41391-025-01004-4","DOIUrl":"10.1038/s41391-025-01004-4","url":null,"abstract":"<p><strong>Background: </strong>There is no report upon the remote surgery of radical prostatectomy and comparisons between local surgeries. This study aims to evaluate the feasibility and safety of the innovative remote tele-surgical robotic platforms in performing radical prostatectomy.</p><p><strong>Methods: </strong>The study comprised 13 patients diagnosed with prostate cancer who underwent remote radical prostatectomy using a 5 G wireless network and the innovative remote robotic systems (Tele-RARP). Additionally, the research involved 31 patients who underwent radical prostatectomy with the local Toumai robotic system (TM-RARP) between October 2022 and April 2024, and 36 patients who underwent radical prostatectomy with the da Vinci Xi platform (Xi-RARP) during the same period under the supervision of the same surgical team. Data on demographics, perioperative factors, clinicopathologic information, and postoperative results were collected for a total of 80 patients.</p><p><strong>Results: </strong>The completion of 13 Tele-RARP procedures was successful without significant intraoperative or postoperative issues. No instances of intraoperative blood transfusion or surgical conversion were reported. The operation, console, and docking time for both the remote and local surgeries showed minimal differences. Neither local nor remote surgery nor da Vinci Xi surgery exhibited significant variations in terms of blood loss, intraoperative complications, or postoperative prognosis. Both TM-RARP and Tele-RARP presented very manageable task loads.</p><p><strong>Conclusions: </strong>Performing tele-surgical robotic-assisted radical prostatectomy using the innovative Toumai and Edge robotic surgical systems via a 5 G wireless network is not only feasible but also safe.</p><p><strong>Registration number: </strong>ChiCTR2400085386, ChiCTR2300077721.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning-based MRI imaging for prostate cancer diagnosis: systematic review and meta-analysis.","authors":"Yusheng Zhao, Lei Zhang, Subo Zhang, Jiajing Li, Kaimin Shi, Di Yao, Qiuzi Li, Tao Zhang, Lei Xu, Lei Geng, Yi Sun, Jinxin Wan","doi":"10.1038/s41391-025-00997-2","DOIUrl":"10.1038/s41391-025-00997-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the diagnostic value of machine learning-based MRI imaging in differentiating benign and malignant prostate cancer and detecting clinically significant prostate cancer (csPCa, defined as Gleason score ≥7) using systematic review and meta-analysis methods.</p><p><strong>Methods: </strong>Electronic databases (PubMed, Web of Science, Cochrane Library, and Embase) were systematically searched for predictive studies using machine learning-based MRI imaging for prostate cancer diagnosis. Sensitivity, specificity, and area under the curve (AUC) were used to assess the diagnostic accuracy of machine learning-based MRI imaging for both benign/malignant prostate cancer and csPCa.</p><p><strong>Results: </strong>A total of 12 studies met the inclusion criteria, with 3474 patients included in the meta-analysis. Machine learning-based MRI imaging demonstrated good diagnostic value for both benign/malignant prostate cancer and csPCa. The pooled sensitivity and specificity for diagnosing benign/malignant prostate cancer were 0.92 (95% CI: 0.83-0.97) and 0.90 (95% CI: 0.68-0.97), respectively, with a combined AUC of 0.96 (95% CI: 0.94-0.98). For csPCa diagnosis, the pooled sensitivity and specificity were 0.83 (95% CI: 0.77-0.87) and 0.73 (95% CI: 0.65-0.81), respectively, with a combined AUC of 0.86 (95% CI: 0.83-0.89).</p><p><strong>Conclusion: </strong>Machine learning-based MRI imaging shows good diagnostic accuracy for both benign/malignant prostate cancer and csPCa. Further in-depth studies are needed to validate these findings.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival benefit associated with first-line androgen receptor pathway inhibitors for de novo metastatic castration-sensitive prostate cancer.","authors":"Stephen J Freedland, Agnes Hong, Nader El-Chaar, Amanda M De Hoedt, Janet Kim, Claire Evans, Joshua A Parrish, Maelys Touya, Krishnan Ramaswamy, Lin Gu, Thomas J Polascik","doi":"10.1038/s41391-025-01000-8","DOIUrl":"https://doi.org/10.1038/s41391-025-01000-8","url":null,"abstract":"<p><strong>Background: </strong>Limited real-world data exist on the effectiveness of treatment intensification (TI) with androgen receptor pathway inhibitors (ARPI) in de novo metastatic castration-sensitive prostate cancer (mCSPC). This study compared outcomes of TI or first-generation nonsteroidal antiandrogens (NSAAs) to androgen-deprivation therapy (ADT) alone in US patients with de novo mCSPC.</p><p><strong>Methods: </strong>Veterans Affairs patients with de novo mCSPC (February 2018-June 2020) confirmed via chart review were grouped into ADT alone, ADT + NSAAs, or ADT + ARPI cohorts using predefined recruitment quotas. Outcomes included inverse probability of treatment weighting (IPTW)-adjusted overall survival (OS), progression to metastatic castration-resistant prostate cancer (mCRPC), and prostate-specific antigen (PSA) response.</p><p><strong>Results: </strong>A total of 384 patients were identified (ADT alone: 163, ADT + NSAA: 101, ADT + ARPI: 120). Median follow-up was 37.2, 38.1, and 34.8 months for ADT alone, ADT + NSAA, and ADT + ARPI, respectively. Compared with ADT alone, ADT + ARPI showed significantly better OS (HR [95% CI]: 0.61 [0.43 to 0.87], p = 0.007), lower risk of progression to mCRPC (0.46 [0.33 to 0.66], p < 0.001), and higher PSA response rate (PSA decline of ≥50% and ≥90% from baseline, and to <0.2 ng/mL and <0.1 ng/mL any time during first-line treatment; all p < 0.05). Outcomes with ADT + NSAA did not differ from ADT alone. ADT + ARPI was the most common second-line mCSPC and first-line mCRPC treatment.</p><p><strong>Conclusions: </strong>First-line ADT + ARPI was associated with significantly improved outcomes vs ADT alone in de novo mCSPC. These real-world results align with the benefits demonstrated in trials, supporting integration of TI with ARPIs into clinical practice to improve survival outcomes in patients with de novo mCSPC.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Prevalence of lower urinary tract symptoms in taxi drivers: a cross-sectional web-based survey.","authors":"Vincenzo Li Marzi, Stefania Musco, Riccardo Lombardo, Antonio Cicione, Luca Gemma, Simone Morselli, Maria Lucia Gallo, Sergio Serni, Riccardo Campi, Cosimo De Nunzio","doi":"10.1038/s41391-025-01006-2","DOIUrl":"https://doi.org/10.1038/s41391-025-01006-2","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The application of mixed reality navigation system in robot-assisted radical prostatectomy for high-risk prostate cancer: a propensity score‑matched cohort study.","authors":"Wangmin Liu, Siyu Zhou, Xueyang Yu, Yufei Yu, Hongbo Su, Qi Miao, Meng Gao, Zhiqiang Cao, Jianbin Bi, Lizhu Chen, Jian Wang, Mo Zhang","doi":"10.1038/s41391-025-01003-5","DOIUrl":"https://doi.org/10.1038/s41391-025-01003-5","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the efficacy and advantages of MR navigation system in robot-assisted radical prostatectomy (RARP) for high-risk prostate cancer (PCa).</p><p><strong>Methods: </strong>We retrospectively studied 147 patients with high-risk PCa based on D'Amico risk criteria from July 2021 to November 2023. All patients chose MR-assisted RARP (MR-RARP) or standard RARP (S-RARP) after receiving comprehensive counseling on the benefits and risks of both procedures. After propensity score-matching, 57 patients were included in each group. Perioperative, functional and oncological outcomes were compared. Logistic and Cox regression models were used to identify predictors of positive surgical margin (PSM), biochemical recurrence (BCR), continence and potency recovery.</p><p><strong>Results: </strong>The MR-RARP group had higher nerve-sparing (NS) rates (78.9% vs 54.4%, P = 0.021) and lower PSM rates (10.5% vs 26.3%, P = 0.030). Continence recovery rates were higher in the MR-RARP group at catheter removal (40.4% vs 22.8%, P = 0.044), 1 month (61.4% vs 38.6%, P = 0.015) and 3 months (73.7% vs 47.4%, P = 0.004), with no significant differences at 6 months (82.5% vs 73.7%, P = 0.258) and 12 months (93.0% vs 87.7%, P = 0.341). Furthermore, the MR-RARP group demonstrated higher potency rates at 1 month (42.1% vs 21.1%, P = 0.016) and 3 months (57.9% vs 36.8%, P = 0.024), whereas outcomes were comparable at 6 months (66.7% vs 56.1%, P = 0.248) and 12 months (77.2% vs 66.7%, P = 0.211). With a median follow-up of 28 months, BCR-free survival showed no significant differences (P = 0.295). Multivariate analyses confirmed MR navigation as an independent predictor of PSM, continence, and potency recovery (all P < 0.05). Statistical power analysis indicated a power of 0.847.</p><p><strong>Conclusions: </strong>Real-time intraoperative MR navigation enhances surgical precision, facilitates NS techniques, and optimizes early continence and potency recovery without compromising oncological safety.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting side-specific extraprostatic extension in prostate cancer using an 18F-DCFPyL PSMA-PET/CT-based nomogram.","authors":"Neeraja Tillu, Ashutosh Maheshwari, Kaushik Kolanukuduru, Manish Choudhary, Yashaswini Agarwal, Himanshu Joshi, Shokhi Goel, Hannah Sur, Reuben Ben-David, Basil Kaufmann, Asher Mandel, Henry Jodka, Brenda Hug, Lianne Ohayon, Susanna Baek, Coskun Kacagan, Vinayak Wagaskar, Murilo de Almeida Luz, Ashutosh Tewari","doi":"10.1038/s41391-025-01001-7","DOIUrl":"https://doi.org/10.1038/s41391-025-01001-7","url":null,"abstract":"<p><strong>Background: </strong>Extraprostatic extension (EPE) in prostate cancer (PCa) has implications for nerve-sparing approaches. mpMRI-based nomograms show modest accuracy, highlighting the need for improved predictive models. This study evaluates ¹⁸F-DCFPyL prostate-specific membrane antigen (PSMA) positron emission tomography/ computed tomography (PET/CT) for predicting side-specific EPE using maximum standardized uptake value (SUVmax).</p><p><strong>Methods: </strong>This single-center cohort study included patients undergoing RALP by a single surgeon (AKT) from January 2022 to September 2024. Baseline variables included demographics, PSA, biopsy, MRI, and PSMA parameters (SUVmax, EPE, SVI). The primary endpoint was side-specific EPE on final pathology. Univariable and multivariable logistic regression identified significant predictors. A nomogram was built based on this. To evaluate model performance, a 1000-iteration bootstrap approach was used to compare (1) the institutional MRI-only 2018 model, (2) an MRI + PSMA Fixed Model, and (3) a retrained MRI + PSMA Model built on each bootstrap sample.</p><p><strong>Results: </strong>Three hundred fifty-five patients were analyzed. EPE was detected in 18.9% by MRI and 5.4% by PSMA PET. Median intraprostatic SUVmax was 11.30. EPE-positive sides were more likely to have MRI/PSMA-detected EPE (p < 0.001), PIRADS 5 lesions (p < 0.001), aggressive biopsy GGG (p < 0.001), higher positive cores (p < 0.001), and greater percent tumor involvement (p < 0.001). Median SUVmax was significantly higher in the EPE group (9.1 vs. 5.4; p < 0.001). Multivariable analysis identified PSA, MRI-detected EPE, GGG, tumor involvement percentage, and SUVmax ≥13 as significant predictors. The PSMA + MRI Fixed Model outperformed the MRI-only model (median AUC: 0.7542 vs. 0.7350) with p < 0.001. Calibration plots showed strong agreement between predicted and observed probabilities, and decision curve analysis demonstrated greater net clinical benefit across relevant thresholds.</p><p><strong>Conclusion: </strong>We developed a nomogram integrating PSMA PET with MRI and clinicopathological variables, outperforming our institutional model. PSMA uptake strongly predicts side-specific EPE, which can enhance preoperative assessment and improve postoperative functional outcomes.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head-to-head comparison of diagnostic test accuracy between biparametric and multiparametric MRI: an updated systematic review and bivariate meta-analysis.","authors":"Carlos A Garcia-Becerra, Maria I Arias-Gallardo, Jesus E Juarez-Garcia, Veronica Soltero-Molinar, Mariabelen I Rivera-Rocha, Luis F Parra-Camaño, Natalia Garcia-Becerra, Carlos M García-Gutiérrez","doi":"10.1038/s41391-025-00999-0","DOIUrl":"https://doi.org/10.1038/s41391-025-00999-0","url":null,"abstract":"<p><strong>Background: </strong>Prostate Cancer (PCa) is a leading cause of cancer-related mortality globally. Clinically significant PCa (CsPCa) is associated with more aggressive disease, making accurate diagnosis crucial. Multiparametric Magnetic Resonance Imaging (Mp-MRI) is a well-established tool for PCa detection, but the dynamic contrast-enhanced (DCE) sequence raises concerns due to cost, risks, and patient experience. Biparametric MRI (Bp-MRI) has emerged as an alternative, but its diagnostic performance compared to Mp-MRI has not been thoroughly examined through a systematic review and meta-analysis in recent years.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted to compare the diagnostic accuracy of Bp-MRI and Mp-MRI for detecting CsPCa by assessing the databases MEDLINE/PubMed, CENTRAL Cochrane, and ClinicalTrials.gov. Studies published between 2012 and 2024 that compared Bp-MRI and Mp-MRI using histopathological analysis as the reference standard were included. Data were extracted to obtain diagnostic test accuracy measurements (sensitivity, specificity, diagnostic odds ratio, positive and negative likelihood ratios) and study characteristics. Statistical analysis involved two bivariate random-effects models, a summary Receiver Operating Characteristic (sROC) curve, and meta-regression models assessing the comparison of both diagnostic test accuracies and the interaction of different study-level covariates.</p><p><strong>Results: </strong>Nineteen studies involving 5,173 patients were included. Mp-MRI demonstrated a pooled sensitivity of 0.90 (95% CI: 0.87-0.93) and a specificity of 0.64 (95% CI: 0.50-0.76), while Bp-MRI showed a pooled sensitivity of 0.89 (95% CI: 0.85-0.92) and a specificity of 0.73 (95% CI: 0.62-0.82). Both modalities showed similar diagnostic performance with overlapping sROC curves. Meta-regression revealed no statistically significant difference between the two tools, and the study-level covariates did not influence the results.</p><p><strong>Conclusion: </strong>Bp-MRI is a viable alternative to Mp-MRI for detecting CsPCa, with comparable diagnostic accuracy, especially when contrast agents are a concern. Further prospective randomized studies are needed to confirm these findings.</p><p><strong>Registry: </strong>PROSPERO (CRD42024552125).</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Prostate MRI and clinicopathologic risk calculator to predict laterality of extraprostatic extension at radical prostatectomy.","authors":"Eric V Li, Ashley E Ross, Hiten D Patel","doi":"10.1038/s41391-025-01002-6","DOIUrl":"https://doi.org/10.1038/s41391-025-01002-6","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular risks in men with prostate cancer: a pragmatic, clinician-oriented review of risk stratification and management strategies.","authors":"Aditya Bhave, Harikrishnan Hyma Kunhiraman, Tarek Nahle, Ritu Reddy, Omar Makram, Priyanshu Nain, Viraj Shah, Umang Swami, Sagar A Patel, Ashanda Esdaille, Martha Terris, Avirup Guha","doi":"10.1038/s41391-025-00998-1","DOIUrl":"https://doi.org/10.1038/s41391-025-00998-1","url":null,"abstract":"<p><strong>Background/objectives: </strong>Recent advances in prostate cancer management have improved overall survival and quality of life for those afflicted. However, these patients continue to suffer from a high burden of cardiovascular disease through a variety of mechanisms, including both the cancer itself as well as prostate cancer-specific treatments.</p><p><strong>Subjects/methods: </strong>Cardiovascular disease is now the leading cause of death in this population, and current data suggests that many patients remain sub-optimally controlled from a risk factor standpoint. There is a lack of consensus and standardized guidelines on cardiovascular risk stratification and specific management strategies in the urology, medical oncology, radiation oncology, and primary care settings.</p><p><strong>Results/conclusions: </strong>We review available literature and provide a cardiovascular risk stratification schema for prostate cancer patients that clinicians in each of these settings can utilize. We also highlight a shared decision-making model, consistent risk restratification, and social determinants of health as care priorities to optimize cardiovascular health for this at-risk population.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}