Prostate Cancer and Prostatic Diseases最新文献

{"title":"Clarifying the clinical role of biparametric MRI: reflections on diagnostic equivalence and patient-level stratification.","authors":"Xinyu Wang, Changhong Yan","doi":"10.1038/s41391-025-01035-x","DOIUrl":"https://doi.org/10.1038/s41391-025-01035-x","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207410","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 times they are (still) a-Changin'.","authors":"Cristian Fiori, Daniele Amparore, Matteo Manfredi, Sabrina De Cillis, Francesco Porpiglia","doi":"10.1038/s41391-025-01031-1","DOIUrl":"https://doi.org/10.1038/s41391-025-01031-1","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192523","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":"Lymph node dissection based on 18F-PSMA PET/CT during radical prostatectomy for intermediate and high risk prostate cancer: interim results of a prospective, randomized study.","authors":"Zhuo Jia, Qiwei Liu, Kan Liu, Yachao Liu, Shaoxi Niu, Yuqi Jia, Zhiqiang Chen, Zhuoran Li, Jin Luo, Jinqiao Li, Songliang Du, Weimin Ci, Xu Zhang, Baojun Wang","doi":"10.1038/s41391-025-01029-9","DOIUrl":"https://doi.org/10.1038/s41391-025-01029-9","url":null,"abstract":"<p><strong>Background: </strong>Pelvic lymph node dissection (PLND) is integral to prostate cancer staging, but its therapeutic value remains debated. PSMA PET/CT has shown high accuracy in detecting lymph node metastasis (LNM). This study evaluates the feasibility of performing PLND based on PSMA PET/CT findings during robotic-assisted radical prostatectomy (RARP).</p><p><strong>Methods: </strong>In this prospective, randomized study, biopsy-confirmed prostate cancer (PCa) patients with intermediate or high risk were enrolled. Patients with distant metastasis or prior endocrine therapy were excluded. All underwent 18F-PSMA PET/CT imaging, and those with LNM were assigned to Group A. Patients without LNM were randomized in a 1:1 ratio into Groups B and C. All patients underwent RARP and Groups A and B with PLND while Group C without. The primary outcomes were PSMA PET/CT accuracy in detecting LNM and oncological results. This trial is registered with the Chinese Clinical Trial Registry (ChiCTR2200063256).</p><p><strong>Results: </strong>Between September 2022 and August 2023, 120 PCa patients were enrolled. The sensitivity, specificity, accuracy, positive predictive value (PPV), and NPV of PSMA PET/CT were 76.5%, 86.8%, 65.0%, 92.0%, and 84.3%. There were no significant differences in clinical parameters, progression-free survival (PFS) or PSA persistence between Groups B and C. However, PLND patients had longer surgical times, hospital stays, and higher complication rates.</p><p><strong>Conclusions: </strong>PSMA PET/CT offers high specificity and NPV in detecting LNM.LND may be unnecessary for node-negative patients identified by PSMA PET/CT, with close follow-up recommended for those not undergoing LND.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150535","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":"Endoscopic simulators in benign prostatic hyperplasia surgical training: a scoping review.","authors":"Nicolas Siron, Othmane Zekraoui, Marie-Lyssa Lafontaine, Claudia Deyirmendjian, Liam Murad, Tudor Pintilei, Sophie Abou Samra, Abbas Guennoun, Anis Assad, Kussil Oumedjbeur, Ryan Schwartz, Dean Elterman, Bilal Chughtai, Marcelino Rivera, Naeem Bhojani","doi":"10.1038/s41391-025-01022-2","DOIUrl":"https://doi.org/10.1038/s41391-025-01022-2","url":null,"abstract":"<p><strong>Introduction: </strong>Simulation-based training (SBT) is designed to mimic real-life surgeries and help surgeons develop skills they can transfer to the operating room in a risk-free environment. With the emergence of numerous surgical therapies for benign prostatic hyperplasia (BPH), a need has developed for new learning tools in addition to standard clinical exposure. In this scoping review, we aimed to provide a comprehensive and updated outline of available endoscopic BPH simulators.</p><p><strong>Methods: </strong>We conducted a scoping review in accordance with the Joanna Briggs Institute methodology. References were identified through searches of MEDLINE, Embase, Web of Science, and CINAHL from inception to March 2025. A search of Google Scholar was also conducted to identify grey literature references. Keywords searched included those related to simulators, medical education and BPH surgeries. Studies included were original articles on simulators used for endoscopic BPH surgery. Data pertaining to simulator validity, acceptability and feasibility were collected.</p><p><strong>Results: </strong>Forty-five records were included, with one reference consisting of a multi-modality curriculum used for simulating two BPH surgeries. Thirty studies assessed transurethral resection of prostate (TURP) simulators, six studies for GreenLight laser prostatectomy (PVP), eight studies for anatomic endoscopic enucleation of the prostate (AEEP) procedures, and two articles for Urolift. For TURP simulators, four bench-top models, nine virtual reality simulators, two food-based phantoms, and one porcine model were identified. For HoLEP simulators, three bench-top models, two VR simulators, and one human cadaver prostate model were assessed. Furthermore, virtual simulation was the only modality tested for PVP (two simulators), ThuLEP (one simulator), and Urolift (one simulator).</p><p><strong>Conclusion: </strong>Our results suggest a need for developing SBT models other than TURP. Future iterations of BPH surgical models should be evaluated using the modern definition of validity with the goal of integration into surgical curriculum.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150452","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: Should systematic prostatic biopsies be discontinued?\"","authors":"Yung-Chi Shih, Shang-Ju Hsieh","doi":"10.1038/s41391-025-01027-x","DOIUrl":"https://doi.org/10.1038/s41391-025-01027-x","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138457","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":"Perioperative outcomes comparing the DaVinci 5 with DaVinci Xi in patients undergoing robotic-assisted radical prostatectomy.","authors":"Sumeet Kumar Reddy, Marcio Covas Moschovas, Shady Saikali, Yu Ozawa, Ahmed Gamal, Rohan Sharma, Travis Rogers, Marco Sandri, Vipul Patel","doi":"10.1038/s41391-025-01025-z","DOIUrl":"https://doi.org/10.1038/s41391-025-01025-z","url":null,"abstract":"<p><strong>Background: </strong>In the last two decades, several Da Vinci robotic platforms have been released. The new generation DaVinci-5 robot (DV5) promises hardware and software improvements with the potential for enhanced operative performance. The study aimed to compare the intraoperative performances and short-term perioperative outcomes between the DV5 and DaVinci-Xi robotic platforms in patients undergoing robotic-assisted radical prostatectomy (RARP).</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort study from April to May 2024, during a unique 4-week period when both the Da Vinci 5 (DV5) and Da Vinci Xi (DV-Xi) platforms were available. A total of 103 patients who underwent robotic-assisted radical prostatectomy with the DV5 were retrospectively compared to 101 patients operated on with the DV-Xi during the same time frame. The primary endpoint was the comparison of intraoperative performance metrics between groups, including operative time, estimated blood loss, and intraoperative complications.</p><p><strong>Results: </strong>The DV5 had shorter median console time (80 min, IQR [80-90] vs 90 min, IQR [80-90], median difference = 10 min, p < 0.001) and shorter median total operative time (96 min, IQR [90-103] vs 100 min, IQR [98-105], median difference = 4 min, p < 0.001). Neither group had any device malfunctions, intraoperative complications, or blood transfusions. We could not find the difference in hospital length-of-stay, postoperative complication rate, and surgical margin status. This study was done at a high-volume prostate cancer referral centre, which may limit the study findings' generalizability.</p><p><strong>Conclusion: </strong>This is the first study comparing outcomes of the DV5 and DVXi robotic platforms in patients undergoing RARP. The use of the DV5 robot was associated with modest gains in some perioperative outcomes, but these values were not clinically significant in our routine. Due to the short-term follow-up, we are still evaluating the long-term impacts of this new platform on these patient's outcomes.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131907","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":"Using patient-reported outcomes from the PROCLAIM trial to assess the impact of universal germline genetic testing for prostate cancer patients.","authors":"Neal D Shore, Christopher M Pieczonka, Sean Heron, Mukaram Gazi, David J Cahn, Laurence H Belkoff, Aaron D Berger, Brian Mazzarella, Joseph Veys, David Morris, Richard Bevan-Thomas, Alexander Engelman, Paul Dato, David R Wise, Mary Kay Hardwick, Kerry W Aradhya, Brandie Heald, Robert L Nussbaum, Kathryn E Hatchell, Brianna Bucknor, Edward D Esplin, Sarah M Nielsen","doi":"10.1038/s41391-025-01013-3","DOIUrl":"https://doi.org/10.1038/s41391-025-01013-3","url":null,"abstract":"<p><strong>Background: </strong>Although germline genetic testing can inform medical management for patients with prostate cancer (PCa), data are limited regarding patient-reported outcomes (PROs) after germline genetic testing for PCa. Recall and comprehension of germline genetic testing results, uptake of post-test clinical recommendations, and psychological impact of germline genetic testing among patients with PCa were evaluated.</p><p><strong>Methods: </strong>This is a secondary analysis of data from the PROCLAIM trial. PROs were analyzed overall and by germline genetic testing results. Differences between groups were determined by two-tailed Fisher's exact test with significance set at p < 0.05.</p><p><strong>Results: </strong>Among 494 patients with informative survey responses, 60% and 71% accurately recalled and interpreted their germline genetic testing results, respectively, with the highest rates among patients with negative results and the lowest among those with variant of uncertain significance-only (VUS) results. Among 42/55 (76%) patients with positive results for whom clinicians made germline genetic testing-informed recommendations, 39 (93%) completed or planned to complete >1 clinical recommendation. Conversely, no further recommendations were made for 160/221 (72%) and 211/218 (97%) patients with VUS and negative results, respectively. However, 57% (213/371) of these patients indicated that they or their family members intended to pursue clinical management strategies that were not recommended by their clinicians. Of the patients who responded to the survey, >90% of patients reported no post-germline genetic testing increase in their level of concern for themselves or their family members.</p><p><strong>Conclusion: </strong>germline genetic testing for patients with PCa did not cause appreciable psychological harm to the tested patients. Furthermore, patients with positive results had a high uptake of clinician-recommended management strategies. Of note, there were inconsistencies in the understanding of VUS results, with some clinicians making recommendations not warranted by personal/family history; conversely, some patients pursued management strategies not recommended by their clinicians. This suggests that educational efforts are needed in the communication of germline genetic testing results and clinical recommendations to patients.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125933","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":"Addition of a surgery-specific module to a perioperative, telemedicine program for improving functional outcomes after radical prostatectomy: a prospective, multicenter, non-randomized study.","authors":"Alessandro Uleri, Eric Potiron, Naoufel Miaadi, Gilles Pasticier, Alberto Martini, Nordine Deffar, Nam-Son Vuong, Gilles Gourtaud, Benjamin Pradère, Lara Mroueh, Bernard Malavaud, Michaël Baboudjian, Jean-Baptiste Beauval, Jean Rouffilange, Laurent Brureau, Guillaume Ploussard, Charles Dariane, Alexandre de la Taille","doi":"10.1038/s41391-025-01026-y","DOIUrl":"https://doi.org/10.1038/s41391-025-01026-y","url":null,"abstract":"<p><strong>Background: </strong>Digital perioperative programs offer promising solutions to overcome organizational constraints of traditional prehabilitation, potentially improving recovery while reducing healthcare burden and costs. We aimed to assess the impact of adding a surgery-specific module to an optimized digital perioperative program on improving functional outcomes after radical prostatectomy (RP).</p><p><strong>Methods: </strong>This was a multicentre, prospective, comparative, non-randomized trial including consecutive robot-assisted RP. Intervention was the implementation of the Betty (Better Surgery) coaching program combined with the activation of a RP-specific pre- and rehabilitation module. The primary endpoint was continence recovery, defined as \"0 or 1 safety pad per day\" at 6 weeks after surgery. Secondary endpoints were mid-term continence, need for postoperative physiotherapy, erectile function, complications, and readmissions.</p><p><strong>Results: </strong>A total of 177 and 156 RP cases were included in the control and experimental groups. Baseline and pathological variables were statistically comparable between groups. The mean patient age and PSA were 65.3 years and 11 ng/ml, respectively. At 6 weeks after RP, 83.3% of patients following the digital program were continent, as compared with 68.4% in the control group (p = 0.002). The need for postoperative physiotherapy for persistent incontinence was significantly reduced in the digital program group (27.5%, versus 58.8%, p < 0.001). Patients who followed the digital program experienced lower complications although not statistically significant (p = 0.1), unplanned visits (p = 0.025), reoperation rates (p = 0.025), more same-day discharge surgery (p = 0.030), and higher satisfaction (9.4/10 versus 8.3/10, p < 0.001). The main limitation was the absence of randomization.</p><p><strong>Conclusions: </strong>Besides the benefits provided by the perioperative digital program, the addition of a pre- and rehabilitation module, including surgery-specific content, significantly improved functional recovery after RP and perioperative outcomes.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092586","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":"Modern active surveillance in low- and intermediate-risk prostate cancer without re-biopsy.","authors":"Jale Lakes, Rouvier Al-Monajjed, Isabelle Busshoff, Anne Hübner, Matthias Boschheidgen, Birte Valentin, Gerald Antoch, Peter Albers, Lars Schimmöller, Jan Philipp Radtke","doi":"10.1038/s41391-025-01010-6","DOIUrl":"https://doi.org/10.1038/s41391-025-01010-6","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058572","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":"Brachytherapy monotherapy for favorable and select unfavorable intermediate risk prostate cancer.","authors":"Martin King, Grgur Mirić, Robert Galbreath, Ryan Fiano, Shalini Moningi, Kent Wallner, Peter Orio","doi":"10.1038/s41391-025-01021-3","DOIUrl":"https://doi.org/10.1038/s41391-025-01021-3","url":null,"abstract":"<p><strong>Background: </strong>Current National Comprehensive Cancer Network guidelines define brachytherapy monotherapy as a suitable treatment for favorable intermediate risk (FIR) and unfavorable intermediate risk (UIR) prostate cancer. Our objective is to define the subgroup of patients suitable for brachytherapy monotherapy.</p><p><strong>Methods: </strong>We conducted a single-institutional retrospective analysis of intermediate risk prostate cancer, treated with brachytherapy with or without androgen deprivation therapy (ADT) and/or external beam radiation therapy (EBRT). The primary endpoint was biochemical failure (BF), defined as prostate specific antigen (PSA) > 0.4 ng/mL. For monotherapy, multivariate Fine-Gray analysis was used to identify risk factors associated with BF. Univariate analysis was performed to evaluate whether ADT and/or EBRT were associated with BF for patients without and with such factors.</p><p><strong>Results: </strong>Among 1622 patients, the median follow-up was 10.4 years. For monotherapy, PSA ≥ 10 ng/mL (adjusted sHR 3.01; 95% CI: 1.10-8.27; p = 0.032) and cT2b-c disease (adjusted sHR 4.52; 95% CI: 1.85-11.07; p = 0.001) were associated with BF. The 10-year incidences of BF after monotherapy for patients without and with these risk factors were 5.8% (3.8% FIR, 8.8% UIR) versus 17.2% (9.3% FIR, 23.9% UIR), respectively. For the cT1-T2a/PSA < 10 risk group, neither the addition of ADT (sHR 0.90; 95% CI: 0.38-2.1; p = 0.82) nor EBRT (sHR 0.65; 95% CI: 0.36-1.18; p = 0.16) was associated with biochemical failure. For the cT2b-T2c and/or PSA ≥ 10 subgroup, ADT (sHR: 0.33; 95% CI: 0.14-0.74; p = 0.007) but not EBRT (sHR 0.66; 95% CI: 0.34-1.31; p = 0.24) was associated with BF.</p><p><strong>Conclusions: </strong>Brachytherapy monotherapy is suitable for all FIR, and UIR disease meeting cT1-T2a/PSA < 10 criteria.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040774","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}