Andrea Alberti, Mattia Lo Re, Rossella Nicoletti, Paolo Polverino, Anna Cadenar, Elena Ciaralli, Francesca Solazzi, Beatrice Giustozzi, Francesco Sessa, Anna Rivetti, Riccardo Campi, Arcangelo Sebastianelli, Sergio Serni, Mauro Gacci
{"title":"Transperineal laser ablation in the management of benign prostatic hyperplasia: an updated systematic review and pooled analysis.","authors":"Andrea Alberti, Mattia Lo Re, Rossella Nicoletti, Paolo Polverino, Anna Cadenar, Elena Ciaralli, Francesca Solazzi, Beatrice Giustozzi, Francesco Sessa, Anna Rivetti, Riccardo Campi, Arcangelo Sebastianelli, Sergio Serni, Mauro Gacci","doi":"10.1038/s41391-025-00952-1","DOIUrl":"10.1038/s41391-025-00952-1","url":null,"abstract":"<p><strong>Introduction: </strong>Standard surgical options for Benign Prostatic Hyperplasia [BPH], despite their excellent functional outcomes, are associated with multiple side effects and require general/spinal anesthesia and hospitalization. In this scenario, Transperineal Laser Ablation of the Prostate [TPLA] emerged as an ultra-minimally invasive ejaculation-sparing procedure, showing promising functional results, with a good safety profile. This systematic review aimed to provide an overview of the current role of TPLA in clinical practice, focusing on operative setting, safety, and efficacy.</p><p><strong>Evidence acquisition: </strong>Literature search was performed on June 12th, 2024 using PubMed, Embase, and Cochrane Central databases, following the EAU Guidelines Office and the PRISMA statement recommendations. All studies reporting outcomes after TPLA procedures were included.</p><p><strong>Evidence synthesis: </strong>Seventeen studies were included in this systematic review, of which 2 RCTs compared TPLA with TURP, 12 prospective and 3 retrospective non-randomized studies (of which 1 comparing TPLA and Prostatic Artery Embolization [PAE]). All procedures were performed using the same EchoLaser<sup>TM</sup> system (SoracteLite<sup>TM</sup>) (Elesta s.r.l., Calenzano (FI), Italy), however great heterogeneity exists considering inclusion criteria, peri- and post-operative management. Mainly low-grade complications (Clavien-Dindo [CD] Grade ≤ II) were reported, while no major adverse events (CD grade > III) occurred. In all studies TPLA led to a great improvement in urinary function, up to 5 years after the procedure, while not significantly impacting erectile and ejaculatory functions.</p><p><strong>Conclusions: </strong>TPLA showed promising results both in the short- and mid-term, improving urinary function while preserving sexual function and keeping a good safety profile. Since the evidence available is still limited, larger prospective comparative studies are warranted to confirm the efficacy of TPLA and to adequately compare it to standard endoscopic techniques and other minimally invasive surgical treatments.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617039","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 critical role of mitochondrial dysfunction in ADT-induced neurotoxicity.","authors":"Yu-Hsiang Lin, Kuo-Jen Lin, I-Hung Shao","doi":"10.1038/s41391-025-00958-9","DOIUrl":"https://doi.org/10.1038/s41391-025-00958-9","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543176","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}
Steven Kaplan, Ronald P Kaufman, Dean Elterman, Bilal Chughtai, Claus Roehrborn
{"title":"Extended LUTS medication use following BPH surgical treatment: a US healthcare claims analysis.","authors":"Steven Kaplan, Ronald P Kaufman, Dean Elterman, Bilal Chughtai, Claus Roehrborn","doi":"10.1038/s41391-025-00953-0","DOIUrl":"10.1038/s41391-025-00953-0","url":null,"abstract":"<p><strong>Background: </strong>Postoperative medication use is an important yet relatively unexplored element of the benign prostatic hyperplasia patient journey. We assessed and compared the percentage of patients who required medication postoperatively after the three most common BPH surgeries in the real world: transurethral resection of the prostate (TURP), photovaporization procedure with GreenLight Laser (PVP), and prostatic urethral lift (PUL) with the UroLift system.</p><p><strong>Methods: </strong>Within a random representative sample of US Medicare and commercial insurance claims, patients with at least one year of follow-up data available after an outpatient TURP, PVP, or PUL procedure were linked to pharmaceutical claims to elucidate rates of continuous and de novo use of alpha-blockers, 5-alpha reductase inhibitors, or combination medical therapy. Periods of interest were perioperative (use within three months postoperatively and not beyond) and one and five years postoperatively.</p><p><strong>Results: </strong>36 629 men diagnosed with BPH underwent outpatient TURP (n = 20 319), GreenLight PVP (n = 10 517) and PUL (n = 5 793) procedures within the claims dataset. The rate of medical therapy use through one year was lowest for PUL (4.1%) compared to TURP (6.2%) and PVP (6.6%), and was equivalent between procedures through five years (10.6% TURP, 10.4% PVP, and 10.3% PUL).</p><p><strong>Conclusions: </strong>Patients who undergo surgery to treat BPH may desire to discontinue or bypass BPH medications. However, these data demonstrated that approximately 10% of BPH patients used medication through five years postoperatively, regardless of which procedure they underwent.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524242","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}
Giuseppe Maiolino, Juan Ignacio Martinez-Salamanca, Eric Barret
{"title":"Reply to \"Oncological results and cancer control definition in focal therapy for Prostate Cancer: a systematic review\".","authors":"Giuseppe Maiolino, Juan Ignacio Martinez-Salamanca, Eric Barret","doi":"10.1038/s41391-025-00954-z","DOIUrl":"https://doi.org/10.1038/s41391-025-00954-z","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468883","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}
Giulio Francolini, Niccolò Bertini, Vanessa Di Cataldo, Pietro Garlatti, Michele Aquilano, Saverio Caini, Alessio Bruni, Gianluca Ingrosso, Rolando Maria D'angelillo, Luca Tagliaferri, Matteo Augugliaro, Luca Triggiani, Silvana Parisi, Giorgia Timon, Fabio Arcidiacono, Giulia Marvaso, Barbara Alicja Jereczek-Fossa, Andrea Lancia, Ciro Franzese, Filippo Alongi, Gabriele Simontacchi, Daniela Greto, Pierluigi Bonomo, Mauro Loi, Giulio Frosini, Luca Burchini, Isacco Desideri, Icro Meattini, Richard K Valicenti, Lorenzo Livi
{"title":"Impact of stereotactic body radiotherapy after progression in castrate resistant prostate cancer patients undergoing first line abiraterone treatment. A subgroup analysis from ARTO trial (NCT03449719).","authors":"Giulio Francolini, Niccolò Bertini, Vanessa Di Cataldo, Pietro Garlatti, Michele Aquilano, Saverio Caini, Alessio Bruni, Gianluca Ingrosso, Rolando Maria D'angelillo, Luca Tagliaferri, Matteo Augugliaro, Luca Triggiani, Silvana Parisi, Giorgia Timon, Fabio Arcidiacono, Giulia Marvaso, Barbara Alicja Jereczek-Fossa, Andrea Lancia, Ciro Franzese, Filippo Alongi, Gabriele Simontacchi, Daniela Greto, Pierluigi Bonomo, Mauro Loi, Giulio Frosini, Luca Burchini, Isacco Desideri, Icro Meattini, Richard K Valicenti, Lorenzo Livi","doi":"10.1038/s41391-025-00950-3","DOIUrl":"10.1038/s41391-025-00950-3","url":null,"abstract":"<p><strong>Background: </strong>ARTO trial was a phase II randomized trial suggesting the benefit of a concomitant treatment strategy including Abiraterone acetate plus predisone (AAP) and stereotactic body radiotherapy (SBRT) in oligometastatic castrate resistant prostate cancer (omCRPC). The object of the current analysis is to explore whether the benefit provided by SBRT to AAP is maintained at later stages of disease after oligoprogression METHODS: Patients enrolled in ARTO trial in whom a first progression event was reported were divided in two groups according to the treatment approach received, regardless of the initial randomization. After first progression event, Patients in Group A received SBRT on oligoprogressive disease, while patients in group B received second line systemic treatment. Palliative RT was not considered for the purpose of this analysis. Progression-Free survival (PFS) 1 and 2 were defined as time between AAP start and first progression event and time between first and second progression event, death or last follow up, (whichever came first), respectively. Cox regression analysis was performed to compare PFS1 + PFS2 in patients in group A vs Group B. Kaplan-Meier analysis was performed to compare overall survival between the two groups RESULTS: Median PFS1 + PFS2 was 45.9 months vs. not reached in group A (n = 43) vs Group B (n = 20), respectively (HR 0.63, 95% CI 0.17-2.33, p value 0.489), no significant difference was detected. Median OS was not reached in neither of the two arms of treatment, with a non-significant trend in favour of the experimental arm (HR 0.50, 95% CI 0.14-1.78, p = 0.284) CONCLUSIONS: Results from the present analysis show that SBRT after progression may be a viable and feasible option for omCRPC after progression if compared to second line systemic therapy.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459194","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}
Miguel Valdivia Y Alvarado, Obinna Obuekwe, Gal Saffati, Kajal Khodamoradi, Akhil Muthigi, Ricardo R Gonzalez
{"title":"The evolving landscape of BPH surgical treatments: considering semen parameters in clinical decision-making.","authors":"Miguel Valdivia Y Alvarado, Obinna Obuekwe, Gal Saffati, Kajal Khodamoradi, Akhil Muthigi, Ricardo R Gonzalez","doi":"10.1038/s41391-025-00939-y","DOIUrl":"https://doi.org/10.1038/s41391-025-00939-y","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459196","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}
Rossella Nicoletti, Andrea Alberti, Vineet Gauhar, Elena Ciaralli, Chi Hang Yee, Peter Chiu, David Leung, Daniele Castellani, Theodoros Tokas, Bhaskar Somani, Francesco Sessa, Dmitry Enikeev, Nikhil Vasdev, Sergio Serni, Riccardo Campi, Mauro Gacci, Antony Chi Fai Ng, Jeremy Yuen Chun Teoh
{"title":"Is there a role of PSMA-PET in focal therapy planning and follow-up?","authors":"Rossella Nicoletti, Andrea Alberti, Vineet Gauhar, Elena Ciaralli, Chi Hang Yee, Peter Chiu, David Leung, Daniele Castellani, Theodoros Tokas, Bhaskar Somani, Francesco Sessa, Dmitry Enikeev, Nikhil Vasdev, Sergio Serni, Riccardo Campi, Mauro Gacci, Antony Chi Fai Ng, Jeremy Yuen Chun Teoh","doi":"10.1038/s41391-025-00944-1","DOIUrl":"10.1038/s41391-025-00944-1","url":null,"abstract":"<p><strong>Introduction: </strong>Focal therapy (FT) is a promising alternative to radical treatments for localized Prostate Cancer (PCa) in selected patients. However, it is not yet considered a standard treatment option, and there is currently no consensus on managing patients after FT. In this context, Prostate-Specific Membrane Antigen Positron Emission Tomography (PSMA-PET) may support multiparametric MRI (mpMRI) for both pre-operative planning and follow-up. The aim of this systematic review was to provide a comprehensive overview of the current applications of PSMA-PET in the field of FT and to analyze its future perspectives.</p><p><strong>Evidence acquisition: </strong>A literature search was performed using PubMed and Scopus databases, following the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement recommendations. All studies reporting data on PSMA-PET performed before and/or after FT for PCa were included. A narrative synthesis was employed to summarize the review findings. No quantitative synthesis was performed due to the heterogeneity and limitations of the studies.</p><p><strong>Evidence synthesis: </strong>Seven studies (2 case reports, 1 retrospective, and 4 prospective single-center studies) were included in this review. A moderate-severe risk of bias was assessed for the included studies. In the field of FT, PSMA-PET showed promising but yet not validated results with several possible applications: (1) pre-operative planning and staging, aiming to improve patient selection trough the identification of intraprostatic suspected lesions and more accurate local and systemic staging; (2) guidance for biopsy and Region of Interest (ROI) definition; (3) follow-up imaging tool, aiming to decrease the number of unnecessary surveillance biopsies.</p><p><strong>Conclusions: </strong>Limited evidence exists regarding the use of PSMA-PET in the field of FT, considering pre-operative setting, treatment guidance and its use as a non-invasive tool to evaluate treatment success or failure and for follow-up. In this scenario, even if the current evidence is still limited and inconclusive, PSMA-PET showed promising results with several possible applications.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410068","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":"Less is more: the \"Safety Net Approach\" balances precision and safety.","authors":"Michele Marchioni, Luigi Schips, Luca Cindolo","doi":"10.1038/s41391-025-00948-x","DOIUrl":"https://doi.org/10.1038/s41391-025-00948-x","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391562","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":"Stereotactic body radiotherapy: a second chance for radio-recurrent prostate cancer.","authors":"Nicolas Vial, Thomas Zilli","doi":"10.1038/s41391-025-00947-y","DOIUrl":"https://doi.org/10.1038/s41391-025-00947-y","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365525","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}