Prostate Cancer and Prostatic Diseases最新文献

{"title":"Ultra-hypofractionation for node-positive prostate cancer: pushing boundaries and redefining standards.","authors":"Jennifer Le Guévelou, Mathilde Jeandin, Antonio Angrisani, Davide Giovanni Bosetti, Mohamed Shelan, Thomas Zilli","doi":"10.1038/s41391-025-00976-7","DOIUrl":"https://doi.org/10.1038/s41391-025-00976-7","url":null,"abstract":"<p><p>Radiotherapy is a cornerstone in the management of node-positive prostate cancer. Advances in imaging modalities and radiation therapy techniques have led to the evolution of treatment standards for this patient population. This review aims to explore the therapeutic advancements of the past decade, with a focus on the role of ultra-hypofractionated radiotherapy in node-positive prostate cancer.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028714","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":"Integrating clinical and technological perspectives to enhance predictive modeling in prostate cancer surgery.","authors":"Shengyi Chen, Yuekun Fang, Bin Cheng","doi":"10.1038/s41391-025-00978-5","DOIUrl":"10.1038/s41391-025-00978-5","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994456","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 zoledronic acid to enzalutamide and androgen deprivation therapy in metastatic hormone-sensitive prostate cancer: the randomized phase II BONENZA trial.","authors":"Alberto Dalla Volta, Francesca Valcamonico, Andrea Zivi, Giuseppe Procopio, Pierangela Sepe, Gianluca Del Conte, Nunzia Di Meo, Silvia Foti, Stefania Zamboni, Caterina Messina, Eleonora Lucchini, Anna Rizzi, Marco Ravanelli, Stefano Calza, Francesca Zacchi, Giovannino Ciccone, Nazareno Suardi, Roberto Maroldi, Davide Farina, Alfredo Berruti","doi":"10.1038/s41391-025-00975-8","DOIUrl":"https://doi.org/10.1038/s41391-025-00975-8","url":null,"abstract":"<p><strong>Background: </strong>Zoledronic acid (ZA) in combination with androgen deprivation therapy (ADT) has never proved additional activity in patients with advanced prostate cancer. However, conventional imaging is poorly reliable in monitoring disease response of metastatic bone lesions.</p><p><strong>Methods: </strong>BonEnza is a randomized phase II multicenter clinical trial designed to compare activity of ADT plus Enzalutamide (E) plus/minus ZA in term of bone response rate by Whole-Body Diffusion-Weighted Magnetic Resonance Imaging (WB-DW-MRI). From February 2018 to June 2021, 126 patients with metastatic hormone-sensitive prostate cancer (mHSPC) and bone metastasis at bone scan were enrolled. Patients were randomized in a 1:1 to receive E 160 mg OD orally alone (E arm) or in combination with ZA 4 mg intravenously every 4 weeks (EZ arm). Primary endpoint of the study was overall response rate (ORR) in bone metastases, secondary endpoints were ORR with conventional imaging, progression free survival (PFS) and overall survival (OS). A logistic model was used to evaluate the association between treatment arm and ORR.</p><p><strong>Results: </strong>After a median follow-up of 31.9 months, according to an intent to treat analysis, the ORR was superimposable in both arms: 69.8% (95% Confidence Interval [CI]: 57.5-79.9%), Odds Ratio: 1.00 (95%CI 0.47-2.15; p > 0.9). No advantage in favor of EZ arm over E arm emerged either in terms of PFS (Hazard Ratio [HR] 0.77, 95%CI 0.44-1.37; p = 0.4) or OS (HR 1.09; 95%CI 0.54-2.2; p = 0.8). A main limitation of this study was the inability of WB-DW-MRI to evaluate disease response in 17 patients.</p><p><strong>Conclusions: </strong>ZA did not improve bone response rate to E plus ADT in mHSPC patients. WB-DW-MRI is a reliable technique to evaluate the response of prostate cancer bone metastases to systemic therapy.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014151","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":"Gleason pattern 4 and active surveillance in patients with grade group 2 prostate cancer.","authors":"Alessandro Uleri, Michael Baboudjian, Riccardo Leni, Marco Oderda, Arthur Peyrottes, Claudia Kesch, Mulham Al-Nader, Charles Dariane, Helene Baud, Jonathan Olivier, Anna Redondo Rios, Francesco Sanguedolce, Vincent Benard, Olivier Windisch, Massimo Valerio, Giorgio Gandaglia, Guillaume Ploussard","doi":"10.1038/s41391-025-00977-6","DOIUrl":"https://doi.org/10.1038/s41391-025-00977-6","url":null,"abstract":"<p><strong>Background: </strong>To report active surveillance (AS) outcomes in patients with Grade Group (GG) 2 prostate cancer (PCa) according to the baseline amount of pattern 4 on image-guided biopsy.</p><p><strong>Methods: </strong>Our database includes GG2 PCa patients managed with AS in ten European centers.</p><p><strong>Results: </strong>In total, 104 patients were included (median pattern 4: 10%, ranges 5-40). The percentage of pattern 4 was not statistically correlated with upgrading (Spearman, r = 0.073, p = 0.5) or downgrading on confirmatory biopsy (r = -0.049, p = 0.6). The median follow-up was 33 months. In multivariable Cox regression analysis, percentage of pattern 4 was not associated with GG3 upgrading (p = 0.6) or definitive treatment (p = 0.4).</p><p><strong>Conclusions: </strong>Patients with GG2 PCa should not be excluded from AS solely because of grade 4 > 10% when other parameters are otherwise favorable.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022002","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":"Short term results after minimally invasive treatments for benign prostatic enlargement: the first randomized trial comparing transperineal laser ablation and water vapor ablation.","authors":"Matteo Pacini, Alessandro Zucchi, Andrea Salonia, Eleonora Sollazzi, Giada Macrì, Rachele Volterrani, Vittorio Bini, Petar Antonov, Atanas Ivanov, Alessia d'Arma, Cosimo De Nunzio, Riccardo Bartoletti","doi":"10.1038/s41391-025-00972-x","DOIUrl":"https://doi.org/10.1038/s41391-025-00972-x","url":null,"abstract":"<p><strong>Background: </strong>Interest in minimally invasive techniques (MISTs) for treating benign prostatic hyperplasia (BPH) has increased over the years due to their ability to improve symptoms while minimizing complications. Moreover, these procedures can be performed in an outpatient setting, potentially reducing patients' discomfort. The aim of our randomized trial is to evaluate and compare the efficacy of Transperineal Laser Ablation (TPLA^TM) and Water Vapor Ablation (WVA) in the treatment of BPH.</p><p><strong>Methods: </strong>Eighty consecutive patients were randomized 1:1 to the two techniques between January and July 2024. Both procedures were under conscious sedations and patients were same day discharged. All patients underwent standardized follow-up, including International Prostate Symptoms Score (IPSS) and uroflowmetry assessments at 3- and 6-months post-treatment.</p><p><strong>Results: </strong>At 6 months, IPSS and Quality of Life (QoL) scores improved significantly from baseline (p < 0.001), in favor of TPLA at both time points (p ≤ 0.03). General Linear Model analysis showed that QoL improvement was faster in the TPLA group (p: 0.005), though no significant difference persisted at 6 months. Uroflow parameters, including maximum flow, average flow, and post-void residual volume, demonstrated significant improvement without notable differences between the two groups (p < 0.001 for all comparisons). All patients were same day discharged, except one who required prolonged continuous bladder irrigation. Postoperative complications occurred in 11 cases, with only one (a prostatic abscess) classified as Clavien-Dindo ≥3. The main limitations of the study are the sample size and short follow-up duration.</p><p><strong>Conclusions: </strong>TPLA and WVA are safe outpatient procedures that provide comparable functional outcomes. However, TPLA appears to offer a faster improvement in patient-reported symptoms.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980258","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 enucleation of the prostate (EEP) versus transurethral resection of the prostate (TURP): advantages and implications.","authors":"Othmane Zekraoui, Dean Elterman, Bilal Chughtai, Naeem Bhojani","doi":"10.1038/s41391-025-00974-9","DOIUrl":"https://doi.org/10.1038/s41391-025-00974-9","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018443","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":"Real-world analyses of major adverse cardiovascular events and mortality risk after androgen deprivation therapy initiation in black vs. white prostate cancer patients.","authors":"Judd W Moul, Deborah M Boldt-Houle, Mack Roach","doi":"10.1038/s41391-025-00963-y","DOIUrl":"https://doi.org/10.1038/s41391-025-00963-y","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer(PCa) patients treated with androgen deprivation therapy(ADT) may experience major adverse cardiovascular events(MACE) [1]. Racial disparities in PCa incidence and outcomes have been noted. In contrast to older studies, three recent studies found significantly longer overall survival in Black vs. White patients: 2019 meta-analysis of nine phase III trials in men with metastatic castration-resistant PCa(CRPC) (n = 8820) [2]; 2020 registry study in men with metastatic CRPC (n = 1902) [3]; and 2023 study in men with non-metastatic CRPC (n = 12,992) [4]. Our \"real-world\" data study compared MACE and all-cause mortality risk for Black vs. White PCa patients. Compared to prior studies [1-4], our study encompassed a broader scope and was not exclusive to CRPC patients.</p><p><strong>Methods: </strong>Historical, longitudinal patient-level were collected from the Decision Resources Group (DRG, now Clarivate) Real World Evidence repository. The analysis included PCa patients receiving ≥1 ADT 1991-2020. Multivariable regression model accounted for baseline metastasis, BMI (<18.5 vs. ≥18.5 kg/m²), oncology vs. urology setting, antagonist vs. agonist, personal MACE history, tobacco history, baseline prostate-specific antigen (>4 vs. ≤4 ng/mL), race (White vs. Black), statin use, increasing age per year, ethnicity (non-Hispanic vs. Hispanic), increasing ADT exposure per year, diabetes, hypertension, and family MACE history.</p><p><strong>Results: </strong>MACE risk was higher for White patients than Black (4.0% vs. 2.4% at one year after ADT initiation; 21.0% vs. 13.3% at four years). Mortality risk after ADT initiation was 1.6% and 2.6% at 1 year and 11.7% and 18.1% at 4 years for Black and White patients, respectively.</p><p><strong>Conclusions: </strong>Our analysis reveals a unique finding that MACE and all-cause mortality incidence were higher in White vs. Black patients. Black race is associated with lower MACE rates and improved survival for men undergoing ADT treatment. Whether selection bias, underlying biology or other factors are responsible for these differences remains unknown.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029177","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 enucleation vs. robot-assisted simple prostatectomy for large prostates: a systematic review and meta-analysis of patients' perspectives.","authors":"Andrea Alberti, Francesca Conte, Sara Costagli, Anna Cadenar, Rossella Nicoletti, Alessio Pecoraro, Arcangelo Sebastianelli, Jeremy Yuen Chun Teoh, Antonio Cicione, Riccardo Autorino, Henry H Woo, Ruben De Groote, Dean Elterman, Marcus Drake, Stavros Gravas, Vincenzo Ficarra, Cosimo De Nunzio, Sergio Serni, Riccardo Campi, Mauro Gacci","doi":"10.1038/s41391-025-00973-w","DOIUrl":"https://doi.org/10.1038/s41391-025-00973-w","url":null,"abstract":"<p><strong>Introduction: </strong>Since Endoscopic Enucleation of the Prostate [EEP] and Robot-Assisted Simple Prostatectomy [RASP] showed comparable functional results, treatment selection is often based on clinicians' and patients' preferences. The aim of this systematic review was to compare Patient-Reported Outcomes Measures [PROMs] and Patient-Reported Experience Measures [PREMs] in patients with large prostate glands treated with EEP and RASP.</p><p><strong>Evidence acquisition: </strong>Literature search was performed on August 29^th 2024 using the MEDLINE, EMBASE, and Cochrane CENTRAL databases, following the EAU Guidelines Office and the PRISMA statement recommendations. All comparative studies reporting validated PROMs/PREMs for both interventions (EEP and RASP) were included. Studies reporting within-treatment comparisons only (e.g., HoLEP vs. ThuLEP) were excluded.</p><p><strong>Evidence synthesis: </strong>Ten studies involving 1105 patients (430 RASP, 675 EEP) were included in this systematic review. Follow-up ranged from 2 to 24 months. Considering urinary function, all authors reported a great improvement for both EEP and RASP at short- and mid-term, with no significant differences between endoscopic and robotic procedures. Alongside the lower symptom scores, patient-reported Quality of Life [QoL] significantly improved for both techniques. Erectile function remained stable after EEP and RASP in most of the studies, while some of them even reported a significant improvement. No studies reporting PREMs were retrieved.</p><p><strong>Conclusions: </strong>Both RASP and EEP led to a great improvement in urinary function and QoL, safeguarding sexual function, with no significant difference between the different techniques in terms of functional outcomes. None of the included studies reported PREMs. A standardization of PROMs/PREMs and their integration in clinical practice is warranted, to understand the real impact of these treatments, helping physicians and patients for an individualized shared decision-making process.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036510","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":"Rezūm water vapor therapy vs. thulium laser enucleation for the treatment of benign prostatic hyperplasia in patients with large prostates: a multicenter prospective comparative study.","authors":"Celeste Manfredi, Lorenzo Spirito, Carmelo Quattrone, Francesco Bottone, Lorenzo Romano, Raffaele Balsamo, Francesco Trama, Felice Crocetto, Biagio Barone, Luigi Napolitano, Savio Domenico Pandolfo, Antonio Franco, Francesco Ditonno, Francesco Uricchio, Giovanni Di Lauro, Ferdinando Fusco, Javier Romero-Otero, Cosimo De Nunzio, Riccardo Autorino, Marco De Sio, Davide Arcaniolo","doi":"10.1038/s41391-025-00971-y","DOIUrl":"https://doi.org/10.1038/s41391-025-00971-y","url":null,"abstract":"<p><strong>Background: </strong>Despite the growing body of evidence supporting the use Rezūm in patients with benign prostatic hyperplasia (BPH) and large prostates, comparative studies with the current gold standard in this clinical setting are lacking.</p><p><strong>Aim: </strong>To compare the efficacy and safety of Rezūm and Thulium Laser Enucleation of the Prostate (ThuLEP) in patients with BPH and large prostates.</p><p><strong>Methods: </strong>We conducted a multicenter prospective comparative study. Consecutive patients with prostate volume (PV) ≥ 80 mL undergoing ThuLEP or Rezūm were included. Patient evaluation was performed at baseline and at 3, 6, and 12 months after surgery. International Prostate Symptom Score (IPSS)-Total was chosen as the primary outcome, while International Index of Erectile Function (IIEF-EF), four-item version of Male Sexual Health Questionnaire (MSHQ-EjD Short Form), and postoperative complications Clavien-Dindo (CD) grade ≥ III were selected as the secondary outcomes.</p><p><strong>Results: </strong>A total of 246 patients were enrolled (126 ThuLEP, 120 Rezūm). Mean (SD) PV was 106.0 (16.5) mL in the ThuLEP group and 101.4 (14.8) mL in the Rezūm group (p = 0.55). Mean (SD) IPSS-Total was statistically significantly lower in the ThuLEP group compared to the Rezūm group at every postoperative time point (p < 0.001); however, the difference between the mean values never reached the Minimal Clinically Important Difference (MCID). IIEF-EF score significantly improved in both groups (p < 0.001), with no significant difference between the two procedures. Significant differences in MSHQ-EjD Function and Bothers in favor of Rezūm were observed at all postoperative time points (p < 0.001). Bleeding with clots requiring reintervention (CD ≥ III) for hemostasis and evacuation occurred in 5 (3.96%) men undergoing ThuLEP and 1 (0.83%) man undergoing Rezūm (p = 0.21).</p><p><strong>Conclusions: </strong>Both ThuLEP and Rezūm significantly improve urinary symptoms in patients with BPH and large prostates. ThuLEP appears statistically but not clinically superior to Rezūm in improving LUTS.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990453","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":"New trends on the management of localized prostate cancer.","authors":"Vincenzo Ficarra, Cosimo De Nunzio, Vincenzo Mirone, Giuseppe Carrieri","doi":"10.1038/s41391-025-00951-2","DOIUrl":"https://doi.org/10.1038/s41391-025-00951-2","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812160","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}