Prostate Cancer and Prostatic Diseases最新文献

{"title":"Impact of a rash management guide in patients receiving apalutamide for high-risk localized prostate cancer in the Apa-RP study.","authors":"Neal Shore, Jason Hafron, Daniel Saltzstein, Amitabha Bhaumik, Pankaj Aggarwal, Jennifer Phillips, Tracy McGowan","doi":"10.1038/s41391-024-00858-4","DOIUrl":"https://doi.org/10.1038/s41391-024-00858-4","url":null,"abstract":"<p><strong>Background/objectives: </strong>Based on the SPARTAN and TITAN studies, apalutamide is approved for patients with nonmetastatic castration-resistant and metastatic castration-sensitive prostate cancer. Skin rash was a common adverse reaction across indications. We hypothesized that earlier identification and intervention could improve rash outcomes.</p><p><strong>Subjects/methods: </strong>A prespecified rash management guide outlining recommended skin care practices was provided to all patients enrolled in Apa-RP (NCT04523207). Rash-related safety data from Apa-RP were compared descriptively with data from SPARTAN and TITAN.</p><p><strong>Results: </strong>Patients in Apa-RP experienced improved rash-related outcomes vs those in SPARTAN and TITAN.</p><p><strong>Conclusions: </strong>Increased vigilance and proactive management may reduce the incidence, severity, and duration of rash during apalutamide treatment.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538534","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":"Should systematic prostatic biopsies be discontinued?","authors":"Laurence Klotz","doi":"10.1038/s41391-024-00849-5","DOIUrl":"https://doi.org/10.1038/s41391-024-00849-5","url":null,"abstract":"<p><strong>Introduction: </strong>The use of systematic biopsies in addition to targeted biopsies is based on multiple studies showing that 15-20% of \"clinically significant\" cancers are missed on targeted biopsies. Concern about these 'missed' cancers drives many interventions. This includes systematic biopsies in men with negative imaging and in men having targeted biopsies, and drives a preference for total gland treatment in men who may be candidates for partial gland ablation. This article summarizes recent genomic and clinical data indicating that, despite \"clinically significant\" histology, MRI invisible lesions are genomically and clinically favorable. These studies have demonstrated that the genetic aberrations associated with cancer visibility are the same aberrations that drive cancer invasiveness and metastasis. Thus invisible cancers, even if undiagnosed at baseline, are in most cases indolent and pose little threat to the patient. The implications are that patients should be monitored with imaging rather than systematic biopsy, and subject to repeat targeted biopsy for evidence of MR progression. Patients prefer this strategy. It has many advantages in terms of reduced burden of care, cost, psychological benefits, and less diagnosis of insignificant cancer.</p><p><strong>Conclusion: </strong>It is now appropriate to abandon systematic biopsies in most patients.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470344","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":"ChatGPT can help guide and empower patients after prostate cancer diagnosis.","authors":"Harry Collin, Kandice Keogh, Marnique Basto, Stacy Loeb, Matthew J Roberts","doi":"10.1038/s41391-024-00864-6","DOIUrl":"https://doi.org/10.1038/s41391-024-00864-6","url":null,"abstract":"<p><strong>Background/objectives: </strong>Patients often face uncertainty about what they should know after prostate cancer diagnosis. Web-based information is common but is at risk of being of poor quality or readability.</p><p><strong>Subjects/methods: </strong>We used ChatGPT, a freely available Artificial intelligence (AI) platform, to generate enquiries about prostate cancer that a newly diagnosed patient might ask and compared to Google search trends. Then, we evaluated ChatGPT responses to these questions for clinical appropriateness and quality using standardised tools.</p><p><strong>Results: </strong>ChatGPT generates broad and representative questions, and provides understandable, clinically sound advice.</p><p><strong>Conclusions: </strong>AI can guide and empower patients after prostate cancer diagnosis through education. However, the limitations of the ChatGPT language-model must not be ignored and require further evaluation and optimisation in the healthcare field.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141458935","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":"Sexual outcomes in men who have sex with men who underwent radical prostatectomy.","authors":"F Vedovo, C Lonati, N Suardi, L Mariani, P Capogrosso, V Ficarra, A Salonia, C Trombetta","doi":"10.1038/s41391-024-00861-9","DOIUrl":"https://doi.org/10.1038/s41391-024-00861-9","url":null,"abstract":"<p><strong>Background: </strong>Sexual difficulties are a recognized consequence of prostate cancer (PCa) treatments. An estimated one in three men who have sex with men (MSM) receive PCa a diagnosis during their lifetime. MSM may experience all types of sexual dysfunction as reported in men who have sex with women (MSW), along with a number of more specific bothersome problems. This systematic literature review aims to evaluate sexual outcomes in MSM who have undergone radical prostatectomy (RP).</p><p><strong>Methods: </strong>A systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The searches were made using relevant keywords in the PubMed, Scopus, and Web of Science databases, thus including the whole literature from January 2000 to November 2023. Studies which did not allow to retrieve data on sexual outcomes on MSM treated with RP for PCa were excluded. Data on sexual outcomes and health-related quality of life (HRQoL) were retrieved, mostly including changes in libido, erectile function, ejaculatory disorders, orgasm, climacturia, changes in role-in-sex identity, changes in sexual partnerships, and the presence of painful receptive anal intercourses (AI).</p><p><strong>Prospero id: </strong>CRD42024502592.</p><p><strong>Results: </strong>Six articles met the inclusion criteria. In total, data of 260 patients were analyzed. Three main themes emerged: (a) MSM may experience specific sexual dysfunctions due to the different dynamics of their intimacy; (b) the lack of tool validated on gay and bisexual population to assess sexual outcomes (c) the need for a tailored approach that also takes into account sexual orientation throughout the oncological journey.</p><p><strong>Conclusions: </strong>MSM undergoing RP may experience similar sexual problems as MSW. Painful AI should be considered a potential post-operative adverse outcome in MSM. Future studies should prioritize validating a questionnaire that explores AI. Healthcare providers should adopt a tailored approach that takes into account sexual orientation throughout the cancer journey.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141451367","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 risk calculators into routine clinical workflow for the detection of prostate cancer: next steps to achieve widespread adoption","authors":"Cody M. Anger,&nbsp;James L. Stallworth,&nbsp;Soroush Rais-Bahrami","doi":"10.1038/s41391-024-00859-3","DOIUrl":"10.1038/s41391-024-00859-3","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":"27 3","pages":"365-366"},"PeriodicalIF":5.1,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41391-024-00859-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Editorial comment on “Reevaluating ‘Top-Down’ HoLEP: the case for anterior fibromuscular stroma as a surgical landmark”","authors":"Hazem Elmansy","doi":"10.1038/s41391-024-00860-w","DOIUrl":"10.1038/s41391-024-00860-w","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":"27 3","pages":"578-578"},"PeriodicalIF":5.1,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41391-024-00860-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The current landscape of stereotactic body radiation therapy for metastatic castration-resistant prostate cancer.","authors":"Jennifer Le Guevelou, Francesco Cuccia, Ronan Flippot, Giuseppe Ferrera, Mario Terlizzi, Thomas Zilli, Renaud De Crevoisier, Jean-Michel Hannoun-Levi, Stephane Supiot, Paul Sargos, David Pasquier","doi":"10.1038/s41391-024-00862-8","DOIUrl":"10.1038/s41391-024-00862-8","url":null,"abstract":"<p><strong>Background: </strong>The onset of castration-resistance is associated with dismal outcomes in patients with prostate cancer (PCa). Metastasis directed therapy has been investigated in multiple disease settings and may improve outcomes in selected patients. Our systematic review aims to summarize evidence with stereotactic body radiotherapy (SBRT) in castration-resistant prostate cancer (CRPC).</p><p><strong>Methods: </strong>The literature search was performed on March 2024, on Pubmed, using the keywords \"SBRT\" AND \"CRPC\", and \"stereotactic ablative radiotherapy (SABR)\" AND \"CRPC\". This search retrieved a total of 108 articles, 19 were included.</p><p><strong>Results: </strong>The literature is largely dominated by retrospective series. In men with metachronous oligoprogression, SBRT with androgen receptor pathway inhibitor significantly increased progression-free survival (PFS) including biochemical progression-free survival in a randomized phase II trial (hazard ratio of 0.35, p < 0.001). In patients continuing ADT, the bPFS ranged between 9.5 months to 17.9 months, and next systemic treatment-free survival (NEST-FS) reached up to 2 years. In men with induced oligoprogression, SBRT enabled NEST-FS up to 3 years. SBRT was well tolerated, with less than 5% grade 3 toxicity reported across studies.</p><p><strong>Conclusion: </strong>In the population of patients with oligometastatic CRPC, SBRT enables long-term biochemical response and PFS. In the oligoprogressive setting, SBRT could be integrated to prolong the duration and efficacy of systemic therapies. Nevertheless, the level of evidence remains very low and inclusion within prospective trials remain the preferred option for this population of patients.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427452","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":"Fatty acid diet and prostate cancer: a treasure hunt or a wild goose chase?","authors":"Georges Mjaess, Thierry Roumeguère, Kéziah Korpak, Pierre Van Antwerpen, Karim Zouaoui Boudjeltia","doi":"10.1038/s41391-024-00854-8","DOIUrl":"https://doi.org/10.1038/s41391-024-00854-8","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141420558","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":"Can ChatGPT provide high-quality patient information on male lower urinary tract symptoms suggestive of benign prostate enlargement?","authors":"Angie K Puerto Nino, Valentina Garcia Perez, Silvia Secco, Cosimo De Nunzio, Riccardo Lombardo, Kari A O Tikkinen, Dean S Elterman","doi":"10.1038/s41391-024-00847-7","DOIUrl":"https://doi.org/10.1038/s41391-024-00847-7","url":null,"abstract":"<p><strong>Background: </strong>ChatGPT has recently emerged as a novel resource for patients' disease-specific inquiries. There is, however, limited evidence assessing the quality of the information. We evaluated the accuracy and quality of the ChatGPT's responses on male lower urinary tract symptoms (LUTS) suggestive of benign prostate enlargement (BPE) when compared to two reference resources.</p><p><strong>Methods: </strong>Using patient information websites from the European Association of Urology and the American Urological Association as reference material, we formulated 88 BPE-centric questions for ChatGPT 4.0+. Independently and in duplicate, we compared the ChatGPT's responses and the reference material, calculating accuracy through F1 score, precision, and recall metrics. We used a 5-point Likert scale for quality rating. We evaluated examiner agreement using the interclass correlation coefficient and assessed the difference in the quality scores with the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>ChatGPT addressed all (88/88) LUTS/BPE-related questions. For the 88 questions, the recorded F1 score was 0.79 (range: 0-1), precision 0.66 (range: 0-1), recall 0.97 (range: 0-1), and the quality score had a median of 4 (range = 1-5). Examiners had a good level of agreement (ICC = 0.86). We found no statistically significant difference between the scores given by the examiners and the overall quality of the responses (p = 0.72).</p><p><strong>Discussion: </strong>ChatGPT demostrated a potential utility in educating patients about BPE/LUTS, its prognosis, and treatment that helps in the decision-making process. One must exercise prudence when recommending this as the sole information outlet. Additional studies are needed to completely understand the full extent of AI's efficacy in delivering patient education in urology.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318130","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":"Nerve-sparing radical prostatectomy using the neurovascular structure-adjacent frozen-section examination (NeuroSAFE): results after 20 years of experience.","authors":"Francesca Ambrosini, Felix Preisser, Derya Tilki, Hans Heinzer, Georg Salomon, Uwe Michl, Thomas Steuber, Tobias Maurer, Felix K H Chun, Lars Budäus, Randi M Pose, Carlo Terrone, Thorsten Schlomm, Pierre Tennstedt, Hartwig Huland, Markus Graefen, Alexander Haese","doi":"10.1038/s41391-024-00851-x","DOIUrl":"https://doi.org/10.1038/s41391-024-00851-x","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the long-term oncological outcomes and functional results of the neurovascular structure-adjacent frozen-section examination (NeuroSAFE) during nerve-sparing (NS) radical prostatectomy (RP).</p><p><strong>Materials and methods: </strong>A 10-yr survival analysis on 11069 RPs performed with or without the NeuroSAFE, between January 2002 to June 2011 was carried out. In the NeuroSAFE cohort, the neurovascular structure-adjacent prostatic margins are removed and stained for cryo-sectioning during RP. In case of a PSM, partial or full removal of the neurovascular bundle was performed. The impact of NeuroSAFE on biochemical recurrence-free survival (BFS), salvage radiation therapy-free survival, metastasis-free survival, and prostate cancer-specific survival at 10 years was analyzed. 1-year (1-yr) erectile function (EF), 1-yr, and 2-yr continence rates were assessed in propensity score-based matched cohorts.</p><p><strong>Results: </strong>Median follow-up was 121 (IQR: 73, 156) months. No differences in BFS between NeuroSAFE and non-NeuroSAFE were recorded (10-yr BFS: NeuroSAFE vs non-Neurosafe, pT2: 81% vs 84%, p = 0.06; pT3a: 58% vs. 63%, p = 0.6; ≥pT3b: 22% vs. 27%, p = 0.99). No differences were found between the two groups in terms of sRFS (pT2: p = 0.1; pT3a: p = 0.4; ≥pT3b: p = 0.4) (Fig. 1B, Table 2), and MTS (pT2: p = 0.3; pT3a: p = 0.6; ≥pT3b: p = 0.9). The NeuroSAFE-navigated patients reported a better 1-yr EF than non-NeuroSAFE (68% vs. 58%, p = 0.02) and no differences in 1-yr and 2-yr continence rates (92.4% vs. 91.8%, and 93.4% vs. 93%, respectively). The main limitation is the retrospective study design.</p><p><strong>Conclusions: </strong>While the NeuroSAFE approach did not show significant improvements in long-term oncologic or continence outcomes, it did provide an opportunity for a higher proportion of patients to improve postoperative functional results, possibly through increased nerve-sparing procedures.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306727","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}