Prostate Cancer and Prostatic Diseases最新文献

{"title":"Hypofractionated radiotherapy in elderly patients (≥75 years) affected by localized prostate cancer: a multicenter retrospective analysis from the IPOPROMISE study.","authors":"Gianluca Ingrosso, Eleonora Festa, Saverio Caini, Elisabetta Ponti, Giulio Francolini, Chiara Doccioli, Andrea Lancia, Simona Fondelli, Roberto Santini, Maurizio Valeriani, Luciana Rago, Alessio Bruni, Antonietta Augurio, Fabio Trippa, Donatella Russo, Maria Tamburo, Silvana Parisi, Simona Borghesi, Sara Gomellini, Silvia Scoccianti, Daniela Musio, Marco Stefanacci, Giuseppe Facondo, Teodora Statuto, Giulia Miranda, Bianca Santo, Alessandro Di Marzo, Rita Bellavita, Annamaria Vinciguerra, Lorenzo Livi, Cynthia Aristei, Beatrice Detti","doi":"10.1038/s41391-025-00962-z","DOIUrl":"https://doi.org/10.1038/s41391-025-00962-z","url":null,"abstract":"<p><strong>Background: </strong>Prostate Cancer (PCa) is the second leading cause of cancer death in the elderly (≥75 years). There is currently little data on hypofractionated radiotherapy in older patients affected by localized PCa. We present the long-term results of hypofractionated radiotherapy in elderly patients with localized PCa from the IPOPROMISE database.</p><p><strong>Materials and methods: </strong>retrospective analysis of 719 PCa elderly (≥75 years) patients treated with daily volumetric image-guided hypofractionated radiotherapy between 2007 and 2020. For survival endpoints, we used Kaplan-Meier survival curves and univariate and multivariable Cox's proportional hazards regression models.</p><p><strong>Results: </strong>Median age at PCa diagnosis was 78.4 years (interquartile [IQR], 76.8-80.3 years), 74% of patients had a modified Charlson co-morbidity index (elderly-PCa-CCI, (e-PCCI)) of 0. Based on NCCN risk grouping, 399 patients (55.5%) were affected by unfavorable to very high-risk disease. Median follow-up was 4.2 years (IQR 2.4-6.4 years). 31/719 (4.3%) patients died from any cause. At 5 years, overall survival (OS), cancer-specific survival (CSS), and metastasis-free survival were 95.6% (95% CI 93.4-97.1%), 99.2% (95%CI 97.9-99.7%), and 97.3% (95% CI 95.1-98.5%), respectively. In multivariate analysis, baseline PSA, and Gleason score were associated with MFS. On univariate analysis, e-PCCI ≥ 2 was associated with OS (p = 0.02). The 5-year freedom from late grade ≥2 gastrointestinal (GI) and genitourinary (GU) toxicity were 95.1% (95% CI 93.0-96.5%) and 96.7% (95% CI 93.7-97.1%), respectively.</p><p><strong>Conclusions: </strong>Our results represent a valuable add-on to the current literature, confirming the prominent role of radiotherapy in the cure of elderly fit patients affected by localized disease.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650153","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":"A generalised vision transformer-based self-supervised model for diagnosing and grading prostate cancer using histological images.","authors":"Abadh K Chaurasia, Helen C Harris, Patrick W Toohey, Alex W Hewitt","doi":"10.1038/s41391-025-00957-w","DOIUrl":"https://doi.org/10.1038/s41391-025-00957-w","url":null,"abstract":"<p><strong>Background: </strong>Gleason grading remains the gold standard for prostate cancer histological classification and prognosis, yet its subjectivity leads to grade variability between pathologists, potentially impacting clinical decision-making. Herein, we trained and validated a generalised AI-driven system for diagnosing prostate cancer using diverse datasets from tissue microarray (TMA) core and whole slide images (WSIs) with Haematoxylin and Eosin staining.</p><p><strong>Methods: </strong>We analysed eight prostate cancer datasets, which included 12,711 histological images from 3648 patients, incorporating TMA core images and WSIs. The Macenko method was used to normalise colours for consistency across diverse images. Subsequently, we trained a multi-resolution (5x, 10x, 20x, and 40x) binary classifier to identify benign and malignant tissue. We then implemented a multi-class classifier for Gleason patterns (GP) sub-categorisation from malignant tissue. Finally, the models were externally validated on 11,132 histology images from 2176 patients to determine the International Society of Urological Pathology (ISUP) grade. Models were assessed using various classification metrics, and the agreement between the model's predictions and the ground truth was quantified using the quadratic weighted Cohen's Kappa (κ) score.</p><p><strong>Results: </strong>Our multi-resolution binary classifier demonstrated robust performance in distinguishing malignant from benign tissue with κ scores of 0.967 on internal validation. The model achieved κ scores ranging from 0.876 to 0.995 across four unseen testing datasets. The multi-class classifier also distinguished GP3, GP4, and GPs with an overall κ score of 0.841. This model was further tested across four datasets, obtaining κ scores ranging from 0.774 to 0.888. The models' performance was compared against an independent pathologist's annotation on an external dataset, achieving a κ score of 0.752 for four classes.</p><p><strong>Conclusion: </strong>The self-supervised ViT-based model effectively diagnoses and grades prostate cancer using histological images, distinguishing benign and malignant tissues and classifying malignancies by aggressiveness. External validation highlights its robustness and clinical applicability in digital pathology.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634400","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":"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^TM system (SoracteLite^TM) (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":"Editorial Expression of Concern: Ethanol promotes cytotoxic effects of tumor necrosis factor-related apoptosis-inducing ligand through induction of reactive oxygen species in prostate cancer cells","authors":"M. K. Plante,&nbsp;W. T. Arscott,&nbsp;J. B. Folsom,&nbsp;S. W. Tighe,&nbsp;R. J. Dempsey,&nbsp;U. V. Wesley","doi":"10.1038/s41391-025-00960-1","DOIUrl":"10.1038/s41391-025-00960-1","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":"28 2","pages":"528-528"},"PeriodicalIF":5.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41391-025-00960-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543175","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 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}

{"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}

{"title":"Standardizing targeted and perilesional biopsy: considerations and challenges","authors":"Olivier Windisch,&nbsp;Massimo Valerio,&nbsp;Jean de la Rosette","doi":"10.1038/s41391-025-00955-y","DOIUrl":"10.1038/s41391-025-00955-y","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":"28 2","pages":"526-527"},"PeriodicalIF":5.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41391-025-00955-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468884","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":"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}

{"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}

{"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}