Prostate International最新文献

{"title":"Whole gland versus partial gland ablation in patients with localized prostate cancer treated by high-intensity focused ultrasound ablation.","authors":"Hae Sung Lee, Sang Hun Song, Hakmin Lee, Sung Kyu Hong","doi":"10.1016/j.prnil.2024.09.001","DOIUrl":"10.1016/j.prnil.2024.09.001","url":null,"abstract":"<p><strong>Background: </strong>Focal therapy is considered one of the treatment options for localized prostate cancer (PCa), particularly for low or very-low-risk patients. In this study, we compared the mid-term oncological outcomes in localized PCa patients treated with high-intensity focused ultrasound (HIFU).</p><p><strong>Methods: </strong>We retrospectively analyzed 237 patients who underwent HIFU for localized PCa. Patients were divided into two groups based on ablation type: whole gland ablation (WGA) and partial gland ablation (PGA). Follow-up biopsies were performed after one year postoperatively, and the oncological outcomes were compared between the groups.</p><p><strong>Results: </strong>Among the total of 237 patients, 54 subjects were treated by WGA and 183 subjects by PGA. After one year postoperatively, follow-up biopsies were conducted on 199 patients, revealing residual cancer in 21.4% of WGA group and 15.3% of PGA group. Additionally, clinically significant (CS) cancer was observed in 14.3% of WGA group and 8.3% of PGA group. Survival analyses revealed significantly longer failure-free (<i>P</i> < 0.001) and salvage-free survival (<i>P</i> < 0.001) in WGA group than in PGA group. Similarly, in the intermediate-high risk group, WGA group exhibited longer failure-free (<i>P</i> = 0.005) and salvage-free survival (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>HIFU was performed with acceptable oncological outcomes in localized PCa. Despite higher proportion of high-risk patients in WGA group, WGA was associated with significantly better failure-free survival and salvage-free survival. Further prospective and multi-center studies are warranted.</p>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"12 4","pages":"213-218"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903145","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":"Comparing the efficacy of tadalafil and tamsulosin for managing erectile dysfunction and lower urinary tract symptoms in prostate brachytherapy patients: a prospective study.","authors":"Nozomi Hayakawa, Ryuichi Mizuno, Tomoki Tanaka, Yutaka Shiraishi, Kazuhiro Matsumoto, Takeo Kosaka, Eiji Kikuchi, Mototsugu Oya","doi":"10.1016/j.prnil.2024.09.004","DOIUrl":"10.1016/j.prnil.2024.09.004","url":null,"abstract":"<p><strong>Introduction: </strong>Adverse events, such as erectile dysfunction (ED) and lower urinary tract symptoms (LUTS), are significant concerns in prostate cancer (PCa) patients treated with Iodine 125 (I-125) low-dose rate (LDR) prostate brachytherapy (PB). Alpha antagonists and phosphodiesterase-5 inhibitors are used to manage these events. The present study compared the efficacy of low-dose tadalafil with that of tamsulosin for concomitant ED and LUTS in PCa patients treated with I-125 LDR PB.</p><p><strong>Materials and methods: </strong>One hundred and seventeen patients who received PB for low- or intermediate-risk localized PCa were analyzed. They were randomized into two groups, one receiving tamsulosin (<i>N</i> = 58) and the other receiving low-dose tadalafil (<i>N</i> = 59) immediately after PB. Sexual and urinary functions were assessed at various time points post-PB using questionnaires and objective measurements. The primary endpoint was sexual function measured by the International Index of Erectile Function-15 (IIEF-15) EF domain scores 6 months after PB. Secondary endpoints were sexual function measured by total IIEF-15 scores and Erection Hardness Scores 6 months after PB. The exploratory endpoint was the LUTS status 6 months after PB.</p><p><strong>Results: </strong>No significant differences were observed in baseline characteristics between the two groups. Tadalafil exerted stronger effects on sexual function, particularly erection hardness, than tamsulosin. No significant differences were observed in the management of LUTS between both treatments.</p><p><strong>Conclusion: </strong>Low-dose tadalafil and tamsulosin may manage LUTS equally after PB. Low-dose tadalafil may contribute to the maintenance of erectile function, particularly erection hardness, after PB; therefore, it is a viable option for patients with baseline erectile function.</p>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"12 4","pages":"231-237"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903041","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":"Weekly versus 2-weekly versus 3-weekly docetaxel to treat metastatic castration-resistant prostate cancer.","authors":"Hyeong Dong Yuk, Miso Kim, Bhumsuk Keam, Ja Hyeon Ku, Cheol Kwak, Chang Wook Jeong","doi":"10.1016/j.prnil.2024.09.002","DOIUrl":"10.1016/j.prnil.2024.09.002","url":null,"abstract":"<p><strong>Background: </strong>To compare the efficacy and toxicity of docetaxel treatment regimens in metastatic castration-resistant prostate cancer (mCRPC).</p><p><strong>Methods: </strong>We retrospectively analyzed 162 patients diagnosed with mCRPC who underwent docetaxel chemotherapy between 2009 and 2020. The patients were divided into three groups according to the dosage and interval of docetaxel (DCT) chemotherapy regimen: 30 mL/m² weekly, 50 mL/m² biweekly (every 2 weeks), and 75 mL/m² triweekly (every 3 weeks).</p><p><strong>Results: </strong>There were no significant differences in the prostate-specific antigen (PSA) response rates (<i>P</i> = 0.709). The median time to progression was 3.0 [interquartile range (IQR 2.0-5.3)] months, 5.0 (IQR 2.0-13.0) months, and 5.0 (IQR 3.0-12.0) months in the weekly, biweekly, and triweekly groups, respectively (<i>P</i> = 0.062). The median overall survival (OS) was 12.5 (IQR 6.0-14.0) months, 18.8 (IQR 5.5-23.5) months, and 22.9 (IQR 11.0-33.0) months in the weekly, biweekly, and triweekly groups, respectively (<i>P</i> < 0.001). There were no differences in all toxicity and Grade 3 or higher toxicity. In Cox multivariate regression analysis, the Eastern Cooperative Oncology Group performance status (ECOG-PS), response to chemotherapy, and chemotherapy cycle also affected the PFS. Age, ECOG-PS, and chemotherapy cycle affected the OS.</p><p><strong>Conclusions: </strong>The various options for optimal chemotherapy are indicated depending on the patient's conditions during the diagnosis of mCRPC. Treatment with DCT at 2-week or even 1-week intervals appears to be well tolerated in men diagnosed with mCRPC and represents a useful option when the conventional triweekly regimen is not tolerated due to poor patient condition.</p>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"12 4","pages":"219-223"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903059","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":"Oncological outcomes after radical prostatectomy of localized prostate cancer: stratified by magnetic resonance imaging and risk classification.","authors":"Gyoohwan Jung, Byeongdo Song, Hyungwoo Ahn, Sung Il Hwang, Hak Jong Lee, Ki Young Huh, Sang Hun Song, Sangchul Lee, Seok-Soo Byun, Sung Kyu Hong","doi":"10.1016/j.prnil.2024.09.003","DOIUrl":"10.1016/j.prnil.2024.09.003","url":null,"abstract":"<p><strong>Background: </strong>We investigated whether combining T2-weighted magnetic resonance imaging (MRI) findings and clinical risk categories improves upon established prognostic indicators of oncological outcomes in prostate cancer.</p><p><strong>Methods: </strong>Patients who underwent radical prostatectomy, but not preoperative hormone therapy, radiotherapy, or chemotherapy, for localized prostate cancer at Seoul National University Bundang Hospital from October 2007 to April 2016 were included. MRIs were classified according to the Prostate Imaging-Reporting and Data System (PI-RADS). Patients were divided into the following five groups: 1, no focal suspicious lesion; 2, organ-confined suspicious lesion PI-RADS ≤3; 3, organ-confined suspicious lesion PI-RADS 4 or 5; 4, suspicious lesion with extraprostatic extension (EPE), no seminal vesicle invasion (SVI); 5, suspicious lesion with EPE and SVI. Risk classified according to the National Comprehensive Cancer Network (NCCN) and MRI findings were combined to analyze survival curves for biochemical recurrence (BCR)-free and metastasis-free survival. The area under a time-dependent receiver operating characteristic was analyzed for event prediction after 5 years.</p><p><strong>Results: </strong>We analyzed 1,290 patients. In multivariate Cox regression models, PI-RADS ≥4 (hazard ratio [HR] 2.33, <i>P</i> < 0.001), EPE (HR 1.46, <i>P</i> = 0.027), SVI (HR 5.03, <i>P</i> < 0.001) and NCCN high-risk (HR 2.33, 95% CI 1.66-3.26, <i>P</i> < 0.001) were associated with BCR. For metastasis, EPE (HR 2.33, <i>P</i> = 0.047), SVI (HR 13.08, <i>P</i> < 0.001) and NCCN high-risk (HR 2.78, <i>P</i> = 0.026) were independent risk factors. Depending on MRI group, BCR-free survival significantly decreased in NCCN intermediate-risk (<i>P</i> = 0.001) and high-risk (<i>P</i> < 0.001) groups, and metastasis-free survival decreased in the intermediate-risk group (<i>P</i> = 0.39) and significantly decreased in the high-risk (<i>P</i> < 0.001) group. Adding MRI group to NCCN risk classification significantly improved the predictive accuracy for BCR in comparison with NCCN risk classification alone (<i>P</i> = 0.042), but not for metastasis (<i>P</i> = 0.012).</p><p><strong>Conclusion: </strong>Combining prostate MRI with NCCN risk classification improves the prediction value of BCR following radical prostatectomy for localized prostate cancer.</p>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"12 4","pages":"224-230"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903052","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":"Negative magnetic resonance imaging cannot be used to omit an initial prostate biopsy - An ambispective study","authors":"","doi":"10.1016/j.prnil.2024.03.005","DOIUrl":"10.1016/j.prnil.2024.03.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Up to 40% of patients with suspected prostate cancer (PCa) have a negative prebiopsy magnetic resonance imaging (nMRI), and up to 15% of them may have clinically significant PCa (csPCa). The ability to predict the presence of csPCa despite nMRI may help avoid unnecessary biopsies. We aimed to determine the negative predictive value (NPV) of mpMRI, the influence of MRI reporting patterns in clinical practice, and the factors that might predict csPCa among men with an nMRI.</p></div><div><h3>Methodology</h3><p>In an IRB-approved, ambispective study, men who underwent prostate biopsy from 2016 to 2023 and had a prebiopsy MRI, were included to determine the presence of csPCa. The reporting patterns of institutional and noninstitutional MRI were evaluated. Age, digital rectal examination (DRE) findings, prostate specific antigen (PSA), PSA density (PSAD), and MRI reports were evaluated for their ability to predict csPCa in men with nMRI.</p></div><div><h3>Results</h3><p>1660 patients who underwent prostate biopsy were assessed for eligibility, and 685 patients were enrolled in the study. The median age, PSA and PSAD were 60 years, 11.63 ng/ml and 0.23 ng/ml/cm³, respectively. 62 (9%) men had an nMRI, among which csPCa, non-csPCa, and negative biopsy were found in 34%, 5%, and 61% of men, respectively. 61% had an institutional MRI, while 39% had a noninstitutional MRI. The sensitivity and NPV of any MRI for csPCa were 93% and 66%, respectively, which improved to 96% and 81% for institutional MRI. Univariate and multivariate analyses showed abnormal DRE and PSAD ≥0.25 ng/ml/cc as predictive factors for csPCa in men with an nMRI.</p></div><div><h3>Conclusion</h3><p>34% of men with negative MRIs were found to harbor csPCa on prostate biopsy. The NPV of institutional MRI was higher than for noninstitutional MRI. Men with an abnormal DRE or PSAD ≥0.25 ng/ml/cc had a higher incidence of csPCa despite an nMRI.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"12 3","pages":"Pages 128-133"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888224000254/pdfft?md5=f7af690461eefe149824fa33a0afd692&pid=1-s2.0-S2287888224000254-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140793585","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":"Corrigendum to “Screening and validation of novel serum panel of microRNA in stratification of prostate cancer” [Prostate Int 11 (2023) 150–158]","authors":"","doi":"10.1016/j.prnil.2024.01.001","DOIUrl":"10.1016/j.prnil.2024.01.001","url":null,"abstract":"","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"12 3","pages":"Page 178"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888224000011/pdfft?md5=fd8eee33630a8555a857e7362ec45bec&pid=1-s2.0-S2287888224000011-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139508521","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 association between inflammatory bowel disease and risk of prostate cancer: a population-based retrospective study based on Korean National Health Insurance Service database","authors":"","doi":"10.1016/j.prnil.2024.05.001","DOIUrl":"10.1016/j.prnil.2024.05.001","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this study was to determine whether inflammatory bowel disease (IBD) is associated with the risk of developing prostate cancer (PCa) through a population-based study.</p></div><div><h3>Materials and methods</h3><p>Male patients aged ≥40 years, diagnosed with IBD from 2010 to 2013 and without IBD were identified and followed-up till 2019. A matched cohort of male patients with and without IBD in a ratio of 1:4 was created based on age, income level, and Charlson comorbidity index. Multivariate Cox regression analysis was conducted to evaluate the association of IBD with the prescence of PCa and PCa requiring definitive treatment within 1 year of diagnosis. The hazard ratio (HR) and 95% confidence interval (CI) were stratified by Crohn's disease, ulcerative colitis (UC), and subtypes.</p></div><div><h3>Results</h3><p>After matching, 15,751 IBD patients and 62,346 controls were analyzed. Over a median follow-up period of 96 months, the HR for PCa was significantly increased in patients with IBD (HR: 2.44; 95% CI: 2.08–2.86, <em>P</em> &lt; 0.001). IBD was also associated with PCa requiring definitive treatment within 1 year (HR: 2.67; 95% CI: 2.09–3.42, <em>P</em> &lt; 0.001). In subgroup analysis, UC (HR: 2.83; 95% CI: 2.18–3.69, <em>P</em> &lt; 0.001) showed higher risk of PCa requiring definitive treatment than for Crohn's disease (HR: 2.21; 95% CI: 1.43–3.43, <em>P</em> = 0.0004). All-cause death in patient-diagnosed PCa was the highest in UC of pancolitis (HR: 2.26; 95% CI: 0.99–5.16, <em>P</em> = 0.054), and the lowest in ulcerative proctitis (HR: 0.35; 95% CI: 0.21–0.60, <em>P</em> = 0.0001).</p></div><div><h3>Conclusion</h3><p>IBD was associated with an increased incidence of PCa in our matched analysis.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"12 3","pages":"Pages 139-144"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S228788822400031X/pdfft?md5=9202d041a8980face92ceb2c94e2c88b&pid=1-s2.0-S228788822400031X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141142651","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":"Utility of transperineal template-guided mapping prostate biopsy in biopsy-naïve men with PI-RADS 1-2 on multiparametric magnetic resonance imaging","authors":"","doi":"10.1016/j.prnil.2024.04.002","DOIUrl":"10.1016/j.prnil.2024.04.002","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the outcomes of transperineal template-guided mapping biopsy (TTMB) in biopsy-naïve men with multiparametric magnetic resonance imaging (mpMRI) results of Prostate Imaging-Reporting and Data System (PI-RADS) 1-2.</p></div><div><h3>Patients and methods</h3><p>We retrospectively reviewed TTMB outcomes in biopsy naïve patients with PI-RADS 1-2 at a single center from August 2018 to May 2023. The patients' clinicopathologic data were reviewed, clinically significant prostate cancer (csPCa) detection rates were identified. We determined significant predictive factors and determined those optimal cutoff point using receiver operating characteristic (ROC) curves.</p></div><div><h3>Results</h3><p>255 biopsy naïve patients with PI-RADS 1-2 underwent TTMB. 72 (28.2%) were diagnosed with prostate cancer and 30 (11.8%) were diagnosed with csPCa. ROC curves were used to identify predictive factors for diagnosing csPCa. Age (area under ROC curve [AUC]: 0.74, 95% CI: 0.65–0.83, <em>P</em> &lt; 0.001) and prostate specific antigen density (PSAD) (AUC: 0.63, 95% CI: 0.53–0.72, <em>P</em> = 0.025) were significant predictive factors, and the optimal cutoff points determined using the Youden index were 65 years and 0.15 ng/mL/mL, respectively.</p></div><div><h3>Conclusion</h3><p>Of biopsy-naïve patients classified as PI-RADS 1–2, 11.8% were diagnosed with csPCa, and we identified age and PSAD as significant predictive factors. Our study will help determine the biopsy method for patients with PI-RADS 1–2 without biopsy experience.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"12 3","pages":"Pages 134-138"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888224000278/pdfft?md5=c3656b950e9849c93702a42d05f47111&pid=1-s2.0-S2287888224000278-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140795191","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":"Hematospermia does not increase the risk of prostate cancer detection in prostate biopsy","authors":"","doi":"10.1016/j.prnil.2024.06.004","DOIUrl":"10.1016/j.prnil.2024.06.004","url":null,"abstract":"<div><h3>Background</h3><p>Studies on the association between hematospermia and prostate cancer are insufficient. The purpose of this study was to determine the prevalence of prostate cancer in patients with hematospermia using large United States population data.</p></div><div><h3>Materials and methods</h3><p>This was a retrospective observational cohort study. Administrative claims data were extracted from the IBM® MarketScan Research Database. Patients who had undergone a prostate biopsy and newly diagnosed patients with hematospermia before prostate biopsy from January 2007 to December 2014 were included using the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) codes. Treatment methods were identified with the Current Procedural Terminology (CPT) code.</p></div><div><h3>Results</h3><p>A total of 369,170 adult men had a prostate biopsy. The mean age of patients was 62 years (range, 18 to 100 years). Among the TRUS bx patients, the number of patients with hematospermia was 1,357 (0.4%). The prostate cancer detection rate was significantly lower in patients with hematospermia than in patients without hematospermia (30.4% vs. 48.0%, <em>P</em> &lt; 0.01). During the study period, 83,712 patients had hematospermia, of whom only 1.6% underwent a prostate biopsy.</p></div><div><h3>Conclusions</h3><p>Only 1.6% of hematospermia patients underwent a prostate biopsy. Prostate cancer was detected at a lower rate in those with hematospermia than in those without hematospermia. This study suggests that the presence of hematospermia prior to biopsy does not increase the risk of prostate cancer detection.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"12 3","pages":"Pages 151-154"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888224000357/pdfft?md5=7e5ec955a1f764d9fa87d348c6cb5853&pid=1-s2.0-S2287888224000357-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141402584","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":"A new parameter to increase the predictive value of multiparametric prostate magnetic resonance imaging for clinically significant prostate cancer in targeted biopsies: lesion density","authors":"","doi":"10.1016/j.prnil.2024.06.001","DOIUrl":"10.1016/j.prnil.2024.06.001","url":null,"abstract":"<div><h3>Aim</h3><p>To investigate the predictive value of lesion length in multiparametric prostate magnetic resonance imaging with respect to prostate volume for clinically significant prostate cancer diagnosis in targeted biopsies.</p></div><div><h3>Materials and methods</h3><p>The data of biopsy-naïve patients in the Turkish Urooncology Association Prostate Cancer Database who underwent targeted prostate biopsies were included in this study. Lesion density is calculated as the ratio of lesion length (mm) in MR to prostate volume (cc). The biopsy results were divided into either clinically significant or insignificant cancer and benign groups. The difference in parameters between groups is evaluated by multivariable analysis to determine independent risk factors for clinically significant prostate cancer diagnosis.</p></div><div><h3>Results</h3><p>A total of 590 lesion biopsies were included in the study. In univariable analysis, prostate-specific antigen (PSA), PSA density, number of cores taken, lesion length, lesion density, patient age, and digital rectal examination findings were found to be different at a statistically significant level between groups (<em>P</em> values, respectively: 0.001, &lt;0.001, &lt;0.001, &lt;0.001, &lt;0.001, 0.012, 0.001). Subgroup analysis demonstrated that the lesion density was still significantly different between groups for all Prostate Imaging - Reporting and Data System (PI-RADS) 3, 4, and 5 subgroups (<em>P</em> values, respectively: 0.001, &lt;0.001, &lt;0.001). The multivariable analysis demonstrated that lesion density, along with the number of cores taken and the PI-RADS score of the lesion is an independent risk factor for predicting clinically significant prostate cancer, with the highest odds ratio among all parameters (OR: 27.31 [CI: 7.9–94.0]).</p></div><div><h3>Conclusion</h3><p>This study demonstrated that lesion size with respect to prostate volume is an important independent risk factor for the prediction of clinically significant prostate cancer in the lesion-targeted biopsy. Combined with the PI-RADS score and parameters like digital rectal examination (DRE) findings and PSA density may further increase predictive power and help clinicians decide whether to perform a biopsy in low-risk patients or perform a re-biopsy for high-risk patients subsequent to an initial negative biopsy.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"12 3","pages":"Pages 145-150"},"PeriodicalIF":2.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888224000321/pdfft?md5=e928443ad0100bb55c7ccd02b9735a62&pid=1-s2.0-S2287888224000321-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141413064","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}