Prostate International最新文献

{"title":"Time to castrate the cost? the rising expense of chemical castration for the management of prostate cancer","authors":"Alice Thomson ,&nbsp;Haidar Al Saffar ,&nbsp;Jake Tempo ,&nbsp;Nathan Lawrentschuk ,&nbsp;Declan G. Murphy ,&nbsp;Marlon Perera","doi":"10.1016/j.prnil.2025.01.003","DOIUrl":"10.1016/j.prnil.2025.01.003","url":null,"abstract":"<div><h3>Background</h3><div>Androgen deprivation therapy (ADT) remains the backbone of treatment of advanced prostate cancer. Conventionally, this is achieved by means of Gonadotropin Releasing Hormone (GnRH) analogs, though in recent years, four novel androgen receptor pathway inhibitors (nARPIs) have been approved for the treatment of advanced prostate cancer. We aim to analyze the increase in cost of chemical castration in advanced prostate cancer associated with the introduction of these medications.</div></div><div><h3>Methods and methods</h3><div>The publicly available Pharmaceutical Benefits Scheme database was accessed for conventional ADT and nARPI prescription data between January 2010 and January 2024. The number of prescriptions and cost of prescriptions were categorized by month and state. A descriptive analysis was performed outlining the therapy-prescribing patterns and discordances at a national and state-/territory-based level.</div></div><div><h3>Results</h3><div>From January 2010 to January 2024, over 1.7 million scripts were dispensed for conventional ADT compared to 412,925 for nAPRI therapy. The average cost for ADT rose from $9.9 million to 10.9 million. The average cost for nARPI therapy rose from $5.2 million to $17.3 million. There was significant difference between state-prescribing practices despite population-adjusted analysis.</div></div><div><h3>Conclusions</h3><div>While intensified treatment has proven to improve prostate cancer survival, this had led to an exponential increase in the cost of treatment. Clinicians must exercise caution when prescribing these medications to ensure patients will appropriately benefit from their advantage to cancer-specific survival in the context of their overall health to ensure appropriate distribution of resources.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 3","pages":"Pages 142-147"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027858","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":"Anterior versus posterior first approach for robot assisted radical prostatectomy-perioperative, functional, and oncological outcomes","authors":"Faisal Masood Pirzada,&nbsp;Amlesh Seth,&nbsp;Rishi Nayyar,&nbsp;Brusabhanu Nayak,&nbsp;Rajeev Kumar","doi":"10.1016/j.prnil.2025.01.001","DOIUrl":"10.1016/j.prnil.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Robot-assisted radical prostatectomy (RARP) is commonly performed using either the anterior (AF) or posterior first (PF) approaches, depending upon where the dissection begins. While there is some data comparing outcomes of conventional RARP and Retzius sparing posterior RARP, there is limited data comparing outcomes between the AF and PF approaches to conventional RARP. We compared the two approaches in terms of perioperative, functional, and oncological outcomes.</div></div><div><h3>Materials and methods</h3><div>We retrospectively reviewed our data of RARP performed between 2014 and 2023 and identified 258 patients who had undergone the procedure using one of the two approaches. The choice of approach was dependent upon the surgeon with five surgeons with varying experience having performed all surgeries. We compared the two cohorts for perioperative, functional, and oncological outcomes.</div></div><div><h3>Results</h3><div>One hundred thirty-nine patients underwent RARP using the AF approach and 119 the PF approach. AF group were younger and had larger prostate volume at baseline. Operative time, blood loss was higher in the PF approach, whereas the positive surgical margins, biochemical recurrence, need for adjuvant therapy, potency, and continence parameters were similar between the two groups.</div></div><div><h3>Conclusions</h3><div>Our data suggests that the AF approach offers certain advantages in operative outcomes in RARP. However, this could be due to surgeon experience and needs better-controlled studies for validation.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 3","pages":"Pages 137-141"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027855","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":"Concurrent antiandrogen therapy in the salvage radiotherapy setting for recurrent prostate cancer: a literature review","authors":"Dhiraj Mannar,&nbsp;Ryan Urban,&nbsp;Tina Zhang,&nbsp;Michael Peacock","doi":"10.1016/j.prnil.2024.11.001","DOIUrl":"10.1016/j.prnil.2024.11.001","url":null,"abstract":"<div><div>Radical prostatectomy is widely used to treat localized prostate cancer; however, 20%-50% of patients will experience disease progression despite surgical management. Management of these patients involves salvage radiotherapy (SRT), which has variable efficacy ranging from cure to disease progression in roughly 50% of cases with aggressive prognostic factors. Based on the success in combining antiandrogen therapy (AAT) with definitive radiotherapy for prostate cancer, it has been suggested that the addition of AAT may benefit patients receiving SRT. Here we review the literature surrounding the rationale for AAT in this setting and synthesize the results of several key trials assessing the benefits of AAT within the SRT setting.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 3","pages":"Pages 121-127"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027856","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":"Comparison of the efficacy and safety of holmium laser enucleation of the prostate and prostate artery embolization: Short-term follow-up results","authors":"Ei Chan Lim ,&nbsp;Hui Mo Gu ,&nbsp;Seong Hyeon Yu ,&nbsp;Do Gyeong Lim ,&nbsp;Ho Seok Chung ,&nbsp;Seung Il Jung ,&nbsp;Dongdeuk Kwon ,&nbsp;Yang Jun Kang ,&nbsp;Nam Yeol Yim ,&nbsp;Eu Chang Hwang","doi":"10.1016/j.prnil.2025.03.001","DOIUrl":"10.1016/j.prnil.2025.03.001","url":null,"abstract":"<div><h3>Purpose</h3><div>The treatment options for benign prostatic hyperplasia vary. Holmium laser enucleation of the prostate (HoLEP) and prostate artery embolization (PAE) have emerged as novel surgical treatments for benign prostatic hyperplasia. However, limited comparative evidence exists between these two techniques. Thus, we investigated their efficacy and adverse events with a short-term follow-up.</div></div><div><h3>Materials and methods</h3><div>This prospective study reviewed the medical records of 329 patients who underwent HoLEP (<em>n</em> = 249) or PAE (<em>n</em> = 80). The International Prostate Symptom Score (IPSS), IPSS Quality of Life (QoL), maximal flow rate (MFR), and post-void residual urine (PVR) were measured to assess efficacy. For adverse events, the International Index of Erectile Function-5 (IIEF-5), the Male Sexual Health Questionnaire (MSHQ)-Short Form, and procedure-related complications were evaluated. All variables were compared within and between the two treatments at baseline and 1 and 3 months after the procedure.</div></div><div><h3>Results</h3><div>A total of 108 patients were matched for each group and baseline characteristics were balanced between the groups. The IPSS, IPSS QoL, MFR, and PVR improved following each procedure. However, compared with PAE, HoLEP achieved greater improvements in the IPSS, IPSS QoL, MFR, and PVR from baseline to 3 months (all <em>P</em> &lt; 0.05). In terms of sexual function, PAE better preserved both erectile (<em>P</em> = 0.001) and ejaculatory (<em>P</em> = 0.001) function compared with HoLEP over the same period. The overall incidence of adverse events was higher with HoLEP (28.1%) than with PAE (10%) (relative risk 3.19; 95% confidence interval 1.61–6.34, <em>P</em> = 0.009). One case of penile glans necrosis, a unique adverse event, was observed following PAE.</div></div><div><h3>Conclusions</h3><div>In the short term, HoLEP and PAE can significantly improve lower urinary tract symptoms. However, compared with PAE, HoLEP provides superior efficacy yet is associated with less preservation of sexual function and a higher rate of adverse events.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 3","pages":"Pages 155-160"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027857","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":"Pelvic lymph node management in prostate cancer: a narrative review","authors":"Bryan Chong ,&nbsp;Vincent Khor ,&nbsp;Jing Xue Hoo ,&nbsp;Alvin Lee ,&nbsp;Yu Guang Tan ,&nbsp;Henry Ho ,&nbsp;Christopher Cheng ,&nbsp;Kae Jack Tay ,&nbsp;Jeffrey Tuan ,&nbsp;John Yuen ,&nbsp;Kenneth Chen","doi":"10.1016/j.prnil.2025.02.001","DOIUrl":"10.1016/j.prnil.2025.02.001","url":null,"abstract":"<div><div>Pelvic lymph node management plays an important role in the staging and treatment of early prostate cancer, especially for higher risk patients. This narrative review explores the current practices and emerging techniques, including advanced imaging, surgical techniques, and radiotherapeutic strategies. The introduction of prostate-specific membrane antigen (PSMA) positron emission tomography/ computed tomography (PET/CT) has revolutionized nodal staging, offering improved diagnostic accuracy compared to conventional imaging modalities. However, pelvic lymph node dissection (PLND) remains the gold standard, albeit with significant morbidity and uncertain survival benefits due to its invasive nature. Less invasive approaches, such as sentinel lymph node biopsy and radioguided surgery, are promising techniques which aim to reduce procedural morbidity, while maintaining a reasonable standard of staging accuracy. We also explored the role of extended lymph node dissection (ePLND), which suggests potential oncological benefits in selected patients. Additionally, advancements in radiation therapy, including whole-pelvic irradiation guided by predictive risk scores offer alternative modalities for managing node-positive disease. However, the current heterogeneity in clinical protocols and outcomes highlights the need for more standardization and robust comparative studies. This review highlights the evolving paradigm of pelvic lymph node management, advocating for personalized approaches that integrate molecular imaging and emerging technologies to optimize outcomes for prostate cancer patients.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 3","pages":"Pages 128-136"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027854","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":"Treatment outcomes with radium-223 in patients with metastatic castration-resistant prostate cancer with bone metastasis in real-world practice: a multiinstitutional study","authors":"Hiroyuki Kitano ,&nbsp;Kunihiro Hashimoto ,&nbsp;Yasuhisa Hasegawa ,&nbsp;Akira Fujita ,&nbsp;Shunsuke Shinmei ,&nbsp;Fumiaki Kirishima ,&nbsp;Satoshi Shirane ,&nbsp;Akihiro Asami ,&nbsp;Miki Naito ,&nbsp;Yuki Kohada ,&nbsp;Kohei Kobatake ,&nbsp;Yohei Sekino ,&nbsp;Masao Kato ,&nbsp;Yuichi Kadonishi ,&nbsp;Hideki Mochizuki ,&nbsp;Mitsuru Kajiwara ,&nbsp;Nobuyuki Hinata","doi":"10.1016/j.prnil.2025.03.004","DOIUrl":"10.1016/j.prnil.2025.03.004","url":null,"abstract":"<div><h3>Background</h3><div>Radium-223 (Ra-223) treatment is used to extend the overall survival (OS) of patients with metastatic castration-resistant prostate cancer (mCRPC) with bone metastases. However, the optimal timing for its administration remains ambiguous. Hence, this study aimed to determine the optimal timing for Ra-223 administration.</div></div><div><h3>Materials and methods</h3><div>We retrospectively included Japanese men with mCRPC with bone metastases who were treated with Ra-223. The primary endpoint was OS from Ra-223 treatment. Secondary endpoints included the maximum reduction in alkaline phosphatase (ALP), lactate dehydrogenase (LDH), and prostate-specific antigen (PSA) levels and the incidence of adverse events following Ra-223 treatment. The exploratory endpoint was the association between clinical parameters and OS.</div></div><div><h3>Results</h3><div>Overall, 100 men with mCRPC with bone metastasis treated with Ra-223 wereenrolled. The median OS from the Ra-223 treatment was 38.6 months. Post Ra-223 treatment, ALP, LDH, and PSA levels decreased in 78.6%, 56.1%, and 44.9% of patients, respectively. Grade ≥3 anemia occurred in three (4.1%) patients. The median OS of patients with ≥10 months from diagnosis to developing mCRPC (52.4 months, <em>P</em> &lt; 0.014), a PSA doubling time ≥3 months (52.4 months, <em>P</em> = 0.035), prior docetaxel (DOC) treatment (108.2 months, <em>P</em> = 0.002), five or less numbers of bone metastasis (97.9 months, <em>P</em> = 0.006), five or more cycles of Ra-223 treatment (46.1 months, <em>P</em> = 0.045), hemoglobin measuring ≥13.1 g/dl (52.4 months, <em>P</em> = 0.003), ALP measuring ≤260 (54.8 months, <em>P</em> = 0.003), or LDH measuring ≤220 (46.1 months, <em>P</em> = 0.002) was significantly longer than that of those who had &lt;10 months from diagnosis to developing mCRPC, a PSA doubling time &lt;3 months, absence of prior DOC treatment, more than five bone metastasis, less than four cycles of Ra-223 treatment, hemoglobin measuring &lt;13.1 g/dl, ALP measuring &gt;260, or LDH measuring &gt;220. Multivariate analysis showed that prior DOC administration prolonged the OS.</div></div><div><h3>Conclusions</h3><div>Ra-223 treatment is safe and effective for mCRPC.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 3","pages":"Pages 167-173"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027851","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":"Second primary cancer risk and survival in prostate cancer patients: A nationwide analysis","authors":"Jihye Hyun ,&nbsp;Jooyoung Lee ,&nbsp;Tuan Thanh Nguyen ,&nbsp;Se Young Choi","doi":"10.1016/j.prnil.2025.01.004","DOIUrl":"10.1016/j.prnil.2025.01.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Different treatments for prostate cancer (PC) could affect a patient’s risk of developing second primary cancers (SPCs). We assessed the incidence of SPC and overall survival (OS) after SPC diagnosis in patients with PC who underwent radical prostatectomy (RP) or radiation therapy (RT) as primary treatment.</div></div><div><h3>Methods</h3><div>Using the National Health Insurance Service database in South Korea, all male patients with PC between 2002 and 2018 were corrected for selection bias between the RT and RP groups by inverse probability of treatment weighting. The primary outcome was the incidence of SPC, and secondary outcome was OS after SPC diagnosis; cumulative incidence functions for competing risks of each SPC type were evaluated between the RP and RT groups. Cox regression analysis evaluated OS after SPC.</div></div><div><h3>Results</h3><div>Among 26,254 patients with PC, 20.3% and 79.7% were treated with RT and RP, respectively. Patients with PC had a 7% lower risk of all SPCs than the general male population [standardized incidence ratio (SIR) = 0.93]. Bladder (SIR = 1.65) and thyroid (SIR = 2.75) cancers were more common in both treatment groups. At 10-year follow-up, patients who underwent RP were less likely to have colon cancer than those who underwent RT [risk difference (%) = −0.9]. The former had a lower risk of death following lung (aHRs: 0.70; P = 0.010) and colon (aHRs: 0.53; P = 0.001) SPCs and a higher risk of death following esophageal SPC (aHRs: 6.9; P = 0.008).</div></div><div><h3>Conclusions</h3><div>SPC incidence and OS after SPC diagnosis may be influenced by the initial PC treatment. The choice of primary treatment for PC should guide the follow-up care and subsequent treatment strategies for SPCs.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 3","pages":"Pages 148-154"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027859","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 prevalence of dyslipidemia in patients with prostate cancer","authors":"Tae Hyung Kim,&nbsp;Do Gyeong Lim,&nbsp;Ho Seok Chung,&nbsp;Eu Chang Hwang,&nbsp;Taek Won Kang,&nbsp;Dong Deuk Kwon,&nbsp;Seung Il Jung","doi":"10.1016/j.prnil.2025.03.005","DOIUrl":"10.1016/j.prnil.2025.03.005","url":null,"abstract":"<div><h3>Background</h3><div>The treatment of dyslipidemia in prostate cancer has been associated with a reduced risk of cancer progression and improved survival outcomes. The aim of this study was to examine the prevalence of dyslipidemia in patients newly diagnosed with prostate cancer and to identify the risk factors for newly detected dyslipidemia.</div></div><div><h3>Methods</h3><div>This retrospective study assessed the prevalence of dyslipidemia in patients who were newly diagnosed with prostate cancer and treated between 2010 and 2022. Patients who did not undergo anticancer treatments (surgery, radiation therapy, or medical androgen deprivation therapy) were excluded. The prevalence of dyslipidemia was analyzed according to disease status (localized vs. metastatic prostate cancer) and the duration of medical androgen deprivation therapy (ADT). Additionally, risk factors for newly detected dyslipidemia were evaluated.</div></div><div><h3>Results</h3><div>Out of 1,700 patients with prostate cancer (1,367 localized and 333 metastatic), 470 patients (27.6%) had dyslipidemia. The prevalence of previously existing dyslipidemia at the time of prostate cancer diagnosis (165 patients, 12.1%; 47 patients, 14.1%) and newly diagnosed dyslipidemia following treatment (199 patients, 14.6%; 59 patients, 17.7%) did not differ significantly between the localized and metastatic prostate cancer groups (<em>P</em> = 0.149; <em>P</em> = 0.311). The incidence of newly detected dyslipidemia increased significantly with the duration of ADT (&lt;1 year, 14.3%; 1–2 years, 16.0%; &gt;2 years, 24.7%; <em>P</em> = 0.001). Multivariable analysis revealed that ADT lasting more than 2 years was the only independent risk factor for newly detected dyslipidemia (OR, 2.80; 95% CI, 1.72–4.53; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The study demonstrated that a longer duration of androgen deprivation therapy was associated with a higher prevalence of dyslipidemia. Understanding the relationship between dyslipidemia and prostate cancer may help improve the management and treatment outcomes for patients with prostate cancer.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 3","pages":"Pages 174-178"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027852","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":"Corrigendum to “Hematospermia does not increase the risk of prostate cancer detection in prostate biopsy” [Prostate Int 12 (2024) 151–154]","authors":"Jae Ryun Park ,&nbsp;Sung Hyun Paick ,&nbsp;Woo Suk Choi ,&nbsp;Aram Kim ,&nbsp;Hyeong Gon Kim ,&nbsp;Benjamin I. Chung ,&nbsp;Hyoung Keun Park","doi":"10.1016/j.prnil.2025.06.003","DOIUrl":"10.1016/j.prnil.2025.06.003","url":null,"abstract":"","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 3","pages":"Page 179"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027853","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":"Efficacy of tamsulosin 0.4 mg for the treatment in male with the international Prostate Symptom Score ≥ 20 compared with tamsulosin 0.2 mg","authors":"Yu Seob Shin ,&nbsp;Jae Heon Kim ,&nbsp;Zhao Luo ,&nbsp;Lin Chuan ,&nbsp;Sung Chul Kam","doi":"10.1016/j.prnil.2025.03.002","DOIUrl":"10.1016/j.prnil.2025.03.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Tamsulosin 0.2 mg is commonly used as the start dose for Asian benign prostatic hyperplasia (BPH) patients, while the 0.4 mg is recommended for Western countries. Recent studies reported that efficacy and safety of tamsulosin 0.4 mg is superior to that of tamsulosin 0.2 mg. However, there is a lack of evidence about the efficacy of tamsulosin 0.4 mg for a long time follow-up and focused on BPH patients who complained of severe International Prostate Symptom Scores (IPSSs). This study aimed to evaluate the efficacy of tamsulosin 0.4 mg compared with tamsulosin 0.2 mg in Korean BPH patients with severe IPSSs.</div></div><div><h3>Materials and methods</h3><div>We reviewed data from 13,115 men treated with tamsulosin for symptomatic lower urinary tract symptoms (LUTS) between January 2015 and June 2020. A total of 2,280 participants with a baseline total IPSS ≥20 who completed 4, 12, and 24-week follow-up IPSS and uroflowmetry (UFM) assessments without changing their initial tamsulosin dose were included. The participants were divided into two groups: Group 1 treated with tamsulosin 0.4 mg and Group 2 treated with tamsulosin 0.2 mg. The primary objective of the present study was to prove the superiority of tamsulosin 0.4 mg to 0.2 mg for improvement in total IPSS score and also prove it in IPSS subscores and UFM.</div></div><div><h3>Results</h3><div>Total IPSS for Group 1 (n = 984) had a significant decrease at four weeks compared with Group 2 (n = 1,296) (<em>P</em> = 0.027), and the obstructive subscore decreased more at 12 weeks in Group 1 than in Group 2 (<em>P</em> = 0.042). At four weeks, the maximum urinary flow rate (Qmax) significantly improved in Group 1 compared with Group 2 (<em>P</em> &lt; 0.011). However, there were no significant efficacy differences between the groups at 24 weeks.</div></div><div><h3>Conclusion</h3><div>This study demonstrates the potential superiority of tamsulosin 0.4 mg in improving IPSS and UFM parameters in Korean BPH patients with severe IPSS during the short-term follow-up. However, long-term efficacy requires further investigation.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 3","pages":"Pages 161-166"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027880","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}