Prostate International最新文献

{"title":"Predictors of false-positive results in men with Prostate Imaging–Reporting and Data System 4 lesions","authors":"Hee Youn Kim,&nbsp;Seung-Ju Lee,&nbsp;Jung Hoon Kim,&nbsp;Mahadevan Raj Rajasekaran","doi":"10.1016/j.prnil.2026.03.002","DOIUrl":"10.1016/j.prnil.2026.03.002","url":null,"abstract":"<div><h3>Background</h3><div>To identify predictive factors of false-positive results in men with Prostate Imaging–Reporting and Data System (PI-RADS) 4 lesions on multiparametric MRI and to evaluate potential factors for improving risk stratification in this high-risk category.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 811 men with PI-RADS 4 lesions who underwent prostate biopsy (November 2020–February 2025). Clinical data [age, PSA, PSA density (PSAD), prostate volume] and radiographic features {anatomical location [peripheral zone (PZ) vs. transitional zone (TZ)], multiplicity} were assessed. Multivariate logistic regression analysis identified independent predictors of false-positive results. Interaction between location and multiplicity was evaluated for zone-specific risk profiles.</div></div><div><h3>Results</h3><div>Of the 811 patients, 523 (64.5%) had benign pathology (false-positive). Independent predictors of false-positive results included younger age, lower PSAD, prior negative biopsy, and TZ location. TZ lesions had significantly higher odds of a false-positive result compared to PZ lesions (OR: 6.919, 95% CI: 4.440-10.781, <em>P</em> &lt; 0.001). A divergent pattern was observed between location and multiplicity: in the PZ, multiplicity did not affect cancer risk, whereas in the TZ, multiple lesions showed a trend toward benign pathology (<em>P</em> = 0.087), with the lowest predicted cancer probability (10.0%) in patients with multiple TZ lesions.</div></div><div><h3>Conclusion</h3><div>False-positive PI-RADS 4 assessments were associated with features characteristic of BPH, particularly TZ localization and lower PSAD. Current biopsy recommendations may be suboptimal for patients with these benign-favoring features. Incorporating lesion localization and volume-adjusted metrics into risk stratification could potentially reduce unnecessary biopsies.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 2","pages":"Pages 211-215"},"PeriodicalIF":4.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362079","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":"Seminal vesicle injury during radical prostatectomy does not affect the oncological outcome of prostate cancer patients","authors":"Viktoria Schütz,&nbsp;Alexandra Nieder,&nbsp;Ruth Himmelsbach,&nbsp;Albrecht Stenzinger,&nbsp;Constantin Schwab,&nbsp;Johannes Huber,&nbsp;Anette Duensing,&nbsp;Stefan Duensing,&nbsp;Markus Hohenfellner","doi":"10.1016/j.prnil.2026.02.005","DOIUrl":"10.1016/j.prnil.2026.02.005","url":null,"abstract":"<div><h3>Background</h3><div>Seminal vesicle invasion (SVI; stage T3b) in prostate cancer (PCa) patients is associated with a worse prognosis compared to extraprostatic tumor extension (pT3a). For reasons remaining largely unknown, patients with stage T3b have a higher risk of progression, metastatic dissemination, and death from PCa than patients stage pT3a. The seminal vesicles (SVs) have been shown to provide a favorable microenvironment for tumor progression. During radical prostatectomy (RP), injury to the SV leads to leakage of SV fluid, providing a potential breeding ground for PCa cells. To our knowledge, the effect of intraoperative SV injury on the oncological outcome has not been investigated. Herein, we report on oncological outcome in patients with and without documented intraoperative SV injury.</div></div><div><h3>Materials and methods</h3><div>A total of 1,139 consecutive PCa patients undergoing RP between 2005 and 2023 were included in this single-center study. The presence/absence of SV injury during RP was documented. SV injury was defined as any tear/incision of the SVs resulting in leakage of SV fluid. Clinical endpoints were progression-free survival (PFS; defined as biochemical recurrence-free survival) and cancer-specific survival.</div></div><div><h3>Results</h3><div>A total of 1,086 (95.4%) patients received robotic-assisted RP. 4.6% of patients underwent open (<em>n</em> = 48) or perineal (<em>n</em> = 5) RP. Intraoperative SV injury occurred in 358 patients (31.4%) while the SVs stayed intact in 781 patients (68.2%). Clinico-pathological characteristics did not significantly differ between the two patient groups, including the presence of histopathologically proven SVI. Over a follow-up period of &gt;10 years, no differences in PFS (<em>p</em> = 0.779) and cancer-specific survival (<em>P</em> = 0.364) were observed. There was also no difference in local recurrence between the two groups (<em>P</em> = 0.697). During follow-up, six patients (0.5%) died from PCa.</div></div><div><h3>Conclusions</h3><div>Intraoperative SV injury had no effect on the oncological outcome of PCa patients in our cohort; even when SVI, stage ≥ pT3a disease, and/or positive surgical margins were present.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 2","pages":"Pages 204-210"},"PeriodicalIF":4.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362086","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":"Clinical utility of the prostate health index density in patients with negative mpMRI or prior negative biopsy","authors":"Minoru Kobayashi,&nbsp;Naoya Okubo,&nbsp;Takao Kamai","doi":"10.1016/j.prnil.2026.01.001","DOIUrl":"10.1016/j.prnil.2026.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Multiparametric MRI (mpMRI) has improved prostate cancer (PCa) detection; however, false-negative rates remain non-negligible, particularly among men with PI-RADS 1–2 lesions or those with persistently elevated PSA after a prior negative biopsy (PNB). The Prostate Health Index (PHI) and its volume-adjusted derivative, PHI density (PHID), have emerged as promising biomarkers for addressing these diagnostic gaps. This study evaluated the diagnostic performance of PHI and PHID, and examined whether incorporating age enhances PHID-based risk stratification in patients with negative mpMRI or PNB.</div></div><div><h3>Methods</h3><div>This retrospective cohort included 261 men with PSA ≥4.0 ng/mL and either PI-RADS ≤2 mpMRI findings or PNB. Serum PSA, free PSA, and [−2]proPSA were measured, and PHI and PHID were calculated using standard formulas. All patients underwent transperineal biopsy within three months. Logistic regression and ROC analyses assessed predictors of clinically significant PCa. Age-stratified ROC analyses and bootstrap resampling (2,000 iterations) were performed to evaluate uncertainty in AUC and cutoff stability across the predefined age groups. Decision curve analysis (DCA) assessed clinical utility.</div></div><div><h3>Results</h3><div>Among 117 biopsied men, 42 (35.9 %) had csPCa; in the mpMRI-negative subgroup, 28.8 % harbored csPCa. PHID demonstrated the strongest discriminatory ability (AUC 0.754; cutoff 1.568), and remained an independent predictor in multivariate analysis (OR 5.21). Incorporating age improved diagnostic performance (AUC 0.796; <em>P</em> = 0.009). DCA demonstrated that PHID + Age yielded a consistently greater net benefit than PHID alone across clinically relevant threshold probabilities. Although age-stratified AUCs were comparable, bootstrap analyses revealed markedly wider cutoff variability in men &lt;65 years, indicating reduced threshold stability.</div></div><div><h3>Conclusions</h3><div>PHID is a robust marker for detecting csPCa in men with negative mpMRI or PNB, and age-adjusted PHID further improves diagnostic accuracy and clinical utility, although instability of cutoff values in younger men warrants caution.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 2","pages":"Pages 156-161"},"PeriodicalIF":4.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148361824","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":"Asia-Pacific collaborative consensus statements on water vapor thermal therapy (Rezūm) incorporating a systematic review, a two-round Delphi survey, and a consensus meeting","authors":"Brian Wai Hei Siu,&nbsp;Jeremy Man Hon Ho,&nbsp;Xeng Inn Fam,&nbsp;Yu-Chao Hsu,&nbsp;Min Gu Park,&nbsp;Jae Hyun Jung,&nbsp;Weida Lau,&nbsp;Adistra Satjakoesoemah,&nbsp;Teerapon Amornvesukit,&nbsp;Suntchai Wirotsaengthong,&nbsp;Angus Man Chung Chan,&nbsp;Varat Woranisarakul,&nbsp;Anand Dharaskar,&nbsp;C. Mallikarjuna,&nbsp;Chi Fai Ng,&nbsp;Ka Lun Lo","doi":"10.1016/j.prnil.2026.04.004","DOIUrl":"10.1016/j.prnil.2026.04.004","url":null,"abstract":"<div><h3>Background</h3><div>Water vapor thermal therapy (WVTT) is a minimally invasive surgical therapy (MIST) for benign prostatic hyperplasia (BPH). While its efficacy has been demonstrated, high-quality evidence concerning optimal patient selection and perioperative management is limited, leading to heterogeneous application. This is an Asia-Pacific (APAC) collaborative effort aiming to develop a consensus statement to standardize various aspects of WVTT therapy for clinical practice and to guide future research.</div></div><div><h3>Methods</h3><div>The consensus statement was developed using a modified Delphi method, consistent with previous urological consensus statements. First, a systematic review was performed to identify areas of uncertainty across the entire WVTT clinical pathway. Next, 150 urologists from the Asia-Pacific region with experience in WVTT were invited to complete a two-round online Delphi survey. Finally, a 13-member consensus panel meeting (each with ≥50 cases of experience) was held to review, discuss, and re-vote on statements without prior consensus. ‘Consensus agree’ was pre-defined as follow: ≥70% of participants scoring a statement 7-9 and ≤15% scoring it 1-3 (on a 9-point Likert scale).</div></div><div><h3>Results</h3><div>Based on the ‘uncertainties’ review of 197 studies, 92 statements were generated. Through two rounds of Delphi survey, consensus was reached on 74 statements. The consensus panel reached agreement on a further 10 out of 18 statements, resulting in 84 final statements. The statements provide guidance on six domains: case selection (e.g., feasibility in refractory retention and median lobes), preoperative preparation (e.g., management of antithrombotic medications), patient counseling, surgical procedure (e.g., anesthesia and injection strategies), postoperative management and follow-up (e.g., medication discontinuation), and data reporting and outcome measures.</div></div><div><h3>Conclusions</h3><div>Using a modified Delphi method, this APAC collaborative consensus provides comprehensive recommendations to standardize and optimize the use of WVTT. It aims to serve as a critical reference for clinicians and inform future research until more robust, long-term comparative evidence becomes available.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 2","pages":"Pages 173-190"},"PeriodicalIF":4.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148361772","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":"Active surveillance could apply to one-quarter of Korean prostate cancer cases: Insights from a 27,075-patient cohort","authors":"Young Hwii Ko,&nbsp;Sang Won Kim,&nbsp;Nak-Hoon Son","doi":"10.1016/j.prnil.2025.12.004","DOIUrl":"10.1016/j.prnil.2025.12.004","url":null,"abstract":"<div><h3>Background</h3><div>The aims of this study were to estimate an upper bound for the proportion of men newly diagnosed with prostate cancer in Korea who could be managed with active surveillance (AS) when favorable intermediate-risk disease is included and to describe variation in AS eligibility by calendar year, administrative district, and residential setting.</div></div><div><h3>Materials and methods</h3><div>We analyzed biopsy-confirmed prostate cancer diagnosed in 2010, 2012, 2014, 2016, 2018, and 2020 across 51 general hospitals nationwide. Risk was classified using routinely collected clinicopathologic variables (prostate-specific antigen, clinical T stage, Gleason grade group, and biopsy core involvement); AS eligibility was defined as the union of low risk, potentially low risk, and favorable intermediate risk. Group differences in proportions were evaluated using χ² tests; temporal trend was assessed using a Cochran–Armitage trend test. Primary analyses used complete cases.</div></div><div><h3>Results</h3><div>Among 27,075 men (37.9% of nationally reported cases in the indexed years), 1,476 (5.45%) were low risk, 1,082 (4.00%) potentially low risk, 4,028 (14.88%) favorable intermediate risk, 5,880 (21.72%) unfavorable intermediate risk, and 14,609 (53.94%) high risk. Overall, 6,586 (24.3%) were AS-eligible. By year, AS eligibility decreased from 27.6% (2010) to 22.0% (2020) (<em>p</em> &lt; 0.001). Across 17 districts, eligibility ranged from 16.9% (Chungbuk) to 29.3% (Gyeonggi) (<em>p</em> &lt; 0.001). Urban areas (dong) had higher eligibility than rural areas (eup/myeon): 26.4% versus 20.5% (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Approximately one-quarter of newly diagnosed men in Korea appear potentially eligible for AS under a maximized definition that includes favorable intermediate-risk disease. AS eligibility differed significantly by year, region, and residential setting.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 2","pages":"Pages 127-131"},"PeriodicalIF":4.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148361808","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":"Transrectal ultrasound–cystogram versus X-ray–cystogram versus no cystogram: high volume retrospective study","authors":"Helene Schuetz,&nbsp;Lukas Hohenhorst,&nbsp;Yamini Nagaraj,&nbsp;Markus Graefen,&nbsp;Pierre Tennstedt,&nbsp;Georg Salomon,&nbsp;Randi M. Pose","doi":"10.1016/j.prnil.2025.12.005","DOIUrl":"10.1016/j.prnil.2025.12.005","url":null,"abstract":"<div><h3>Background</h3><div>A comparison among X-ray-cystograms (CGs), TRUS-CGs, and no CG to determine the required indwelling time of urinary catheters after radical prostatectomy (RP).</div></div><div><h3>Material and methods</h3><div>We retrospectively analyzed patients who underwent robotic-assisted RP in our clinic from January 2018 to October 2022. A primary X-ray-CG was performed before the corona pandemic and a TRUS-CG was performed during the corona pandemic. The primary endpoint was the proportion of CGs needed and the proportion of catheter reinsertions.</div></div><div><h3>Results</h3><div>We identified 5,307 patients. Of those, 2,803 (52.8 %) did not initially receive a CG, 1643 (31 %) received an X-ray-CG and 861 (16.2 %) received a TRUS-CG. Patients who first had an X-ray-CG were most likely to receive repeated CGs (8.5 % vs. 6.7 % in TRUS patients vs. 0.2 % in patients without CG, <em>P</em> &lt; 0.001). TRUS-CG and X-ray patients had the shortest catheter dwell time [in median 5d vs. 5d (X-ray) vs. 10 d (no CG), <em>P</em> &lt; 0.001], whereas the rate of catheter reinsertion was higher in the TRUS-CG group [5.2 % vs. 4.2 % (X-ray) vs. 1.7 % (no CG), <em>P</em> &lt; 0.001]. There was no statistically significant difference in continence one year after RP between the groups (<em>P</em> = 0.6).</div><div>In regression models, only operation time [odds ratio (OR):1, <em>P</em> = 0.001] and TRUS-CG (OR: 1.28, <em>P</em> = 0.003) were independent risk factors for incontinence one year after RP and X-ray-CG (OR: 2.4, <em>P</em> &lt; 0.001), TRUS-CG (OR: 2.9, <em>P</em> &lt; 0.001) and operation time (OR: 0.99, <em>P</em> = 0.005) were independent risk factors for catheter reinsertion.</div></div><div><h3>Conclusion</h3><div>The non-X-ray based method (TRUS-CG) could be safely used to assess the adequacy of the anastomosis, although the catheter reinsertion rate was slightly higher.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 2","pages":"Pages 132-137"},"PeriodicalIF":4.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362037","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 proposal for integrating intraductal carcinoma of the prostate into pathological T substaging","authors":"Remi Semba,&nbsp;Katsunori Uchida,&nbsp;Takeshi Sasaki,&nbsp;Takahiro Inoue,&nbsp;Hiroshi Miyamoto","doi":"10.1016/j.prnil.2026.01.003","DOIUrl":"10.1016/j.prnil.2026.01.003","url":null,"abstract":"<div><h3>Background</h3><div>The present study aims primarily to determine how incorporation of intraductal carcinoma of the prostate (IDCP) detected in radical prostatectomy (RP) specimens into pathological T (pT) impacts patient outcomes.</div></div><div><h3>Methods</h3><div>The study included 1,190 patients who had undergone RP at Mie University Hospital (Tsu, Mie, Japan) from 2015 to 2023 (<em>n</em> = 470) and at the University of Rochester Medical Center (Rochester, NY, USA) from 2010 to 2011 (<em>n</em> = 720). The risks of biochemical recurrence (BCR) were compared in RP patients with or without IDCP according to the pT stage (i.e., pT2/IDCP+, pT2/IDCP-, pT3a/IDCP+, pT3a/IDCP-, pT3b/IDCP+, and pT3b/IDCP-).</div></div><div><h3>Results</h3><div>The prognosis of the pT2/IDCP group was significantly better than that of the other groups (<em>P</em> &lt; 0.001). Meanwhile, there was no statistically significant difference in BCR between pT2/IDCP+ and pT3a/IDCP- (<em>P</em> = 0.548). In pT3b patients, IDCP had no additional prognostic impact.</div></div><div><h3>Conclusions</h3><div>IDCP in pT2 and pT3a cases was strongly associated with the risk of BCR. In addition, the prognosis for pT2/IDCP + versus pT3a/IDCP- or pT3b/IDCP- versus pT3b/IDCP+ was comparable. These findings indicate that IDCP may confer a BCR risk comparable to that of extraprostatic extension in pT2 cases but its prognostic impact appears limited in pT3b disease.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 2","pages":"Pages 169-172"},"PeriodicalIF":4.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148361748","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":"Holmium laser enucleation of the prostate versus transurethral resection of the prostate for benign prostatic hyperplasia: evidence from a Korean retrospective analysis using the Common Data Model","authors":"Yunseo Lee,&nbsp;Changwon Lim,&nbsp;Kwanghyun Kim,&nbsp;Seungchol Park,&nbsp;Daesung Cho,&nbsp;Woong Bin Kim,&nbsp;Byeong Jin Kang,&nbsp;Se Young Choi","doi":"10.1016/j.prnil.2025.12.007","DOIUrl":"10.1016/j.prnil.2025.12.007","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to evaluate and compare the efficacy and safety of transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) for treating benign prostatic hyperplasia using standardized multicenter data.</div></div><div><h3>Materials and methods</h3><div>We retrospectively collected data from six Korean hospitals using the Common Data Model and performed a meta-analysis. Patients were categorized into TURP (control) and HoLEP (experimental) groups, and risk ratios were calculated to compare postoperative outcomes and complications. Sensitivity analyses were conducted by sequentially excluding each hospital’s data to assess the robustness of the findings.</div></div><div><h3>Results</h3><div>HoLEP was associated with significantly lower reoperation and transfusion rates, as well as reduced postoperative use of medications (including alpha-blockers and 5-alpha reductase inhibitors), compared to TURP. Conversely, beta-3 agonist usage was notably higher in the HoLEP group, suggesting the need for further investigation in this area. Sensitivity analyses confirmed that the overall results remained robust across individual hospital exclusions.</div></div><div><h3>Conclusions</h3><div>The meta-analysis demonstrates that HoLEP offers superior efficacy and safety over TURP for benign prostatic hyperplasia treatment, particularly by reducing reoperation and transfusion rates and lowering long-term medication dependency. These findings support the clinical adoption of HoLEP as a viable alternative to TURP, although the increased beta-3 agonist usage in the early postoperative period merits further study.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 2","pages":"Pages 144-150"},"PeriodicalIF":4.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362106","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":"Visceral and subcutaneous fat attenuation as prognostic indicators of survival in castration resistant prostate cancer","authors":"Ji Eun Heo,&nbsp;Hyun Ho Han,&nbsp;Won Sik Jang,&nbsp;Seung Hwan Lee,&nbsp;Won Sik Ham,&nbsp;Woong Kyu Han,&nbsp;Young Deuk Choi,&nbsp;Jongsoo Lee","doi":"10.1016/j.prnil.2026.01.002","DOIUrl":"10.1016/j.prnil.2026.01.002","url":null,"abstract":"<div><h3>Background</h3><div>While previous studies have examined the link between body fat mass and prognosis in patients with castration-resistant prostate cancer (CRPC), limited evidence exists regarding the prognostic role of specific fat characteristics. We aimed to analyze the relationship between body fat characteristics and cancer-specific survival (CSS) in patients newly diagnosed with CRPC.</div></div><div><h3>Methods</h3><div>Subcutaneous fat attenuation (SAT-HU) and visceral fat attenuation (VAT-HU) were quantified using Hounsfield units (HU) on computed tomography scans at the time of CRPC diagnosis. Average HU values were measured at the L3 vertebra. Patients were stratified into quartiles by SAT-HU and VAT-HU values, and survival outcomes were estimated for each subgroup.</div></div><div><h3>Results</h3><div>Among the 420 patients studied, 340 (81.0%) died from prostate cancer (PC), with a median CSS of 21 months. SAT-HU quartiles were as follows: Q1 (−121.2 to −108.2 HU), Q2 (−108.1 to −102.2 HU), Q3 (−102.1 to −96.0 HU), and Q4 (−95.9 to −52.6 HU). VAT-HU quartiles were as follows: Q1 (−112.6 to −100.9 HU), Q2 (−100.8 to −96.3 HU), Q3 (−96.2 to −89.8 HU), and Q4 (−89.7 to −57.2 HU). The proportion of patients receiving both androgen receptor pathway inhibitor and chemotherapy was the highest in Q1, while chemotherapy alone was the most common in Q4. Median CSS by quartile were Q1: 44, Q2: 24, Q3: 20, and Q4: 12 months for SAT-HU, and Q1: 39, Q2: 29, Q3: 19, and Q4: 13 months for VAT-HU (both <em>P</em> &lt; 0.001). Multivariate analysis showed that higher SAT-HU (hazard ratio [HR] 1.686, <em>P</em> = 0.004) and VAT-HU (HR 1.850, <em>P</em> &lt; 0.001) independently predicted poorer CSS.</div></div><div><h3>Conclusions</h3><div>Higher SAT-HU and VAT-HU were associated with worse CSS in patients with CRPC. These findings highlight the potential of fat tissue attenuation as a valuable imaging biomarker for prognosis in CRPC, warranting further studies into its clinical application.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 2","pages":"Pages 162-168"},"PeriodicalIF":4.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362099","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":"Irreversible electroporation in focal therapy for prostate cancer: current status and future directions","authors":"Francisco O. Durazo-Ruiz,&nbsp;Rocío Roldán-Testillano,&nbsp;Lara Rodriguez-Sanchez,&nbsp;M. Pilar Laguna,&nbsp;Liam N. Mendez-Bisgaard,&nbsp;Adel Arezki,&nbsp;Hussein Elkhatib,&nbsp;Alejandro Hevia-Feliu,&nbsp;Kai Zhang,&nbsp;Jonathan Fainberg,&nbsp;Nathan Perlis,&nbsp;Jean de la Rosette,&nbsp;Bernardino Miñana-López,&nbsp;Theo M. de Reijke,&nbsp;Maurice Anidjar,&nbsp;Mark Emberton,&nbsp;Phillip D. Stricker,&nbsp;Rafael Sanchez-Salas","doi":"10.1016/j.prnil.2025.11.001","DOIUrl":"10.1016/j.prnil.2025.11.001","url":null,"abstract":"<div><div>The treatment of prostate cancer (PCa) requires approaches that eliminate malignant tissue while preserving essential urinary and sexual functions. Irreversible electroporation (IRE) represents a targeted ablative strategy that disrupts cellular membrane integrity through precise electrical pulses, demonstrating the capacity to ablate cancerous foci while sparing adjacent neurovascular bundles and sphincter mechanisms. This structured review examines the mechanistic foundations of IRE technology, evaluates current clinical evidence regarding safety and efficacy, and explores promising applications that may redefine precision urologic care. Existing clinical studies demonstrate encouraging oncological control rates with superior preservation of continence and erectile function compared to whole-gland treatments, though patient selection criteria and long-term durability remain areas requiring further investigation. Emerging applications include salvage therapy following radiation failure, integration with advanced multiparametric imaging for precision targeting, and combination strategies with systemic therapies. The regulatory approval status and economic implications of IRE implementation vary significantly across healthcare systems, creating disparities in patient access and adoption of this technology that must be addressed to ensure equitable availability of focal ablation options. As the technology matures, establishing standardized treatment protocols, refining patient selection algorithms, and conducting robust comparative effectiveness studies will be essential to define the optimal role of IRE within prostate cancer management.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 2","pages":"Pages 116-126"},"PeriodicalIF":4.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362066","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}