Prostate International最新文献

{"title":"Risks and side effects in the medical management of benign prostatic hyperplasia","authors":"Abdulghafour Halawani ,&nbsp;Ryan Paterson ,&nbsp;Tianshuang Zhong ,&nbsp;Katie Du ,&nbsp;Runhan Ren ,&nbsp;Connor M. Forbes","doi":"10.1016/j.prnil.2023.11.004","DOIUrl":"10.1016/j.prnil.2023.11.004","url":null,"abstract":"<div><p>Benign prostatic hyperplasia affects up to 80% of men in their lifetime. It causes bladder outflow obstruction, leading to lower urinary tract symptoms, which can have a large impact on quality of life. Lifestyle modifications and pharmacotherapy are often offered as first-line treatments for patients. These include alpha blockers, 5-alpha-reductase inhibitors, phosphodiesterase-5 inhibitors, anticholinergics, B3-agonists, and desmopressin. While often well tolerated, these pharmacotherapies do have significant side effects, which both clinicians and patients should understand and discuss in order to make an informed treatment decision among alternatives. The purpose of this review is to provide a current overview of the risks and side effects of commonly used medications in benign prostatic hyperplasia management.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000612/pdfft?md5=c109359cfa332b99fd9e90dc0c24fee7&pid=1-s2.0-S2287888223000612-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138519701","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":"Does androgenic alopecia aggravate the risk of prostate cancer? Evidence from Mendelian randomization","authors":"Xianghua Shi ,&nbsp;Yuan Pan ,&nbsp;Jianhua Liu ,&nbsp;Fei Luo ,&nbsp;Binbin Li ,&nbsp;Yuan Hu ,&nbsp;Kai Chen","doi":"10.1016/j.prnil.2024.04.001","DOIUrl":"10.1016/j.prnil.2024.04.001","url":null,"abstract":"<div><h3>Background</h3><p>Epidemiological reports indicate a potential association between androgenic alopecia (AGA) and increased prostate cancer (PC) prevalence, but conflicting reports also exist. This study aims to elucidate the causality of AGA on PC risk using Mendelian randomization (MR) analysis.</p></div><div><h3>Materials and methods</h3><p>Two-sample MR analyses utilized public genome-wide association studies summary data for single-nucleotide polymorphisms associated with AGA. Four statistical methods were used: inverse variance weighted (IVW), MR-Egger, weighted median, and weighted mode, with IVW as the preliminary estimation method. Additionally, sensitivity analyses were conducted to address pleiotropic bias.</p></div><div><h3>Results</h3><p>Genetically proxied AGA did not demonstrate a causal effect on PC risk (IVW <em>P</em> &gt; 0.05). Consistently, complementary methods yielded results aligned with IVW.</p></div><div><h3>Conclusions</h3><p>Our MR analysis indicates no causal relationship between genetically predicted AGA and PC risk, suggesting that observed associations in epidemiological studies may not be causal.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888224000266/pdfft?md5=4a15fc861ca5748549ec52b1499355f2&pid=1-s2.0-S2287888224000266-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140769253","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":"Surgical management of post prostatectomy incontinence","authors":"Natalija Kovacevic ,&nbsp;Priya Padmanabhan","doi":"10.1016/j.prnil.2024.04.005","DOIUrl":"10.1016/j.prnil.2024.04.005","url":null,"abstract":"<div><p>Post prostatectomy incontinence (PPI) is a well-recognized and bothersome complication following radical prostatectomy. Conservative measures such as pelvic floor physical therapy, biofeedback, and medication are first line management of PPI. When first line therapies fail, patients are offered a variety of surgical procedures based on the degree of incontinence, prior radiation therapy, and comorbidities. Among the various surgical options, placement of an artificial urinary sphincter (AUS) is the gold standard for PPI. However, AUS placement has a high rate of re-operation and requires good manual dexterity. In cases of mild-moderate incontinence, especially in patients without prior radiation therapy, male slings and proACT are a less invasive option. Bulking therapy, although highly successful for female stress urinary incontinence (SUI), is not currently advised in the treatment of male SUI. Regardless of surgical approach used to treat PPI, providers should counsel patients regarding risks of re-operation and have an open an honest discussion regarding the degree of continence that can be restored following each procedure.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888224000308/pdfft?md5=a99f484226677a2ba056a56c679aba13&pid=1-s2.0-S2287888224000308-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141063315","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":"Exploring the potential of ex-vivo 7-T magnetic resonance imaging on patients with clinically significant prostate cancer: visibility and size perspective","authors":"Hyungwoo Ahn ,&nbsp;Jung Kwon Kim ,&nbsp;Sung Il Hwang ,&nbsp;Sung Kyu Hong ,&nbsp;Seok-Soo Byun ,&nbsp;Sang Hun Song ,&nbsp;Gheeyoung Choe ,&nbsp;Hye Mi Jee ,&nbsp;Sung Woo Park","doi":"10.1016/j.prnil.2024.02.001","DOIUrl":"10.1016/j.prnil.2024.02.001","url":null,"abstract":"<div><h3>Background</h3><p>Despite progress in multiparametric magnetic resonance imaging (MRI), issues of prostate cancer invisibility and underestimated tumor burden persist. This study investigates the potential of an ultra-high field MRI at 7-T in an <em>ex-vivo</em> setting to address these limitations.</p></div><div><h3>Methods</h3><p>This prospective study included 54 tumors from 20 treatment-naïve clinically significant prostate cancer patients, confirmed by biopsy, despite negative findings on preoperative 3-T MRI. <em>Ex-vivo</em> 7-T MRI of resected prostates was performed, with assessment on tumor visibility and size. Factors influencing visibility were analyzed using logistic regression analyses.</p></div><div><h3>Results</h3><p>Tumor visibility was confirmed in 80% of patients, and 48% of all tumors on <em>ex-vivo</em> imaging. Gleason pattern 4 percentage (odds ratio 1.09) and tumor size on pathology (odds ratio 1.36) were significantly associated with visibility (<em>P</em> &lt; 0.05). Mean MRI-visible and invisible tumor sizes were 10.5 mm and 5.3 mm, respectively. The size discrepancy between MRI and pathology was 2.7 mm.</p></div><div><h3>Conclusion</h3><p>Tumor visibility on <em>ex-vivo</em> 7-T MRI was influenced by tumor grade and size. The notable tumor visibility initially overlooked on 3-T MRI, along with small size discrepancy with pathology, suggests potential improvements in resolution.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888224000035/pdfft?md5=2c4731d30af6ea08beaf886d312b2a36&pid=1-s2.0-S2287888224000035-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139951976","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":"Effects of bladder neck sparing on continence outcomes of robotic-assisted radical prostatectomy: a systemic review and metaanalysis","authors":"Joongwon Choi, Yun-Jung Yang, Chung Un Lee, Jung Hoon Kim, Jin Wook Kim, Jong Hyun Tae, Se Young Choi, In Ho Chang, Eun-Jung Yang, Yong Seong Lee","doi":"10.1016/j.prnil.2024.04.004","DOIUrl":"https://doi.org/10.1016/j.prnil.2024.04.004","url":null,"abstract":"Restoration of postoperative urinary continence after robot-assisted radical prostatectomy (RARP) is affected by diverse factors. We compared the pad-free and positive margin rates of patients who underwent RARP with or without bladder neck sparing (BNS) for prostate cancer. During this systematic review and metaanalysis, we performed an electronic search of the Web of Science, Embase, Cochrane Central Register of Controlled Trials, and PubMed to find original articles comparing RARP with and without BNS for prostate cancer. We identified six studies (2,351 patients in total) who underwent RARP with or without BNS. A metaanalysis of the pad-free rate at 3 months was performed. The overall pad-free rate at 3 months for patients who underwent RARP with BNS was significantly higher than that of patients who underwent RARP alone (control group) (odds ratio, 1.86; 95% confidence interval [CI], 1.22–2.82), with high heterogeneity ( = 0.005; I = 67.45%). The pad-free rates at 7 days, 6 months, and 1 year and positive surgical margin rates of patients who underwent BNS were not significantly different than those in the control group. Although no statistical difference was observed, the catheterization period of the BNS group was shorter than that of the control group (standardized mean difference = −0.08; 95% CI, −0.16 to 0.01). Although RARP with BNS did not affect the long-term outcome of continence, it had a significant effect on the early recovery of continence.","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141063324","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 Comparison of Surgical Outcomes between Outpatient and Inpatient Robot-Assisted Radical Prostatectomy: A Systematic Review and Meta-Analysis","authors":"T. Nguyen, Muhammed A. Moukhtar Hammad, Ryan W. Dobbs, H. Vuong, Jacob Basilius, Khoa Quy, Hanh Thi Tuyet Ngo, An Nguyen, Thi Tuyet Mai Tran, Narmina Khanmammadova, Trinh Ngoc Khanh Van, S. Ali, Ho Yee Tiong, Se Young Choi, Mohammed Shahait, David I. Lee","doi":"10.1016/j.prnil.2024.04.003","DOIUrl":"https://doi.org/10.1016/j.prnil.2024.04.003","url":null,"abstract":"","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140781331","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":"Prostate cancer nomograms and their application in Asian men: a review","authors":"Sridhar Panaiyadiyan,&nbsp;Rajeev Kumar","doi":"10.1016/j.prnil.2023.07.004","DOIUrl":"10.1016/j.prnil.2023.07.004","url":null,"abstract":"<div><p>Nomograms help to predict outcomes in individual patients rather than whole populations and are an important part of evaluation and treatment decision making. Various nomograms have been developed in malignancies to predict and prognosticate clinical outcomes such as severity of disease, overall survival, and recurrence-free survival. In prostate cancer, nomograms were developed for determining need for biopsy, disease course, need for adjuvant therapy, and outcomes. Most of these predictive nomograms were based on Caucasian populations. Prostate cancer is significantly affected by race, and Asian men have a significantly different racial and genetic susceptibility compared to Caucasians, raising the concern in generalizability of these nomograms. We reviewed the existing literature for nomograms in prostate cancer and their application in Asian men. There are very few studies that have evaluated the applicability and validity of the existing nomograms in these men. Most have found significant differences in the performance in this population. Thus, more studies evaluating the existing nomograms in Asian men or suggesting modifications for this population are required.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000375/pdfft?md5=02a4aeda1182a32fdf578fb64dd725b5&pid=1-s2.0-S2287888223000375-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48246419","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":"High-power holmium laser versus thulium fiber laser for endoscopic enucleation of the prostate in patients with glands larger than 80 ml: Results from the Prostate Endoscopic EnucLeation study group","authors":"Ee Jean Lim ,&nbsp;Daniele Castellani ,&nbsp;Bhaskar K. Somani ,&nbsp;Mehmet I. Gökce ,&nbsp;Khi Yung Fong ,&nbsp;Fernando G. Sancha ,&nbsp;Thomas R.W. Herrmann ,&nbsp;Sarvajit Biligere ,&nbsp;Azimdjon N. Tursunkulov ,&nbsp;Marco Dellabella ,&nbsp;Mario Sofer ,&nbsp;Dmitry Enikeev ,&nbsp;Vladislav Petov ,&nbsp;Nariman Gadzhiev ,&nbsp;Dean Elterman ,&nbsp;Abhay Mahajan ,&nbsp;Moises R. Socarras ,&nbsp;Dilmurod S. Yunusov ,&nbsp;Furkat Nasirov ,&nbsp;Jeremy Y.C. Teoh ,&nbsp;Vineet Gauhar","doi":"10.1016/j.prnil.2023.12.001","DOIUrl":"10.1016/j.prnil.2023.12.001","url":null,"abstract":"<div><h3>Background</h3><p>Endoscopic enucleation of the prostate (EEP) has gained acceptance as an equitable alternative to transurethral resection of the prostate for benign prostate hyperplasia (BPH). Our primary aim is to compare peri-operative outcomes of EEP using thulium fiber laser (TFL) against high-power holmium laser (HPHL) in hands of experienced surgeons for large prostates (≥80 ml in volume). Secondary outcomes were assess complications within 1 year of follow up.</p></div><div><h3>Materials and Methods</h3><p>We retrospectively reviewed patients with benign prostatic hyperplasia who underwent EEP with TFL or HPHL in 13 centers (January 2019-January 2023). Patients with prostate volume ≥80 ml were included, while those with concomitant prostate cancer, previous prostate/urethral surgery, and pelvic radiotherapy were excluded.</p></div><div><h3>Results</h3><p>Of 1,929 included patients, HPHL was utilized in 1,459 and TFL in 470. After propensity score matching (PSM) for baseline characteristics, 247 patients from each group were analyzed. Overall operative time (90 [70, 120] vs. 52.5 [39, 93] min, <em>P</em> &lt; 0.001) and enucleation time (90 [70, 105] vs. 38 [25, 70] min, <em>P</em> &lt; 0.001) were longer in the TFL group, with comparable morcellation time (13 [10, 19.5] vs. 13 [10, 16.5] min, <em>P</em> = 0.914). In terms of postoperative outcomes, there were no differences in 30-day complications such as acute urinary retention, urinary tract infection or sepsis. In the PSM cohort, univariable analyses showed that higher age, lower preoperative Qmax, higher preoperative PVRU, and longer operation time were associated with higher odds of postoperative incontinence, while 2-lobe enucleation had lower odds of incontinence compared to 3-lobe enucleation.</p></div><div><h3>Conclusions</h3><p>This real-world study reaffirms that HPHL and TFL in large prostates are equally efficacious in terms of 30-day complications. TFL with the en-bloc technique has a shorter operative time which significantly improves short- and medium-term functional outcomes.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000727/pdfft?md5=1212268e327c25ef1c3e88bb75013194&pid=1-s2.0-S2287888223000727-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138682502","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":"Real-world effects of novel androgen receptor axis-targeted agents on oncological outcomes in non-metastatic castration-resistant prostate cancer: A multi-institutional retrospective study","authors":"Naoki Fujita ,&nbsp;Shingo Hatakeyama ,&nbsp;Ryuji Tabata ,&nbsp;Kazutaka Okita ,&nbsp;Koichi Kido ,&nbsp;Itsuto Hamano ,&nbsp;Toshikazu Tanaka ,&nbsp;Daisuke Noro ,&nbsp;Noriko Tokui ,&nbsp;Yuichiro Suzuki ,&nbsp;Takahiro Yoneyama ,&nbsp;Yasuhiro Hashimoto ,&nbsp;Satoshi Sato ,&nbsp;Chikara Ohyama","doi":"10.1016/j.prnil.2023.12.002","DOIUrl":"10.1016/j.prnil.2023.12.002","url":null,"abstract":"<div><h3>Background</h3><p>The benefits of novel androgen receptor axis-targeted agents (ARATs) on oncological outcomes in patients with non-metastatic castration-resistant prostate cancer (nmCRPC) in real-world settings are unclear.</p></div><div><h3>Methods</h3><p>This multi-institutional retrospective study included 178 patients with nmCRPC treated between September 2003 and August 2022. Patients were divided into two groups: those who were treated with any novel ARATs, including apalutamide, enzalutamide, darolutamide, and abiraterone acetate, during any line of nmCRPC treatment (novel ARATs group) and those who were not (control group). Multivariable Cox proportional hazards regression analyses were performed to evaluate the effects of novel ARATs on metastasis-free survival (MFS) and overall survival (OS).</p></div><div><h3>Results</h3><p>The median age and follow-up period after nmCRPC diagnosis were 76 years and 37 months, respectively. Of the 178 patients, 122 (69%) were treated with novel ARATs after nmCRPC diagnosis. The MFS and OS in the novel ARATs group were significantly longer than those in the control group (<em>P</em> &lt; 0.001 and <em>P</em> = 0.020, respectively). In multivariable analyses, a prostate-specific antigen doubling time (PSADT) of &lt;3 months and novel ARATs were independently and significantly associated with MFS and OS. The effects of novel ARATs on MFS were consistently observed across subgroups stratified by age (&lt;75 years or ≥75 years), history of radical treatment (no or yes), biopsy Gleason score (&lt;9 or ≥9), clinical stage (≤cT3 and cN0, or cT4 or cN1), and PSADT (≥3 months or &lt;3 months).</p></div><div><h3>Conclusion</h3><p>Novel ARATs were significantly associated with improved oncological outcomes in patients with nmCRPC in a real-world setting, regardless of tumor aggressiveness.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000739/pdfft?md5=0a0bcbba166502965eec4a1c704f4629&pid=1-s2.0-S2287888223000739-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138741266","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":"Real-world prostate-specific antigen reduction and survival outcomes of metastatic hormone-sensitive prostate cancer patients treated with apalutamide: An observational, retrospective, and multicentre study","authors":"Alicia López-Abad ,&nbsp;Miguel Ramírez Backhaus ,&nbsp;Gerardo Server Gómez ,&nbsp;Enrique Cao Avellaneda ,&nbsp;Cristóbal Moreno Alarcón ,&nbsp;Pedro López Cubillana ,&nbsp;Pablo Yago Giménez ,&nbsp;Pedro de Pablos Rodríguez ,&nbsp;María J. Juan Fita ,&nbsp;Miguel Á. Climent Durán ,&nbsp;Iris Guardiola Ruiz ,&nbsp;Natalia Vidal Crespo ,&nbsp;Miriam Artés Artés ,&nbsp;Raúl Montoya Chinchilla ,&nbsp;Juan Moreno Avilés ,&nbsp;Pablo L. Guzmán Martínez-Valls ,&nbsp;Pedro Á. López González","doi":"10.1016/j.prnil.2023.10.003","DOIUrl":"10.1016/j.prnil.2023.10.003","url":null,"abstract":"<div><h3>Background</h3><p>Metastatic hormone-sensitive prostate cancer (mHSPC) treatment has changed drastically during the last years with the emergence of androgen receptor–targeted agents (ARTAs). ARTA combined with androgen deprivation therapy has demonstrated better oncological and survival outcomes in these patients. However, the optimal choice among different ARTAs remains uncertain due to their analogous efficacy.</p></div><div><h3>Objectives</h3><p>The objective of this study was to describe prostate-specific antigen (PSA) response and oncological outcomes of patients with mHSPC treated with apalutamide.</p></div><div><h3>Material and methods</h3><p>Medical records from three different hospitals in Spain were used to conduct this study. Patients diagnosed with mHSPC and under apalutamide treatment were included between March 2021 and January 2023. Data regarding PSA response, overall survival (OS), and radiographic progression-free survival (rPFS) were collected and stratified by metastasis volume, timing, and stating.</p></div><div><h3>Results</h3><p>193 patients were included; 34.2% of patients were <em>de novo</em> mHSPC, and the majority was classified as m1b. The 18-month OS and rPFS were 92.5% and 88.9%, respectively. Patients with PSA levels ≤0.2 ng/ml showcased an 18-month OS rate of 98.7%, contrasting with 65.3% for those with PSA &gt;0.2 ng/ml. Similar trends emerged for rPFS (97.4% and 53.7%, respectively). When differentiating between low-volume and high-volume metastasis, the OS rate stood at 98.4% and 80.7%, respectively, while the rPFS rates were 93% and 81.6%, respectively. No significant differences were found between groups stratified by metastasis timing.</p></div><div><h3>Conclusion</h3><p>This real-world study on patients with mHSPC treated with apalutamide plus androgen deprivation therapy revealed robust oncological outcomes, aligning with the emerging evidence. The study's hallmark finding highlights the significance of rapid and deep PSA response as a predictor of improved oncological and survival outcomes.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000570/pdfft?md5=ada34f362fcc9053e1cf3239f1d9bda9&pid=1-s2.0-S2287888223000570-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135371966","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}