Prostate International最新文献

{"title":"The “swipe” technique for prostatic urethral lift: a comparative analysis of 200 patients in a prospective cohort","authors":"Brian W.H. Siu,&nbsp;Crystal H.L. Chan,&nbsp;Ryan W.Y. Yuen,&nbsp;Justin Y.T. Leung,&nbsp;Jeremy M.H. Ho,&nbsp;Yvonne Y.Y. Chan,&nbsp;Athena Y.H. Lee,&nbsp;Janice H.C. Wong,&nbsp;Alex Q. Liu,&nbsp;Jeremy Y.C. Teoh,&nbsp;Peter K.F. Chiu,&nbsp;Chi Fai Ng,&nbsp;Ka Lun Lo","doi":"10.1016/j.prnil.2025.11.003","DOIUrl":"10.1016/j.prnil.2025.11.003","url":null,"abstract":"<div><h3>Background</h3><div>The prostatic urethral lift (PUL) procedure is an established minimally invasive surgical therapy for benign prostatic hyperplasia. However, clinical outcomes can be inconsistent, potentially due to variations in surgical technique. We introduce the “swipe technique”—a novel method employing an anterior-to-lateral swiping motion—designed to improve anterior channel patency. This study compares its outcomes to conventional PUL.</div></div><div><h3>Materials and methods</h3><div>In a prospective registry, 200 consecutive patients undergoing PUL were analyzed. Procedures performed before July 2024 utilized the conventional technique (<em>n</em>=108), while those from July 2024 onward employed the swipe technique (<em>n</em>=92). The primary outcome was the International Prostate Symptom Score (IPSS) at three months. Secondary outcomes included IPSS-Quality of Life (IPSS-QoL), maximum flow rate, recurrent retention, and 30-day readmissions.</div></div><div><h3>Results</h3><div>Baseline characteristics, including prostate volume, preoperative catheter dependence, and baseline IPSS, were comparable between groups. The swipe technique demonstrated superior three-month IPSS (6.1 vs. 7.9 points; <em>p</em>=0.017) and IPSS-QoL (2.3 vs. 2.6 points; <em>p</em>=0.006). Recurrent retention rates were significantly lower with the swipe technique (1.1% vs. 11.1%; <em>p</em>=0.004). Maximum flow rate and same-day catheter-free rates (over 80% in both groups) were comparable. No severe complications (Clavien–Dindo ≥ III) occurred in either group.</div></div><div><h3>Conclusion</h3><div>We reported a novel, effective, and reproducible technique for PUL, the swipe technique. The swipe technique showed better three-month IPSS, three-month IPSS-QoL, and recurrent retention rates than the conventional technique. Further research into the technical aspects of PUL is required to standardize the technique.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 1","pages":"Pages 68-74"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552248","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 paradigm shift in urology training: Laser endoscopic enucleation of the prostate may be easier than transurethral resection of the prostate in the learning curve of urology residents","authors":"Henri L. Morgan,&nbsp;Gabriel E. da Silva,&nbsp;Danilo C. Nagato,&nbsp;Oswaldo O. Neto,&nbsp;Ricardo H. Berjeaut,&nbsp;William C. Nahas,&nbsp;Alberto A. Antunes","doi":"10.1016/j.prnil.2025.12.001","DOIUrl":"10.1016/j.prnil.2025.12.001","url":null,"abstract":"<div><h3>Background</h3><div>Comparative studies on the training of endoscopic enucleation of the prostate (EEP) and transurethral resection of the prostate (TURP) are scarce. EEP’s challenging learning curve has limited its adoption to experienced urologists. Understanding its learning dynamics during residency is essential for optimizing training. This study compares the learning curves of EEP and TURP among urology residents.</div></div><div><h3>Materials and methods</h3><div>retrospective analysis of 129 benign prostatic hyperplasia patients who underwent TURP (<em>n</em> = 73) or EEP (<em>n</em> = 56, 34 thulium laser enucleation of the prostate and 22 holmium laser enucleation of the prostate) between May 2023 and June 2024 was conducted. All surgeries were performed under supervision by second-year urology residents with no prior experience in either procedure. Primary outcomes were resection speed (g/min) and resection ratio (%). Learning curves were assessed using cumulative summation analysis.</div></div><div><h3>Results</h3><div>EEP had a higher resection speed (0.47 vs. 0.32 g/min) and resection ratio (63% vs. 41%) than TURP. Proficiency was reached faster with EEP (5-7 cases) than with TURP (8-12 cases). Learning curves for EEP were more consistent, whereas TURP showed greater variability. Thulium laser enucleation of the prostate had shorter operative times than holmium laser enucleation of the prostate (91 vs. 140 min). There were no significant differences in complications or urinary incontinence. Limitations were the retrospective design, small number of cases per resident, and lack of detailed staff intervention data.</div></div><div><h3>Conclusions</h3><div>EEP is not more difficult to learn than TURP and may offer a more predictable learning curve. Findings support incorporating EEP into residency training programs, even for residents without TURP experience.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 1","pages":"Pages 81-88"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552135","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":"Advances in focal therapy for prostate cancer: current modalities, outcomes, and future directions","authors":"Rocio Roldan-Testillano ,&nbsp;Lara Rodriguez-Sanchez ,&nbsp;Claudia Covarrubias ,&nbsp;Francisco Durazo-Ruiz ,&nbsp;Adel Arezki ,&nbsp;Maurice Anidjar ,&nbsp;Rafael Sanchez-Salas","doi":"10.1016/j.prnil.2025.07.002","DOIUrl":"10.1016/j.prnil.2025.07.002","url":null,"abstract":"<div><div>Focal therapy (FT) has emerged as a promising treatment option for localized prostate cancer (PCa), offering oncologic control with reduced adverse effects compared to radical therapies. Various energy modalities, such as high-intensity focused ultrasound, cryotherapy, irreversible electroporation, and focal laser ablation, among others, selectively target malignant prostate tissue while sparing surrounding structures. Advances in imaging techniques, particularly multiparametric magnetic resonance imaging and prostate-specific membrane antigen-positron emission tomography/computed tomography, have improved lesion localization, patient selection, and treatment monitoring. The incorporation of artificial intelligence is enhancing tumor detection and predicting treatment outcomes. Although significant advancements have been made, challenges such as the lack of long-term data, treatment protocol standardization, and regulatory hurdles still limit widespread adoption. This review explores the current state of focal therapy for prostate cancer, highlighting its mechanisms, technological innovations, clinical outcomes, and future directions.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 1","pages":"Pages 1-9"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transperineal versus transrectal magnetic resonance imaging–fusion ultrasound-guided prostate biopsy: a comparative analysis of cancer detection in patients with prior negative transrectal ultrasound scan biopsy","authors":"Teerachai Singharat ,&nbsp;Winn Wisawasukmongchol ,&nbsp;Julin Opanurak ,&nbsp;Kaureuk Suksupha ,&nbsp;Supoj Ratchanon ,&nbsp;Pea pobpan ,&nbsp;Gantapong Sainont ,&nbsp;Kawintharat Harirugsakul ,&nbsp;Dutsadee Sowanthip","doi":"10.1016/j.prnil.2025.09.001","DOIUrl":"10.1016/j.prnil.2025.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>To compare and identify factors associated with prostate cancer detection between transperineal (TP) and transrectal (TR) magnetic resonance imaging (MRI)-fusion ultrasound-guided prostate biopsy in patients with a prior negative transrectal ultrasound scan (TRUS) biopsy.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 362 patients with a prior negative TRUS-guided biopsy who underwent MRI–ultrasound fusion-guided prostate biopsy at King Chulalongkorn Memorial Hospital between 2015 and 2024 were retrospectively screened. Nineteen were excluded because of insufficient clinical or imaging data. Patients were categorized into two groups: transrectal biopsy (n = 86) and transperineal biopsy (n = 257). Cancer-detection rates, baseline characteristics, MRI parameters, and perioperative complications were compared between the two cohorts.</div></div><div><h3>Results</h3><div>Baseline characteristics, including age, body mass index (BMI), total prostate-specific antigen (PSA), prostate volume, and PSA density, were generally comparable between the TP and TR biopsy groups, except for previous biopsy history and lesion size. The TP approach showed significantly higher detection rates for overall prostate cancer [57.2 % vs 40.7 %; odds ratio (OR): 1.95, 95 % confidence interval (CI): 1.19–3.20; <em>P</em> = 0.008) and clinically significant prostate cancer (csPCa) (38.1 % vs 25.6 %; OR: 1.79, 95 % CI: 1.04–3.10; <em>P</em> = 0.036). In csPCa cases, TP patients were older and had larger lesions compared to TR patients. Multivariate analysis identified older age, higher Prostate Imaging Reporting and Data System (PI-RADS) scores, advanced clinical stage, and TP biopsy as independent predictors of prostate cancer detection. Although perioperative complication rates were similar between groups, post-biopsy sepsis and rehospitalization occurred exclusively in the TR cohort (both <em>P</em> ≤ 0.002).</div></div><div><h3>Conclusion</h3><div>Transperineal biopsy is the preferred approach for patients with a prior negative TRUS biopsy. Cancer detection was correlated with the transperineal approach, higher PI-RADS scores, clinical staging, and older age.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 1","pages":"Pages 15-21"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552196","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":"Differential detection rates of clinically significant prostate cancer in transition zone versus peripheral zone lesions: Implications for transperineal magnetic resonance imaging-targeted biopsy strategy","authors":"Naoya Nagaya ,&nbsp;Tomoya Shirakawa ,&nbsp;Keiji Takahashi ,&nbsp;Tomoki Kimura ,&nbsp;Taiki Ogasa ,&nbsp;Masayoshi Nagata ,&nbsp;Hisamitsu Ide ,&nbsp;Shigeo Horie","doi":"10.1016/j.prnil.2025.09.005","DOIUrl":"10.1016/j.prnil.2025.09.005","url":null,"abstract":"<div><h3>Background</h3><div>The optimal approach for targeting lesions in the transition zone (TZ) versus the peripheral zone (PZ) during magnetic resonance imaging (MRI)-guided prostate biopsy remains unclear. This study investigated whether lesion location could predict the detection of clinically significant prostate cancer (csPCa) in MRI-targeted biopsies.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 338 consecutive patients who underwent MRI/ultrasound fusion-guided targeted biopsy from April 2023 to October 2024. All participants presented with PI-RADS 3–5 lesions and received both targeted and systematic transperineal biopsies. Lesions were categorized as “TZ-only” (restricted to the TZ) or “PZ-included” (involving the PZ). The primary endpoint was the identification of csPCa (Gleason score ≥3 + 4) in targeted biopsy samples. Multivariable logistic regression was used to assess independent predictors.</div></div><div><h3>Results</h3><div>Of the 338 patients, 173 (51.2%) had TZ-only lesions, while 165 (48.8%) had PZ-included lesions. The overall csPCa detection rate (positive findings in either targeted or systematic biopsy) was 52.4%, with targeted biopsy detecting csPCa in 40.8% of cases. Targeted biopsy positivity was significantly lower for TZ-only lesions compared to PZ-included lesions (27.2% vs. 55.2%, <em>P</em> &lt; 0.001), with the greatest disparity seen in PI-RADS 4 lesions (24.8% vs. 53.8%). TZ-only location was found to be an independent negative predictor in multivariable analysis (OR = 0.367; 95% CI, 0.207–0.650; <em>P</em> &lt; 0.001). PSA density (OR = 35.2, <em>P</em> = 0.002) and PI-RADS score (PI-RADS 4, OR = 5.49; PI-RADS 5, OR = 6.80, both <em>P</em> = 0.013) emerged as strong positive predictors.</div></div><div><h3>Conclusions</h3><div>MRI-targeted biopsy yielded significantly lower csPCa detection rates in TZ-only lesions compared to those involving the PZ, especially for PI-RADS 4 lesions. These results underscore the importance of individualized biopsy strategies that place greater emphasis on systematic sampling and clinical indicators for TZ lesions.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 1","pages":"Pages 41-47"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552160","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":"Irreversible electroporation for partial gland ablation: clinical application and outcomes","authors":"Jianliang Liu ,&nbsp;Sean Ong ,&nbsp;Dixon T.S. Woon ,&nbsp;Nathan Lawrentschuk","doi":"10.1016/j.prnil.2025.08.002","DOIUrl":"10.1016/j.prnil.2025.08.002","url":null,"abstract":"<div><div>Prostate cancer (PCa) is the second most commonly diagnosed malignancy in men. Radical treatments such as radical prostatectomy and radiotherapy can be associated with morbidity that impact quality of life. Focal therapy has emerged as a promising alternative to radical whole-gland treatment, with irreversible electroporation (IRE) being a novel nonthermal ablation technique. IRE involves the application of high-voltage, short-duration electrical pulses to induce apoptosis while preserving critical structures such as nerves and blood vessels. This targeted approach aims to minimize adverse effects associated with radical treatments while maintaining oncological efficacy. Despite promising early outcomes, international guidelines have not yet fully endorsed IRE for PCa due to a lack of long-term randomized data. Current evidence suggests that IRE is most suitable for localized low- to intermediate-risk PCa, offering a middle ground between active surveillance and radical treatment. Additionally, salvage IRE has demonstrated potential in managing radio-recurrent PCa, with studies such as the Irreversible Electroporation (IRE) for Prostate Tumour Tissue in patients with Prostate Cancer (FIRE) and SAlvage Focal Irreversible Electroporation-For Recurrent Localized Prostate Cancer (SAFE) trials reporting favorable oncological and functional outcomes. Imaging plays a crucial role in patient selection and treatment planning, with multiparametric magnetic resonance imaging and prostate-specific membrane antigen positron emission tomography being essential for disease localization. While prostate biopsy remains the gold standard for histological confirmation, the utility of tissue, urine, and serum biomarkers in focal therapy is still under investigation. Follow-up protocols for IRE are evolving, with consensus guidelines recommending prostate biopsy at one year, Prostate-specific antigen (PSA) monitoring, and serial multiparametric magnetic resonance imaging. Functional outcomes, including urinary and erectile function, require long-term assessment. While current studies suggest that IRE achieves high rates of local cancer control, out-of-field recurrence remains a concern. Further prospective trials are necessary to establish its role in the definitive management of PCa.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 1","pages":"Pages 10-14"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552163","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":"External validation of the cancer of the prostate risk assessment score to predict treatment failure after high-intensity focused ultrasound","authors":"Éder Silveira Brazão Jr. ,&nbsp;Victor Espinheira Santos ,&nbsp;Thiago Camelo Mourão ,&nbsp;Daniel Coser Gomes ,&nbsp;Jayme Quirino Caon Nobre ,&nbsp;Gustavo de Pádua Brazão ,&nbsp;Renato Almeida Rosa de Oliveira ,&nbsp;Cássia da Silva ,&nbsp;Walter Henriques da Costa ,&nbsp;Gustavo Cardoso Guimarães ,&nbsp;Stênio de Cássio Zequi","doi":"10.1016/j.prnil.2025.09.002","DOIUrl":"10.1016/j.prnil.2025.09.002","url":null,"abstract":"<div><h3>Background</h3><div>High-intensity focused ultrasound (HIFU) is an emerging treatment for localized prostate cancer, but prognostic tools validated in this setting are lacking. This study aimed to determine whether the Cancer of the Prostate Risk Assessment (CAPRA) score predicts biochemical recurrence (BR) and treatment failure (TF) after whole-gland HIFU.</div></div><div><h3>Materials and methods</h3><div>retrospective cohort of 208 patients treated with HIFU at a Brazilian tertiary center between 2011 and 2019 was selected for this study. Patients were stratified using the CAPRA score (range: 0–10; low: 0–2, intermediate: 3–5, and high: 6–10). BR was defined by the Phoenix criterion. TF included salvage treatment, metastasis, systemic therapy, or prostate cancer–specific death. Kaplan–Meier, Cox regression, and time-dependent receiver operating characteristic curve analyses assessed prognostic performance. Calibration was evaluated with bootstrapped Cox models at 5 years.</div></div><div><h3>Results</h3><div>At a median follow-up of 47 months, the CAPRA score predicted BR (hazard ratio: 1.36, 95% confidence interval: 1.20–1.55) and TF (hazard ratio: 1.49, 95% confidence interval: 1.29–1.72). Five-year BR-free survival was 81.5%, 50.7%, and 16.4% for low-, intermediate-, and high-risk groups, respectively. Areas under the curve for BR and TF at 60 months were 0.747 and 0.783, respectively. The CAPRA score stratified risk within D'Amico groups. Calibration was good for both outcomes. Limitations include retrospective design, single-center data, and the absence of systematic post-HIFU biopsy.</div></div><div><h3>Conclusions</h3><div>The CAPRA score is a valid predictor of oncological outcomes after HIFU and provides additional risk stratification beyond traditional systems. Its simplicity and accuracy support its integration into clinical decision-making for patients undergoing prostate ablation. Prospective multicenter studies are needed for broader validation.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 1","pages":"Pages 22-28"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552162","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":"Quality-of-life outcomes following Aquablation in men with poor initial quality of life: pooled analysis of five international studies","authors":"Mario Bitar ,&nbsp;Mohamad Berjaoui ,&nbsp;Naeem Bhojani ,&nbsp;Bilal Chughtai ,&nbsp;Kevin C. Zorn ,&nbsp;Dean Elterman","doi":"10.1016/j.prnil.2025.10.002","DOIUrl":"10.1016/j.prnil.2025.10.002","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aims to evaluate the relationship between specific baseline clinical factors and quality of life (QoL) outcomes at three months in men presenting with poor initial QoL.</div></div><div><h3>Methods</h3><div>This multinational study was conducted a retrospective analysis of international data from men with poor baseline QoL scores (4, 5, or 6) who underwent Aquablation for benign prostatic hyperplasia (BPH). The study involved 310 men with QoL ≤2 and 104 men with QoL &gt;2 at 3 months post-treatment. Baseline clinical characteristics were collected, including the International Prostate Symptom Score (IPSS) for storage and voiding, postvoid residual (PVR), Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD) and International Index of Erectile Function (IIEF-5) for sexually active men.</div></div><div><h3>Results</h3><div>The study involved 310 men with QoL ≤2 and 104 men with QoL &gt;2. The mean age for men with QoL ≤2 was 66.8 years (SD ± 7.5) and 68.3 years (SD ± 8.0) for those with QoL &gt;2. The mean prostate volume was 72.1 mL (SD ± 31.2) for the QoL ≤2 group and 68.4 mL (SD ± 28.0) for the QoL &gt;2 group. In the univariable logistic regression analysis, significant improvement in quality of life at 3 months was observed among patients with poor baseline QoL who had a high PVR volume (PVR &gt;100 mL; OR = 1.737, <em>P</em> = 0.018) and higher baseline erectile function scores (IIEF-5; OR = 1.075, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>In summary, this study adds to the growing evidence supporting Aquablation as an effective intervention for alleviating prostate symptoms and improving QoL in affected men with poor QoL.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 1","pages":"Pages 54-58"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552164","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":"AR-V7 expression in primary non-metastatic prostate cancer and its role in disease progression following initial therapy: a systematic review and meta-analysis","authors":"Marcelo Quintanilha ,&nbsp;Hilária Saugo Faria ,&nbsp;Henrique Leal de Oliveira ,&nbsp;Leo Meira Martins ,&nbsp;Ilma Simoni Brum","doi":"10.1016/j.prnil.2025.12.002","DOIUrl":"10.1016/j.prnil.2025.12.002","url":null,"abstract":"<div><h3>Background</h3><div>The prognostic role of androgen receptor variant 7 (AR-V7) in non-metastatic prostate cancer remains unclear. We conducted a systematic review and meta-analysis to evaluate its impact on primary treatment outcomes and disease progression.</div></div><div><h3>Methods</h3><div>We systematically searched PubMed, Embase, and Cochrane Central for observational studies and randomized controlled trials (RCTs) comparing AR-V7-positive and AR-V7-negative patients with non-metastatic prostate cancer. The primary outcomes were overall survival (OS) and biochemical recurrenc (BCR). Secondary outcomes, including progression-free survival (PFS), cancer-specific survival (CSS), and the incidence of castration-resistant prostate cancer (CRPC), were assessed as non-meta-analyzable endpoints. Hazard ratios (HRs) and risk ratios (RRs) with 95 % confidence intervals (CIs) were calculated using a random effects model. Statistical analyses were conducted in Review Manager software (version).</div></div><div><h3>Results</h3><div>Seven studies were included, comprising 1,383 patients. AR-V7 expression was associated with significantly worse OS (HR 5.75; 95 % CI 2.24–14.78; <em>P</em> &lt; 0.05) but showed no significant difference in BCR between groups (RR 4.81; 95 % CI 0.88–26.35; <em>P</em> = 0.07). Among the non-meta-analyzable secondary outcomes, individual studies suggested that AR-V7-positive patients had a higher risk of CRPC progression, shorter CSS, and reduced PFS compared to AR-V7-negative patients, but heterogeneity in study design and reporting precluded quantitative synthesis.</div></div><div><h3>Conclusion</h3><div>AR-V7 expression is a negative prognostic marker in non-metastatic prostate cancer, associated with significantly reduced OS and increased CRPC progression. While no significant difference was observed in BCR, the trend suggests potential implications for disease monitoring. Further studies with standardized detection methods are needed to clarify AR-V7's role in risk stratification and treatment decisions.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 1","pages":"Pages 89-96"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552238","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":"Irreversible electroporation for localized prostate cancer: risk-stratified oncologic outcomes and functional preservation","authors":"Zhi-Yu Xia ,&nbsp;Jia-Cheng Xiang ,&nbsp;Yu-Xuan Yang ,&nbsp;Fan Xiao,&nbsp;Jun Yang ,&nbsp;Shao-Gang Wang ,&nbsp;Qi-Dong Xia","doi":"10.1016/j.prnil.2025.09.004","DOIUrl":"10.1016/j.prnil.2025.09.004","url":null,"abstract":"<div><div>Prostate cancer (PCa) remains a leading cause of morbidity and mortality among men globally. Irreversible electroporation (IRE), a non-thermal ablation modality, selectively induces tumor cell apoptosis via high-voltage electrical pulses while sparing critical periprostatic structures. 10. (low-risk: 21, intermediate-risk: 21, and high-risk: 7). Serial assessments of PSA, MRI, urinary function (IPSS), and sexual outcomes (IIEF-5) were conducted at intervals of 3 to 6 months postoperatively. Median PSA nadir reached 1.69 ng/mL, with a cumulative clinically significant recurrence rate of 14.28% at a follow-up of up to months. PSA monitoring (&gt;4 ng/ml) demonstrated a true positive rate of 57.1% (4/7 cases) for detecting clinically significant recurrence. Notably, sensitivity for PSA&gt;10 ng/mL was limited to 28.6% (2/7 cases). Risk-stratified analysis revealed clinically significant recurrence rates of 4.8%, 19.0%, and 28.6% for low-risk, intermediate-risk, and high-risk cohorts, respectively. Postoperative complications included urinary incontinence (6.1%) and sexual dysfunction (4.1%), with no metastatic progression observed. These findings position IRE as a promising therapeutic strategy for localized PCa, offering favorable functional preservation and encouraging oncological control, particularly in low-to intermediate-risk patients. However, the elevated clinically significant recurrence rates observed in intermediate-high risk cohorts underscore two critical imperatives: first, the exploration of combined therapeutic regimens to mitigate recurrence risk, and second, establishing risk-stratified PSA thresholds and integrating advanced imaging biomarkers to enable dynamic postoperative surveillance.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"14 1","pages":"Pages 35-40"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552239","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}