Prostate International最新文献

{"title":"Cervi Parvum Cornu complex for men with lower urinary tract symptoms: a multicenter, randomized, double-blind, placebo-controlled trial","authors":"Dongho Shin ,&nbsp;Byung Il Yoon ,&nbsp;Soomin Kim ,&nbsp;JunJie Piao ,&nbsp;Kyung-Hwa Jeon ,&nbsp;Youngjoo Kwon ,&nbsp;Sang-Hyuck Park ,&nbsp;Young Tae Koo ,&nbsp;Jin-Soo Kim ,&nbsp;Dong Sup Lee ,&nbsp;U-Syn Ha ,&nbsp;Sae Woong Kim ,&nbsp;Hoon Jang ,&nbsp;Woong Jin Bae","doi":"10.1016/j.prnil.2023.09.002","DOIUrl":"10.1016/j.prnil.2023.09.002","url":null,"abstract":"<div><h3>Background</h3><p>To evaluate the efficacy and safety of <em>Cervi Parvum Cornu</em>, Angelicae Gigantis Radix and Glycyrrhizae Radix complex (CAG) in men with moderate lower urinary tract symptoms (LUTS).</p></div><div><h3>Materials and methods</h3><p>From November 2020 to January 2022, participants with International Prostate Symptom Score (IPSS) of 12–19 in two centers were recruited and randomize into three groups: a CAG 500 mg/day group (CAG 500), a CAG 1000 mg/day group (CAG 1000), and a placebo group (PG). They were treated for 12 weeks. The primary endpoint was change of IPSS at the end of study from baseline. Secondary end points included change of prostate specific antigen (PSA), testosterone, dihydrotestosterone (DHT), maximum urinary flow rate (Q max), post-void residual volume (PVR), International Index of Erectile Function (IIEF), and drug safety.</p></div><div><h3>Results</h3><p>A total of 103 patients were able to finish the study according to the study protocol. Total IPSS and sub-scores (residual urine sensation, frequency, weak stream, hesistancy, nocturia, and quality of life) in CAG 500 and CAG 1000 were significantly improved at the 12^th week compared to those of the PG. Changes of serum PSA, DHT, and testosterone levels at the 12^th week from baseline did not show significant differences among the three groups. Q max and PVR changes did not show significant differences among the three groups either. Total IIEF and sub-scores (erectile function, orgasmic function, sexual desire, intercourse satisfaction) in CAG 1000 were significantly improved at 12^th week compared to those in PG. No significant adverse events were found.</p></div><div><h3>Conclusions</h3><p>CAG is well tolerated in patients with moderate LUTS. Treatment with CAG for 12 weeks has a therapeutic effect on moderate LUTS.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"11 4","pages":"Pages 222-227"},"PeriodicalIF":3.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000417/pdfft?md5=7a5bc39f39dedbfad71178229af7e742&pid=1-s2.0-S2287888223000417-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135249483","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":"Safety and efficacy of tamsulosin 0.4 mg as an initial dose in 1,219 Korean patients with moderate to severe lower urinary tract symptoms: data from a phase IV study","authors":"Jun Ho Lee ,&nbsp;Yeon Won Park ,&nbsp;Moon-hwa Park ,&nbsp;Tag Keun Yoo","doi":"10.1016/j.prnil.2023.09.003","DOIUrl":"10.1016/j.prnil.2023.09.003","url":null,"abstract":"<div><h3>Background</h3><p>An initial dose of tamsulosin 0.2 mg is frequently prescribed for Asian men. We investigated the safety and efficacy of tamsulosin 0.4 mg as the initial dose in Korean men with moderate to severe lower urinary tract symptoms (LUTSs) in everyday clinical practice.</p></div><div><h3>Materials and methods</h3><p>A phase IV study was conducted in South Korea. Eligible patients were prescribed tamsulosin 0.4 mg for 6 months. We excluded patients with previous exposure to LUTS drugs and patients with an international prostate symptom score (IPSS) &lt; 8.</p></div><div><h3>Results</h3><p>The mean total IPSS, storage subscore, voiding symptoms subscore, and quality of life significantly decreased from 18.0, 10.8, 7.2, and 3.8 to 12.8, 7.5, 5.3, and 2.6, respectively, after 6 months of treatment. The number of nocturia episodes significantly decreased from 3.0 to 2.2 in patients who reported at least 2 nocturia events at baseline. A mean reduction in the IPSS was quantitatively equivalent in all age groups. The mean reduction in the IPSS was greater in the IPSS ≥ 20 group than in the IPSS &lt; 20 group (mean reduction in the total IPSS: −2.6 in the IPSS &lt; 20 group; −9.4 in the IPSS ≥ 20 group). All treatment-emergent adverse events were mild. The most frequently recorded treatment-emergent adverse event was dizziness, which was reported in 22 patients (1.8%).</p></div><div><h3>Conclusion</h3><p>Treatment of LUTS with tamsulosin 0.4 mg as the initial dose for 6 months in Korean men was effective in improving LUTS and showed a favorable safety profile in a real-life setting.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"11 4","pages":"Pages 228-232"},"PeriodicalIF":3.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000533/pdfft?md5=a1b6756cd64d3f52e2070286e37ace11&pid=1-s2.0-S2287888223000533-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135389609","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":"Detection of anterior prostate cancer using a magnetic resonance imaging-transrectal ultrasound fusion biopsy in cases with initial biopsy and history of systematic biopsies","authors":"Masakazu Abe ,&nbsp;Ryo Takata ,&nbsp;Daiki Ikarashi ,&nbsp;Kie Sekiguchi ,&nbsp;Daichi Tamura ,&nbsp;Shigekatsu Maekawa ,&nbsp;Renpei Kato ,&nbsp;Mitsugu Kanehira ,&nbsp;Takashi Ujiie ,&nbsp;Wataru Obara","doi":"10.1016/j.prnil.2023.08.002","DOIUrl":"10.1016/j.prnil.2023.08.002","url":null,"abstract":"<div><h3>Background</h3><p>Prostate cancer in the anterior region may be missed on a transrectal systematic biopsy (SBx). Therefore, this study aimed to evaluate the performance of magnetic resonance imaging-transrectal ultrasound (MRI-TRUS) fusion targeted biopsy (TBx) in detecting anterior region cancer in patients with a history of SBxs.</p></div><div><h3>Methods</h3><p>Prostate biopsies were performed in 224 patients after multiparametric MRI, among whom 119 patients with prostate imaging reporting and data system (PI-RADS version 2) scores of 3 to 5 underwent MRI-TRUS fusion TBxs. Afterward, cancer detection rates (CDRs) and TBx-positive core regions were compared by categorizing patients into those with or without a history of SBxs.</p></div><div><h3>Results</h3><p>Total CDR was 68.8% (44/64 cases) in the initial biopsy group (Initial-Bx group) and 47.3% (26/55 cases) in the previous-negative-systematic biopsy group (Pre-Neg-SBx group) (<em>P</em> = 0.018). Interestingly, both TBx- and SBx-core positive cases were more common in the Initial-Bx group than in the Pre-Neg-SBx group (Initial-Bx group: 75% [33/44 cases] vs. Pre-Neg-SBx group: 42.3% [11/26 cases], <em>P</em> = 0.006). However, only TBx-core positive cases were more common in the Pre-Neg-SBx group than in the Initial-Bx group (Initial-Bx group: 11.4% [5/44 cases] vs. Pre-Neg-SBx group: 30.8% [8/26 cases], <em>P</em> = 0.043). In addition, the proportion of anterior lesions detected by TBx cores was higher in the Pre-Neg-SBx group than in the Initial-Bx group (Initial-Bx group: 26.3% [10/38 cases] vs. Pre-Neg-SBx group: 52.6% [10/19 cases], <em>P</em> = 0.049).</p></div><div><h3>Conclusion</h3><p>Using MRI-TRUS fusion TBx in the evaluation of previously negative SBx cases improved the detection rate of anterior lesions, which might have been missed in previous SBxs. Especially in patients with a history of SBxs mpMRI should be performed to screen for anterior lesions.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"11 4","pages":"Pages 212-217"},"PeriodicalIF":3.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000399/pdfft?md5=49af9f3de32857c6baf4678f9bb7a78e&pid=1-s2.0-S2287888223000399-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49153425","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":"Single-port and multiport robot-assisted radical prostatectomy: A meta-analysis","authors":"Tuan Thanh Nguyen ,&nbsp;Ryan W. Dobbs ,&nbsp;Huy Gia Vuong ,&nbsp;Khoa Quy ,&nbsp;Hanh Thi Tuyet Ngo ,&nbsp;Anh Tuan Mai ,&nbsp;Mai Tran Thi Tuyet ,&nbsp;Minh Sam Thai ,&nbsp;Ho Yee Tiong ,&nbsp;Se Young Choi ,&nbsp;Mohammed Shahait ,&nbsp;David I. Lee","doi":"10.1016/j.prnil.2023.04.002","DOIUrl":"10.1016/j.prnil.2023.04.002","url":null,"abstract":"<div><h3>Objective</h3><p>To compare the perioperative, oncological, and functional outcomes between single-port robot-assisted radical prostatectomy (SP-RARP) and multiport robot-assisted radical prostatectomy (MP-RARP) via a meta-analysis.</p></div><div><h3>Methods</h3><p>For relevant articles, three electronic databases, including PubMed, Scopus, and Web of Science, were searched from their inception until January 15, 2022. A meta-analysis has been reported in line with PRISMA 2020 and AMSTAR Guidelines. The risk ratio and weighted mean difference (MD) were applied for the comparison of dichotomous and continuous variables with 95% confidence intervals (CI).</p></div><div><h3>Results</h3><p>Of the 368 retrieved abstracts, 41 underwent full-text review, and seven studies were included in the final analysis, comprising a total cohort of 1,934 cases of RARP (355 SP-RARP cases and 1,579 MP-RARP cases). Compared to MP-RARP, the SP-RARP group had less postoperative pain score (MD = –0.7, 95% CI –1 to –0.4, <em>P</em>&lt;0.001), morphine milligram equivalents usage (MD = –3.8, 95% CI –7.5 to –0.1, <em>P</em>=0.04), hospital stay (MD = –1, 95% CI –1.8 to –0.1, <em>P</em>=0.019), and urinary catheterization time (MD = –1.1, 95% CI –1.9 to –0.3, <em>P</em>=0.008). However, the SP-RARP group had a longer console time than the MP-RARP group (MD = 5.3, 95% CI 2.6 to 7.9, <em>P</em>&lt;0.001).</p></div><div><h3>Conclusions</h3><p>Our study demonstrated that early results were mostly equivalent with the single-port approach. This technology may help to reduce the hospital stay and postoperative pain for patients undergoing radical prostatectomy compared to MP-RARP, without compromising the functional and early oncological outcomes.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"11 4","pages":"Pages 187-194"},"PeriodicalIF":3.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000181/pdfft?md5=637506a7442efdda055caf04e435b865&pid=1-s2.0-S2287888223000181-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42026495","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":"Reviving intimacy: Penile rehabilitation strategies for men after prostate cancer treatment","authors":"James Stinson ,&nbsp;Nelson Bennett","doi":"10.1016/j.prnil.2023.06.001","DOIUrl":"10.1016/j.prnil.2023.06.001","url":null,"abstract":"<div><p>There have been considerable advances in the field of penile rehabilitation for upwards of 90% of men adversely affected by either short-term or long-term erectile dysfunction after definitive prostate cancer treatment. Despite the evolving landscape of treatment modalities for penile rehabilitation, there is a lack of consensus in the urologic community on the best therapies due to the level of evidence and efficacies of the current and emerging offerings. This review of current and next-generation interventions provides a practical approach to the myriad of data to make a better-informed decision based on the pathophysiology and highest-quality evidence available.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"11 4","pages":"Pages 195-203"},"PeriodicalIF":3.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000314/pdfft?md5=ffa5e39a54d10055b96f65cfc65a7563&pid=1-s2.0-S2287888223000314-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41332033","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":"Artificial intelligence in urologic oncology: the actual clinical practice results of IBM Watson for Oncology in South Korea","authors":"Taeyoung Park,&nbsp;Philip Gu,&nbsp;Chang-Hee Kim,&nbsp;Kwang Taek Kim,&nbsp;Kyung Jin Chung,&nbsp;Tea Beom Kim,&nbsp;Han Jung,&nbsp;Sang Jin Yoon,&nbsp;Jin Kyu Oh","doi":"10.1016/j.prnil.2023.09.001","DOIUrl":"10.1016/j.prnil.2023.09.001","url":null,"abstract":"<div><h3>Background</h3><p>Artificial intelligence (AI) is changing our life, including the medical field. Repeated machine learning using big data made various fields more predictable and accurate. In medicine, IBM Watson for Oncology (WFO), trained by Memorial Slone Kettering Cancer Center (MSKCC), was first introduced and applied in 14 countries worldwide.</p><p>Our study was designed to assess the feasibility of WFO in actual clinical practice. We aimed to investigate the concordance rate between WFO and multidisciplinary tumor board (MTB) in Urologic cancer patients.</p></div><div><h3>Materials and methods</h3><p>We reviewed retrospectively collected data for consecutive patients who underwent WFO and MTB simultaneously in the diagnosis of urologic malignancy before determining further treatment between August 2017 and September 2020. We compared the recommendation of the AI system, WFO (IBM Watson Health, Cambridge, MA), with the opinion of MTB for further managing all patients diagnosed with urologic malignancies such as prostate, bladder, and kidney cancer.</p></div><div><h3>Results</h3><p>A total of 55 patients were enrolled in our study. The number of patients with prostate cancer was 48. The number of bladder and kidney cancer patients was 5 and 2, respectively. The overall concordance rate between WFO and MTB was 92.7%. Three patients could not suggest proper treatment options using WFO, and the recommended choice of WFO was not feasible in the Korean Health Insurance Review and Assessment Service.</p></div><div><h3>Conclusions</h3><p>The decision of WFO showed a high concordance rate with a multidisciplinary tumor board for urologic oncology. However, some recommendations of WFO were not feasible in actual practice, and WFO still has some points to improve and modify. Interestingly, applying WFO is likely to facilitate a multidisciplinary team approach.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"11 4","pages":"Pages 218-221"},"PeriodicalIF":3.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2287888223000405/pdfft?md5=d079b9c289366d335716651a6ca34640&pid=1-s2.0-S2287888223000405-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135889550","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":"Prostate-specific antigen kinetics in hypofractionated radiation therapy alone for intermediate- and high-risk localized prostate cancer","authors":"Tae Hoon Lee ,&nbsp;Hongryull Pyo ,&nbsp;Gyu Sang Yoo ,&nbsp;Hyun Moo Lee ,&nbsp;Seong Soo Jeon ,&nbsp;Seong Il Seo ,&nbsp;Byong Chang Jeong ,&nbsp;Hwang Gyun Jeon ,&nbsp;Hyun Hwan Sung ,&nbsp;Minyong Kang ,&nbsp;Wan Song ,&nbsp;Jae Hoon Chung ,&nbsp;Bong Kyung Bae ,&nbsp;Won Park","doi":"10.1016/j.prnil.2023.07.002","DOIUrl":"10.1016/j.prnil.2023.07.002","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to evaluate the treatment outcomes and define the prostate-specific antigen (PSA) kinetics as potential prognostic factors in patients with intermediate- or high-risk localized prostate cancer (PCa) who underwent moderately hypofractionated radiation therapy.</p></div><div><h3>Methods</h3><p>The study retrospectively reviewed the medical records of 149 patients with intermediate- or high-risk localized PCa who underwent definitive radiation therapy (70 Gy in 28 fractions) without androgen deprivation therapy. Clinical outcomes were analyzed based on risk stratification (favorable-intermediate, unfavorable-intermediate, and high-risk). The biochemical failure rate (BFR) and clinical failure rate (CFR) were stratified based on the PSA nadir and the time to the PSA nadir to identify the prognostic effect of PSA kinetics. Acute and late genitourinary and gastrointestinal adverse events were analyzed.</p></div><div><h3>Results</h3><p>Significant differences were observed in the BFR and CFR according to risk stratification. No recurrence was observed in the favorable intermediate-risk group. The 7-year BFR and CFR for the unfavorable intermediate-risk and high-risk groups were 19.2% and 9.8%, and 31.1% and 25.3%, respectively. Patients with a PSA nadir &gt;0.33 ng/mL or a time to the PSA nadir &lt;36 months had a significantly greater BFR and CFR. The crude rate of grade 3 late adverse events was 3.4% (genitourinary: 0.7%; gastrointestinal: 2.7%). No grade 4–5 adverse event was reported.</p></div><div><h3>Conclusion</h3><p>A significant difference in clinical outcomes was observed according to risk stratification. The PSA nadir and time to the PSA nadir were strongly associated with the BFR and CFR. Therefore, PSA kinetics during follow-up are important for predicting prognosis.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"11 3","pages":"Pages 173-179"},"PeriodicalIF":3.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/c1/main.PMC10513905.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41102283","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":"Changes of resistance indices after medication in benign prostatic hyperplasia: a prospective study","authors":"Dong Jin Park ,&nbsp;Se Yun Kwon ,&nbsp;Young Jin Seo ,&nbsp;Hye Jin Byun ,&nbsp;Kyung Seop Lee","doi":"10.1016/j.prnil.2023.02.001","DOIUrl":"10.1016/j.prnil.2023.02.001","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to determine the relationship between resistive indices (RIs) and changes in prostate size after medical treatment in patients with benign prostatic hyperplasia (BPH).</p></div><div><h3>Methods</h3><p>A total of 86 patients with BPH were included in the study, excluding 42 patients with a total prostate volume (TPV) of &lt;30 cc or taking α1-adrenergic blockers and 5α-reductase inhibitors (5ARI) before study participation. Therefore, the data for 44 patients were analyzed. All patients were treated with α1-adrenergic blockers and 5ARIs. The variables examined were prostate-specific antigen, International Prostate Symptom Score, quality of life score, maximal urinary flow rate, residual urine volume, TPV, transition zone volume, and RIs of the urethral artery and left and right capsular arteries. These variables were assessed at baseline and after 3 and 6 months of treatment.</p></div><div><h3>Results</h3><p>The mean TPV was 43.5 ± 10.9 and decreased to 35.2 ± 11.5 and 33.9 ± 9.8 after 3 and 6 months of treatment, respectively (<em>p</em> &lt; 0.001). The mean RI of the urethral artery, right capsular artery, and left capsular artery at pretreatment did not decrease significantly. However, comparing the baseline with 3-month data, TPV at 3 months/TPV at baseline was significantly correlated with RI changes in the left capsular artery (r = 758; <em>P</em> &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>In patients with BPH, α1-adrenergic blocker and 5ARI medications for 3 and 6 months did not result in a significant reduction in the RI of the urethral artery and both capsular arteries. Larger scale, prospective studies are needed to evaluate the relationship between TPV and RI reductions.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"11 3","pages":"Pages 139-144"},"PeriodicalIF":3.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10513904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41131742","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":"How to avoid prostate biopsy in men with Prostate Image-Reporting and Data System 3 lesion? Development and external validation of new biopsy indication using prostate health index density","authors":"Jae Yeon Kim ,&nbsp;Seong Soo Jeon ,&nbsp;Jae Hoon Chung ,&nbsp;Seung Soo Lee ,&nbsp;Sung-Woo Park","doi":"10.1016/j.prnil.2023.07.001","DOIUrl":"10.1016/j.prnil.2023.07.001","url":null,"abstract":"<div><h3>Background</h3><p>To develop a customized prostate biopsy indication using prostate health index density (PHID) combined with multiparametric magnetic resonance imaging (mpMRI) and assess the reliability of the PHID cutoff value in external populations.</p></div><div><h3>Methods</h3><p>A total of 521 cognitive MRI/ultrasonography fusion prostate biopsies and biomarker tests for prostate-specific antigen (PSA), free PSA, and PHI were performed after mpMRI. The predictive value for clinically significant prostate cancer (csPCa; Gleason score≥7) of PSA derivatives was examined using the ROC curve. We developed a new biopsy indication utilizing a PHID cutoff based on the Prostate Image-Reporting and Data System (PI-RADS) score, which was externally validated.</p></div><div><h3>Results</h3><p>The combination of PHID and mpMRI (AUC = 0.884) demonstrated the highest predictive ability for csPCa, although PHID (AUC = 0.843) and PI-RADS (AUC = 0.806) individually also showed a high diagnostic value. When a PHID cutoff of 0.75 was used in men with PI-RADS 3 lesions, the negative predictive value of csPCa was 100%, and approximately half of the biopsies could be safely avoided.</p></div><div><h3>Conclusion</h3><p>Compared to PHID or PI-RADS scores alone, the combination of PHID and PI-RADS scores increased the accuracy of csPCa detection and the number of cases in which biopsy could be avoided. In men with PI-RADS 3 lesions, the optimal PHID cutoff ≥0.75 can prevent half of the unnecessary biopsies without missing csPCa. In men with PI-RADS 4-5 lesions, biopsies are warranted regardless of PHID values because csPCa could be accompanied by low PHID.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"11 3","pages":"Pages 167-172"},"PeriodicalIF":3.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/19/c1/main.PMC10513902.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41165388","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":"Predictive factors for disease progression after salvage radiation therapy in biochemical recurrent patients treated by radical prostatectomy","authors":"Koichi Aikawa ,&nbsp;Shoji Kimura ,&nbsp;Fumihiko Urabe ,&nbsp;Kosuke Iwatani ,&nbsp;Kojiro Tashiro ,&nbsp;Atsuhiko Ochi ,&nbsp;Hirokazu Abe ,&nbsp;Manabu Aoki ,&nbsp;Takahiro Kimura","doi":"10.1016/j.prnil.2023.04.001","DOIUrl":"10.1016/j.prnil.2023.04.001","url":null,"abstract":"<div><h3>Objective</h3><p>Salvage radiation therapy (SRT) is standard treatment for patients after radical prostatectomy (RP). However, the optimal timing of SRT remains to be elucidated.</p></div><div><h3>Material and methods</h3><p>We retrospectively reviewed 133 prostate cancer (PCa) patients who underwent SRT for biochemical recurrence after RP. Disease progression was defined as repeated prostate-specific antigen (PSA) level more than 0.2 ng/mL, greater than the post-SRT nadir or radiographic progression. A receiver operating characteristic curve analysis was used to identify the optimal pre-SRT PSA level for predicting progression after SRT. Cox regression analyses were performed to elucidate the association between clinicopathologic characteristics and disease progression.</p></div><div><h3>Results</h3><p>Fifty-one PCa patients (38.4%) experienced disease progression after SRT. The optimal cutoff value of the pre-SRT PSA for predicting disease progression was 0.44 ng/mL. In multivariable analysis, pre-SRT PSA &gt;0.44 ng/mL was a significant independent predictor of post-SRT disease progression [hazard ratio (HR): 2.02, <em>P</em> = 0.02]. Although the pre-SRT PSA &gt;0.44 ng/mL did not maintain its independent association with disease progression in the multivariable analysis of patients with adverse pathology (HR: 1.63, <em>P</em> = 0.22), PSA within 4 weeks after RP as a continuous variable was significantly associated with disease progression (HR: 1.19, <em>P</em> = 0.04)</p></div><div><h3>Conclusions</h3><p>Our results highlight that in PCa patients who undergo RP, SRT should be performed before their PSA reaches 0.44 ng/mL. In patients with adverse pathology disease, a high PSA level within the 4 weeks after RP might identify those who are likely to have disease progression, and these patients might require systemic therapy.</p></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"11 3","pages":"Pages 145-149"},"PeriodicalIF":3.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/6f/main.PMC10513901.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41134532","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}