Prostate最新文献

{"title":"The Prognostic Value of the Prostate Adenocarcinoma With Ductal Feature in Patients With Advanced Prostate Cancer Treated With Abiraterone Acetate.","authors":"Yifu Shi, Xinyuan Wei, Fengnian Zhao, Junru Chen, Guangxi Sun, Xingming Zhang, Jiayu Liang, Xu Hu, Pengfei Shen, Zhenhua Liu, Ling Nie, Ni Chen, Jinge Zhao, Hao Zeng","doi":"10.1002/pros.24869","DOIUrl":"10.1002/pros.24869","url":null,"abstract":"<p><strong>Background: </strong>The prognostic value of the prostate adenocarcinoma (PAC) with ductal feature in patients with advanced prostate cancer treated with abiraterone acetate has not been scrutinized. This study aims to explore the predictive value of PAC with ductal feature on the therapeutic efficacy of abiraterone therapy in metastatic prostate cancer (mPCa) patients.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 569 patients with mPCa receiving abiraterone at either the metastatic hormone-sensitive (mHSPC, N = 165) or castration-resistant prostate cancer (mCRPC, N = 404) stage. PSM was performed to balance the baseline characteristics between individuals with and without ductal features. Kaplan-Meier curves and Cox regression were used to analyze the predictive significance of ductal feature on abiraterone efficacy, including PSA response, PSA progression-free survival (PSA-PFS), radiographic progression-free survival (rPFS), and overall survival (OS).</p><p><strong>Results: </strong>Totally, ductal feature was detected in 40/569 (7.0%) men, with 18 and 22 in the mHSPC and mCRPC cohorts, respectively. The PSA response rate was comparable for people with and without ductal features for both cohorts. Notably, in the mHSPC cohort, patients with and without ductal features shared similar median PSA-PFS (not reached vs. 32.6-months, p = 0.593) and rPFS (not reached vs. 35.0-months, p = 0.768). Similar results were observed in the mCRPC cohort (median PSA-PFS: 21.2- vs. 11.6-months, p = 0.100; median rPFS: 34.6- vs. 18.7-months, p = 0.092). COX regression further revealed that ductal feature was not an indicator of unfavorable PSA-PFS or rPFS in the mHSPC and mCRPC cohort.</p><p><strong>Conclusion: </strong>In conclusion, our findings indicated that there is insufficient evidence to differentiate the therapeutic efficacy of AA in mPCa based on the presence or absence of ductal features. However, further validation through larger-scale studies is required to substantiate them.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"659-669"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Neoadjuvant Chemohormonal Therapy With GnRH Antagonist and Low-Dose Estramustine in Very High-Risk Prostate Cancer Undergoing Robotic Radical Prostatectomy.","authors":"Takanari Kambe, Masashi Kubota, Toshinari Yamasaki, Mutsushi Kawakita, Shiori Murata, Yuto Hattori, Yoichiro Tohi, Yuya Sekine, Ryoma Kurahashi, Kimihiro Shimatani, Atsuro Sawada, Hiromitsu Negoro, Ryoichi Saito, Takayuki Goto, Takashi Kobayashi","doi":"10.1002/pros.24875","DOIUrl":"10.1002/pros.24875","url":null,"abstract":"<p><strong>Background: </strong>High-risk patients with prostate cancer (PC) frequently experience biochemical recurrence (BCR) after surgery. Thus numerous studies have investigated the efficacy of neoadjuvant therapies for high-risk PC patients; however, no protocol has been established. This study aimed to assess the effect of androgen deprivation therapy combined with low-dose estramustine phosphate (EMP) on BCR compared with androgen deprivation therapy (ADT) alone in high- and very high-risk patients with PC.</p><p><strong>Methods: </strong>This retrospective study targeted patients with PC meeting the National Comprehensive Cancer Network high-risk criteria (cT1-4N0M0), with 173 patients in the exposure group who received neoadjuvant chemohormonal therapy (gonadotropin-releasing hormone [GnRH] antagonist combined with low-dose EMP), and 490 patients in the control group treated with and neoadjuvant hormone therapy (NHT) (ADT ± first-generation anti-androgens). Data for each group were extracted from a database of patients who underwent robot-assisted laparoscopic prostatectomy at 25 tertiary care centers across Japan between 2011 and 2023. The inverse probability of treatment weighting was used to adjust for baseline differences. The primary outcome was BCR-free survival, with hazard ratios (HRs) calculated using a Cox proportional hazards model between the high-risk and very high-risk groups.</p><p><strong>Results: </strong>After adjustment, the standardized mean difference was < 0.1. The exposure group had 3 and 5-year BCR-free survival rates of 82.1% and 74.6%, respectively, compared with 70.8% and 64.4% in the control group (HR: 0.55; 95% confidence interval [CI]: 0.35-0.88). For high-risk patients, the rates were 87.1% and 84.2% at both 3 and 5 years in the intervention group and 83.5% and 75.0% in the control group (HR: 0.66; 95% CI: 0.30-1.47). For very high-risk patients, the 3-year and 5-year rates were 75.3% and 65.7% in the intervention group and 57.3% and 53.6% in the control group (HR: 0.53; 95% CI: 0.30-0.92).</p><p><strong>Conclusions: </strong>In patients with very high-risk PC undergoing robot-assisted laparoscopic prostatectomy, a GnRH antagonist and low-dose EMP yielded better BCR-free survival outcomes than NHT.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"684-692"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reassessing the Role of Low PSA in Prognosis Across Grades of Prostate Cancer: A Cohort Study.","authors":"Cheng Shen, Zhan Chen, Fei-Hong Hu, Wei Wang, Yong-Shen Pan, Yong Zhang, Wei Zhang, Xin-Feng Chen, Hong-Lin Chen, Hua Zhu, Bing Zheng","doi":"10.1002/pros.24860","DOIUrl":"10.1002/pros.24860","url":null,"abstract":"<p><strong>Background: </strong>Prior studies have concentrated exclusively on how different prostate-specific antigen (PSA) levels affect the prognosis of high-grade prostate cancer (PCa), often overlooking the prognosis of low-grade PCa.</p><p><strong>Methods: </strong>The present cohort study included individuals diagnosed with PCa from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2021. The all-cause mortality (ACM) and prostate cancer-specific mortality (PCSM) for each treatment group was calculated stratified by the four PSA levels (≤ 4.0, 4.1-10.0, 10.1-20.0, and > 20.0 ng/mL). Fine and Gray competing-risks analyses were conducted to calculate hazard ratios (HRs) with 95% confidence intervals (CIs). Cox proportional hazards regression analyses using PSA as a continuous variable with restricted cubic splines (RCS) were conducted to allow for potential nonlinear relationships.</p><p><strong>Results: </strong>This study encompassed 416,825 male patients diagnosed with PCa. Compared to individuals with PSA value between 4.1 and 10.0 ng/mL, a significant association between low levels of PSA (≤ 4.0 ng/mL) and an increased risk of ACM (AHR = 1.15, 95% CI: 1.12-1.19; p < 0.001) and PCSM (AHR = 1.49, 95% CI: 1.38-1.61; p < 0.001) was observed. Additionally, the increased risk of ACM (AHR = 1.35, 95% CI: 1.29-1.40; p < 0.001) and PCSM (AHR = 1.84, 95% CI: 1.67-2.02; p < 0.001) are more pronounced within the first 5 years post-diagnosis. In most subgroups, similar results were observed. The RCS curves further corroborated the correlation between PSA value and the risk of mortality.</p><p><strong>Conclusion: </strong>Low PSA levels are notably linked to a heightened risk for both ACM and PCSM, irrespective of the grade of PCa being high or low. There is a need to initiate new studies that tackle novel diagnostics and therapeutics.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"580-593"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Nutritional Index as a Biomarker in Metastatic Hormone-Sensitive Prostate Cancer: Impact on Survival and Treatment Optimization.","authors":"Muhammet Bekir Hacioglu, Ahmet Kucukarda, Ivo Gokmen, Ali Fuat Gurbuz, Murat Araz, Fatma Akdag Kahvecioglu, Ilhan Hacibekiroglu, Orhun Akdoğan, Ozan Yazıcı, Fatma Aysun Akkus, Abdussamet Çelebi, Osman Kostek, Bulent Erdogan","doi":"10.1002/pros.24876","DOIUrl":"10.1002/pros.24876","url":null,"abstract":"<p><strong>Objective: </strong>The Prognostic Nutritional Index (PNI), reflects the nutritional and immunological status of the patient and has been associated with outcomes in various cancers. In this study, the prognostic significance of PNI in metastatic hormone-sensitive prostate cancer (mHSPC) and its potential role in guiding treatment decisions between abiraterone acetate and enzalutamide is investigated.</p><p><strong>Methods: </strong>Retrospective analysis was performed on 167 mHSPC patients treated between 2019 and 2024. PNI was calculated using the formula: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (/mm³). Patients were stratified into high and low PNI groups according to a cutoff value of 49.98, determined via receiver operating characteristic (ROC) analysis. Survival outcomes, including overall survival (OS), radiographic progression-free survival (rPFS), and PSA progression-free survival (PSA-PFS), were assessed. Treatment responses to abiraterone acetate and enzalutamide were compared within PNI strata.</p><p><strong>Results: </strong>Patients with PNI > 49.98 had significantly longer median OS than those with PNI ≤ 49.98 (36.6 months vs. 30.0 months, p < 0.01). Multivariate analysis identified high PNI, ECOG performance status 0-1, and absence of visceral metastasis as independent predictors of improved OS. Among patients with low PNI, those treated with enzalutamide had superior OS compared to those receiving abiraterone acetate (p = 0.004), while no significant OS difference was noted between treatments in the high PNI group (p = 0.55).</p><p><strong>Conclusion: </strong>PNI serves as a significant prognostic biomarker in mHSPC, correlating with overall survival and potentially influencing treatment efficacy between abiraterone acetate and enzalutamide. Integrating PNI into clinical practice may aid in tailoring individualized treatment options.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"693-702"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcriptome-Wide Association Study Identified Novel Blood Tissue Gene Biomarkers for Prostate Cancer Risk.","authors":"Yanfa Sun, Jingjing Zhu, Hua Zhong, Zichen Zhang, Fubo Wang, Akira Nakamura, Yanhui Liu, Jiawen Liu, Jie Yu, Guanghua Zeng, Xin Lin, Dan Zhou, Chong Wu, Liang Wang, Youping Deng, Lang Wu","doi":"10.1002/pros.24859","DOIUrl":"10.1002/pros.24859","url":null,"abstract":"<p><strong>Objective: </strong>A number of susceptibility genes in prostate tissue have been identified to be associated with prostate cancer (PCa) risk. However, the reported genes based on assessing prostate tissue could not fully explain PCa genetic susceptibility. It is believed that genes functioning in the immune system may fill in the gap of some missing heritability.</p><p><strong>Methods: </strong>To study potential susceptibility genes acting in such pathways, we performed a transcriptome-wide association study (TWAS) of 79,194 PCa cases and 61,112 control of European ancestry by using three sets of gene expression prediction models of blood tissue.</p><p><strong>Results: </strong>A total of 470 genes were associated at false discovery rates-corrected p-value < 0.05, of which 51 were implicated as likely causal genes based on fine-mapping analysis. Compared with previous literature, 133 novel genes were reported for the first time. Of the identified genes, five (CREB3L4, GSTP1, MAPK3, NKX3-1, and PIK3C2B) were enriched in a PCa signaling pathway, and 128 genes were enriched in five PCa categories. Importantly, 13 genes (SCP2, LMNA, ZNF148, H2AFV, TACC1, FLII, SUPT4H1, CD300LF, MYO9B, COX6B1, CTSA, EP300, and TSPO) showed consistent effect directions for the measured levels in circulating immune cells between PCa cases and controls, and 14 genes (SLC39A1, ZBTB7B, TRIM59, NCEH1, N4BP2, TAGAP, TACC1, TRAF1, AIP, SECTM1, C18orf54, ZNF793, YIF1B, and TSPO) showed consistency for levels in blood exosomes between PCa patients and controls.</p><p><strong>Conclusion: </strong>The identified blood-based candidate susceptibility genes provide further insights into the genetic basis of PCa risk.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"567-579"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression-Free Survival Prediction Performance of ChatGPT: Analysis With Real Life Data in Early and Locally Advanced Prostate Cancer.","authors":"Engin Eren Kavak, İsmail Dilli","doi":"10.1002/pros.24871","DOIUrl":"10.1002/pros.24871","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the progression-free survival (PFS) time in patients with early-stage and locally advanced prostate cancer and to compare the estimates provided by ChatGPT with actual survival data.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients diagnosed with early-stage/locally advanced prostate cancer. Each patient's estimated PFS times were calculated using an artificial intelligence chatbot. These estimates were generated by considering several factors, including the patient's clinical characteristics, tumor stage, treatment modalities, and biochemical parameters. A statistical comparison was conducted between the predicted PFS and actual PFS times.</p><p><strong>Results: </strong>The AI chatbot tended to overestimate the overall PFS times. A statistically significant discrepancy was observed between the predicted and actual survival times (p < 0.05). A discrepancy of 9.19 months was observed between the PFS predictions made by ChatGPT and the actual PFS. The bias value was 48.57, yet this discrepancy had a negligible impact on clinical practice (Cohen's d = 0.189).</p><p><strong>Discussion: </strong>Artificial intelligence-based models have the potential to play an important role in the prediction of progression in cancers such as prostate cancer, where 5-10-year survival rates can reach 100%. However, this study's findings indicate that the AI model's predictions are not aligned with the actual clinical data. The reliability of the integration of artificial intelligence into clinical decision support systems can be enhanced through the undertaking of comprehensive future studies.</p><p><strong>Conclusion: </strong>The use of artificial intelligence in predictive modeling may prove an effective approach for forecasting the PFS of prostate cancer. It has the potential to supplant the nomograms that are currently in use. Nevertheless, further studies are required to substantiate the accuracy and reliability of these systems.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"677-683"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Vivo Efficacy of a Macrocyclic Peptoid-Peptide Hybrid That Selectively Modulates the Beta-Catenin/TCF Interaction to Inhibit Prostate Cancer.","authors":"Justine Habault, Jennifer L Franco, Susan Ha, Jeffry A Schneider, Maud Voisin, David R Wise, Kwok-Kin Wong, Michael J Garabedian, Kent Kirshenbaum, Susan K Logan","doi":"10.1002/pros.24868","DOIUrl":"10.1002/pros.24868","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer is the most common form of male cancer and can initially be treated as a localized disease. Although the 5-year survival rate at diagnosis approaches 100 percent, a subset of patients will subsequently develop resistance to treatment. This may ultimately lead to metastatic castration resistant prostate cancer (mCRPC), for which the prognosis is much less favorable. The importance of the Wnt/β-catenin pathway in treatment-resistant prostate cancer has inspired efforts to exploit the interaction of β-catenin with its transcription binding partners as a therapeutic strategy for prostate cancer.</p><p><strong>Methods: </strong>Peptoid-peptide macrocycles are attractive design scaffolds for disrupting protein-protein interactions. In this study, we evaluate a library of these macrocycles and demonstrate their selectivity for the β-catenin/TCF (T Cell Factor) interaction.</p><p><strong>Results: </strong>Importantly, we show that the macrocycles do not significantly alter the binding of β-catenin to cell surface protein, E-cadherin. Our lead sequence, Macrocycle 13, (MC13) was also tolerant of modifications aimed to improve aqueous solubility while retaining activity. Herein, we demonstrate in vivo proof of principle for using peptidomimetic macrocycles to target the β-catenin/TCF interaction. Treated prostate cancer mouse xenografts show markedly diminished tumor growth and decreased levels of myc protein. MC13 also inhibits growth in an organoid model with genetic alterations frequently found in prostate cancer. Transcriptome analysis of prostate cancer cells treated with MC13 reveals downregulation of key pathways, including Wnt/β-catenin and c-myc. Furthermore, chromatin immunoprecipitation (ChIP) analysis shows reduced β-catenin at its target genes, axin2 and c-myc.</p><p><strong>Conclusion: </strong>Our findings underscore the therapeutic potential of peptoid-peptide macrocycle inhibition of β-catenin in prostate cancer.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"646-658"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RETRACTION: Interleukin-4 Activates Androgen Receptor Through CBP/p300.","authors":"","doi":"10.1002/pros.24874","DOIUrl":"10.1002/pros.24874","url":null,"abstract":"<p><strong>Retraction: </strong>S. O. Lee, J. Y. Chun, N. Nadiminty, W. Lou, S. Feng, and A. C. Gao, \"Interleukin-4 Activates Androgen Receptor Through CBP/p300,\" The Prostate 69, no. 2 (2009): 126-132, https://doi.org/10.1002/pros.20865. The above article, published online on 25 September 2008 in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor-in-Chief, Dr. Samuel Denmeade; and Wiley Periodicals LLC. The publisher received a report from a third party which indicated that the Pol II bands had been duplicated between Figures 1A and 1B. This image duplication was confirmed by the publisher. The report also indicated that images had been reused between Figure 1 in this article and Figure 3 in the following article by some of the same authors: (Chun et al. 2006 [10.1158/1535-7163.MCT-05-0389]). Both articles describe different experimental conditions. The authors responded to an inquiry by the publisher but reported that the original data were no longer available and did not provide an explanation for the evidence of image duplications. The retraction has been agreed to because the evidence of image duplications both in this article and with other published research fundamentally compromises the results described in this article. The authors did not respond to our notice regarding the retraction.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"628"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid and Deep Prostate-Specific Antigen Decline is a Prognostic Marker in Metastatic Hormone-Sensitive Prostate Cancer: A Real-World Multi-Intuitional Analysis.","authors":"Kotaro Suzuki, Takuto Hara, Hiromitsu Watanabe, Keita Nakane, Kiyoshi Takahara, Taku Naiki, Takahiro Yasui, Ryoichi Shiroki, Takuya Koie, Hideaki Miyake","doi":"10.1002/pros.24847","DOIUrl":"10.1002/pros.24847","url":null,"abstract":"<p><strong>Background: </strong>Prostate-specific antigen (PSA) kinetics has been investigated as a prognostic marker in post hoc analyses of clinical trials. This study validated the prognostic value of rapid and deep PSA decline in metastatic hormone-sensitive prostate cancer (mHSPC) using real-world data.</p><p><strong>Methods: </strong>In total, 1296 patients with mHSPC were retrospectively reviewed. We assessed the prognostic value of a PSA decline to ≤ 0.2 ng/mL after 12 weeks of treatment and investigated several potential risk factors for a poor PSA response.</p><p><strong>Results: </strong>Of 1296 patients, 714 (cohort 1: 55.1%) were treated with conventional hormonal therapy, while 582 (cohort 2: 44.9%) received androgen signaling inhibitors. There were significant differences in progression-free survival and overall survival between patients with PSA decline to ≤ 0.2 ng/mL by 12 weeks of treatment and others (p < 0.001 for each). In addition, patients with an initial PSA ≥ 200 ng/mL, Clinical T4 and Grade Group 5 were less likely to achieve PSA decline to ≤ 0.2 ng/mL by 12 weeks of treatment, with odds ratios of 0.31 (p < 0.001), 0.67 (p = 0.039) and 0.70 (p = 0.043), respectively.</p><p><strong>Conclusion: </strong>Our findings suggested that PSA decline to ≤ 0.2 ng/mL by 12 weeks of treatment may be a useful prognostic biomarker for mHSPC in the real-world setting. The prognostic value of this should be further investigated in a prospective cohort, and identification of an optimal cutoff value is necessary for its application in clinical trial design or clinical practice.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"448-455"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional and Oncological Outcomes of Very Large Prostate Sizes Post Robotic Radical Prostatectomy: A Propensity Score-Matched Analysis.","authors":"Ahmed Gamal, Marcio C Moschovas, Abdel R Jaber, Shady Saikali, Sumeet Reddy, Avaneesh Kunta, Marco Sandri, Travis Rogers, Vipul Patel","doi":"10.1002/pros.24848","DOIUrl":"10.1002/pros.24848","url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted radical prostatectomy (RARP) is widely used as the main surgical approach to treat prostate cancer in the United States. Prostate size is often described as a factor affecting the outcomes of RARP as shown by many studies. However, these studies are limited to a small number of patients.</p><p><strong>Objective: </strong>To evaluate the functional and oncologic outcomes of RARP in very large prostate sizes.</p><p><strong>Methods: </strong>Three hundred and seventy-five RARP patients were divided into two groups according to prostate size: Group 1 had prostates larger than 150 g and Group 2 smaller than 50 g. Perioperative variables were matched with propensity score matching 1:3 and postoperative variables were analyzed for significant differences in outcomes between groups. Variables analyzed included estimated blood loss (EBL), operative time, catheter time, hospitalization time, postoperative complications, pathological staging, positive surgical margins (PSM) rates, biochemical recurrence (BCR), potency, and continence rates.</p><p><strong>Results: </strong>The two groups exhibited similar preoperative characteristics. Patients with larger prostates (Group 1) were more likely to have higher blood loss (EBL), longer console time, and more days with catheter. However, we could not find significant difference in the overall postoperative complications (Clavien-Dindo). Pathological outcomes were also statistically different as patients with larger prostates had (69.7%) more pT2 disease and (12.1%) lower rates of PSM. Finally, we could not find significant difference in the functional outcomes between the groups.</p><p><strong>Conclusion: </strong>The results demonstrate that prostate size impacts multiple outcomes. Larger prostates had lower-grade disease, reduced EPE and PSM rates, with no significant differences in BCR or functional outcomes. Perioperative differences, such as increased blood loss and console time, were also observed.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"456-462"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}