Prostate最新文献

{"title":"Treatment Noncompletion and Shorter Radiation Regimens Among US Patients With Prostate Cancer: A Focus on Asian American and Pacific Islander Patients.","authors":"Rohit V Mantena, Rishabh Bhadouriya, Urvish Jain, Tej A Patel, Bhav Jain, Aditya Arkalgud, Alessandro Hammond, Stephanie Wang, Khushi Kohli, Ranvir Iyengar, Perisa Ashar, Siddharth Kesiraju, Alexander G Goglia, Roshal R Patel, Mohammed Alshalalfa, Jonathan E Leeman, Paul L Nguyen, Brandon A Mahal, Edward Christopher Dee","doi":"10.1002/pros.24887","DOIUrl":"https://doi.org/10.1002/pros.24887","url":null,"abstract":"<p><strong>Background: </strong>Higher rates of radiation therapy (RT) noncompletion may be associated with certain demographic groups in patients with prostate cancer (PC). We examined disparities in noncompletion and receipt of shorter RT regimens among disaggregated Asian American and Pacific Islander groups in the US.</p><p><strong>Methods: </strong>We performed a retrospective cohort analysis of all patients diagnosed with localized PC (2004-2017) in the National Cancer Database who identified as White, East Asian, Southeast Asian, Pacific Islander, or South Asian who were treated with definitive RT. The two primary outcomes were 1) treatment noncompletion and 2) receiving shorter RT regimens. Regression models were adjusted for relevant sociodemographic and clinical factors.</p><p><strong>Results: </strong>The analytic cohort was comprised of 143,379 patients [White, n = 140,656 (98.10%); East Asian, n = 1,150 (0.80%); Southeast Asian, n = 925 (0.65%); Pacific Islander, n = 195 (0.14%); South Asian, n = 453 (0.32%)]. On multivariable analysis, Southeast Asian patients were associated with increased rate of noncompletion compared to White patients (Southeast Asian vs. White; OR: 1.55 [95% CI: 1.29-1.86], p < 0.001). Geographic region of the treatment facility within the United States also was significant, as patients from the South Atlantic (OR: 1.32 [95% CI: 1.24-1.41], p < 0.001), East North Central (OR: 1.09 [95% CI: 1.03-1.17], p = 0.007), East South Central (OR: 1.54 [95% CI: 1.41-1.68], p < 0.001), and West South Central (OR: 1.14 [95% CI: 1.04-1.24], p = 0.005) regions all had higher rates of noncompletion in comparison to patients from New England. Distance from treatment facility, presence of comorbidities, and education attainment rates significantly impacted treatment noncompletion as well. Additionally, our study reports disparities in receipt of short course RT. Pacific Islander patients had substantially higher rates of SBRT (OR: 2.60 [95% CI: 1.10-6.16], p = 0.030) compared to White patients, while Hispanic patients had lower rates of SBRT (OR: 0.48 [95% CI: 0.40-0.57], p < 0.001). Furthermore, receiving treatment in urban (OR: 0.68 [95% CI: 0.61-0.76], p < 0.001) and metro (OR: 0.50 [95% CI: 0.39-0.65], p < 0.001) facilities was associated with reduced access to SBRT than facilities in rural areas. Patients who received treatment in the Middle Atlantic (OR: 3.28 [95% CI: 2.91-3.68], p < 0.001), South Atlantic (OR: 2.72 [95% CI: 2.40-3.09], p < 0.001), East North Central (OR: 1.53 [95% CI: 1.34-1.75], p < 0.001), East South Central (OR: 3.07 [95% CI: 2.61-3.63], p < 0.001), West North Central (OR: 2.35 [95% CI: 2.02-2.75], p < 0.001), and Mountain (OR: 2.45 [95% CI: 2.01-2.97], p < 0.001) regions of the United States had significantly higher rates of SBRT compared to patients from New England.</p><p><strong>Conclusions: </strong>This analysis found that Southeast Asian patients had higher rates of RT noncompletion in compariso","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756011","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":"Analytical and Real-World Clinical Characterization of S2,3PSA% Test in MRI Fusion Targeted Prostate Biopsy Population.","authors":"Yuki Miura, Tohru Yoneyama, Hayato Yamamoto, Hiromu Suzuki, Takuma Otsubo, Eriko Fujita, Fumiyasu Tsushima, Shintaro Goto, Teppei Okamoto, Naoki Fujita, Masahiro Ishiyama, Tadashi Yoshizawa, Shingo Kakeda, Shingo Hatakeyama, Chikara Ohyama","doi":"10.1002/pros.24894","DOIUrl":"https://doi.org/10.1002/pros.24894","url":null,"abstract":"<p><strong>Background: </strong>The α2,3-sialyl N-glycosylated free prostate-specific antigen ratio (S2,3PSA%) was approved in Japan as a prostate cancer (PCa) diagnostic test. We evaluated the analytical characterization and real-world diagnostic performance of S2,3PSA%.</p><p><strong>Methods: </strong>The precision testing, dilution linearity, measurement sensitivity, preanalytical stability, and interferences of S2,3PSA, α2,6-sialyl N-glycosylated free PSA (S2,6PSA), and S2,3PSA% were performed. The diagnostic accuracy detecting PCa of S2,3PSA% was prospectively evaluated in 253 men (Cohort 1, vs. PI-RADS) and in 145 men (Cohort 2, vs. PI-RADS, prostate health index, phi) who scheduled MRI-targeted biopsy by area under the receiver operating characteristics curve (AUC).</p><p><strong>Results: </strong>The precision of the S2,3PSA, S2,6PSA, and S2,3PSA% were all < 3.4% coefficient of variation. The dilution linearity of S2,3PSA had a correlation coefficient of 0.9949-0.9987. The detection limit of S2,3PSA and S2,6PSA was 0.044 and 0.029 ng/mL, respectively. Serum S2,3PSA and S2,6PSA concentrations were stable at 6°C for 24 h and -20°C for 90 days, while S2,3PSA% was unchanged at 6°C and -20°C for 90 days or under five freeze-thaw cycles. Serum S2,3PSA and S2,3PSA% were not affected by any interferences and drugs. In Cohort 1, AUC of S2,3PSA% (0.776, 95% CI 0.719-0.832) detecting PCa was comparable to that of PI-RADS (0.746, 0.685-0.807, p = 0.7996). In Cohort 2, AUC of S2,3PSA% detecting PCa (0.837, 0.774-0.901) was comparable to PI-RADS (0.779, 0.703-0.854, p = 0.3037), and phi (0.867, 0.809-0.926, p = 0.3000).</p><p><strong>Conclusions: </strong>Analytical characteristics of S2,3PSA% perform well and the diagnostic performance of S2,3PSA% was comparable to phi and MRI.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756006","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":"Developments in Ultrasound-Based Imaging for Prostate Cancer Detection.","authors":"Reid Vassallo, Miles P Mannas, Septimiu E Salcudean, Peter C Black","doi":"10.1002/pros.24893","DOIUrl":"https://doi.org/10.1002/pros.24893","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer is a significant health issue worldwide, but methods to screen for and diagnose this disease have significant inherent limitations. Some efforts to address these limitations have involved the use of ultrasound-based imaging methods.</p><p><strong>Methods: </strong>This narrative review paper focuses on recent developments in the use of medical imaging, with a focus on ultrasound and related methods, to improve the diagnosis of prostate cancer. These methods include: elastography, contrast-enhanced ultrasound, targeted contrast agents, quantitative ultrasound, multiparametric ultrasound, micro-ultrasound, and photoacoustic imaging.</p><p><strong>Results: </strong>This paper provides an update on clinically relevant imaging technologies which are in the technical and preclinical literature.</p><p><strong>Conclusion: </strong>Novel methods and their performance are highlighted, including how they address limitations in current clinical care.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732608","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":"The Prostate Microbiome Is Associated With Prostate Size and PSA Level, Independent of Age, in BPH Patients.","authors":"Alec Sun, Juan Sebastian Rodriguez-Alvarez, Shelby Harper, Prajit Khooblall, Thien Dang, Smita De, Aaron W Miller","doi":"10.1002/pros.24891","DOIUrl":"https://doi.org/10.1002/pros.24891","url":null,"abstract":"<p><strong>Background: </strong>The etiology of benign prostatic hyperplasia (BPH) is not well understood, though recent literature suggests that the urinary tract microbiome may play a role. We aimed to examine the prostatic microbiome in BPH and its associations with patient characteristics.</p><p><strong>Methods: </strong>Men undergoing Holmium Laser Enucleation of the Prostate (HoLEP) were recruited if they were over 18 years old and had no history of prostate cancer, prostate surgery, or pelvic radiation. Exclusion criteria included positive preoperative urine culture, bladder stones, or catheter-dependence. Patient characteristics including age, prostate-specific antigen (PSA), American Urological Association symptom score (AUASS), and history of biopsy were recorded. Intraoperatively, prostate tissue was collected from each patient, as well as catheterized urine, urethral swabs, and swabs of the specimen container. Samples underwent DNA extraction, 16S sequencing, and analysis using R statistical software. Associations between bacterial taxonomic diversity and patient characteristics were quantified through Sparcc correlations.</p><p><strong>Results: </strong>Fifty patients were recruited. Mean age, PSA, prostate size, and AUASS were 67.8 years, 4.0 ng/mL, 108.6 g, and 19.4, respectively. After bioinformatic decontamination of prostate samples, alpha and beta diversity analyses indicated that microbiomes from the prostate, urethra, and urine were all distinct (p = 0.001); microbiota from the urine and urethra had higher similarity to each other than that of the prostate. Campylobacter, Caryophanaceae, Enterobacter, and Senegalimassilia positively correlated with prostate size or PSA.</p><p><strong>Conclusions: </strong>The prostatic microbiome is unique and distinct from that of urine and urethra, with several known pathogens positively correlating with prostate size and PSA.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694604","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":"A Phase II, Single Arm, Multicentre Trial of Triamcinolone With a GnRH Analog for Castrate-Resistant Prostate Cancer (TRICREST).","authors":"Kenrick Ng, Garima Priyadarshini, Shah-Jalal Sarker, Angus Robinson, Neil McPhail, Aaron Prendergrast, Charlotte Ackermann, Ernese Xhafa-Hamiti, Michelle Greenwood, Norman Taylor, William Drake, Jonathan Shamash","doi":"10.1002/pros.24877","DOIUrl":"https://doi.org/10.1002/pros.24877","url":null,"abstract":"<p><strong>Background: </strong>Corticosteroids are active in castration-resistant prostate cancer (CRPC) by suppression of adrenal androgen production. Triamcinolone is an intramuscular steroid injection which has putative advantages over commonly used steroids, such as dexamethasone and prednisolone.</p><p><strong>Methods: </strong>This was a multicentre, phase II study of intramuscular triamcinolone administered monthly in patients with chemotherapy-naïve CRPC. 55 patients were recruited from 2012 to 2016. Imaging was performed every 3 months. The primary end point was radiological and symptomatic progression-free survival (PFS). Secondary end points included PSA progression, weight changes, and toxicity. We also conducted an exploratory analysis on steroid androgenic precursors, collected before and 1 month after triamcinolone, to measure correlation to PFS.</p><p><strong>Results: </strong>At a median follow-up time of 18.7 months, the median radiological PFS was 9.4 months (95% confidence interval [CI]: 7.4-20.3 months), and the 6-month radiological PFS rate was 69.1% (95% CI: 55.1%-79.5%). The 50% PSA response rate was 63.6% (95% CI: 49.6-76.2). There were no treatment-related deaths. The most common grade 3 toxicity was hypertension (44%), but only five patients (9%) required concomitant medication. Proximal myopathy was observed in 22 patients (40%). There was no evidence of weight gain (mean weight 83.5 kg pre-study and 79.8 kg post-study). Urinary total androgen metabolites and dehydroepiandrosterone did not predict response to triamcinolone.</p><p><strong>Conclusion: </strong>Intramuscular triamcinolone is an effective hormonal agent in CRPC. Its side-effect profile is different from other steroids and has the advantage of supervised administration.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"e24877"},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659709","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":"Outcome of Subsequent Therapies After ¹⁷⁷Lu-Vipivotide Tetraxetan for Metastatic Castrate-Resistant Prostate Cancer: A Tertiary Cancer Center Experience.","authors":"Meryam Losee, Michael Kavanaugh, Mofei Liu, Nuno Borges, Veronica Haberman, Jolivette Ritzer, Andrew Wolanski, Sudhir Bhimaniya, Atish D Choudhury, Hyewon Hyun, Hailey Stoltenberg, Kerry L Kilbridge, Alicia Morgans, Mark Pomerantz, Matthew Robertson, Christopher Sakellis, Hina Shah, Mary-Ellen Taplin, Xiao X Wei, Thomas Ng, Praful Ravi, Heather Jacene","doi":"10.1002/pros.24880","DOIUrl":"https://doi.org/10.1002/pros.24880","url":null,"abstract":"<p><strong>Background: </strong>¹⁷⁷Lu-vipivotide tetraxetan (¹⁷⁷Lu-PSMA-617, LuPSMA) improves overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC) after at least one taxane chemotherapy and androgen receptor pathway inhibitor. There are limited data on the clinical course and outcomes of patients with mCRPC after receipt of LuPSMA.</p><p><strong>Methods: </strong>We queried an IRB-approved prospectively maintained registry of all patients with mCRPC who received standard-of-care LuPSMA at our institution between June 2022 and January 2024. Clinical data about LuPSMA and subsequent therapies were extracted from the electronic medical record, including the type and number of subsequent systemic therapies, reason for treatment cessation, hematologic toxicity and supportive treatment, and PSA50 response to subsequent therapy (defined as a ≥ 50% decrease in PSA).</p><p><strong>Results: </strong>A total of 146 patients were evaluated; mean age 72 (range 52-87), observed median follow-up 5.9 months (range 0.51-18.7). Forty-four received systemic treatment after LuPSMA. The most common subsequent treatment after LuPSMA was chemotherapy (n = 27), primarily cabazitaxel ± carboplatin/cisplatin (n = 23), and the median number of cycles received was 4 (range 1-7). In 35/44 men with available hematologic toxicity data, 13 developed grade ≥ 3 anemia, 7 had ≥ grade 3 thrombocytopenia, and 16 received hematologic support. PSA50 to post-LuPSMA treatment occurred in 10/36 (28%) evaluable patients. Median overall survival from subsequent systemic therapy was 7.6 months (95% CI 5.81-NR).</p><p><strong>Conclusions: </strong>30% of patients receiving standard-of-care LuPSMA received subsequent therapy, mostly cabazitaxel-containing regimens. Post-LuPSMA treatment appeared tolerable and was associated with a PSA50 response rate of 28%. These outcomes may be biased by limited standard-of-care life-prolonging treatment options at the time of LuPSMA FDA approval, but it also highlights the continued need to develop novel therapeutic strategies for mCRPC post-LuPSMA.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659711","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":"Efficacy and Feasibility of Cabazitaxel for Very Elderly Patients of ≥ 80 Years of Age With Metastatic Castration-Resistant Prostate Cancer: A Real-World Multi-Intuitional Analysis.","authors":"Kotaro Suzuki, Junichiro Hirata, Yasuyoshi Okamura, Yukari Bando, Takuto Hara, Tomoaki Terakawa, Yoji Hyodo, Koji Chiba, Jun Teishima, Hideaki Miyake","doi":"10.1002/pros.24889","DOIUrl":"https://doi.org/10.1002/pros.24889","url":null,"abstract":"<p><strong>Background: </strong>Cabazitaxel (CBZ) is a key drug used for metastatic castration-resistant prostate cancer (mCRPC). However, clinical trial data on CBZ in very elderly patients are still lacking. This study aimed to investigate the efficacy and feasibility of CBZ for mCRPC patients of ≥ 80 years of age.</p><p><strong>Methods: </strong>We retrospectively reviewed 484 patients with mCRPC who started CBZ treatment between September 2019 and March 2024. Therapeutic efficacy (PSA response, progression-free survival, overall survival, and safety profile) was compared between patients of < 80 years of age (< 80 group) and those of ≥ 80 years of age (≥ 80 group). In addition, risk factors associated with grade ≥ 3 neutropenia in the ≥ 80 group were investigated using a logistic regression model.</p><p><strong>Results: </strong>Seventy-three (15.1%) patients were included in the ≥ 80 group. Although more patients in the ≥ 80 group received a reduced dose relative to the < 80 group, there was no significant difference in therapeutic efficacy between the two groups. The incidence of grade ≥ 3 neutropenia was similar between two groups (< 80: 27.5% vs. ≥ 80: 31.5%). In the ≥ 80 group, BMI < 22 kg/m² and neutrophil count ≤ 5000 cells/µL were significantly associated with grade ≥ 3 neutropenia, with odds ratios of 5.28 (p = 0.005) and 4.00 (p = 0.023), respectively.</p><p><strong>Conclusion: </strong>In mCRPC patients of ≥ 80 years of age, CBZ showed similar safety and efficacy to younger patients. Our findings suggest that CBZ treatment with appropriate dose modification and prophylactic AE treatments may be still beneficial for elderly mCRPC patients in the current aging population.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639851","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":"Incidental Brain Metastases From Prostate Cancer Diagnosed With PSMA PET/CT and MRI: A Case Series and Literature Review.","authors":"Mark Willy L Mondia, Prem P Batchala, Robert Dreicer, Michael E Devitt, Matthew R McCord, Melike Mut, Jason P Sheehan, David Schiff, Camilo E Fadul","doi":"10.1002/pros.24890","DOIUrl":"https://doi.org/10.1002/pros.24890","url":null,"abstract":"<p><strong>Background: </strong>Brain metastases (BMETS) from prostate cancer are rare. Hence, brain imaging in neurologically asymptomatic patients with advanced prostate cancer (aPC) is not routinely performed. Prostate-specific membrane antigen (PSMA) PET/CT uses a radiotracer that binds to prostate cancer epithelial cells and is FDA-approved for initial staging for high-risk prostate cancer, detecting prostate cancer recurrence, and determining eligibility for radionuclide therapy.</p><p><strong>Methods: </strong>We report six patients with asymptomatic BMETS from aPC found on staging PSMA PET/CT or MRI. Along with cranial MRI, PSMA PET/CT may be useful for detecting asymptomatic intracranial metastasis in select patients with prostate cancer.</p><p><strong>Results: </strong>Brain metastases were diagnosed in four patients by staging PSMA PET/CT scan-three after systemic disease progression and one during routine surveillance. In two other patients, BMETS were detected using MRI despite negative PSMA PET/CT for brain lesions. All were neurologically asymptomatic. Three patients had undetectable serum prostate-specific antigen (PSA) concentrations; one had neuroendocrine differentiation on histology.</p><p><strong>Conclusion: </strong>In patients with poorly differentiated or neuroendocrine aPC, BMETS may occur without neurologic symptoms and stable PSA. PSMA PET/CT may complement brain MRI for identifying BMETS in these patients.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626963","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":"Socioeconomic Disparities in Prostate Cancer Treatment: The Impact of Area Deprivation Index on Initial Treatment Type for Localized PCa in a North-American Cohort.","authors":"Silvia Viganò, Marco Finati, Alex Stephens, Alessandro Bertini, Alessio Finocchiaro, Giovanni Lughezzani, Nicolò Buffi, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Marta Rossanese, Ettore Di Trapani, Vincenzo Ficarra, Akshay Sood, Craig Rogers, Firas Abdollah","doi":"10.1002/pros.24882","DOIUrl":"https://doi.org/10.1002/pros.24882","url":null,"abstract":"<p><strong>Background: </strong>Socioeconomic status and geographical location contribute to disparities in localized prostate cancer (PCa) treatment. We examined the impact of area of deprivation index (ADI) on initial treatment type for localized PCa in a North-American cohort.</p><p><strong>Methods: </strong>We performed a retrospective analysis of patients diagnosed with localized PCa, treated within Henry Ford Health (HFH), between 1995 and 2022, with available ADI-data. ADI was assigned based on residential census block group, ranked as a national deprivation percentile. Patients were categorized into three treatment-groups: radical prostatectomy (RP), radiation therapy (RT) and \"other\" treatment. Using multinomial logistic regression, we assessed ADI impact on treatment choice. After excluding patients without cT, ISUP-grade and/or PSA, we stratified by D'Amico risk-classification and repeated the regression analysis in each subgroup.</p><p><strong>Results: </strong>Among 14,204 patients, 28.4% were NHB. Median (IQR) age at diagnosis was 65 (59-71) years. Median (IQR) ADI was 58 (36-83) for overall cohort and 51 (30-74), 66 (45-91), and 62 (39-88) for RP, RT, and \"other\" groups, respectively (p < 0.0001). Multivariable analysis showed ADI as an independent predictor of treatment choice (p = 0.01): for each 10-unit increase in ADI, patients were 3% more likely to receive RT and 10% less likely to receive RP. High ADI predicted a lower likelihood of receiving initial surgery across all risk-groups (p < 0.001).</p><p><strong>Conclusions: </strong>Patients in more advantaged areas were more likely to receive RP, while those in disadvantaged areas received more RT. Recognizing how neighborhood factors affect treatment choices is crucial for improving health equity and reducing disparities in PCa outcomes.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"e24882"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598199","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":"Propensity Score Matched Analysis of External Beam Radiotherapy With or Without Focal Boost to Intraprostatic Lesions in Prostate Cancer.","authors":"Cem Onal, Ozan Cem Guler, Gurcan Erbay, Birhan Demirhan, Aysenur Elmali, Melek Yavuz","doi":"10.1002/pros.24888","DOIUrl":"https://doi.org/10.1002/pros.24888","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the impact of radiotherapy (RT) with or without a simultaneous integrated boost (SIB) to intraprostatic lesions on survival, recurrence, and toxicity in localized prostate cancer (PCa). Key prognostic and predictive factors were also analyzed.</p><p><strong>Materials and methods: </strong>A retrospective analysis included 712 intermediate- and high-risk PCa patients treated with external beam RT at 78 Gy, with or without SIB (up to 86 Gy), between 2010 and 2018. Propensity score matching (PSM) was used to ensure comparability. Outcomes assessed included biochemical disease-free survival (bDFS), prostate cancer-specific survival (PCSS), local recurrence (LR), distant metastasis (DM), and treatment-related toxicities.</p><p><strong>Results: </strong>After PSM, 417 patients were analyzed (208 with SIB, 209 without). Over a median follow-up of 8.6 years, the SIB group showed higher 8-year bDFS (93.8% vs. 83.5%; p = 0.006) and lower rates of DM (6.1% vs. 13.0%; p = 0.003) and LR (1.8% vs. 6.9%; p = 0.03). PCSS was similar between groups (95.7% vs. 92.3%; p = 0.38). Advanced T stage and absence of SIB were predictors of worse bDFS, DM, and LR, while higher Gleason score were associated with poorer PCSS and DM in multivariable analysis. There were no significant differences in 8-year Grade ≥ 2 GU (10.1% vs. 10.5%; p = 0.98) or GI (7.8% vs. 6.5%; p = 0.64) toxicities between the SIB and non-SIB groups.</p><p><strong>Conclusions: </strong>SIB with external beam RT significantly improves bDFS and reduces LR and DM in intermediate- and high-risk PCa, with no increase in significant toxicities. These findings emphasize the value of dose escalation in achieving better local control and long-term outcomes while maintaining patient safety.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607033","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}