Prostate最新文献

{"title":"Evaluating the Efficacy of Barley Water in Alleviating Radiotherapy-Induced Dysuria in Prostate Cancer Patients: A Randomized Placebo-Controlled Trial.","authors":"Vida Nazari, Omid Keshavarzian, Mehdi Pasalar, Shadi Ghasemi, Bahram Mofid, Homa Hajimehdipoor, Mohammad Amin Annabi, Ghazaleh Heydarirad","doi":"10.1002/pros.70008","DOIUrl":"10.1002/pros.70008","url":null,"abstract":"<p><strong>Background: </strong>Radiotherapy is an essential treatment for various cancers, including prostate cancer (PCa), but it can lead to several adverse events, such as dysuria. While there is no gold standard treatment for this condition, some options, including herbal preparations, are suggested in traditional medicine. This study aimed to evaluate the efficacy of barley water compared to placebo in patients with PCa.</p><p><strong>Methods: </strong>This randomized placebo-controlled study compared an oral barley water decoction to a placebo after adjuvant radiotherapy in patients with PCa at a clinic in Tehran, Iran. Patients received a daily decoction of barley water or placebo for 1 week and were followed for 8 weeks. Patients, physicians, outcome assessors, and statisticians were blinded to the assigned treatment. The primary outcome was radiotherapy-induced dysuria, measured using the International Prostate Symptom Score (IPSS). Secondary outcomes included quality of life, analgesics use, and adverse events.</p><p><strong>Results: </strong>A total of 90 PCa patients were randomized to barley water (n = 45) or placebo (n = 45). Analyses showed no significant differences in dysuria, quality of life, or analgesic use between the groups. Adverse events were similar for both groups; however, patient satisfaction was significantly higher in the barley water group (p = 0.047).</p><p><strong>Conclusions: </strong>Barley water showed no clinical benefit over placebo in managing radiotherapy-induced dysuria in PCa patients. This finding underscores the importance of rigorous clinical evaluation of herbal remedies and highlights the need for evidence-based interventions to ensure patient safety and enhance quality of life.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1272-1281"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692481","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":"Impact of Intraoperative Enlarged Median Lobe on Functional Recovery Following Robot-Assisted Radical Prostatectomy: A Retrospective Cohort Analysis.","authors":"Rohan Sharma, Yu Ozawa, Marcio C Moschovas, Shady Saikali, Marco Sandri, Travis Rogers, Vipul R Patel","doi":"10.1002/pros.70021","DOIUrl":"10.1002/pros.70021","url":null,"abstract":"<p><strong>Background: </strong>The impact of intraoperative enlarged median lobe (EML) on outcomes following robot-assisted radical prostatectomy (RARP) remains underexplored. We aimed to evaluate the functional and oncological outcomes in patients with and without EML undergoing RARP.</p><p><strong>Methods: </strong>We retrospectively reviewed 9710 patients who underwent RARP between 2012 and 2021. Patients were stratified into two groups based on intraoperative identification of EML: Group A (no EML, n = 7985) and Group B (EML, n = 1725). Perioperative, pathological, functional, and oncological outcomes were compared. Kaplan-Meier survival curves and log-rank tests were used to assess biochemical recurrence (BCR) and functional recovery.</p><p><strong>Results: </strong>Median follow-up was 72 months. Patients in Group B were older (65 vs. 63 years, p < 0.001), had higher PSA (6.20 vs. 5.76 ng/mL, p < 0.001), and lower PSA density (0.09 vs. 0.12 ng/mL/cc, p < 0.001). Group B had more low-risk disease (29.8% vs. 24.1%, p < 0.001) and ISUP Grade Group 1 on biopsy (36.1% vs. 26.7%, p < 0.001). Operative time was longer in Group B (119 vs. 110 min, p < 0.001). Continence outcomes were comparable (p = 0.3). Among patients aged < 55 years with baseline SHIM > 21, potency recovery was high regardless of EML or nerve-sparing status. Group B demonstrated a significantly lower 10-year cumulative BCR rate (p = 0.042).</p><p><strong>Conclusions: </strong>RARP in patients with EML is associated with favorable oncological outcomes and equivalent continence recovery. Potency recovery is primarily influenced by age and baseline sexual function, rather than EML presence or nerve-sparing.</p><p><strong>Trial registration: </strong>This study is part of the prostate cancer registry (No. 237998).</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1342-1351"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735480","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":"Refining the CHAARTED Classification: Clinical Utility of a Novel Integrated Risk Stratification Model Incorporating Gleason Grade and Biochemical Markers in Japanese Patients With Metastatic Hormone-Sensitive Prostate Cancer.","authors":"Takanori Tokunaga, Keita Kobayashi, Kazuhiro Nagao, Kouki Fujikawa, Kazuo Oba, Kimio Takai, Hiroaki Matsumoto, Shigeru Sakano, Satoshi Shirataki, Yasuhide Tei, Masanori Tabara, Satoru Yoshihiro, Seiji Yano, Hideaki Ito, Seiji Kitahara, Chietaka Ohmi, Jumpei Akao, Koji Shiraishi","doi":"10.1002/pros.70019","DOIUrl":"10.1002/pros.70019","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, we aimed to develop and validate a novel risk stratification model integrating Gleason grade and biochemical markers to predict the prognosis of Japanese patients with metastatic hormone-sensitive prostate cancer (mHSPC). We also assessed its clinical utility as a complementary tool to the CHAARTED classification for guiding therapeutic decision-making.</p><p><strong>Methods: </strong>This multicenter retrospective study included patients with mHSPC treated between January 2018 and December 2023 at Yamaguchi University Hospital and its affiliated institutions. Patients who received androgen deprivation therapy combined with either an androgen receptor signaling inhibitor or docetaxel as the initial therapy were included. The primary endpoint was time to castration-resistant prostate cancer (TTCRPC). Independent prognostic factors were identified using multivariable Cox proportional hazards models, and a new risk classification was constructed.</p><p><strong>Results: </strong>In total, 294 patients were analyzed. Multivariable analysis identified Gleason grade group 5, lactate dehydrogenase above the upper limit of normal, and albumin < 4.0 g/dL as independent predictors for TTCRPC. Stratification by the number of these factors (Low, 0-1; Intermediate, 2; High, 3) revealed a clear separation of TTCRPC outcomes (median: not reached, 35 months, and 12 months, respectively; log-rank p < 0.0001). Combined with CHAARTED volume classification, high-volume patients with 0-1 risk factors had a prognosis similar to low-volume patients, whereas those with ≥ 2 factors had significantly poorer outcomes.</p><p><strong>Conclusions: </strong>This novel risk model enabled the refinement of prognostic stratification in conjunction with CHAARTED, facilitating tailored treatment intensity among high-volume patients. Accordingly, further prospective studies are warranted.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1323-1331"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676607","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":"Use of Droplet Digital PCR for Consistent Detection of TMPRSS2:ERG Gene Fusion Transcripts Initiated In Vitro.","authors":"Megan H Check, Sarah E Ernst, Karen S Sfanos","doi":"10.1002/pros.70013","DOIUrl":"10.1002/pros.70013","url":null,"abstract":"<p><strong>Background: </strong>Gene fusions are hybrid genes that arise from chromosomal rearrangements linking two independent genes. The most common gene fusion in prostate cancer involves the 5' androgen-regulated TMPRSS2 promoter fused with the 3' ETS transcription factor ERG. TMPRSS2:ERG (T:E) gene fusions occur in about half of all prostate cancers and are considered an early event in oncogenesis. Investigations into the mechanism behind T:E gene fusion initiation using in vitro systems are hindered by the technical limitations posed by fluorescence in situ hybridization and suboptimal sensitivity of reverse transcription quantitative PCR (RT-qPCR). The objective of this study was to develop a reliable, user-friendly method of detecting low-abundance T:E gene fusion transcripts as a read-out for putative T:E gene fusions generated in cells.</p><p><strong>Methods: </strong>We assessed the sensitivity of droplet digital PCR (ddPCR) by quantifying T:E gene fusion transcripts using gene fragment- or cell-based standard curves. Next, we evaluated dihydrotestosterone (DHT), genotoxic insults (irradiation, etoposide), and inflammatory agents tumor necrosis factor-alpha (TNF-α) and hydrogen peroxide (H₂O₂) as initiators of T:E fusions in a fusion-negative prostate cell line (LNCaP). Finally, we performed RT-qPCR to measure the expression of androgen receptor (AR), AR-regulated genes (TMPRSS2, NKX3.1) and the downstream activation target of TNF-α, NF-κB.</p><p><strong>Results: </strong>We identified ddPCR as a sensitive method for detecting rare T:E gene fusion transcripts and observed consistent detection in reactions containing a single T:E gene fragment, or 1 fusion-positive cell per 10,000 fusion-negative cells. Consistent with prior studies, the ddPCR assay identified DHT combined with etoposide as potent, synergistic initiators of T:E gene fusion transcript expression in LNCaP cells. We did not detect T:E gene fusion transcripts after LNCaP exposure to irradiation, TNF-α, or H₂O₂. We determined that TNF-α and H₂O₂ exposure led to global downregulation of AR signaling, which may have limited the formation or expression of treatment-initiated genomic T:E fusions. Therefore, one limitation of the ddPCR assay is the requirement for T:E fusion mRNA expression.</p><p><strong>Conclusions: </strong>Our proposed method significantly improves the feasibility of testing novel initiators of the T:E gene fusion and can be applied to additional studies investigating mechanisms of gene fusion initiation in prostate and other cancers.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1282-1289"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610362","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":"Oncological Outcomes After Robotic Salvage Radical Prostatectomy in Patients Primarily Treated With Focal Versus Radiation Therapy: A Junior ERUS/YAU Collaborative Study.","authors":"Mike Wenzel, Arjun Nathan, Marcio Covas Moschovas, Christian Wagner, Giorgio Calleris, Fabrizio Di Maida, Juan Gomez Rivas, Carlo Andrea Bravi, Ruben De Groote, Federico Piramide, Filippo Turri, Keith Kowalczyk, Christoph Würnschimmel, Gopal Sharma, Iulia Andras, Edward Lambert, Nikolaos Liakos, Danny Darlington, Marco Paciotti, Gabriele Sorce, Philipp Mandel, Antonio Galfano, Senthil Nathan, Giancarlo Marra, Paolo Dell'Oglio, Alexandre Mottrie, Felix K H Chun, Vipul Patel, Alberto Breda, Alessandro Larcher","doi":"10.1002/pros.70020","DOIUrl":"10.1002/pros.70020","url":null,"abstract":"<p><strong>Background: </strong>To evaluate surgical and cancer-control outcome differences in robotic salvage radical prostatectomy (s-RARP) patients after primary prostate cancer treatment with radiation (RT) versus focal therapy (FT).</p><p><strong>Methods: </strong>The Junior ERUS/Young Academic Urologist Working Group Robotics in Urology conducted a multicentric project to investigate biochemical recurrence-free (BCR), metastases-free (MFS) and overall survival outcomes in s-RARP patients primarily treated with RT versus FT.</p><p><strong>Results: </strong>Overall, 439 s-RARP patients qualified for analyses, of which 54% initially received RT with a median time interval between primary cancer treatment and s-RARP of 48 months. Patients with RT more frequently exhibited unfavorable oncological characteristics before s-RARP (PSA, ISUP score), as well as pathological ISUP score (all ≤ 0.01), relative to FT patients. No differences in postoperative complications were observed (p > 0.9). In BCR-free analyses, no significant differences between RT and FT were observed (hazard ratio [HR]: 1.30, p = 0.2). In MFS and OS analyses, patients with RT harbored a higher risk of metastases (HR: 10.1, p < 0.001) and death (HR: 5.1, p = 0.02), relative to FT s-RARP patients, but not after multivariable adjustment. In subgroup analyses of 201 FT patients, 80% received high-intensified focused ultrasound (HIFU). No difference in BCR-free survival was observed for HIFU- versus non-HIFU s-RARP patients (p = 0.9).</p><p><strong>Conclusions: </strong>Important differences in tumor characteristics between RT versus FT s-RARP patients exist. These baseline differences translate into unfavorable short-term MFS- and OS outcomes for RT s-RARP patients.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1332-1341"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700291","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":"MEIS2 Modulates Oxidative Phosphorylation and ROS Generation to Affect CD8⁺ T Cell Antitumor Immunity in Prostate Cancer.","authors":"Dengjun Han, Changyi Jiang, Hongjian Liu, Dayong Ye, Xiaofu Zeng, Yujie Wang, Xianyong Li, Mingqiang Su, Yang Cheng","doi":"10.1002/pros.70051","DOIUrl":"https://doi.org/10.1002/pros.70051","url":null,"abstract":"<p><strong>Background: </strong>The response of prostate cancer (PCa) to immunotherapy remains suboptimal. Although MEIS homeobox 2 (MEIS2) has been shown to delay the malignant progression of PCa by inhibiting cancer cell proliferation, promoting DNA damage, and affecting CD8⁺ T cell immune surveillance, its role in immune regulation and the underlying mechanisms remain elusive.</p><p><strong>Methods: </strong>MEIS2 expression in PCa and its correlation with CD8⁺ T cells were characterized using bioinformatics analysis and cell experiments. Using qPCR, flow cytometry, and ELISA, the impact of MEIS2 on CD8⁺ T cell antitumor immunity was assessed. To delineate the role of MEIS2 in oxidative phosphorylation and ROS generation, OCR, ATP, and ROS measurements were collected. Finally, the oxidative phosphorylation inhibitor MCH32 was introduced and rescue experiments were conducted to elucidate the mechanism by which MEIS2 regulated CD8⁺ T cell cytotoxicity.</p><p><strong>Results: </strong>MEIS2 expression in PCa was found to be downregulated, positively correlating with CD8⁺ T cell infiltration. Functionally, MEIS2 overexpression enhanced the cytotoxicity of CD8⁺ T cells. Mechanistically, MEIS2 was notably enriched in oxidative phosphorylation and ROS pathways. Knockdown of MEIS2 in cancer cells stimulated oxidative phosphorylation and ROS production, which impaired CD8⁺ T cell antitumor immunity. Treatment with the oxidative phosphorylation inhibitor MCH32 reversed these effects induced by MEIS2 knockdown.</p><p><strong>Conclusion: </strong>Targeting MEIS2 could represent a clinically relevant approach to enhancing CD8⁺ T cell antitumor efficacy in PCa, our findings indicate.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201968","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":"Robotic-Assisted Radical Prostatectomy in the Elderly Patient-A Study of Functional, Surgical, and Oncological Outcomes in an Australian Cohort.","authors":"Victor Yu, Patrick-Julien Treacy, Ruban Thanigasalam, Nariman Ahmadi, Norbert Doeuk, Henry Woo, Lewis Chan, Jacob Bird, Kate Alexander, Juliette Cotte, Daniel Steffens, Scott Leslie","doi":"10.1002/pros.70063","DOIUrl":"https://doi.org/10.1002/pros.70063","url":null,"abstract":"<p><strong>Background: </strong>Curative surgery for prostate cancer is uncommonly offered to patients aged ≥ 75, balancing functional outcomes against survival benefit. The increased adoption of robotic-assisted radical prostatectomy (RARP) and improved overall life expectancy challenges this paradigm. The objective of this study was to compare functional outcomes between elderly and younger patients following RARP.</p><p><strong>Methods: </strong>Retrospective review of a prospective multicentre database including all RARP patients between October 2016 and December 2023. Patients were divided into cohorts based on age; elderly (≥ 75 years) and younger (< 75 years). Variables included baseline demographics (body mass index [BMI], American Society of Anaesthesiologists [ASA] classification, prostate specific antigen [PSA], and Gleason score), surgical (technique, complications, and length of stay), pathological (histopathology, margins, and PSA) and functional (incontinence, International Prostate Symptom Score [IPSS], International Index of Erectile Function [IIEF-5], and Expanded Prostate Index Composite [EPIC]) outcomes. Univariate (chi-square and t-tests) and multivariate analysis were performed to compare cohorts against the primary outcome of continence at 1-year (number of pads/day), with p-values < 0.05 considered statistically significant.</p><p><strong>Results: </strong>A total of 397 patients were included (< 75; n = 332, ≥ 75; n = 65). No statistically significant differences were detected in continence at 1-year in ≥ 75 (< 75; 0.73 [0.59-0.87], ≥ 75; 0.66 [0.37-0.95] mean pads/24 h, p = 0.8), despite significantly lower nerve preservation and bladder-neck spare rates (< 75; 37.3%, ≥ 75; 21.5%). IIEF-5 scores were worse in the ≥ 75 group (1.60 ± 1.17 vs. 5.73 ± 6.93 p < 0.001), however there were no significant differences in IPSS. Patient in the elderly cohort had more severe disease (67.7% T3, ≥ 75 vs. 47.3%, < 75, p < 0.05). Rates of positive surgical margins (28.3% vs. 30.8% [≥ 75]) and PSA recurrence (25% vs. 23% [≥ 75]) were similar. Complication rates were low in both groups with no significant differences (3% vs. 6.6% [≥ 75]) and were of lower severity in the ≥ 75 group.</p><p><strong>Conclusion: </strong>RARP in carefully selected elderly patients does not increase risk of urinary incontinence and should not be disregarded in an aging population with higher overall life expectancy.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202088","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":"c-Kit-Mediated PI3K/AKT and Wnt/β-Catenin Signaling Drives Resistance to 5α-Reductase Inhibitors in Benign Prostatic Hyperplasia.","authors":"Jun Zhu, Junduo Wang, Meng Gu, Huan Xu, Yanbo Chen, Bin Xu, Qi Chen","doi":"10.1002/pros.70046","DOIUrl":"https://doi.org/10.1002/pros.70046","url":null,"abstract":"<p><strong>Background: </strong>Resistance to 5α-reductase inhibitors (5ARIs) represents a significant therapeutic challenge in benign prostatic hyperplasia (BPH) clinical management. While the c-Kit-mediated signaling has been implicated in various pathological conditions, its role in BPH and 5ARI resistance remains undefined.</p><p><strong>Methods: </strong>Patient-derived organoids (PDOs) were established from BPH specimens and characterized through immunofluorescence, immunohistochemistry, and RT-qPCR analysis. Transcriptomic profiling was performed to identify differentially expressed genes between 5ARI-sensitive and resistant samples. The functional significance of c-Kit-mediated signaling was evaluated using selective inhibitor ISCK03. Further analysis identified cellular targets of c-Kit inhibition, and downstream signaling mechanisms were characterized through pathway analysis.</p><p><strong>Results: </strong>RNA sequencing revealed differentially expressed genes between 5ARI-sensitive and resistant BPH PDOs, with significant enrichment in KIT and related genes. Enhanced c-Kit expression was confirmed in 5ARI-resistant specimens through multiple methodologies. Selective c-Kit inhibition with ISCK03 specifically suppressed 5ARI-resistant PDOs proliferation while sparing sensitive ones. Tests utilizing single-cell-derived organoids identified basal epithelial cells as primary targets of c-Kit inhibition. Mechanistic studies demonstrated that c-Kit maintains 5ARI resistance through the PI3K/AKT and Wnt/β-catenin signaling axis, with c-Kit inhibition significantly downregulating this pathway.</p><p><strong>Conclusions: </strong>c-Kit-mediated signaling is associated with 5ARI resistance in BPH, potentially through modulation of PI3K/AKT and Wnt/β-catenin pathways. These findings highlight c-Kit as a potential therapeutic target for overcoming 5ARI resistance.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187771","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":"Association of Weight Loss and BMI on PSA Levels and Overall Survival in Veterans With Metastatic Castrate-Resistant Prostate Cancer.","authors":"Nicholas Fedele, R Jackson Wilson, Jason Doherty, Priya Baxi, Daniel Eaton, Nina Cheranda, Srinivas Govindan, Suhong Luo, Martin W Schoen","doi":"10.1002/pros.70060","DOIUrl":"https://doi.org/10.1002/pros.70060","url":null,"abstract":"<p><strong>Background: </strong>There is a complex relationship between body weight and survival in prostate cancer. While increased BMI is associated with increased prostate cancer incidence and death, obesity is associated with improved survival in metastatic castrate-resistant prostate cancer (mCRPC). However, little is known about the effect of weight change before the treatment of mCRPC on survival. We assessed the association between BMI, weight loss before treatment, PSA levels, and overall survival in mCRPC.</p><p><strong>Methods: </strong>Veterans treated with abiraterone or enzalutamide for de novo mCRPC from May 2011 to June 2017 were identified within the VHA. BMI and weight loss in the year before treatment were determined. Kruskal-Wallis, χ² tests, ANOVA, Kaplan-Meier, and Cox proportional hazard modeling tests were used to assess the association between BMI, weight loss, PSA at the start of treatment, and overall survival, with covariates including age, race, and Charlson Comorbidity Index.</p><p><strong>Results: </strong>We identified 8857 veterans treated for mCRPC with weight loss values available and 8438 patients with BMI values available. There was shorter survival in veterans with weight loss > 10% of body weight (median = 9.8 months, n = 1332) compared with 5%-10% loss (median = 16.1 months, n = 1619) and stable weight (median = 25.1 months, n = 5906). Mean PSA levels increased (106.3, 160.0, 267.8) as BMI decreased (BMI > 30, BMI 25-30, BMI < 25), respectively. As weight loss increased (stable weight vs. weight loss 5%-10% vs. weight loss > 10%), mean PSA levels increased (112.2, 205.8, 405.9), respectively. Compared with a stable weight, both losing 5%-10% of weight (HR: 1.30, 95% CI: 1.22-1.38) and losing > 10% of weight (HR: 1.98, 95% CI: 1.85-2.12) are independently associated with increased mortality. Analyses in subgroups revealed BMI > 30 with stable weight to be the most favorable group in terms of survival, while BMI < 25 with > 10% weight loss had the highest mortality risk (HR: 2.63, 95% CI: 2.39-2.89).</p><p><strong>Conclusion: </strong>Weight loss the year before treatment is associated with increased mortality and higher PSA levels in patients with mCRPC. The effect of weight loss is independent of BMI, where we found that lower BMI is associated with increased mortality and higher PSA levels in patients with mCRPC. This risk increases with the magnitude of weight loss, with lower BMI categories compounding the risk. Both weight loss and BMI should be incorporated into survival models to improve prognostication in mCRPC.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187744","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":"Influence of 5-Alpha Reductase Inhibitors on PI-RADS Scores and Prostate Cancer Detection: A Systematic Review and Meta-Analysis.","authors":"Lian Qiong, Li Qingyi, Guo Bohong, Hao YouCheng, Liu Qiangzhao","doi":"10.1002/pros.70066","DOIUrl":"https://doi.org/10.1002/pros.70066","url":null,"abstract":"<p><strong>Background: </strong>The impact of 5-alpha reductase inhibitors (5-ARIs) on Prostate Imaging Reporting and Data System (PI-RADS) tumor classifications and prostate cancer (PCa) detection were reviewed and analyzed.</p><p><strong>Method: </strong>A comprehensive systematic review and meta-analysis were conducted by evaluating published studies examining the influence of 5-ARIs on PI-RADS lesions and PCa detection. The Web of Science, PubMed, and Embase databases were accessed for relevant study retrieval. Statistical analyses were performed through the use of STATA v.16.0.</p><p><strong>Results: </strong>Seven studies, comprising 12,132 participants, were included. Compared to men who had not received 5-ARIs, those exposed to 5-ARIs exhibited no significant differences in PCa diagnosis (OR 0.97, 95% CI 0.86-1.08; p = 0.55) or clinically significant PCa (csPCa) diagnosis (OR 1.01, 95% CI 0.89-1.16; p = 0.85). Further subgroup analyses demonstrated that 5-ARI-exposed men had comparable PCa diagnosis in PI-RADS 3 (OR 0.85, 95% CI 0.65-1.12; p = 0.25), PI-RADS 4 (OR 1.01, 95% CI 0.85-1.21; p = 0.84), and PI-RADS 5 (OR 1.01, 95% CI 0.81-1.26; p = 0.87) groups relative to 5-ARI-naïve men.</p><p><strong>Conclusions: </strong>These findings suggest that 5-ARIs do not significantly alter PI-RADS lesion distribution or impact PCa and csPCa diagnosis. Consequently, exposure to 5-ARIs should not influence MRI-based diagnostic approaches in patients with suspected PCa.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187725","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}