Prostate最新文献

{"title":"Evaluating the Heterogeneity of Advanced Prostate Cancer by ¹⁸F-DCFPyL and ¹⁸F-FDG PET/CT in a Prospective Cohort.","authors":"GuangHao Chen, YueKai Li, ShangZhen Geng, LinChen Lv, Yong Wang, Xin Li, ShouZhen Chen, BenKang Shi","doi":"10.1002/pros.24881","DOIUrl":"https://doi.org/10.1002/pros.24881","url":null,"abstract":"<p><strong>Purpose: </strong>¹⁸F-DCFPyL (targeted PSMA) and ¹⁸F-FDG dual-tracer PET/CT combination with next-generation sequencing was applied in a prospective cohort of men with prostate cancer to identify the clinical and genetic characteristics with heterogeneous PET/CT imaging features.</p><p><strong>Methods: </strong>104 men with documented prostate cancer underwent ¹⁸F-DCFPyL and ¹⁸F-FDG PET/CT, of which 83 underwent next-generation sequencing for detecting variation of AR, TP53, RB1, PTEN, etc. Lesions were classified into DCFPyL+FDG± lesions and DCFPyL-FDG+ lesions and analyzed for heterogeneous distribution. We divided the patients with positive lesions into DCFPyL+FDG± group and DCFPyL-FDG+ group, then compared the differences in clinical features and genetic mutations between the two groups with CRPC.</p><p><strong>Results: </strong>Overall, 92 men had positive lesions detected. By comparing lesion distribution with the DCFPyL+FDG ± , DCFPyL-FDG+ disease had higher proportions of visceral metastases (4.1% vs. 1.0%, p = 0.002). DCFPyL-FDG+ was more frequently found in CRPC cohorts, and in the CRPC cohort, patients with DCFPyL-FDG+ lesions often had worse PSA response. Exploratory analysis showed that TP53 and/or RB1 mutations might be a risk factor for DCFPyL-FDG+ disease (OR = 10.625, 95% CI 3.492-32.332, p < 0.001).</p><p><strong>Conclusion: </strong>Patients with DCFPyL-FDG+ lesions were more likely to have visceral metastases detected, be found in castration-resistant cohorts, have TP53 and/or RB1 mutations detected, and have poor therapeutic response compared to patients with DCFPyL+FDG± lesions. Therefore, dual-tracer (¹⁸F-DCFPyL and ¹⁸F-FDG) PET/CT is recommended for patients with low PSMA expression incompatible with the true burden of the disease and those with TP53 and/or RB1 mutations to better evaluate the disease burden, tumor heterogeneity, and prognosis.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568870","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 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":"https://doi.org/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":"e24869"},"PeriodicalIF":2.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate Specific Antigen Density and Clinically-Significant Prostate Cancer: The Influence of Prostatic Volume.","authors":"Elizabeth Robinson, Netty Kinsella, Derfel Ap Dafydd, Joshua Shur, Aslam Sohaib, Steve Hazell, Paul Bassett, Pardeep Kumar, Erik Mayer, Declan Cahill, Samuel J Withey","doi":"10.1002/pros.24886","DOIUrl":"https://doi.org/10.1002/pros.24886","url":null,"abstract":"<p><strong>Background: </strong>Prostate specific antigen density (PSAd) is one of the strongest predictors of clinically-significant prostate cancer (csPCa) in risk calculators. There is little evidence on the effect of prostate volume on the diagnostic performance of PSAd. Our aim was to define the diagnostic accuracy of PSAd for predicting csPCa across prostate volumes.</p><p><strong>Methods: </strong>548 patients who underwent magnetic resonance imaging (MRI) and biopsy were included in this retrospective study. Patients were grouped by prostate volume; small (≤ 30 mL), medium (> 30 to < 50 mL), large (≥ 50 mL). Sensitivity and specificity of PSAd were assessed at thresholds of ≥ 0.10, ≥ 0.15, and ≥ 0.20 ng/mL/mL for two definitions of csPCa.</p><p><strong>Results: </strong>At all PSAd thresholds and for both definitions of csPCa, there was a statistically significant and clinically-relevant difference in diagnostic performance across prostate volume groups. Sensitivity was highest in small glands, lowest in large glands; the opposite being true for specificity. Using a PSAd threshold of ≥ 0.15 ng/mL/mL, sensitivity for ISUP grade ≥ 2 PCa was 83.1%, 63.6%, and 33.3% for small, medium and large prostates (p ≤ 0.001) with specificities of 48.5%, 67.5% and 79.3%, respectively (p = 0.005).</p><p><strong>Conclusions: </strong>Diagnostic performance of PSAd varied significantly by prostate volume, and by applying a single PSAd threshold across all prostate volumes risks missing csPCa in men with larger glands, whilst performing unnecessary biopsies in those with smaller glands. Defining PSAd thresholds according to prostate volume categories can therefore improve its use as a risk predictor for csPCa.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544417","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":"Zinc Attenuates Prostate Hyperplasia and Inflammatory Injury in Obese Rats by Regulating Zinc Homeostasis and Inhibiting the JAK1/STAT3 Pathway.","authors":"Yuanjing Li, Zongkai Wu, Jing Ma, Xuan Liu, Chenhui Zhang, JiaoYing Ma, Wen Li, Bangrong Zhao, Shusong Wang","doi":"10.1002/pros.24883","DOIUrl":"https://doi.org/10.1002/pros.24883","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Obesity is an important risk factor for prostate damage. The importance of zinc in male reproductive spermatogenesis and the anti-inflammatory properties of zinc have been studied. However, the role of zinc in obesity-induced prostate proliferation and inflammatory injury and changes in zinc transporters are unknown and require extensive research and validation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;In this study, we modeled high-fat-fed obese rats. Then, the zinc supplementation group was given daily intragastric administration of zinc sulfate saline solution, while the control group and the high-fat group received the same amount of saline intragastric administration for 8 consecutive weeks. Sperm parameters were statistically analyzed, serum hormones were determined by chemiluminescence immunoanalyzer, and biochemical indexes were determined by automatic biochemical instrument. Inflammatory factors in prostate tissue were evaluated by enzyme-linked immunosorbent assay (ELISA), zinc content in prostate tissue was determined by inductively coupled plasma mass spectrometry (ICP-MS), and zinc transporters, inflammation and apoptosis indicators in prostate tissues were analyzed by Western Blot analysis (WB).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;We found that obese rats had decreased sperm motility and sperm count and decreased androgens, leading to male reproductive disorders, whereas sperm motility and sperm count were increased in obese rats after zinc supplementation. The prostate epithelial cells of obese rats showed papillary proliferation with leukocyte infiltration, and the papillary proliferation of epithelial cells was alleviated after zinc supplementation. Meanwhile, pro-inflammatory cytokines and insulin growth factors IL-6, IL-1β, and IGF1 were significantly increased in prostate tissues of obese rats, whereas they were decreased after zinc supplementation. The expression of zinc transporters ZIP10 and ZIP6 was increased and the expression of ZnT3 was decreased in obese rats, while the expression of zinc transporters ZIP6 and ZIP10 was decreased and the expression of ZnT3 was increased after zinc supplementation. WB results showed that zinc supplementation reduced the expression of JAK1/STAT3, elevated the expression of caspase8, caspase3, and Bax, and decreased the expression of Bcl2. Bcl2 expression. This may be due to the fact that zinc supplementation can reduce the level of prostate inflammatory factors and insulin growth factor and promote apoptosis, thus improving prostate cell proliferation and inflammatory injury.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Zinc ameliorates prostate proliferation and inflammatory injury in obese rats by regulating zinc homeostasis, inhibiting the JAK1/STAT3 signaling pathway, and promoting apoptosis. These results provide new insights into the role of zinc as a regulator of prostate metabolism and further illustrate the potential application of zinc in male reproductive","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544419","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":"Evaluating the Prognostic Impact of Apparent Diffusion Coefficient in Definitive Radiotherapy for Gleason Score 7 Prostate Cancer Patients.","authors":"Cem Onal, Aysenur Elmali, Gurcan Erbay, Birhan Demirhan, Philip Sutera, Matthew P Deek, Phuoc T Tran, Ozan Cem Guler","doi":"10.1002/pros.24833","DOIUrl":"10.1002/pros.24833","url":null,"abstract":"<p><strong>Background: </strong>To investigate the utility of diffusion-weighted magnetic resonance imaging (DW-MRI) in evaluating Gleason score (GS) 7 tumors before definitive radiotherapy (RT) and to explore its association with clinicopathological factors and treatment outcomes.</p><p><strong>Materials and methods: </strong>Clinical data of 266 prostate cancer (PCa) patients with biopsy-confirmed GS 7 who underwent RT were retrospectively analyzed. Pretreatment DW-MRI was utilized to measure apparent diffusion coefficient (ADC) values of primary tumors. Treatment outcomes, including biochemical disease-free survival (bDFS) and prostate cancer-specific survival (PCSS), were assessed. Statistical analyses were conducted to determine the correlation between tumor ADC values, clinicopathological factors, and treatment outcomes.</p><p><strong>Results: </strong>Tumors with a GS of 3 + 4 had significantly higher ADC values than those with a GS of 4 + 3 (0.746 ± 0.150 vs. 0.702 ± 0.157 × 10^-³ mm²/s; p < 0.001). Median follow-up time was 8.6 years, and the 7-year rates for bDFS and PCSS were 89.1% and 95.3%, respectively. Lower tumor ADC values were significantly correlated with higher GS and increased risk of disease progression. A primary tumor ADC cutoff value of 0.682 × 10^-³ mm²/s was identified for predicting disease progression. Patients with higher ADC values exhibited significantly better 7-year bDFS rates (92.8% vs. 83.2%; p = 0.02). However, GS 4 + 3 tumors independently predicted poorer bDFS and PCSS outcomes. In the multivariable analysis, only GS 4 + 3 tumor was predictive for worse bDFS and PCSS.</p><p><strong>Conclusions: </strong>Tumor ADC values are a reliable biomarker for differentiating between GS 3 + 4 and 4 + 3 tumors in the GS 7 category. Tumors exhibiting lower ADC values have been associated to higher risk factors and an increased likelihood of disease progression, particularly in GS 3 + 4 tumors where GS upgrading could happen.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"344-353"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774732","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":"Comparison of Prognosis and Health-Related Quality of Life Between Robot-Assisted Radical Prostatectomy Versus High-Dose-Rate Brachytherapy Combined With External Beam Radiation Therapy and Hormone Therapy for High-Risk Prostate Cancer.","authors":"Yuya Iwahashi, Takahito Wakamiya, Hiroki Kawabata, Ryusuke Deguchi, Satoshi Muraoka, Takaya Inagaki, Yasutaka Noda, Shimpei Yamashita, Yasuo Kohjimoto, Tetsuo Sonomura, Isao Hara","doi":"10.1002/pros.24831","DOIUrl":"10.1002/pros.24831","url":null,"abstract":"<p><strong>Background: </strong>We compare the oncological outcomes and health-related quality of life (HRQOL) in men with high-risk prostate cancer after robot-assisted radical prostatectomy (RARP) versus that after high-dose-rate brachytherapy + external beam radiotherapy + hormone therapy (hereafter: \"HDR+\").</p><p><strong>Methods: </strong>We included 233 men who underwent RARP and 179 men who underwent HDR+ for high-risk prostate cancer at our hospital. We investigated the following oncologic outcomes: time to biochemical recurrence, time to development of castration-resistant prostate cancer (CRPC), cancer-specific survival, and overall survival. HRQOL was assessed using SF-8 and Expanded Prostate Cancer Index Composite (EPIC) at baseline and at 3, 6, 12, and 24 months after treatment. Propensity score matching was performed to adjust the background of the two treatment groups.</p><p><strong>Results: </strong>The HDR+ group had a significantly lower rate of biochemical recurrence than the RARP group (p ≤ 0.01). There were no significant differences between the two groups in the time to CRPC, in cancer-specific survival, or in overall survival. The two groups had similar HRQOL, according to SF-8. The urinary domain of EPIC was significantly worse in the RARP group at 3 and 6 months postoperatively than in the HDR+ group (p ≤ 0.01). Urinary function and urinary incontinence were significantly worse in the RARP group than in the HDR+ group at all time points postoperatively (p ≤ 0.01), while urinary irritation/obstruction was significantly worse in the HDR+ group at 12 months than in the RARP group (p ≤ 0.01). Bowel function was similar between the two groups.</p><p><strong>Conclusions: </strong>Both RARP and HDR+ were considered to be effective treatments for patients with high-risk prostate cancer in terms of oncological outcomes. Our RARP group had more postoperative urinary incontinence than our HDR+ group, while the HDR+ group had more frequent urination as a symptom of late genitourinary toxicity than the RARP group.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"327-336"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787803","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":"Coconut Oil Mitigates the Effects of Aging on the Mongolian Gerbil Prostate.","authors":"Luiz Henrique Alves Guerra, Nayara Fernanda da Costa Castro, Fernanda Costa Jubilato, Letícia Aparecida Marques, Ellen Cristina Rivas Leonel, Stanislau Bogusz Junior, Silvana Gisele Pegorin Campos, Paula Rahal, Sebastião Roberto Taboga, Marilia Freitas Calmon, Patrícia Simone Leite Vilamaior","doi":"10.1002/pros.24842","DOIUrl":"10.1002/pros.24842","url":null,"abstract":"<p><strong>Background: </strong>Benign prostatic hyperplasia (BPH) is a disease linked to the hormonal imbalance that occurs during aging and over the last decades, complementary and alternative medicines have come on the scene as a treatment option for BPH, such as herbal medicines. Coconut oil has been shown to be capable of interfering in testosterone-induced BPH. However, until now there is no study of the effect of coconut oil during aging. The present study evaluated the effect of the intake of coconut oil on the prostate of aging gerbils (Meriones unguiculatus).</p><p><strong>Methods: </strong>Two experimental groups were assigned: Gavage control (GC-animals subjected to gavage with water for 1 year, n = 11) and coconut oil (CO-animals subjected to gavage with coconut oil for 1 year, n = 11). Testosterone, and estradiol serum levels were determined by ELISA assay and histopathological analysis employed Hematoxylin-Eosin. Cell proliferation index was determined by PHH3 immunohistochemistry and TUNEL assay and receptors of androgen (AR) and estrogen (ERα and ERβ) were evaluated on the prostate.</p><p><strong>Results: </strong>The CO group exhibited a lower prostate weight (↓16.62%), decreased thickness of the prostate muscle stroma (↓18.27%), reduced expression of both AR (↓51.32) and ERα (↓14.26%) and reduced the percentage of BPH (↓1.53%) and intraepithelial neoplasms in the prostate (↓14.24%). Coconut oil intake mitigated age-related changes and increased the rate of apoptosis in prostatic cells (↑54.32).</p><p><strong>Conclusions: </strong>Coconut oil treatment throughout aging helped counteract the negative effects of aging on prostate health.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"395-406"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883564","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":"PI-RADS in Predicting csPCa: A Comparison Between Academic and Nonacademic Centers.","authors":"Angelo Orsini, Simone Ferretti, Annamaria Porreca, Pietro Castellan, Giulio Litterio, Davide Ciavarella, Antonio De Palma, Francesco Berardinelli, Andrea D Pizzi, Emanuela D'Angelo, Marta di Nicola, Luigi Schips, Michele Marchioni","doi":"10.1002/pros.24832","DOIUrl":"10.1002/pros.24832","url":null,"abstract":"<p><strong>Introduction: </strong>The introduction of multiparametric prostate magnetic resonance imaging (mpMRI) has revolutionized prostate cancer (PCa) diagnosis, enhancing the localization of clinically significant prostate cancer (csPCa) and guiding targeted biopsies. However, significant disparities in the execution, interpretation, and reporting of prostate MRI examinations across centers necessitate greater standardization and accuracy. This study compares the diagnostic efficacy of mpMRI from academic and nonacademic centers in detecting csPCa and identifies factors associated with csPCa detection.</p><p><strong>Materials and methods: </strong>Between July 2018 and October 2023, we prospectively followed 810 men at SS. Annunziata Hospital of Chieti who underwent MRI/US fusion biopsies due to elevated prostate-specific antigen (PSA) and/or abnormal digital rectal examination (DRE). Patients with mpMRI-documented suspicious lesions classified as PI-RADS ≥ 3 were included. Patients were divided into two groups based on the source of their mpMRI (academic or nonacademic centers). All biopsies were conducted using the MRI/US fusion technique. Clinical, mpMRI, and pathological data were collected and analyzed. Statistical analyses were performed using R software.</p><p><strong>Results: </strong>The cohort included 354 patients from academic centers and 456 from nonacademic centers. There were no significant differences in patient demographics, such as age and PSA levels, between the groups. Patients at academic centers were more likely to receive a higher number of elevated PI-RADS scores compared to those at nonacademic centers (PI-RADS > 3: 72.6% vs. 62.3%, p = 0.003). Histopathological analysis revealed no significant differences in the ISUP grade distribution between groups. Increased age, PSA levels, and positive DRE were significantly associated with higher odds of detecting csPCa. Median PSA density was significantly higher in patients with csPCa compared to those without csPCa (0.14 vs. 0.11 ng/mL/cm³, p < 0.001). Academic centers exhibited a higher odds ratio for csPCa detection in patients with PI-RADS scores > 3 compared to nonacademic centers.</p><p><strong>Conclusion: </strong>Our study highlights significant variability in PI-RADS score assignments between academic and nonacademic centers, affecting csPCa detection rates. This variability underscores the need for greater standardization in PI-RADS scoring to reduce disparities and improve diagnostic uniformity across centers.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"337-343"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873512","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":"ERG and PTEN Role on Active Surveillance for Low-Risk Prostate Cancer in the Multiparametric MRI Era.","authors":"Marco Aurelio Watanabe Yorioka, Claudio Bovolenta Murta, Kátia Ramos Moreira Leite, Leonardo Cardili, Evandro Sobroza de Mello, Arnaldo Jose de Carvalho Fazoli, Maurício Dener Cordeiro, Rafael Ferreira Coelho, Públio Cesar Cavalcante Viana, Cesar Sadao Nicolino Kohama, William Carlos Nahas, José Pontes-Júnior","doi":"10.1002/pros.24835","DOIUrl":"10.1002/pros.24835","url":null,"abstract":"<p><strong>Background: </strong>Our study aimed to correlate ERG and PTEN expressions in prostate biopsy with multiparametric magnetic resonance imaging PI-RADS score, clinical reclassification, and prognosis of very low-risk prostate cancer (PCa) patients under active surveillance (AS).</p><p><strong>Methods: </strong>We evaluated 101 very low-risk PCa patients under AS between 2013 and 2018. They were followed with DRE, PSA, MRI, and re-biopsies every 1-2 years. Per cause biopsy was recommended if PSA > 10 ng/mL, suspicious DRE, or PI-RADS ≥ 4 was present. ERG and PTEN expressions were assessed by immunohistochemistry at biopsy. Reclassification was defined by PSA > 10 ng/mL, re-biopsy with > 3 positive cores, > 50% positive core, Gleason Score (GS) upgrading ≥ 3 + 4 or extreme GS upgrading ≥ 4 + 3. We correlated ERG and PTEN with reclassification, PI-RADS, pathologic outcomes, and biochemical recurrence in patients surgically treated after reclassification.</p><p><strong>Results: </strong>After a 49.2-month follow-up, 80% of patients showed reclassification, and GS upgrading was the most common criterion. Seventy-four out of 81 patients with reclassification underwent local treatment and seven had biochemical recurrence during a mean 39.7-month follow-up. At biopsy, positive ERG expression was found in 39.6% of patients and PTEN loss in 12.6%. PTEN loss was associated with GS upgrading (OR = 9.7, p = 0.011) in univariate analysis. PTEN loss was correlated with GS upgrading; these patients had a 9.7-fold greater chance of upgrading when compared to PTEN-positive patients. ERG-positive was associated with PI-RADS ≥ 4 (OR = 2.8, p = 0.026). At multivariate analysis, PI-RADS ≥ 4 was predictor of GS upgrading (OR = 25.2, p < 0.001); MRI PI-RADS score remained an independent factor for extreme GS upgrading, together with PSAd > 0.15 (OR = 15.1, p = 0.012 and OR = 5.76, p = 0.012, respectively).</p><p><strong>Conclusions: </strong>Neither ERG-positive nor PTEN loss were associated with upgrading during AS. ERG and PTEN biomarkers, despite commonly studied in advanced PCa, have yet no defined role in very low-risk PCa under AS. PI-RADS score was an independent predictor of GS upgrading and extreme upgrading during AS.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"364-373"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803528","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":"Racial Disparities in Future Development of Lethal Prostate Cancer Based on Midlife Baseline Prostate-Specific Antigen.","authors":"Giuseppe Chiarelli, Matthew Davis, Alex Stephens, Marco Finati, Giuseppe Ottone Cirulli, Chase Morrison, Akshay Sood, Giuseppe Carrieri, Alberto Briganti, Francesco Montorsi, Giovanni Lughezzani, Nicolò Buffi, Craig Rogers, Firas Abdollah","doi":"10.1002/pros.24834","DOIUrl":"10.1002/pros.24834","url":null,"abstract":"<p><strong>Background: </strong>Previous studies found that Midlife Baseline PSA (MB PSA) predicts the risk of developing lethal prostate cancer (PCa), although the cohorts were homogenous in terms of racial compositions. We aimed to investigate racial disparities in the predictive value of MB PSA for lethal PCa in a diverse, contemporary, North American population.</p><p><strong>Methods: </strong>Our cohort included White and Black men aged 40-59 years, who underwent MB PSA through our health system. Cumulative incidence curves depicted lethal PCa stratified by race and MB PSA above/below the median. We utilized time-dependent Receiver Operating Characteristic (ROC) curves and Area Under the ROC Curve (AUC) to compare the performance of MB PSA in predicting lethal PCa based on race. Multivariable regression (MVA) was used to examine the impact of the MB PSA in predicting lethal PCa by race.</p><p><strong>Results: </strong>We included 112,967 men, of whom 27% were Black. The cumulative incidence estimate with MB PSA values equal to the median at 15 years of follow-up was 0.13 (0.04, 0.32) for White men and 0.55 (0.24, 1.11) for Black men. AUCs comparison showed no statistically significant differences in the predictive role of MB PSA for lethal PCa between White and Black men. At MVA, using White patients with PSA ≤ median as the reference group, the HR of lethal PCa for White men with PSA > median aged 40-44, 45-49, 50-54, and 55-59 was respectively 2.98 (1.59-5.57), 3.01 (1.89-4.81), 5.10 (3.38-7.70), and 3.38 (2.32-4.92). While for Black men was respectively 5.50 (2.94-10.27), 4.19 (2.59-6.78), 9.79 (6.37-15.04), and 7.53 (5.03-11.26) (all p < 0.001).</p><p><strong>Conclusion: </strong>Our findings indicate that for the same MB PSA and within the same age category, Black men have a greater risk of developing lethal PCa than White men. A separate cut-off should be created for MB PSA, if this is to be used to guide PSA screening in clinical practice.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"354-363"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803529","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}