Prostate最新文献

{"title":"Machine Learning Approach Identifies miRNA Biomarkers for Post Surgical Patient Stratification in Prostate Cancer.","authors":"Gobi Thillainadesan, Yutaka Amemiya, Robert Nam, Arun Seth","doi":"10.1002/pros.70034","DOIUrl":"https://doi.org/10.1002/pros.70034","url":null,"abstract":"<p><strong>Introduction: </strong>Effective management of post-prostate cancer is hindered by the limitations of current prognostic tools in accurately assessing disease aggressiveness. Radical prostatectomy remains a standard treatment, but some patients develop biochemical recurrence and metastasis, underscoring the need for improved postsurgical prognostic tools.</p><p><strong>Methods: </strong>This investigation involved sequencing data derived from 38 matched prostate cancer patients who had undergone RP. Initial statistical analysis helped identify the most significant miRNAs, which were further subjected to unsupervised clustering and stepwise selection. A linear discriminant analysis (LDA) model was then trained and tested using a miRNA combination method to pinpoint biomarkers predictive of metastasis.</p><p><strong>Results: </strong>Out of 1123 miRNAs initially identified, 519 were selected as high-confidence candidates. Parametric analysis of these miRNAs discerned 41 that effectively distinguished between patients who developed metastasis postoperatively and those who did not. Utilizing LDA, this study harnessed 41 miRNAs in a combinatorial approach, identifying eight key miRNAs (hsa-miR-106b-3p, hsa-miR-769-5p, hsa-miR-182-5p, hsa-miR-194-5p, hsa-miR-345-5p, hsa-miR-183-3p, hsa-miR-200a-3p, hsa-miR-301a-3p) that collectively stratified the metastatic group from control with up to 91% accuracy. This model's effectiveness was supported by a receiver operating characteristic analysis, demonstrating an area under the curve of 80% or higher for the best miRNA combinations. Notably, the performance of this eight-miRNA panel was consistent with CAPRA-based risk stratification.</p><p><strong>Conclusion: </strong>Our study presents a miRNA-based machine learning model that distinguishes metastatic from non-metastatic prostate cancer patients following surgery. The panel's alignment with CAPRA underscores its clinical relevance and highlights its potential for integration into future clinical frameworks.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862706","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":"Analysis of the Increased Incidence of Aggressive Prostate Cancer After Prior Testicular Cancer.","authors":"Kevin Xu, Amir Khan, Peter Evancho, Matthew Chu, Andrew Riggin, Hubert Huang, M Minhaj Siddiqui","doi":"10.1002/pros.70035","DOIUrl":"https://doi.org/10.1002/pros.70035","url":null,"abstract":"<p><strong>Purpose: </strong>Men with a history of testicular cancer are known to have an increased risk of developing prostate cancer. The objective of this study is to determine if testicular cancer survivors are predisposed to a higher incidence of aggressive prostate cancer later in life and greater risks of mortality.</p><p><strong>Materials and methods: </strong>The Surveillance, Epidemiology, and End Results database was searched for patients diagnosed with prostate cancer and either no prior cancer diagnosis or a previous diagnosis (≥ 5 years ago) of either testicular cancer or another cancer with a high survival rate (5-year survival > 70%). Cox regression models were used to determine the risk of mortality.</p><p><strong>Results: </strong>Of the 392,238 prostate cancer patients, 423 had a history of testicular cancer, 31,428 had a history of another cancer, and 377,975 had no prior history of cancer. The mean ages of prostate cancer diagnosis were 62.53 +/- 8.23 years, 67.95 +/- 8.46 years, and 67.95 +/- 9.47, respectively (p < 0.001). Testicular cancer was associated with earlier mortality on survival analysis in multivariable analysis controlling for age of prostate cancer diagnosis, race, clinical T stage, PSA level at diagnosis, and Gleason score.</p><p><strong>Conclusions: </strong>A history of testicular cancer may be associated with an increased risk of developing early prostate cancer and increased mortality. Confirmatory studies are warranted.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862705","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":"Mortality and Additional Treatment Rates in Pathologically High-Risk Prostate Cancer With Prostate-Specific Antigen Persistence at Robot-Assisted Radical Prostatectomy: Long-Term Report From Single Tertiary Referral Center.","authors":"Alessandro Bertini, Alex Stephens, Alessio Finocchiaro, Silvia Viganò, Antonio Perri, Giovanni Lughezzani, Nicolò Buffi, Gabriele Sorce, Vincenzo Ficarra, Alberto Briganti, Andrea Salonia, Francesco Montorsi, Akshay Sood, Mani Menon, Craig Rogers, Firas Abdollah","doi":"10.1002/pros.70031","DOIUrl":"https://doi.org/10.1002/pros.70031","url":null,"abstract":"<p><strong>Background: </strong>Long-term cancer control efficacy of robotic-assisted laparoscopic prostatectomy (RALP) in men with pathologically high-risk prostate cancer and prostate-specific antigen (PSA) persistence remains poorly addressed in the literature. Our aim was to evaluate long-term survival and additional treatment (AT) rates in these individuals.</p><p><strong>Methods: </strong>We included 803 patients who underwent RALP for pathologically high-risk PCa (pT ≥ 3a, pN0-1 or GG ≥ 4) between 2001 and 2022 at a single tertiary referral center (Henry Ford Hospital, Detroit). Patients without adequate information about PSA persistence were excluded from the analysis (n = 128). Kaplan-Meier curves estimated AT free-survival (ATFS) and all-cause mortality (ACM) free-survival, whereas the competing risk method was used to estimate cancer-specific mortality (CSM) free-survival, after stratification according to PSA persistence. Competing risk and Cox regression models tested the impact of PSA persistence on three endpoints: AT rates, CSM, and ACM.</p><p><strong>Results: </strong>Our final cohort consisted of 675 who underwent RALP for pathologically high-risk PCa, 187 (27.7%) of whom had PSA persistence. The median age at surgery was 64 years (IQR 59-68), and the median follow-up duration was 75 months (IQR 33-125). Patients with PSA persistence were more likely to have higher PSA values at surgery (8 vs. 7 ng/mL, p < 0.001), pT3b-4 PCa (62.5% vs. 39.9%, p < 0.001), pN1 PCa (55.6% vs. 35.7%, p < 0.001), and positive surgical margins (PSMs) (65.2% vs. 43.4%, p < 0.001). Moreover, patients in the PSA persistence group had higher proportion undergoing only hormone therapy (HT) (24.1% vs. 11.9%, p < 0.001) and radiotherapy (RT) plus HT (50.8% vs. 31.1%, p < 0.001), reporting higher median PSA values at RT (0.6 vs. 0.2 ng/mL, p < 0.001), compared to patients with undetectable PSA. At 10 years after RALP, CSM-FS and ACM-FS were 79.7% versus 90.3% (Gray-test p-value = 0.001) and 72.1% versus 79.6% (log-rank p-value = 0.013), for persistent versus undetectable PSA, respectively. The 10-year rates of ATFS were 6.6% versus 33.2% (log-rank p-value < 0.0001), for persistent versus undetectable PSA, respectively. At MVA, persistent PSA was associated with AT (HR: 3.05, p < 0.001), but not with CSM (HR: 1.49, p = 0.2) or ACM (HR: 1.09, p = 0.9).</p><p><strong>Conclusion: </strong>Patients with pathologically high-risk PCa and PSA persistence after RALP, despite being at greater hazard of AT (HT and/or RT), did not have less favorable cancer control outcomes at 10 years than their counterparts with undetectable PSA levels. Our report provides the longest follow-up after RALP for this subset of patients, making it a valuable resource for counseling patients on the long-term oncologic outcomes of this procedure and postoperative adjuvant/salvage therapies.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818321","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 Concomitant Hormone Therapy on the Diagnostic Performance of ¹⁸F-Piflufolastat PET/CT in Prostate Cancer Patients: A Sub-Group Analysis of OSPREY Cohort B.","authors":"Lawrence Saperstein, Steven P Rowe, Michael A Gorin, Kenneth J Pienta, Barry A Siegel, Michael J Morris, Saradha Baskaran, Nancy Stambler, Vincent A DiPippo, Bela S Denes","doi":"10.1002/pros.24909","DOIUrl":"10.1002/pros.24909","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the impact of hormone therapy (HT) on the diagnostic performance of ¹⁸F-piflufolastat PET/CT in OSPREY (NCT02981368) cohort B patients with recurrent or metastatic prostate cancer.</p><p><strong>Methods: </strong>¹⁸F-piflufolastat PET/CT was evaluated in OSPREY cohort B patients (n = 117 men) with elevated prostate-specific antigen (PSA) levels and suspected local recurrence or metastatic disease on baseline conventional imaging. Patients were stratified based on HT status, and sensitivity and positive predictive value (PPV) were determined for the subset of 93 patients with evaluable pathology. Baseline serum PSA and testosterone levels were determined within 30 days before dosing using standardized laboratory methods.</p><p><strong>Results: </strong>In OSPREY cohort B, 34.4% of patients (32/93) were on at least one concomitant HT with a median exposure duration of 15.5 months. The median baseline PSA and testosterone levels for patients on concurrent HT (n = 32) were 31.6 ng/mL and 9 ng/dL, respectively. For patients not on concurrent therapy (n = 61), median PSA and testosterone levels were 6.1 ng/mL and 317.35 ng/dL, respectively. The median sensitivity of ¹⁸F-piflufolastat PET/CT across three readers was 96.4% (95%CI: 80.8%-100%) in patients receiving concurrent HT and 95.4% (95%CI: 83.7%-99.6%) in patients not receiving concurrent HT. A modest increase in median PPV was observed in patients receiving concomitant HT (median of three readers: 90.0% [95%CI: 73.6, 97.3]) compared to patients not receiving concomitant therapy (median of three readers: 77.4% [95%CI: 66.1, 88.6]).</p><p><strong>Conclusions: </strong>The diagnostic performance of ¹⁸F-piflufolastat PET/CT was unaffected by concomitant HT in OSPREY cohort B patients with recurrent and/or metastatic prostate cancer.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1005-1015"},"PeriodicalIF":2.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053935","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 Holmium Laser Enucleation of the Prostate on Active Surveillance for Prostate Cancer in Patients With Lower Urinary Tract Symptoms.","authors":"Charly Bâcle, Emilien Seizilles De Mazancourt, Nadia Abid, Alain Ruffion, Olivier Rouvière, Marc Colombel, Hakim Fassi-Fehri","doi":"10.1002/pros.24906","DOIUrl":"10.1002/pros.24906","url":null,"abstract":"<p><strong>Background: </strong>Active surveillance (AS) is a recommended strategy for low- or favorable intermediate-risk prostate cancers (PCa), avoiding more invasive treatments. However, the concurrent development of symptomatic benign prostatic hyperplasia (BPH) may necessitate holmium laser enucleation of the prostate (HoLEP). This study aims to evaluate the impact of HoLEP on patients under AS for PCa.</p><p><strong>Methods: </strong>Medical records of patients under AS for PCa diagnosed between 2010 and 2023 were retrospectively reviewed. Patients with a life expectancy of more than 10 years and a follow-up of at least 1 year were included. Functional and oncological outcomes, as well as follow-up data (PSA levels, PSA density (PSA-D), mpMRI, prostate biopsies), were collected. Patients who underwent HoLEP were compared to those who did not. The primary endpoint was discontinuation of AS.</p><p><strong>Results: </strong>A total of 310 patients under AS were included, of whom 62 (20%) underwent HoLEP. Prostate volume was higher in the HoLEP group than in the non-operated group (70 vs. 50 g, p < 0.0001), and PSA density was lower (0.09 vs. 0.12 p < 0.0001). The median enucleated volume was 62 mL (IQR 34-85). Grade group (GG) 1 and 2 prostate cancer was identified in enucleated pathology in 17 (27%) and 3 (5%) patients, respectively. No patient had a GG lesion ≥ 3 on the enucleated pathology. The rate of AS discontinuation was 18% in the HoLEP group vs. 56% in the control group (p < 0.01). Multivariate analysis identified HoLEP as a protective factor for continued AS (HR = 0.231; p < 0.0001). At last follow-up, PSA and PSA density were significantly lower in the HoLEP group (2 vs. 7.7 p < 0.0001 and 0.06 vs. 0.14 p < 0.0001, respectively).</p><p><strong>Conclusion: </strong>Performing HoLEP in patients under AS for PCa with LUTS due to BPH may reduce the risk of deferred prostate cancer treatment, without altering oncological outcomes or future treatment options. HoLEP significantly impacts AS parameters, modifying patient monitoring. Further studies are needed to confirm these findings and establish appropriate follow-up protocols.</p><p><strong>Trial registration: </strong>CNIL number 24-5016.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"989-999"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026864","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":"Multicenter External Validation and Optimization of a Proposed Nomogram for Prostate-Specific Membrane Antigen PET/CT Accuracy in Biochemical Recurrence.","authors":"Laura Chamorro Castillo, Inés Rivero Belenchón, Ignacio Puche Sanz, Rocío Saiz Marenco, Ana Victoria Ojeda Claro, Néstor Sánchez Martínez, Rafael Medina López, Alvaro Juárez Soto, Jose Luis Álvarez Ossorio, Emilio García Galisteo, Julia Carrasco Valiente, Bernardo Herrera Imbroda, Juan Moreno Jiménez, Juan Antonio Vallejo Casas, Antonio Rodríguez, Adrián Santiago Ortiz, Juan Pablo Campos Hernández, Enrique Gómez Gómez","doi":"10.1002/pros.24910","DOIUrl":"10.1002/pros.24910","url":null,"abstract":"<p><strong>Introduction: </strong>Prostate-specific membrane antigen (PSMA) PET/CT has been established as the standard imaging technique after biochemical recurrence (BCR) of prostate cancer (PCa). However, its availability is not widespread, thus, patient selection criteria are necessary. For this reason, a European nomogram was recently developed with the intention of helping to predict and identify those patients with BCR at high risk for a positive PSMA PET/CT. The aim of our study was to test the external validity of this nomogram in a large regional cohort of patients and its impact as a selective tool for patients with BCR who should undergo a PSMA PET/CT.</p><p><strong>Methodology: </strong>A multicenter, observational, and retrospective study to validate, calibrate, and readjust the European PSMA PET/CT positivity prediction nomogram in a cohort of patients with BCR after radical treatments for localized PCa. Clinical and demographic data were analyzed. We evaluated the detection rate of PSMA PET/CT, the association of different variables with a positive PSMA PET/CT, and the accuracy of the nomogram, summarized in an ROC curve and a clinical decision curve. The nomogram was then modified and improved for our cohort.</p><p><strong>Results: </strong>A cohort of 413 patients with BCR undergoing PSMA PET/CT was evaluated. Median age, PSA, and PSAdt were 66 years, 0.52 ng/mL, and 7 months, respectively. Median time to BCR was 34 months and the predominant ISUP was 3 (31%). Most patients underwent radical prostatectomy (88%). PSMA PET/CT was positive in 67% of patients, with pelvic involvement in 32% and 24% positivity outside the pelvis. The independent variables associated with a positive PSMA PET/CT were PSA value (OR: 1.94 (1.2-3.19), with a PSA level ≥ 0.5 ng/dL), and a PSA persistence after primary treatment (OR 2.95 (95% CI 1.37-7.14)). The original nomogram had a low predictive ability, with an AUC of 0.57 (95% CI: 0.52-0.62). It was necessary to adjust and calibrate this to obtain a novel nomogram with an AUC of 0.84 (95% CI 0.70-0.98). The DCA showed a greater net benefit from the use of this nomogram at intermediate threshold levels.</p><p><strong>Conclusion: </strong>The nomogram showed a low predictive ability in our external validation. Nevertheless, our novel nomogram demonstrated a moderate-high predictive ability, which could thus optimize the selection of BCR patients who are candidates for PSMA PET/CT.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1016-1023"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063294","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":"Survival Outcomes for Rural Patients With Advanced Prostate Cancer: A SEER Investigation.","authors":"Liang G Qu, J Bailey Vaselkiv, Marlon Perera, Lorelei Mucci","doi":"10.1002/pros.24915","DOIUrl":"10.1002/pros.24915","url":null,"abstract":"<p><strong>Background: </strong>Differences may exist in survival for patients with de novo metastatic prostate cancer according to urban-rural status.</p><p><strong>Methods: </strong>This cohort study utilized the Surveillance, Epidemiology, and End Results database. Data on demographics, urban-rural status, histopathology, and survival were extracted for men aged ≤ 75 years, diagnosed with metastatic prostate cancer between 2009 and 2018. Patients missing rurality status or survival outcome-related data were excluded. Differences between urban and rural cohorts in overall and cancer-specific survival were analyzed using Cox regression and restricted mean survival time. Subgroup analyses were performed for variant histological subtypes of prostate cancer. Sensitivity analyses were performed for varying definitions of rurality.</p><p><strong>Results: </strong>Altogether, 21,290 participants were included. The cohorts of rural and urban participants differed in age, race, US region, and marital status. Cox regression failed to demonstrate associations between urban-rural status and overall survival (adjusted hazard ratio = 1.03, 95% confidence interval: 0.97-1.09) and cancer-specific survival (1.03, 0.97-1.10). Restricted mean survival time modeling demonstrated that urban patients lived 2.29 months longer than rural patients (95% confidence interval: 0.61-3.97). Sub-analyses of neuroendocrine, intraductal, and other histological subtypes, did not demonstrate any association between urban-rural status and overall survival. A more selective definition of rurality resulted in a persisting difference in overall survival (2.12 months, 0.24-4.01) through restricted mean survival time. Similarly, a broader definition of rurality also resulted in a difference in overall survival (1.98 months, 0.59-3.36).</p><p><strong>Conclusion: </strong>This study demonstrated that US individuals with metastatic prostate cancer residing rurally may have slightly poorer survival compared to patients from urban areas.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1052-1061"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112812","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 Area of Deprivation Index With Active Surveillance (AS) Utilization and Adherence to as Guidelines: Results From a Contemporary North American Cohort.","authors":"Alessandro Bertini, Alex Stephens, Alessio Finocchiaro, Viganò Silvia, Dinesh Arjun, Guivatchian Elnaz, Cusmano Nicholas, Giovanni Lughezzani, Nicolò Buffi, Ettore Di Trapani, Vincenzo Ficarra, Alberto Briganti, Andrea Salonia, Francesco Montorsi, Akshay Sood, Craig Rogers, Firas Abdollah","doi":"10.1002/pros.24911","DOIUrl":"10.1002/pros.24911","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Active Surveillance (AS) for Prostate Cancer (PCa) requires regular follow-up, raising concerns that socioeconomic barriers may result in underutilization or decreased adherence to AS guidelines. We examined the relationship between socioeconomic factors, measured by the Area Deprivation Index (ADI), and AS habits in a contemporary North American cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We included all the patients aged ≤ 75 years and diagnosed with low (ISUP GG = 1, PSA ≤ 10 ng/mL and cT1N0M0) and intermediate risk (ISUP GG = 2, PSA 10-20 ng/mL or cT2N0M0) PCa at Henry Ford Health (HFH) between 1995 and 2023. An ADI score was assigned to each patient based on their residential census block group, ranked as a percentile of deprivation relative to the national level. The higher the ADI, the more the area has a socioeconomic disadvantage. Logistic regression analysis tested the impact of ADI on AS utilization and adherence to AS guidelines. Only patients who underwent at least 1 PSA test per year and at least 1 biopsy every 4 years were considered as \"adherent to guidelines\".&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our final cohort consisted of 4376 patients eligible for AS, 919 of whom actually underwent AS. Older patients (66 vs. 62 years, p &lt; 0.0001) and those diagnosed in more recent years (2017 vs. 2010, p &lt; 0.0001) had higher probability to undergo AS. Moreover, patients in the AS group more likely to be NHB (36% vs. 25%, p &lt; 0.0001), had higher ADI score (61 vs. 55, p &lt; 0.0001), more comorbidities according to Charlson Comorbidity Index (CCI) score, (19.5%% vs. 13.8%, p &lt; 0.0001) and higher probability to harbor low risk PCa (65.7% vs. 26.6%, p &lt; 0.0001), compared to patients who underwent active treatment. Among the 919 patients in AS, only 410 were \"adherent to guidelines\". Patients following guidelines were more likely to be NHW (64.1% vs. 52.8%, p &lt; 0.003), and had lower ADI percentile (55.5 vs. 66, p &lt; 0.0003). Furthermore, AS patients managed according to the prevailing guidelines received more PSAs tests (1.8 vs. 0.8, p &lt; 0.0001) and prostate biopsies (0.3 vs. 0.0, p &lt; 0.0001) per year, thus reporting both higher upgrading rates during AS (35.6% vs. 23%, p &lt; 0.0001) and an increased probability to undergo active treatment (48% vs. 27%, p &lt; 0.0001). At MVA, patients with a higher ADI score reported higher probability to undergo AS (OR: 1.06, 95% CI: 1.02-1.10, p = 0.004), but at the same time they were less likely to follow AS' guidelines (OR: 0.94, 95% CI: 0.89-0.99, p = 0.02).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Patients in the most deprived areas had a higher likelihood of undergoing AS but were more prone to receive guideline-discordant care. This should be taken into consideration by physicians when recommending AS for those men living in the least advantaged neighborhoods. Our study highlights the need for targeted community reforms to enhance proper and informed AS utilization among socioeconomically disad","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1024-1035"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026862","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":"Reply - Letter to the Editor: Bimodal Imaging at MRI Fusion Prostate Biopsy Will Gain Further Importance in the Future.","authors":"Fabian Falkenbach, Fatima Ahmad-Sterkau, Mykyta Kachanov, Dirk Beyersdorff, Daniel Koehler, Francesca Ambrosini, Gernot Ortner, Tobias Maurer, Markus Graefen, Lars Budäus","doi":"10.1002/pros.24914","DOIUrl":"10.1002/pros.24914","url":null,"abstract":"","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1071-1072"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128406","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":"Bimodal Imaging: Detection Rate of Clinically Significant Prostate Cancer Is Higher in MRI Lesions Visible to Transrectal Ultrasound.","authors":"Fu Feng, Zhanping Xu","doi":"10.1002/pros.24839","DOIUrl":"10.1002/pros.24839","url":null,"abstract":"","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1069-1070"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129612","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}