ProstatePub Date : 2025-01-01Epub Date: 2024-10-13DOI: 10.1002/pros.24793
Hemal Semwal, Colton Ladbury, Ali Sabbagh, Osama Mohamad, Derya Tilki, Arya Amini, Jeffrey Wong, Yun Rose Li, Scott Glaser, Bertram Yuh, Savita Dandapani
{"title":"Machine learning and explainable artificial intelligence to predict pathologic stage in men with localized prostate cancer.","authors":"Hemal Semwal, Colton Ladbury, Ali Sabbagh, Osama Mohamad, Derya Tilki, Arya Amini, Jeffrey Wong, Yun Rose Li, Scott Glaser, Bertram Yuh, Savita Dandapani","doi":"10.1002/pros.24793","DOIUrl":"10.1002/pros.24793","url":null,"abstract":"<p><strong>Background: </strong>Though several nomograms exist, machine learning (ML) approaches might improve prediction of pathologic stage in patients with prostate cancer. To develop ML models to predict pathologic stage that outperform existing nomograms that use readily available clinicopathologic variables.</p><p><strong>Methods: </strong>Patients with prostate adenocarcinoma who underwent surgery were identified in the National Cancer Database. Seven ML models were trained to predict organ-confined (OC) disease, extracapsular extension, seminal vesicle invasion (SVI), and lymph node involvement (LNI). Model performance was measured using area under the curve (AUC) on a holdout testing data set. Clinical utility was evaluated using decision curve analysis (DCA). Performance metrics were confirmed on an external validation data set.</p><p><strong>Results: </strong>The ML-based extreme gradient boosted trees model achieved the best performance with an AUC of 0.744, 0.749, 0.816, 0.811 for the OC, ECE, SVI, and LNI models, respectively. The MSK nomograms achieved an AUC of 0.708, 0.742, 0.806, 0.802 for the OC, ECE, SVI, and LNI models, respectively. These models also performed the best on DCA. Findings were consistent on both a holdout internal validation data set as well as an external validation data set.</p><p><strong>Conclusions: </strong>Our ML models better predicted pathologic stage relative to existing nomograms at predicting pathologic stage. Accurate prediction of pathologic stage can help oncologists and patients determine optimal definitive treatment options for patients with prostate cancer.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"3-12"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481063","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}
ProstatePub Date : 2025-01-01Epub Date: 2024-10-14DOI: 10.1002/pros.24805
Cheuk-Yin Tang, Joshua J X Li, Ka Long Leung, Hei Yuet Ma, Joanna K M Ng, Ryan T L Yan, Jeremy Y Teoh, Christopher J VandenBussche, Gary M Tse
{"title":"Is prostatic adenocarcinoma detectable by urine cytology-A multicenter retrospective review.","authors":"Cheuk-Yin Tang, Joshua J X Li, Ka Long Leung, Hei Yuet Ma, Joanna K M Ng, Ryan T L Yan, Jeremy Y Teoh, Christopher J VandenBussche, Gary M Tse","doi":"10.1002/pros.24805","DOIUrl":"10.1002/pros.24805","url":null,"abstract":"<p><strong>Introduction: </strong>Urine cytology is robust for the diagnosis of urothelial lesions, but data on the detection rates of prostatic adenocarcinoma in urine cytology is limited. In this study, a multicenter review was performed to define the clinical role of urine cytology in diagnosis of prostatic adenocarcinoma.</p><p><strong>Methods: </strong>Cytologic diagnoses of lower tract urine cytology specimens with histology-proven prostatic adenocarcinoma from three institutions, from a period of over two decades, were reviewed. Clinicopathological parameters-tumor grade, stage, histologic features, and preanalytical factors-prostate-specific antigen (PSA) level and lesion size, were retrieved and compared with cytologic diagnoses.</p><p><strong>Results: </strong>In total, 2115 urine cytology specimens from 1119 patients were retrieved. The atypia (or above/C3+) and suspicious (or above/C4+) rates were 19.48% and 3.36%. Bilobar and extracapsular involvement, lymphovascular invasion, Gleason score, and International Society of Urological Pathology grade were associated with a positive urine diagnosis (p < 0.05). The atypia (C3+) and suspicious (C4+) rates of urine cytology in patients with a PSA level of ≤4.0 ng/mL was paradoxically higher (p < 0.01), but PSA levels correlated positively with urine diagnosis at higher cutoffs (>10, >20, >50, >100 ng/mL). All these factors remained significant on multivariate analysis (p < 0.05), including a negative correlation with low-PSA (≤4.0 ng/mL, p = 0.001) and positive correlation with high-PSA (>20 ng/mL, p = 0.020). Lesion size and multifocality were not associated with urine cytology diagnosis (p > 0.05).</p><p><strong>Conclusion: </strong>Urine cytology showed low sensitivity in detection of prostatic adenocarcinoma. Detection rates were largely positively correlated with PSA levels but not for lesion size nor multifocality, limiting its clinical utility.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"97-104"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481062","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":"Prognostic model for second progression-free survival and overall survival in patients with high-risk metastatic hormone-sensitive prostate cancer treated with abiraterone acetate and androgen deprivation therapy.","authors":"Shintaro Narita, Takafumi Yanagisawa, Shingo Hatakeyama, Kenichi Hata, Kazutoshi Fujita, Takashi Ueda, Toshikazu Tanaka, Shinya Maita, Shuji Chiba, Hiromi Sato, Yuya Sekine, Mizuki Kobayashi, Soki Kashima, Ryohei Yamamoto, Kazuyuki Numakura, Mitsuru Saito, Koichiro Takayama, Katsumi Okane, Toshiya Ishida, Yohei Horikawa, Teruaki Kumazawa, Jiro Shimoda, Ikuya Iwabuchi, Takehiro Suzuki, Osamu Ukimura, Takahiro Kimura, Chikara Ohyama, Kyoko Nomura, Tomonori Habuchi","doi":"10.1002/pros.24802","DOIUrl":"10.1002/pros.24802","url":null,"abstract":"<p><strong>Background: </strong>To develop and validate a prognostic risk model for high-risk metastatic hormone-sensitive prostate cancer (mHSPC) patients treated with upfront abiraterone acetate (ABI).</p><p><strong>Methods: </strong>This retrospective multicenter study involved 233 high-risk mHSPC patients who received upfront ABI, developed by three academic centers. The model was externally validated with an independent cohort of 282 patients. To identify independent prognostic factors for second progression-free survival (PFS2) and develop the best-fitted model, Cox proportional hazards regression, followed by the Akaike information criterion, was used. Patients were categorized into three groups based on their risk scores. PFS2 and overall survival (OS) were evaluated according to the risk groups in the discovery and validation cohorts.</p><p><strong>Results: </strong>The median age was 72 (range 51-89) years, with a median follow-up duration of 27 months. Independent factors linked to PFS2 included an Eastern Cooperative Oncology Group performance status ≥2, a primary Gleason score of 5, an extent of disease score of ≥3 or liver metastasis, and lactate dehydrogenase >220 U/L. Median PFS2 for favorable-, intermediate-, and poor-risk groups were not reached, 43 months, and 16 months, respectively. The median OS was 29 months in the poor-risk group, whereas it was not reached in the favorable- and intermediate-risk groups. The 2-year OS rates in the favorable-, intermediate- and poor-risk groups were 94.5%, 80.1%, and 60.3%, respectively. The validation cohort confirmed the risk model's relationship with PFS2 and OS. The median PFS2 and OS in the high-risk group were 21 months and 32 months, respectively.</p><p><strong>Conclusions: </strong>Our prognostic model, including five clinical factors, is useful for patient care and treatment selection in high-risk mHSPC patients treated with ADT plus ABI. The developed model could provide more accurate information, guide treatment decisions, or classify patients in future clinical trials.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"73-81"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332496","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}
ProstatePub Date : 2025-01-01Epub Date: 2024-09-22DOI: 10.1002/pros.24798
Elizabeth U Tran, Eric Royz, Kyra Yamamoto, Samantha Marley, Alexander Song, Elizabeth Pan, Aaron M Lee, Daniel Herchenhorn, Sam Denmeade, Emmanuel S Antonarakis, Mark Markowski, Rana R McKay
{"title":"Bipolar androgen therapy for treatment of metastatic castration-resistant prostate cancer: A case series.","authors":"Elizabeth U Tran, Eric Royz, Kyra Yamamoto, Samantha Marley, Alexander Song, Elizabeth Pan, Aaron M Lee, Daniel Herchenhorn, Sam Denmeade, Emmanuel S Antonarakis, Mark Markowski, Rana R McKay","doi":"10.1002/pros.24798","DOIUrl":"10.1002/pros.24798","url":null,"abstract":"<p><strong>Introduction: </strong>Advanced prostate cancer treatment has improved with androgen receptor signaling inhibitors (ARPI), yet many patients develop metastatic castration-resistant prostate cancer (mCRPC), characterized by sustained androgen receptor (AR) signaling. Bipolar androgen therapy (BAT) introduces supraphysiologic testosterone levels to inhibit tumor growth, offering novel treatment for mCRPC by exploiting AR-dependent mechanisms.</p><p><strong>Case presentations: </strong>Case 1: A 53-year-old man with mCRPC, post multiple systemic therapies, initiated BAT and pembrolizumab, achieving PSA reduction and improved quality of life before progression. The patient exhibited AR amplification, which may have contributed to favorable response to BAT. Case 2: A 73-year-old man with recurrent prostate cancer, stable on ADT and abiraterone, experienced PSA decline with BAT to an undetectable level, maintaining stability post-therapy discontinuation. Case 3: A 73-year-old man with metastatic prostate cancer, initially resistant to enzalutamide, achieved clinical benefit and disease control with BAT, although he did not meet PSA response criteria, patient had remarkable response upon enzalutamide rechallenge. Case 4: A 90-year-old man with localized prostate cancer, refractory to multiple treatments, experienced symptom relief and PSA reduction with BAT before progression.</p><p><strong>Conclusion: </strong>BAT represents a promising treatment strategy for mCRPC. This case series underscores BAT's potential to induce significant clinical and biochemical responses, resensitize tumors to ARPIs, and improve patients' quality of life. Despite eventual progression in some cases, BAT offers a period of disease control. Further research is needed to optimize patient selection and understand the molecular determinants of BAT responsiveness.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"40-47"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301126","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}
ProstatePub Date : 2025-01-01Epub Date: 2024-10-28DOI: 10.1002/pros.24803
Marco Finati, Chase Morrison, Alex Stephens, Giuseppe Chiarelli, Giuseppe Ottone Cirulli, Shane Tinsley, Matthew Davis, Akshay Sood, Nicolò Buffi, Giovanni Lughezzani, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Gian Maria Busetto, Carlo Bettocchi, Craig Rogers, Giuseppe Carrieri, Firas Abdollah
{"title":"Association of race with incidence, characteristics, and mortality from incidental prostate cancer: Analysis of two North American contemporary cohorts.","authors":"Marco Finati, Chase Morrison, Alex Stephens, Giuseppe Chiarelli, Giuseppe Ottone Cirulli, Shane Tinsley, Matthew Davis, Akshay Sood, Nicolò Buffi, Giovanni Lughezzani, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Gian Maria Busetto, Carlo Bettocchi, Craig Rogers, Giuseppe Carrieri, Firas Abdollah","doi":"10.1002/pros.24803","DOIUrl":"10.1002/pros.24803","url":null,"abstract":"<p><strong>Background: </strong>Non-Hispanic Black (NHB) men are at higher risk both for incidence and mortality from prostate cancer (PCa) compared to Non-Hispanic White (NHW) men, but these findings arise from biopsy-detected PCa reports. We aimed to compare the incidence, subsequent management and cancer-specific mortality (CSM) of incidental PCa among NHB and NHW men, using two different North American cohorts.</p><p><strong>Methods: </strong>The Surveillance, Epidemiology and End-Result (SEER: 2004-2017) and our institutional Henry Ford Health (HFH: 1995-2022) databases were queried to identify men diagnosed with incidental PCa. Cumulative incidence estimates were used to calculate CSM differences between NHB and NHW men. Competing-risk multivariable regression analysis tested the impact of race on CSM, after accounting for all available covariates.</p><p><strong>Results: </strong>A total of 418 and 6,124 incidental PCa cases were recorded in HFH and SEER database respectively. No pathological differences were observed between NHB and NHW men in both the cohorts, except for prostate-specific antigen (PSA) value at diagnosis, which was higher in NHB men. At 10-years, the CSM rates were 5.5% vs 7.2% in our cohort and 8.6% vs 10.3% in the SEER cohort for NHW and NHB men, respectively (all Gray's test p-value > 0.05). At multivariable, race was not an independent predictor of CSM in our HFH cohort (HR: 1.46, 95% CI: 0.57-3.71, p = 0.6). In the SEER cohort, NHB men were 34% less likely to die from PCa from 1 year to the next (95% CI: 0.49-0.90, p = 0.008), when compared with NHW men.</p><p><strong>Conclusions: </strong>In the comparison of incidental PCa findings between NHB and NHW men, both groups had similar pathological characteristic and survival outcomes. These findings are different from the 'conventional' screening-detected PCa and suggest that racial differences have minimal to no adverse effects on PCa-specific mortality after incidental diagnosis.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"82-89"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513094","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}
ProstatePub Date : 2024-12-01Epub Date: 2024-09-01DOI: 10.1002/pros.24785
Fabian Falkenbach, Fatima Ahmad-Sterkau, Mykyta Kachanov, Dirk Beyersdorff, Daniel Koehler, Francesca Ambrosini, Gernot Ortner, Tobias Maurer, Markus Graefen, Lars Budäus
{"title":"Bimodal imaging: Detection rate of clinically significant prostate cancer is higher in MRI lesions visible to transrectal ultrasound.","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.24785","DOIUrl":"10.1002/pros.24785","url":null,"abstract":"<p><strong>Background: </strong>To explore the detection rates of clinically significant prostate cancer (csPCa; ISUP ≥2) in patients with a single MRI lesion that is visible or invisible on transrectal ultrasound (TRUS) during biopsy.</p><p><strong>Methods: </strong>Retrospective analyses of patients who underwent targeted and systematic biopsy of the prostate for one MRI-visible lesion (PI-RADS score ≥ 3) between 2017 and 2022. TRUS-visibility, PI-RADS score, and clinical parameters were recorded prospectively. Univariable and multivariable logistic regression models were used to identify predictors of csPCa.</p><p><strong>Results: </strong>277 consecutive patients with one MRI-visible lesion were identified. A correlating lesion on TRUS was present in 147/277 (53%). The median age, PSA level, and prostate volume were 68.0 years (IQR: 62.0-73.0), 7.3 ng/ml (IQR: 5.4-10.8) and 45.0 cc (IQR: 32.0-68.0), respectively. Baseline parameters were not significantly different between the two groups. CsPCa was detected in 59/130 (45%) without and in 102/147 (69%) patients with a corresponding TRUS lesion. In multivariable logistic regression analysis predicting csPCa, TRUS-visibility (OR: 2.13, CI: 1.14-4.03, p = 0.02) and PI-RADS score (PI-RADS 4: OR: 7.28, CI: 3.33-17.19; PI-RADS 5: OR: 13.39, CI: 5.27-36.83, p < 0.001) achieved independent predictor status.</p><p><strong>Conclusions: </strong>Bimodal-visible lesions more often harbored csPCa and were easier to target. TRUS-visibility of MRI lesions is an independent predictor of csPCa. Therefore, education in both modalities is essential. Despite MRI, the ultrasound should still be diligently examined.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1448-1455"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114831","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}
ProstatePub Date : 2024-12-01Epub Date: 2024-09-08DOI: 10.1002/pros.24790
Breno Barros Alves, Pedro Gabrich, Luciano A Favorito
{"title":"Prospective results of the minimally invasive laser enucleation of the prostate (MiLEP).","authors":"Breno Barros Alves, Pedro Gabrich, Luciano A Favorito","doi":"10.1002/pros.24790","DOIUrl":"10.1002/pros.24790","url":null,"abstract":"<p><strong>Background: </strong>The objective of the present study is to prospectively analyze the prostate enucleation procedure with Holmium Laser using the minimally invasive technique (MiLEP), comparing the outcomes and their variables pre- and postoperatively.</p><p><strong>Methods: </strong>We studied men aged 40 years or over, with prostate volumes greater than or equal to 35 cm³ with lower urinary tract symptoms due to BPH. We performed flowmetry and administered the IPSS questionnaire before and 6 months after the MiLEP procedure. The patients were operated on with a 60 W Holmium Laser (Cyber-Ho Quanta System®) using 54 W of power (energy 1.8 J and frequency of 30 Hz). Enucleation was performed using the en bloc technique with early sphincter release. After enucleation, the tissue was morcellated using a 22 Fr morcescope (RZ-Medizintechnik GmbH, Tuttlingen, Germany) and Piranha (Richard Wolf) morcellator. The final Hemostasis after morcelation was made using laser with 30wW power, energy at 1,0 joules and frequency at 30 Hertz. Student's T test and Man-Whitney was used to statistical analysis (p < 0.05).</p><p><strong>Results: </strong>After selection we submitted 73 patients (mean age= 68.2 years) to MiLEP procedure with a follow up of 6 months. The prostate volume presented an average of 94.53 cm³ (65 to 112 cm³, SD = 5.363) preoperatively. The urinary continence rate after the procedure was greater than 95% after 1 week and 99% in the 1st month. All patients were continent after 6 months. The IPSS questionnaire before (mean = 21.18 points/SD = 6.557) and after (mean = 7.92 points/SD = 2.408) the MiLEP had statistical significance (p < 0.001). The flowmetry(ml/s) before (9.02/SD = 2.842) and after (21.07/SD = 6.228) the MiLEP had statistical significance (p < 0.001). The average time of the procedure was 78.5 min and the bladder catheter was removed after 18 h in mean. In 4 patients (5.8%) we observed hematuria and in 1 case (1.47%) the patient needs urinary catheterization.</p><p><strong>Conclusion: </strong>MiLEP is a safe and effective procedure, with significant improvement in urinary flow and symptoms in the short term. Although the results of this study were satisfactory and the urinary incontinence rate was lower compared to HoLEP data found in the literature, multicenter studies with longer follow-up are needed to confirm these findings.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1501-1505"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156662","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}
ProstatePub Date : 2024-12-01Epub Date: 2024-09-22DOI: 10.1002/pros.24794
Xiangbin Kong, Zhilong Dong, Weiwei Hu, Jun Mi, Jie Xiao, Yiran Wang, Wenfang Chen, Zixu Pei, Zongyao Hao, Chaozhao Liang, Qi Wang, Zhiping Wang
{"title":"The role of gut microbiota involved in prostate microenvironment and symptoms improvement in chronic prostatitis/chronic pelvic pain syndrome patients treated with low-intensity extracorporeal shock wave.","authors":"Xiangbin Kong, Zhilong Dong, Weiwei Hu, Jun Mi, Jie Xiao, Yiran Wang, Wenfang Chen, Zixu Pei, Zongyao Hao, Chaozhao Liang, Qi Wang, Zhiping Wang","doi":"10.1002/pros.24794","DOIUrl":"10.1002/pros.24794","url":null,"abstract":"<p><strong>Background: </strong>Low-intensity extracorporeal shockwave therapy (Li-ESWT) is emerging as a promising and safe treatment for Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). In this study, we aimed to investigate the role of the gut microbiota involved in the prostate microenvironment and symptom improvement during the Li-ESWT for CP/CPPS patients.</p><p><strong>Methods: </strong>CP/CPPS patients not taking antibiotics or other treatments were included. NIH-Chronic Prostatitis Symptom Index (NIH-CPSI), International Prostate Symptom Score (IPSS), and International Index of Erectile Function (IIEF-5) were used to evaluate the effectiveness of Li-ESWT at the end of treatment. Visual analogue scale/score was used to evaluate the pain during procedure. Stool and semen samples were collected before and after Li-ESWT. Shotgun metagenomics analyzed gut microbiota, while ELISA and other diagnostic kits detected biochemical changes in seminal plasma.</p><p><strong>Result: </strong>Of the 60 enrolled patients, 52 completed treatment. Li-ESWT response rate was 78.8% (41/52) at end of treatment. Among responders, the subitems of the NIH-CPSI; IPSS; and IIEF-5 scores improved significantly, and the seminal plasma analysis showed decreased TNF-a and MDA levels and increased SOD and Zn<sup>2+</sup> levels posttreatment. Gut microbiome analysis indicated that posttreatment, both α and β diversity increased, and the abundance of certain specific species significantly increased. Fifty-eight pathways significantly enriched posttreatment, notably in branched-chain amino acid synthesis and butyrate synthesis. The abundance of several specific species was found to be significantly higher in non-responders than responders. Among responders, at the species level, some bacteria associated with NIH-CPSI and its subscales, IPSS, IIEF-5, and prostate microenvironment markers (TNF-a, MDA, Zn<sup>2+</sup>, and SOD) were identified.</p><p><strong>Conclusions: </strong>Our study demonstrates for the first time that Li-ESWT improves the prostate microenvironment and gut microbiota in CP/CPPS patients. Treatment nonresponse may be associated with a high abundance of specific pathogens before treatment. The gut microbiota could have a significant impact on Li-ESWT response and the prostate microenvironment.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1525-1536"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301130","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}
ProstatePub Date : 2024-12-01Epub Date: 2024-08-18DOI: 10.1002/pros.24782
Chia-Ling Hsieh, Anh Duy Do, Chia-Yen Hsueh, Mafewu Olga Raboshakga, Tran Ngoc Thanh, Tran Tien Tai, Hsing-Jien Kung, Shian-Ying Sung
{"title":"L1CAM mediates neuroendocrine phenotype acquisition in prostate cancer cells.","authors":"Chia-Ling Hsieh, Anh Duy Do, Chia-Yen Hsueh, Mafewu Olga Raboshakga, Tran Ngoc Thanh, Tran Tien Tai, Hsing-Jien Kung, Shian-Ying Sung","doi":"10.1002/pros.24782","DOIUrl":"10.1002/pros.24782","url":null,"abstract":"<p><strong>Background: </strong>A specific type of prostate cancer (PC) that exhibits neuroendocrine (NE) differentiation is known as NEPC. NEPC has little to no response to androgen deprivation therapy and is associated with the development of metastatic castration-resistant PC (CRPC), which has an extremely poor prognosis. Our understanding of genetic drivers and activated pathways in NEPC is limited, which hinders precision medicine approaches. L1 cell adhesion molecule (L1CAM) is known to play an oncogenic role in metastatic cancers, including CRPC. However, the impact of L1CAM on NEPC progression remains elusive.</p><p><strong>Methods: </strong>L1CAM expression level was investigated using public gene expression databases of PC cohorts and patient-derived xenograft models. L1CAM knockdown was performed in different PC cells to study in vitro cell functions. A subline of CRPC cell line CWR22Rv1 was established after long-term exposure to abiraterone to induce NE differentiation. The androgen receptor-negative cell line PC3 was cultured under the tumor sphere-forming condition to enrich cancer stemness features. Several oxidative stress inducers were tested on PC cells to observe L1CAM-mediated gene expression and cell death.</p><p><strong>Results: </strong>L1CAM expression was remarkably high in NEPC compared to CRPC or adenocarcinoma tumors. L1CAM was also correlated with NE marker expressions and associated with the adenocarcinoma-to-NEPC progression in gene expression databases and CRPC cells with NE differentiation. L1CAM also promoted cancer stemness and NE phenotypes in PC3 cells under cancer stemness enrichment. L1CAM was also identified as a reactive oxygen species-induced gene, by which L1CAM counteracted CRPC cell death triggered by ionizing radiation.</p><p><strong>Conclusions: </strong>Our results unveiled a new role of L1CAM in the acquisition of the NE phenotype in PC, contributing to the NE differentiation-related therapeutic resistance of CRPC.</p>","PeriodicalId":54544,"journal":{"name":"Prostate","volume":" ","pages":"1434-1447"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996956","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}