Clinical genitourinary cancer最新文献

{"title":"Cost-Effectiveness Analysis of Lenvatinib plus Pembrolizumab or Everolimus as First-Line Treatment for Advanced Renal Cell Carcinoma","authors":"Huanrui Zheng ,&nbsp;Jin Zhou ,&nbsp;Yao Tong ,&nbsp;Jinhua Zhang","doi":"10.1016/j.clgc.2024.102264","DOIUrl":"10.1016/j.clgc.2024.102264","url":null,"abstract":"<div><h3>Background</h3><div>Recently, due to its promising efficacy against advanced renal cell carcinoma (RCC), the combination therapy with lenvatinib and pembrolizumab or everolimus has been approved as a first-line treatment for patients with advanced RCC in China and the United States. However, the high costs of combination therapies, especially of those new drugs, may limit their viability as clinical treatment options. Thus, our study aimed to evaluate the cost-effectiveness of using lenvatinib plus pembrolizumab or everolimus as a first-line treatment for patients with advanced RCC from the perspective of the Chinese healthcare system and US third-party payers.</div></div><div><h3>Methods</h3><div>We established a Markov model using TreeAge Pro 2022 software to estimate and compare the cost and effectiveness of the therapy with lenvatinib plus pembrolizumab or everolimus with those of sunitinib therapy for treating advanced RCC based on the clinical data derived from a phase III randomized controlled trial (CLEAR, ClinicalTrials.gov number NCT02811861). Transition probabilities and other data were calculated and obtained by using parametric survival modeling. The direct medical costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were used as economic indicators in this analysis. The robustness of the model was assessed by performing one-way and probability sensitivity analyses (PSA).</div></div><div><h3>Results</h3><div>Among the 3 treatment strategies, the sunitinib 1 was the least expensive option. All ICERs were far higher than the thresholds of $38,024 and $100,000 selected for China and the United States, respectively. The ICERs of the therapy with lenvatinib plus pembrolizumab versus sunitinib therapy were 106,749.06 US$/QALY and $414,672.19 US$/QALY in China and the United States, respectively. Thus, among these 2, the former strategy was less cost-effective than the latter. In addition, the ICERs of the lenvatinib plus everolimus treatment vs. sunitinib treatment were $44,353.18 US$/QALY and $292,653.10 US$/QALY in China and the United States, respectively. Thus, among these 2 strategies, the former was less cost-effective than the latter. The total cost of the lenvatinib plus everolimus treatment strategy was lower than that of lenvatinib plus pembrolizumab; however, the former treatment was less effective than the latter.</div></div><div><h3>Conclusion</h3><div>The treatment with lenvatinib plus pembrolizumab or everolimus is less cost-effective than the sunitinib treatment for patients with advanced RCC in China and the United States.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102264"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792982","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":"Trends and Disparities in Inpatient Palliative Care Use in Metastatic Renal Cell Carcinoma Patients Receiving Critical Care Therapy","authors":"Carolin Siech ,&nbsp;Simone Morra ,&nbsp;Lukas Scheipner ,&nbsp;Andrea Baudo ,&nbsp;Mario de Angelis ,&nbsp;Letizia Maria Ippolita Jannello ,&nbsp;Nawar Touma ,&nbsp;Jordan A. Goyal ,&nbsp;Zhe Tian ,&nbsp;Fred Saad ,&nbsp;Shahrokh F. Shariat ,&nbsp;Nicola Longo ,&nbsp;Luca Carmignani ,&nbsp;Ottavio de Cobelli ,&nbsp;Sascha Ahyai ,&nbsp;Alberto Briganti ,&nbsp;Cristina Cano Garcia ,&nbsp;Luis A. Kluth ,&nbsp;Felix K.H. Chun ,&nbsp;Pierre I. Karakiewicz","doi":"10.1016/j.clgc.2024.102269","DOIUrl":"10.1016/j.clgc.2024.102269","url":null,"abstract":"<div><h3>Purpose</h3><div>Temporal trends in and predictors of inpatient palliative care use in patients with metastatic renal cell carcinoma (mRCC) undergoing critical care therapy are unknown.</div></div><div><h3>Methods</h3><div>Relying on the National Inpatient Sample (2008-2019), we identified mRCC patients undergoing critical care therapy, namely invasive mechanical ventilation, percutaneous endoscopic gastrostomy tube insertion, dialysis for acute kidney failure, total parenteral nutrition, or tracheostomy. Estimated annual percentage changes (EAPC) analyses and multivariable logistic regression models addressed inpatient palliative care use.</div></div><div><h3>Results</h3><div>Of 3802 mRCC patients undergoing critical care therapy, 817 (21.5%) received inpatient palliative care. Overall, inpatient palliative care use increased from 4.9% to 31.5% between 2008 and 2019 (EAPC +9.2%). In subgroup analyses, the highest increase in inpatient palliative care use was observed in the Midwest (EAPC: +11.9%), in the South (EAPC +10.4%), and in teaching hospitals (EAPC +9.0%; all <em>P</em> ≤ .004). In logistic regression models, teaching hospital status (odds ratio [OR] 1.41) and contemporary year interval (OR 2.12; all <em>P</em> &lt; .001) independently predicted higher inpatient palliative care rates. Conversely, hospital admission in the Northeast (OR 0.53) or in the South (OR 0.79; all <em>P</em> ≤ .03) was associated with lower inpatient palliative care rates than in the West.</div></div><div><h3>Conclusion</h3><div>In mRCC patients, inpatient palliative care rates have improved over time, with the highest increase in hospitals in the Midwest and in the South. Moreover, admission to teaching hospitals or in the West is associated with higher inpatient palliative care rates. In consequence, regional disparities, as well as differences according to teaching hospital status represent targets to achieve comprehensive inpatient palliative care coverage in mRCC patients receiving critical care therapy.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102269"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815306","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":"Development and Validation of Prognostic Model for Metastatic Castration-Resistant Prostate Cancer Patients Treated With First-Line Abiraterone or Enzalutamide","authors":"Orazio Caffo ,&nbsp;Umberto Basso ,&nbsp;Carlo Cattrini ,&nbsp;Paola Ermacora ,&nbsp;Marco Maruzzo ,&nbsp;Martina Alberti ,&nbsp;Cecilia Anesi ,&nbsp;Davide Bimbatti ,&nbsp;Massimiliano Cani ,&nbsp;Veronica Crespi ,&nbsp;Giovanni Farinea ,&nbsp;Dzenete Kadrija ,&nbsp;Stefania Kinspergher ,&nbsp;Eleonora Lai ,&nbsp;Ludovica Lay ,&nbsp;Francesca Maines ,&nbsp;Alessia Mennitto ,&nbsp;Francesco Pierantoni ,&nbsp;Alessandro Samuelly ,&nbsp;Susanna Urban ,&nbsp;Antonello Veccia","doi":"10.1016/j.clgc.2024.102265","DOIUrl":"10.1016/j.clgc.2024.102265","url":null,"abstract":"<div><h3>Introduction</h3><div>Over the years, several prognostic models were developed in patients receiving chemotherapy for metastatic castration resistant prostate cancer (mCRPC), while data on androgen-receptor signaling inhibitors (ARSI) in a real-world setting are limited.</div></div><div><h3>Patients and methods</h3><div>We compared a consecutive series of 565 mCRPC patients receiving first-line ARSI at 4 high-volume Italian Centers (development set) to an external series of 180 patients receiving the same treatment at another Italian high-volume Center (training set), between 2011 and 2022.</div><div>Sixteen clinical and baseline laboratory variables were selected to develop a prognostic model. Patients were categorized into risk groups according to the number of independent factors positively associated with overall survival (OS).</div></div><div><h3>Results</h3><div>In the development cohort, after a median follow-up of 21.1 months, the median OS was 30.4 months (95% CI 27.5-33.4). At the multivariate analysis, 7 variables [age, prostate specific antigen (PSA) doubling time, baseline levels of hemoglobin, PSA, time to castration resistance, ECOG PS and bone metastases number) were included into the final model.</div><div>The median OS was 13.4, 25.7 and 46.4 months in poor (0-2 factors), intermediate (3-4 factors) and good (≥ 5 factors) prognosis group, respectively.</div><div>The application of the model to the validation set confirmed its ability to prognosticate for OS. The model c-indexes were 0.68 (95% CI 0.64-0.72) and 0.75 (95% CI 0.68-0.81) in the development and validation cohort, respectively.</div></div><div><h3>Conclusions</h3><div>Our model, based on clinical and laboratory variables readily assessable in clinical practice, might prognosticate the OS of mCRPC patients receiving first-line ARSI.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102265"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815282","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":"Complex Decision Making for Individual Patients With Penile Cancer: Benchmarking Divergent Practices in European High-Volume Reference Centers: Results From eUROGEN Survey","authors":"Laura Elst ,&nbsp;Darren Shilhan ,&nbsp;Michelle Battye ,&nbsp;Jure Murgić ,&nbsp;Ana Frӧbe ,&nbsp;Maarten Albersen ,&nbsp;Marija Miletić","doi":"10.1016/j.clgc.2024.102275","DOIUrl":"10.1016/j.clgc.2024.102275","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Penile cancer (PeCa) remains a challenge due to its rarity and the lack of prospective studies, leading to treatment challenges and controversies. Guidelines offer recommendations, but discrepancies with clinical practice persist. This study analyzed treatment practices among specialists managing high-risk PeCa in European reference centers.</div></div><div><h3>Methods</h3><div>A cross-sectional survey included 39 PeCa specialists from 13 European countries representing high-volume centers. Descriptive analysis assessed (neo)adjuvant therapy preferences, systemic regimen choices, immunotherapy use, and next-generation sequencing (NGS) integration.</div></div><div><h3>Key findings and limitations</h3><div>Variations in managing high-risk PeCa, especially in (neo)adjuvant therapy utilization, were noted among participants. The differences highlight the influence of professional backgrounds and variations in treatment approaches between participants. Systemic regimen preferences and immunotherapy utilization also varied. Limited NGS integration indicated gaps in precision medicine adoption. Limitations included sample size, self-reported data, and cross-sectional design.</div></div><div><h3>Conclusions and clinical implications</h3><div>This study offered insights into PeCa management by specialists in high-volume European reference centers, stressing the need for evidence-based recommendations, guideline adherence, and collaboration to enhance PeCa care.</div></div><div><h3>Patient summary</h3><div>Managing PeCa is complex due to its rarity and treatment controversies. This study examined practices among specialists in European reference centers, revealing treatment variations. The findings emphasize the importance of evidence-based care and collaboration in optimizing PeCa management.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102275"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848700","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 Outcomes Between African American and European American Patients With Metastatic Clear Cell Renal Cell Carcinoma Receiving Immune Checkpoint Inhibitors","authors":"Jasmeet Kaur ,&nbsp;Jill S. Hasler ,&nbsp;Elizabeth A. Handorf ,&nbsp;Matthew R. Zibelman ,&nbsp;Fern Anari ,&nbsp;Daniel M. Geynisman ,&nbsp;Pooja Ghatalia","doi":"10.1016/j.clgc.2025.102304","DOIUrl":"10.1016/j.clgc.2025.102304","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Immune checkpoint inhibitors (ICIs) and ICI/tyrosine kinase inhibitor (TKI) (ICI-based) combinations are standard first-line treatment (tx) options for patients with metastatic clear cell renal cell carcinoma (mRCC). However, only 1% of patients enrolled in trials studying these agents were Blacks.</div></div><div><h3>Methods</h3><div>Patients with mRCC who received front-line ICI-based tx or sunitinib after 2011 were included from the Flatiron Health electronic record-derived database. We analyzed progression-free survival in African American (Black) and European American (White) patients and tested the interaction between treatment type and race. Multivariable Cox proportional hazards models were used to assess associations with outcomes.</div></div><div><h3>Key Findings and Limitations</h3><div>Of 2,592 eligible pts, 2,379 (91.8%) were White, and 213 (8.2%) were Black. Of these, 1453 (56%) received ICI-based tx and 1139 (44%) received sunitinib. IMDC favorable, intermediate/poor and unknown risk was noted among 6%, 77.5% and 16.4% of White patients and 3.3%, 86.8% and 9.9% of Black patients. Median age was 64 years. There was no significant difference in PFS between Black and White patients receiving ICI-based treatment compared to sunitinib [hazard ratio (HR) for interaction between treatment type and race was 1.063 (0.78-1.45, <em>P</em> = .7)]. The interaction term between race and treatment type showed that there was no evidence of a differential treatment effect by race in the first 10 months (HR = 0.931 (0.79-1.10); <em>P</em> = .40), however significantly improved after 10 months (HR = 0.697 (0.56-0.87); <em>P</em> = .001). The retrospective nature of the study is a limitation</div></div><div><h3>Conclusions and Clinical Implications</h3><div>The study found no significant difference in treatment effects between White and Black patients receiving ICI-based first-line treatment and should be the standard of care for both Black and White patients.</div></div><div><h3>Patient Summary</h3><div>We reviewed Flatiron databases of patients with mRCC from both Black and White populations, finding that ICI-based therapy should be considered the standard of care for patients from both racial backgrounds.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102304"},"PeriodicalIF":2.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101028","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":"Investigating the Potential to Offer Reproductive Organ Preserving Radical Cystectomy to More Female Bladder Cancer Patients","authors":"Nina Pappot,&nbsp;Sophia Liff Maibom,&nbsp;Maja Vejlgaard,&nbsp;Ulla Nordström Joensen","doi":"10.1016/j.clgc.2025.102303","DOIUrl":"10.1016/j.clgc.2025.102303","url":null,"abstract":"<div><h3>Introduction</h3><div>Traditional radical cystectomy (tRC) in female bladder cancer (BC) patients includes removal of the ovaries, uterus, and anterior vaginal wall. Reproductive organ preserving radical cystectomy (ROPRC) offers less invasive surgery with comparable survival and better functional outcomes for selected patients. The objective of this study is to investigate the current number of ROPRC at our institution and the potential for increased adoption of the procedure based on precystectomy assessment criteria.</div></div><div><h3>Patients and methods</h3><div>A retrospective cohort study of female patients treated with radical cystectomy between 2017 and 2021 at a single high volume academic center in Denmark. Suspicion of stage T4 was assessed based on precystectomy CT, transurethral resection of bladder tumor with bimanual palpation, and intraoperative assessment at cystectomy. Median follow-up was 36 months for both tRC and ROPRC. The primary outcome was number of ROPRC. The secondary outcome was potential for ROPRC in the tRC population. Frequencies and predictive values were calculated.</div></div><div><h3>Results</h3><div>A total of 118 female BC patients were included. Four patients underwent ROPRC, all with non–muscle-invasive BC. None had local recurrence. In tRC (n = 114), stage T4 BC was suspected in 31% (35/114) and 14% (16/114) had pT4 at final pathology. There was no suspicion of stage T4 BC in 83 patients, and 82 of these had &lt;pT4 at final pathology, providing a negative predictive value for identifying stage T4 BC before pathology of 99%. The potential for ROPRC in the tRC population was 69% (79/114). Limitations were the retrospective single center study and limited number of ROPRC.</div></div><div><h3>Conclusions</h3><div>Only 4 women over a 5-year period underwent complete or partial ROPRC. The preoperative prediction of stage T4 was accurate, which could reflect a potential to offer ROPRC to more than two thirds of female cystectomy patients currently undergoing tRC.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102303"},"PeriodicalIF":2.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076511","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":"Enzalutamide and Docetaxel in Combination With Androgen Deprivation for Men With Metastatic Hormone-Sensitive Prostate Cancer: ENZADA, a Phase II Trial","authors":"Earle F. Burgess ,&nbsp;Claud M. Grigg ,&nbsp;Danielle Boselli ,&nbsp;James T. Symanowski ,&nbsp;AliReza Golshayan ,&nbsp;David L. Graham ,&nbsp;Kwabena Osei-Boateng ,&nbsp;Nagajyothi Gavini ,&nbsp;Jiang Zhu ,&nbsp;Landon C. Brown ,&nbsp;Sarah Norek ,&nbsp;Xhevahire J. Begic ,&nbsp;Derek Raghavan","doi":"10.1016/j.clgc.2025.102302","DOIUrl":"10.1016/j.clgc.2025.102302","url":null,"abstract":"<div><h3>Background</h3><div>Androgen receptor pathway inhibitors (ARPI) in combination with docetaxel (Doc) and androgen deprivation therapy (ADT) has improved outcomes for men with metastatic hormone sensitive prostate cancer (mHSPC). We hypothesized that combining ADT with Doc and enzalutamide (Enz) would improve the 52-week prostate-specific antigen (PSA) complete response (CR) rate compared to a historical control with ADT + Doc.</div></div><div><h3>Methods</h3><div>In a single arm phase II trial, treatment-naïve patients with mHSPC received ADT + Doc every 3 weeks up to 6 cycles and Enz daily until progression. The primary endpoint was 52-week PSA CR. Secondary endpoints included safety/toxicity, best PSA response, time to castration resistance and overall survival (OS).</div></div><div><h3>Results</h3><div>Between Sep 2017 and Aug 2021, 40 patients were enrolled and 36 evaluable for the primary endpoint. At data cutoff, median follow up was 56.1 months. Thirty patients (75%) had high-volume disease. Median age was 64.5 years. Median pretreatment PSA was 129.5ng/ml. 52-week PSA CR occurred in 22/36 (61.1%) patients compared to historical control (<em>P</em> &lt; .001). Median OS was not reached. Patients who did not achieve a 52-week PSA CR had shorter OS (HR, 4.67; 95% CI 1.41-15.55; <em>P</em> = .006). Treatment-related Grade 3 to 5 adverse events occurred in 17/40 (42.5%) patients.</div></div><div><h3>Conclusion</h3><div>ADT+Doc+Enz improved 52-week PSA CR compared to historical control with ADT+Doc. Achieving a PSA CR after 1 year of therapy correlated with improved OS. These results are consistent with recent phase III studies and support using triplet regimens that combine ADT+Doc+ARPI for newly diagnosed mHSPC.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102302"},"PeriodicalIF":2.3,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101080","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":"Trends and Disparities in Prostate Cancer Mortality in the United States (1999–2020)","authors":"Nouman Aziz ,&nbsp;Waseem Nabi ,&nbsp;Muzamil Khan ,&nbsp;Abu Huraira Bin Gulzar ,&nbsp;Shree Rath ,&nbsp;Muhammad Ansab ,&nbsp;Danisha kumar ,&nbsp;Adnan Bhat","doi":"10.1016/j.clgc.2024.102298","DOIUrl":"10.1016/j.clgc.2024.102298","url":null,"abstract":"<div><h3>Background</h3><div>Prostate cancer is a leading cause of cancer-related mortality among men in the United States. Over the past two decades, the observed decline in prostate cancer mortality can be attributed to advancements in screening, early detection, and treatment. However, persistent disparities related to race, geography, and age highlight the need for targeted interventions to improve outcomes.</div></div><div><h3>Methods</h3><div>This study evaluated trends in prostate cancer mortality among men aged 45 years and older in the United States, using data from CDC WONDER (1999-2020). Age-adjusted mortality rates (AAMRs) per 100,000 individuals were analyzed using a log-linear regression model to calculate annual percentage changes (APCs) and 95 % confidence intervals. Crude rates were utilized to calculate APCs within specific age subgroups.</div></div><div><h3>Results</h3><div>The AAMR related to prostate cancer significantly declined from 89.87 per 100,000 in 1999 to 52.92 in 2020. A steeper decline was noted from 1999 to 2013 (APC = −3.44), followed by a slower reduction thereafter (APC = −0.61), which coincided with changes in PSA screening guidelines introduced in 2012. African American men had the highest mortality rates but also experienced the most significant decline, decreasing from 199.91 per 100,000 in 1999 to 104.42 in 2020. Regional disparities evolved over time, with the West overtaking the South in mortality rates by 2020. Non-metropolitan areas consistently exhibited higher mortality rates compared to metropolitan regions. Age-stratified data indicated that AAMR increased with age, with the most notable declines seen in men aged 85 years and older.</div></div><div><h3>Conclusion</h3><div>Prostate cancer mortality in the United States has significantly decreased over the past 2 decades; however, the rate of progress has slowed in recent years. It is crucial to address racial, geographic, and age-related disparities to further reduce mortality and enhance equity in health outcomes.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102298"},"PeriodicalIF":2.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048658","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 Prehabilitation in the Precystectomy Pathway in Patients With Bladder Cancer on Postoperative Outcomes","authors":"Sasha E. Knowlton ,&nbsp;Alexis C. Wardell ,&nbsp;Angela Smith ,&nbsp;Marc Bjurlin ,&nbsp;Matthew Nielsen ,&nbsp;Hung-Jui Tan","doi":"10.1016/j.clgc.2024.102297","DOIUrl":"10.1016/j.clgc.2024.102297","url":null,"abstract":"<div><h3>Purpose</h3><div>Prehabilitation in patients with bladder cancer recommended for cystectomy has the potential to improve functional status and outcomes after cystectomy. Prior research has shown that increasing exercise preoperatively can improve strength and quality of life, but research has not yet investigated the impact on length of stay, readmissions, complications and mortality.</div></div><div><h3>Methods</h3><div>We compared historical controls (2021-2022) for patients with bladder cancer who underwent radical cystectomy at a major academic center to those referred for prehabilitation consultation (2023) on postoperative outcomes, namely hospital length of stay, 30 and 90 day readmission rates, postoperative complications and 90-day mortality.</div></div><div><h3>Results</h3><div>In total, 16 patients received prehabilitation consultation and were compared to 175 patients who did not receive consultation. There were no significant differences in hospital length of stay or 30 or 90 day readmission rates. There were differences in the incidences of some postoperative complications, although not statistically significant.</div></div><div><h3>Conclusions</h3><div>In this study, prehabilitation consultation did not improve length of stay, 30 or 90 day readmission rates or some postoperative complications, but was limited by low rate of referral. Further research is needed regarding the implementation of prehabilitation programs for bladder cancer.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102297"},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030503","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":"CIRCULATING miR-1-3p, miR-96-5p, miR-148a-3p, and miR-375-3p Support Differentiation Between Prostate Cancer and Benign Prostate Lesions","authors":"Rafał Osiecki ,&nbsp;Piotr Popławski ,&nbsp;Dorota Sys ,&nbsp;Joanna Bogusławska ,&nbsp;Alex Białas ,&nbsp;Marek Zawadzki ,&nbsp;Agnieszka Piekiełko-Witkowska ,&nbsp;Jakub Dobruch","doi":"10.1016/j.clgc.2024.102294","DOIUrl":"10.1016/j.clgc.2024.102294","url":null,"abstract":"<div><h3>Introduction</h3><div>microRNAs <strong>(</strong>miRNAs) are small noncoding RNAs and promising cancer biomarkers. Prostate-specific antigen (PSA) testing revolutionized prostate cancer (PCa) diagnostics and monitoring. However, PSA testing also contributes to PCa overdiagnoses that are detrimental on patients’ health and may lead to overtreatment. Here, we searched for circulating miRNAs that could serve as biomarkers facilitating differentiation between PCa and benign prostate hyperplasia (BPH).</div></div><div><h3>Patients</h3><div>66 patients with PCa or BPH were investigated (33 patients in each cohort). Men with PCa underwent minimally invasive radical prostectomy (RP), whereas men with BPH underwent either holmium laser enucleation of the prostate (HOLEP), transurethral resection of the prostate (TURP) or simple prostatectomy.</div></div><div><h3>Methods</h3><div>We performed RNAseq of PCa and BPH serum samples, integrated our data with TCGA-PRAD cohort, followed by qPCR validation using independent cohort of PCa and BPH patients.</div></div><div><h3>Results</h3><div>RNAseq detected 295 miRNAs in serum samples, including 283 miRNAs that were both expressed by PCa tissues and present in PCa sera. 10 miRNAs were selected for qPCR validation. Expression of serum miR-1-3p, miR-96-5p, miR-148a-3p, and miR-375-3p was decreased in PCa patients when compared to BPH samples. Diagnostic accuracy of combinations of PSA with geometric means of [miR-1-3p, miR-148a-3p], [miR-148a-3p, miR-375-3p], and [miR-375-3p, miR-96-5p] exceed diagnostic value of PSA alone, with the top AUC 0.97 for [miR-1-3p, miR-148a-3p]/PSA (cut-off &lt; 0.002893, sensitivity 95.83 %, specificity 91.30 %).</div></div><div><h3>Conclusions</h3><div>In conclusion, we found a miRNAs that can support PCa diagnosis.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102294"},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042839","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}