Pub Date : 2024-07-10DOI: 10.1038/s41391-024-00866-4
Carolin Siech, Mario de Angelis, Letizia Maria Ippolita Jannello, Francesco Di Bello, Natali Rodriguez Peñaranda, Jordan A. Goyal, Zhe Tian, Fred Saad, Shahrokh F. Shariat, Stefano Puliatti, Nicola Longo, Ottavio de Cobelli, Alberto Briganti, Benedikt Hoeh, Philipp Mandel, Luis A. Kluth, Felix K. H. Chun, Pierre I. Karakiewicz
Background
To assess cancer-specific mortality (CSM) and other-cause mortality (OCM) rates in patients with rare histological prostate cancer subtypes.
Methods
Using the Surveillance, Epidemiology, and End Results database (2004–2020), we applied smoothed cumulative incidence plots and competing risks regression (CRR) models.
Results
Of 827,549 patients, 1510 (0.18%) harbored ductal, 952 (0.12%) neuroendocrine, 462 (0.06%) mucinous, and 95 (0.01%) signet ring cell carcinoma. In the localized stage, five-year CSM vs. OCM rates ranged from 2 vs. 10% in acinar and 3 vs. 8% in mucinous, to 55 vs. 19% in neuroendocrine carcinoma patients. In the locally advanced stage, five-year CSM vs. OCM rates ranged from 5 vs. 6% in acinar, to 14 vs. 16% in ductal, and to 71 vs. 15% in neuroendocrine carcinoma patients. In the metastatic stage, five-year CSM vs. OCM rates ranged from 49 vs. 15% in signet ring cell and 56 vs. 16% in mucinous, to 63 vs. 9% in ductal and 85 vs. 12% in neuroendocrine carcinoma. In multivariable CRR, localized neuroendocrine (HR 3.09), locally advanced neuroendocrine (HR 9.66), locally advanced ductal (HR 2.26), and finally metastatic neuroendocrine carcinoma patients (HR 3.57; all p < 0.001) exhibited higher CSM rates relative to acinar adenocarcinoma patients.
Conclusions
Compared to acinar adenocarcinoma, patients with neuroendocrine carcinoma of all stages and locally advanced ductal carcinoma exhibit higher CSM rates. Conversely, CSM rates of mucinous and signet ring cell adenocarcinoma do not differ from those of acinar adenocarcinoma.
{"title":"Rare histological prostate cancer subtypes: Cancer-specific and other-cause mortality","authors":"Carolin Siech, Mario de Angelis, Letizia Maria Ippolita Jannello, Francesco Di Bello, Natali Rodriguez Peñaranda, Jordan A. Goyal, Zhe Tian, Fred Saad, Shahrokh F. Shariat, Stefano Puliatti, Nicola Longo, Ottavio de Cobelli, Alberto Briganti, Benedikt Hoeh, Philipp Mandel, Luis A. Kluth, Felix K. H. Chun, Pierre I. Karakiewicz","doi":"10.1038/s41391-024-00866-4","DOIUrl":"https://doi.org/10.1038/s41391-024-00866-4","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>To assess cancer-specific mortality (CSM) and other-cause mortality (OCM) rates in patients with rare histological prostate cancer subtypes.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Using the Surveillance, Epidemiology, and End Results database (2004–2020), we applied smoothed cumulative incidence plots and competing risks regression (CRR) models.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Of 827,549 patients, 1510 (0.18%) harbored ductal, 952 (0.12%) neuroendocrine, 462 (0.06%) mucinous, and 95 (0.01%) signet ring cell carcinoma. In the localized stage, five-year CSM vs. OCM rates ranged from 2 vs. 10% in acinar and 3 vs. 8% in mucinous, to 55 vs. 19% in neuroendocrine carcinoma patients. In the locally advanced stage, five-year CSM vs. OCM rates ranged from 5 vs. 6% in acinar, to 14 vs. 16% in ductal, and to 71 vs. 15% in neuroendocrine carcinoma patients. In the metastatic stage, five-year CSM vs. OCM rates ranged from 49 vs. 15% in signet ring cell and 56 vs. 16% in mucinous, to 63 vs. 9% in ductal and 85 vs. 12% in neuroendocrine carcinoma. In multivariable CRR, localized neuroendocrine (HR 3.09), locally advanced neuroendocrine (HR 9.66), locally advanced ductal (HR 2.26), and finally metastatic neuroendocrine carcinoma patients (HR 3.57; all <i>p</i> < 0.001) exhibited higher CSM rates relative to acinar adenocarcinoma patients.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Compared to acinar adenocarcinoma, patients with neuroendocrine carcinoma of all stages and locally advanced ductal carcinoma exhibit higher CSM rates. Conversely, CSM rates of mucinous and signet ring cell adenocarcinoma do not differ from those of acinar adenocarcinoma.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141571614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1038/s41391-024-00857-5
Stavros Gravas, Cosimo De Nunzio, Luís Campos Pinheiro, Javier Ponce de León, Konstantinos Skriapas, Ziad Milad, Riccardo Lombardo, Mariana Medeiros, Pantelis Makrides, Michael Samarinas, Mauro Gacci
Background: Prostatic inflammation is an important etiological component of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). The Prostatic Inflammation Nomogram Study (PINS) aimed to develop and validate a nomogram for predicting the presence of prostatic inflammation in men with LUTS.
Methods: This non-interventional, cross-sectional, prospective study was conducted in six secondary/tertiary centers across Cyprus, Greece, Italy, Portugal, and Spain. Men (≥40 years) with BPH/LUTS scheduled to undergo prostatic surgery or transrectal ultrasound-guided (TRUS) prostate biopsy were included. Fifteen demographic and clinical participant characteristics were selected as possible predictors of prostatic inflammation. The presence of inflammation (according to Irani score) in the prostatic tissue samples obtained from surgery/TRUS biopsy was determined. The effect of each characteristic on the likelihood a prostate specimen demonstrated inflammation (classified by Irani score into two categories, 0-2 [no/minimal inflammation] or 3-6 [moderate/severe inflammation]) was assessed using multiple logistic regression. A nomogram was developed and its discriminatory ability and validity were assessed.
Results: In total, 423 patients (mean age 68.9 years) were recruited. Prostate volume ultrasound (PVUS) > 50 mL, history of urinary tract infection (UTI) treatment, presence of diabetes, and International Prostate Symptom Score (IPPS) Storage score were statistically significant predictors of Irani classification. Logistic regression demonstrated a statistically significant effect for leucocytes detected via urine dipstick, presence of diabetes, PVUS > 50 mL, history of UTIs, and higher IPSS Storage score for the odds of an inflammatory score category of 3-6 versus 0-2. The nomogram had a concordance index of 0.71, and good internal validity.
Conclusions: The nomogram developed from PINS had good predictive ability and identified various characteristics to be predictors of prostatic inflammation. Use of the nomogram may aid in individualizing treatment for LUTS, by identifying individuals who are candidates for therapies targeting prostatic inflammation.
{"title":"Development and validation of a clinical nomogram to predict prostatic inflammation in men with lower urinary tract symptoms.","authors":"Stavros Gravas, Cosimo De Nunzio, Luís Campos Pinheiro, Javier Ponce de León, Konstantinos Skriapas, Ziad Milad, Riccardo Lombardo, Mariana Medeiros, Pantelis Makrides, Michael Samarinas, Mauro Gacci","doi":"10.1038/s41391-024-00857-5","DOIUrl":"https://doi.org/10.1038/s41391-024-00857-5","url":null,"abstract":"<p><strong>Background: </strong>Prostatic inflammation is an important etiological component of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). The Prostatic Inflammation Nomogram Study (PINS) aimed to develop and validate a nomogram for predicting the presence of prostatic inflammation in men with LUTS.</p><p><strong>Methods: </strong>This non-interventional, cross-sectional, prospective study was conducted in six secondary/tertiary centers across Cyprus, Greece, Italy, Portugal, and Spain. Men (≥40 years) with BPH/LUTS scheduled to undergo prostatic surgery or transrectal ultrasound-guided (TRUS) prostate biopsy were included. Fifteen demographic and clinical participant characteristics were selected as possible predictors of prostatic inflammation. The presence of inflammation (according to Irani score) in the prostatic tissue samples obtained from surgery/TRUS biopsy was determined. The effect of each characteristic on the likelihood a prostate specimen demonstrated inflammation (classified by Irani score into two categories, 0-2 [no/minimal inflammation] or 3-6 [moderate/severe inflammation]) was assessed using multiple logistic regression. A nomogram was developed and its discriminatory ability and validity were assessed.</p><p><strong>Results: </strong>In total, 423 patients (mean age 68.9 years) were recruited. Prostate volume ultrasound (PVUS) > 50 mL, history of urinary tract infection (UTI) treatment, presence of diabetes, and International Prostate Symptom Score (IPPS) Storage score were statistically significant predictors of Irani classification. Logistic regression demonstrated a statistically significant effect for leucocytes detected via urine dipstick, presence of diabetes, PVUS > 50 mL, history of UTIs, and higher IPSS Storage score for the odds of an inflammatory score category of 3-6 versus 0-2. The nomogram had a concordance index of 0.71, and good internal validity.</p><p><strong>Conclusions: </strong>The nomogram developed from PINS had good predictive ability and identified various characteristics to be predictors of prostatic inflammation. Use of the nomogram may aid in individualizing treatment for LUTS, by identifying individuals who are candidates for therapies targeting prostatic inflammation.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-05DOI: 10.1038/s41391-024-00863-7
Matthew Loria, Tomasz Tabernacki, David Gilbert, Mart Andrew Maravillas, Megan McNamara, Shubham Gupta, Kirtishri Mishra
{"title":"Addressing questions related to \"incidence of prostate cancer in trans-women in the US: a large database analysis\".","authors":"Matthew Loria, Tomasz Tabernacki, David Gilbert, Mart Andrew Maravillas, Megan McNamara, Shubham Gupta, Kirtishri Mishra","doi":"10.1038/s41391-024-00863-7","DOIUrl":"https://doi.org/10.1038/s41391-024-00863-7","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-05DOI: 10.1038/s41391-024-00858-4
Neal Shore, Jason Hafron, Daniel Saltzstein, Amitabha Bhaumik, Pankaj Aggarwal, Jennifer Phillips, Tracy McGowan
Background/objectives: Based on the SPARTAN and TITAN studies, apalutamide is approved for patients with nonmetastatic castration-resistant and metastatic castration-sensitive prostate cancer. Skin rash was a common adverse reaction across indications. We hypothesized that earlier identification and intervention could improve rash outcomes.
Subjects/methods: A prespecified rash management guide outlining recommended skin care practices was provided to all patients enrolled in Apa-RP (NCT04523207). Rash-related safety data from Apa-RP were compared descriptively with data from SPARTAN and TITAN.
Results: Patients in Apa-RP experienced improved rash-related outcomes vs those in SPARTAN and TITAN.
Conclusions: Increased vigilance and proactive management may reduce the incidence, severity, and duration of rash during apalutamide treatment.
{"title":"Impact of a rash management guide in patients receiving apalutamide for high-risk localized prostate cancer in the Apa-RP study.","authors":"Neal Shore, Jason Hafron, Daniel Saltzstein, Amitabha Bhaumik, Pankaj Aggarwal, Jennifer Phillips, Tracy McGowan","doi":"10.1038/s41391-024-00858-4","DOIUrl":"https://doi.org/10.1038/s41391-024-00858-4","url":null,"abstract":"<p><strong>Background/objectives: </strong>Based on the SPARTAN and TITAN studies, apalutamide is approved for patients with nonmetastatic castration-resistant and metastatic castration-sensitive prostate cancer. Skin rash was a common adverse reaction across indications. We hypothesized that earlier identification and intervention could improve rash outcomes.</p><p><strong>Subjects/methods: </strong>A prespecified rash management guide outlining recommended skin care practices was provided to all patients enrolled in Apa-RP (NCT04523207). Rash-related safety data from Apa-RP were compared descriptively with data from SPARTAN and TITAN.</p><p><strong>Results: </strong>Patients in Apa-RP experienced improved rash-related outcomes vs those in SPARTAN and TITAN.</p><p><strong>Conclusions: </strong>Increased vigilance and proactive management may reduce the incidence, severity, and duration of rash during apalutamide treatment.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-27DOI: 10.1038/s41391-024-00849-5
Laurence Klotz
Introduction: The use of systematic biopsies in addition to targeted biopsies is based on multiple studies showing that 15-20% of "clinically significant" cancers are missed on targeted biopsies. Concern about these 'missed' cancers drives many interventions. This includes systematic biopsies in men with negative imaging and in men having targeted biopsies, and drives a preference for total gland treatment in men who may be candidates for partial gland ablation. This article summarizes recent genomic and clinical data indicating that, despite "clinically significant" histology, MRI invisible lesions are genomically and clinically favorable. These studies have demonstrated that the genetic aberrations associated with cancer visibility are the same aberrations that drive cancer invasiveness and metastasis. Thus invisible cancers, even if undiagnosed at baseline, are in most cases indolent and pose little threat to the patient. The implications are that patients should be monitored with imaging rather than systematic biopsy, and subject to repeat targeted biopsy for evidence of MR progression. Patients prefer this strategy. It has many advantages in terms of reduced burden of care, cost, psychological benefits, and less diagnosis of insignificant cancer.
Conclusion: It is now appropriate to abandon systematic biopsies in most patients.
{"title":"Should systematic prostatic biopsies be discontinued?","authors":"Laurence Klotz","doi":"10.1038/s41391-024-00849-5","DOIUrl":"https://doi.org/10.1038/s41391-024-00849-5","url":null,"abstract":"<p><strong>Introduction: </strong>The use of systematic biopsies in addition to targeted biopsies is based on multiple studies showing that 15-20% of \"clinically significant\" cancers are missed on targeted biopsies. Concern about these 'missed' cancers drives many interventions. This includes systematic biopsies in men with negative imaging and in men having targeted biopsies, and drives a preference for total gland treatment in men who may be candidates for partial gland ablation. This article summarizes recent genomic and clinical data indicating that, despite \"clinically significant\" histology, MRI invisible lesions are genomically and clinically favorable. These studies have demonstrated that the genetic aberrations associated with cancer visibility are the same aberrations that drive cancer invasiveness and metastasis. Thus invisible cancers, even if undiagnosed at baseline, are in most cases indolent and pose little threat to the patient. The implications are that patients should be monitored with imaging rather than systematic biopsy, and subject to repeat targeted biopsy for evidence of MR progression. Patients prefer this strategy. It has many advantages in terms of reduced burden of care, cost, psychological benefits, and less diagnosis of insignificant cancer.</p><p><strong>Conclusion: </strong>It is now appropriate to abandon systematic biopsies in most patients.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-26DOI: 10.1038/s41391-024-00864-6
Harry Collin, Kandice Keogh, Marnique Basto, Stacy Loeb, Matthew J Roberts
Background/objectives: Patients often face uncertainty about what they should know after prostate cancer diagnosis. Web-based information is common but is at risk of being of poor quality or readability.
Subjects/methods: We used ChatGPT, a freely available Artificial intelligence (AI) platform, to generate enquiries about prostate cancer that a newly diagnosed patient might ask and compared to Google search trends. Then, we evaluated ChatGPT responses to these questions for clinical appropriateness and quality using standardised tools.
Results: ChatGPT generates broad and representative questions, and provides understandable, clinically sound advice.
Conclusions: AI can guide and empower patients after prostate cancer diagnosis through education. However, the limitations of the ChatGPT language-model must not be ignored and require further evaluation and optimisation in the healthcare field.
{"title":"ChatGPT can help guide and empower patients after prostate cancer diagnosis.","authors":"Harry Collin, Kandice Keogh, Marnique Basto, Stacy Loeb, Matthew J Roberts","doi":"10.1038/s41391-024-00864-6","DOIUrl":"https://doi.org/10.1038/s41391-024-00864-6","url":null,"abstract":"<p><strong>Background/objectives: </strong>Patients often face uncertainty about what they should know after prostate cancer diagnosis. Web-based information is common but is at risk of being of poor quality or readability.</p><p><strong>Subjects/methods: </strong>We used ChatGPT, a freely available Artificial intelligence (AI) platform, to generate enquiries about prostate cancer that a newly diagnosed patient might ask and compared to Google search trends. Then, we evaluated ChatGPT responses to these questions for clinical appropriateness and quality using standardised tools.</p><p><strong>Results: </strong>ChatGPT generates broad and representative questions, and provides understandable, clinically sound advice.</p><p><strong>Conclusions: </strong>AI can guide and empower patients after prostate cancer diagnosis through education. However, the limitations of the ChatGPT language-model must not be ignored and require further evaluation and optimisation in the healthcare field.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141458935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-25DOI: 10.1038/s41391-024-00861-9
F Vedovo, C Lonati, N Suardi, L Mariani, P Capogrosso, V Ficarra, A Salonia, C Trombetta
Background: Sexual difficulties are a recognized consequence of prostate cancer (PCa) treatments. An estimated one in three men who have sex with men (MSM) receive PCa a diagnosis during their lifetime. MSM may experience all types of sexual dysfunction as reported in men who have sex with women (MSW), along with a number of more specific bothersome problems. This systematic literature review aims to evaluate sexual outcomes in MSM who have undergone radical prostatectomy (RP).
Methods: A systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The searches were made using relevant keywords in the PubMed, Scopus, and Web of Science databases, thus including the whole literature from January 2000 to November 2023. Studies which did not allow to retrieve data on sexual outcomes on MSM treated with RP for PCa were excluded. Data on sexual outcomes and health-related quality of life (HRQoL) were retrieved, mostly including changes in libido, erectile function, ejaculatory disorders, orgasm, climacturia, changes in role-in-sex identity, changes in sexual partnerships, and the presence of painful receptive anal intercourses (AI).
Prospero id: CRD42024502592.
Results: Six articles met the inclusion criteria. In total, data of 260 patients were analyzed. Three main themes emerged: (a) MSM may experience specific sexual dysfunctions due to the different dynamics of their intimacy; (b) the lack of tool validated on gay and bisexual population to assess sexual outcomes (c) the need for a tailored approach that also takes into account sexual orientation throughout the oncological journey.
Conclusions: MSM undergoing RP may experience similar sexual problems as MSW. Painful AI should be considered a potential post-operative adverse outcome in MSM. Future studies should prioritize validating a questionnaire that explores AI. Healthcare providers should adopt a tailored approach that takes into account sexual orientation throughout the cancer journey.
背景:性生活困难是公认的前列腺癌(PCa)治疗的后果。据估计,每三名男男性行为者(MSM)中就有一名在其一生中被诊断出患有前列腺癌。男男性行为者可能会经历与女男性行为者(MSW)报告的所有类型的性功能障碍,以及一些更具体的困扰问题。本系统性文献综述旨在评估接受根治性前列腺切除术(RP)的 MSM 的性功能结果:方法:按照《系统综述和元分析首选报告项目》(PRISMA)指南进行了系统综述。在 PubMed、Scopus 和 Web of Science 数据库中使用相关关键词进行检索,从而将 2000 年 1 月至 2023 年 11 月期间的所有文献都包括在内。无法检索到接受 PCa RP 治疗的 MSM 的性结果数据的研究被排除在外。我们检索了有关性结果和健康相关生活质量(HRQoL)的数据,主要包括性欲变化、勃起功能、射精障碍、性高潮、排尿困难、性角色认同变化、性伴侣关系变化以及肛交疼痛(AI):CRD42024502592.Results:六篇文章符合纳入标准。共分析了 260 名患者的数据。结果:共有六篇文章符合纳入标准,共分析了 260 名患者的数据,得出三大主题:(a)由于亲密关系的动态不同,MSM 可能会出现特殊的性功能障碍;(b)缺乏针对男同性恋和双性恋人群的有效工具来评估性功能结果;(c)在整个肿瘤治疗过程中,需要一种考虑到性取向的定制方法:结论:接受 RP 治疗的 MSM 可能会遇到与 MSW 类似的性问题。在 MSM 中,AI 疼痛应被视为一种潜在的术后不良后果。未来的研究应优先验证探讨 AI 的问卷。医疗服务提供者应采取有针对性的方法,在整个癌症治疗过程中考虑到性取向问题。
{"title":"Sexual outcomes in men who have sex with men who underwent radical prostatectomy.","authors":"F Vedovo, C Lonati, N Suardi, L Mariani, P Capogrosso, V Ficarra, A Salonia, C Trombetta","doi":"10.1038/s41391-024-00861-9","DOIUrl":"https://doi.org/10.1038/s41391-024-00861-9","url":null,"abstract":"<p><strong>Background: </strong>Sexual difficulties are a recognized consequence of prostate cancer (PCa) treatments. An estimated one in three men who have sex with men (MSM) receive PCa a diagnosis during their lifetime. MSM may experience all types of sexual dysfunction as reported in men who have sex with women (MSW), along with a number of more specific bothersome problems. This systematic literature review aims to evaluate sexual outcomes in MSM who have undergone radical prostatectomy (RP).</p><p><strong>Methods: </strong>A systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The searches were made using relevant keywords in the PubMed, Scopus, and Web of Science databases, thus including the whole literature from January 2000 to November 2023. Studies which did not allow to retrieve data on sexual outcomes on MSM treated with RP for PCa were excluded. Data on sexual outcomes and health-related quality of life (HRQoL) were retrieved, mostly including changes in libido, erectile function, ejaculatory disorders, orgasm, climacturia, changes in role-in-sex identity, changes in sexual partnerships, and the presence of painful receptive anal intercourses (AI).</p><p><strong>Prospero id: </strong>CRD42024502592.</p><p><strong>Results: </strong>Six articles met the inclusion criteria. In total, data of 260 patients were analyzed. Three main themes emerged: (a) MSM may experience specific sexual dysfunctions due to the different dynamics of their intimacy; (b) the lack of tool validated on gay and bisexual population to assess sexual outcomes (c) the need for a tailored approach that also takes into account sexual orientation throughout the oncological journey.</p><p><strong>Conclusions: </strong>MSM undergoing RP may experience similar sexual problems as MSW. Painful AI should be considered a potential post-operative adverse outcome in MSM. Future studies should prioritize validating a questionnaire that explores AI. Healthcare providers should adopt a tailored approach that takes into account sexual orientation throughout the cancer journey.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141451367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-20DOI: 10.1038/s41391-024-00859-3
Cody M. Anger, James L. Stallworth, Soroush Rais-Bahrami
{"title":"Integrating risk calculators into routine clinical workflow for the detection of prostate cancer: next steps to achieve widespread adoption","authors":"Cody M. Anger, James L. Stallworth, Soroush Rais-Bahrami","doi":"10.1038/s41391-024-00859-3","DOIUrl":"10.1038/s41391-024-00859-3","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41391-024-00859-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-20DOI: 10.1038/s41391-024-00860-w
Hazem Elmansy
{"title":"Correction: Editorial comment on “Reevaluating ‘Top-Down’ HoLEP: the case for anterior fibromuscular stroma as a surgical landmark”","authors":"Hazem Elmansy","doi":"10.1038/s41391-024-00860-w","DOIUrl":"10.1038/s41391-024-00860-w","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41391-024-00860-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-19DOI: 10.1038/s41391-024-00862-8
Jennifer Le Guevelou, Francesco Cuccia, Ronan Flippot, Giuseppe Ferrera, Mario Terlizzi, Thomas Zilli, Renaud De Crevoisier, Jean-Michel Hannoun-Levi, Stephane Supiot, Paul Sargos, David Pasquier
Background: The onset of castration-resistance is associated with dismal outcomes in patients with prostate cancer (PCa). Metastasis directed therapy has been investigated in multiple disease settings and may improve outcomes in selected patients. Our systematic review aims to summarize evidence with stereotactic body radiotherapy (SBRT) in castration-resistant prostate cancer (CRPC).
Methods: The literature search was performed on March 2024, on Pubmed, using the keywords "SBRT" AND "CRPC", and "stereotactic ablative radiotherapy (SABR)" AND "CRPC". This search retrieved a total of 108 articles, 19 were included.
Results: The literature is largely dominated by retrospective series. In men with metachronous oligoprogression, SBRT with androgen receptor pathway inhibitor significantly increased progression-free survival (PFS) including biochemical progression-free survival in a randomized phase II trial (hazard ratio of 0.35, p < 0.001). In patients continuing ADT, the bPFS ranged between 9.5 months to 17.9 months, and next systemic treatment-free survival (NEST-FS) reached up to 2 years. In men with induced oligoprogression, SBRT enabled NEST-FS up to 3 years. SBRT was well tolerated, with less than 5% grade 3 toxicity reported across studies.
Conclusion: In the population of patients with oligometastatic CRPC, SBRT enables long-term biochemical response and PFS. In the oligoprogressive setting, SBRT could be integrated to prolong the duration and efficacy of systemic therapies. Nevertheless, the level of evidence remains very low and inclusion within prospective trials remain the preferred option for this population of patients.
{"title":"The current landscape of stereotactic body radiation therapy for metastatic castration-resistant prostate cancer.","authors":"Jennifer Le Guevelou, Francesco Cuccia, Ronan Flippot, Giuseppe Ferrera, Mario Terlizzi, Thomas Zilli, Renaud De Crevoisier, Jean-Michel Hannoun-Levi, Stephane Supiot, Paul Sargos, David Pasquier","doi":"10.1038/s41391-024-00862-8","DOIUrl":"10.1038/s41391-024-00862-8","url":null,"abstract":"<p><strong>Background: </strong>The onset of castration-resistance is associated with dismal outcomes in patients with prostate cancer (PCa). Metastasis directed therapy has been investigated in multiple disease settings and may improve outcomes in selected patients. Our systematic review aims to summarize evidence with stereotactic body radiotherapy (SBRT) in castration-resistant prostate cancer (CRPC).</p><p><strong>Methods: </strong>The literature search was performed on March 2024, on Pubmed, using the keywords \"SBRT\" AND \"CRPC\", and \"stereotactic ablative radiotherapy (SABR)\" AND \"CRPC\". This search retrieved a total of 108 articles, 19 were included.</p><p><strong>Results: </strong>The literature is largely dominated by retrospective series. In men with metachronous oligoprogression, SBRT with androgen receptor pathway inhibitor significantly increased progression-free survival (PFS) including biochemical progression-free survival in a randomized phase II trial (hazard ratio of 0.35, p < 0.001). In patients continuing ADT, the bPFS ranged between 9.5 months to 17.9 months, and next systemic treatment-free survival (NEST-FS) reached up to 2 years. In men with induced oligoprogression, SBRT enabled NEST-FS up to 3 years. SBRT was well tolerated, with less than 5% grade 3 toxicity reported across studies.</p><p><strong>Conclusion: </strong>In the population of patients with oligometastatic CRPC, SBRT enables long-term biochemical response and PFS. In the oligoprogressive setting, SBRT could be integrated to prolong the duration and efficacy of systemic therapies. Nevertheless, the level of evidence remains very low and inclusion within prospective trials remain the preferred option for this population of patients.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":null,"pages":null},"PeriodicalIF":5.1,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}