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Clinical implications of Wnt pathway genetic alterations in men with advanced prostate cancer. 晚期前列腺癌男性 Wnt 通路基因改变的临床意义。
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-17 DOI: 10.1038/s41391-024-00869-1
Amanda Broderick, Elizabeth Pan, Jinju Li, Alec Chu, Clara Hwang, Pedro C Barata, Frank Cameron Cackowski, Matthew Labriola, Alyssa Ghose, Mehmet Asim Bilen, Deepak Kilari, Bicky Thapa, Michael Piero, Laura Graham, Abhishek Tripathi, Rohan Garje, Vadim S Koshkin, Erik Hernandez, Tanya B Dorff, Michael Thomas Schweizer, Ajjai Shivaram Alva, Rana R McKay, Andrew J Armstrong

Background: Aberrant Wnt signaling has been implicated in prostate cancer tumorigenesis and metastasis in preclinical models but the impact of genetic alterations in Wnt signaling genes in men with advanced prostate cancer is unknown.

Methods: We utilized the Prostate Cancer Precision Medicine Multi-Institutional Collaborative Effort (PROMISE) clinical-genomic database for this retrospective analysis. Patients with activating mutations in CTNNB1 or RSPO2 or inactivating mutations in APC, RNF43, or ZNRF3 were defined as Wnt-altered, while those lacking such alterations were defined as Wnt non-altered. We compared patient characteristics and clinical outcomes as well as co-occurring genetic alterations according to Wnt alteration status.

Results: Of the 1498 patients included, 193 (12.9%) were Wnt-altered. These men had a statistically significant 2-fold increased prevalence of liver and lung metastases as compared with Wnt non-altered patients at the time of initial diagnosis, (4.66% v 2.15% ; 6.22% v 3.07%), first metastatic disease diagnosis (10.88% v 5.29%; 13.99% v 6.21%), and CRPC development (11.40% v 6.36%; 12.95% v 5.29%). Wnt alterations were associated with more co-occurring alterations in RB1 (10.4% v 6.2%), AR (38.9% vs 25.7%), SPOP (13.5% vs 4.1%), FOXA1 (6.7% vs 2.8%), and PIK3CA (10.9% vs 5.1%). We found no significant differences in overall survival or other clinical outcomes from initial diagnosis, first metastatic disease, diagnosis of CRPC, or with AR inhibition for mCRPC between the Wnt groups.

Conclusions: Wnt-altered patients with prostate cancer have a higher prevalence of visceral metastases and are enriched in RB1, AR, SPOP, FOXA1, and PIK3CA alterations. Despite these associations, Wnt alterations were not associated with worse survival or treatment outcomes in men with advanced prostate cancer.

背景:在临床前模型中,Wnt 信号转导异常与前列腺癌的肿瘤发生和转移有关,但 Wnt 信号转导基因的遗传改变对晚期前列腺癌男性患者的影响尚不清楚:我们利用前列腺癌精准医学多机构协作努力(PROMISE)临床基因组数据库进行了这项回顾性分析。CTNNB1或RSPO2发生激活突变或APC、RNF43或ZNRF3发生灭活突变的患者被定义为Wnt改变患者,而没有发生此类改变的患者被定义为Wnt非改变患者。我们根据 Wnt 改变状态比较了患者特征、临床结果以及并发遗传改变:在纳入的 1498 名患者中,有 193 人(12.9%)发生了 Wnt 改变。与未发生 Wnt 改变的患者相比,这些男性患者在初次诊断(4.66% 对 2.15%;6.22% 对 3.07%)、首次转移性疾病诊断(10.88% 对 5.29%;13.99% 对 6.21%)和 CRPC 发展(11.40% 对 6.36%;12.95% 对 5.29%)时的肝脏和肺部转移发生率在统计学上显著增加了 2 倍。Wnt改变与更多的RB1(10.4% vs 6.2%)、AR(38.9% vs 25.7%)、SPOP(13.5% vs 4.1%)、FOXA1(6.7% vs 2.8%)和PIK3CA(10.9% vs 5.1%)共存改变相关。我们发现,从最初诊断、首次转移性疾病、诊断为CRPC或使用AR抑制剂治疗mCRPC开始,Wnt组之间的总生存期或其他临床结果没有明显差异:结论:Wnt改变的前列腺癌患者内脏转移率较高,且富含RB1、AR、SPOP、FOXA1和PIK3CA改变。尽管存在这些关联,但Wnt改变与晚期前列腺癌男性患者更差的生存期或治疗效果无关。
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引用次数: 0
Effect of metformin on incidence, recurrence, and mortality in prostate cancer patients: integrating evidence from real-world studies. 二甲双胍对前列腺癌患者发病率、复发率和死亡率的影响:整合来自真实世界研究的证据。
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-16 DOI: 10.1038/s41391-024-00871-7
Yuchen Liu, Qingfang Zhang, Xuan Huang

Purpose: Metformin has been suggested to reduce the risk of cancer. However, previous studies have been inconsistent regarding the relationship between metformin use and the risk of occurrence of prostate cancer (PCa). The purpose of this study was to assess the effect of metformin on clinical outcomes in patients with PCa in a meta-analysis and to explore the possible dose-response relationship.

Methods: A systematic literature search was conducted in 10 electronic databases and 4 registries. The combined relative risks (RRs) were calculated using a random-effects model with 95% confidence interval (CIs) to assess the effect of metformin on the risk of PCa. Relevant subgroup analyses and sensitivity analyses were performed.

Results: The across studies results show that metformin use associated with lower incidence of PCa (RR: 0.82, 95% CI: 0.74-0.91). Metformin use was also found to reduce PCa recurrence, but the results were not statistically significant (RR: 0.97, 95% CI: 0.81-1.15). Metformin use was not associated with PCa mortality (RR: 0.94, 95% CI: 0.81-1.09). The results of subgroup analyses indicated that the type of study was a cohort study and the population came from both Asia and Europe showed that taking metformin reduced the incidence of PCa. A linear correlation was found between the duration of metformin use and its protective effect.

Conclusions: This meta-analysis revealed an independent correlation between metformin use and reduced incidence of PCa. Metformin use was not associated with either PCa recurrence rate or mortality. Furthermore, the effect of metformin on PCa incidence was found to be related to duration.

目的:二甲双胍被认为可以降低患癌风险。然而,关于二甲双胍的使用与前列腺癌(PCa)发病风险之间的关系,以往的研究结果并不一致。本研究旨在通过一项荟萃分析评估二甲双胍对PCa患者临床预后的影响,并探讨可能存在的剂量-反应关系:在10个电子数据库和4个登记处进行了系统性文献检索。采用随机效应模型计算合并相对风险(RRs)和95%置信区间(CIs),以评估二甲双胍对PCa风险的影响。研究还进行了相关的亚组分析和敏感性分析:各项研究结果表明,服用二甲双胍可降低 PCa 的发病率(RR:0.82,95% CI:0.74-0.91)。使用二甲双胍还能降低 PCa 复发率,但结果在统计学上并不显著(RR:0.97,95% CI:0.81-1.15)。二甲双胍与 PCa 死亡率无关(RR:0.94,95% CI:0.81-1.09)。亚组分析结果表明,研究类型为队列研究,研究对象来自亚洲和欧洲,结果显示服用二甲双胍可降低 PCa 的发病率。服用二甲双胍的时间长短与其保护作用呈线性相关:这项荟萃分析表明,服用二甲双胍与降低 PCa 发病率之间存在独立的相关性。使用二甲双胍与 PCa 复发率或死亡率均无关。此外,二甲双胍对 PCa 发病率的影响还与持续时间有关。
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引用次数: 0
RE: "Can ChatGPT provide high-quality patient information on male lower urinary tract symptoms suggestive of benign prostate enlargement?" RE: "ChatGPT 能否为男性下尿路症状提示良性前列腺增生提供高质量的患者信息?
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-16 DOI: 10.1038/s41391-024-00874-4
Hinpetch Daungsupawong, Viroj Wiwanitkit
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引用次数: 0
Effects of high-intensity interval training on cardiometabolic biomarkers in patients with prostate cancer undergoing active surveillance: a randomized controlled trial. 高强度间歇训练对接受主动监测的前列腺癌患者心脏代谢生物标志物的影响:随机对照试验。
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-15 DOI: 10.1038/s41391-024-00867-3
Dong-Woo Kang, Catherine J Field, Dhruvesh Patel, Adrian S Fairey, Normand G Boulé, Christina M Dieli-Conwright, Kerry S Courneya

Purpose: To report the effects of a 12-week high-intensity interval training (HIIT) program on cardiometabolic biomarkers in patients with prostate cancer on active surveillance (AS) from the Exercise During Active Surveillance for Prostate Cancer (ERASE) Trial.

Methods: Fifty-two men with prostate cancer on AS were randomized to either an exercise (HIIT; n = 26) or usual care (UC; n = 26) group. The HIIT intervention consisted of progressive, supervised, aerobic HIIT at an intensity of 85 to 95% VO2peak for 28 to 40 min per session performed three times/week for 12 weeks. Blood samples were collected at baseline and postintervention to analyze cardiometabolic biomarkers. Analysis of covariance was used to examine between-group mean differences.

Results: Blood data were obtained from 49/52 (94%) participants at postintervention. Participants were aged 63.4 ± 7.1 years and 40% were obese. The HIIT group attended 96% of the planned exercise sessions. No significant between-group changes in weight were observed after the intervention. Compared to UC, HIIT significantly improved total cholesterol (-0.40 mmol/L; 95% confidence interval[CI], -0.70 to -0.10; p = 0.011), non-high-density lipoprotein-c (-0.35 mmol/L; 95% CI, -0.60 to -0.11; p = 0.006), insulin (-13.6 pmol/L; 95% CI, -25.3 to -1.8; p = 0.025), insulin-like growth factor (IGF)-1 (-15.0 ng/mL; 95% CI, -29.9 to -0.1; p = 0.048), and IGF binding protein (IGFBP)-3 (152.3 ng/mL; 95% CI, 12.6 to 292.1; p = 0.033). No significant differences were observed for fasting glucose, HbA1c, other lipid markers, IGFBP-1, adiponectin, and leptin.

Conclusions: The ERASE Trial showed that a 12-week aerobic HIIT program improved several cardiometabolic biomarkers in patients with prostate cancer on AS that may contribute to cardiovascular health benefits and potentially influence signaling pathways in the progression of prostate cancer. Further research is needed to confirm the effects of exercise on cardiometabolic markers in men with prostate cancer on AS and determine if these effects are associated with improved long-term clinical outcomes.

目的:报告为期12周的高强度间歇训练(HIIT)计划对前列腺癌患者心脏代谢生物标志物的影响:52名接受主动监测的前列腺癌男性患者被随机分配到运动组(HIIT;26人)或常规护理组(UC;26人)。HIIT干预包括循序渐进、有监督的有氧HIIT,强度为85%至95% VO2peak,每次28至40分钟,每周三次,持续12周。在基线和干预后收集血液样本以分析心脏代谢生物标志物。采用协方差分析法检验组间平均差异:49/52(94%)名参与者在干预后获得了血液数据。参与者的年龄为(63.4 ± 7.1)岁,40%为肥胖。HIIT 组参加了计划运动课程的 96%。干预后,组间体重无明显变化。与 UC 相比,HIIT 显著改善了总胆固醇(-0.40 mmol/L;95% 置信区间[CI],-0.70 至 -0.10;p = 0.011)、非高密度脂蛋白-c(-0.35 mmol/L;95% CI,-0.60 至 -0.11;p = 0.006)、胰岛素(-13.6 pmol/L;95% CI,-25.3 至 -1.8;p = 0.025)、胰岛素样生长因子(IGF)-1(-15.0 ng/mL;95% CI,-29.9 至 -0.1;p = 0.048)和 IGF 结合蛋白(IGFBP)-3(152.3 ng/mL;95% CI,12.6 至 292.1;p = 0.033)。空腹血糖、HbA1c、其他血脂指标、IGFBP-1、脂肪连素和瘦素均无明显差异:ERASE试验表明,为期12周的有氧HIIT计划改善了前列腺癌患者在AS治疗过程中的多种心脏代谢生物标志物,这可能有助于心血管健康,并可能影响前列腺癌进展的信号通路。还需要进一步的研究来证实运动对前列腺癌男性患者心血管代谢标志物的影响,并确定这些影响是否与长期临床结果的改善有关。
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引用次数: 0
Rare histological prostate cancer subtypes: Cancer-specific and other-cause mortality 罕见组织学前列腺癌亚型:癌症特异性死亡率和其他原因死亡率
IF 4.8 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-10 DOI: 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.

背景评估罕见组织学亚型前列腺癌患者的癌症特异性死亡率(CSM)和其他原因死亡率(OCM)。结果在 827,549 例患者中,1510 例(0.18%)患有导管癌,952 例(0.12%)患有神经内分泌癌,462 例(0.06%)患有粘液腺癌,95 例(0.01%)患有标志环细胞癌。在局部晚期阶段,5 年 CSM 与 OCM 的比率分别为:针状癌 2% 与 10%,粘液腺癌 3% 与 8%,神经内分泌癌 55% 与 19%。在局部晚期阶段,针状癌患者的五年CSM与OCM对比率为5%比6%,导管癌患者为14%比16%,神经内分泌癌患者为71%比15%。在转移阶段,标志环细胞和粘液腺癌的五年CSM与OCM比率分别为49%和16%,导管癌为63%和9%,神经内分泌癌为85%和12%。在多变量CRR中,局部神经内分泌癌(HR 3.09)、局部晚期神经内分泌癌(HR 9.66)、局部晚期导管癌(HR 2.26)和最终转移性神经内分泌癌患者(HR 3.57;均为P < 0.结论与尖腺癌相比,各期神经内分泌癌和局部晚期导管癌患者的 CSM 率更高。相反,粘液腺癌和印戒细胞腺癌的 CSM 率与尖腺癌没有差异。
{"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> &lt; 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":"16 1","pages":""},"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}
引用次数: 0
Development and validation of a clinical nomogram to predict prostatic inflammation in men with lower urinary tract symptoms. 开发并验证用于预测下尿路症状男性前列腺炎症的临床提名图。
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-06 DOI: 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.

背景:前列腺炎症是良性前列腺增生症(BPH)和下尿路症状(LUTS)的重要病因。前列腺炎症提名图研究(PINS)旨在开发和验证一种提名图,用于预测患有下尿路症状的男性是否存在前列腺炎症:这项非干预性、横断面、前瞻性研究在塞浦路斯、希腊、意大利、葡萄牙和西班牙的六个二级/三级中心进行。研究对象包括计划接受前列腺手术或经直肠超声引导(TRUS)前列腺活检的良性前列腺增生症/前列腺痛(BPH/LUTS)男性患者(≥40 岁)。研究人员选择了 15 个人口统计学和临床参与者特征作为前列腺炎症的可能预测因素。确定了手术/TRUS 活检获得的前列腺组织样本中是否存在炎症(根据伊尼评分)。使用多重逻辑回归评估了每个特征对前列腺标本显示炎症(按伊尼评分分为 0-2 [无/轻度炎症] 或 3-6 [中度/重度炎症] 两类)的可能性的影响。结果:共招募了 423 名患者(平均年龄 68.9 岁)。前列腺体积超声(PVUS)> 50 mL、尿路感染(UTI)治疗史、糖尿病和国际前列腺症状评分(IPPS)存储评分对 Irani 分级有显著的统计学预测作用。逻辑回归结果表明,通过尿液浸量计检测到的白细胞、糖尿病、PVUS > 50 mL、UTI 治疗史和较高的 IPSS 存储评分对炎症评分类别为 3-6 和 0-2 的几率具有统计学意义。该提名图的一致性指数为 0.71,具有良好的内部有效性:根据 PINS 开发的提名图具有良好的预测能力,并确定了可预测前列腺炎症的各种特征。使用该提名图可以帮助对前列腺痛进行个体化治疗,确定哪些人适合采用针对前列腺炎症的疗法。
{"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":" ","pages":""},"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}
引用次数: 0
Addressing questions related to "incidence of prostate cancer in trans-women in the US: a large database analysis". 解决与 "美国变性女性的前列腺癌发病率:大型数据库分析 "相关的问题。
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-05 DOI: 10.1038/s41391-024-00863-7
Matthew Loria, Tomasz Tabernacki, David Gilbert, Mart Andrew Maravillas, Megan McNamara, Shubham Gupta, Kirtishri Mishra
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引用次数: 0
Impact of a rash management guide in patients receiving apalutamide for high-risk localized prostate cancer in the Apa-RP study. 在 Apa-RP 研究中,皮疹管理指南对接受阿帕鲁胺治疗高危局部前列腺癌患者的影响。
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2024-07-05 DOI: 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.

背景/目的:根据SPARTAN和TITAN研究,阿帕鲁胺被批准用于治疗非转移性阉割耐药和转移性阉割敏感前列腺癌患者。皮疹是各适应症中常见的不良反应。我们假设早期识别和干预可以改善皮疹的治疗效果:向所有入组 Apa-RP (NCT04523207) 的患者提供了预设的皮疹管理指南,其中概述了推荐的皮肤护理方法。将 Apa-RP 中与皮疹相关的安全性数据与 SPARTAN 和 TITAN 的数据进行了描述性比较:结果:与 SPARTAN 和 TITAN 相比,Apa-RP 患者的皮疹相关结果有所改善:结论:提高警惕和积极管理可降低阿帕鲁胺治疗期间皮疹的发生率、严重程度和持续时间。
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引用次数: 0
Should systematic prostatic biopsies be discontinued? 是否应该停止系统性前列腺活检?
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2024-06-27 DOI: 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.

介绍:多项研究表明,靶向活检会漏检 15-20% 具有 "临床意义 "的癌症,因此,除靶向活检外,还需使用系统活检。对这些 "漏检 "癌症的担忧推动了许多干预措施的实施。这包括对影像学检查阴性的男性和进行靶向活检的男性进行系统性活检,并倾向于对可能适合部分腺体消融的男性进行全腺体治疗。本文总结了最近的基因组学和临床数据,这些数据表明,尽管组织学上 "有临床意义",但核磁共振成像看不见的病灶在基因组学和临床上都是有利的。这些研究表明,与癌症可见性相关的基因畸变正是导致癌症侵袭和转移的畸变。因此,隐匿性癌症即使在基线时未被诊断出来,在大多数情况下也是不活跃的,对患者的威胁很小。其意义在于,应通过成像而非系统活检对患者进行监测,并在有 MR 进展的证据时重复进行有针对性的活检。患者更喜欢这种策略。它在减轻护理负担、成本、心理益处以及减少对不重要癌症的诊断等方面有很多优势:结论:现在对大多数患者放弃系统性活检是合适的。
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引用次数: 0
ChatGPT can help guide and empower patients after prostate cancer diagnosis. ChatGPT 可以在前列腺癌确诊后为患者提供指导和帮助。
IF 5.1 2区 医学 Q1 ONCOLOGY Pub Date : 2024-06-26 DOI: 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.

背景/目的:患者在确诊前列腺癌后往往不清楚自己应该知道些什么。基于网络的信息很常见,但存在质量或可读性差的风险:我们使用免费提供的人工智能(AI)平台 ChatGPT 生成新确诊患者可能提出的有关前列腺癌的询问,并与谷歌搜索趋势进行比较。然后,我们使用标准化工具评估了 ChatGPT 对这些问题的回复的临床适宜性和质量:结果:ChatGPT 生成了广泛而有代表性的问题,并提供了易于理解、临床上合理的建议:结论:通过教育,人工智能可以在前列腺癌确诊后为患者提供指导并增强其能力。然而,ChatGPT 语言模型的局限性不容忽视,需要在医疗保健领域进一步评估和优化。
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引用次数: 0
期刊
Prostate Cancer and Prostatic Diseases
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