Pub Date : 2025-08-21DOI: 10.1038/s41391-025-01012-4
Yung-Chi Shih, Shang-Ju Hsieh
{"title":"“Re: does biodegradable peri-rectal spacer mitigate treatment toxicities in radiation therapy for localized prostate cancer—a systematic review and meta-analysis.”","authors":"Yung-Chi Shih, Shang-Ju Hsieh","doi":"10.1038/s41391-025-01012-4","DOIUrl":"10.1038/s41391-025-01012-4","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":"28 4","pages":"1021-1022"},"PeriodicalIF":5.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966254","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 : 2025-08-21DOI: 10.1038/s41391-025-01011-5
Renning Zheng, Nadine A Friedrich, Michael Luu, Rebecca Gale, Dmitry Khodyakov, Stephen J Freedland, Brennan Spiegel, Timothy J Daskivich
Background: AUA guidelines for shared decision making (SDM) in prostate cancer recommend discussion of five content areas in consultations: (1) cancer severity (tumor risk (TR), pathology results (PR)); (2) life expectancy (LE); (3) cancer prognosis (CP); (4) baseline urinary and erectile function (UF and EF); and (5) treatment side effects (erectile dysfunction (ED), urinary incontinence (UI), and irritative urinary symptoms (LUTS)). However, patient retention of information after the visit and inconsistent risk communication by physicians are barriers to informed SDM. We sought to develop natural language processing (NLP) models based on recorded consultations to provide key information to patients and audit quality of physician communication.
Methods: We used 50 consultation transcripts to train and validate NLP models to identify sentences related to key concepts. We then tested whether communication quality across entire consultations could be determined by sentences with the highest model-predicted topic concordance in 20 separate consultation transcripts.
Results: Our development dataset included 28,927 total sentences, with 75% reserved for training and 25% for internal validation. The Random Forest model had the highest accuracy for identifying topic-concordant sentences, with area under the curve 0.98, 0.94, 0.89, 0.92, 0.84, 0.96, 0.98, 0.97, and 0.99 for TR, PR, LE, CP, UF, EF, ED, UI, and LUTS compared with manual coding across all concepts in the internal validation dataset. In 20 separate consultations, the top 10 model-identified sentences correctly graded communication quality across entire consultations with accuracies of 100%, 90%, 95%, 95%, 80%, 95%, 85%, 100%, and 95% for TR, PR, LE, CP, UF, EF, ED, UI, and LUTS compared with manual coding, respectively.
Conclusions: NLP models accurately capture key information and grade quality of physician communication in prostate cancer consultations, providing the foundation for scalable quality assessment of risk communication.
{"title":"Development and validation of a natural language processing system to assess quality of physician communication in prostate cancer consultations.","authors":"Renning Zheng, Nadine A Friedrich, Michael Luu, Rebecca Gale, Dmitry Khodyakov, Stephen J Freedland, Brennan Spiegel, Timothy J Daskivich","doi":"10.1038/s41391-025-01011-5","DOIUrl":"10.1038/s41391-025-01011-5","url":null,"abstract":"<p><strong>Background: </strong>AUA guidelines for shared decision making (SDM) in prostate cancer recommend discussion of five content areas in consultations: (1) cancer severity (tumor risk (TR), pathology results (PR)); (2) life expectancy (LE); (3) cancer prognosis (CP); (4) baseline urinary and erectile function (UF and EF); and (5) treatment side effects (erectile dysfunction (ED), urinary incontinence (UI), and irritative urinary symptoms (LUTS)). However, patient retention of information after the visit and inconsistent risk communication by physicians are barriers to informed SDM. We sought to develop natural language processing (NLP) models based on recorded consultations to provide key information to patients and audit quality of physician communication.</p><p><strong>Methods: </strong>We used 50 consultation transcripts to train and validate NLP models to identify sentences related to key concepts. We then tested whether communication quality across entire consultations could be determined by sentences with the highest model-predicted topic concordance in 20 separate consultation transcripts.</p><p><strong>Results: </strong>Our development dataset included 28,927 total sentences, with 75% reserved for training and 25% for internal validation. The Random Forest model had the highest accuracy for identifying topic-concordant sentences, with area under the curve 0.98, 0.94, 0.89, 0.92, 0.84, 0.96, 0.98, 0.97, and 0.99 for TR, PR, LE, CP, UF, EF, ED, UI, and LUTS compared with manual coding across all concepts in the internal validation dataset. In 20 separate consultations, the top 10 model-identified sentences correctly graded communication quality across entire consultations with accuracies of 100%, 90%, 95%, 95%, 80%, 95%, 85%, 100%, and 95% for TR, PR, LE, CP, UF, EF, ED, UI, and LUTS compared with manual coding, respectively.</p><p><strong>Conclusions: </strong>NLP models accurately capture key information and grade quality of physician communication in prostate cancer consultations, providing the foundation for scalable quality assessment of risk communication.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966294","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 : 2025-08-19DOI: 10.1038/s41391-025-01015-1
Khi Yung Fong, Vineet Gauhar, Thomas R. W. Herrmann, Carlotta Nedbal, Dmitry Enikeev, Jeremy Yuen-Chun Teoh, Sarvajit Biligere, Steffi Kar Kei Yuen, Daniele Castellani, Bhaskar Kumar Somani, Patrick Juliebø-Jones, Valerie Huei Li Gan, Edwin Jonathan Aslim, Ee Jean Lim
Machine learning (ML) and artificial intelligence (AI) have demonstrated powerful functionality in the healthcare setting thus far. We aimed to construct an AI model to predict postoperative incontinence after enucleation surgery for benign prostatic hyperplasia (BPH). Data were taken from two BPH registries and split into training and validation datasets. The following characteristics were used as predictors of incontinence: age, prostate volume, preoperative IPSS, QoL score, Qmax and post-void residual; presence of preoperative indwelling catheter, early apical release (EAR), enucleation type (2-lobe, 3-lobe, or en-bloc), and laser energy type. Six types of ML models were constructed using the training dataset and applied to the validation dataset to assess their accuracy. 3828 patients from both databases were analyzed. Median age was 68, median prostate volume was 85.5 cc. 5.4% had a preoperative indwelling catheter. The commonest enucleation type was 2-lobe, the commonest energy type was Thulium fiber laser, and EAR was performed in 34.0%. Of the six ML models tested, extreme gradient boosting with manual fine tuning was the best-performing with an accuracy of 86.2%, sensitivity of 96.8%, specificity of 23.7%, PPV of 88.2%, and NPV of 55.9%. We hereby present an ML model for incontinence prediction post-surgery for BPH. Its main strengths are high sensitivity and PPV, meaning that if a patient is predicted to be incontinent using this model, this is likely to reflect the eventual outcome. This allows clinicians to pay closer attention on follow-up to detect and manage postoperative incontinence expediently.
{"title":"Machine learning models to predict postoperative incontinence after endoscopic enucleation of the prostate for benign prostatic hyperplasia: An EAU-Endourology study","authors":"Khi Yung Fong, Vineet Gauhar, Thomas R. W. Herrmann, Carlotta Nedbal, Dmitry Enikeev, Jeremy Yuen-Chun Teoh, Sarvajit Biligere, Steffi Kar Kei Yuen, Daniele Castellani, Bhaskar Kumar Somani, Patrick Juliebø-Jones, Valerie Huei Li Gan, Edwin Jonathan Aslim, Ee Jean Lim","doi":"10.1038/s41391-025-01015-1","DOIUrl":"10.1038/s41391-025-01015-1","url":null,"abstract":"Machine learning (ML) and artificial intelligence (AI) have demonstrated powerful functionality in the healthcare setting thus far. We aimed to construct an AI model to predict postoperative incontinence after enucleation surgery for benign prostatic hyperplasia (BPH). Data were taken from two BPH registries and split into training and validation datasets. The following characteristics were used as predictors of incontinence: age, prostate volume, preoperative IPSS, QoL score, Qmax and post-void residual; presence of preoperative indwelling catheter, early apical release (EAR), enucleation type (2-lobe, 3-lobe, or en-bloc), and laser energy type. Six types of ML models were constructed using the training dataset and applied to the validation dataset to assess their accuracy. 3828 patients from both databases were analyzed. Median age was 68, median prostate volume was 85.5 cc. 5.4% had a preoperative indwelling catheter. The commonest enucleation type was 2-lobe, the commonest energy type was Thulium fiber laser, and EAR was performed in 34.0%. Of the six ML models tested, extreme gradient boosting with manual fine tuning was the best-performing with an accuracy of 86.2%, sensitivity of 96.8%, specificity of 23.7%, PPV of 88.2%, and NPV of 55.9%. We hereby present an ML model for incontinence prediction post-surgery for BPH. Its main strengths are high sensitivity and PPV, meaning that if a patient is predicted to be incontinent using this model, this is likely to reflect the eventual outcome. This allows clinicians to pay closer attention on follow-up to detect and manage postoperative incontinence expediently.","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":"29 1","pages":"175-180"},"PeriodicalIF":5.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883545","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 : 2025-08-12DOI: 10.1038/s41391-025-01009-z
Nicholas A. Zorko, Allison Makovec, Andrew Elliott, Samuel Kellen, John R. Lozada, Ali T. Arafa, Martin Felices, Madison Shackelford, Pedro Barata, Yousef Zakharia, Vivek Narayan, Mark N. Stein, Kevin K. Zarrabi, Akash Patnaik, Mehmet A. Bilen, Milan Radovich, George Sledge, Wafik S. El-Deiry, Elisabeth I. Heath, Dave S. B. Hoon, Chadi Nabhan, Jeffrey S. Miller, Justin H. Hwang, Emmanuel S. Antonarakis
{"title":"Correction: Natural killer cell infiltration in prostate cancers predict improved patient outcomes","authors":"Nicholas A. Zorko, Allison Makovec, Andrew Elliott, Samuel Kellen, John R. Lozada, Ali T. Arafa, Martin Felices, Madison Shackelford, Pedro Barata, Yousef Zakharia, Vivek Narayan, Mark N. Stein, Kevin K. Zarrabi, Akash Patnaik, Mehmet A. Bilen, Milan Radovich, George Sledge, Wafik S. El-Deiry, Elisabeth I. Heath, Dave S. B. Hoon, Chadi Nabhan, Jeffrey S. Miller, Justin H. Hwang, Emmanuel S. Antonarakis","doi":"10.1038/s41391-025-01009-z","DOIUrl":"10.1038/s41391-025-01009-z","url":null,"abstract":"","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":"28 4","pages":"1030-1030"},"PeriodicalIF":5.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41391-025-01009-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837481","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 : 2025-08-07DOI: 10.1038/s41391-025-01008-0
Jasmine Saunders, Veda N Giri, Susan T Vadaparampil, Adrian Rivera, Tatiana Sanchez Nolasco, Mariana Rangel Camacho, Nataliya Byrne, Michele Santacatterina, Stacy Loeb
Background: Hispanic/Latinx males and those who are non-English proficient are significantly less likely to receive germline genetic evaluation for prostate cancer. Undertesting can impact downstream outcomes, including reduced access to approved targeted therapies, barriers to precision medicine trials, and hereditary cancer assessment for patients and family members. The goal of our study was to explore the knowledge and perceptions of genetic testing among U.S. Hispanic males, with the ultimate goal to identify potentially actionable targets to increase guideline-concordant genetic evaluation.
Methods: We conducted a nationwide online survey including U.S. Hispanic males aged ≥ 40 in English and Spanish using the 9-item Knowledge of Hereditary Prostate Cancer Scale and adapted questions about desire for more information from the Behavioral Beliefs about BRCA Genetic Counseling scale.
Results: Among 807 participants, the mean score for genetic knowledge was 5.8 out of 9, with gaps in understanding of incomplete penetrance of genes and maternal genetic inheritance. Medical mistrust and lower health literacy were associated with significantly lower knowledge of prostate cancer genetics. Overall, attitudes toward genetic counseling were favorable, with the majority of participants endorsing that it would help with decision-making, is concordant with cultural beliefs, and that they were interested in more information. Concerns about genetic evaluation included cost and impact for insurance.
Conclusions: Despite generally favorable attitudes toward genetic evaluation among Hispanic males, there are important knowledge gaps, including the importance of both maternal and paternal family history, as well as logistical concerns. Addressing these gaps through culturally targeted outreach may help to promote equitable uptake of germline genetic evaluation.
{"title":"Knowledge and attitudes toward prostate cancer germline genetic testing among Hispanic males.","authors":"Jasmine Saunders, Veda N Giri, Susan T Vadaparampil, Adrian Rivera, Tatiana Sanchez Nolasco, Mariana Rangel Camacho, Nataliya Byrne, Michele Santacatterina, Stacy Loeb","doi":"10.1038/s41391-025-01008-0","DOIUrl":"https://doi.org/10.1038/s41391-025-01008-0","url":null,"abstract":"<p><strong>Background: </strong>Hispanic/Latinx males and those who are non-English proficient are significantly less likely to receive germline genetic evaluation for prostate cancer. Undertesting can impact downstream outcomes, including reduced access to approved targeted therapies, barriers to precision medicine trials, and hereditary cancer assessment for patients and family members. The goal of our study was to explore the knowledge and perceptions of genetic testing among U.S. Hispanic males, with the ultimate goal to identify potentially actionable targets to increase guideline-concordant genetic evaluation.</p><p><strong>Methods: </strong>We conducted a nationwide online survey including U.S. Hispanic males aged ≥ 40 in English and Spanish using the 9-item Knowledge of Hereditary Prostate Cancer Scale and adapted questions about desire for more information from the Behavioral Beliefs about BRCA Genetic Counseling scale.</p><p><strong>Results: </strong>Among 807 participants, the mean score for genetic knowledge was 5.8 out of 9, with gaps in understanding of incomplete penetrance of genes and maternal genetic inheritance. Medical mistrust and lower health literacy were associated with significantly lower knowledge of prostate cancer genetics. Overall, attitudes toward genetic counseling were favorable, with the majority of participants endorsing that it would help with decision-making, is concordant with cultural beliefs, and that they were interested in more information. Concerns about genetic evaluation included cost and impact for insurance.</p><p><strong>Conclusions: </strong>Despite generally favorable attitudes toward genetic evaluation among Hispanic males, there are important knowledge gaps, including the importance of both maternal and paternal family history, as well as logistical concerns. Addressing these gaps through culturally targeted outreach may help to promote equitable uptake of germline genetic evaluation.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800044","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 : 2025-08-06DOI: 10.1038/s41391-025-01007-1
Daniel R Dickstein, Alex J Bates, Christopher W Wheldon, Ryan Haggart, Kristine M C Talley, Deborah C Marshall, B R Simon Rosser
Background: The differential impacts of radical prostatectomy (RP) and external beam radiotherapy (EBRT) on sexual health in gay and bisexual men (GBM) with prostate cancer remain understudied, limiting recommendations incorporating preferred sexual behavior.
Methods: Secondary analysis of Restore-2 compared outcomes in GBM after RP (n = 127) or EBRT (n = 27).
Results: Compared to RP, EBRT was associated with lower rates of climacturia (11% vs. 59%, p < 0.001), condom-related erectile dysfunction (27% vs. 51%, p = 0.047), and decreased penile length/girth (49% vs. 69%, p = 0.07), but higher rates of anodyspareunia (33% vs. 14%, p = 0.06).
Conclusions: Exploratory findings suggest EBRT for insertive intercourse, RP for receptive intercourse.
{"title":"Treatment choice and sexual health outcomes in gay and bisexual men with prostate cancer.","authors":"Daniel R Dickstein, Alex J Bates, Christopher W Wheldon, Ryan Haggart, Kristine M C Talley, Deborah C Marshall, B R Simon Rosser","doi":"10.1038/s41391-025-01007-1","DOIUrl":"10.1038/s41391-025-01007-1","url":null,"abstract":"<p><strong>Background: </strong>The differential impacts of radical prostatectomy (RP) and external beam radiotherapy (EBRT) on sexual health in gay and bisexual men (GBM) with prostate cancer remain understudied, limiting recommendations incorporating preferred sexual behavior.</p><p><strong>Methods: </strong>Secondary analysis of Restore-2 compared outcomes in GBM after RP (n = 127) or EBRT (n = 27).</p><p><strong>Results: </strong>Compared to RP, EBRT was associated with lower rates of climacturia (11% vs. 59%, p < 0.001), condom-related erectile dysfunction (27% vs. 51%, p = 0.047), and decreased penile length/girth (49% vs. 69%, p = 0.07), but higher rates of anodyspareunia (33% vs. 14%, p = 0.06).</p><p><strong>Conclusions: </strong>Exploratory findings suggest EBRT for insertive intercourse, RP for receptive intercourse.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789805","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 : 2025-07-30DOI: 10.1038/s41391-025-01005-3
Egesta Lopci, Massimo Lazzeri, Vittorio Fasulo, Davide Maffei, Pier Paolo Avolio, Alessandro Tallari, Stefano Moretto, Ludovica Cella, Marcello Rodari, Federica Mrakic Sposta, Paolo Casale, Nicolò Maria Buffi, Giovanni Lughezzani
The Prostate Imaging after Focal Ablation (PI-FAB) score has been recently proposed for scoring the appearance on multiparametric magnetic resonance imaging (mpMRI) of prostate cancer after focal therapy. The progressive implementation of prostate specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) into the management of prostate cancer has revolutionized the diagnostic work-up and inspired our proposal for a dedicated PSMA Focal Ablation Imaging (PSMA-FAB) scoring system. Based on pre- and post-treatment imaging, the classification is categorized into: PSMA-FAB 1 (continue monitoring); PSMA-FAB2 (assess PSA kinetics and MRI, with biopsy to be considered in case of suspicion); and PSMA-FAB 3 (recommend biopsy). Furthermore, a combined Focal-therapy Imaging Response Evaluation Score (FIRE-SCORE) embedding PI-FAB and PSMA-FAB scores is suggested to help patient's management at follow up.
{"title":"Prostate specific membrane antigen focal ablation imaging (PSMA-FAB).","authors":"Egesta Lopci, Massimo Lazzeri, Vittorio Fasulo, Davide Maffei, Pier Paolo Avolio, Alessandro Tallari, Stefano Moretto, Ludovica Cella, Marcello Rodari, Federica Mrakic Sposta, Paolo Casale, Nicolò Maria Buffi, Giovanni Lughezzani","doi":"10.1038/s41391-025-01005-3","DOIUrl":"10.1038/s41391-025-01005-3","url":null,"abstract":"<p><p>The Prostate Imaging after Focal Ablation (PI-FAB) score has been recently proposed for scoring the appearance on multiparametric magnetic resonance imaging (mpMRI) of prostate cancer after focal therapy. The progressive implementation of prostate specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) into the management of prostate cancer has revolutionized the diagnostic work-up and inspired our proposal for a dedicated PSMA Focal Ablation Imaging (PSMA-FAB) scoring system. Based on pre- and post-treatment imaging, the classification is categorized into: PSMA-FAB 1 (continue monitoring); PSMA-FAB2 (assess PSA kinetics and MRI, with biopsy to be considered in case of suspicion); and PSMA-FAB 3 (recommend biopsy). Furthermore, a combined Focal-therapy Imaging Response Evaluation Score (FIRE-SCORE) embedding PI-FAB and PSMA-FAB scores is suggested to help patient's management at follow up.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754119","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 : 2025-07-28DOI: 10.1038/s41391-025-01004-4
Sunyi Ye, Ding Peng, Lixian Zhu, Yi Zhu, Anbang He, Taile Jing, Xiaolin Yao, Shilong Wei, Qianqian Zhao, Jieyin Chen, Yanle Ye, Jingshuang Cai, Jin Zhou, Ping Wang, Zhiyang Huang, Shuo Wang, Dan Xia
Background: There is no report upon the remote surgery of radical prostatectomy and comparisons between local surgeries. This study aims to evaluate the feasibility and safety of the innovative remote tele-surgical robotic platforms in performing radical prostatectomy.
Methods: The study comprised 13 patients diagnosed with prostate cancer who underwent remote radical prostatectomy using a 5 G wireless network and the innovative remote robotic systems (Tele-RARP). Additionally, the research involved 31 patients who underwent radical prostatectomy with the local Toumai robotic system (TM-RARP) between October 2022 and April 2024, and 36 patients who underwent radical prostatectomy with the da Vinci Xi platform (Xi-RARP) during the same period under the supervision of the same surgical team. Data on demographics, perioperative factors, clinicopathologic information, and postoperative results were collected for a total of 80 patients.
Results: The completion of 13 Tele-RARP procedures was successful without significant intraoperative or postoperative issues. No instances of intraoperative blood transfusion or surgical conversion were reported. The operation, console, and docking time for both the remote and local surgeries showed minimal differences. Neither local nor remote surgery nor da Vinci Xi surgery exhibited significant variations in terms of blood loss, intraoperative complications, or postoperative prognosis. Both TM-RARP and Tele-RARP presented very manageable task loads.
Conclusions: Performing tele-surgical robotic-assisted radical prostatectomy using the innovative Toumai and Edge robotic surgical systems via a 5 G wireless network is not only feasible but also safe.
{"title":"5G-remote radical prostatectomy under novel robotic systems: a prospective comparative cohort study with local surgeries.","authors":"Sunyi Ye, Ding Peng, Lixian Zhu, Yi Zhu, Anbang He, Taile Jing, Xiaolin Yao, Shilong Wei, Qianqian Zhao, Jieyin Chen, Yanle Ye, Jingshuang Cai, Jin Zhou, Ping Wang, Zhiyang Huang, Shuo Wang, Dan Xia","doi":"10.1038/s41391-025-01004-4","DOIUrl":"10.1038/s41391-025-01004-4","url":null,"abstract":"<p><strong>Background: </strong>There is no report upon the remote surgery of radical prostatectomy and comparisons between local surgeries. This study aims to evaluate the feasibility and safety of the innovative remote tele-surgical robotic platforms in performing radical prostatectomy.</p><p><strong>Methods: </strong>The study comprised 13 patients diagnosed with prostate cancer who underwent remote radical prostatectomy using a 5 G wireless network and the innovative remote robotic systems (Tele-RARP). Additionally, the research involved 31 patients who underwent radical prostatectomy with the local Toumai robotic system (TM-RARP) between October 2022 and April 2024, and 36 patients who underwent radical prostatectomy with the da Vinci Xi platform (Xi-RARP) during the same period under the supervision of the same surgical team. Data on demographics, perioperative factors, clinicopathologic information, and postoperative results were collected for a total of 80 patients.</p><p><strong>Results: </strong>The completion of 13 Tele-RARP procedures was successful without significant intraoperative or postoperative issues. No instances of intraoperative blood transfusion or surgical conversion were reported. The operation, console, and docking time for both the remote and local surgeries showed minimal differences. Neither local nor remote surgery nor da Vinci Xi surgery exhibited significant variations in terms of blood loss, intraoperative complications, or postoperative prognosis. Both TM-RARP and Tele-RARP presented very manageable task loads.</p><p><strong>Conclusions: </strong>Performing tele-surgical robotic-assisted radical prostatectomy using the innovative Toumai and Edge robotic surgical systems via a 5 G wireless network is not only feasible but also safe.</p><p><strong>Registration number: </strong>ChiCTR2400085386, ChiCTR2300077721.</p>","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732894","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 : 2025-07-28DOI: 10.1038/s41391-025-00997-2
Yusheng Zhao, Lei Zhang, Subo Zhang, Jiajing Li, Kaimin Shi, Di Yao, Qiuzi Li, Tao Zhang, Lei Xu, Lei Geng, Yi Sun, Jinxin Wan
This study aims to evaluate the diagnostic value of machine learning-based MRI imaging in differentiating benign and malignant prostate cancer and detecting clinically significant prostate cancer (csPCa, defined as Gleason score ≥7) using systematic review and meta-analysis methods. Electronic databases (PubMed, Web of Science, Cochrane Library, and Embase) were systematically searched for predictive studies using machine learning-based MRI imaging for prostate cancer diagnosis. Sensitivity, specificity, and area under the curve (AUC) were used to assess the diagnostic accuracy of machine learning-based MRI imaging for both benign/malignant prostate cancer and csPCa. A total of 12 studies met the inclusion criteria, with 3474 patients included in the meta-analysis. Machine learning-based MRI imaging demonstrated good diagnostic value for both benign/malignant prostate cancer and csPCa. The pooled sensitivity and specificity for diagnosing benign/malignant prostate cancer were 0.92 (95% CI: 0.83–0.97) and 0.90 (95% CI: 0.68–0.97), respectively, with a combined AUC of 0.96 (95% CI: 0.94–0.98). For csPCa diagnosis, the pooled sensitivity and specificity were 0.83 (95% CI: 0.77–0.87) and 0.73 (95% CI: 0.65–0.81), respectively, with a combined AUC of 0.86 (95% CI: 0.83–0.89). Machine learning-based MRI imaging shows good diagnostic accuracy for both benign/malignant prostate cancer and csPCa. Further in-depth studies are needed to validate these findings.
{"title":"Machine learning-based MRI imaging for prostate cancer diagnosis: systematic review and meta-analysis","authors":"Yusheng Zhao, Lei Zhang, Subo Zhang, Jiajing Li, Kaimin Shi, Di Yao, Qiuzi Li, Tao Zhang, Lei Xu, Lei Geng, Yi Sun, Jinxin Wan","doi":"10.1038/s41391-025-00997-2","DOIUrl":"10.1038/s41391-025-00997-2","url":null,"abstract":"This study aims to evaluate the diagnostic value of machine learning-based MRI imaging in differentiating benign and malignant prostate cancer and detecting clinically significant prostate cancer (csPCa, defined as Gleason score ≥7) using systematic review and meta-analysis methods. Electronic databases (PubMed, Web of Science, Cochrane Library, and Embase) were systematically searched for predictive studies using machine learning-based MRI imaging for prostate cancer diagnosis. Sensitivity, specificity, and area under the curve (AUC) were used to assess the diagnostic accuracy of machine learning-based MRI imaging for both benign/malignant prostate cancer and csPCa. A total of 12 studies met the inclusion criteria, with 3474 patients included in the meta-analysis. Machine learning-based MRI imaging demonstrated good diagnostic value for both benign/malignant prostate cancer and csPCa. The pooled sensitivity and specificity for diagnosing benign/malignant prostate cancer were 0.92 (95% CI: 0.83–0.97) and 0.90 (95% CI: 0.68–0.97), respectively, with a combined AUC of 0.96 (95% CI: 0.94–0.98). For csPCa diagnosis, the pooled sensitivity and specificity were 0.83 (95% CI: 0.77–0.87) and 0.73 (95% CI: 0.65–0.81), respectively, with a combined AUC of 0.86 (95% CI: 0.83–0.89). Machine learning-based MRI imaging shows good diagnostic accuracy for both benign/malignant prostate cancer and csPCa. Further in-depth studies are needed to validate these findings.","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":"29 1","pages":"159-166"},"PeriodicalIF":5.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41391-025-00997-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732914","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 : 2025-07-25DOI: 10.1038/s41391-025-01000-8
Stephen J. Freedland, Agnes Hong, Nader El-Chaar, Amanda M. De Hoedt, Janet Kim, Claire Evans, Joshua A. Parrish, Maelys Touya, Krishnan Ramaswamy, Lin Gu, Thomas J. Polascik
Limited real-world data exist on the effectiveness of treatment intensification (TI) with androgen receptor pathway inhibitors (ARPI) in de novo metastatic castration-sensitive prostate cancer (mCSPC). This study compared outcomes of TI or first-generation nonsteroidal antiandrogens (NSAAs) to androgen-deprivation therapy (ADT) alone in US patients with de novo mCSPC. Veterans Affairs patients with de novo mCSPC (February 2018–June 2020) confirmed via chart review were grouped into ADT alone, ADT + NSAAs, or ADT + ARPI cohorts using predefined recruitment quotas. Outcomes included inverse probability of treatment weighting (IPTW)-adjusted overall survival (OS), progression to metastatic castration-resistant prostate cancer (mCRPC), and prostate-specific antigen (PSA) response. A total of 384 patients were identified (ADT alone: 163, ADT + NSAA: 101, ADT + ARPI: 120). Median follow-up was 37.2, 38.1, and 34.8 months for ADT alone, ADT + NSAA, and ADT + ARPI, respectively. Compared with ADT alone, ADT + ARPI showed significantly better OS (HR [95% CI]: 0.61 [0.43 to 0.87], p = 0.007), lower risk of progression to mCRPC (0.46 [0.33 to 0.66], p < 0.001), and higher PSA response rate (PSA decline of ≥50% and ≥90% from baseline, and to <0.2 ng/mL and <0.1 ng/mL any time during first-line treatment; all p < 0.05). Outcomes with ADT + NSAA did not differ from ADT alone. ADT + ARPI was the most common second-line mCSPC and first-line mCRPC treatment. First-line ADT + ARPI was associated with significantly improved outcomes vs ADT alone in de novo mCSPC. These real-world results align with the benefits demonstrated in trials, supporting integration of TI with ARPIs into clinical practice to improve survival outcomes in patients with de novo mCSPC.
{"title":"Survival benefit associated with first-line androgen receptor pathway inhibitors for de novo metastatic castration-sensitive prostate cancer","authors":"Stephen J. Freedland, Agnes Hong, Nader El-Chaar, Amanda M. De Hoedt, Janet Kim, Claire Evans, Joshua A. Parrish, Maelys Touya, Krishnan Ramaswamy, Lin Gu, Thomas J. Polascik","doi":"10.1038/s41391-025-01000-8","DOIUrl":"10.1038/s41391-025-01000-8","url":null,"abstract":"Limited real-world data exist on the effectiveness of treatment intensification (TI) with androgen receptor pathway inhibitors (ARPI) in de novo metastatic castration-sensitive prostate cancer (mCSPC). This study compared outcomes of TI or first-generation nonsteroidal antiandrogens (NSAAs) to androgen-deprivation therapy (ADT) alone in US patients with de novo mCSPC. Veterans Affairs patients with de novo mCSPC (February 2018–June 2020) confirmed via chart review were grouped into ADT alone, ADT + NSAAs, or ADT + ARPI cohorts using predefined recruitment quotas. Outcomes included inverse probability of treatment weighting (IPTW)-adjusted overall survival (OS), progression to metastatic castration-resistant prostate cancer (mCRPC), and prostate-specific antigen (PSA) response. A total of 384 patients were identified (ADT alone: 163, ADT + NSAA: 101, ADT + ARPI: 120). Median follow-up was 37.2, 38.1, and 34.8 months for ADT alone, ADT + NSAA, and ADT + ARPI, respectively. Compared with ADT alone, ADT + ARPI showed significantly better OS (HR [95% CI]: 0.61 [0.43 to 0.87], p = 0.007), lower risk of progression to mCRPC (0.46 [0.33 to 0.66], p < 0.001), and higher PSA response rate (PSA decline of ≥50% and ≥90% from baseline, and to <0.2 ng/mL and <0.1 ng/mL any time during first-line treatment; all p < 0.05). Outcomes with ADT + NSAA did not differ from ADT alone. ADT + ARPI was the most common second-line mCSPC and first-line mCRPC treatment. First-line ADT + ARPI was associated with significantly improved outcomes vs ADT alone in de novo mCSPC. These real-world results align with the benefits demonstrated in trials, supporting integration of TI with ARPIs into clinical practice to improve survival outcomes in patients with de novo mCSPC.","PeriodicalId":20727,"journal":{"name":"Prostate Cancer and Prostatic Diseases","volume":"29 1","pages":"167-174"},"PeriodicalIF":5.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41391-025-01000-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708535","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}
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