Prostate International最新文献

{"title":"Application of robotics in the treatment of benign prostatic hyperplasia: a narrative review","authors":"Hyung Joon Kim ,&nbsp;Sung Kyu Hong","doi":"10.1016/j.prnil.2024.06.002","DOIUrl":"10.1016/j.prnil.2024.06.002","url":null,"abstract":"<div><div>A range of surgical approaches are available for treating benign prostatic hyperplasia (BPH), with emphasis placed not only on their effectiveness but also on minimizing invasiveness. The advent of surgical robotics has revolutionized BPH treatment, with robot-assisted simple prostatectomy offering a less invasive alternative to traditional approaches. The emergence of single-port systems has also earned attention for being effective in confined spaces. Aquablation represents a distinct robotic platform utilizing a heat-free, high-velocity waterjet to ablate prostate adenomas according to pre-registered configurations under real-time imaging. These novel technologies have proven to treat large prostates exceeding 80 mL efficiently and safely. Furthermore, Aquablation, along with technical modifications such as urethra-sparing robot-assisted simple prostatectomy, have demonstrated effectiveness in preserving ejaculatory function, thereby enhancing patients' overall quality of life. As evidence accumulates and technology and techniques evolve, robotic interventions for BPH may serve as a new standard in the field in the future.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 2","pages":"Pages 74-80"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141413657","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}

{"title":"Usefulness of free PSA ratio to enhance detection of clinically significant prostate cancer in patients with PI-RADS<3 and PSA≤10","authors":"Ji Eun Heo,&nbsp;Hyun Ho Han,&nbsp;Won Sik Jang,&nbsp;Won Sik Ham,&nbsp;Woong Kyu Han,&nbsp;Young Deuk Choi,&nbsp;Jongsoo Lee","doi":"10.1016/j.prnil.2024.12.001","DOIUrl":"10.1016/j.prnil.2024.12.001","url":null,"abstract":"<div><h3>Background</h3><div>The necessity of prostate biopsy in patients with a Prostate Imaging–Reporting and Data System (PI-RADS) score below 3 and prostate-specific antigen (PSA) levels of 4–10 ng/ml remains controversial. We tested the diagnostic performance of the free PSA ratio (%fPSA) in detecting clinically significant cancer (CSC) in patients with PI-RADS &lt;3 and PSA ≤10 ng/ml.</div></div><div><h3>Methods</h3><div>We analyzed 1435 prostate biopsies performed by a single operator between April 2018 and January 2023 at a single institution. PSA and free PSA results on the day of biopsy or within 1 month were used, and all biopsies were performed after prostate magnetic resonance imaging (MRI). CSC was defined as Gleason grade group ≥2.</div></div><div><h3>Results</h3><div>Among 208 men with PI-RADS &lt;3 and PSA ≤10 ng/ml, CSC was detected in 37 (17.8%) patients. The median age was 65 years (interquartile range [IQR] 61–71), with a median PSA level of 5.06 ng/ml (IQR 3.98–7.08) and a median %fPSA of 18.2% (IQR 13.7–22.0). The area under the curve was 0.757 (95% confidence interval, 0.674–0.841), with a %fPSA cutoff of 17.6%, sensitivity of 86.5%, specificity of 63.7%, positive likelihood ratio (LR) of 2.38, and negative LR of 0.21. CSC was diagnosed in 5 out of 114 patients (4%) with %fPSA &gt;17.6%, compared to 32 out of 94 patients (34%) with %fPSA &lt;17.6%.</div></div><div><h3>Conclusions</h3><div>In patients with PI-RADS &lt;3 and PSA ≤10 ng/ml, %fPSA values &lt; 17.6% may facilitate early prostate cancer diagnosis in those who might not undergo biopsy based on MRI results alone. Additionally, unnecessary biopsies could be avoided in patients with elevated PSA levels when %fPSA exceeds 17.6%.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 2","pages":"Pages 112-115"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307496","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}

{"title":"Use versus nonuse of antimicrobial prophylaxis prior to transperineal prostate biopsy: a propensity score-matched analysis","authors":"Dong Sup Lee,&nbsp;Seung-Ju Lee,&nbsp;Su Jin Kim,&nbsp;Je Mo Yoo,&nbsp;Young Hyo Choi,&nbsp;Hee Youn Kim","doi":"10.1016/j.prnil.2024.12.002","DOIUrl":"10.1016/j.prnil.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Transperineal prostate biopsy offers advantage over a transrectal approach by reducing the risk of infectious complications. However, the necessity for antimicrobial prophylaxis (AP) before a transperineal prostate biopsy is less clear. This study aimed to study the rate of infectious complications following transperineal prostate biopsy with or without AP.</div></div><div><h3>Materials and methods</h3><div>Propensity score matching was done for 1,273 patients who underwent transperineal prostate biopsy between October 2020 and October 2024 to adjust for differences in covariates. Parameters including the rate of urinary tract infection (UTI) requiring or not requiring hospitalization between patients who received AP and those who did not receive AP were then compared.</div></div><div><h3>Results</h3><div>A total of 288 patients were matched for each group and baseline characteristics were balanced between groups. The overall incidence of UTI was very low in both groups without significant difference. UTI requiring hospitalization occurred in only one patient in the AP group (0.1%) and none in the non-AP group. Nonhospitalized UTI occurred in 0.7% of the AP group and 0.3% of the non-AP group (<em>P</em> = 1.000).</div></div><div><h3>Conclusion</h3><div>There was no significant difference in the rate of UTI based on the use or nonuse of AP prior to transperineal prostate biopsy. The overall incidence of UTI was very low regardless of the use of AP. Omission of AP prior to transperineal prostate biopsy might be possible, which would help promote antimicrobial stewardship.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 2","pages":"Pages 107-111"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144307985","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}

{"title":"A comparison of surgical outcomes between outpatient and inpatient robot-assisted radical prostatectomy: A systematic review and meta-analysis","authors":"Tuan T. Nguyen ,&nbsp;Muhammed A. Moukhtar Hammad ,&nbsp;Ryan W. Dobbs ,&nbsp;Huy G. Vuong ,&nbsp;Jacob Basilius ,&nbsp;Khoa Quy ,&nbsp;Hanh T.T. Ngo ,&nbsp;An Nguyen ,&nbsp;Thi Tuyet Mai Tran ,&nbsp;Narmina Khanmammadova ,&nbsp;Trinh N.K. Van ,&nbsp;Sohrab N. Ali ,&nbsp;Ho Yee Tiong ,&nbsp;Se Young Choi ,&nbsp;Mohammed Shahait ,&nbsp;David I. Lee","doi":"10.1016/j.prnil.2024.04.003","DOIUrl":"10.1016/j.prnil.2024.04.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Several institutions have reported their experience with outpatient robot-assisted radical prostatectomy (O-RARP). However, it is unclear if the utilization of this approach represents an improvement over inpatient robot-assisted radical prostatectomy (I-RARP). This meta-analysis sought to compare the surgical outcomes between O-RARP and I-RARP.</div></div><div><h3>Methods</h3><div>For relevant articles, three electronic databases, including PubMed, Scopus, and Web of Science, were searched from their inception until April 30, 2022. A meta-analysis has been reported in line with PRISMA 2020 and AMSTAR guidelines. The risk ratio (RR) and weighted mean difference (MD) were applied for the comparison of dichotomous and continuous variables with 95% confidence intervals (CI).</div></div><div><h3>Results</h3><div>of the 297 retrieved abstracts, 12 underwent full-text review, and 11 studies were included in the final analysis, comprising a total cohort of 2,875 cases of robot-assisted radical prostatectomy (892 O-RARP cases and 1,983 I-RARP cases). Compared to I-RARP, the O-RARP group had lower mean operative time (MD = −9.4 minutes, 95% CI −15.1 to −3.7, <em>P</em> = 0.001), fewer overall postoperative complications (RR = 0.65, 95% CI 0.46 to 0.92, <em>P</em> = 0.017), shorter hospital stay (MD = −22.9 hours, 95% CI −26.0 to −19.7, <em>P</em> ≤ 0.001), and lower postoperative opioid requirements (RR = 0.45, 95% CI 0.28 to 0.71, <em>P</em> = 0.001). There were no significant differences in other outcomes, including: estimated blood loss, postoperative pain score, unscheduled visits after surgery, positive surgical margins, biochemical recurrence, International Prostate Symptom Score (IPSS) after surgery, or three- and six-month continence rates.</div></div><div><h3>Conclusions</h3><div>This meta-analysis demonstrates that O-RARP is a safe and feasible option for patients undergoing surgery for localized prostate cancer. Further studies are needed to better evaluate optimal patient selection, associated healthcare costs, and patient-reported outcomes.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 1","pages":"Pages 1-9"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140781331","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}

{"title":"Preoperative prostatic artery embolization before transurethral resection of the prostate for prostate glands larger than 80 mL: the first randomized controlled trial","authors":"Alvin Y.M. Lee ,&nbsp;Shu Hui Neo ,&nbsp;Bellamy A. Brodie ,&nbsp;Tze Kiat Ng ,&nbsp;Edwin J. Aslim ,&nbsp;Zong Yi Chin ,&nbsp;Michael M. Ladera ,&nbsp;Soon Hing Chong ,&nbsp;Pradesh Kumar ,&nbsp;Allen S.P. Sim ,&nbsp;John S.P. Yuen ,&nbsp;Sivanathan Chandramohan ,&nbsp;Kenneth Chen","doi":"10.1016/j.prnil.2024.10.004","DOIUrl":"10.1016/j.prnil.2024.10.004","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the impact of preoperative prostate artery embolization (PAE) on intraoperative blood loss during transurethral resection of the prostate (TURP) in glands larger than 80 cc.</div></div><div><h3>Material and methods</h3><div>A prospective, surgeon-blinded randomized controlled clinical trial was conducted at a single tertiary center. Patients with a prostate volume of more than 80 cc with indications for TURP were randomized (1:1) to the following groups: preoperative prostatic artery embolization followed by TURP (Group A—intervention arm) and TURP alone (Group B—control arm). The primary outcome studied was blood loss measured as the drop in hemoglobin level postoperatively, and the secondary outcome measured was resection efficiency (resected weight per min) and postoperative complication rate.</div></div><div><h3>Results</h3><div>Our study included 10 patients each in group, A and B. The median prostate volume was 119 mL and 140 mL and the median preoperative hemoglobin was 13.3 g/dL (interquartile range: 12.5 – 14.3 g/dL) and 14.4 g/dL (interquartile range: 10.1–15.2 g/dL) in groups A and B, respectively. Change in postoperative hemoglobin was significantly greater in Group B than in Group A (−1.4 g/dL versus +0.5 g/dL, <em>P</em> = 0.015). There were no significant differences in the weight of resected prostate chips (52 g versus 73 g, <em>P</em> = 0.089) and resection efficiency (0.7 g/min versus 0.6 g/min, <em>P</em> = 0.853) between groups A and B. Two patients in Group B received one unit of red blood cell transfusion compared to only 1 patient in Group A (<em>P</em> = 1.000). One patient from each group had to be brought back to the operation room for hemostasis.</div></div><div><h3>Conclusion</h3><div>Our study demonstrated that preoperative prostate artery embolization reduces intraoperative blood loss in men with large prostates undergoing TURP but did not impact resection efficiency or complication rate.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 1","pages":"Pages 22-27"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680772","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}

{"title":"Assessing the influence of prostate tissue traits on Gallium-68 prostate-specific membrane-antigen positron-emission tomography/computed tomography: predictive factors for image positivity and locoregional recurrence in prostate cancer patients treated with radical prostatectomy and without prior or salvage treatment","authors":"Cristina Gutiérrez Castañé ,&nbsp;José E. Robles García ,&nbsp;Jorge M. Núñez-Córdoba ,&nbsp;Andrés Calva López ,&nbsp;Vanessa Talavera Cobo ,&nbsp;Carmina A. Muñoz Bastidas ,&nbsp;Juan Colombas Vives ,&nbsp;Francisco J. Ancizu Marckert ,&nbsp;Bernardino Miñana López","doi":"10.1016/j.prnil.2024.11.002","DOIUrl":"10.1016/j.prnil.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Gallium-68 prostate-specific membrane-antigen positron emission tomography/computed tomography (⁶⁸Ga-PSMA-11 PET/CT) has recently emerged as a novel imaging modality, potentially improving oncologic outcomes for prostate cancer patients. This study aimed to assess the potential predictive factors associated with ⁶⁸Ga-PSMA-11 PET/CT positivity following persistent prostate-specific antigen (PSA) levels and primary biochemical recurrence post-radical prostatectomy (RP), focusing on prostate specimen characteristics. Furthermore, we aim to identify predictive factors for locoregional recurrence.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 230 prostate cancer patients treated with RP and without prior salvage or adjuvant radiotherapy or systemic treatments. All patients underwent ⁶⁸Ga-PSMA-11 PET/CT scans to detect prostate cancer recurrence detection. Pathological findings were carefully examined and correlated with ⁶⁸Ga-PSMA-11 PET/CT positivity and locoregional recurrence.</div></div><div><h3>Results</h3><div>Our analysis showed that ⁶⁸Ga-PSMA-11 PET/CT positivity was associated with International Society of Urological Pathology (ISUP) grade group ≥3, presence of positive lymph node invasion at the time of RP, positive extra-prostatic extension, involvement of seminal vesicles and post-RP PSA levels ≥0.1 ng/ml. Additionally, we identified ISUP grade group 2 and ISUP grade group ≥3, whether with or without positive lymph node invasion, along with extra-prostatic extension, involvement of seminal vesicles and post-RP PSA ≥0.1 ng/ml were identified as factors associated with pelvic node recurrence.</div></div><div><h3>Conclusion</h3><div>Pathological findings emerge as robust predictors of ⁶⁸Ga-PSMA-11 PET/CT positivity and locoregional recurrences in cases of initial biochemical recurrence or persistence without prior adjuvant or salvage treatment. This diagnostic approach facilitates potential adjustments in management strategies, such as PSMA-guided radiotherapy or PSMA-guided lymphadenectomy.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 1","pages":"Pages 34-40"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680847","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}

{"title":"Clinical significance of primary tumor progression in metastatic hormone-sensitive prostate cancer","authors":"Yasutaka Yamada ,&nbsp;Shinichi Sakamoto ,&nbsp;Takuya Tsujino ,&nbsp;Sinpei Saito ,&nbsp;Kodai Sato ,&nbsp;Kazuki Nishimura ,&nbsp;Tatsuo Fukushima ,&nbsp;Ko Nakamura ,&nbsp;Yuki Yoshikawa ,&nbsp;Tomohisa Matsunaga ,&nbsp;Ryoichi Maenosono ,&nbsp;Manato Kanesaka ,&nbsp;Takayuki Arai ,&nbsp;Tomokazu Sazuka ,&nbsp;Yusuke Imamura ,&nbsp;Kazumasa Komura ,&nbsp;Kazuo Mikami ,&nbsp;Kazuyoshi Nakamura ,&nbsp;Satoshi Fukasawa ,&nbsp;Kazuto Chiba ,&nbsp;Tomohiko Ichikawa","doi":"10.1016/j.prnil.2024.11.005","DOIUrl":"10.1016/j.prnil.2024.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Clinical significance of primary tumor progression in patients with metastatic hormone-sensitive prostate cancer (mHSPC) is unclear.</div></div><div><h3>Methods</h3><div>Clinical data from 987 patients with mHSPC from multiple institutions between September 1999 and November 2023 were reviewed. The prognostic impact of primary tumor progression was examined along with other clinical parameters. Castration-resistant prostate cancer progression-free survival (CRPC PFS) and overall survival (OS) were analyzed as clinical outcomes. Student's t-test, Cox proportional hazards models, and Kaplan-Meier methods were utilized to validate the clinical significance.</div></div><div><h3>Results</h3><div>The median age and initial prostate-specific antigen (iPSA) values were 74 and 221 ng/ml, respectively. 632 (64%) and 355 (36%) patients had clinical T stage ≤3 and 4 at diagnosis, respectively. mHSPC patients with clinical T stage 4 were more likely to have a higher grade group (GG), higher frequency of lymph node metastasis, lower hemoglobin (Hb), and more high-volume/risk disease in comparison with those with clinical T stage ≤3. Patients with cT4 were associated with shorter CRPC PFS (<em>P</em>=0.0002) and OS (<em>P</em> &lt; 0.0001). Multivariate analysis identified cT4 as an independent prognostic factor for OS (HR=1.33, <em>P</em>=0.03) along with age, GG, lactate dehydrogenase (LDH), alkaline phosphatase (ALP), albumin (Alb), and high-volume disease. After propensity score matching, patients with cT4 had unfavorable OS in comparison with those with ≤cT3 (<em>P</em>=0.0279). Furthermore, when combined with tumor volume, men with low-volume + cT4 achieved a prognosis comparable to that of patients with high-volume+≤cT3 and high-volume + cT4 (<em>P</em>=0.6876 and <em>P</em>=0.1679, respectively).</div></div><div><h3>Conclusion</h3><div>Bulkiness of primary prostate tumor was associated with worse outcomes in patients with mHSPC. Men with cT4 will require multimodal and intensive therapeutic strategies irrespective of tumor volume.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 1","pages":"Pages 60-66"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680769","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}

{"title":"Sex hormones, blood metabolites and proteins mediating the causal associations between gut microbiota and prostatic diseases: evidences from Mendelian randomization study","authors":"Tianrui Liu ,&nbsp;Feixiang Yang ,&nbsp;Zhige Wang ,&nbsp;Yunyun Mei ,&nbsp;Hao Li ,&nbsp;Kun Wang ,&nbsp;Xiangyu Zhang ,&nbsp;Yiding Chen ,&nbsp;Yang Zhang ,&nbsp;Jialin Meng","doi":"10.1016/j.prnil.2024.11.004","DOIUrl":"10.1016/j.prnil.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>The causal relationships between the gut microbiota and prostate cancer, prostatitis, and benign prostatic hyperplasia remain uncertain. We intend to identify the causal connections between the gut microbiota and prostatic diseases and investigate the potential mechanisms involved.</div></div><div><h3>Methods</h3><div>A two-sample Mendelian randomization (MR) analysis was conducted to elucidate the impact of 196 gut microbiota on prostatic diseases risk. Reverse MR, linkage disequilibrium regression score (LDSC), and colocalization analyses were performed to strengthen causal evidence. Phenome-wide MR (Phe-MR) analysis was used to evaluate the potential side effects of targeting the detected gut microbiota. We designed a two-step MR study to assess the mediating effects of sex hormones, blood metabolites, and proteins.</div></div><div><h3>Results</h3><div>According to the MR analyses, 31 bacterial taxa were causally associated with prostatic diseases, of which 23 types were newly identified. In addition, <em>Alphaproteobacteria</em> restrained prostate cancer, <em>Ruminococcaceae UCG009</em> prevented prostatitis, and <em>Clostridiales</em> posed a risk for benign prostatic hyperplasia. LDSC and colocalization analyses indicated that the detected associations were not confounded by genetic correlation or LD from common causal loci. In the mediation analysis, we identified 53 mediators linking the gut microbiota to prostatic diseases, with a specific emphasis on the critical roles played by sex hormones and blood metabolites, and identified 34 proteins that may be used as therapeutic targets, especially FGFR1 and XPNPEP1.</div></div><div><h3>Conclusions</h3><div>Our study represents the first comprehensive exploration of the causal effects of the gut microbiota on prostatic diseases and reveals the mediating effects of sex hormones and blood metabolites on the “gut-prostate axis.”</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 1","pages":"Pages 49-59"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680792","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}

{"title":"Single-dose vs prolonged antibiotic prophylaxis of fosfomycin for transrectal prostate biopsy: a single-center prospective, randomized, controlled trial","authors":"Ádám M. Fehér ,&nbsp;Zoltán Bajory ,&nbsp;Nándor Czimbalmos ,&nbsp;Katalin Burián ,&nbsp;Andrea Lázár ,&nbsp;Ferenc Rárosi ,&nbsp;Béla Köves","doi":"10.1016/j.prnil.2024.10.005","DOIUrl":"10.1016/j.prnil.2024.10.005","url":null,"abstract":"<div><h3>Background</h3><div>Transrectal prostate biopsy is a commonly performed urological procedure in which antibiotic prophylaxis is recommended. Fluoroquinolone-type antibiotics are no longer acceptable in the EU. Fosfomycin-trometamol may be used, but there is no evidence regarding its ideal dose and administration time.</div></div><div><h3>Methods</h3><div>Patients who underwent prostate biopsy between 2021 and 2023 were evaluated prospectively. 204 patients were randomized into two arms: 102 patients (Arm A) received a single-dose of fosfomycin-trometamol one hour before surgery, and 102 patients (Arm B) received one additional dose of fosfomycin-trometamol 48 hours after the first dose. Urine tests and questionnaires were administered during the postoperative period and the subsequent four weeks to identify any symptoms, infectious, or other complications.</div></div><div><h3>Results</h3><div>There was no statistical difference in the rate of asymptomatic bacteriuria (4.90% (5) vs. 8.82% (9), <em>P</em> = 0.27) symptomatic urinary tract infection (0% (0) vs. 1.96% (2), <em>P</em> = 0.50), or febrile urinary tract infection (0% (0) vs. 0.98% (1), <em>P</em> = 1) between the groups. Only hematuria was significantly more common in Arm B (6.86% (7) vs. 16.67% (17), <em>P</em> = 0.03), whereas other complications did not differ significantly. There was no statistical difference in hospitalization (0.98% (1) vs. 2.94 (3), <em>P</em> = 0.62) or mortality rate (0 % (0) vs. 0.98% (1), <em>P</em> = 1). Sub-group analysis of previous antibiotic users showed no difference in terms of complications.</div></div><div><h3>Conclusion</h3><div>There is no significant difference in infectious complications between single-dose and prolonged prophylaxis of fosfomycin-trometamol for transrectal prostate biopsy. A single-dose of fosfomycin one hour before biopsy is an ideal choice with a better ecological impact compared with prolonged antibiotic prophylaxis for transrectal prostate biopsy.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 1","pages":"Pages 28-33"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680773","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}

{"title":"Incidence and risk factors for dermatologic adverse events following apalutamide use: a real-world data analysis in the Korean population","authors":"Sangmin Lee,&nbsp;Bumjin Lim,&nbsp;Jung Kwon Kim,&nbsp;In Gab Jeong,&nbsp;Jun Hyuk Hong,&nbsp;Hanjong Ahn,&nbsp;Jungyo Suh","doi":"10.1016/j.prnil.2024.10.002","DOIUrl":"10.1016/j.prnil.2024.10.002","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to assess the incidence, severity, and onset of dermatologic adverse events (dAEs) in Korean patients treated with apalutamide for metastatic hormone-sensitive prostate cancer (mHSPC) and to identify clinical and laboratory predisposing factors.</div></div><div><h3>Materials and methods</h3><div>We retrospectively analyzed data of patients treated with apalutamide for mHSPC at a tertiary referral center in Korea between April 2023 and March 2024. Patients with a radical prostatectomy history or insufficient data were excluded. The onset, severity, and management of dAEs were evaluated and compared between patients with and without dAEs. Clinical and laboratory data from 1 month prior to apalutamide administration were collected. Logistic regression was performed to identify predictors of dAEs, and the predictive value of serum albumin levels was analyzed using the receiver operating characteristic (ROC) curve.</div></div><div><h3>Results</h3><div>Twenty-six (40.0%) of the 65 patients developed dAEs, including nine (13.8%) with Grade ≥3 events. The median onset of dAEs was 66.5 (45–78) days. Patients with dAEs had significantly lower initial prostate-specific antigen levels (70.4 vs. 301.6 ng/mL), higher Eastern Cooperative Oncology Group Performance Status (ECOG-PS; 30.8% vs. 5.1%), and lower serum albumin levels (3.8 vs. 4.1 g/dL). Logistic regression identified elevated Eastern Cooperative Oncology Group-Performance Status (ECOG-PS) and hypoalbuminemia as significant predictors of dAEs. ROC analysis for serum albumin levels produced an area under the curve of 0.739, with a cutoff value of 3.85 g/dL, yielding a sensitivity and specificity of 65.4% and 74.4%, respectively.</div></div><div><h3>Conclusion</h3><div>dAEs are prevalent in Korean patients treated with apalutamide for mHSPC, with ECOG-PS and serum albumin levels identified as significant risk factors.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 1","pages":"Pages 10-14"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680770","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}