Objective   68 Ga-PSMA-HBED-CC positron emission tomography (PET)/computed tomography (CT) represents a clinically relevant technique for the evaluation of prostate cancer (PCa) patients, whereas 18 F-AIF-PSMA-HBED-CC is a novel tracer produced in our center, with suitable radiochemical purity for clinical purposes. We prospectively compared the diagnostic values of both tracers for the detection of metastatic disease in patients with intermediate-/high-risk PCa at initial staging. Materials and Methods  Sixty-six patients (mean age: 63 years; range: 52-78 years) with PCa at initial staging (Gleason score ≥6; median prostate-specific antigen [PSA]: 10 ng/mL; range:1.7-152 ng/mL) prospectively underwent routine 68 Ga-PSMA-11 and 18 F-AlF-PSMA-11 PET/CT scanning with a 64-slice PET/CT scan with time-of-flight (TOF) correction. We measured the maximum standardized uptake value (SUVmax) and lesion-to-background ratio (LBR) in all coincidentally detected lesions. Open prostatectomy and pelvic lymph node dissection were performed in nonmetastatic patients. Histopathology, correlative imaging, and/or clinical follow-up were considered the gold standard. Follow-up was conducted at least 4 months after PET/CT scanning (median: 6.4 months; range: 4-11 months). Sensitivity, specificity, and predictive values were calculated. Results  The overall detection rate was 85% (56/66) for both tracers. At least one suspicious lesion indicating potential PCa metastasis was detected in 20 (30%) and 21 (32%) of 66 patients for 68 Ga-PSMA-11 and 18 F-AIF-PSMA-11 tracers, respectively. A total of 145 extra-prostatic lesions were detected in the bone ( n  = 56), lymph nodes ( n  = 88), and lung ( n  = 1) by at least one radiopharmaceutical: 131 (90%) for 68 Ga-PSMA-11 and 123 (85%) for 18 F-AlF-PSMA-11. In concordant lesions, a significant correlation was found between the SUVmax of both tracers ( r  = 0.90, p  = 0.001). The SUVmax and LBR for 18 F-AlF-PSMA-11 were higher in bone foci ( n  = 39) compared with 68 Ga-PSMA-11 (7.2 vs. 8.9 and 14 vs. 13, respectively, p  = 0.02). For the detection of systemic metastasis, the sensitivity values were the same for both techniques: 0.90 (95% confidence interval [CI]: 0.68-0.98). We calculated specificities of 0.96 (95% CI: 0.85-0.99) and 0.94 (95% CI: 0.82-0.98) for 68 Ga-PSMA-11 and 18 F-AlF-PSMA-11, respectively. Conclusions   68 Ga-PSMA-11 and 18 F-AlF-PSMA-11 PET/CT seem to be clinically equivalent imaging techniques for the assessment of primary intermediate-/high-risk PCa with promising potential for the detection of metastatic spread that would impact patient management.

Background: In prostate cancer (PCa) patients, discrepancies between biopsy-assigned Gleason Scores and those determined from surgical specimens are frequently reported. This phenomenon, known as Gleason score upgrade (GSU), can have significant clinical implications. This work aims to understand the factors contributing to GSU for refining prostate cancer management strategies. Methods: Data from 779 patients diagnosed with histologically confirmed PCa who underwent robot-assisted radical prostatectomy at a single tertiary care institution between January 2005 and December 2020 were examined. Results: In the univariable setting, 5-alpha reductase inhibitor (5-ARI) use was associated with a higher percentage of upgrading (42.3% vs. 30.4% among non-users; p = 0.03942). A more advanced pathological T stage (p = 0.01114) and lymph node positivity (p < 0.00001) correlated significantly with GSU. In the logistic regression model, advanced pathological stage increased the odds more than twofold (OR = 2.807, p = 0.00135). 5-ARI use was associated with notably higher odds of upgrading (OR = 3.809, p = 0.00004). Younger age slightly increased the likelihood of GSU (OR = 0.951 per year increase in age, p = 0.01101). Conclusions: Younger age, advanced pathological stage, and the use of 5-alpha reductase inhibitors were identified as significant predictors of GSU.

This study aimed to evaluate the efficacy of the combination of ultrasound-guided transversus abdominis plane block (TAPB) and a novel anterior approach of sacral plexus block (SPB) on postoperative pain following laparoscopic radical prostatectomy.

Double-blinded, prospective, randomized study.

University-affiliated tertiary care hospital.

Ninety patients aged 40 to 80 years with American Society of Anesthesiologists (ASA) physical status of I-III scheduled to undergo elective laparoscopic radical prostatectomy under general anesthesia.

Patients were randomized to receive TAPB alone (Control group) or the combination of TAPB and anterior approach of SPB (SPB group).

The primary outcome was cumulative intravenous morphine equivalent consumption at 24 h postoperatively. Secondary outcomes included pain scores, the incidence and severity of catheter-related bladder discomfort, patient satisfaction for analgesia, rescue analgesia requirement, time to first patient-controlled analgesia (PCA) demand, the incidence of side effects, and clinical recovery.

The median (interquartile range [IQR]) intravenous morphine equivalent was 28 (24, 30) mg in the SPB group compared with the control group, which had a median (IQR) of 34 (30, 41) mg. The median difference of -6 (95 % confidence interval, -8 to -4, P<0.001) was statistically different but not clinically important. The incidence of catheter-related bladder discomfort at 1 h, 4 h and 8 h after surgery were significantly lower in the SPB group. The SPB decreased the pain scores at 1 h postoperatively, prolonged the time to first PCA demand, and increased the Quality of Recovery-15 score at 48 h postoperatively. No significant differences were observed in satisfaction scores, the requirement for rescue analgesia, time to first flatus and ambulation, and the incidence of adverse effects.

The addition of the anterior approach of SPB was not superior to TAPB alone in reducing opioid consumption for laparoscopic radical prostatectomy. However, it was associated with lower early postoperative pain scores, decreased incidence of catheter-related bladder discomfort, and improved quality of recovery.

Background/Objectives: Prostate-specific antigen (PSA) persistence, defined as a postoperative PSA level ≥ 0.1 ng/mL measured within 4-8 weeks after radical prostatectomy (RP), predicts biochemical recurrence (BCR) and adverse oncological outcomes. The influence of nerve-sparing (NS) surgical techniques on PSA persistence remains debated, especially among patients with high-risk pathological features. This study aimed to evaluate the impact of NS techniques on PSA persistence following robot-assisted radical prostatectomy (RARP), considering tumor characteristics, surgical parameters, and patient-specific factors. Methods: A retrospective cohort analysis was performed on 779 patients who underwent RARP at a single institution between January 2002 and December 2015. The inclusion criteria consisted of histologically confirmed prostate cancer with available preoperative and postoperative data, including PSA measurements taken 4-8 weeks after surgery. PSA persistence served as the primary outcome. Statistical analyses included descriptive statistics, univariate and multivariable logistic regression models to identify predictors of PSA persistence, and Spearman's correlation along with the Kruskal-Wallis H test to evaluate associations. Results: Of the 779 patients included, 55% underwent NS surgery (51% unilateral, 49% bilateral). The mean preoperative PSA was 11.85 ng/mL (SD: 7.63), while the mean postoperative PSA was 0.70 ng/mL (SD: 4.42). An elevated postoperative PSA was associated with a larger tumor size (r = 0.1285, p < 0.001), advanced pathological stages (χ2 = 45.10, p = 3.79 × 10-9), and higher Gleason scores (χ2 = 24.74, p = 1.57 × 10-4). NS surgery correlated with a lower postoperative PSA (mean: 0.20 ng/mL) compared to non-NS procedures (mean: 0.65 ng/mL), with slight differences between unilateral (mean: 0.30 ng/mL) and bilateral (mean: 0.35 ng/mL) NS approaches. Multivariable regression analysis identified advanced pathological stage (coefficient = 1.16, p = 0.04) as an independent predictor of PSA persistence, while NS techniques had no significant independent effect (coefficient = -0.01, p = 0.99). Conclusions: Nerve-sparing surgical techniques do not independently predict PSA persistence after RARP when adjusting for tumor-related factors and confounders. Advanced pathological stage, particularly stage pT3b, primarily determines PSA persistence. These findings highlight the necessity of personalized surgical planning informed by preoperative imaging and patient-centered decision making to optimize oncological and functional outcomes.

Radical prostatectomy with pelvic lymph node dissection is the best treatment for intermediate- to high-risk localized prostate cancer (PCa). However, conventional white light surgery has difficulties in identifying tumor boundary and micrometastases intraoperatively. Fluorescence guided surgery (FGS) can solve the above difficulties, but lacks tumor-specific near-infrared fluorescent (NIRF) probes in PCa. STEAP1 was an ideal target in PCa treatment and imaging. Here, we constructed a PCa specific fluorescent probe based on extracellular vesicles targeting STEAP1 (AS-EVs) loaded with NIRF dye S0456 and evaluated its preclinical profiles. In vitro and in vivo studies both showed S0456@AS-EVs was safe and showed strong targeting ability to PCa in various mice xenograft models. S0456@AS-EVs could clear rapidly from blood (half-time of 4.29 h) and retain in the STEAP1 positive tumor tissues for more than 72 h with the highest tumor background ratio (TBR) of 3:1, which was superior to ICG, free S0456, ICG@Ctrl-EVs and S0456@Ctrl-EVs (p < 0.01). Finally, S0456@AS-EVs was applied in FGS on intramuscular model, and the tumors were resected under white light and fluorescence respectively. Compared with white light surgery, mice undergoing FGS had lower positive margin rate and better postoperative survival (p = 0.0342).

To evaluate the relationship between total lesion PSMA (PSMATL), serum PSA, histopathological findings and biochemical recurrence (BCR) in patients with localised prostate cancer (PCa).

This retrospective study assessed men undergoing 68Ga-PSMA-11 PET/CT for newly diagnosed or treatment-naïve PCa localised to the prostate gland. Volumes of interest were manually mapped to derive SUVmax, SUVmean, PSMA-avid tumour volume and PSMATL. PSMATL was defined as the product of PSMA-avid primary tumour volume and SUVmean. Spearman correlation tests evaluated associations between PET parameters and PSA, ISUP GG and radical prostatectomy (RP) histopathological outcomes. Associations between PET parameters and clinical outcomes were determined using Cox proportional hazards regression with results presented as HR and 95% CI.

A total of 200 patients were included, with a median age of 68 (IQR 62-73) years, PSA of 9.5 (6.6-13.0) ng/ml and follow-up of 41 (25-60) months. Median PSMATL was 29.6 (14.8-54.8) and SUVmax 11.0 (6.8-17.9). PSMATL and SUVmax demonstrated a weak correlation with baseline PSA (ρ = 0.334, p < 0.001 and ρ = 0.343, p < 0.001), and PSMATL showed a weak correlation with PSA density in the RP subgroup (ρ = 0.242, p = 0.021). Among 109 (54.5%) patients undergoing RP, PSMATL and SUVmax showed a weak correlation with ISUP GG (ρ = 0.233, p = 0.015 and ρ = 0.340, p < 0.001). There was a weak correlation between PSMATL and primary tumour stage (ρ = 0.244, p = 0.010) and lymph node stage (ρ = 0.259, p = 0.007). PSMATL was significantly higher in those with seminal vesicle involvement (p = 0.011), perineural invasion (p = 0.025) and lymphovascular invasion (p = 0.002). BCR occurred in 46 patients (42%), with a 1% increased risk of BCR per unit increase in PSMATL (HR 1.01, 95% CI 1.00-1.02, p = 0.011).

PSMATL correlates with PSA, PSA density, ISUP GG, RP histopathological findings and BCR. As an adjunct to SUVmax, PSMATL has the potential to be a useful prognostic tool. Further research is needed to assess its clinical utility.

Conflicting results exist regarding the associations between dietary acid load (DAL) and cancer risk. This study aimed to investigate the association between DAL and the odds of prostate cancer (PC) in the Iranian population.

One hundred and twenty participants (60 controls and 60 newly diagnosed PC patients) engaged in a hospital-based case-control study conducted from April to September 2015. A validated, 160-item semi-quantitative food frequency questionnaire (FFQ) was used to assess usual dietary intakes. DAL was calculated using potential renal acid load (PRAL) and net endogenous acid production (NEAP). Multivariate logistic regression was performed to estimate odds ratios (ORs).

Both PRAL (OR = 5.44; 95% CI = 2.09-14.17) and NEAP (OR = 4.88; 95% CI = 2.22-13.41) were associated with increased odds of PC in the crude model. After adjusting for potential confounders (energy intake, smoking, physical activity, ethnicity, job, education, and medication use), being in the third category of PRAL (OR = 3.42; 95% CI = 1.11-8.65) and NEAP (OR = 3.88; 95% CI = 1.26-9.55) were significantly associated with increased odds of PC.

Our findings suggest that dietary acid load may be linked to an increased risk of PC; however, further prospective studies with larger sample sizes and longer durations are necessary to validate these findings.

We aimed to compare the efficacy of three different antiseptic methods to determine the most effective prophylactic approach to prevent infectious complications after transrectal ultrasound-guided prostate biopsy (TRUS-PB). The methods evaluated were transrectal povidone-iodine injection (TRPI), biopsy needle disinfection with chlorhexidine, and biopsy needle disinfection with formalin.

Between January 2018 and January 2023, 904 patients who underwent TRUS-PB were retrospectively analyzed. All patients had prophylactic antibiotic use and negative urine/rectal culture results. Patients were divided into three groups according to the antiseptic protocol: Group 1 (n = 245) received only TRPI injection into the rectum before biopsy, Group 2 (n = 295) received only chlorhexidine needle disinfection before biopsy, and Group 3 (n = 364) received only formalin needle disinfection before biopsy. The biopsy needles used in our clinic are not single-use and are used on other patients after sterilization. The primary endpoint was the incidence of infectious complications within 30 days post-procedure. Continuous variables were analyzed using the Mann-Whitney U test, while categorical variables were analyzed using the Chi-square test, and post-hoc analysis was applied for pairwise comparisons between groups. Univariate and multivariate logistic regression analysis was performed to evaluate factors associated with postoperative infection.

The overall infection rate was 20.4%. Infection rates were 4.5% in the TRPI group, 16.6% in the chlorhexidine group, and 34.1% in the formalin group (p < 0.001). The TRPI group showed significantly lower rates of all infectious complications compared to other groups. Disinfection of biopsy needles with chlorhexidine was found to be significantly more effective in preventing infectious complications compared to disinfection with formalin (p < 0.001).

TRPI injection before TRUS-PB appears to be more effective in preventing post-biopsy infectious complications compared to needle disinfection with chlorhexidine or formalin. This method may be considered as a preferred antiseptic approach for TRUS-PB procedures.

Biochemical recurrence (BCR) of prostate cancer (PCa) negatively impacts patients' post-surgery quality of life, and the traditional predictive models have shown limited accuracy. This study develops an AI-based prognostic model using deep learning that incorporates androgen receptor (AR) regional features from whole-slide images (WSIs). Data from 545 patients across two centres are used for training and validation. The model showed strong performances, with high accuracy in identifying regions with high AR expression and BCR prediction. This AI model may help identify high-risk patients, aiding in better treatment strategies, particularly in underdeveloped areas.

To discern whether reduced infection rates were attributed to antiseptic solutions or mechanical rectal irrigation.

After receiving ethical approval, the study included patients who underwent transrectal prostate biopsy due to elevated PSA or abnormal digital rectal examination findings, and prostate cancer under active surveillance, at Tepecik Training and Research Hospital between April 2022 and June 2023. Standard antibiotic prophylaxis was administered. Patients were randomized into three equal groups according to the rectal irrigation strategy.

Overall complications occurred in 4%. Despite distinct cleaning agents, there was no significant difference in infection rates (p = 0.780) or fever incidence (p = 0.776). Pathological analyses revealed comparable outcomes (p = 0.764).

The study challenges the prevailing belief that antiseptic solutions are indispensable for infection prevention, as saline demonstrated similar efficacy. Limitations include data gaps from potential external hospital visits and absent rectal microorganism swab culture. While TRUS-PB remains the gold standard, this study suggests that mechanically cleansing the rectal mucosa with saline-a cost-effective, side-effect-free alternative-may be a viable infection prevention method, particularly beneficial for patients with antiseptic allergies. The findings prompt a reconsideration of the necessity of antiseptic solutions in TRUS-PB, offering an alternative approach to mitigate infectious complications.

This study demonstrates the feasibility and benefits of using a deep learning-based approach for attenuation correction in [ 68 Ga]Ga-PSMA PET scans.

A dataset of 700 prostate cancer patients (mean age: 67.6 ± 5.9 years, range: 45-85 years) who underwent [ 68 Ga]Ga-PSMA PET/computed tomography was collected. A deep learning model was trained to perform attenuation correction on these images. Quantitative accuracy was assessed using clinical data from 92 patients, comparing the deep learning-based attenuation correction (DLAC) to computed tomography-based PET attenuation correction (PET-CTAC) using mean error, mean absolute error, and root mean square error based on standard uptake value. Clinical evaluation was conducted by three specialists who performed a blinded assessment of lesion detectability and overall image quality in a subset of 50 subjects, comparing DLAC and PET-CTAC images.

The DLAC model yielded mean error, mean absolute error, and root mean square error values of -0.007 ± 0.032, 0.08 ± 0.033, and 0.252 ± 125 standard uptake value, respectively. Regarding lesion detection and image quality, DLAC showed superior performance in 16 of the 50 cases, while in 56% of the cases, the images generated by DLAC and PET-CTAC were found to have closely comparable quality and lesion detectability.

This study highlights significant improvements in image quality and lesion detection capabilities through the integration of DLAC in [ 68 Ga]Ga-PSMA PET imaging. This innovative approach not only addresses challenges such as bladder radioactivity but also represents a promising method to minimize patient radiation exposure by integrating low-dose computed tomography and DLAC, ultimately improving diagnostic accuracy and patient outcomes.

In this prospective study, we investigated the correlation between prostate-specific antigen (PSA) levels in the blood of patients with prostate cancer in biochemical recurrence after radical treatment with the semiquantitative parameters standard uptake value maximum (SUV max ) and the total metabolic tumor volume (TMTV) in the metastatic foci depicted in 18F-prostate-specific membrane antigen (PSMA)-1007 and 18F-choline PET/computed tomography (CT) imaging.

We prospectively examined 104 patients with biochemical relapse of prostate cancer after primary definitive treatment. All patients underwent one 18F-PSMA-1007 and one 18F-choline PET/CT examination in randomized order within a time frame of 10 days and were followed for at least 6 months (182 ± 10 days). The semiquantitative parameters of SUV max and metabolic tumor volume (MTV) of each neoplastic lesion in PET/CT imaging were calculated, and further summation of each MTV value was done to calculate the TMTV.

According to the Spearman correlation analysis, a positive correlation was found between PSA levels and SUV max and TMTV scores in the metastatic foci of 18F-PSMA-1007 PET/CT ( r  = 0.24 and 0.35, respectively; P  < 0.05) and SUV max in the lesions of 18F-choline PET/CT ( r  = 0.28; P  < 0.0239). However, a positive but NS correlation was demonstrated between values of PSA and TMTV for each lesion in the 18F-choline PET/CT study ( r  = 0.22; P  = 0.0795). The detection rate of the different PSA levels with a cutoff of 1 ng/ml was higher for 18F-PSMA-1007 than 18F-choline.

In biochemical relapse patients there is a positive correlation between PSA levels in the blood and the semiquantitative parameters SUV max and TMTV of the metastatic foci in the 18F-PSMA-1007 and 18F-Choline PET/CT imaging.

Introduction Prostate cancer remains the most prevalent cancer among men and continues to present a significant public health challenge globally. The disease's growing prevalence has heightened the demand for skilled professionals capable of obtaining histological samples for accurate diagnosis, as tissue biopsy remains the cornerstone for diagnosing prostate cancer. Surgical care practitioners have become integral to the surgical team, and their roles have expanded to include performing biopsies. This paper evaluates the outcomes of transrectal ultrasound-guided (TRUS) prostate biopsies conducted by a surgical care practitioner (SCP) and explores the implications for resource-poor countries. Methods We retrospectively collated data from 218 patients who underwent TRUS prostate systematic biopsy by a surgical care practitioner between 2020 and 2022. We evaluated the prostate-specific antigen (PSA) values, MRI Likert score where available, and histological data and determined diagnostic yield and complication rates. Results The mean age and PSA level of the men were 69.7 years and 61.2 ng/ml, respectively; an average of 12 cores were obtained per biopsy. The cancer detection rate was 128/218 (59%), with a mean Gleason grade of 2.8. From available MRI, Likert 3 was the most common finding, 45/103 (43.6%), and prostate cancer was found in 40%. The mean MRI Likert scores for a positive and negative biopsy were 4 and 3.3, respectively. We recorded three complications (1%), all Clavien-Dindo 1 to 2, with no mortality. Conclusion A well-trained, supported, and supervised surgical care practitioner can safely and effectively perform TRUS systematic prostate biopsies and may improve access to prostate cancer diagnosis in developing countries.

Ubiquitinases are known to catalyze ubiquitin chains on target proteins to regulate various physiological functions like cell proliferation, autophagy, apoptosis, and cell cycle progression. As a member of E3 ligase, ubiquitin protein ligase E3 component n-recognin 5 (UBR5) belongs to the HECT E3 ligase and has been reported to be correlated with various pathophysiological processes. In this review, the authors give a comprehensive insight into the structure and function of UBR5. The authors discuss the specific domains of UBR5 and explore their biological functions separately. Furthermore, the authors describe the involvement of UBR5 in different pathophysiological conditions, including immune response, virus infection, DNA damage response, and protein quality control. Moreover, the authors provide a thorough summary of the important roles and regulatory mechanisms of UBR5 in cancers and other diseases. On the whole, investigating the domains and functions of UBR5, elucidating the underlying mechanisms of UBR5 with various substrates in detail may provide new theoretical basis for the treatment of diseases, including cancers, which could improve future studies to construct novel UBR5-targeted therapy strategies.

Tissue ablation techniques have emerged as a critical component of modern medical practice and biomedical research, offering versatile solutions for treating various diseases and disorders. Percutaneous ablation is minimally invasive and offers numerous advantages over traditional surgery, such as shorter recovery times, reduced hospital stays, and decreased healthcare costs. Intra-procedural imaging during ablation also allows precise visualization of the treated tissue while minimizing injury to the surrounding normal tissues, reducing the risk of complications. Here, the mechanisms of tissue ablation and innovative energy delivery systems are explored, highlighting recent advancements that have reshaped the landscape of clinical practice. Current clinical challenges related to tissue ablation are also discussed, underlining unmet clinical needs for more advanced material-based approaches to improve the delivery of energy and pharmacology-based therapeutics.

Background/Objectives: The presence of seminal vesicle invasion (SVI) in prostate cancer (PCa) is associated with poorer postoperative outcomes. This study evaluates the predictive value of magnetic resonance imaging (MRI) and prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) for SVI in PCa. Methods: This cohort study included consecutive robotic prostatectomy patients for PCa at three Australian tertiary referral centres between April 2016 and September 2022. MRI and PSMA PET/CT results, clinicopathological variables, including age, BMI, prostate-specific antigen (PSA), PSA density, DRE, Biopsy Gleason score, Positive biopsy cores, PIRADS v2.1 score, MRI volume and MRI lesion size were extracted. The sensitivity, specificity, and accuracy of MRI and PSMA PET/CT for predicting SVI were compared with the histopathological results by receiver operating characteristic (ROC) analysis. Subgroup univariate and multivariate analysis was performed. Results: Of the 528 patients identified, 86 had SVI on final pathology. MRI had a low sensitivity of 0.162 (95% CI: 0.088-0.261) and a high specificity of 0.963 (95% CI: 0.940-0.979). The PSMA PET/CT had a low sensitivity of 0.439 (95% CI: 0.294-0591) and a high specificity of 0.933 (95% CI: 0.849-0.969). When MRI and PSMA PET/CT were used in combination, the sensitivity and specificity improved to 0.514 (95%CI: 0.356-0.670) and 0.880 (95% CI: 0.813-0.931). The multivariate regression showed a higher biopsy Gleason score (p = 0.033), higher PSA (p < 0.001), older age (p = 0.001), and right base lesions (p = 0.003) to be predictors of SVI. Conclusions: MRI and PSMA PET/CT independently underpredicted SVI. The sensitivity and AUC improved when they were used in combination. Multiple clinicopathological factors were associated with SVI on multivariate regression and predictive models incorporating this information may improve oncological outcomes.

Benign prostatic hyperplasia and prostate cancer are often associated with lower urinary tract symptoms, which can severely affect patient quality of life. To address this challenge, we developed and optimized an injectable compound, prostate ablation and drug delivery agent (PADA), for percutaneous prostate tissue ablation and concurrently delivered therapeutic agents. PADA is an ionic liquid composed of choline and geranic acid mixed with anticancer therapeutics and a contrast agent. The PADA formulation was optimized for mechanical properties compatible with hand injection, diffusion capability, cytotoxicity against prostate cells, and visibility of an x-ray contrast agent. PADA also exhibited antibacterial properties against highly resistant clinically isolated bacteria in vitro. Ultrasound-guided injection, dispersion of PADA in the tissue, and tissue ablation were tested ex vivo in healthy porcine, canine, and human prostates and in freshly resected human tumors. In vivo testing was conducted in a murine subcutaneous tumor model and in the canine prostate. In all models, PADA decreased the number of viable cells in the region of dispersion and supported the delivery of nivolumab throughout a portion of the tissue. In canine survival experiments, there were no adverse events and no impact on urination. The injection approach was easy to perform under ultrasound guidance and produced a localized effect with a favorable safety profile. These findings suggest that PADA is a promising therapeutic prostate ablation strategy to treat lower urinary tract symptoms.

The free-to-total prostate-specific antigen (f/t-PSA) ratio is of great significance in the accurate diagnosis of prostate cancer. Herein, a smartphone-based detection system is reported using a colorimetric reaction integrated with proximity-induced bio-barcode and the clustered regularly interspaced short palindromic repeats (CRISPR)/Cas12a assay for f/t-PSA ratio detection. DNA/antibody recognition probes are designed to bind f-PSA or t-PSA and induce the release of the DNA bio-barcode. The CRISPR/Cas12a system is activated by the DNA bio-barcode to release Ag+ from the C-Ag+-C structure of the hairpin DNA. The released Ag+ is used to affect the tetramethylbenzidine (TMB)-H2O2-based colorimetric reaction catalyzed by Pt nanoparticles (NPs), as the peroxidase-like activity of the Pt NPs can be efficiently inhibited by Ag+. A smartphone with a self-developed app is used as an image reader and analyzer to analyze the colorimetric reaction and provide the results. A limit of detection of 0.06 and 0.04 ng mL-1 is achieved for t-PSA and f-PSA, respectively. The smartphone-based method showed a linear response between 0.1 and 100 ng mL-1 of t-PSA or f-PSA. In tests with clinical samples, the smartphone-based method successfully diagnosed prostate cancer patients from benign prostatic hyperplasia patients and healthy cases with high sensitivity and specificity.

To develop a semi-automatic model integrating radiomics, deep learning, and clinical features for Bone Metastasis (BM) prediction in prostate cancer (PCa) patients using Biparametric MRI (bpMRI) images.

A retrospective study included 414 PCa patients (BM, n=136; NO-BM, n=278) from two institutions (Center 1, n=318; Center 2, n=96) between January 2016 and December 2022. MRI scans were confirmed with BM status via PET-CT or ECT pre-treatment. Tumor areas on bpMRI images were delineated as tumor's region of interest (ROI) using auto-delineation tumor models, evaluated with Dice similarity coefficient (DSC). Samples were auto-sketched, refined, and used to train the ResNet BM prediction model. Clinical, radiomics, and deep learning data were synthesized into the ResNet-C model, evaluated using receiver operating characteristic (ROC).

The auto-segmentation model achieved a DSC of 0.607. Clinical BM prediction's internal validation had an accuracy (ACC) of 0.650 and area under the curve (AUC) of 0.713; external cohort had an ACC of 0.668 and AUC of 0.757. The deep learning model yielded an ACC of 0.875 and AUC of 0.907 for the internal, and ACC of 0.833 and AUC of 0.862 for the external cohort. The Radiomics model registered an ACC of 0.819 and AUC of 0.852 internally, and ACC of 0.885 and AUC of 0.903 externally. ResNet-C demonstrated the highest ACC of 0.902 and AUC of 0.934 for the internal, and ACC of 0.885 and AUC of 0.903 for the external cohort.

The ResNet-C model, utilizing bpMRI scanning strategy, accurately assesses bone metastasis (BM) status in newly diagnosed prostate cancer (PCa) patients, facilitating precise treatment planning and improving patient prognoses.

Prostate cancer patients are a heterogeneous group as regards the aggressiveness of the disease. The relationship of steroid hormones with the aggressiveness of prostate cancer is unclear. It is known that the anti-Müllerian hormone (AMH) inhibits prostate cancer cell lines in vitro. The aim of this study is to investigate the relationship of AMH and steroid hormones with the aggressiveness of prostate cancer.

This was a prospective study of consecutive radical prostatectomy patients. We measured the following hormones: total testosterone, sex hormone-binding globulin, albumin, luteinizing hormone, follicle-stimulating hormone, estradiol, dehydroepiandrosterone sulfate, androstenedione, and AMH. The minimum follow-up after radical prostatectomy was 5 years. For the aggressiveness of prostate cancer, we considered the following three variables: post-operative Gleason score (GS) ≥ 8, TNM pΤ3 disease, and prostate-specific antigen (PSA) biochemical recurrence (BCR).

In total, 91 patients were enrolled. The mean age and PSA were 64.8 years and 9.3 ng/dl, respectively. The median post-operative GS was 7. Low AMH blood levels were correlated with higher post-operative GS (p = 0.001), as well as with PSA BCR (p = 0.043). With pT3 disease, only albumin was (negatively) correlated (p = 0.008). ROC analysis showed that AMH is a good predictor of BCR (AUC 0.646, 95% CI 0.510-0.782, p = 0.043); a cutoff value of 3.06 ng/dl had a positive prognostic value of 71.4% and a negative prognostic value of 63.3% for BCR. Cox regression analysis showed that AMH is a statistically significant and independent prognostic marker for BCR (p = 0.013). More precisely, for every 1 ng/ml of AMH rise, the probability for PSA BCR decreases by 20.8% (HR = 0.792). Moreover, in Kaplan-Meier analysis, disease-free survival is more probable in patients with AMΗ ≥ 3.06 ng/ml (p = 0.004).

Low AMH blood levels were correlated with aggressive prostate cancer in this radical prostatectomy cohort of patients. Therefore, AMH could be a prognostic biomarker for the aggressiveness of the disease.

Prostate cancer (PCa) is a prevalent male malignancy that originates in the epithelial cells of the prostate. In terms of incidence and mortality of malignant tumors in men, PCa ranks second and fifth globally and first and third among men in Europe and the United States, respectively. These figures have gradually increased in recent years. The primary modalities used to diagnose PCa include prostate-specific antigen (PSA), multiparametric magnetic resonance imaging (mpMRI), and prostate puncture biopsy. Among these techniques, prostate puncture biopsy is considered the gold standard for the diagnosis of PCa; however, this method carries the potential for missed diagnoses. The preoperative evaluation of the patient in this study suggested advanced PCa. However, the initial prostate puncture biopsy was inconsistent with the preoperative diagnosis, and instead of waiting for a repeat puncture of the prostate primary, we performed a biopsy of the rib metastasis, which was later diagnosed as advanced PCa.

Image-guided surgery (IGS) refers to surgery navigated by medical imaging technology, helping doctors better clarify tumor boundaries, identify metastatic lymph nodes and preserve surrounding healthy tissue function. Recent studies have provided expectable momentum of the application of IGS in prostate cancer (PCa). The authors aim to comprehensively construct a bibliometric analysis of the application of IGS in PCa.

The authors searched publications related to application of IGS in PCa from 2013 to 2023 on the web of science core collection (WoSCC) databases. VOSviewer, CiteSpace, and R package 'bibliometrix' were used for bibliometric analysis.

Two thousand three eighty-nine articles from 75 countries and 2883 institutions led by the United States were included. The number of publications related to the application of IGS in PCa kept high in the last decade. Johns Hopkins University is the top research institutions. Journal of Nuclear Medicine has the highest popularity as the selection of journal and co-cited journal. Pomper Martin G. had published the most paper. Ali Afshar-Oromieh was co-cited most frequently. The clinical efficacy of PSMA-PET/CT in PCa diagnosis and treatment are main topics in this research field, with emerging focuses on the use of fluorescence imaging guidance technology in PCa. 'PSMA' and 'PET/CT' are the main keywords as long-term research hotspots.

This study is the first bibliometric analysis of researches on application of IGS in PCa with three recognized bibliometric software, providing an objective description and comprehensive guidance for the future relevant investigations.

The aim of this systematic review was to summarize national and international guidelines that made recommendations for monitoring patients diagnosed with low-risk cancer. It appraised the quality of guidelines and determined whether the guidelines adequately identified patients for monitoring, specified which tests to use, defined monitoring intervals, and stated triggers for further intervention. It then assessed the evidence to support each recommendation.

Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses, we searched PubMed and Turning Research into Practice databases for national and international guidelines' that were written in English and developed or updated between 2012 and 2023. Quality of individual guidelines was assessed using the AGREE II tool.

Across the 41 published guidelines, 48 different recommendations were identified: 15 (31%) for prostate cancer, 11 (23%) for renal cancer, 6 (12.5%) for thyroid cancer, and 10 (21%) for blood cancer. The remaining 6 (12.5%) were for brain, gastrointestinal, oral cavity, bone and pheochromocytoma and paraganglioma cancer. When combining all guidelines, 48 (100%) stated which patients qualify for monitoring, 31 (65%) specified which tests to use, 25 (52%) provided recommendations for surveillance intervals, and 23 (48%) outlined triggers to initiate intervention. Across all cancer sites, there was a strong positive trend with higher levels of evidence being associated with an increased likelihood of a recommendation being specific (P = 0.001) and the evidence for intervals was based on expert opinion or other guidance.

With the exception of prostate cancer, the evidence base for monitoring low-risk cancer is weak and consequently recommendations in clinical guidelines are inconsistent. There is a lack of direct evidence to support monitoring recommendations in the literature making guideline developers reliant on expert opinion, alternative guidelines, or indirect or nonspecific evidence.

Irreversible electroporation (IRE) is a non-thermal ablation technique for local tumor treatment known to be influenced by pulse duration and voltage settings, affecting its efficacy. This study aims to investigate the effects of bipolar IRE with different pulse durations in a prostate cancer mouse model. The therapeutic effectiveness was assessed with in vitro cell experiments, in vivo tumor volume changes with magnetic resonance imaging, and gross and histological analysis in a mouse model. The tumor volume continuously decreased over time in all IRE-treated groups. The tumor volume changes, necroptosis (%), necrosis (%), the degree of TUNEL-positive cell expression, and ROS1-positive cell (%) in the long pulse duration-treated groups (300 μs) were significantly increased compared to the short pulse duration-treated groups (100 μs) (all p < 0.001). The bipolar IRE with a relatively long pulse duration at the same voltage significantly increased IRE-induced cell death in a prostate cancer mouse model.

To develop and evaluate a machine learning radiomics model based on biparametric magnetic resonance imaging MRI (bpMRI) to predict bone metastasis (BM) status in newly diagnosed prostate cancer (PCa) patients.

We retrospectively analyzed bpMRI scans of PCa patients from multiple centers between January 2016 and October 2021. 348 PCa patients were recruited from two institutions for this study. The first institution contributed 284 patients, stratified and randomly divided into training and internal validation cohorts at a 7:3 ratio. The remaining 64 patients were sourced from the second institution and comprised the external validation cohort. Radiomics features were extracted from axial T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) tumor regions. We developed the radiomics prediction model for BM in the training cohort and validated it in the internal and external validation cohorts. As a benchmark, we trained the logistic regression model with lasso feature reduction (LFR-LRM) in the training cohort and further compared it with Naive Bayes, eXtreme Gradient Boosting (XGboost), Random Forest (RF), GBDT, SVM, Adaboost, and KNN algorithms and validated in both the internal and external cohorts. The performance of several predictive models was assessed by receiver operating characteristic (ROC).

The LFR-LRM model achieved an area under the receiver operating characteristic curve (AUC) of 0.89 (95% CI: 0.822-0.974) and an accuracy of 0.828 (95% CI: 0.713-0.911). The AUC and accuracy in external validation were 0.866 (95% CI: 0.784-0.948) and 0.769 (95% CI: 0.648-0.864), respectively. The RF and XGBoost models outperformed the LFR-LRM, with AUCs of 0.907 (95% CI: 0.863-0.949) and 0.928 (95% CI: 0.882-0.974) and accuracies of 0.831 (95% CI: 0.727-0.907) and 0.884 (95% CI: 0.792-0.946). External validation for these models yielded AUCs and accuracies of 0.911 (95% CI: 0.861-0.966), 0.921 (95% CI: 0.889-0.953), and 0.846 (95% CI: 0.735-0.923) and 0.876 (95% CI: 0.771-0.945), respectively.

The XGboost machine learning model is more accurate than LFR-LRM for predicting BM in patients with newly confirmed PCa.

We aimed to assess the association between comorbidities and prostate cancer management.

We studied 12,603 South Australian men diagnosed with prostate cancer between 2003 and 2019. Comorbidity was measured one year prior to prostate cancer diagnosis using a medication-based comorbidity index (Rx-Risk). Binomial logistic regression analyses were used to assess the association between comorbidities and primary treatment selection (active surveillance, radical prostatectomy (RP), external beam radiotherapy (EBRT) with or without androgen deprivation therapy (ADT), brachytherapy, ADT alone, and watchful waiting (WW)). Certain common comorbidities within Rx-Risk (cardiac disorders, diabetes, chronic airway diseases, depression and anxiety, thrombosis, and chronic pain) were also assessed. All models were adjusted for sociodemographic and tumor characteristics.

Likelihood of receiving RP was lower among men with Rx-Risk score ≥3 (odds ratio (OR) 0.62, 95%CI:0.56-0.69) and Rx-Risk 2 (OR 0.80, 95%CI:0.70-0.92) compared with no comorbidity (Rx-Risk ≤0). Men with high comorbidity (Rx-Risk ≥3) were more likely to have received ADT alone (OR 1.76, 95%CI:1.40-2.21), EBRT (OR 1.30, 95%CI:1.17-1.45) or WW (OR 1.49, 95%CI:1.19-1.88) compared with Rx-Risk ≤0. Pre-existing cardiac and respiratory disorders, thrombosis, diabetes, depression and anxiety, and chronic pain were associated with lower likelihood of selecting RP and higher likelihood of EBRT (except chronic airway disease) or WW (except diabetes and depression and anxiety). Cardiac disorders and thrombosis were associated with higher likelihood of selecting ADT alone. Furthermore, age had greater effect on treatment choice than the level of comorbidity.

High comorbidity burden was associated with primary treatment choice, with significantly less RP and more EBRT, WW and ADT alone among men with higher levels of comorbidity. Each of the individual comorbid conditions also influenced treatment selection.

Undertreatment of otherwise healthy men in their seventies with prostate cancer has been reported previously.

Using information in a Swedish prostate cancer research database, patterns of management and cancer-specific mortality were compared across age groups in over 70,000 men diagnosed with intermediate- or high-risk nonmetastatic prostate cancer between 2008 and 2020. Crude probabilities of death were estimated non-parametrically. Staging procedures, primary treatment, and cancer death were compared using regression models, adjusting for patient and tumor characteristics.

During the study period, the proportion of men treated with curative intent increased in ages 70-74 (intermediate-risk from 45% to 72% and high-risk from 49% to 84%), 75-79 (intermediate-risk from 11% to 52% and high-risk from 12% to 70%), and 80-84 years (intermediate-risk from < 1% to 14% and high-risk from < 1% to 30%). Older age was associated with lower likelihoods of staging investigations and curative treatment, also after adjustment for tumor characteristics and comorbidity. Men treated with curative intent and those initially managed conservatively had lower crude risks of prostate cancer death than men receiving androgen deprivation treatment (ADT). In adjusted analyses, ADT was associated with higher prostate cancer mortality than curative treatment across ages and risk groups. Among men managed conservatively, prostate cancer mortality was higher in ages 70 and above.

Use of curative treatment increased substantially in older men with prostate cancer between 2008 and 2020. Our findings suggest reduced age-bias and under-treatment, likely reflecting improved individualized decision-making and adherence to guidelines recommending more active management of older men.

To assess the utility of 18F-PSMA-1007 PET/MRI in initial staging of intermediate- to high-risk prostate cancer (HRPCa).

A total of 46 patients with pathologically verified intermediate and/or HRPCa who underwent 18F-PSMA-1007 PET/MRI with dedicated pelvic high-resolution multiparametric MRI (mpMRI) were included.

PET/MRI showed 100% sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and accuracy in detecting seminal vesicle (SV) and rectal invasion, versus 87.5%, 100%, 100% 93.8%, 95.7% and 50%, 100%,100%, 95.5%, and 95.7% for mpMRI respectively. However, PET/MRI had poor SN (40% and 0%) but high SP (94.4% and 100%) in detection of UB and neurovascular bundle (NV) invasion compared to 100% SN and SP for mpMRI. PET/MRI demonstrated stronger TNM staging agreement with the gold standard than mpMRI-WBMRI. It demonstrated concordance with T, N, and M stages in 40, 41, and 36 patients (k 0.84, 0.60, and 0.68, respectively) versus 29, 33, and 31 patients (k 0.54, 0.22, and 0.50) with accurate over all staging of 38/46 patients versus 30/46 patients (K 0.52 versus 0.22).

18F-PSMA-1007 PET/MRI is a promising imaging modality with high diagnostic accuracy in staging intermediate- and HRPCa; it improves local tumour evaluation and provides precise TNM staging.

18F-PSMA-1007 PET/MRI could have high diagnostic accuracy as shown in the current study for staging HRPCa patients that is crucial for treatment selection. We think that our study will contribute to the body of knowledge and improve the literature surrounding the clinical uses of integrated 18F-PSMA-1007 PET/MRI.

Prostate cancer (PCa) patients receiving radiotherapy may be predisposed to secondary malignancies. This study aimed to determine the association between PCa treatments, including radical prostatectomy (RP), external beam radiation therapy (EBRT), brachytherapy (BT) and androgen deprivation therapy (ADT); and secondary bladder and colorectal cancer.

A cohort study was constructed using Quebec administrative databases (Med-Echo and RAMQ). Included men were diagnosed and treated for PCa between 2000 and 2016. Patients with bladder or colorectal cancer prior to PCa were excluded. Follow-up ended at the earliest of the following: incidence of bladder or colorectal cancer, death, or December 31, 2016. EBRT, BT, EBRT+ADT, RP + ADT or ADT only were compared individually to RP. The incidence of secondary bladder and colorectal cancer were computed. Inverse probability of treatment weighting (IPTW) based on a propensity score was used to control for potential confounding. IPTW-Cox proportional hazards models were used.

A significant association was found between secondary bladder cancer and EBRT (HR: 1.84, 95%CI: 1.60;2.13), and also EBRT+ADT (HR: 2.08, 95%CI: 1.67;2.56), but not with BT (HR: 1.36, 95%CI: 0.68;2.74). Secondary colorectal cancer was significantly associated to either EBRT (HR: 1.36, 95%CI: 1.21;1.53); or BT (HR: 2.46, 95%CI: 1.71;3.54). The association between ADT alone and both secondary cancers was also significant (HR: 1.98, 95%CI: 1.69;2.31 and HR: 1.69, 95%CI: 1.49;1.92, respectively).

Compared to PCa patients undergoing RP, the secondary bladder cancer was associated with EBRT, ADT, alone or in combination. The secondary colorectal cancer was also associated with receiving either EBRT, BT or ADT.

This meta-analysis aims to comprehensively assess the impact of laparoscopic radical prostatectomy (LRP) on wound infection in patients with prostate cancer (PCa). A systematic search was conducted, from database inception to November 2023, in EMBASE, Google Scholar, Cochrane Library, PubMed, Wanfang and China National Knowledge Infrastructure databases for randomized controlled trials (RCTs) comparing LRP with open radical prostatectomy (ORP) in the treatment of PCa. Two researchers independently screened the literature, extracted data and conducted quality assessments based on pre-defined inclusion and exclusion criteria. Stata 17.0 software was employed for data analysis. Overall, 15 RCTs involving 1458 PCa patients were included. The analysis revealed the incidence of wound infection (odds ratio [OR] = 0.28, 95% confidence interval [CI] = 0.16-0.51, p < 0.001) and complications (OR = 0.27, 95% CI = 0.20-0.37, p < 0.001) was significantly lower in the LRP group compared to the ORP group. This study demonstrates that LRP in PCa patients can effectively reduce the incidence of wound infections and complications, indicating significant therapeutic efficacy and justifying its broader clinical application.

To compare the diagnostic performance and radiological staging impact of 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) compared to 99 Tc whole-body bone scan (WBBS) for the detection of skeletal metastasis in the primary staging of prostate cancer (PCa).

A prospective institutional database was retrospectively examined for patients who underwent both PSMA PET and WBBS within a 1 week interval for PCa primary staging. Lesions were categorised as 'negative', 'equivocal', or 'definite' based on nuclear medicine physician interpretation. Metastatic burden was characterised for each imaging modality according to three groups: (i) local disease (no skeletal metastases), (ii) oligometastatic disease (three or fewer skeletal metastases), or (iii) polymetastatic disease (more than three skeletal metastases).

There were 667 patients included. The median (interquartile range) prostate-specific antigen level was 9.2 (6.2-16) ng/mL and 60% of patients were high risk according to a modified D'Amico risk classification. The overall distribution of skeletal metastasis detection changed across the two scans overall (P = 0.003), being maintained within high-risk (P = 0.030) and low-risk (P = 0.018) groups. PSMA PET/CT identified more definite skeletal metastases compared to WBBS overall (10.3% vs 7.3%), and according to risk grouping (high: 12% vs 9%, intermediate: 4% vs 1%). Upstaging was more common with PSMA PET/CT than WBBS (P = 0.001). The maximum standardised uptake value (SUVmax ) of the primary tumour was associated with upstaging of skeletal metastases on PSMA PET/CT (P = 0.025), while age was associated with upstaging on WBBS (P = 0.021). The SUVmax of the primary tumour and metastases were both higher according to extent of metastatic disease (P = 0.001 and P < 0.001, respectively).

More skeletal metastases were detected with PSMA PET/CT than WBBS, resulting in a higher upstaging rate mostly in high-risk patients. The SUVmax of the primary tumour and metastases was associated with upstaging.

Prostate cancer (PCa) is the most prevalent genitourinary malignancy in men, with a significant proportion of patients developing biochemical recurrence (BCR) after treatment. The immune microenvironment and metabolic alterations have crucial implications for the tumorigenesis and progression of PCa. Therefore, identifying metabolic genes associated with the immune microenvironment holds promise for predicting BCR and improving PCa prognosis.

In this study, ssGSEA and hierarchical clustering analysis were first conducted to evaluate and group PCa samples, followed by the use of the ESTIMATE and CIBERSORT algorithms to characterize the immunophenotypes and tumor microenvironment. The differential metabolic genes (MTGs) between groups were utilized to develop a prognostic-related signature. The predictive performance of the signature was assessed by principal component analysis (PCA), receiver operating characteristic (ROC) curve analysis, survival analysis, and the TIDE algorithm. A miRNA-MTGs regulatory network and predictive nomogram were constructed. Moreover, the expression of prognostic MTGs in PCa was detected by RT‒qPCR.

PCa samples from the TCGA cohort were separated into two groups: the immune-low group and immune-high group. Forty-eight differentially expressed MTGs between the groups were identified, including 37 up-regulated and 11 down-regulated MTGs. Subsequently, CEL, CYP3A4, and PDE6G were identified as the genes most strongly associated with the BCR of PCa patients and these genes were utilized to establish the MTGs-based prognostic signatures. PCA, ROC curves analysis, Kaplan-Meier survival analysis, and the nomogram all showed the good predictive ability of the signature regardless of clinical variables. Furthermore, the MTGs-based signature was indicated as a potential predictive biomarker for immunotherapy response. Nine miRNAs involved in the regulation of prognostic MTGs were determined. In addition to the CEL gene, the PDE6G and CYP3A4 genes were expressed at higher levels in PCa samples.

The MTGs-based signature represents a novel approach with promising potential for predicting BCR in PCa patients.

Several data support the efficacy/effectiveness, safety and favorable impact on quality of life of triptorelin treatment in patients with prostate cancer. However, little evidence is available concerning triptorelin use in the long term.

We analyzed data on triptorelin treatment in patients with prostate cancer in an integrated Italian administrative database, covering around 6 million health-assisted subjects throughout the country. Patients with at least one prescription for triptorelin in the period 2010-2020 and with no evidence of metastasis were included and followed up until 2021. Overall survival (OS) and duration of treatment were analyzed using Kaplan-Meier curves, starting from the date of first prescription.

The cohort included a total of 3,411 patients (mean age: 76.8 ± 8.7 years), of whom 1,326 (38.9%) were treated with triptorelin only and 2,085 (61.1%) with triptorelin combined with an anti-androgen. Overall, 847 (24.8%) patients with prostate cancer died and 1,037 (30.4%) had a treatment switch during the follow-up period, and both the median OS and median duration of treatment were not reached in both groups. The mean annual total cost per patient was estimated as 5,574 €, with almost half of the costs related to medication expenses (2,737 €).

We found a long survival and duration of triptorelin treatment in this population of Italian patients with prostate cancer. This study with a long follow-up period further highlights the usefulness of healthcare utilization databases to integrate results obtained from clinical studies with those from everyday clinical practice.

Benign prostatic hyperplasia (BHP) is a common disease in the urinary system and often appears in old male patients with the incidence increasing proportionally to age.

The study aimed to describe the anatomy and imaging findings of the prostatic artery (PAs) on 3D rendering dual-energy multi-sequence computed tomography (DECT) in patients with symptomatic benign prostatic hypertrophy (BPH) treated by prostatic artery embolisation (PAE).

The study was conducted on 64 patients with BPH who underwent DECT scans with 3D rendering of the pelvic artery before intervention from August 2022 to November 2023. The PAs were independently evaluated for each side, focusing on the number of branches, origin, tortuosity, atherosclerotic plaque, and anastomoses with adjacent arteries.

Among 128 pelvic sides where the PAs can be observed, the rate of finding 01 prostate artery on each side was high (96.1%), and the rate of 02 prostate arteries on each side was rare (3.9%). In 133 prostatic arteries, the most common type of prostatic artery according to origin is type I (29.6%), followed by type III (24.6%). The atherosclerotic prostatic artery rate is 24.6%, and the average diameter is 1.5±0.4 mm. The tortuosity prostate artery accounted for 74.6%. The anastomosis to the contralateral prostatic artery rate is 48.4%, followed by the penis and rectum anastomoses.

PAs have abundant original varies between the left and right sides and between patient to patient. The most common form arises from the internal pudendal artery.

Prostate cancer (PC) is one of the most common cancers in men and becoming the second leading cause of cancer fatalities. At present, the lack of effective strategies for prognosis of PC patients is still a problem to be solved. Therefore, it is significant to identify potential gene signatures for PC patients' prognosis. Here, we summarized 71 different prognostic gene signatures for PC and concluded 3 strategies for signature construction after extensive investigation. In addition, 14 genes frequently appeared in 71 different gene signatures, which enriched in mitotic and cell cycle. This review provides extensive understanding and integrated analysis of current prognostic signatures of PC, which may help researchers to construct gene signatures of PC and guide future clinical treatment.

To analyze the 10-year biochemical relapse-free survival (BRFS), locoregional relapse-free survival (LRFS), metastasis-free survival (MFS), and overall survival (OS) in patients diagnosed with localized prostate adenocarcinoma treated with radiotherapy (RT) ± androgen deprivation therapy (ADT), according to the risk groups based on multiparametric magnetic resonance imaging (mpMRI) instead of digital rectal exam (DRE).

We retrospectively evaluated 140 consecutive patients diagnosed with localized prostate adenocarcinoma, stratified into different risk groups-low (LR), intermediate (IR), and high (HR) by mpMRI results.

After a median follow-up of 104 months, in LR group (n = 15), 10-year BRFS was 86.7%, 10-year LRFS was 86.7%, 10-year MFS was 93.3%, and 10-year OS was 100%. In IR group (n = 80), 10-year BRFS was 80.5%, 10-year LRFS was 86.1%, 10-year MFS was 92.6%, and 10-year OS was 76%. In HR group (n = 45), 10-year BRFS was 72.8%, 10-year LRFS was 78.7%, 10-year MFS was 82.1%, and 10-year OS was 77% (2 deaths from prostate cancer). According to mpMRI results, 36 (25.7%) patients change the risk group and 125 (89.28%) patients change the TNM stage. There was a trend for higher metastatic relapse in patients who switched from IR to HR (due to mpMRI) versus the patients who remained in the IR (20%, vs. 1.81% p = 0.059). Multivariate analysis showed that locoregional relapse was strongly associated with distant relapse (OR = 9.28; 95%CI: 2.60-33.31). There were no cases of acute grade 3 toxicity. Late grade 3 genitourinary, gastrointestinal, and sexual toxicity were 2.8%, 0.7%, and 1.2%, respectively.

This is the first study with a 10-year median follow-up of patients diagnosed with localized prostate cancer treated with radiotherapy according to the risk groups established by mpMRI. Our findings show that mpMRI is a key tool to diagnose and establish risk groups in these patients, to optimize their treatment.