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Significance of atypical small acinar proliferation and extensive high-grade prostatic intraepithelial neoplasm in clinical practice.

INTRODUCTION: Prostate cancer (PCa) is one of the most commonly diagnosed neoplasms in elderly men. The precancerous lesion of PCa is considered a high-grade prostate intraepithelial neoplasm (HG-PIN), while atypical small acinar proliferation (ASAP) is commonly considered as an under-diagnosed cancer. The aim of the study was to establish the impact of ASAP and extensive HG-PIN on pre-biopsy prostate-specific antigen (PSA) levels and the risk of cancer development in subsequent biopseis. MATERIAL AND METHODS: The 1,010 men suspected for PCa were included in the study based on elevated PSA, a…

Hormone therapy for radiorecurrent prostate cancer.

BACKGROUND: The management of patients who relapse after radical radiotherapy is a challenging problem for the multidisciplinary team. This … , it would seem appropriate to offer immediate therapy to men with advanced disease or unfavourable prostate-specific antigen (PSA) kinetics at relapse. Patients with more favourable risk factors and PSA kinetics may be considered for watchful waiting and deferred ADT to avoid or delay the associated toxicities. Patients with non-metastatic disease can be given the option …

Effect of whole pelvic radiotherapy for patients with locally advanced prostate cancer treated with radiotherapy and long-term androgen deprivation therapy.

PURPOSE: To evaluate the effect of whole pelvic radiotherapy (WPRT) in prostate cancer patients treated with RT and long-term (>1 year) androgen deprivation therapy (ADT). METHODS AND MATERIALS: Prostate cancer patients with high-risk features (Stage T3-T4 and/or Gleason score≥7 and/or prostate-specific antigen level≥20 ng/mL) who had undergone RT and long-term ADT were included in the present analysis. Patients with bowel inflammatory disease, colon diverticula, and colon diverticulitis were excluded from WPRT and treated with prostate-only radiotherapy (PORT). Patients were grouped accordin…

Body mass index is weakly associated with, and not a helpful predictor of, disease progression in men with clinically localized prostate carcinoma treated with radical prostatectomy.

BACKGROUND: Several studies have recently suggested an association between body mass index (BMI) and disease progression after radical prost … er 1986 and May 2003. Clinicopathologic variables analyzed included BMI (kg/m2), preoperative serum prostate-specific antigen level (ng/mL), clinical T classification, year of surgery, race, biopsy-derived primary and secondary Gleason grades, and INVBMI, known to better correlate with percent body fat than BMI. Cox regression analysis was used to examine the possible asso …

Analysis of G/A polymorphism in the androgen response element I of the PSA gene and its interactions with the androgen receptor polymorphisms.

OBJECTIVES: To compare the in vitro functional activity of the prostate-specific antigen (PSA) androgen response element (ARE) I alleles alone or in combination with androgen receptor (AR) polymorphisms and to determine the association of ARE I alleles with serum PSA in men without clinical prostatic disease. Data are conflicting regarding the association of PSA promoter alleles with serum PSA in men. METHODS: In vitro functional analyses of ARE I and AR polymorphisms were conducted by luciferase reporter assays in LNCaP and PC-3 cells. Associations among serum PSA, ARE I, and AR genotypes we…

"Utility of PET/CT with [18F] F-fluorocholine in assessing the response to antiandrogenic therapy in patients with prostate cancer.".

OBJECTIVE: To evaluate the correlation between response assessment measured by PET/CT with [18F] F-fluorocholine (Choline PET/CT) and serum levels of PSA in patients with prostate cancer under antiandrogenic treatment. METHODOLOGY: A retrospective study included patients with CRPC (castration-resistant prostate cancer) and HSPC (hormone sensitive prostate cancer) treated with enzalutamide, abiraterone, or apalutamide between June 2018 and July 2021, who underwent baseline and a follow-up Choline PET/CT. The difference in maximum SUVmax (ΔSUV) between both studies and the PSA value before and

Prostate Bed Delineation Guidelines for Postoperative Radiation Therapy: On Behalf Of The Francophone Group of Urological Radiation Therapy.

PURPOSE: Prostate bed (PB) irradiation is considered the standard postoperative treatment after radical prostatectomy (RP) for tumors with high-risk features or persistent prostate-specific antigen, or for salvage treatment in case of biological relapse. Four consensus guidelines have been published to standardize practices and reduce the interobserver variability in PB delineation but with discordant recommendations. To improve the reproducibility in the PB delineation, the Francophone Group of Urological Radiotherapy (Groupe Francophone de Radiothérapie Urologique [GFRU]) worked to propose a…

Outcomes of men on active surveillance for low-risk prostate cancer at a safety-net hospital.

PURPOSE: To characterize demographic, disease, and cancer outcomes of men on active surveillance (AS) at a safety-net hospital and characterize those who were lost to follow-up (LTFU). METHODS: From January 2004 to November 2014, 104 men with low-risk prostate cancer (PCa) were followed with AS at Zuckerberg San Francisco General Hospital (ZSFG). Criteria for AS have evolved over time; however, patients with diagnostic prostate-specific antigen (PSA) 10ng/mL or less, clinical stage T1/2, biopsy Gleason score 3 + 3 or 3 + 4, 33% or fewer positive cores, and 50% or less tumor in any single core…

Phyllodes tumor of the verumontanum: a case report.

The current report presents the case of a 42-year-old male with extraordinarily salient urination difficulty that had lasted 6 months. Transrectal ultrasonography and pelvic magnetic resonance imaging demonstrated prostatic hyperplasia and cyst. PSA level was 20.65 (>4) μg/L in the patient. Transrectal prostatic biopsy revealed benign prostatic hyperplasia. He agreed to receive plasmakinetic resection of the prostate. During operation a lobulated lump was unexpectedly found on the verumontanum, with the prostate macroscopically normal. Complete tumor excision was performed and pathological ass

The efficacy of duration of prophylactic antibiotics in transrectal ultrasound guided prostate biopsy.

INTRODUCTION: We aimed to evaluate the efficacy of the duration of prophylactic antibiotic administration in patients undergoing transrectal ultrasound (TRUS) guided biopsy. MATERIAL AND METHODS: A total of 367 patients undergoing a prostate biopsy between September 2007 and June 2009 was reviewed retrospectively and divided into 2 groups according to prophilaxy: oral ciprofloxacin (750 mg every 12 hours) for 3 or more days in Group-1 and single day in Group-2. Demographic characteristics of patients, symptoms, PSA values, IPSS scores, prostate sizes, pathologic results and complications were

Screening for prostate cancer in high risk populations.

PURPOSE: Black men and men with a family history of prostate cancer are at higher risk for this disease and may have an earlier age of onset. Consequently, screening at a younger age has been recommended for high risk men, however, there are limited data on actual screening results in young, high risk populations. MATERIALS AND METHODS: In men 50 years old or older we compared screening results in 1,224 black men, 1,227 men with a positive family history and 63 men who were both with those of 15,964 nonblack men with no known family history. In high risk men in their forties we also evaluated

Pulsed Thulium:YAG laser enucleation versus open simple prostatectomy for large-gland benign prostatic hyperplasia: a retrospective comparative observational study.

BACKGROUND: Evidence on high-peak-power pulsed Thulium:YAG laser enucleation (p-ThuLEP) remains limited, particularly for large prostates. T … nd early functional results [International Prostate Symptom Score (IPSS), maximum flow rate (Qmax), prostate-specific antigen (PSA)]. Multivariable logistic regression adjusted for prostate volume, anticoagulant use, and positive urine culture. RESULTS: p-ThuLEP significantly reduced hospital stay [mean difference -3.04 days; 95% confidence interval (CI): -4.09 to -2.16; …

PCa Detection in PI-RADS 4 and 5 Lesions: Comparison of [68Ga]Ga-PSMA-11 PET/CT-Guided Robot-Assisted Biopsy Versus mpMRI Cognitive-Fusion TRUS-Guided Prostate Biopsy.

Lesions with a Prostate Imaging-Reporting and Data System (PI-RADS) score of 4 or greater on multiparametric MRI (mpMRI) indicate a high lik … ndomized clinical trial (NCT05137561) enrolled biopsy-naïve men age 50-90 y with elevated levels of prostate-specific antigen (≥4 ng/mL) and abnormal digital rectal examination findings. All participants underwent mpMRI, and those with a PI-RADS score of 4 or greater were randomized into 2 arms. In arm 1, participants underwent PGPB for a [68Ga]Ga-PSMA-avid lesion, and par …

Small-Cell Carcinoma of the Bladder With Concurrent High-Grade Prostate Cancer: A Case Report and Review of the Literature.

Small-cell carcinoma of the bladder (SCCB) is a rare, aggressive neuroendocrine malignancy associated with early metastasis and poor surviva … uring this period, he was also diagnosed with high-risk prostate adenocarcinoma (Gleason 4 + 5 = 9, prostate-specific antigen (PSA) > 100 ng/mL, with normal PSA range less than or equal to 4 ng/mL) and was initiated on androgen deprivation therapy. After recovery and surgical repair of a large inguinal hernia (that would have hindered external beam radiation therapy planni …

Preoperative ADT combined with docetaxel for conversion therapy in large-volume and unresectable locally advanced or oligometastatic prostate cancer: a multicenter retrospective study (YHCG-001 study).

BACKGROUND: The value of radical prostatectomy (RP) in large volume and unresectable locally advanced prostate cancer (LAPC) or oligometasta … therapy discussion. The primary endpoint was surgical conversion rate. Secondary endpoints included prostate-specific antigen (PSA) progression-free survival (PSA-PFS), overall survival (OS), PSA response rate, adverse events, pathological response, perioperative complications, urinary continence, and sexual function. RESULTS: Among 31 enrolled patients, the mean age was …

The effect of povidone-iodine-enhanced rectal enema on procedure-related infectious complications before transrectal ultrasound-guided prostate biopsy: A prospective randomized study.

BACKGROUND: To prospectively evaluate the effects of rectal cleansing using a povidone-iodine (PI) and PI enhanced rectal enema on procedure-related infectious complications in patients undergoing transrectal prostate biopsy. METHODS: Between September 2023 and March 2024, patients scheduled for their first transrectal ultrasound-guided prostate biopsy due to elevated prostate-specific antigen levels, suspicious multiparametric prostate magnetic resonance imaging findings, or abnormal digital rectal examination were prospectively randomized into 2 groups (n = 60 each). All patients received s…

Transvesical Clipless Robot-Assisted Radical Prostatectomy Using a Multiport Plat-form: Technical Feasibility and Early Outcomes.

INTRODUCTION: Robot-assisted radical prostatectomy (RARP) continues to evolve with surgical approaches aimed at preserving continence-relate … s). One patient (Case 3) presented with a focal apical positive surgical margin on final pathology; prostate-specific antigen levels were undetectable in all cases during early follow-up. The approach was technically feasible and familiar to surgeons experienced in anterior RARP. Larger prostate volume may limit intravesical working space and apical visualization. CONCLUS …

Predictors of Treatment Failure and Second-Line Therapy Outcomes After Rezūm Therapy for Benign Prostatic Hyperplasia.

Background Rezūm water vapor thermal therapy has emerged as a minimally invasive treatment option for benign prostatic hyperplasia (BPH). Ho … nd January 2023. Baseline demographic and clinical characteristics, including age, prostate volume, prostate-specific antigen (PSA), post-void residual volume (PVR), and International Prostate Symptom Score (IPSS), were collected. Treatment failure was defined as the need for secondary intervention. Multivariable logistic regression was performed to identify predictors of …

Nanotechnology in Prostate Cancer: PSMA-Targeted Nanoplatforms, TME-Responsive Therapy, Immunomodulation, and Clinical Translation Challenges.

The field of nanotechnology has demonstrated considerable potential in the diagnosis and treatment of prostate cancer, particularly through the use of prostate-specific membrane antigen (PSMA)-targeted platforms and tumor microenvironment (TME)-responsive systems. In the context of diagnosis, nanoparticle-based molecular imaging probes have been shown to enhance detection sensitivity and specificity. These probes include superparamagnetic iron oxide, which is utilized in magnetic resonance imaging, and near-infrared fluorescent nanomicelles. Additionally, nanostructured liquid biopsy systems h

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… The high detection rate of prostate cancer can be attributed to two major factors: population aging and the widespread adoption of prostate-specific antigen (PSA) screening. …

Incidence, surveillance and natural history of high-grade prostatic epithelial neoplasia in the era of multiparametric MRI and targeted biopsy.

OBJECTIVES: To determine the incidence of isolated high grade prostatic epithelial neoplasia (iHGPIN) following magnetic resonance imaging ( … es were performed between June 2012 and October 2021. The surveillance protocol for iHGPIN included prostate-specific antigen assessment every 6 months, digital rectal examinations annually, and multiparametric MRI (mpMRI) at 3 years. Repeat biopsies were recommended primarily for suspicious mpMRI, defined as a new Prostate Imaging-Reporting and Data System (PI-RADS) score …