346 results match your criteria Pathologic Assessment of Radical Prostatectomy


Focal p53 protein expression and lymphovascular invasion in primary prostate tumors predict metastatic progression.

Sci Rep 2022 03 30;12(1):5404. Epub 2022 Mar 30.

Joint Pathology Center, Silver Spring, MD, 20910, USA.

TP53 is one of the most frequently altered genes in prostate cancer. The precise assessment of its focal alterations in primary tumors by immunohistochemistry (IHC) has significantly enhanced its prognosis. p53 protein expression and lymphovascular invasion (LVI) were evaluated for predicting metastatic progression by IHC staining of representative whole-mounted prostate sections from a cohort of 189 radical prostatectomy patients with up to 20 years of clinical follow-up. Read More

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mEPE-score: a comprehensive grading system for predicting pathologic extraprostatic extension of prostate cancer at multiparametric magnetic resonance imaging.

Eur Radiol 2022 Jul 15;32(7):4942-4953. Epub 2022 Mar 15.

Department of Surgical Sciences, Radiology Unit, University of Turin, Via Genova 3, 10126, Turin, Italy.

Objective: To investigate the diagnostic accuracy of the PI-RADS v2.1 multiparametric magnetic resonance imaging (mpMRI) features in predicting extraprostatic extension (mEPE) of prostate cancer (PCa), as well as to develop and validate a comprehensive mpMRI-derived score (mEPE-score).

Methods: We retrospectively reviewed all consecutive patients admitted to two institutions for radical prostatectomy for PCa with available records of mpMRI performed between January 2015 and December 2020. Read More

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Predicting biochemical-recurrence-free survival using a three-metabolic-gene risk score model in prostate cancer patients.

BMC Cancer 2022 Mar 4;22(1):239. Epub 2022 Mar 4.

Department of Urology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, 110004, People's Republic of China.

Background: Biochemical recurrence (BCR) after initial treatment, such as radical prostatectomy, is the most frequently adopted prognostic factor for patients who suffer from prostate cancer (PCa). In this study, we aimed to construct a prognostic model consisting of gene expression profiles to predict BCR-free survival.

Methods: We analyzed 70 metabolic pathways in 152 normal prostate samples and 494 PCa samples from the UCSC Xena dataset (training set) via gene set enrichment analysis (GSEA) to select BCR-related genes and constructed a BCR-related gene risk score (RS) model. Read More

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Effects of the 2012 and 2018 US preventive services task force prostate cancer screening guidelines on pathologic outcomes after prostatectomy.

Prostate 2022 02 22;82(2):216-220. Epub 2021 Nov 22.

Department of Surgery, Division of Urologic Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.

Background: In May 2018, the US Preventive Services Task Force (USPSTF) recommended prostate cancer (PCa) screening for ages 55-69 be an individual decision. This changed from the USPSTF's May 2012 recommendation against screening for all ages. The effects of the 2012 and 2018 updates on pathologic outcomes after prostatectomy are unclear. Read More

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February 2022

Concordance of biopsy and pathologic ISUP grading in salvage radical prostatectomy patients for recurrent prostate cancer.

Prostate 2022 02 22;82(2):254-259. Epub 2021 Nov 22.

Martini-Klinik Prostate Cancer Center, University Hospital Hamburg Eppendorf, Hamburg, Germany.

Purpose: To investigate the concordance of biopsy and pathologic International Society of Urological Pathology (ISUP) grading in salvage radical prostatectomy (SRP) patients for recurrent prostate cancer.

Methods: Within a high-volume center database, we identified patients who underwent SRP for recurrent prostate cancer (PCa) between 2004 and 2020. Upgrading, downgrading, concordance, and any discordance between posttreatment biopsy ISUP and ISUP at SRP were tested. Read More

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February 2022

Artificial Intelligence-assisted Prostate Cancer Diagnosis: Radiologic-Pathologic Correlation.

Radiographics 2021 Oct;41(6):1676-1697

From the Department of Radiology, Clínica Las Nieves, HT Médica, Calle Carmelo Torres Núm 2, 23007 Jaén, Spain (L.A.M., A.L.); Paige.AI, New York, NY (J.A.R.); Department of Radiology, Duke University Medical Center, Durham, NC (R.T.G.); and Department of Radiology, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain (R.G.F.).

The classic prostate cancer (PCa) diagnostic pathway that is based on prostate-specific antigen (PSA) levels and the findings of digital rectal examination followed by systematic biopsy has shown multiple limitations. The use of multiparametric MRI (mpMRI) is now widely accepted in men with clinical suspicion for PCa. In addition, clinical information, PSA density, risk calculators, and genomic and other "omics" biomarkers are being used to improve risk stratification. Read More

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October 2021

The clinical impact of strict criteria for active surveillance of prostate cancer in Korean population: Results from a prospective cohort.

Investig Clin Urol 2021 07 30;62(4):430-437. Epub 2021 Apr 30.

Department of Urology, Seoul National University Hospital, Seoul, Korea.

Purpose: To evaluate the clinical impact of strict selection criteria for active surveillance (AS) of prostate cancer in a Korean population.

Materials And Methods: A single-center, prospectively collected AS cohort from December 2016 to February 2019 was used. Following pre-determined criteria, patients were categorized into "strict AS" and "non-strict AS" groups. Read More

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The impact of pretreatment PSA on risk stratification in men with Gleason 6 prostate cancer: Implications for active surveillance.

Urol Oncol 2021 11 13;39(11):783.e21-783.e30. Epub 2021 May 13.

Boston University School of Medicine, Boston, MA. Electronic address:

Background: There are limited data to support the safety of active surveillance in men with favorable-intermediate risk prostate cancer due only to a prostate specific antigen (PSA) above 10 ng/ml. We therefore evaluated the impact of pretreatment PSA on risk-stratification in men with Gleason 6 prostate cancer.

Methods: We identified men aged 18 to 75 with cT1-2cN0cM0, pre-treatment PSA < 20 ng/ml, Gleason 6 prostate cancer diagnosed from 2010 to 2016 in the National Cancer Database who underwent radical prostatectomy. Read More

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November 2021

Prognostic Features of Biochemical Recurrence of Prostate Cancer Following Radical Prostatectomy Based on Multiparametric MRI and Immunohistochemistry Analysis of MRI-guided Biopsy Specimens.

Radiology 2021 06 13;299(3):613-623. Epub 2021 Apr 13.

From the Clinical Research Directorate, Frederick National Laboratory for Cancer Research sponsored by the National Cancer Institute (S.A.H.); Molecular Imaging Branch (S.A.H., S.M., Y.M., T.S., J.S., P.L.C., B.T.), Laboratory of Pathology (M.J.M.), Center for Interventional Oncology (B.J.W.), and Urologic Oncology Branch (S.M., P.A.P.), National Cancer Institute, National Institutes of Health, 9000 Rockville Pike, Building 10, Room B3B85, Bethesda, Md 20892; Center for Prostate Disease Research, John P. Murtha Cancer Center, Department of Surgery, Uniformed Services University of the Health Sciences (W.G., D.Y., J.C., I.L.R., S.S., A.D., I.A.S.) and Urology Service (I.L.R.), Walter Reed National Military Medical Center, Bethesda, Md; and Department of Genitourinary Pathology, Joint Pathology Center, Silver Spring, Md (I.A.S.).

Background Although prostate MRI is routinely used for the detection and staging of localized prostate cancer, imaging-based assessment and targeted molecular sampling for risk stratification are an active area of research. Purpose To evaluate features of preoperative MRI and MRI-guided biopsy immunohistochemistry (IHC) findings associated with biochemical recurrence (BCR) of prostate cancer after surgery. Materials and Methods In this retrospective case-control study, patients underwent multiparametric MRI before MRI-guided biopsy followed by radical prostatectomy between 2008 and 2016. Read More

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Favorable intermediate risk prostate cancer with biopsy Gleason score of 6.

BMC Urol 2021 Apr 5;21(1):52. Epub 2021 Apr 5.

Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.

Background: To identify potential prognostic factors among patients with favorable intermediate risk prostate cancer with a biopsy Gleason score 6.

Methods: From 2003 to 2019, favorable intermediate risk patients who underwent radical prostatectomy were included in this study. All patients were evaluated preoperatively with MRI. Read More

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Results of a Randomized Phase II Trial of Intense Androgen Deprivation Therapy prior to Radical Prostatectomy in Men with High-Risk Localized Prostate Cancer.

J Urol 2021 07 8;206(1):80-87. Epub 2021 Mar 8.

Dana-Farber Cancer Institute, Boston, Massachusetts.

Purpose: This multicenter randomized phase 2 trial investigates the impact of intense androgen deprivation on radical prostatectomy pathologic response and radiographic and tissue biomarkers in localized prostate cancer (NCT02903368).

Materials And Methods: Eligible patients had a Gleason score ≥4+3=7, prostate specific antigen >20 ng/mL or T3 disease and lymph nodes <20 mm. In Part 1, patients were randomized 1:1 to apalutamide, abiraterone acetate, prednisone and leuprolide (AAPL) or abiraterone, prednisone, leuprolide (APL) for 6 cycles (1 cycle=28 days) followed by radical prostatectomy. Read More

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Assessment of PSIM (Prostatic Systemic Inflammatory Markers) Score in Predicting Pathologic Features at Robotic Radical Prostatectomy in Patients with Low-Risk Prostate Cancer Who Met the Inclusion Criteria for Active Surveillance.

Diagnostics (Basel) 2021 Feb 20;11(2). Epub 2021 Feb 20.

Department of Urology, European Institute of Oncology, IRCCS, 20141 Milan, Italy.

Background: circulating levels of lymphocytes, platelets and neutrophils have been identified as factors related to unfavorable clinical outcome for many solid tumors. The aim of this cohort study is to evaluate and validate the use of the Prostatic Systemic Inflammatory Markers (PSIM) score in predicting and improving the detection of clinically significant prostate cancer (csPCa) in men undergoing robotic radical prostatectomy for low-risk prostate cancer who met the inclusion criteria for active surveillance.

Methods: we reviewed the medical records of 260 patients who fulfilled the inclusion criteria for active surveillance. Read More

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February 2021

Cell-cycle risk score more accurately determines the risk for metastases and death in prostatectomy patients compared with clinical features alone.

Prostate 2021 03 21;81(4):261-267. Epub 2021 Jan 21.

Myriad Genetics, Inc., Salt Lake City, Utah, USA.

Background: Prostate cancer treatment aims to prevent metastases and disease-specific mortality. Pathologic parameters have limited ability to predict these outcomes, but biomarkers can improve risk discrimination. We evaluated the ability of cell-cycle progression and combined cell-cycle risk scores to predict metastases and disease-specific mortality after prostatectomy. Read More

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Ductal Prostate Cancers Demonstrate Poor Outcomes with Conventional Therapies.

Eur Urol 2021 02 3;79(2):298-306. Epub 2020 Dec 3.

The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA. Electronic address:

Background: Ductal prostate adenocarcinoma (DAC) is a rare, aggressive, histologic variant of prostate cancer that is treated with conventional therapies, similar to high-risk prostate adenocarcinoma (PAC).

Objective: To assess the outcomes of men undergoing definitive therapy for DAC or high-risk PAC and to explore the effects of androgen deprivation therapy (ADT) in improving the outcomes of DAC.

Design, Setting, And Participants: A single-center retrospective review of all patients with cT1-4/N0-1 DAC from 2005 to 2018 was performed. Read More

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February 2021

Sequential Prostate Magnetic Resonance Imaging in Newly Diagnosed High-risk Prostate Cancer Treated with Neoadjuvant Enzalutamide is Predictive of Therapeutic Response.

Clin Cancer Res 2021 01 6;27(2):429-437. Epub 2020 Oct 6.

Genitourinary Malignancies Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland.

Purpose: For high-risk prostate cancer, standard treatment options include radical prostatectomy (RP) or radiotherapy plus androgen deprivation therapy (ADT). Despite definitive therapy, many patients will have disease recurrence. Imaging has the potential to better define characteristics of response and resistance. Read More

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January 2021

Development of a technique for evaluating the presence of malignant cells in prostatic fluid during robotic prostatectomy.

Urol Oncol 2021 03 29;39(3):192.e1-192.e6. Epub 2020 Aug 29.

Department of Urology, Mayo Clinic, Rochester, MN. Electronic address:

Introduction: To develop a technique to collect fluid expressed during robot-assisted radical prostatectomy (RARP) to assess whether malignant cells may have been inadvertently introduced into the surgical field.

Methods: Men with clinically localized grade group 2 to 5 prostate adenocarcinoma undergoing RARP were identified. Following bladder neck division, fluid expressed via prostatic urethra during seminal vesicle dissection was aspirated (specimen A). Read More

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Assessment of Postprostatectomy Radiotherapy as Adjuvant or Salvage Therapy in Patients With Prostate Cancer: A Systematic Review.

JAMA Oncol 2020 Nov;6(11):1793-1800

Robert H. Lurie Comprehensive Cancer Center, Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Importance: After radical prostatectomy, adverse pathologic features and postoperative prostate-specific antigen (PSA) levels can herald disease recurrence or progression. Postoperative radiotherapy (RT) remains beneficial in this setting.

Objective: To examine the evidence supporting the use of postoperative RT as well as recent advances that help determine timing, scope, and use in combination with androgen deprivation therapy (ADT) with or without lymphatic irradiation. Read More

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November 2020

Inter-observer variability of cribriform architecture and percent Gleason pattern 4 in prostate cancer: relation to clinical outcome.

Virchows Arch 2021 Feb 20;478(2):249-256. Epub 2020 Aug 20.

Department of Pathology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.

The Grade group is an important parameter for clinical decision-making in prostate cancer. Recently, percent Gleason pattern 4 and presence of invasive cribriform and/or intraductal carcinoma (CR/IDC) have been recognized for their independent predictive value for prostate cancer outcome. There is sparse data on the inter-observer agreement for these pathologic features in practice. Read More

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February 2021

Three-tiered Subclassification System of High-risk Prostate Cancer in Men Managed With Radical Prostatectomy: Implications for Treatment Decision-making.

Urology 2020 11 4;145:197-203. Epub 2020 Aug 4.

Harvard Radiation Oncology Program, Boston, MA. Electronic address:

Objective: To inform treatment decisions for patients with high-risk prostate cancer (PCa), we determined rates of adverse pathologic factors and overall survival (OS) among subgroups of high-risk men.

Methods: Using the National Cancer Database, 89,450 patients with clinical N0M0 unfavorable intermediate-risk, favorable high-risk (cT1c, Gleason 6, prostate-specific antigen [PSA] > 20 ng/mL or cT1c, biopsy Gleason 8, PSA < 10 ng/mL), standard high-risk (all other cT3a, biopsy Gleason ≥ 8, or PSA > 20 ng/mL), or very high-risk (cT3b-T4 or biopsy primary Gleason pattern 5) PCa treated with radical prostatectomy were identified. Rates of adverse pathologic factors (positive surgical margins, T4 disease, or pathologic lymph node involvement) were compared across subgroups. Read More

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November 2020

Postoperative Biochemical Failure in Patients With PI-RADS Category 4 or 5 Prostate Cancers: Risk Stratification According to Zonal Location of an Index Lesion.

AJR Am J Roentgenol 2020 10 8;215(4):913-919. Epub 2020 Jul 8.

Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Irwon-dong, Gangnam-gu, Seoul 06351, Republic of Korea.

The objective of our study was to assess postoperative biochemical failure in patients with prostate cancer according to zonal location of an index lesion classified as Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) category 4 or 5. Consecutive patients ( = 232) with prostate cancer who had PI-RADSv2 category 4 or 5 lesions on MRI and who underwent radical prostatectomy were retrospectively evaluated. We investigated clinical (prostate-specific antigen density), MRI (PI-RADSv2 category of index lesion and zonal location, assessed as peripheral zone [PZ] or transition zone [TZ], of index lesion), and pathologic (tumor volume, tumor grade, and presence of extraprostatic extension) parameters. Read More

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October 2020

Cause of Mortality after Radical Prostatectomy and the Impact of Comorbidity in Men with Prostate Cancer: A Multi-institutional Study in Korea.

Cancer Res Treat 2020 Oct 3;52(4):1242-1250. Epub 2020 Jul 3.

Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Purpose: This study aimed to examine the causes of death in Korean patients who underwent radical prostatectomy for prostate cancer and investigate the relationship between comorbidity and mortality.

Materials And Methods: We conducted a retrospective multicenter cohort study including 4,064 consecutive patients who had prostate cancer and underwent radical prostatectomy between January 1998 and June 2013. The primary endpoint of this study was all-cause mortality, and the secondary endpoints were cancer-specific mortality (CSM) and other-cause mortality (OCM). Read More

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October 2020

The Use of Cumulative Sum Analysis to Derive Institutional and Surgeon-Specific Learning Curves for Robot-Assisted Radical Prostatectomy.

J Endourol 2020 09 31;34(9):969-973. Epub 2020 Jul 31.

Department of Urology, St. Luke's International Hospital, Tokyo, Japan.

The cumulative sum (CUSUM) approach has been adopted to evaluate surgical competence in various contexts. The CUSUM method comprises sequential monitoring of cumulative differences from a target level in performance quality over time, allowing the detection of deviations from the target. We use the CUSUM method in this study to derive both institutional and surgeon-specific learning curves for robot-assisted radical prostatectomy (RARP). Read More

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September 2020

Can we define reliable risk factors for anastomotic strictures following radical prostatectomy?

Urologia 2020 Nov 27;87(4):170-174. Epub 2020 Jun 27.

Department of Urology, Ludwig Maximilian University of Munich, Munich, Germany.

Background: To identify risk factors for anastomotic strictures in patients after radical prostatectomy.

Methods: In all, 140 prostate cancer patients with one or more postoperative anastomotic strictures after radical prostatectomy were included. All patients underwent transurethral anastomotic resection at the University Hospital of Munich between January 2009 and May 2016. Read More

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November 2020

National trends in the management of patients with positive surgical margins at radical prostatectomy.

World J Urol 2021 Apr 19;39(4):1141-1151. Epub 2020 Jun 19.

Department of Urology, Yale School of Medicine, 789 Howard Avenue, FMP 300, New Haven, CT, 06520, USA.

Purpose: To evaluate practice patterns of planned post-operative radiation therapy (RT) among men with positive surgical margins (PSM) at radical prostatectomy.

Methods: We identified 43,806 men within the National Cancer Database with pathologic node-negative prostate cancer diagnosed in 2010 through 2014 with PSM. The primary endpoint was receipt of planned (RT) within a patient's initial course of treatment. Read More

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Retzius-sparing robotic-assisted laparoscopic radical prostatectomy: racial considerations for 250 consecutive cases.

J Robot Surg 2021 Apr 29;15(2):221-228. Epub 2020 May 29.

Division of Urology, Department of Surgery, Section of Urology, Augusta University, 1120 15th Street, BA-8414, Augusta, GA, 30912-4050, USA.

Our objective is to report the functional and oncologic outcomes of a cohort of 250 consecutive prostate cancer patients undergoing a Retzius-sparing approach and to assess for racial differences in continence outcomes. This was a prospective, single-center, case series of 250 consecutive prostate cancer patients who underwent a Retzius-sparing robotic-assisted laparoscopic radical prostatectomy by a single surgeon between May 2015 and April 2019. Our primary objective was to report post-operative continence outcomes of patients undergoing this technique. Read More

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External validation of the Briganti nomogram predicting lymph node invasion in patients with intermediate and high-risk prostate cancer diagnosed with magnetic resonance imaging-targeted and systematic biopsies: A European multicenter study.

Urol Oncol 2020 11 26;38(11):847.e9-847.e16. Epub 2020 May 26.

Urology Department, Hôpital Erasme, University Clinics of Brussels, Université Libre de Bruxelles, Brussels, Belgium.

Objective: To validate a nomogram predicting lymph node invasion (LNI) in prostate cancer patients undergoing radical prostatectomy taking into consideration multiparametric-magnetic resonance imaging (mp-MRI) parameters and targeted biopsies in a western European cohort.

Patients And Methods: A total of 473 men diagnosed by targeted biopsies, using software-based MRI-ultrasound image fusion system, and operated by radical prostatectomy with extended pelvic lymph node dissection across 11 Europeans centers between 2012 and 2019 were identified. Area under the curve of the receiver operator characteristic curve, calibration plot and decision curve analysis were used to evaluated the performance of the model. Read More

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November 2020

Shape Analysis of Peripheral Zone Observations on Prostate DWI: Correlation to Histopathology Outcomes After Radical Prostatectomy.

AJR Am J Roentgenol 2020 06 31;214(6):1239-1247. Epub 2020 Mar 31.

Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, 1053 Carling Ave, C1 Radiology, Ottawa, ON K1Y 4E9, Canada.

The objective of our study was to subjectively and quantitatively assess shape features of peripheral zone (PZ) tumors at DWI compared with pathologic outcomes. During the study period, 241 consecutive men with PZ dominant prostate tumors underwent 3-T MRI including DWI before undergoing radical prostatectomy. DW images of these patients were retrospectively assessed by two blinded radiologists. Read More

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Pathologically Node-Positive Prostate Cancer: Casting for Cure When the Die Is Cast?

Cancer J 2020 Jan/Feb;26(1):58-63

Department of Urology, University of Michigan Medical School, Ann Arbor, MI.

The postoperative management of men with lymph node involved prostate cancer (pN+) remains a challenge as there is a general lack of randomized trial data and a range of management strategies. Retrospective studies suggest a variable clinic course for patients with pN+ prostate cancer. Some men progress rapidly to metastatic disease despite further therapies, whereas other men can have a period of prolonged quiescence without adjuvant androgen deprivation therapy (ADT) or radiation therapy (RT). Read More

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Preoperative prostate health index and %p2PSA as the significant biomarkers of postoperative pathological outcomes of prostate cancer in Korean males: A prospective multi-institutional study.

Investig Clin Urol 2020 01 17;61(1):42-50. Epub 2019 Dec 17.

Department of Urology, Kangwon National University School of Medicine, Chuncheon, Korea.

Purpose: To evaluate the clinical utility of percentage of serum prostate-specific antigen (proPSA) to free PSA (%p2PSA) and the prostate health index (PHI) for predicting aggressive pathological outcomes of radical prostatectomy (RP) in Korean males.

Materials And Methods: This prospective observational multicenter study included 160 Korean males who consecutively underwent RP. The predictive utility of preoperative %p2PSA and PHI for predicting the following pathological outcomes of RP including pT3 disease, pathologic Gleason sum ≥7, and Gleason sum upgrading was investigated using multivariate and decision-curve analyses. Read More

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January 2020

Impact of MRI and Targeted Biopsies on Eligibility and Disease Reclassification in MRI-positive Candidates for Active Surveillance on Systematic Biopsies.

Urology 2020 03 30;137:126-132. Epub 2019 Dec 30.

Department of Urology, Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France; Department of Urology, CHU Toulouse, Toulouse, France.

Objective: To assess the impact of concomitant targeted biopsies (TB) for predicting final disease reclassification in MRI-positive low-risk prostate cancer patients eligible for active surveillance (AS) on systematic biopsies (SB).

Materials And Methods: From a prospective database, we included all prebiopsy MRI-positive men fulfilling AS criteria at diagnosis (Toronto [n = 114], UCSF [n = 82], or PRIAS [n = 60] criteria) on SB. All patients underwent a combination of SB and software-based fusion TB, and an immediate radical prostatectomy. Read More

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