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World J Urol 2020 Jun 19. 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

J Robot Surg 2020 May 29. 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

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

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

Clin Genitourin Cancer 2020 04 19;18(2):95-104. Epub 2019 Jul 19.

Department of Urology, University of Modena and Reggio Emilia, Modena, Italy. Electronic address:

Histopathologic examination of the pathologic specimens using hematoxylin & eosin stains represents the backbone of the modern pathology. It is time-consuming; thus, "real-time" assessment of prostatic and periprostatic tissue has gained special interest in the diagnosis and management of prostate cancer. The current study focuses on the review of the different available techniques for "real-time" evaluation of surgical margins during radical prostatectomy (RP). Read More

J Cancer Res Clin Oncol 2020 Mar 19;146(3):687-694. Epub 2019 Nov 19.

Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 1630 Dong Fang Road, 200127, Shanghai, China.

Objective: To assess the use of the cell cycle progression (CCP) score versus actual risk stratification practice in making treatment decisions for prostate cancer patients with locally adverse pathology after radical prostatectomy (RP).

Patients And Methods: Men with adverse pathologic features, pT3 or positive surgical margins who underwent RP in 2010-2014 at Renji hospital were retrospectively analyzed. The primary outcome was biochemical recurrence (BCR) after RP. Read More

Urology 2020 Mar 6;137:102-107. Epub 2019 Nov 6.

Department of Urology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA. Electronic address:

Objective: To assess the impact of excluding Gleason Grade Group 1 (GG1) prostate cancer (CaP) cores from current pre-radical prostatectomy (RP) nomograms.

Methods: Multi-institutional retrospective chart review was performed on all RP patients with prostate biopsy between 2008 and 2018. Patients were individually assessed using the Memorial Sloan Kettering Cancer Center (MSKCC) and Briganti nomograms using the following iterations: (1) Original [ORIG] - all available core data and (2) Selective [SEL] - GG1 cores considered negative. Read More

Clin Genitourin Cancer 2020 04 26;18(2):e112-e121. Epub 2019 Sep 26.

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

Introduction: The purpose of this study was to investigate adherence to recommended adjuvant radiotherapy (aRT) in radical prostatectomy (RP) patients with adverse pathologic features and to analyse the outcome of patients who followed or denied this recommendation.

Patients And Methods: We included 1140 consecutive RP patients (2006-2015) with non-organ confined (pT3) prostate cancer and either positive surgical margins (R1) and/or lymph node involvement (pN1) and non-detectable postoperative prostate-specific antigen who received multidisciplinary aRT recommendations. Patients were stratified into adherence versus non-adherence to recommendations. Read More

Virchows Arch 2019 Dec 7;475(6):735-744. Epub 2019 Oct 7.

Department of Pathology, Unit of Anatomical Pathology, Department of Surgery, Faculty of Medicine, Cordoba, Spain and Champalimaud Clinical Center, Lisbon, Portugal.

Focal or non-focal/extensive extraprostatic extension of prostate carcinoma is an important pathologic prognostic parameter to be reported after radical prostatectomy. Currently, there is no agreement on how to measure and what are the best cutoff points to be used in practice. We hypothesized that digital microscopy would potentially provide more objective measurements of extraprostatic extension, thus better defining its clinical significance. Read More

Eur Urol Oncol 2020 Feb 4;3(1):10-20. Epub 2019 Sep 4.

Weill Cornell Medical College, New York, NY, USA. Electronic address:

Context: Multiparametric magnetic resonance imaging (mpMRI)-targeted transrectal prostate biopsy (TBx) may better predict pathology at radical prostatectomy than systematic transrectal prostate biopsy (SBx).

Objective: To assess concordance between biopsy and radical prostatectomy pathology in men undergoing a TBx as compared with those undergoing an SBx.

Evidence Acquisition: Four electronic databases (Ovid MEDLINE, Ovid EMBASE, the Cochrane Library [Wiley], and EBSCHOHost) were searched from inception until July 2018. Read More

Clin Genitourin Cancer 2019 10 20;17(5):e1054-e1059. Epub 2019 Jun 20.

Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA. Electronic address:

Background: We tested for associations between socioeconomic status (SES) and adverse prostate cancer pathology in a population of African American (AA) men treated with radical prostatectomy (RP).

Patients And Methods: We retrospectively reviewed data from 2 institutions for AA men who underwent RP between 2010 and 2015. Household incomes were estimated using census tract data, and patients were stratified into income groups relative to the study population median. Read More

Urol Oncol 2019 09 14;37(9):574.e19-574.e24. Epub 2019 Jun 14.

Department of Urology, Tel-Aviv Sourasky Medical Center, Sackler School Of Medicine, Tel-Aviv University, Tel Aviv-Yafo, Israel.

Introduction: Data on the accuracy of 68Ga-PSMA positron emission tomography/computed tomography (PET/CT) in patients with intermediate/high-risk prostate cancer are being accumulated. Its role in assessing the extent of local disease has not been fully elaborated.

Aim: To determine the performance characteristics of 68Ga-PSMA PET/CT in identifying local disease extension in patients with intermediate/high risk prostate cancer. Read More

Lipids Health Dis 2019 May 28;18(1):124. Epub 2019 May 28.

Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

Background: Lipid profiles are believed to play an important role in the tumorigenesis and progression of prostate cancer (PCa), but research combining those data is lacking. Therefore, this meta-analysis aims to assess the prognostic role of lipid profiles after RP.

Method: We systematically searched PubMed, Embase, and Cochrane Library Central Register of Controlled Trials for articles evaluating association between lipid profiles and prognosis after RP. Read More

AJR Am J Roentgenol 2019 10 23;213(4):836-843. Epub 2019 May 23.

Department of Medical Imaging, The Ottawa Hospital, 1053 Carling Ave, Rm C159, Ottawa, ON K1Y 4E9, Canada.

The purpose of this study is to evaluate dynamic contrast-enhanced (DCE) MRI (DCE-MRI)-upgraded Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) peripheral zone (PZ) observations stratified by a size threshold of 15 mm. Two blinded radiologists independently assessed 301 patients with 326 clinically significant tumors (Gleason score [GS] ≥ 7) using multiparametric MRI performed before radical prostatectomy (RP) between 2012 and 2017 and then assigned PI-RADSv2 scores for the tumors. PI-RADSv2 category 3 PZ observations upgraded on the basis of abnormal DCE-MRI findings were tabulated, agreement was calculated, and discrepancies were resolved by consensus. Read More

Am J Surg Pathol 2019 08;43(8):1061-1065

Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY.

In the eighth edition AJCC staging, all organ-confined disease is assigned pathologic stage T2, without subclassification. We investigated whether total tumor volume (TTV) and/or maximum tumor diameter (MTD) of the index lesion are useful in improving prediction of biochemical recurrence (BCR) in pT2 patients. We identified 1657 patients with digital tumor maps and quantification of TTV/MTD who had pT2 disease on radical prostatectomy (RP). Read More

Int Urol Nephrol 2019 Aug 16;51(8):1349-1355. Epub 2019 May 16.

Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Building 10, Room 3-1621 NW, Bethesda, MD, 20814, USA.

Purpose: Index tumor volume (ITV) measured on radical prostatectomy (RP) specimens has been shown to be associated with adverse pathologic and oncologic outcomes. We evaluate the value of ITV calculated from prostate multiparametric MRI (mpMRI) in predicting adverse clinical and pathologic outcomes.

Materials And Methods: Data from a prospectively maintained, single-institution database were analyzed for patients who underwent mpMRI prior to RP (2007-2016). Read More

Urology 2019 Aug 30;130:113-119. Epub 2019 Apr 30.

Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium.

Objective: To investigate the impact of magnetic resonance imaging (MRI) information on clinical staging, risk stratification, and treatment recommendations for prostate cancer (PCa) according to the European Association of Urology (EAU) guidelines.

Methods: We performed a single-center analysis of 180 men with PCa, undergoing clinical staging by digital rectal examination (DRE) as well as MRI before their robot-assisted radical prostatectomy. Patients were stratified according to the EAU guidelines into 4 well-defined risk categories, based on their clinical T-stage assessed by either DRE or MRI. Read More

Prostate Cancer Prostatic Dis 2019 12 17;22(4):617-623. Epub 2019 Apr 17.

Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Background: This study aims to assess the effect of statin therapy on outcomes among men managed with active surveillance.

Methods: This is a retrospective cohort study evaluating 635 men managed with active surveillance from 2005 to 2015 at a large, academic medical center. The primary endpoints of analyses are disease reclassification (i. Read More

Asian Pac J Cancer Prev 2019 Mar 26;20(3):783-788. Epub 2019 Mar 26.

Department of Urology, Kitasato University Kitasato Institute Hospital, Tokyo, Japan. Email:

Objective: Several prognostic factors for biochemical recurrence after radical prostatectomy have been reported, including initial prostate-specific antigen level, Gleason score, positive surgical margin, and seminal vesicle invasion. Here we investigate whether Gleason pattern 5 is a predictor for biochemical recurrence. Methods: This retrospective study included 168 patients who underwent laparoscopic radical prostatectomy from 2006 to 2015. Read More

Urology 2019 05 10;127:80-85. Epub 2019 Feb 10.

Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address:

Objective: To analyze the factors associated with Grade group (GG) downgrading post-radical prostatectomy.

Patients And Methods: We performed a retrospective analysis of 536 patients who underwent robot-assisted laparoscopic radical prostatectomy from February 2014 to October 2015. We have analyzed the clinical, radiological, and pathologic factors associated with GG downgrading in final pathology. Read More

Radiology 2019 03 22;290(3):709-719. Epub 2019 Jan 22.

From the Department of Urology and Pediatric Urology, University Medical Center, Mainz, Germany (S.M.); Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Md (S.M., J.B., S.G., G.H., K.R., P.A.P.); Molecular Imaging Program, National Cancer Institute, National Institutes of Health, 10 Center Dr, MSC 1182, Building 10, Room B3B85, Bethesda, MD 20892-1088 (S.M., C.S., M.C., P.L.C., B.T.); Division of Cancer Treatment and Diagnosis: Biometric Research Program, National Cancer Institute, National Institutes of Health, Rockville, Md (J.H.S.); Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, NCI Campus at Frederick, Frederick, Md (S.H.); Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Md (M.J.M.); and Center for Interventional Oncology, National Cancer Institute and Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Md (B.J.W.).

Purpose To evaluate MRI features associated with pathologically defined extraprostatic extension (EPE) of prostate cancer and to propose an MRI grading system for pathologic EPE. Materials and Methods In this prospective study, consecutive male study participants underwent preoperative 3.0-T MRI from June 2007 to March 2017 followed by robotic-assisted laparoscopic radical prostatectomy. Read More

Minerva Urol Nefrol 2019 Jun 17;71(3):264-272. Epub 2019 Jan 17.

Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy.

Background: The knowledge of tumor location and extension can allow a modulated radical prostatectomy in order to minimize positive surgical margins and reduce functional morbidity after surgery in patients with prostate cancer (PCa). Multiparametric (mp) magnetic resonance imaging (MRI) could allow the assessment of tumor extension and of its relationship with external structures. Aim of this study is to propose a new radiological Wheeler (rW) staging system applied to mp-MRI, based on the pathologic staging system (pW) for the local assessment of PCa. Read More

Urology 2019 04 3;126:76-82. Epub 2019 Jan 3.

Blue Earth Diagnostics, Inc., Burlington, MA.

Objective: To validate the 17-gene Oncotype DX Genomic Prostate Score (GPS) biopsy-based gene expression assay as a predictor of adverse pathology (AP, Gleason score [pGS] ≥4+3and/or ≥pT3) in a prospectively enrolled cohort.

Methods: Between July 2014 and September 2015, 1200 men with very low-, low-, and favorable intermediate-risk prostate cancer enrolled in a multi-institutional prospective study of the GPS assay (NCT03502213). The subset who proceeded to immediate radical prostatectomy (RP) after GPS testing was included in a prespecified subanalysis of GPS on biopsy and its association with surgical AP on RP using logistic regression and receiver operating characteristic curves. Read More

Turk J Urol 2018 Aug 17. Epub 2018 Aug 17.

Department of Urology, İstanbul Medeniyet University, İstanbul, Turkey.

Objective: To investigate the factors to predict Gleason score upgrading (GSU) of patients with prostate cancer who were evaluated by using the International Society for Urological Pathology (ISUP) 2014 Gleason grading system.

Material And Methods: Between January 2008 and December 2015, we retrospectively investigated patients who had undergone radical prostatectomy and followed up in the uro-oncology outpatient clinic. The pathologic specimens of the patients were evaluated based on the ISUP 2014 classification system. Read More

Urol Oncol 2018 12 13;36(12):528.e7-528.e13. Epub 2018 Nov 13.

Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX; Department of Urology, Weill Cornell Medical College, New York, NY. Electronic address:

Purpose: To evaluate the predictive and prognostic role as well as the clinical impact on decision-making of serum cholinesterase (ChoE) levels in patients treated with radical prostatectomy for clinically nonmetastatic prostate cancer.

Materials And Methods: We conducted a retrospective analysis of our multi institutional database. Preoperative ChoE was evaluated as continuous and dichotomized variable using a visual assessment of the functional form of the association of ChoE with biochemical recurrence (BCR)-free survival. Read More

Actas Urol Esp 2019 03 22;43(2):84-90. Epub 2018 Oct 22.

Servicio de Cirugía General y Digestiva, Hospital Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España.

Introduction: Given the high prevalence of erectile dysfunction in male population between 40-70 years old and the effect of radical prostatectomy on this domain, it is important to perform a baseline study.

Material And Methods: Prior radical prostatectomy, erectile function has been assessed prospectively in 112 prostate cancer patients using the erectile function (EF) domain of the International Index of Erectile Function (EF-IIEF), Erectile Hardness Score (EHS) and a penile doppler ultrasound (PDUS). Comorbidities and Charlson index were collected. Read More

World J Urol 2019 Jul 22;37(7):1321-1328. Epub 2018 Oct 22.

Department of Urology, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, South Korea.

Purpose: Prostate-specific antigen nadir and time to prostate-specific antigen nadir are predictors of disease progression in patients who undergo radical prostatectomy. However, a mutually conflicting relationship exists between them. Thus, we compared postoperative prostate-specific antigen levels at the first follow-up with the expected levels while considering the half-life of prostate-specific antigen to improve the prediction of biochemical failure after radical prostatectomy in patients with adverse pathologic features. Read More

Am Fam Physician 2018 06;97(12):798-805

Eastern Virginia Medical School, Portsmouth, VA, USA.

In the United States, prostate cancer will be diagnosed in one out of seven men in his lifetime. Most cases are localized, and only one in 39 men will die from the disease. Prostate cancer is most often detected using serum prostate-specific antigen testing. Read More

BMC Urol 2018 Sep 10;18(1):78. Epub 2018 Sep 10.

Institut du cancer de Montréal and Centre de recherche du Centre hospitalier de l'Université de Montréal, 900, St-Denis St, room R10-464, Montréal, Québec, H2X 0A9, Canada.

Background: Refinement of parameters defining prostate cancer (PC) prognosis are urgently needed to identify patients with indolent versus aggressive disease. The Canadian Prostate Cancer Biomaker Network (CPCBN) consists of researchers from four Canadian provinces to create a validation cohort to address issues dealing with PC diagnosis and management.

Methods: A total of 1512 radical prostatectomy (RP) specimens from five different biorepositories affiliated with teaching hospitals were selected to constitute the cohort. Read More

Eur Urol 2018 11 1;74(5):668-675. Epub 2018 Sep 1.

Department of Urology, University of California San Francisco, San Francisco, CA, USA.

Background: Despite the availability of numerous genomic predictors of prostate cancer (PCa) outcome, few comparative studies have been performed.

Objective: To compare the prognostic utility of previously validated immunohistochemical (IHC) markers with an expression-based cell-cycle progression (CCP) score.

Design, Setting, And Participants: We identified 424 men with localized PCa treated with radical prostatectomy (RP). Read More

Prostate Cancer Prostatic Dis 2018 11 7;21(4):594-603. Epub 2018 Aug 7.

Department of Pathology, Icahn School of Medicine at Mt. Sinai, 1468 Madison Avenue, New York City, NY, 10029, USA.

Background: Postoperative risk assessment remains an important variable in the effective treatment of prostate cancer. There is an unmet clinical need for a test with the potential to enhance the Gleason grading system with novel features that more accurately reflect a personalized prediction of clinical failure.

Methods: A prospectively designed retrospective study utilizing 892 patients, post radical prostatectomy, followed for a median of 8 years. Read More

J Vasc Interv Radiol 2018 05 23;29(5):589-597. Epub 2018 Mar 23.

Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

Purpose: To provide initial data on tumoricidal efficacy of embolization on prostate cancer via histopathologic examination of prostatectomy specimens after embolization.

Materials And Methods: In this bicentric prospective trial, 12 men with localized prostate cancer underwent radical prostatectomy 6 weeks after prostatic artery embolization (PAE) from October 2016 to May 2017. PAE was performed with the use of 100-μm Embozene microspheres (Boston Scientific, Natick, Massachusetts). Read More

Virchows Arch 2018 Mar 16;472(3):451-460. Epub 2018 Feb 16.

Department of Pathology, Unit of Anatomical Pathology, Department of Surgery, Faculty of Medicine, Cordoba, Spain.

Positive surgical margin (PSM) extension reported as focal or non-focal/extensive is an important pathologic prognostic parameter after radical prostatectomy. Likewise, there is limited or no agreement on how to measure and what the best cut-off points to be used in practice are. We hypothesized that digital microscopy (DM) would potentially provide a more objective way to measure PSM and better define its clinical significance. Read More

World J Urol 2018 May 24;36(5):713-718. Epub 2018 Jan 24.

Texas Health Presbyterian Dallas, 8230 Walnut Hill Lane, Suite 700, Dallas, TX, 75231, USA.

Purpose: The purpose this study is to evaluate the efficacy of multiparametric ultrasound-targeted biopsies in patients undergoing initial biopsy of the prostate for the suspicion of prostate cancer.

Materials And Methods: A total of 167 patients who are biopsy naïve underwent multiparametric ultrasound-targeted biopsy of the prostate. All patients had a transrectal ultrasound which included gray-scale evaluation and color Doppler evaluation. Read More

J Korean Med Sci 2018 Jan 29;33(5):e36. Epub 2018 Jan 29.

Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

Background: Significant clinical heterogeneity within contemporary risk group is well known, particularly for those with intermediate-risk prostate cancer (IRPCa). Our study aimed to analyze the ability of the Cancer of the Prostate Risk Assessment (CAPRA) score to discern between favorable and non-favorable risk in patients with IRPCa.

Methods: We retrospectively reviewed the data of 203 IRPCa patients who underwent extraperitoneal robot-assisted radical prostatectomy (RARP) performed by a single surgeon. Read More

Asian J Urol 2017 Jan 19;4(1):31-36. Epub 2016 Nov 19.

The Smith Institute for Urology, Hofstra Northwell School of Medicine, New Hyde Park, NY, USA.

Objective: Extracapsular extension (ECE) of prostate cancer is a poor prognostic factor associated with progression, recurrence after treatment, and increased prostate cancer-related mortality. Accurate staging prior to radical prostatectomy is crucial in avoidance of positive margins and when planning nerve-sparing procedures. Multi-parametric magnetic resonance imaging (mpMRI) of the prostate has shown promise in this regard, but is hampered by poor sensitivity. Read More

Eur Urol 2018 07 10;74(1):107-114. Epub 2017 Dec 10.

Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Background: Prostate cancer patients who have a detectable prostate-specific antigen (PSA) postprostatectomy may harbor pre-existing metastatic disease. To our knowledge, none of the commercially available genomic biomarkers have been investigated in such men.

Objective: To evaluate if a 22-gene genomic classifier can independently predict development of metastasis in men with PSA persistence postoperatively. Read More

Int Urol Nephrol 2017 Dec 13;49(12):2119-2125. Epub 2017 Sep 13.

Department of Urology, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, Korea.

Purpose: Reports on the impact of a family history of prostate cancer among Asians are scarce. We evaluated whether a positive prostate cancer family history is associated with the prognosis and features of the disease.

Methods: From January 2006 to December 2015, patients who received treatment for pathologically diagnosed prostate cancer were enrolled. Read More

Oncol Res Treat 2017 10;40(9):508-514. Epub 2017 Aug 10.

Aim: The aim of this study was to clarify and examine the outcomes of prostate cancer patients classified as intermediate risk (IR) using the D'Amico risk classification system, specifically focusing on the influence of primary and secondary biopsy Gleason score (BGS).

Patients And Methods: An institutional review board-approved database of robotic-assisted radical prostatectomies performed after 2006 was stratified by standard D'Amico criteria. IR patients were then sub-stratified by BGS. Read More

Eur Urol Focus 2018 01 23;4(1):80-86. Epub 2016 Nov 23.

Division of Urology, San Luigi Gonzaga Hospital-Orbassano, University of Turin, Turin, Italy.

Background: The literature is lacking randomised controlled trials comparing robot-assisted (RARP) and laparoscopic (LRP) radical prostatectomy, especially for follow-up >1 yr.

Objective: To report 5-yr outcomes for our previously published prospective randomised study comparing RARP and LRP.

Design, Setting, And Participants: From January 2010 to January 2011, 120 patients with organ-confined prostate cancer were enrolled and randomly assigned to RARP or LRP. Read More

Eur Urol Focus 2019 01 17;5(1):69-76. Epub 2017 Jun 17.

Harvard Medical School, Boston, MA, USA; Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA, USA. Electronic address:

Background: It is unknown whether active surveillance can be safely offered to patients with Gleason 3+4 favorable intermediate-risk (FIR) prostate cancer.

Objective: To examine the incidence and predictors of upgrading and upstaging among patients with Gleason 3+4 FIR disease.

Design, Setting, And Participants: The study involved 10 089 patients in the National Cancer Database diagnosed from 2010 to 2012 with Gleason 3+4 disease, prostate-specific antigen (PSA) <10ng/ml, and cT1c-2a prostate cancer with <50% positive biopsy cores (PBCs) who underwent radical prostatectomy. Read More

JAMA Oncol 2018 Jan;4(1):89-92

The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Importance: Active surveillance is recommended for patients with very low-risk (VLR) and low-risk (LR) prostate cancer. Despite controversy, recent clinical guidelines state surveillance may be considered for men with low-volume intermediate-risk (LVIR) disease.

Objective: To compare rates of adverse pathologic findings among VLR, LR, and LVIR men electing immediate radical prostatectomy and evaluate criteria to define if a favorable intermediate-risk group minimizing risk exists. Read More

Eur J Nucl Med Mol Imaging 2017 Sep 23;44(10):1622-1635. Epub 2017 May 23.

Nuclear Medicine, Humanitas Cancer Center, Humanitas Clinical and Research Hospital, Via Manzoni 56, 20089, Rozzano, MI, Italy.

Methods: After primary treatment, biochemical relapse (BCR) occurs in a substantial number of patients with prostate cancer (PCa). PET/CT imaging with prostate-specific membrane antigen based tracers (68Ga-PSMA) has shown promising results for BCR patients. However, a standardized image interpretation methodology has yet to be properly agreed. Read More

J Cancer Res Clin Oncol 2017 Sep 18;143(9):1871-1878. Epub 2017 May 18.

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

Purpose: To evaluate the better risk stratification based on surgical pathology, and to predict oncologic outcomes after radical prostatectomy (RP) with a better scoring system in high-risk prostate cancer (PCa) patients.

Methods: We evaluated high-risk PCa patients (PSA >20 ng/ml, ≥cT3a, or Gleason score 8-10) who underwent RP between 2007 and 2013 at our institute. We classified patients into three groups according to their pathologic outcomes: favorable (pT2, Gleason score ≤7, and node negative), intermediate (specimen-confined disease (pT2-3a, node negative PCa with negative surgical margins) but not in the favorable group), and unfavorable (the remaining patients). Read More

World J Urol 2017 Oct 10;35(10):1517-1524. Epub 2017 May 10.

Department of Urology, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377, Munich, Germany.

Purpose: Gleason score upgrading should be considered when indicating surgery in prostate cancer (PCa) patients. In elderly patients, definitive treatment of low-risk PCa must be weighed with the risks of overtreatment. Our aim was to evaluate rates of Gleason score upgrading in patients ≥75 years undergoing radical prostatectomy (RP) for localized PCa and to identify predictors associated with upgrading. Read More

Urologia 2017 Apr 22;84(2):93-97. Epub 2017 Apr 22.

Department of Urology, ASST Rohdense, G. Salvini Hospital, Garbagnate Milanese, Milan - Italy.

Introduction: Three-dimensional (3D) laparoscopy with a flexible camera was developed to overcome the main limitation of traditional laparoscopic surgery, which is two-dimensional (2D) vision.The aim of our article is to present the largest casistic of 3D laparoscopic radical prostatectomy (LRP) available in literature and evaluate our results in terms of pentafecta and compare it with the literature.

Methods: We retrospectively evaluated consecutive patients who underwent LRP with 3D technology between March 2014 and December 2015. Read More

Eur Urol 2018 02 8;73(2):168-175. Epub 2017 Apr 8.

James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins School of Medicine, Baltimore, MD, USA. Electronic address:

Background: Risk of prostate cancer-specific mortality (PCSM) is highly variable for men with adverse pathologic features at radical prostatectomy (RP); a majority will die of other causes. Accurately stratifying PCSM risk can improve therapy decisions.

Objective: Validate the 22 gene Decipher genomic classifier (GC) to predict PCSM in men with adverse pathologic features after RP. Read More

J Clin Oncol 2017 Jun 28;35(18):1982-1990. Epub 2017 Mar 28.

Deepansh Dalela, Mani Menon, and Firas Abdollah, Henry Ford Health System, Detroit, MI; María Santiago-Jiménez, Kasra Yousefi, and Elai Davicioni, GenomeDx Biosciences, Vancouver, British Columbia, Canada; R. Jeffrey Karnes, Mayo Clinic, Rochester, MN; Ashley E. Ross, Johns Hopkins Hospital, Baltimore, MD; Adam P. Dicker and Robert B. Den, Thomas Jefferson University, Philadelphia, PA; Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles, CA; Edward M. Schaeffer, Northwestern University Feinberg School of Medicine, Chicago, IL; and Alberto Briganti, Vita Salute San Raffaele Hospital, Milan, Italy.

Purpose Despite documented oncologic benefit, use of postoperative adjuvant radiotherapy (aRT) in patients with prostate cancer is still limited in the United States. We aimed to develop and internally validate a risk-stratification tool incorporating the Decipher score, along with routinely available clinicopathologic features, to identify patients who would benefit the most from aRT. Patient and Methods Our cohort included 512 patients with prostate cancer treated with radical prostatectomy at one of four US academic centers between 1990 and 2010. Read More

Eur Urol 2017 08 18;72(2):238-249. Epub 2017 Mar 18.

Academic Urology Unit, The Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey, UK.

Context: The incidence of low-risk prostate cancer (PCa) has increased as a consequence of prostate-specific antigen testing.

Objective: In this collaborative review article, we examine recent literature regarding low-risk PCa and the available prognostic and therapeutic options.

Evidence Acquisition: We performed a literature review of the Medline, Embase, and Web of Science databases. Read More

Anticancer Res 2017 03;37(3):1237-1242

Department of Radiation Oncology, Cedars Sinai Medical Center, Los Angeles, CA, U.S.A.

Background/aim: We evaluated whether sub-stratifying intermediate-risk (IR) prostate cancer using the Memorial Sloan Kettering Cancer (MSKCC) or Prostate Cancer Risk Stratification (ProCaRS) model predicts for adverse imaging or pathologic features.

Patients And Methods: 56 consecutive IR patients who underwent multi-parametric MRI (mpMRI) and radical prostatectomy (RP) were studied. The different groups were tested for correlation with adverse findings. Read More