A Case of Triplet Therapy Showing Remarkable Efficacy for Multiorgan Metastatic Recurrence After Radical Prostatectomy in Prostate Cancer

RADICALS-HD: Reflections before the Results are Known

LIFE AFTER RADICAL PROSTATECTOMY: A LONGITUDINAL STUDY

Lifelong Yearly Prostate Specific Antigen Surveillance is Not Necessary for Low Risk Prostate Cancer Treated With Radical Prostatectomy

Radical Prostatectomy After Previous Prostate Surgery: Clinical and Functional Outcomes

Prognostic Implications of Multiparametric Magnetic Resonance Imaging and Concomitant Systematic Biopsy in Predicting Biochemical Recurrence After Radical Prostatectomy in Prostate Cancer Patients Diagnosed with Magnetic Resonance Imaging–targeted Biopsy

BackgroundBone metastasis is a serious complication following radical prostatectomy in prostate cancer patients, significantly affecting their long-term survival. This study aims to develop a clinical predictive model utilizing Magnetic Resonance Imaging (MRI) and advanced machine learning algorithms to identify key factors that increase the risk of bone metastasis (BM).Patients and methodsThe study analyzed a cohort of 1161 prostate cancer patients, including 38 who developed bone metastasis. Preoperative T2-weighted images (T2WI) were obtained, and tumor lesions were manually delineated to extract relevant features from the imaging data. Spearman correlation analysis, the least absolute shrinkage and selection operator (LASSO) algorithm, and logistic regression were used to select and construct the model. Four machine learning algorithms—extreme gradient boosting (XGBoost), random forest (RF), support vector machine (SVM), and k-nearest neighbor (KNN)—were employed to predict BM occurrence, integrating these with clinical information.ResultsAmong the four prognostic models evaluated, the XGBoost algorithm performed the best. In the training dataset, the XGBoost model achieved an AUC of 0.926 (0.870-0.982), an accuracy of 0.847 (0.773-0.921), a sensitivity of 0.880 (0.835-0.926), and a specificity of 0.829 (0.755-0.904). In the validation dataset, the XGBoost model attained an AUC of 0.706 (0.586-0.826), an accuracy of 0.687 (0.661-0.713), a sensitivity of 0.693 (0.557-0.829), and a specificity of 0.664 (0.505-0.822). The external validation dataset yielded an AUC of 0.91, demonstrating the robust predictive capabilities of the XGBoost model.ConclusionThe predictive model for bone metastasis in prostate cancer, developed using the XGBoost machine learning algorithm, shows high accuracy and significant clinical relevance. This model provides a valuable tool for identifying high-risk patients, potentially informing better management and treatment strategies.

Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Timing of Androgen Deprivation Therapy and its Impact on Survival After Radical Prostatectomy: A Matched Cohort Study

Whether the conventional 1.5-month to 2.0-month time interval following radical prostatectomy (RP) for prostate cancer (PC) is sufficient to accurately document a persistent prostate-specific antigen (PSA) remains unanswered. To evaluate the time necessary to accurately document a persistent PSA level after RP. This cohort study evaluated whether a significant interaction existed between (1) a pre-RP PSA level greater than 20 ng/mL vs 20 ng/mL or less and (2) persistent PSA vs undetectable PSA after RP on PC-specific mortality (PCSM) risk and all-cause mortality (ACM) risk, adjusting for known PC prognostic factors, age at RP, year of RP, and the time-dependent use of post-RP radiation therapy (RT) and androgen deprivation therapy (ADT). Whether an increasing persistent PSA level was associated with a worse prognosis was also investigated. Patients with T1N0M0 to T3N0M0 PC treated with RP between 1992 and 2020 at 2 academic centers were included. Follow-up data were collected until November 2023. Data were analyzed from July 2024 to January 2025. RP. Adjusted hazard ratio (aHR) of ACM and PCSM risk. Of 30 461 patients included in the discovery cohort, the median (IQR) age was 64 (59-68) years; of 12 837 patients included in the validation cohort, the median (IQR) age was 59 (54-64) years. Compared with patients with undetectable PSA, among patients with persistent PSA, a pre-RP PSA level greater than 20 ng/mL vs 20 ng/mL or less was significantly associated with reduced ACM risk (aHR, 0.69; 95% CI, 0.51-0.91; P = .01; P for interaction < .001) and PCSM risk (aHR, 0.41; 95% CI, 0.25-0.66; P < .001; P for interaction = .02). This result remained after adjustment for prostate volume and was confirmed in the validation cohort for PCSM risk and may represent a higher proportion of patients with a pre-RP PSA greater than 20 ng/mL vs 20 ng/mL or less who could have reached an undetectable PSA level if additional time for PSA assessment occurred before initiating post-RP therapy for presumed persistent PSA. Notably, there was more frequent and a shorter median time to post-RP RT plus ADT or ADT use in patients with a pre-RP PSA greater than 20 ng/mL (244 of 446 [54.7%] at a median [IQR] of 2.68 [1.51-4.40] months) vs 20 ng/mL or less (338 of 972 [34.8%] at a median [IQR] of 3.30 [2.00-5.39] months). These treatment times were shorter than the times to an undetectable PSA in observed patients (median [IQR] of 2.96 [1.84-3.29] months vs 3.37 [2.35-4.09] months, respectively). Increasing persistent PSA level was associated with an increased ACM risk (aHR, 1.14; 95% CI, 1.04-1.24; P = .004) and PCSM risk (aHR, 1.27; 95% CI, 1.12-1.45; P < .001). PSA level assessed for at least 3 months after RP may minimize overtreatment, and in this study, a higher persistent PSA level was associated with a worse prognosis.

Predicting Biochemical Recurrence-Free Survival for Patients With Positive Pelvic Lymph Nodes at Radical Prostatectomy

MP6-05 THE ASSOCIATION OF PREOPERATIVE NEUTROPHIL TO LYMPHOCYTE RATIO WITH ONCOLOGIC OUTCOMES FOLLOWING RADICAL PROSTATECTOMY FOR PROSTATE CANCER

Point-Counterpoint: Radioisotope-guided Lymphadenectomy for Pelvic Node Staging: The SENTINELLE Study.

MP37-18 SOX2 IS ASSOCIATED WITH EXTRACAPSULAR EXTENSION FOLLOWING RADICAL PROSTATECTOMY FOR PROSTATE CANCER

LONG-TERM HAZARD OF PROGRESSION AFTER RADICAL PROSTATECTOMY FOR CLINICALLY LOCALIZED PROSTATE CANCER: CONTINUED RISK OF BIOCHEMICAL FAILURE AFTER 5 YEARS

RADICAL PROSTATECTOMY IN A COMMUNITY PRACTICE