Prostate Cancer Cases Research Articles

Machine learning algorithms that predict the risk of prostate cancer based on metabolic syndrome and sociodemographic characteristics: a prospective cohort study

BackgroundGiven the rapid increase in the prevalence of prostate cancer (PCa), identifying its risk factors and developing suitable risk prediction models has important implications for public health. We used machine learning (ML) approach to screen participants with high risk of PCa and, specifically, investigated whether participants with metabolic syndrome (MetS) exhibited an elevated PCa risk.MethodsA prospective cohort study was performed with 41,837 participants in South Korea. We predicted PCa based on MetS, its components, and sociodemographic factors using Cox proportional hazards and five ML models. Integrated Brier score (IBS) and C-index were used to assess model performance.ResultsA total of 210 incident PCa cases were identified. We found good calibration and discrimination for all models (C-index ≥ 0.800 and IBS = 0.01). Importantly, performance increased after excluding MetS and its components from the models; the highest C-index was 0.862 for survival support vector machine. In contrast, first-degree family history of PCa, alcohol consumption, age, and income were valuable for PCa prediction.ConclusionML models are an effective approach to develop prediction models for survival analysis. Furthermore, MetS and its components do not seem to influence PCa susceptibility, in contrast to first-degree family history of PCa, age, alcohol consumption, and income.

Radical prostatectomy outcomes of prostate cancer cases: Insights from a leading surgeon's experience in Azerbaijan.

Prostate cancer is a significant health concern worldwide and ranks as the 4th most frequent cancer among men in Azerbaijan. While robot-assisted laparoscopic radical prostatectomy is the preferred surgical technique in many countries, open retropubic radical prostatectomy (ORP) remains the primary treatment option in Azerbaijan due to limited access to robotic surgical systems. This study aims to analyze the outcomes of ORP in patients with local and locally advanced prostate cancer. We retrospectively evaluated 95 men who underwent extraperitoneal retropubic ORP for prostate cancer at our center between May 2020 and December 2023. Comprehensive data on patient demographics, preoperative parameters, surgical details, and postoperative outcomes were collected. Statistical analyses were conducted using IBM SPSS 27.0 software. The mean age of the patients was 65.9 years. The median preoperative PSA level was 14.8 ng/mL, and lymph node enlargement was identified in 29.5% of patients. A rectal injury occurred in one patient (1.1%) as the only intraoperative complication. The mean intraoperative blood loss was 330 mL, and the median hospital stay was 6 days. A positive surgical margin was observed in 38.9% of cases. Diabetes mellitus and higher intraoperative blood loss were associated with prolonged hospital stays (≥ 7 days). Erectile dysfunction was reported in 52.6% of patients 6 months postoperatively, while urinary incontinence was observed in 2.2%. ORP outcomes in Azerbaijan are comparable to those reported for laparoscopic and robot-assisted techniques in terms of perioperative and oncological results. Despite the absence of advanced surgical technology, ORP remains an effective treatment option for prostate cancer when performed by experienced surgeons.

Theorising masculinity, ageing, and the lived body: the case of prostate cancer

This article conceptualises how masculinity and masculine ideals are played out in relation to prostate cancer treatment and its side-effects, offering a heuristic and theoretical perspective with which to make sense of the complex interrelationship between lived gendered bodies and social structures. With the support of three case studies of older men treated for prostate cancer, the article explores how the concept of hegemonic masculinity can be used to analyse the ill and ageing body. A phenomenologically informed approach to the body, which illustrates how masculinity is lived and experienced through certain body schemas, is used. The three case studies show variation in how masculinity is enacted and embodied, illustrating actions to (1) restore and maintain masculinity through phallic experience; (2) reconstruct masculinity by connecting bodily experience to notions of the ageing and a less potent body; and (3) to counter narrowly defined notions of masculinity by dissociating or decoupling masculinity from ideals of potency and performance. With the help of the case studies, the strategies identified, and the fluidity and dynamism of the concept of hegemonic masculinity, findings reveal how inequalities between men and women are produced and maintained, in and through bodily experience, and diverse body schemas.

Occupational exposures of firefighting and prostate cancer risk in the Norwegian Fire Departments Cohort.

Excess incidence of prostate cancer (PC) is frequently observed among firefighters; however, the association with specific occupational exposures of firefighting, as well as the influence of a medical surveillance bias, remains unclear. Our aim was to study PC risk within a firefighter cohort, applying indicators of exposures. We used indicators of various firefighting exposures to examine PC risk among men in the Norwegian Fire Departments Cohort (N=4251). Incident PC cases, including clinical characteristics, were obtained from the Cancer Registry of Norway (1960-2021). Cox regression was used to estimate hazard ratios (HR) by cumulative exposure in tertiles (reference: lowest) for all, aggressive, and indolent PC, with adjustment for age and birth cohort. The cumulative incidence of PC across birth cohorts and diagnostic periods was examined. No clear associations emerged for any of the exposure indicators, although we observed an HR of 1.31 [95% confidence interval (CI) 0.63-2.72] for aggressive PC in the highest tertile of fire exposure score and 1.31 (95% CI 0.60-2.89) for indolent PC in the highest tertile of inhalation score. Assessment of cumulative incidence demonstrated a greater number of diagnoses at younger ages after 1990, particularly for indolent and unclassifiable PC. We found little support for an association between firefighting exposures and PC risk. However, our study had few cases in analyses by clinical stage. Challenges in studies of firefighters' PC risk remain, including difficulties in exposure characterization and the unclear magnitude of a medical surveillance bias.

NSQIP surgical risk calculator: a useful adjunct for the urology multidisciplinary meeting.

Surgical risk calculators are not often routinely used in Urology Multidisciplinary Meetings (MDM), and little is known about their impact on clinical decision-making. The aim of this study is to assess the utility of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) risk calculator for decision-making in the Urology MDM setting, with particular consideration given to decisions about surgical candidacy. We analysed all adult patients discussed in our Urology MDM with urological conditions whose management plan could potentially include major surgery. During a MDM, a consensus management decision was made prior to the NSQIP score being revealed to blinded team members. Any change in decision after revealing the score was documented, including rationale. Sixty-three out of 64 eligible cancer cases being discussed at MDM warranted NSQIP scores being revealed to the MDM post initial consensus. 95.2% (n = 60) did not have a change in the MDM management plan after reveal of NSQIP score. The NSQIP score led to a change in the MDM management decision in three cases: two renal cancer cases where management changed to biopsy with view to microwave ablation if positive, and one prostate cancer case, where management changed to recommend against radical prostatectomy. The NSQIP risk calculator was a useful tool and adjunct in the MDM setting. It served as a safety net where surgical risk was not initially properly estimated by team members, and reinforced decisions where there was concordance between NSQIP score and clinical judgement.

The Value of Digital Rectal Examination (DRE) in Prostate Cancer Diagnostics.

Background and objective Prostate cancer (PCA) is the most prevalent cancer among males.The National Institute for Health and Care Excellence (NICE) recommends referral to PCA diagnostic pathway based on two criteria: (1) abnormal digital rectal examination (DRE)and (2) elevated prostate-specific antigen (PSA).This study evaluates the diagnostic value of routine DRE in patients undergoing PCA assessment with pre-biopsy MRI. Methods We conducted a retrospective analysis of 436 patients on the PCA diagnostic pathway between September 2019 and June 2020, focusing on those with normal MRI [Prostate Imaging Reporting and Data System (PI-RADS) 1-2, n=147] and documented DRE results.Patients were categorised by their DRE status: normal vs. abnormal. The detection of prostate cancer and clinically significant prostate cancer (CSPC, i.e.,Gleason score ≥7) was then compared between the two groups. Results The overall PCA detection rate was 10.2%, while it was 4.67% for CSPC.PCA and CSPC detection were higher with abnormal DRE (19.35% and 6.45% respectively) compared to normal DRE (7.76% and 4.31%). Among 23 patients biopsied, 65% (n=15) had PCA, with CSPC found in 30% (n=7). Of note, 61% (n=14) of biopsied patients had normal DRE, with nine PCA cases, five being CSPC, whereas 39% (n=9) with abnormal DRE had six PCA cases, two being CSPC. Statistical analysis using McNemar's test showed no significant association between DRE and PCA diagnosis (p=0.146) or CSPC (p=0.774). Even thoughabnormal DRE was associated with higher PCA and CSPC detection rates, this finding was not statistically significant. Conclusions Based on our findings, PCA diagnostics can beeffectively performed without DRE. This finding is pertinent when performing remote PCA diagnostic consultations, and it reevaluatesDRE'svalue within the diagnostic pathway while emphasising a PSA- and MRI-based approach.

Diagnostic accuracy of artificial intelligence for the screening of prostate cancer in biparametric magnetic resonance imaging: a systematic review

BACKGROUND: Based on the latest published data, 40,137 new cases of prostate cancer were reported in Russia in 2021, ranking second after lung cancer in men. Thus, prostate cancer is one of the most common malignant neoplasms in men. Accurate and timely detection of prostate cancer is important under the current conditions. AIM: This systematic review aimed to assess the quality of prediction models designed to detect prostate cancer during initial presentation. MATERIALS AND METHODS: A systematic search was performed in eLibrary.ru, PubMed, Google Scholar, Web of Science, and ResearchGate for relevant publications indexed from January 2019 to September 2023 in accordance with the PRISMA protocol. Two authors independently assessed the relevant studies for potential inclusion or exclusion. RESULTS: This systematic review meta-analysis included 21 studies. In total, data from 3,630 patients were analyzed, of which 47% had prostate cancer and 53% had benign prostate neoplasms. The mean age of the patients was 67.1 (36–90) years. In addition, 81% of the studies were based on T2-weighted imaging, 57% on diffusion-weighted imaging, and 76% on apparent diffusion coefficient. Moreover, 43% and 33% of the studies were dedicated to transition zone and prostate peripheral zone neoplasms, respectively, and 52% of the authors examined the whole prostate gland, without dividing it into zones. The most common machine-learning algorithms applied by the investigators were as follows: multiple logistic regression (76%), support vector machine (38%), and random forest (24%). Based on the meta-analysis performed for the receiver operating characteristic-area under the curve (ROC–AUC) assessment with random-effect approach in 73 prediction models described in the publications, the final ROC–AUC was 0.793 [95% CI 0.768–0.818], I2 = 86.71%, p 0.001. The most accurate prediction models were based on the T2-weighted imaging + apparent diffusion coefficients imaging protocol: 0.860 [95% CI 0.813–0.907], and models created according to the “white box” principle (0.834 [95% CI 0.806–0.861]) were more accurate than the “black box” ones (0.733 [95% CI 0.695–0.771]). The models using radiomics and clinical features were slightly more accurate than those using the radiomics parameters alone (0.869 [95% CI 0.844–0.895] vs. 0.779 [95% CI 0.751–0.807]). Model accuracy was nearly identical across transitional and/or peripheral zone studies. CONCLUSIONS: Artificial intelligence demonstrated promising results. However, the clinical applicability may require more intensive expert inspection in healthcare institutions and evaluation of efficacy in prospective studies.

Prevalence of SPOP and IDH Gene Mutations in Prostate Cancer in a Jordanian Population.

Speckle-type POZ (SPOP) is described as an essential tumor suppressor factor in gastric cancer, colorectal cancer, and prostate cancer (PCa). SPOP gene mutations were reported in primary human PCa. Isocitrate dehydrogenase-1 (IDH1) oncogene mutations were detected in gliomas, acute myeloid leukemia, some benign and malignant cartilaginous tumors, and only 1% of PCa. This study aimed to investigate the prevalence of mutations of SPOP and IDH1 genes in PCa in the Jordanian population. One hundred formalin-fixed paraffin-embedded tissue samples were collected from patients diagnosed with prostate adenocarcinoma. The obtained specimens were subjected to genomic DNA extraction, PCR amplification, and direct sequencing of exons 4, 5, 6, and 7 of the SPOP gene and exon 6 of the IDH1 gene. SPOP gene mutations were found in 17% of PCa cases, while no mutation was detected in the screened exon 6 of the IDH1 gene. Clinicopathological data demonstrated a strong correlation between prostate-specific antigen (PSA) levels and both Gleason score (GS) and the International Society of Urological Pathology (ISUP) grade group (GG). There was no significant correlation between PSA levels and age (p = 0.816) nor there were significant associations for SPOP mutational status with age (p = 0.659), PSA levels (p = 0.395), GS (p = 0.259), and ISUP GG (p = 0.424) in the tested population. The study found a strong correlation between PSA levels and both GS and ISUP GG. It also identified a high frequency (17%) of SPOP gene mutations in Jordanian Arab PCa patients, mainly in exon 7. No IDH1 mutations were detected in exon 6.

Real-time diagnosis of sampled lesions in targeted biopsy of prostate Cancer using a novel tracer [64Cu] Cu-DOTA-PSMA-3Q: a pilot preclinical study.

Prostate-specific membrane antigen positron emission tomography (PSMA-PET) guided targeted biopsy has shown potential for detecting more prostate cancer (PCa) cases. However, relying exclusively on imaging may risk missing lesions, an issue that could be addressed by incorporating radiation-guided technology. Accordingly, we aimed to develop a novel PSMA radiotracer with a long half-life, [64Cu]Cu-DOTA-PSMA-3Q, and evaluate its targeting accuracy. Additionally, this research explored the practicability of real-time lesion verification during surgical interventions. In this study, we synthesized the radiotracer [64Cu]Cu-DOTA-PSMA-3Q and verified its PSMA specificity and safety. We prospectively enrolled 18 patients with suspected PCa for PET/CT imaging to assess the efficacy of PCa detection; 10 patients underwent targeted biopsy combined with standard template biopsy at an interval of 24h after injection. The radioactivity of the biopsy tissue was quantified in counts per minute (CPM) using a gamma spectrometer intraoperatively. The efficacy and specificity of [64Cu]Cu-DOTA-PSMA-3Q were confirmed through preclinical cell and animal studies. In clinical settings, PET/CT imaging performed 2h after injection visualized all of the PSMA-positive lesions both within and outside the prostate. The assessment of human organ radiation exposure indicated that the kidneys received the highest absorbed dose, followed by the bladder wall, salivary glands, and liver. In 10 patients, a total of 132 biopsy cores were extracted, with 53 cores histologically confirmed as PCa. The median CPM for PCa tissues was significantly greater at 134,148 CPM compared to 18,39 CPM for normal prostate tissues (P < 0.001). Receiver operating characteristic (ROC) curve analysis yielded an AUC of 0.8837, suggesting high diagnostic accuracy. The optimal diagnostic cut-off was established at 66 CPM, achieving a sensitivity of 77.36%. Radiation-guided technology using [64Cu]Cu-DOTA-PSMA-3Q improves the reliability of PSMA-PET image-guided biopsy, enables instant confirmation of sample lesions during surgical procedures, and holds potential for achieving optimized puncture outcomes. Chinese Clinical Trial Registry ChiCTR2300072655, Registered 20 June 2023.

The causal effect of serum amino acids on the risk of prostate cancer: a two-sample mendelian randomization study

Prostate cancer (PCa) is the second most common malignancy affecting men globally. Recent advances in metabolomics have highlighted significant alterations in specific amino acid (AA) metabolism linked to PCa, indicating their potential utility in diagnosis and therapy. However, no direct causal association between serum AA levels and PCa risk has been established. A total of 35 patients with PCa and 30 individuals with benign prostatic hyperplasia (BPH) were recruited for this study. Targeted metabolomic analysis was performed using ultra-high-performance liquid chromatography-tandem mass spectrometry on serum samples. Two-sample Mendelian randomization (MR) was applied to explore potential causal links between serum AA levels and PCa risk, including mediator effects using dual-phase MR and assessing reverse causality through reverse MR. Results Targeted metabolomic profiling identified six amino acids—glutamate (Glu), Ser, histidine (His), arginine (Arg), aspartic acid (Asp), and glycine (Gly)—that showed significant area under the ROC curve in differentiating between BPH and PCa cases. Notably, Glu demonstrated an inverse association with PCa risk, distinct from the other AAs identified. However, definitive evidence supporting a causal relationship between low Glu levels and increased PCa risk was not observed. Our results suggest a protective role of Glu against PCa development, which may have implications for disease prognosis. Increasing dietary Glu intake may present a potential preventive or therapeutic approach for PCa.

One-Pot Sequential Enrichment of Urinary Extracellular Vesicle and miRNAs Identifies a Noninvasive Biomarker Panel for Prostate Cancer Diagnosis.

Extracellular vesicles (EVs) offer promising noninvasive alternatives for convenient and noninvasive prostate cancer (PCa) diagnosis, but inefficient EV enrichment and cargo extraction hinder discovery and validation for their clinical applications. Here, we present an integrated pipeline based on functionalized magnetic beads to streamline and enhance the efficiency of urinary EV miRNA analysis. EVs are first enriched on amphiphilic magnetic beads through chemical affinity, followed by EV lysis and the isolation of miRNAs through solid phase extraction. The new pipeline demonstrated a more than 10-fold increase in urine EV miRNA extraction efficiency compared to the traditional ultracentrifugation combined TRIzol method while reducing the sample processing time to within 1 h. The one-bead strategy further allowed us to automate the procedure on a 96-channel instrument. We applied the pipeline to analyze urine samples from 108 benign prostatic hyperplasia (BPH) controls and 92 PCa cases. Among 195 miRNA biomarkers from the literature, we prioritized 18 miRNAs for quantification and successfully validated 12 miRNAs with a ratio-based normalized method. The quantification data from BPH controls and PCa cases in the training set were subjected to a machine learning analysis of Random Forest, through which we generated a five-miRNA panel consisting of miR-148a-5p, miR-21-5p, miR-181a-5p, miR-222-3p, and miR-100-5p. This panel showed high sensitivity (89%) and specificity (72%) in the test set, highlighting immense potential of this streamlined pipeline for noninvasive diagnosis.

A Case of Metastatic Castration-resistant Prostate Cancer with Tumor Mutation Burden-high Presented Remarkable Response to Atezolizumab

ABSTRACT The anti-PD-1 antibody pembrolizumab has been demonstrated to be effective for unresectable solid tumors with high-tumor mutation burden (TMB). However, the evidence for the benefit of anti-PD-L1 antibody for prostate cancer is scare. In this case report, a patient with metastatic castration-resistant prostate cancer treated with life-prolonging agents including androgen receptor signaling inhibitors and taxanes was treated with the anti-PD-L1 antibody atezolizumab for TMB-high in the BELIEVE trial (jRCTs031190104). After initiation of atezolizumab, the prostate-specific antigen level decreased and a durable partial objective response was achieved. The findings of this case support the treatment with immune checkpoint inhibitors for TMB-high prostate cancer.

Unexpectedly high variability in determining tumour extent in prostatic biopsies: implications for active surveillance.

Tumour content in prostatic biopsies is an important indicator of prostate cancer volume and patient prognosis. Consequently, guidelines typically recommend reporting it as a percentage or linear length (mm). This study aimed to determine the current practices for reporting tumour content in prostatic biopsies and evaluated the consistency among pathologists in diagnosing 10 standard biopsy cases of prostate cancer to assess interobserver variability. A web-based survey gathered data on demographics, experience and attitudes regarding the reporting of prostate cancer and its extent in biopsies. Virtual microscopy allowed analysis of 10 biopsy cases, each consisting of a single slide of prostate cancer. Self-reports from 304 participants recruited via the International Society of Urological Pathology and the German Society of Pathology were analysed. Most participants (43.4%) reported tumour extent as percentage of the biopsy core, 37.6% reported percentages and mm and 18.3% reported mm exclusively. The methods used to determine percentages showed an unexpected spread of choices, leading to considerable variability in results. Additionally, 40.8% of participants took part in the practical segment of the survey. The reported measures of tumour extent confirmed a notable interobserver variability, which was significantly higher for reported percentages. A high rate of interobserver variability in reporting tumour content in prostatic biopsies was found. This matter is especially critical for patients who are candidates for active surveillance. Reporting absolute measures of tumour content has the advantage of lower variability in comparison to percentages.

The Association between Systemic Inflammation and the Prostate Cancer: based on the National Health and Nutrition Examination Survey and Mendelian Randomization Analysis.

The purpose of this combination research was to examine the relationship between systemic inflammation and the risk of prostate cancer (PCa) through the National Health and Nutrition Examination Survey (NHANES) cross-sectional study and two-sample Mendelian randomization (MR) analysis. We incorporated NHANES data spanning the years 2001 to 2010, with exposure as systemic inflammation, evaluated using systemic immune-inflammation index (SII) and outcome as PCa, and performed multivariate logistic regression and restricted cubic spline (RCS) to test the correlation between SII and PCa. Further, two-sample MR was used to identify causal associations between specific immune cells and PCa. A total of 7706 participants (age≥40 years) were included in the analysis in the cross-sectional study, including 350 PCa cases, 7356 controls. Higher SII levels were associated with increased odds of PCa (P<.05). The odds ratio (OR) for PCa was 1.51 (95% CI 1.09-2.08) for the highest versus lowest quartile of SII levels in the fully adjusted model. Also, the RCS analysis showed a threshold effect, with SII levels above 8.90 associated with increased odds of PCa. In addition, MR results suggested a causal relationship between CD62L- monocyte, CD62L- HLA DR+ monocyte, CD14+ CD16+ monocyte, CD62L- Dendritic Cell, Monocytic Myeloid-Derived Suppressor Cell, CD28- CD8dim T cell, CD39+ resting CD4 regulatory T cell and PCa (P<.05). This combination analysis provides evidence for a significant causal relationship between systemic inflammation and PCa risk. These findings highlight systemic inflammation and inflammatory immune responses as potential modifiable risk factors for PCa.

Germline sequence variation in cancer genes in Rwandan breast and prostate cancer cases

Cancer genetic data from Sub-Saharan African (SSA) are limited. Patients with female breast (fBC), male breast (mBC), and prostate cancer (PC) in Rwanda underwent germline genetic testing and counseling. Demographic and disease-specific information was collected. A multi-cancer gene panel was used to identify germline Pathogenic Variants (PV) and Variants of Uncertain Significance (VUS). 400 patients (201 with BC and 199 with PC) were consented and recruited to the study. Data was available for 342 patients: 180 with BC (175 women and 5 men) and 162 men with PC. PV were observed in 18.3% fBC, 4.3% PC, and 20% mBC. BRCA2 was the most common PV. Among non-PV carriers, 65% had ≥1 VUS: 31.8% in PC and 33.6% in BC (female and male). Our findings highlight the need for germline genetic testing and counseling in cancer management in SSA.

Effectiveness of Systemic Immune-Inflammatory Index in Predicting Bone Metastasis in Newly Diagnosed Prostate Cancer Patients

Objective To explore the effectiveness of systemic immune inflammation index (Systemic immune-inflammation index, SII) in predicting bone metastasis in patients with newly diagnosed prostate cancer (Prostatic cancer, PCa). Methods The retrospective analysis of 200 cases of prostate cancer from January 2020 to June 2023 and 70 cases of bone metastasis compared the expression difference of SII between the two groups and analyzed the clinical diagnostic value of SII in prostate cancer bone metastasis. The resulting SII in the bone metastasis group was 500.63(351.24-696.57) 109/ L, the SII in the no-bone metastasis group was 350.12(258.41-529.40) 109/ L, statistically significant, P &lt;0.05. The ROC curve analysis revealed that its sensitivity was 68.63% and its specificity was 60.95%. Conclusion System immune inflammation index (SII) has certain application value for bone metastasis in patients with newly diagnosed prostate cancer (PCa), and high level of SII indicates poor prognosis, which is worth further clinical study.

FDG PET/CT Scan Still Can Help in Evaluation of Prostate Cancer.

Although 18F-FDG PET/CT scan is not the preferred modality to evaluate prostate cancer patients due to generally low uptake of FDG in prostate cancer cells, it can still be helpful in some selected cases with diagnostic dilemma. Here we are presenting an unusual prostate cancer case, status post radical prostatectomy, with heterogenous uptake in osseous lesions on 68Ga-PSMA PET/CT scan and low PSA values. He was referred for further evaluation with 18F-FDG PET/CT scan, revealing widely metastatic lesions in bone and liver, in addition to mildly avid recurrence in prostatectomy surgical bed and also metastasis in the spleen.

Prostate cancer incidence rates, trends, and treatment related to prostate-specific antigen screening recommendations in the United States

BackgroundChanges in US prostate-specific antigen (PSA) screening guidelines have impacted prostate cancer (PCa) incidence rates and trends. This study shows corresponding changes in PCa incidence rates and describes treatment patterns by tumor stage, age, and race/ethnicity. MethodsAnalyses were based on 777,152 cases diagnosed in 17 population-based tumor registries in the SEER Program of the US National Cancer Institute, 2007–2021. Rates were age adjusted and trends assessed using annual percent change and joinpoint regression. ResultsPCa age-adjusted incidence rates (per 100,000) fell from 165.8 in 2007 to 101 in 2014 (APC=-6.51, p<0.05) and then rose to 121.2 in 2021 (APC=1.87, p< 0.05). The significant fall and rise in rates appeared in ages 55–69 and ≥70, all racial/ethnic groups (except in Hispanics during 2014–2021), and in local/regional stage. PCa incidence rates by tumor stage, age, and race/ethnicity were presented and discussed. A few PCa cases were identified through autopsy or death certificate among the racial/ethnic groups (0.68 %-1.37 %). Unstaged cases identified through sources other than autopsy or death certificate significantly varied by race/ethnicity, ranging from 4.13 % for non-Hispanic (NH) Whites to 9.5 % for Hispanic (Chi-square p <.0001). In 2017–2021, surgery occurred in 33 % of cases (primarily in local/regional cases, inversely associated with age), radiation in 30 % of cases (increasing with age in local/regional stage cases and decreasing with age in distant stage cases), and chemotherapy in 2 % of cases (<1 % in local/regional stage cases and 9 %-38 % for age groups in distant stage cases). Several racial/ethnic differences in treatment exist, such as NH Blacks (vs. NH Whites) with local/regional disease were significantly less likely to receive surgery and more likely to receive radiation. ConclusionsUnderstanding trends and patterns of PCa rates and treatment among patients by tumor stage, age, and race/ethnicity can guide public health planning in relation to screening and treatment.

Diagnostic Value of Radiomics Based on Various Diffusion Models in Magnetic Resonance Imaging for Prostate Cancer Risk Stratification.

The use of Magnetic Resonance Imaging (MRI) and radiomics improves the management of Prostate Cancer (PCa) and helps in differentiating between clinically insignificant and significant PCa. This study has explored the diagnostic value of radiomic analysis based on functional parameter maps from monoexponential and diffusion kurtosis models in MRI for differentiating between clinically insignificant and significant PCa. In total, 105 PCa cases, including 38 clinically insignificant and 67 clinically significant PCa cases, were retrospectively analyzed. The patients were randomly divided into training and testing sets in a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed, and 1,352 radiomic features were extracted from ADC, MD, and MK images. Clinical, radiomic, and clinical-radiomic models were developed and compared using receiver operating characteristic curve analysis, decision curve analysis, and calibration curves. Clinical variables, such as TPSA, PI-RADS, and FPSA, were identified as independent risk factors for differentiating between clinically insignificant and significant PCa. In radiomics, three features were identified as highly weighted indicators. The clinical-radiomic model based on the clinical and radiomic features demonstrated the highest predictive efficacy for clinically insignificant and significant PCa, with area under the curve values of 0.940 and 0.861 in the training and test sets, respectively. The predictive model constructed from clinical and radiomic features exhibited substantial diagnostic differentiation capabilities for clinically insignificant and significant PCa. The clinical-radiomic model displayed the highest predictive performance, promising significant contributions to future clinical treatment and assessment of PCa.

Testicular Metastasis: Uncommon Prostate Cancer Case Report

Introduction: Prostate cancer is the second most frequent neoplasm in men, and despite being frequently diagnosed, testicular metastases are rarely described. Objective: to report a case of prostate cancer with testicular metastasis in a patient with more than 15 years of follow-up. Case Report: Caucasian male patient diagnosed with prostate cancer in 2003 and bone metastasis in 2005. After years of follow-up and hormonal treatment, evolved with urinary retention. He underwent transvesical prostatectomy and bilateral orchiectomy. The anatomopathological examination indicated metastatic adenocarcinoma in the right testis. Conclusion: This case demonstrates that prostate cancer can metastasize to rare sites, such as the testis. The presence of these reports helps clinical practice and adds to the literature, encouraging further studies on diagnostic approaches and treatment.