Outcome Of Prostate Cancer Patients Research Articles

Radiogenomics Reveals Correlation between Quantitative Texture Radiomic Features of Biparametric MRI and Hypoxia-Related Gene Expression in Men with Localised Prostate Cancer

To perform multiscale correlation analysis between quantitative texture feature phenotypes of pre-biopsy biparametric MRI (bpMRI) and targeted sequence-based RNA expression for hypoxia-related genes. Images from pre-biopsy 3T bpMRI scans in clinically localised PCa patients of various risk categories (n = 15) were used to extract textural features. The genomic landscape of hypoxia-related gene expression was obtained using post-radical prostatectomy tissue for targeted RNA expression profiling using the TempO-sequence method. The nonparametric Games Howell test was used to correlate the differential expression of the important hypoxia-related genes with 28 radiomic texture features. Then, cBioportal was accessed, and a gene-specific query was executed to extract the Oncoprint genomic output graph of the selected hypoxia-related genes from The Cancer Genome Atlas (TCGA). Based on each selected gene profile, correlation analysis using Pearson's coefficients and survival analysis using Kaplan-Meier estimators were performed. The quantitative bpMR imaging textural features, including the histogram and grey level co-occurrence matrix (GLCM), correlated with three hypoxia-related genes (ANGPTL4, VEGFA, and P4HA1) based on RNA sequencing using the TempO-Seq method. Further radiogenomic analysis, including data accessed from the cBioportal genomic database, confirmed that overexpressed hypoxia-related genes significantly correlated with a poor survival outcomes, with a median survival ratio of 81.11:133.00 months in those with and without alterations in genes, respectively. This study found that there is a correlation between the radiomic texture features extracted from bpMRI in localised prostate cancer and the hypoxia-related genes that are differentially expressed. The analysis of expression data based on cBioportal revealed that these hypoxia-related genes, which were the focus of the study, are linked to an unfavourable survival outcomes in prostate cancer patients.

Comparative efficacy of second-generation androgen receptor inhibitors for treating prostate cancer: A systematic review and network meta-analysis.

Second-generation androgen receptor inhibitors (SGARIs), namely enzalutamide, apalutamide, and darolutamide, are good for improving survival outcomes in prostate cancer patients, but some researchers have shown that using SGARIs increases side effects, which complicates clinicians' choice of. Therefore, we performed this network meta-analysis to assess the efficacy and toxicity of several SGARIs in the treatment of patients with metastatic hormone-sensitive prostate cancer (mHSPC), non-metastatic castration-resistant prostate cancer (nmCRPC), and metastatic castration-resistant prostate cancer (mCRPC). We searched PubMed, EMBASE and Cochrane Library databases from January 2000 to December 2022 to identify randomized controlled studies associated with SGARIs. We use Stata 16.0 and R 4.4.2 for data analysis, hazard ratio (HR) with 95% confidence intervals (CI) were used to assess the results. This meta-analysis included 7 studies with a total of 9488 patients. In mHSPC, enzalutamide and darolutamide had a positive effect on overall survival (OS) (HR, 0.70; 95% CI, 0.59-0.82), but we did not find a difference in their efficacy to improve OS (HR, 1.19; 95% CI, 0.75-1.89). Also in nmCRPC, enzalutamide, apalutamide and darolutamide were beneficial for metastasis-free survival (MFS) (HR, 0.32; 95% CI, 0.25-0.41). Compared to darolutamide, enzalutamide (HR, 0.71; 95% CI, 0.54-0.93) and apalutamide (HR, 0.68; 95% CI, 0.51-0.91) prolonged MFS, but there was no difference in efficacy between enzalutamide and apalutamide (HR, 0.97; 95% CI, 0.73-1.28). Finally in mCRPC, there was no significant difference in indirect effects on OS between pre- and post-chemotherapy enzalutamide (HR, 0.89; 95% CI, 0.70-1.13). However, using enzalutamide before chemotherapy to improve radiographic progression-free survival (rPFS) was a better option (HR, 2.11; 95% CI, 1.62-2.73). The SGARIs used in each trial were beneficial for the primary endpoint in the study. Firstly there was no significant difference in the effect of enzalutamide and darolutamide in improving OS in patients with mHSPC. Secondly improving MFS in patients with nmCRPC was best achieved with enzalutamide and apalutamide. In addition both pre- and post-chemotherapy use of enzalutamide was beneficial for OS in mCRPC patients, but for improving rPFS pre-chemotherapy use of enzalutamide should be preferred.The INPLASY registration number of this systematic review is INPLASY202310084.

Impact of an Expanded Definition of Family History on Outcomes of Active Surveillance for Prostate Cancer.

Despite family history being an established risk factor for prostate cancer, the role of a broader definition of family history inclusive of not just prostate cancer but other genetically related malignancies has not been investigated in the active surveillance population. Here, we evaluate the impact of an expanded definition of family history on active surveillance outcomes. Patients undergoing active surveillance for prostate cancer at Massachusetts General Hospital from 1997-2019 with detailed data available on family cancer history were identified. Primary outcome was biopsy progression-free survival, and secondary outcomes were treatment-free survival, adverse pathological features at prostatectomy, and biochemical recurrence after treatment. Statistical analyses were conducted using the Kaplan-Meier method and Cox regression. Among 855 evaluable patients, 300 (35.1%) patients had any family history of prostate cancer, and 95 (11.1%) had a family history of related malignancies suggestive of a hereditary cancer syndrome. Family history of prostate cancer alone was not associated with biopsy progression, whereas family history suggestive of a hereditary cancer syndrome was associated with a significantly increased risk of biopsy progression (HR 1.43, 95%CI 1.01-2.02), independent of other known clinicopathological risk factors in multivariable analysis. Similarly, family history suggestive of a hereditary cancer syndrome was associated with significantly lower treatment-free survival (HR 1.58, 95%CI 1.14-2.18) in multivariable analysis. No significant association was found between family history and adverse features on surgical pathology or biochemical recurrence. An expanded family history suggestive of a hereditary cancer syndrome is an independent predictor of biopsy progression during active surveillance. Men with such a family history may still be offered active surveillance but should be counseled regarding the higher risk of disease progression.

Büyük prostat hacminin robotik radikal prostatektomi sonrası perioperatif, onkolojik ve fonksiyonel sonuçlar üzerine etkisi: Retrospektif klinik çalışma

Objective: In this study, we aimed to evaluate the effect of large prostate volume on surgical, oncological and functional outcomes in prostate cancer patients who underwent Robot-assisted radical prostatectomy (RARP). Material and Methods: In this study, patients who underwent RARP due to prostate cancer by a single surgeon were divided into two groups as large prostate volume over 75 cc (Group-1) and prostate volume less than 75 cc (Group-2), and these two groups were compared retrospectively. Patients who were followed up for 12 months were assessed. Results: There was no significant difference between the two groups in terms of age, preoperative PSA level, clinical stage distributions, Gleason score, D’Amico risk classification, preoperative potency and continence assessment (p>0.05). The operative time was 169.9 ± 62.5 minutes and 145.6 ± 56.1 minutes in Groups 1 and 2, respectively, and was significantly higher in Group 1 (p= 0.02). Bladder neck reconstruction was performed in 17 (35%) and 2 (3%) patients in Groups 1 and 2, respectively, and it was statistically significantly higher in Group-1 (p=0.001). After removal of the urethral catheter in Group 1 and Group 2, full continence and potency rates were similar during the 1-year follow-up (p >0.05). Biochemical recurrence rates at 6 months and 1 year were similar in Group 1 and Group 2 (p >0.05). Conclusion: In prostate cancer patients with large prostate volume, RARP results in longer operative time and bladder neck reconstruction may be required.. However, in operations performed by experienced surgeons, large prostate volume does not have a negative effect on surgical, functional and oncological outcomes. Keywords: robotic surgical procedures, prostatectomy, prostate, organ size

The prognostic impact of preoperative psma-pet on early oncological outcomes in prostate cancer patients treated with radical prostatectomy: Results of a multi-center analysis

The prognostic impact of preoperative psma-pet on early oncological outcomes in prostate cancer patients treated with radical prostatectomy: Results of a multi-center analysis

Is there an impact of the center performing baseline multiparametric MRI on active surveillance outcomes in prostate cancer patients?

Is there an impact of the center performing baseline multiparametric MRI on active surveillance outcomes in prostate cancer patients?

Impact of performance status on survival outcomes in prostate cancer patients treated with systemic therapy: A systematic review and meta-analysis of randomized controlled trials

Impact of performance status on survival outcomes in prostate cancer patients treated with systemic therapy: A systematic review and meta-analysis of randomized controlled trials

Jumonji domain-containing protein RIOX2 is overexpressed and associated with worse survival outcomes in prostate cancers.

Histone demethylase RIOX2 was cloned as a c-Myc downstream gene involved in cell proliferation and has been implicated as an oncogenic factor in multiple tumor types. Its expression profiles and correlation with disease progression in prostate cancers are unknown. Transcriptomic profiles of Jumanji domain-containing protein genes were assessed using multiple public expression datasets generated from RNA-seq and cDNA microarray assays. RIOX2 protein expression was assessed using an immunohistochemistry approach on a tissue section array from benign and malignant prostate tissues. Gene expression profiles were analyzed using the bioinformatics software R package. Western blot assay examined androgen stimulation on RIOX2 protein expression in LNCaP cells. Among 35 Jumanji domain-containing protein genes, 12 genes were significantly upregulated in prostate cancers compared to benign compartments. COX regression analysis identified that the ribosomal oxygenase 2 (RIOX2) gene was the only one significantly associated with disease-specific survival outcomes in prostate cancer patients. RIOX2 upregulation was confirmed at the protein levels using immunohistochemical assays on prostate cancer tissue sections. Meanwhile, RIOX2 upregulation was associated with clinicopathological features, including late-stage diseases, adverse Gleason scores, TP53 gene mutation, and disease-free status. In castration-resistant prostate cancers (CRPC), RIOX2 expression was positively correlated with AR signaling index but negatively correlated with the neuroendocrinal progression index. However, androgen treatment had no significant stimulatory effect on RIOX2 expression, indicating a parallel but not a causative effect of androgen signaling on RIOX2 gene expression. Further analysis discovered that RIOX2 expression was tightly correlated with its promoter hypomethylation and MYC gene expression, consistent with the notion that RIOX2 was a c-Myc target gene. The Jumanji domain-containing protein RIOX2 was significantly overexpressed in prostate cancer, possibly due to c-Myc upregulation. RIOX2 upregulation was identified as an independent prognostic factor for disease-specific survival.

Racial Disparity in Outcomes Among Prostate Cancer Patients in the Post-Affordable Care Act Period.

Our objective was to assess whether Medicaid expansion is associated with reduced racial disparity in quality of care measured as 30-day mortality, 90-day mortality, and 30-day readmission in prostate cancer patients receiving surgery. We used the National Cancer Database to extract a cohort of African American and White men diagnosed with prostate cancer between 2004 and 2015 and surgically treated. We used 2004-2009 data to observe preexisting racial disparity in outcomes. We used 2010-2015 data to assess racial disparity in outcomes and the interaction of race and Medicaid expansion status. Between 2004 and 2009, 179,762 men met our criteria. In this period, African American patients reported higher hazard of 30- and 90-day mortality and higher odds of 30-day readmission compared to White patients. Between 2010 and 2015, 174,985 men met our criteria. Of these 84% were White and 16% were African American. Main effects models showed that compared to White men, African American men had higher odds of 30-day mortality (OR=1.96, 95% CI = 1.46, 2.67), 90-day mortality (OR=1.40, 95% CI = 1.11, 1.77), and 30-day readmission (OR=1.28, 95% CI = 1.19, 1.38).The interactions between race and Medicaid expansion were not significant (P = .1306, .9499, and .5080, respectively). Improved access to care via Medicaid expansion may not translate into reduced racial disparity in quality-of-care outcomes in prostate cancer patients treated surgically. System-level factors such as availability of and referrals to care, and complex socioeconomic structure may also play a role in improving quality of care and reducing disparities.

Overexpression of YTHDC2 contributes to the progression of prostate cancer and predicts poor outcomes in patients with prostate cancer.

YTH domain-containing protein 2 (YTHDC2), a member of N6-methyladenosine (m6A) readers, has been reported to be closely associated with multiple cancer types. However, very little is known about the YTHDC2 gene and its involvement in prostate cancer. YTHDC2 protein expression level was analyzed and correlated to clinical outcomes in prostate cancer patients who underwent prostatectomy in Guizhou Provincial People's Hospital. The YTHDC2 expression level was also detected in prostate cancer cell lines and an immortalized prostate epithelial cell line BPH-1 and RWPE1 by quantitative real-time reverse transcription polymerase chain reaction. Furthermore, we established stable cell lines (DU145 and PC-3) transfected with either empty vector or the full-length YTHDC2 gene and conducted cell function assays in vitro. Fisher's exact test and Pearson χ2 test were employed, Kaplan-Meier method was used for the survival analysis. Of 32 patient samples who enrolled in this study, YTHDC2 was significantly upregulated in prostate cancer (PCa) patients with higher Gleason scores and serum prostate-specific antigen levels. YTHDC2 expression was significantly elevated in all PCa cell lines compared to BPH-1 and RWPE1 (all p < 0.05). Functionally, the enforced expression of YTHDC2 markedly promoted cell growth, migration, and invasion efficacies in prostate cancer cells. Our data indicate that YTHDC2 upregulation may be potentially associated with the prognosis of prostate cancer patients.

Phosphodiesterase-5 Inhibitor Use in Robot Assisted Radical Prostatectomy Patients Is Associated with Reduced Risk of Death: A Propensity Score Matched Analysis of 1,058 Patients.

We investigated whether the use of a phosphodiesterase-5 inhibitor (PDE5i) after robot assited radical prostatectomy has a survival benefit over non-use patients because there are controversial results on the association between PDE5i use and survival outcomes for prostate cancer patients in literature. We designed a retrospective, matched, large-sample cohort study of 5,545 patients who underwent robot assisted radical prostatectomy (RARP) during 2013-2021 in a single institute. The exclusion criteria was patients who were aged >70 years at surgery, American Society of Anesthesiologists (ASA) physical status classification grade 4 or 5, history of other malignancies, patients who started PDE5i 6 months after survery and patients with follow up period less than 24 months after surgery. Among the 1,843 included patients, 1,298 were PDE5i users, and 545 were PDE5i non-users. We performed propensity score matching (PSM) of PDE5i users (n=529) with non-users (n=529) by adjusting for the variables of age, Gleason grade group, pathological T stage, preoperative ASA physical status grade, and International Index of Erectile Function score. There were no significant difference in patient characteristics according to PSM. Kaplan-Meier curve revealed the difference of overall survival for PDE5i users and non-users (clustered log-rank test p<0.05). In a stratified Cox regression analysis, PDE5i use after RARP was associated with improved overall survival and reduced risk of death (hazard ratio 0.43; confidence interval 0.24-0.79; p=0.007). The limitation of this study was that the indication for the prescription of PDE5i was not given. PDE5i administration after RARP were associated with overall survival of patients with prostate cancer. A further randomized control trial may reveal whether routine use of PDE5i after prostatectomy can improve survival of prostate cancer patient.

Liver Microenvironment Response to Prostate Cancer Metastasis and Hormonal Therapy.

Prostate cancer-associated deaths arise from disease progression and metastasis. Metastasis to the liver is associated with the worst clinical outcomes for prostate cancer patients, and these metastatic tumors can be particularly resistant to the currently widely used chemotherapy and hormonal therapies, such as anti-androgens which block androgen synthesis or directly target the androgen receptor. The incidence of liver metastases is reportedly increasing, with a potential correlation with use of anti-androgen therapies. A key player in prostate cancer progression and therapeutic response is the microenvironment of the tumor(s). This is a dynamic and adaptive collection of cells and proteins, which impart signals and stimuli that can alter biological processes within prostate cancer cells. Investigation in the prostate primary site has demonstrated that cells of the microenvironment are also responsive to hormones and hormonal therapies. In this review, we collate information about what happens when cancer moves to the liver: the types of prostate cancer cells that metastasize there, the response of resident mesenchymal cells of the liver, and how the interactions between the cancer cells and the microenvironment may be altered by hormonal therapy.

Effect of Androgen–Androgen Receptor Directed Therapy on COVID-19 Outcome in Prostate Cancer Patients

TMPRSS2 is utilized by SARS-CoV-2 for cellular entry. Androgen-Androgen receptor directed therapy (A/ARDT) downregulates expression of TMPRSS2. We hypothesized A/ARDT might protect prostate cancer (PCa) patients from poor COVID-19 outcome. A retrospective analysis of PCa patients with COVID-19 infection was performed. 146 PCa cases were identified, 17% were on A/ARDT. Hospitalization rates were same 52% (OR = 0.99, 0.41–2.24). Mean hospitalization was 9.2 (Range: 1–25) and 14.9 (Range: 2–47) days in A/ARDT and non-A/ARDT groups, respectively. While definitive conclusions cannot be made regarding outcome differences between groups due to lack of statistical significance, these data generate hypothesis that A/ARDT might shorten hospitalization stay.

PP12 Presentation Time: 11:20 AM: Prognostic Factors of Outcomes in Prostate Cancer Patients Treated with Permanent Implant: A High-Volume Center Experience

<h3>Purpose</h3> This study aims to report prognostic factors of clinical outcomes of prostate cancer (PCa) patients treated with permanent implant prostate brachytherapy (PIPB) at our institution. <h3>Materials and Methods</h3> The study sample consists of 2364 PCa patients treated with PIPB with or without cytoreductive antiandrogen therapy (ADT) between 1994 and 2020. Kaplan-Meier analyses with log-rank tests were performed to assess and compare biochemical relapse (BCR) according to risk stratification factors, dosimetry parameters or physician performing the implant. Univariate and multivariate Cox regression models were used to identify significative prognostic factors for BCR. <h3>Results</h3> The mean age of the patients at treatment time was 63.7±6.9 years. The median follow-up time was 81 months. Most patients had low-risk clinical features with 73.9% having Gleason score under or equal to 6, 92.6% a pre-treatment PSA value under 10, and 93.4% a clinical stage of T2A or lesser. 30.4% of patients were prescribed ADT. The 5 and 10 years BCR-free survival were 95.4 and 90.1%, respectively. Four physicians (RO) with different clinical experience have performed more than 150 PIPB procedures at our institution: 171, 1099, 805 and 240 cases, respectively for RO1 to RO4. On Kaplan-Meier analysis, the four ROs obtained 80.3, 88.5, 93.5 and 87.0 % 10 years BCR-free survival, respectively. When stratifying patients by D'Amico risk groups, no significative difference was found between ROs on log-rank tests. On univariate Cox model, RO1 (HR=3.43, 95%CI: 1.98-5.92) and RO2 (HR=1.85, 95%CI: 1.23-2.79) had significantly higher hazard ratios than RO3. When correcting for different risk stratification factors in multivariate Cox models, only pre-treatment PSA level (HR=1.11, 95%CI: 1.073-1.148, p<0.001) and ADT use (HR=2.179, 95%CI: 1.524-3.116, p<0.001) were identified as prognostic factors for BCR, but the experience of the RO performing the procedure (p=0.258), clinical stage (p=0.135), age (p=0.166) and dosimetry parameters (D90, p=0.121; V100, p=0.312) were not. <h3>Conclusions</h3> The 26 years' experience of PIPB at our institution shows a five, ten years and all-time BCR-free survival of 95.4, 90.1 and 80.4%, respectively, with the latest failure occurring 18 years after treatment. The most important prognostic factor identified in our cohort of patients were pre-treatment PSA level and ADT usage. Whereas clinical tumor stage, patients' age, dosimetry parameters or RO experience were not found to be significant.

The Outcomes of Definitive Radiotherapy in Patients with Prostate Cancer Using Simultaneous Integrated Boost Technique

<h3>Purpose/Objective(s)</h3> Previous studies had shown a dose-response relationship in prostate cancer during radiotherapy (RT). The clinical outcomes of prostate cancer patients treated with definitive RT using the simultaneous-integrated boost (SIB) technique were investigated in this study. <h3>Materials/Methods</h3> The clinical data of 556 prostate cancer patients who underwent RT using the SIB technique between September 2012 and September 2021 were retrospectively analyzed. In 39 fractions, patients received 78 Gy to the entire prostate±seminal vesicles and 86 Gy to the intraprostatic lesion (IPL). In addition, high-risk patients received 54 Gy pelvic field irradiation. Diffusion-weighted magnetic resonance imaging was used to define the IPL. Failure from biochemical failure (FFBF) and prostate-cancer specific survival (PCSS) were the primary endpoints. Secondary endpoints were progression free survival (PFS) and toxicity. <h3>Results</h3> The median age of the population was 69 years (range: 47–89 years). According to D'Amico risk categories, there were 175 patients (31.5%) classified as low risk, 186 patients (33.4%) classified as intermediate risk, and 195 patients (35.1%) classified as high risk. 253 patients (54.5%) received androgen deprivation therapy. The median duration of follow-up was 58.2 months (range, 4.7–126.8 months) for the entire cohort. The 5-year FFBF, PCSS, and PFS rates were respectively 93.3%, 98.5%, and 84.1%. In 40 patients (7.2%), progression was observed as biochemical failure in 16 patients, distant metastasis in 2 patients, and both biochemical failure and distant metastasis in 22 patients. Only four patients (0.7%) had a local recurrence. Univariate analysis revealed that the pretreatment PSA value, T and N stages, ISUP score, and D'Amico risk groups were all significant prognostic factors for FFBF and PCSS. PSA levels higher than 20 ng/mL [HR=3.39 (95% CI, 1.28–8.94); p=0.01], nodal metastasis [HR=4.03 (95% CI, 1.61–10.03); p=0.003], high risk disease [HR=6.66 (95% CI, 1.72–25.77); p=0.001], and higher ISUP scores [HR=2.31 (95% CI, 1.53–3.49); p<0.001] were all independent predictors of worse FFBF. In multivariable analysis, the significant predictors of worse PCSS were high risk disease [HR=8.96 (95% CI: 2.13–19.71; p=0.01] and a higher ISUP score [HR=12.21 (95% CI: 1.70–87.74; p=0.004]. Acute gastrointestinal (GI) and genitourinary (GU) system toxicities of grade 2 or greater were observed in 7.4% and 14.0% of patients, respectively. Late GI and GU toxicities of grade 2 or greater were observed in 5.3% and 6.9% of patients, respectively. <h3>Conclusion</h3> The treatment strategy of 78 Gy delivered to the entire prostate with a boost dose of 86 Gy to IPL was effective and safe, with excellent biochemical control and PCSS, and very low toxicity rates. Longer follow-up and randomized trials are needed to validate our findings.

The Utility of Mean Apparent Diffusion Coefficient Value in Patients with Prostate Cancer Treated with Definitive Radiotherapy

<h3>Purpose/Objective(s)</h3> By providing more objective measurements, quantitative magnetic resonance imaging (MRI) has the potential to further improve prediction of treatment outcomes for prostate cancer patients. The purpose of this study was to determine whether quantitative multiparametric MRI performed prior to treatment can accurately predict the biochemical outcome of prostate cancer patients receiving definitive radiotherapy (RT). <h3>Materials/Methods</h3> The clinical data of 503 prostate cancer patients who received definitive radiation therapy (RT) between June 2008 and September 2021 were analyzed retrospectively. Prior to RT, all patients had a prostate multiparametric MRI on a 3T MRI scanner. A radiologist outlined the index lesion and measured the quantitative apparent diffusion coefficient (ADC). The Phoenix criteria were used to define biochemical failure. The primary endpoints were failure from biochemical failure (FFBF) and progression free survival (PFS). <h3>Results</h3> The median age of the population was 69 years (range: 47–87 years). According to D'Amico risk categories, there were 183 patients (36.4%) classified as low risk, 156 patients (31%) classified as intermediate risk, and 164 patients (32.6%) classified as high risk. The mean ADC values for tumor and normal prostate tissue were 0.712±0.158 µm²/ms and 1.365±0.227 µm²/ms, respectively (p<0.001). The ADC values were significantly lower in patients with higher PSA (≥20 ng/mL), advanced T stage (≥T3a), nodal metastasis, higher ISUP score (≥3) and high-risk group compared to their counterparts. The median duration of follow-up was 72.9 months (range, 4.3–170.6 months) for the entire cohort. The 5-year FFBF and PFS rates were 93.2% and 86.2%, respectively. Biochemical failure was observed in 42 patients (9.3%). After ‘Receiver Operating Characteristics' (ROC) curve analysis, the cut-off point of ADC for predicting high-risk progression was 0.653 µm²/ms with area under curve of 0.656 (95%CI 0.581 – 0.736; p<0.001). In univariate analysis, PSA, T stage, ISUP score, risk group were significant prognostic factors for FFBF and PFS. Additional prognostic factor for OS was N stage, and age was for PFS. The 5-year FFBF for lower and higher ADC values were 89.1% and 95.6%, respectively (p<0.001). The 5-year PFS was significantly less for patients with lower ADC compared to those with higher ADC (82.2% vs. 88.5%; p = 0.002). In multivariate analysis higher ISUP score and lower ADC values were independent predictors for worse FFBF and PFS rates. Additional predictive factor for dismal PFS was older age. <h3>Conclusion</h3> Our findings suggest that quantitative ADC values of the index lesion may be used to predict biochemical failure and disease progression in patients with prostate cancer following definitive RT. Inferior biochemical control was associated with lower ADC values and higher ISUP scores.

Peripheral blood lymphocyte subsets are associated with the clinical outcomes of prostate cancer patients

BackgroundMany studies have sought associations between the total peripheral blood lymphocyte count and prostate cancer (PCa) prognosis, but not peripheral lymphocyte subsets. We explored the associations between the absolute counts of peripheral lymphocyte subsets and PCa patient survival. Methods135 PCa patients were included in this study. The log-rank test and Kaplan-Meier method were employed to compare overall survival (OS) and progression-free survival (PFS) rates. Univariate and multivariate Cox’s regression analyses were employed to identify prognostic factors. Flow cytometry analysis was used to determine the numbers of peripheral lymphocyte subsets. ResultsPCa patients with lower absolute counts of certain lymphocyte subsets showed poorer PFS and OS than those with higher absolute counts of these cells. The numbers of CD4+ T cells, CD3+ T cells, and natural killer (NK) cells were significantly higher in PCa patients of tumor node metastasis (TNM) Ⅰ-Ⅱ stages than those of TNM ⅠIII-IV stages. Univariate and multivariate Cox’s regression analyses of OS and PFS indicated that neutrophil numbers > 4.81*109/L, CD4+ T cells ≤ 254 /μL, and NK cells ≤ 136 /μL were unfavorably prognostic for patients with PCa. ConclusionsLower absolute counts of certain peripheral lymphocyte subsets (NK cells ≤ 136/μL and CD4+ T cells ≤ 254/μL) are prognostically unfavorable for PCa patients.

The Beneficial Effect of a Healthy Dietary Pattern on Androgen Deprivation Therapy-Related Metabolic Abnormalities in Patients with Prostate Cancer: A Meta-Analysis Based on Randomized Controlled Trials and Systematic Review.

Metabolic abnormalities as side effects of androgen-deprivation therapy (ADT) can accelerate progression of prostate cancer (PCa) and increase risks of cardiovascular diseases. A healthy dietary pattern (DP) plays an important role in regulating glycolipid metabolism, while evidence about DP on ADT-related metabolic abnormalities is still controversial. To explore the effect of DP on metabolic outcomes in PCa patients with ADT, PubMed, Embase, Cochrane, and CINAHL were searched from inception to 10 September 2022. Risk of biases was evaluated through Cochrane Collaboration’s Tool. If heterogeneity was low, the fixed-effects model was carried out; otherwise, the random-effects model was used. Data were determined by calculating mean difference (MD) or standardized MD (SMD) with 95% confidence intervals (CIs). Nine studies involving 421 patients were included. The results showed that healthy DP significantly improved glycated hemoglobin (MD: −0.13; 95% CI: −0.24, −0.02; p = 0.020), body mass index (MD: −1.02; 95% CI: −1.29, −0.75; p < 0.001), body fat mass (MD: −1.78; 95% CI: −2.58, −0.97; p < 0.001), triglyceride (MD: −0.28; 95% CI: −0.51, −0.04; p = 0.020), systolic blood pressure (MD: −6.30; 95% CI: −11.15, −1.44; p = 0.010), and diastolic blood pressure (MD: −2.94; 95% CI: −5.63, −0.25; p = 0.030), although its beneficial effects on other glycolipid metabolic indicators were not found. Additionally, a healthy DP also lowered the level of PSA (MD: −1.79; 95% CI: −2.25, −1.33; p < 0.001). The meta-analysis demonstrated that a healthy DP could improve ADT-related metabolic abnormalities and be worthy of being recommended for PCa patients with ADT.

SC232 - Outcomes of prostate cancer patients with seminal vesicle invasion at multiparametric MRI managed with radical prostatectomy. Do all patients really need for a multi-modal approach?

SC232 - Outcomes of prostate cancer patients with seminal vesicle invasion at multiparametric MRI managed with radical prostatectomy. Do all patients really need for a multi-modal approach?

The Role of Perineural Invasion in Prostate Cancer and Its Prognostic Significance.

Simple SummaryProstate cancer is one of the most frequently diagnosed cancers in men worldwide. Perineural invasion (PNI), the movement of cancer cells along nerves, is a commonly observed approach to tumor spread and is important in both research and clinical practice of prostate cancer. However, despite many studies reporting on molecules and pathways involved in PNI, understanding its clinical relevance remains insufficient. In this review, we aim to summarize the current knowledge of mechanisms and prognostic significance of PNI in prostate cancer, which may provide new perspectives for future studies and improved treatment.Perineural invasion (PNI) is a common indication of tumor metastasis that can be detected in multiple malignancies, including prostate cancer. In the development of PNI, tumor cells closely interact with the nerve components in the tumor microenvironment and create the perineural niche, which provides a supportive surrounding for their survival and invasion and benefits the nerve cells. Various transcription factors, cytokines, chemokines, and their related signaling pathways have been reported to be important in the progress of PNI. Nevertheless, the current understanding of the molecular mechanism of PNI is still very limited. Clinically, PNI is commonly associated with adverse clinicopathological parameters and poor outcomes for prostate cancer patients. However, whether PNI could act as an independent prognostic predictor remains controversial among studies due to inconsistent research aim and endpoint, sample type, statistical methods, and, most importantly, the definition and inclusion criteria. In this review, we provide a summary and comparison of the prognostic significance of PNI in prostate cancer based on existing literature and propose that a more standardized description of PNI would be helpful for a better understanding of its clinical relevance.