Prostatic Neoplasms Research Articles

Material deprivation, racial inequalities and mortality from female breast, prostate, and cervical neoplasm in the Brazilian adult population: an ecological study.

This article aims to identify the relationship between material deprivation and mortality from breast, cervical, and prostate neoplasms in the Brazilian adult population and the relationship between ethnicity/skin color and material deprivation. This cross-sectional ecological study calculated the mean mortality rate per 100,000 inhabitants, and deaths were standardized by age and gender and redistributed per to ill-defined causes, stratified by age group and ethnicity/skin color. We applied the Negative Binomial model, containing the interaction between ethnicity/skin color and the Brazilian Deprivation Index (IBP). We analyzed 85,903 deaths, and the most prevalent were those due to female breast neoplasms. The risk of death from cervical cancer was 8.5% higher for Black women than white women. In other places, mortality was higher among white people. For all causes, mortality increased with age. There was a significant interaction between ethnicity/skin color and IBP for all causes. Only deaths due to cervical neoplasms increased with higher IBP, while a decline was observed in other causes but was less significant among Black people. The IBP offers a multidimensional view of the socioeconomic conditions of the Brazilian population, allowing a better understanding of how social determinants operate on selected neoplasms.

Privação material, desigualdades raciais e mortalidade por neoplasias de mama feminino, próstata e colo de útero na população adulta brasileira: um estudo ecológico

Abstract This article aims to identify the relationship between material deprivation and mortality from breast, cervical, and prostate neoplasms in the Brazilian adult population and the relationship between ethnicity/skin color and material deprivation. This cross-sectional ecological study calculated the mean mortality rate per 100,000 inhabitants, and deaths were standardized by age and gender and redistributed per to ill-defined causes, stratified by age group and ethnicity/skin color. We applied the Negative Binomial model, containing the interaction between ethnicity/skin color and the Brazilian Deprivation Index (IBP). We analyzed 85,903 deaths, and the most prevalent were those due to female breast neoplasms. The risk of death from cervical cancer was 8.5% higher for Black women than white women. In other places, mortality was higher among white people. For all causes, mortality increased with age. There was a significant interaction between ethnicity/skin color and IBP for all causes. Only deaths due to cervical neoplasms increased with higher IBP, while a decline was observed in other causes but was less significant among Black people. The IBP offers a multidimensional view of the socioeconomic conditions of the Brazilian population, allowing a better understanding of how social determinants operate on selected neoplasms.

Material deprivation, racial inequalities and mortality from female breast, prostate, and cervical neoplasm in the Brazilian adult population: an ecological study

Resumen El objetivo es Identificar la relación entre privación material y mortalidad por neoplasias de mama, cuello uterino y próstata en la población adulta brasileña, y la relación entre raza/color y privación material. Este estudio ecológico transversal calculó la tasa media de mortalidad/100.000 habitantes, con defunciones estandarizadas por edad y sexo y redistribuidas según causas mal definidas, estratificadas por grupo de edad y raza/color. Se aplicó el modelo Binomial Negativo conteniendo la interacción entre raza/color y el Índice Brasileño de Privación (IBP). Se analizaron 85.903 defunciones, siendo las más prevalentes las debidas a neoplasias de mama. El riesgo de defunción por cáncer de cuello uterino fue 8,5% mayor para mujeres negras que para blancas. En otros lugares, la mortalidad fue mayor entre las personas blancas. Para todas las causas, hubo un aumento de la mortalidad con el aumento de la edad. Se observó una interacción significativa entre raza/color e IBP para todas las causas. Solo las defunciones por neoplasia cervical aumentaron con el aumento del IBP, en las demás hubo una reducción, pero menos significativa entre las personas negras. El IBP ofrece una visión multidimensional de las condiciones socioeconómicas de la población brasileña, permitiendo una mejor comprensión de cómo los determinantes sociales operan sobre neoplasias seleccionadas.

Lutetium-Specific Prostatic Membrane Antigen (LuPSMA) Treatment for Metastatic Castration-Resistant Prostate Cancer

Introduction: Cancer is one of the leading causes of death globally, with the majority of cases occurring in low-income countries. There are more than a hundred types, divided into sarcomas and carcinomas. Prostate cancer is the most common cancer among men and is usually asymptomatic. Treatment depends on the stage of the disease and may include surgery, hormone therapy, and radiation therapy. In advanced stages, new treatments such as the radiopharmaceutical LuPSMA are investigated to improve patients' quality of life. Material and Methods: An exploratory-descriptive literature review was conducted using qualitative methods. Data collection spanned 2019–2024, sourcing relevant studies from LILACS, SciELO, and PubMed. Search terms included "Prostate Neoplasms," "Lutetium," and "Positron Emission Tomography combined with Computed Tomography," using both Portuguese and English with the boolean operator "AND." After screening 189 articles for relevance, 30 met the inclusion criteria. Results: Theranostic treatment with LuPSMA demonstrated significant improvements in overall survival and progression-free survival in mCRPC patients. The therapy was well-tolerated, with manageable adverse effects. However, challenges remain in predicting outcomes for patients with low PSMA expression. Conclusion: LuPSMA therapy has shown promise in enhancing survival rates and quality of life for mCRPC patients, offering a well-tolerated alternative to conventional treatments. However, there are uncertainties about the therapeutic response and prognosis in patients with low PSMA expression, indicating the need for further research. The study has contributed to imaging and oncology, offering new perspectives on alternative therapies for metastatic cancer and serving as a basis for future investigations into imaging-guided radionuclide therapies.

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.

Microsatellite instability and high tumor mutational burden detected by next generation sequencing are concordant with loss of mismatch repair proteins by immunohistochemistry.

Impairment of DNA mismatch repair function in neoplasms can be assessed by DNA-based methods to assess for high microsatellite instability (MSI-High) or immunohistochemical (IHC) analysis to assess for deficiency of mismatch repair proteins (dMMR). Neoplasms with mismatch repair deficiency often have high tumor mutational burden (TMB-High). MSI-High, dMMR, and TMB-High are all histology agnostic biomarkers for potential therapy using immune checkpoint inhibitors (ICI). In this single center, retrospective study, our primary aim was to assess if NGS-based positive TMB/MSI findings are concordant with patient matched concurrent MMR IHC studies. In addition, we determined if positive TMB/MSI findings are attributable to genetic/epigenetic alterations of MMR genes. Finally, we explored potential associations between IHC, TMB and MSI findings and specific tumor types We screened 4,258 patients in our database who had tumor-normal-testing with our institutional high-throughput NGS-based CLIA assay between Apr 1, 2021-August 31, 2022 for TMB and MSI. We identified 65 patients who had neoplasms with documented TMB-High/MSI-High (n = 59) or TMB-High/MSI-Undetermined (n = 6) results as well as concurrent IHC results for MMR proteins [colorectal (n = 25), endometrial (n = 28), prostatic (n = 7), urothelial (n = 3), other (n = 5)]. The concordance between positive NGS TMB/MSI and MMR results was 98 %. Genetic/epigenetic alterations of MMR genes were documented in 78 % of the neoplasms. IHC studies for dMMR proteins revealed loss of MLH1/PMS2 (n = 33), MSH2/MSH6 (n = 14), MLH1/MSH2/PMS2 (n = 1), MLH1 (n = 1), MSH2 (n = 2), MSH6 (n = 6) and PMS2 (n = 6). All six prostatic neoplasms with dMMR had loss of MSH2/MSH6 (p < 0.0001). We conclude that neoplasms with positive results for TMB/MSI are highly concordant with positive dMMR results. Genetic/epigenetic alterations in the MMR genes are an underlying reason for most positive findings. The association of MSH2/MSH6 loss with prostatic neoplasms is of in-terest, but sample size is limited, and further studies are warranted to address this association.

Epidemiological profile of patients with prostatic neoplasia in a high complexity oncology center

Objective: To describe the profile of prostate cancer patients who sought hospital care at a Brazilian High Complexity Oncology Center, as well as their condition on arrival at the center. Methods: This is a descriptive observational study, based on secondary data from the tumor file in the Hospital Cancer Registry at Afecc-Hospital Santa Rita de Cássia. RStudio and R software were used for descriptive analysis. Results: A total of 5,403 new analytical and non-analytical cases of prostate neoplasms were analyzed between 2000 and 2016. The number of cases had a mean age of 69.40 years (SD=8.82), with an increasing trend over the period (p&lt;0.001). The majority of patients were over 60 years old (86.82%), brown or white (91.97%), with incomplete primary education (52.88%), married (67.37%), referred by SUS (76.12%), with no other primary tumors (97.87%), and histological type classified as adenocarcinoma (96.22%). The variables age (p=0.017), race/skin color (p&lt;0.001) and education (p&lt;0.001) showed statistically significant differences between analytical and non-analytical cases. Conclusion: The analyses show an upward trend in the incidence of prostate cancer over the years, and prostate neoplasia has a tropism for older, married men with a low education level.

Urinary Diversion Can Improve the Chance of Implementing New Therapeutic Lines in Patients with Malignant Ureteral Obstruction: A Multicenter Study.

Malignant ureteral obstruction is generally associated with a poor disease prognosis; therefore, managing these cases is challenging. We describe our experience in treating malignant ureteral obstruction with urinary diversion and the impact of these procedures on the indication for new antineoplastic therapy and survival. We retrospectively reviewed the data of patients with advanced cancer associated with malignant ureteral obstruction who underwent urinary diversion at three tertiary institutions between January 2013 and July 2022. This study included 420 patients (mean age, 58.7 years (range, 18-90 years) with a mean follow-up of 20.3 months. Cervical (36.2%) and bladder cancers (18.6%) were the most prevalent primary neo-plastic sites. The mean creatinine values measured before diversion, 30 days after surgery, and most recently were 3.45, 1.84, and 2.59 mg/dL, respectively. In total, 300 patients (71.4%) received antineoplastic treatment, 195 received palliative treatment, and 105 received curative treatment. After an average of 251.87 postoperative days, 265 (64%) patients died. The mean overall survival was 610.76 days. Patients with prostate and cervical neoplasms had the most prolonged overall survival (573.13 and 549.28 days, respectively), whereas patients with bladder and colorectal cancer had the worst overall survival (480.25 and 370.53 days, respectively). Urinary diversion improves kidney function and opens a therapeutic window for a new line of antineoplastic therapy that provides a cure or increases patient survival.

EPIDEMIOLOGY OF MALIGNANT PROSTATE NEOPLASMS IN THE SUMY REGION

Introduction. One of the most critical medical and social challenges facing the male population globally is the prevalence of malignant tumors of the prostate gland. Cancer-related mortality ranks the second position in Ukraine and worldwide, following cardiovascular diseases. Therefore, early diagnosis remains the most promising and effective strategy for combating malignant tumors. Objective: to investigate the prevalence and frequency of diagnosis of malignant prostate neoplasms in the Sumy region. Materials and Methods. The study utilized statistical data from the medical records of patients with prostate disease treated at the Urology Departments of Sumy Clinical Hospital of St. Panteleimon and Sumy City Clinical Hospital from 2018 to 2022. Results. The statistical analysis revealed that the prevalence of prostate diseases among patients aged 40-54 years was 21.5%, among those aged 55-74 years it was 34.3%, and for patients over 75 years it was 44.2%. An examination of the data regarding when patients sought medical help from the onset of the disease highlighted that most men with prostate cancer were asymptomatic, contributing to the spread of the disease and complicating early-stage diagnosis. Cardiovascular diseases and urinary system disorders (e.g., urolithiasis, benign prostatic hyperplasia, chronic prostatitis, and acute prostatitis) were common comorbidities in these patients. Conclusion. The statistical analysis identified a rising trend in the incidence of malignant prostate tumors in men over 50. Diseases of cardiovascular and urinary system were the most prevalent comorbidities in patients with prostate tumors. The majority of the patients were hospitalized late in the course of the disease.

Profiling of urinary extracellular vesicle protein signatures from patients with cribriform and intraductal prostate carcinoma in a cross-sectional study

Prognostic tests and treatment approaches for optimized clinical care of prostatic neoplasms are an unmet need. Prostate cancer (PCa) and derived extracellular vesicles (EVs) proteome changes occur during initiation and progression of the disease. PCa tissue proteome has been previously characterized, but screening of tissue samples constitutes an invasive procedure. Consequently, we focused this study on liquid biopsies, such as urine samples. More specifically, urinary small extracellular vesicle and particles proteome profiles of 100 subjects were analyzed using liquid chromatography coupled to high-resolution mass spectrometry (LC–MS/MS). We identified 171 proteins that were differentially expressed between intraductal prostate cancer/cribriform (IDC/Crib) and non-IDC/non-Crib after correction for multiple testing. However, the strong correlation between IDC/Crib and Gleason Grade complicates the disentanglement of the underlying factors driving this association. Nevertheless, even after accounting for multiple testing and adjusting for ISUP (International Society of Urological Pathology) grading, two proteins continued to exhibit significant differential expression between IDC/Crib and non-IDC/non-Crib. Functional enrichment analysis based on cancer hallmark proteins disclosed a clear pattern of androgen response down-regulation in urinary EVs from IDC/Crib compared to non-IDC/non-Crib. Interestingly, proteome differences between IDC and cribriform were more subtle, suggesting high proteome heterogeneity. Overall, the urinary EV proteome reflected partly the prostate pathology.

Surgical treatment of a true diverticulum of the bladder in a patient with aplasia of the left kidney. Case report

A bladder diverticulum (BD) is a blindly terminating sac-like protrusion of the bladder wall with or without involvement of the muscular layer. BDs are categorized into true (congenital) and false (acquired), single and multiple. False diverticula are more common and develop in infravesical obstruction due to urethral stricture, prostate neoplasms, neurogenic disorders and other lower urinary tract diseases. Currently, there are no clear recommendations regarding the tactics of treatment of BD, so the choice of treatment method is based on the determination of the cause of BD, assessment of clinical manifestations and diagnostic results (localization, size, number, etc.), as well as the identification of concomitant anomalies and diseases of the upper urinary tract. The priority in the treatment of BD is surgical treatment. The article presents the observation of a patient with a developmental anomaly in the form of aplasia of the left kidney combined with a large congenital BD in the area of the missing mouth of the aplasic left ureter. The results of examination and treatment in the form of laparoscopic diverticulectomy are presented. A brief review of the literature on the problem of diverticulosis has been carried out.

Impact of the diagnostic label for a low-risk prostate lesion: protocol for two online factorial randomised experiments

IntroductionMany types of prostate cancer present minimal risk to a man’s lifespan or well-being, but existing terminology makes it difficult for men to distinguish these from high-risk prostate cancers. This...

Lutetium-specific prostatic membrane antigen (luPSMA) treatment for metastatic castration- resistant prostate cancer

Introduction: Cancer is one of the leading causes of death globally, with the majority of cases occurring in low-income countries. There are more than a hundred types, divided into sarcomas and carcinomas. Prostate cancer is the most common cancer among men and is usually asymptomatic. Treatment depends on the stage of the disease and may include surgery, hormone therapy, and radiation therapy. In advanced stages, new treatments such as the radiopharmaceutical LuPSMA are investigated to improve patients' quality of life. Objective: To analyze the efficacy of treatment with the radiopharmaceutical LuPSMA in patients diagnosed with metastatic prostate cancer through a literature review. Methodology: An exploratory-descriptive literature review with a qualitative approach was conducted, based on books and scientific articles. Data collection took place between 2019 and 2024, including complete and relevant documents on the topic, without language restriction, and excluding irrelevant, duplicate, or incomplete materials. The databases used were LILACS, SciELO, and PubMed, using the descriptors "Prostate Neoplasms," "Lutetium," and "Positron Emission Tomography combined with Computed Tomography" in Portuguese and English, added by the boolean operator "AND". Results: A total of 189 articles were found, of which only 30 were selected, after reading the titles and abstracts, according to the inclusion criteria, showing that theranostics with LuPSMA presents significant results in the quality and survival of patients with mCRPC. Conclusion: The results showed that LuPSMA significantly increased overall survival and progression-free survival compared to standard treatment, while being well tolerated with manageable adverse effects. However, there are uncertainties about the therapeutic response and prognosis in patients with low PSMA expression, indicating the need for further research. The study has contributed to imaging and oncology, offering new perspectives on alternative therapies for metastatic cancer and serving as a basis for future investigations into imaging-guided radionuclide therapies.

MpMRI features of mucinous prostate cancer: two case reports

BackgroundMucinous adenocarcinoma of the prostate (MACP) is one of the rarest variants of prostatic neoplasm, with more aggressive behavior than non-mucinous prostatic cancer. Previous studies suggested that these tumors exhibit different imaging magnetic resonance imaging (MRI) features compared with those of non-mucinous adenocarcinoma of the prostate upon which the conventional PIRADS v2.1 is based. To the best of our knowledge, this case series is the first to describe the multiparametric magnetic resonance imaging features of the MACP.ResultsWe presented two cases of biopsy proven mucinous adenocarcinoma of the prostate studied with multiparametric MRI. In both cases, diagnosis was late because of the different MRI features of MACP than those of the more common adenocarcinoma of the prostate. In both mpMRI, MACP appears to be hyperintense on T2WI, there was not a significant decrease in diffusivity in ADC maps and it exhibits early enhancement in DCE-MRI; the septa resulted in hypointense on T2WI compared to the PZConclusionsAccording to our experience, the conventional PIRADS v2.1 score is not suitable for mucinous prostate adenocarcinoma. MACP appears to be hyperintense on T2WI, has a lower ADC value, and exhibits early enhancement in DCE-MRI; the septa are usually hypointense on T2WI compared to the PZ. It is imperative for radiologists and urologists to be cognizant of this rare variant of prostate cancer to promptly identify and diagnose it, thereby preventing any diagnostic delays.

Clinicopathologic and survival patterns among prostate carcinosarcoma patients in the U.S. An analysis of SEER database.

Prostatic carcinosarcoma comprises <1% of all prostate neoplasms. The literature on this disease is limited to a few case studies, primarily due to the rarity of this malignancy. We aimed to investigate the demographic, clinical, and histologic factors, prognosis, and survival of prostatic carcinosarcoma. The Surveillance, Epidemiology, and End Results (SEER) database was used to identify patients with prostatic carcinosarcoma from 2000-2018. Demographic and clinical data, including age, race, sex, tumor grade, stage, tumor size, lymph node status, metastasis, and treatment modalities, were recorded. Patients with prostatic carcinosarcoma had a median age of 72 years at diagnosis, most cases among White individuals (93%). When reported, the histologic grade comprised moderately differentiated (3.3%), poorly differentiated (56.7%), and undifferentiated/anaplastic (40%) subtypes. In patients with reported data, tumor size varied between 2-5 cm (15.8%) and >5 cm (84.2%). Distant metastasis most commonly occurred in the liver (12.5%) and lung (12.5%), followed by the bone (8.3%). The most common treatment performed was surgery with radiation (32.4%). The five-year overall survival was 11.9%. Prostatic carcinosarcoma affects men in the seventh decade of life. Regional and distant tumor stage is considered an indicator of survival. Prostate carcinosarcoma is rare; due to its aggressive nature, a deeper understanding, and an improved personalized therapeutic approach are necessary for improving patient outcomes in this challenging arena of oncology.

Bicytopenia Revealing an Intramedullary Spinal Cord Metastatic Prostatic Carcinoma

Usually revealed by lower urinary tract symptoms, prostate neoplasms are the most frequent urological cancer. The patient was a 70-year-old man being explored for bicytopenia in the hematology department: anemia and bicytopenia with no urinary symptoms in the first plan. Bone marrow biopsy was done and the histological and immunohistochemical concluded in an intramedullary spinal cord metastasis of an undifferentiated prostatic carcinoma. We have reviewed the literature one other case of intramedullary metastasis of prostatic cancer was detected but the main symptoms were neurological and the patient was already diagnosed with his cancer.

Association between serum vitamin D levels and prostate tumor: a systematic review and meta-analysis

Introduction: Prostate cancer is among the most frequent neoplasms of the male reproductive system, and its relationship with serum vitamin D level is a controversial subject. The present study intended to investigate the relationship between serum vitamin D levels and the risk of prostate carcinoma. Materials and Methods: This study is a systematic review and meta-analysis based on the PRISMA tool. The search was conducted in databases Web of Science, Cochrane, ProQuest, PubMed, and Google Scholar Search Engine until December 1, 2023. Data was analyzed using STATA 14 software. Results: There was no significant relationship between serum vitamin D levels lower than 50 nmol/L (vitamin D level &lt;50 nmol/L) and prostate cancer. In Finland, the risk of prostate carcinoma in male individuals with serum vitamin D levels lower than 50 nmol/L was 34% higher (OR: 1.34, 95% CI: 1.14, 1.54). In South Korea, on the other hand, serum vitamin D levels lower than 50 nmol/L prevented prostate cancer (OR: 0.94, 95% CI: 0.90, 0.99). There was no significant relationship between the serum vitamin D levels lower than 50 nmol/L and prostate neoplasm in men aged 60 to 69 years old (OR: 0.95, 95% CI: 0.83, 1.07), in men 50 to 59 years old. On the other hand, serum vitamin D levels lower than 50 nmol/L increased the risk of prostate tumor by 32% (OR: 1.32, 95% CI: 1.13, 1.55). Furthermore, no significant relationship was observed between serum vitamin D levels higher than 50 nmol/L (vitamin D level ≥ 50 nmol/L) and the risk of prostate cancer (OR: 1.06, 95% CI: 0.99, 1.14). Conclusion: Generally, there was no significant relationship between serum vitamin D levels and the risk of prostate carcinoma; however, the relationship in some subgroups was statistically significant. We therefore recommend conducting additional studies on this subject. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42023491012) and Research Registry (UIN: reviewregistry1773) website.

(075) PSYCHOLOGICAL IMPACT OF THE DIAGNOSIS OF UROLOGIC CANCER ON MALE SEXUALITY

Abstract Introduction Urological neoplasms often affect male sexuality, especially due to the physical consequences of their various therapeutic approaches, particularly in cases of prostate, testicle, and penile tumors. However, the diagnosis of cancer can profoundly affect the emotional well-being of oncology patients, even in cases involving non-reproductive neoplasms. Objective The objective of this study was to assess the impact of a urological neoplasm diagnosis on the sexuality of adult men and evaluate the patient’s perception of the healthcare professional’s approach regarding sexuality at the time of diagnosis. Methods Adult men diagnosed with urological neoplasms, that visited two urology cancer centers between October 2022 and april 2024, underwent interviews using a semi-structured questionnaire prepared by the research team for the collection of objective clinical data. Data were analyzed using RStudio software. Observation of the association between each qualitative variable was conducted using the chi-square test (95% confidence interval). This study was approved by the ethical committee for human experimentation of our university. Results A total of 211 patients were included in this study, with an age range of 22 to 85 years (mean = 65.4). Among these patients, the diagnoses included prostate neoplasms in 167 cases (79.1%), bladder neoplasms in 21 cases (9.9%), kidney neoplasms in 9 cases (4.2%), testicle neoplasms in 8 cases (3.7%), and penis neoplasms in 6 cases (2.8%). Sexual activity was considered important by 191 (90.5%) patients. The majority of patients, 160 (75.8%), decreased sexual frequency after diagnosis. In contrast, 49 patients (23.2%) maintained their pre-diagnosis frequency, while only two patients (0.9%) reported an increase. Ninety-nine (46.9%) patients experienced the onset of anxiety or depression. Additionally, 152 patients (72%) developed various fears, with 108 (51.1%) expressing fear of losing their ability to maintain an erection, and 60 (28.4%) fearing the possibility of transmitting cancer to their partner. Only 49 (23.2%) doctors clearly discussed issues related to sexuality at the time of diagnosis. Forty-one (19.4%) provided only superficial coverage of this topic, and 121 (57.3%) did not mention the subject at all. In terms of patient satisfaction, 92 individuals (43.6%) expressed contentment with their doctors’ approach, while 119 (56.3%) were dissatisfied. There was a statistically significant correlation between patient satisfaction with medical care when it clearly addressed aspects of sexuality (p = 0.001). Moreover, there was a statistically significant association between satisfaction with the medical approach and the tumor site. Bladder tumor patients reported higher satisfaction, whereas prostate and penile cancer patients expressed greater dissatisfaction (p = 0.003). Conclusions Sexual problems are not limited to those with genital urological cancer and can also affect patients with kidney and bladder cancer. The negative impact on male sexuality begins at the time of diagnosis, probably due to anxiety, depression and fears related to cancer and its treatment. Therefore, providing empathetic support, sexual education and multidisciplinary care are extremely important for these patients. Disclosure No.

Erdheim-Chester disease as complex clinical presentation and diagnosis: A case report and concise review of literature.

Erdheim-Chester disease (ECD) is a rare multisystemic disease characterized by the infiltration of multiple organs by foamy CD68 + CD1a-histiocytes. The genetic background consists of gain-of-function somatic mutations in the mitogen-activated protein kinase pathway. The purpose of the present paper is to make a contribution to the scientific literature on ECD by reporting our experience with a complex clinical case report, along with a concise review of the literature. We discussed the unusual clinical presentation, the complex diagnostic process and the comparison with other published cases. A 70-year-old man presented with arthralgia due to multiple bone areas of sclerosis, first diagnosed with metastases of a prostatic neoplasm. Sequential thorax-abdomen, femoral and homer contrast-enhanced computed tomography (CT) showed pericardial effusion, pulmonary fibrosis, and perirenal fibrous tissue as "hairy kidneys." He underwent. Three bone biopsies were unsuccessful to reach diagnosis. A xanthelasma biopsy showed histopathological signs compatible with ECD; genetic analysis showed the mutation BRAFV600E. The patient underwent targeted therapy with vemurafenib (BRAF-inhibitor), discontinued 2 weeks later due to the onset of a diffuse erythematous papular rash on the trunk and limbs. At the 1-year follow-up, there was only progression of chronic kidney disease (CKD). The present case report describes how ECD diagnosis could represent a challenge for clinicians, owing to its heterogeneous clinical presentation. Early diagnosis followed by prompt therapy is essential for modifying the natural history of the disease.

The haemoglobin levels of patients with prostate cancer treated with radical radiotherapy

Introduction: The worldwide estimate points to prostate cancer as the second most frequent cancer in men worldwide, where radiotherapy has been an important modality of curative treatment in managing this neoplasia. The prevalence and impact of cancer-related anemia are not widely known, and it may be overlooked or considered clinically significant. It is believed that the outcomes and toxicity of radiotherapy in prostate cancer treatment may be influenced by blood hemoglobin levels. Objective: To evaluate hemoglobin levels in patients with prostate cancer before and after radiotherapy treatment. Methods: Retrospective, longitudinal study of patients diagnosed with malignant prostate neoplasms undergoing external radiotherapy. Hemoglobin levels were measured before radiotherapy and after treatment completion (20-40 days). Anemia was defined by the World Health Organization as men with values less than 13 g/dl. Prostate cancer recurrence risk classification was based on the National Comprehensive Cancer Network risk criteria. Results: Forty patients were evaluated with measurement of Hemoglobin levels before and after radiotherapy treatment. The mean age was 67 years. According to the risk group classification, 4 patients were low-risk (10%), 27 patients were intermediate-risk (67.5%), and 9 patients were high-risk (22.5%). The mean pre-radiotherapy Hemoglobin levels were 13.3 g/dL, and the mean post-radiotherapy Hemoglobin levels were 10.4 g/dL, p &lt; 0.0001. Conclusion: In this study, a reduction in serum Hemoglobin levels was observed after radiotherapy, highlighting the need for better monitoring of these patients.