Treatment Patterns and Outcomes in Lymph-Node-Positive (pN1) Prostate Cancer: A National Cancer Database Study.

Introduction: Lymph node involvement after radical prostatectomy (pN1) is associated with worse oncologic outcomes, yet its optimal management remains controversial. We evaluated oncologic outcomes and treatment patterns in pN1 prostate cancer.

Patients And Methods: We analyzed data from the National Cancer Database (NCDB) on men undergoing radical pN1 between 2010 and 2020.

Transcriptomic Profile of Perineural Invasion in Prostate Cancer Identifies Prognostic Gene Signatures.

Prostate cancer is a common malignancy among men worldwide, with various histopathologic features that influence its progression and prognosis. One such feature is perineural invasion (PNI), which has been associated with aggressive disease. In this retrospective study, we analyzed genomic alterations associated with PNI in patients who underwent radical prostatectomy.

Age-Specific Impact of Cribriform Pattern in Prostate Cancer Following Radical Prostatectomy.

Background: Cribriform pattern 4 (CP4) is an aggressive variant in prostate cancer linked to worse clinical outcomes, including biochemical recurrence, metastases, and prostate cancer-specific mortality. However, its prognostic significance across age groups remains unclear. This study investigates whether the impact of CP4 on progression-free survival (PFS) differs by age in patients undergoing radical prostatectomy (RP).

Examining Barriers to Practice in Genitourinary and Gynecologic Radiation Oncology: Results from 2 Nationwide Surveys.

Purpose: Gender diversity in academic radiation oncology (RO) has become a topic of interest in recent years, with studies showing that practicing female academic radiation oncologists (AROs) are outnumbered by male colleagues at a rate of approximately 3:1. Gender differences are also observed in subspecialties whose patient populations are overwhelmingly of a single gender, such as genitourinary (GU) and gynecologic (GYN) RO. We aimed to investigate whether challenges exist for academic RO physicians who primarily treat patients of another gender, and, if so, what barriers they face in practice.

Elective Regional Nodal Irradiation in Prostate Cancer.

Elective nodal radiotherapy (ENRT) targets microscopic pelvic lymph node metastases to improve locoregional control in prostate cancer. Recent randomized trials report improved outcomes, particularly in high-risk cohorts, albeit with modest increases in Grade 2 gastrointestinal (GI) and genitourinary (GU) toxicities. Molecular imaging has markedly refined patient selection, enabling precise identification of occult nodal disease and enhancing application of ENRT beyond traditional clinical parameters.

Impact of Prostate Radiotherapy on Survival Outcomes in Patients with Metastatic Castration-sensitive Prostate Cancer: A Meta-analysis of Randomized Phase 3 Clinical Trials.

Background And Objective: Despite advancements in systemic therapy for metastatic castration-sensitive prostate cancer (mCSPC), the survival benefits of radiotherapy (RT) remain uncertain. This meta-analysis evaluates whether addition of RT to the standard of care (SOC) improves radiographic progression-free (rPFS) and overall (OS) survival, with a focus on systemic therapy intensification.

Methods: A targeted review of three phase 3 trials (HORRAD, STAMPEDE, and PEACE-1) was conducted to assess the role of prostate RT in mCSPC.

Projected Prostate Cancer Incidence in the Middle East by 2050: Socioeconomic Disparities and Future Implications.

Purpose: Prostate cancer poses a significant public health challenge in the Middle East, with advanced-stage diagnoses and high mortality rates. However, projections regarding its future incidence are limited. The aims of this study were to estimate prostate cancer incidence in the region through 2050, to evaluate socioeconomic factors contributing to regional disparities, and to provide insights to inform future health care policies and resource allocation.

The Clinical Impact of the Decipher Genomic Classifier in Prostate Cancer.

The Decipher genomic classifier (GC) is a 22-gene expression test that refines risk stratification and informs treatment decisions in localized prostate cancer. Traditional clinicopathologic factors, including prostate-specific antigen levels and kinetics, Gleason score, histologic variants, and tumor stage, do not fully capture disease heterogeneity, leading to potential overtreatment or undertreatment. The Decipher GC has demonstrated clinical utility across risk groups, helping to distinguish candidates for active surveillance in low-risk prostate cancer, refine the need for androgen deprivation therapy in intermediate-risk disease, and guide treatment intensification in high-risk patients.

Impact of Cribriform Pattern on Progression-Free Survival After Radical Prostatectomy in Gleason Score 8-10 Prostate Cancer.

Background: Although extensive research highlights the detrimental effect of cribriform pattern 4 (CP4) on survival in non-high-risk prostate cancer (PC), its prognostic significance in high-risk PC is not well understood. Methods: The individual patient data from the The Cancer Genome Atlas (TCGA) database following radical prostatectomy was retrospectively examined. A predefined statistical analysis was conducted to evaluate the potential association between CP4 and progression-free survival (PFS).

Combination Metastasis-Targeted External Beam Radiation Therapy With Lu-PSMA-617 in Patients With Advanced Castration-Resistant Prostate Cancer.

Purpose: Lu-PSMA-617 (LuPSMA) is an effective radiopharmaceutical therapy for patients with metastatic castration-resistant prostate cancer. While LuPSMA can treat disseminated disease, additional localized control of metastatic disease may be required. Metastasis-targeted external beam radiation therapy (M-EBRT) can be an effective adjunct.

Clinical Outcomes and Genomic Alterations in Gleason Score 10 Prostate Cancer.

: Gleason score (GS) 10 prostate cancer (PC) is a highly aggressive localized disease. Despite advances in treating high-risk PC, the clinical outcomes and molecular underpinnings of GS 10 remain unclear. This study aimed to determine whether GS 10 PC has distinct clinical outcomes from other "high-risk" cancers (i.

Prostate cancer screening in the Middle East and North Africa: a cross-sectional study on current practices.

Background: Prostate cancer is a substantial health concern in the Middle East and North Africa region, with many cases diagnosed at advanced stages, a high mortality to incidence ratio, and low prostate cancer awareness. This study aimed to evaluate prostate cancer screening practices in the region to inform effective early detection and management strategies.

Methods: A cross-sectional survey was conducted from July 1, 2023, to November 8, 2024, among physicians from 19 countries in the Middle East and North Africa region.

Biochemical response to neoadjuvant androgen deprivation therapy before radiation therapy and the risk of death in patients with unfavorable-risk prostate cancer: A secondary analysis of a randomized clinical trial.

Introduction: A prostate-specific antigen (PSA) level >0.5 ng/mL after 9 to 10 weeks of neoadjuvant androgen deprivation therapy and before radiation therapy (RT) was associated with an increased PSA-failure risk; however, the impact on all-cause mortality (ACM) risk after adjusting for serum testosterone level remains unknown.

Methods: From 2005 to 2015, 350 patients with localized, unfavorable-risk prostate cancer (PC) were randomly assigned to receive androgen deprivation therapy and RT plus docetaxel vs standard of care (SOC) with androgen deprivation therapy and RT.

Molecular Alterations Associated with Histologically Overt Stromal Response in Patients with Prostate Cancer.

Prostate cancer has substantial heterogeneity in clinical outcomes and therapeutic responses, posing challenges in predicting disease progression and tailoring treatment strategies. Recent studies have highlighted the potential prognostic value of evaluating the tumor microenvironment, including the presence of a histologically overt stromal response (HOST-response) characterized by peri-glandular stromal changes and architectural distortions. This retrospective study examined patient records from The Cancer Genome Atlas database to identify genomic alterations associated with the HOST-response in prostate cancer.

Prostate Cancer Awareness in the Middle East: A Cross-Sectional International Study.

Purpose: Prostate cancer has emerged as a significant public health challenge in the Middle East, characterized by rising incidence rates and a concerning mortality-to-incidence ratio. Yet, despite these alarming trends, data regarding prostate cancer awareness in the region remain limited. To address this critical knowledge gap, this study investigates prostate cancer awareness within the Middle East.

Histologically Overt Stromal Response and the Risk of Progression after Radical Prostatectomy for Prostate Cancer.

Purpose: Given the variable clinical course of prostate cancer and the limitations of current prognostic factors, this study was conducted to investigate the impact of a histologically overt stromal response (HOST-response) to prostate cancer on clinical outcomes after radical prostatectomy.

Methods: This retrospective analysis utilized The Cancer Genome Atlas (TCGA) to evaluate data from individuals with a confirmed diagnosis of prostate cancer who underwent radical prostatectomy and had available pathology slides. These slides were assessed for the presence of a HOST-response, similar to desmoplasia.

Elective Pelvic Lymph Node Radiation Therapy and the Risk of Death in Patients With Unfavorable-Risk Prostate Cancer: A Postrandomization Analysis.

Purpose: Although a contemporary randomized clinical trial has led to the use of whole-pelvic radiation therapy (WPRT), long-term data evaluating a potential reduction in mortality are lacking and are addressed in the current study.

Materials And Methods: From 2005 to 2015, 350 men with localized, unfavorable-risk prostate cancer (PC) were randomly assigned to receive androgen deprivation therapy (ADT) and RT plus docetaxel versus ADT and RT. Treatment of the pelvic lymph nodes was at the discretion of the treating physician.

Secondary analysis of late major gastrointestinal and genitourinary toxicities in unfavorable-risk prostate cancer patients receiving docetaxel: Insights from a randomized trial.

Background: This study sought to evaluate the late toxicity associated with neoadjuvant and concurrent docetaxel and radiation therapy in patients with prostate cancer.

Methods: A secondary analysis was performed of the phase 3 multicenter randomized trial (Dana-Farber Cancer Institute 05-043) including 350 patients with nonmetastatic unfavorable-risk prostate cancer. Patients were randomized 1:1 to receive androgen deprivation therapy, radiation therapy, and docetaxel versus androgen deprivation therapy and radiation therapy.

Prostate cancer presentation and management in the Middle East.

Background: Although prostate cancer is a prevalent malignancy worldwide, its clinical presentation and management in the Middle East are not well-documented. This study aims to provide insights into the initial clinical presentation and management of prostate cancer in this region.

Methods: A retrospective review was conducted on seven institutional databases from six Middle Eastern countries, including Türkiye, Lebanon, Iraq, Syria, Bahrain, and Jordan, to identify patients diagnosed with prostate cancer in 2021.

Prognosis of South Asian Buccal Mucosa Cancer Patients in the United States: Association of Race with Overall Survival.

Background: Squamous Cell Carcinoma (SCC) of the buccal mucosa and gingiva accounts for approximately 10% of oral and pharyngeal cancers diagnosed in the United States each year, with a disproportionally higher incidence in individuals of South Asian descent. However, little has been documented regarding trends pertaining to overall survival. Thus, this research serves to identify predictors of survival and determine if overall survival (OS) differs for South Asians compared to other races once they develop non-metastatic buccal mucosa or gingiva squamous cell carcinoma.

Burden of prostate cancer in the Middle East: A comparative analysis based on global cancer observatory data.

Background: Prostate cancer represents a significant global health issue, yet our understanding of its impact in the Middle East remains limited. This study aimed to assess the incidence and mortality of prostate cancer in the Middle East, and compare these rates to those in Europe and North America.

Materials And Methods: We utilized the 2020 Global Cancer Observatory data, compiling incidence and mortality rates of prostate cancer in 20 Middle Eastern countries.

Risk of Short-Term Prostate-Specific Antigen Recurrence and Failure in Patients With Prostate Cancer: A Secondary Analysis of a Randomized Clinical Trial.

Importance: A shorter time interval to prostate-specific antigen (PSA) failure is associated with worse clinical outcomes; however, specific factors defining this state remain unknown.

Objective: To evaluate the factors of a short time interval to PSA failure in order to identify patients for treatment escalation randomized clinical trials.

Design, Setting, And Participants: This secondary analysis of a randomized clinical trial was a secondary analysis of the Dana-Farber Cancer Institute 05-043 trial and included 350 patients with nonmetastatic unfavorable risk prostate cancer (PC).