Mortality and Additional Treatment Rates in Pathologically High-Risk Prostate Cancer With Prostate-Specific Antigen Persistence at Robot-Assisted Radical Prostatectomy: Long-Term Report From Single Tertiary Referral Center.

Background: Long-term cancer control efficacy of robotic-assisted laparoscopic prostatectomy (RALP) in men with pathologically high-risk prostate cancer and prostate-specific antigen (PSA) persistence remains poorly addressed in the literature. Our aim was to evaluate long-term survival and additional treatment (AT) rates in these individuals.

Methods: We included 803 patients who underwent RALP for pathologically high-risk PCa (pT ≥ 3a, pN0-1 or GG ≥ 4) between 2001 and 2022 at a single tertiary referral center (Henry Ford Hospital, Detroit).

Long-term Cancer Control Outcomes After Robot-assisted Radical Prostatectomy in Pathologically Non-organ-confined High-risk Prostate Cancer: 20-year Report from a Single Tertiary Referral Center.

Background And Objective: Exhaustive evidence on the long-term efficacy of robot-assisted laparoscopic prostatectomy (RALP) in non-organ-confined high-risk prostate cancer (PC) is still lacking. Our aim was to evaluate long-term oncological outcomes in this subset of patients treated with RALP at a single referral center.

Methods: We included 803 patients with pathologically non-organ-confined high-risk PC (≥pT3a and/or pN1) at RALP between 2001 and 2022 at Henry Ford Hospital (Detroit, MI, USA).

Socioeconomic disparities in prostate cancer screening: the impact of the Area Deprivation Index on PSA screening frequency.

Objective: To investigate the impact of the Area Deprivation Index (ADI) on prostate-specific antigen (PSA) screening patterns in a North American cohort, as the influence of neighbourhood socioeconomic disadvantage on prostate cancer screening intensity has been scantly analysed.

Patients And Methods: We included all men receiving care in Henry Ford Health System, aged 50-69 years and without previous prostate cancer diagnosis at the 31 December 2022. Each patient was assigned an ADI score based on their census block group, categorised into quartiles, with the fourth quartile (Q4, ADI 75-100) representing the most disadvantaged areas.

The Role of Cytoreductive Nephrectomy in Contemporary Metastatic Renal Cell Carcinoma: An Other-Cause Mortality Match Population-Based Study.

Objective: A post-hoc analysis of CARMENA trial revealed that cytoreductive nephrectomy (CN) might still be beneficial for selected metastatic renal cell carcinoma (mRCC) patients. However, selection bias influences the choice of patients for CN, typically favoring those in better health and with a lower risk of all-cause mortality. We aimed to evaluate the impact of CN on cancer-specific mortality (CSM), using a cohort of mRCC patients matched for other-cause mortality (OCM).

Socioeconomic disparities and MIBC survival outcome-An analysis of a statewide cohort.

Purpose: Muscle-invasive bladder cancer (MIBC) is an aggressive malignancy with limited survival improvements despite advancements in treatment. Socioeconomic disparities significantly affect patient outcomes, yet the Area Deprivation Index (ADI), a robust measure of socioeconomic status, has been underexplored in MIBC. This study evaluates the association between ADI and cancer-specific mortality (CSM) in MIBC.

Active Surveillance for Prostate Cancer in "Real-World" Setting: Exploring Racial Disparities.

Introduction And Objectives: Active surveillance (AS) is a safe management strategy for low-risk prostate cancer (PCa), but limited "real-world" data exist outside trial cohorts. This study investigates racial disparities in progression to treatment, upgrading, and prostate cancer-specific mortality (PCSM) in a real-world AS population, aiming to improve healthcare quality.

Methods: We retrospectively analyzed data from the Henry Ford Health System (1995-2023) for men diagnosed with PCa (Gleason Grade ≤ 2, ≤ cT2c, N0-M0, PSA ≤ 20 ng/ml, age < 76 years) and enrolled in AS with ≥ 1 post-diagnosis PSA or biopsy and ≥ 1 year follow-up.

Association of Area of Deprivation Index With Active Surveillance (AS) Utilization and Adherence to as Guidelines: Results From a Contemporary North American Cohort.

Background: Active Surveillance (AS) for Prostate Cancer (PCa) requires regular follow-up, raising concerns that socioeconomic barriers may result in underutilization or decreased adherence to AS guidelines. We examined the relationship between socioeconomic factors, measured by the Area Deprivation Index (ADI), and AS habits in a contemporary North American cohort.

Methods: We included all the patients aged ≤ 75 years and diagnosed with low (ISUP GG = 1, PSA ≤ 10 ng/mL and cT1N0M0) and intermediate risk (ISUP GG = 2, PSA 10-20 ng/mL or cT2N0M0) PCa at Henry Ford Health (HFH) between 1995 and 2023.

Socioeconomic Disparities in Prostate Cancer Treatment: The Impact of Area Deprivation Index on Initial Treatment Type for Localized PCa in a North-American Cohort.

Background: Socioeconomic status and geographical location contribute to disparities in localized prostate cancer (PCa) treatment. We examined the impact of area of deprivation index (ADI) on initial treatment type for localized PCa in a North-American cohort.

Methods: We performed a retrospective analysis of patients diagnosed with localized PCa, treated within Henry Ford Health (HFH), between 1995 and 2022, with available ADI-data.

Impact of transperitoneal anterior, retzius-sparing, extraperitoneal, transvesical and perineal approaches on urinary continence recovery after robot-assisted radical prostatectomy: a systematic review and meta-analysis of comparative studies.

Background: Urinary incontinence significantly impacts on health-related quality of life of patients undergoing radical prostatectomy. In the last decades, several approaches (extraperitoneal, Retzius-sparing (RS), perineal and, transvesical) for robot-assisted radical prostatectomy (RARP) have proposed with the aim to improve functional outcomes in comparison with transperitoneal, anterior ones.

Methods: We performed a systematic review and meta-analysis of studies published in English language, in the last ten years, comparing the different approaches used to perform RARP.

Comparing PSA Screening Patterns and Their Role as Predictor of Prostate Cancer Diagnosis: Analysis of a Contemporary North American Cohort.

Introduction: PSA screening remains a pivotal tool for early prostate cancer (PCa) detection. International guidelines rely on evidence from three major randomized clinical trials: ERSPC, PLCO, and CAP. We aim to examine the percentage of patients in real-world practice who get PSA screening as defined by each of the aforementioned trials.

Racial Disparities in Future Development of Lethal Prostate Cancer Based on Midlife Baseline Prostate-Specific Antigen.

Background: Previous studies found that Midlife Baseline PSA (MB PSA) predicts the risk of developing lethal prostate cancer (PCa), although the cohorts were homogenous in terms of racial compositions. We aimed to investigate racial disparities in the predictive value of MB PSA for lethal PCa in a diverse, contemporary, North American population.

Methods: Our cohort included White and Black men aged 40-59 years, who underwent MB PSA through our health system.

Active surveillance follow-up for prostate cancer: from guidelines to real-world clinical practice.

Purpose: To assess active surveillance (AS) adherence for prostate cancer (PCa) in a "real-world" clinical practice.

Materials And Methods: We utilized our institutional database which was built by interrogating electronic medical records for all men who got diagnosed with PCa from 1995 to 2022. Our cohort included all patients aged < 76 years, with PCa Gleason Grade (GG) 1 or 2, ≤ cT2c, PSA ≤ 20 ng/ml at diagnosis, enrolled on AS, and with at least one biopsy after diagnosis.

Prostate Cancer Screening and Diagnoses in the Transfeminine Population.

Objective: To examine the frequency and rate at which transfeminine patients receive prostate-specific antigen testing compared to a matched cisgender cohort.

Methods: Patients with prostates who had encounters in our health system, are currently age 46 or older, and who are alive were included in our study. Transfeminine patients were identified through diagnosis codes and chart review.

Radical cystectomy versus trimodal therapy for muscle-invasive bladder cancer: Analysis of an other-cause mortality matched cohort.

Objective: Comparative effectiveness studies comparing trimodal therapy (TMT) to radical cystectomy (RC) are typically hindered by selection bias where TMT is usually reserved to patients with poor overall health status. We developed a novel approach by matching patients based on their calculated other-cause mortality (OCM) risk. Using this homogeneous cohort, we tested the impact of TMT vs RC on cancer-specific mortality (CSM).

Assessment of the gender gap in urology industry payments: An Open Payments Program data analysis.

Purpose: The Open Payments Program (OPP), established in 2013 under the Sunshine Act, mandated medical device and pharmaceutical manufacturers to submit records of financial incentives given to physicians for public availability. The study aims to characterize the gap in real general and real research payments between man and woman urologists.

Materials And Methods: The study sample included all urologists in the United States who received at least one general or research payment in the OPP database from 2015 to 2021.

Trends and Costs of Minimally Invasive Surgery for Kidney Cancer in the US: A Population-based Study.

Objective: To analyze temporal trends and costs associated with the use of minimally invasive surgery (MIS) for kidney cancer in the US over the past decade. To examine the impact of social determinants of health (SDOH) on perioperative outcomes.

Methods: The PearlDiver Mariner, a national database of insurance billing records, was queried for this retrospective observational cohort analysis.