Adequacy of prostate cancer prevention and screening recommendations provided by an artificial intelligence-powered large language model.

Purpose: We aimed to assess the appropriateness of ChatGPT in providing answers related to prostate cancer (PCa) screening, comparing GPT-3.5 and GPT-4.

Methods: A committee of five reviewers designed 30 questions related to PCa screening, categorized into three difficulty levels.

Comparison of patient background between a real-world North American cohort and the Göteborg-2 trial.

Objectives: To analyze the generalizability of the Göteborg-2 findings to a North American cohort.

Methods: We replicated the Göteborg-2 inclusion criteria in our Henry Ford Health (HFH) cohort, by identifying all patients 50-60 years old who had a PSA test from 2013 to 2018. The first PSA within the study period was considered PSA at entry, and included in the analysis.

Admission Rates, Healthcare Utilization, and Inpatient Cost of Radiation Cystitis in the United States.

Objective: To assess the incidence, cumulative healthcare burden, and financial impact of inpatient admissions for radiation cystitis (RC), while exploring practice differences in RC management between teaching and nonteaching hospitals.

Methods: We focused on 19,613 patients with a diagnosis of RC within the National Inpatient Sample (NIS) from 2008 to 2014. ICD-9 diagnosis and procedure codes were used.

Trends in Prostate Cancer Screening in the Pre- and Peri-COVID-19 Pandemic Period.

Introduction: This study sought to examine PSA testing rates before, early in, and later in the COVID-19 pandemic.

Methods: Our cohort included test results from men >45 years who received PSA testing at least once at our institution from November 2018 to September 2021 and were alive at the end of that period. Monthly trends were evaluated for 3 periods: pre-COVID (November 2018-February 2020), early-COVID (March-May 2020), and late-COVID (June 2020-September 2021).

Temporal and Racial Trends in Prostate-specific Antigen Screening for U.S. Men With a Family History of Prostate Cancer.

Introduction: Limited data exist on trends in PSA screening in men with a family history of prostate cancer. The aims of our study were to (1) study age-stratified temporal trends in PSA screening from 2000-2018 for men with a family history of prostate cancer and Black men with a family history of prostate cancer, and (2) identify determinants associated with receipt of PSA screening in the aforementioned groups.

Methods: We identified men aged ≥40 years without a prior history of prostate cancer using data from National Health Interview Survey 2000-2018 who self-reported PSA testing in the last 12 months.

External validation of genomic classifier-based risk-stratification tool to identify candidates for adjuvant radiation therapy in patients with prostate cancer.

Objective: To externally validate a Genomic Classifier (GC) based risk-stratification nomogram identifying candidates who would benefit from adjuvant radiation (aRT) therapy after radical prostatectomy (RP).

Methods: We identified 350 patients who underwent RP, between 2013 and 2018, and had adverse pathological features (positive margin, and/or pT3a or higher) on final pathology. Genomic profile was available for all these men.

A Systematic Review of the Role of Definitive Local Treatment in Patients with Clinically Lymph Node-positive Prostate Cancer.

Context: There is uncertainty regarding the oncologic effectiveness and the survival advantage of local treatment (LT) in men with clinically lymph node-positive (cN+) prostate cancer (PCa).

Objective: To systematically review the current literature comparing oncologic outcomes associated with the use of any form of LT for PCa patients with cN+ disease.

Evidence Acquisition: A computerized bibliographic search of the Medline, Embase, and Cochrane databases was performed for all studies reporting comparative oncologic outcomes of LT±androgen deprivation therapy (ADT) versus ADT alone.

Impact of Accountable Care Organizations on Prostate Cancer Screening and Biopsies in the United States.

Introduction: Accountable care organizations are designed to financially incentivize efficiency and reduce low value care. To determine if accountable care organizations have impacted prostate cancer screening patterns, we analyzed trends in prostate specific antigen screening and prostate biopsies by accountable care organization and nonaccountable care organization providers.

Methods: Using a random 20% sample of Medicare claims, we selected men 66 years old or older.

Increasing Rate of Noninterventional Treatment Management in Localized Prostate Cancer Candidates for Active Surveillance: A North American Population-Based Study.

Background: The rate of noninterventional treatment (NIT) in prostate cancer (PCa) active surveillance (AS) candidates is on the rise. However, contemporary data are unavailable. We described community-based NIT rates within 16 Surveillance Epidemiology and End Results (SEER) registries between 2010 and 2014.

The effect of treatment at minority-serving hospitals on outcomes for bladder cancer.

Objectives: Healthcare for racial minorities is densely concentrated at a small subset of hospitals in the United States. Understanding long-term outcomes at these minority-serving hospitals is highly relevant to elucidating the sources of racial disparities in cancer care. We investigated the effect of treatment at a minority-serving hospital on overall survival and receipt of definitive treatment for bladder cancer.

Comparison of Partial Versus Radical Nephrectomy Effect on Other-cause Mortality, Cancer-specific Mortality, and 30-day Mortality in Patients Older Than 75 Years.

Background: Historically, partial nephrectomy (PN) showed no benefit on other-cause mortality (OCM) in elderly patients with small renal masses.

Objective: To test the effect of PN versus radical nephrectomy (RN) on OCM, cancer-specific mortality (CSM), as well as 30-d mortality in patients with nonmetastatic T1a renal cell carcinoma (RCC), aged ≥75 yr old.

Design, Setting, And Participants: Within the Surveillance, Epidemiology and End Results registry (2004-2014), we identified surgically treated patients with nonmetastatic pT1a RCC aged ≥75 yr.

Contemporary Trends and Survival Outcomes After Aborted Radical Prostatectomy in Lymph Node Metastatic Prostate Cancer Patients.

Background: Aborted radical prostatectomy (aRP) in lymph node (LN) metastatic (pN1) prostate cancer (PCa) patients showed worse survival in European patients. Contemporary rates of aRP are unknown in North America.

Objective: To examine the rate of aRP and its effect on cancer-specific mortality (CSM) in contemporary North American patients.

The Impact of Lymph Node Metastases Burden at Radical Prostatectomy.

Background: We hypothesized that a cut-off in positive lymph node (LN) counts may discriminate between cancer-specific mortality (CSM) rates in clinically localized prostate cancer patients treated with radical prostatectomy (RP).

Objective: To test this relationship, we relied on different LN count cut-offs, as well as the continuously coded number of positive LNs (NPN).

Methods: Within the Surveillance, Epidemiology, and End Results database (2004-2014), we identified patients with D'Amico intermediate- or high-risk characteristics who underwent RP and pelvic LN dissection, regardless of pathologic LN stage.

First North American validation and head-to-head comparison of four preoperative nomograms for prediction of lymph node invasion before radical prostatectomy.

Objectives: To perform a head-to-head comparison of four nomograms; namely, the Cagiannos, the 2012-Briganti, the Godoy and the online-Memorial Sloan Kettering Cancer Center (MSKCC), for prediction of lymph node invasion (LNI) in a North American population.

Patients And Methods: A total of 19 775 patients with clinically localized prostate cancer (PCa) who had undergone radical prostatectomy and pelvic lymph node dissection (PLND) were identified within the Surveillance Epidemiology and End Results (SEER) database. All four nomograms were tested using Heagerty's concordance index (C-index), calibration plots and decision curve analysis (DCA).

Variation in the use of active surveillance for low-risk prostate cancer.

Background: This study assessed the use of active surveillance in men with low-risk prostate cancer and evaluated institutional factors associated with the receipt of active surveillance.

Methods: A retrospective, hospital-based cohort of 115,208 men with low-risk prostate cancer diagnosed between 2010 and 2014 was used. Multivariate and mixed effects models were used to examine variation and factors associated with active surveillance.

30-Day Adverse Events Following Cystectomy for Bladder Cancer Versus Benign Bladder Conditions.

Introduction: Cystectomy is a first line treatment for muscle invasive bladder cancer and a last resort option for several benign bladder conditions. It is currently unknown how the perioperative outcomes of cystectomy for cancer differ from those of cystectomy for benign conditions.

Methods: Using the National Surgical Quality Improvement Program database we extracted data on cystectomy between 2006 and 2013.

Contemporary Trends in the Incidence of Metastatic Prostate Cancer Among US Men: Results from Nationwide Analyses.

Studies have noted contrasting findings with regard to the contemporary incidence of metastatic prostate cancer (PCa) in the USA, especially in light of the United States Preventive Services Task Force (USPSTF) recommendations against prostate-specific antigen (PSA) screening in recent years. We used data from the 18 population- based tumor registries of the Surveillance, Epidemiology and End Results (SEER) 2004-2013 database to study trends in the incidence of metastatic PCa among men stratified by age and race. Joinpoint regression analyses were performed to identify time points associated with any statistically significant change in incidence.

Systematic Review of the Volume-Outcome Relationship for Radical Prostatectomy.

Context: Radical prostatectomy (RP) is one of the most complex urological procedures performed. Higher surgical volume has been found previously to be associated with better patient outcomes and reduced costs to the health care system. This has resulted in some regionalization of care toward high-volume facilities and providers; however, the preponderance of RPs is still performed at low-volume institutions.