Prostate Cancer

Is hypofractionated whole pelvis radiotherapy (WPRT) as well tolerated as conventionally fractionated WPRT in prostate cancer patients? The HOPE trial.

Patients with high-risk prostate cancer are at increased risk of lymph node metastasis and are thought to benefit from whole pelvis radiotherapy (WPRT). There has been recent interest in the use of hypofractionated radiotherapy in treating prostate cancer.

Expected impact of MRI-related interreader variability on ProScreen prostate cancer screening trial: a pre-trial validation study.

The aim of this study is to investigate the potential impact of prostate magnetic resonance imaging (MRI) -related interreader variability on a population-based randomized prostate cancer screening trial (ProScreen).

Poly(ADP-Ribose) Polymerase Inhibitors in Prostate Cancer: Molecular Mechanisms, and Preclinical and Clinical Data.

Genomic instability is one of the hallmarks of cancer. The incidence of genetic alterations in homologous recombination repair genes increases during cancer progression, and 20% of prostate cancers (PCas) have defects in DNA repair genes.

The "Is mpMRI Enough" or IMRIE Study: A Multicentre Evaluation of Prebiopsy Multiparametric Magnetic Resonance Imaging Compared with Biopsy.

Multiparametric magnetic resonance imaging (mpMRI) is now recommended prebiopsy in numerous healthcare regions based on the findings of high-quality studies from expert centres. Concern remains about reproducibility of mpMRI to rule out clinically significant prostate cancer (csPCa) in real-world settings.

MRI-Guided Transurethral Ultrasound Ablation in Patients with Localized Prostate Cancer: Three Year Outcomes of a Prospective Phase I Study.

To report the three-year follow-up of a Phase I study of magnetic resonance imaging (MRI)-guided transurethral ultrasound ablation (TULSA) in 30 men with localized prostate cancer. Favorable 12-month safety and ablation precision were previously described.

Mount Sinai Study Shows Novel Surgical Technique For Prostate Cancer Improves Urinary Continence

Senior Author:  Ash Tewari, MBBS, MCh, Chair of the Department of Urology at the Mount Sinai Health System, Professor, Urology, Oncological Sciences, Icahn School of Medicine at Mount Sinai

First Author:  Vinayak G Wagaskar, MBBS, MCh, Clinical Fellow, Department of Urology Icahn School of Medicine at Mount Sinai

Bottom Line: This study described a novel surgical technique, the RARP “hood technique” which showed a reduction in postoperative urinary incontinence and facilitated a early return of continence in patients with localized prostate cancer.

What: In this study, the novel “hood technique” preserved tissue after prostate removal and has the appearance of a “hood” comprising the detrusor apron, arcus tendineus, puboprostatic ligament, anterior vessels, and some fibers of the detrusor muscle. This hood surrounds and safeguards the membranous urethra, external sphincter, and supportive structures.

Why Is the Study Important: Radical prostatectomy is the reference standard for the treatment of localized prostate cancer. This technique has been modified and refined over many years. Nevertheless, the procedure continues to have several common side effects, including urinary incontinence, which can significantly impact the quality of life for prostate cancer survivors and which is the focus of this study.

The hood technique for robotic-assisted prostatectomy described in this study represents a modification to the anterior approach similar to previously published techniques and also preserves the musculofascial structures anterior of the prostate.  This novel study shows that the hood technique confers three key benefits: early continence, a low positive surgical margin rate, and the ability to visualize anatomical landmarks.

Who: This is a study of 300 patients (median age 64 yr.) with localized prostate cancer treated with the RARP hood technique at a major urban hospital between April 2018 and March 2019. This study was conducted at the Mount Sinai Health System.

Conclusions:  Results indicate that the hood technique spares musculofascial structures anterior to the urethral sphincter complex with early return of continence after surgery, without compromising positive surgical margin rates. Exclusion of anterior tumor location contributed to a reduction in positive surgical margins.

Paper Title:  Hood Technique for Robotic Radical Prostatectomy—Preserving Periurethral Anatomical Structures in the Space of Retzius and Sparing the Pouch of Douglas, Enabling Early Return of Continence Without Compromising Surgical Margin Rates

Journal: European Urology

Mount Sinai's Dr. Ash Tewari: “A common side effect that patients worry about following a radical prostatectomy is urinary incontinence. But this study shows that using a novel surgical technique, the RARP “hood technique” we can reduce postoperative urinary incontinence and facilitate early return of continence in patients with localized prostate cancer. In the study, patients also reported better preservation of anatomical structures around the urethra and were able to achieve early return of urinary continence without a negative impact on complications and cancer outcomes.”
Source: "Mount Sinai Study Shows Novel Surgical Technique For Prostate Cancer Improves Urinary Continence". 2020. Newswise.Com

No detrimental effect of a positive family history on postoperative upgrading and upstaging in men with low risk and favourable intermediate-risk prostate cancer: implications for active surveillance.

To assess whether a first-degree family history or a fatal family history of prostate cancer (PCa) are associated with postoperative upgrading and upstaging among men with low risk and favourable intermediate-risk (FIR) PCa and to provide guidance on clinical decision making for active surveillance (AS) in this patient population.

Evolving understanding and categorization of prostate cancer: preventing progression to metastatic castration-resistant prostate cancer: RADAR IV.

INTRODUCTION To interpret data and update the traditional categorization of prostate cancer in order to help treating clinicians make more informed decisions. These updates include guidance regarding how to best use next generation imaging (NGI) with the caveat that the new imaging technologies are still a work in progress.

Androgen receptor signaling-targeted therapy and taxane chemotherapy induce visceral metastasis in castration-resistant prostate cancer.

Visceral metastasis (VM), an important poor prognostic factor of prostate cancer (PC), is not commonly observed in castration sensitive status but is often observed after castration-resistant progression.

Molecular tracing of prostate cancer lethality.

Prostate cancer is diagnosed mostly in men over the age of 50 years, and has favorable 5-year survival rates due to early cancer detection and availability of curative surgical management. However, progression to metastasis and emergence of therapeutic resistance are responsible for the majority of prostate cancer mortalities.