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The current status of hormone treatment for prostate cancer patients in Korean real-world practice:a multi-institutional observational study

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Asian Journal of Andrology 2019年第2期21卷 115-120页

作者： Jung Kwon Kim Jung Jun Kim Taek Won Gang Tae Kyun Kwon Hong Sup Kim Seung Chui Park Jae-Shin Park Jong-Yeon Park Seok Joong Yoon Youn-Soo Jeon Jin Seon Cho Kwan Joong Joo Sung-Hoo Hong Seok-Soo Byun the Korean Urological Oncology Society department of urology Seoul National University Bundang HospitalSeongnam 13620Korea department of urology Hallym University Sacred Heart HospitalAnyang 14068Korea department of urology Kangbuk Samsung HospitalSeoul 03181Korea department of urology Seoul St.Mary HospitalSeoul 06591Korea 不详 department of urology Chonnam National University HospitalGwangju 61469Korea School of Medicine Kyungpook National University Medical CenterDaegu 41404Korea department of urology Konkuk University Medical CenterSeoul 05080Korea department of urology Wonkwang University HospitalIksan 54538Korea department of urology Daegu Catholic University Medical CenterDaegu 41911Korea department of urology Ulsan UniversityGangneung Asan HospitalGangneung 25440Korea department of urology Chungbuk National University HospitalCheongju 28644Korea department of urology Soonchunhyang University HospitalCheonan 31151Korea

We aimed to evaluate the current nationwide trend,efficacy,safety,and quality of life(QoL)profiles of hormone treatment in real-world practice settings for prostate cancer(PCa)patients in Korea.A total of 292 men with any biopsy-proven PCa(TanyNanyMany)from 12 institutions in Korea were included in this multi-institutional,observational study of prospectively collected data.All luteinizing hormone-releasing hormone(LHRH)agonists were allowed to be investigational drugs.Efficacy was defined as(1)the rate of castration(serum testosterone≤50 ng dl^-1)at 4-week visit and(2)breakthrough(serum testosterone>50 ng dl^-1 after castration).Safety assessments included routine examinations for potential adverse events,laboratory tests,blood pressure,body weight,and bone min era I density(BMD,at baseli ne and at the last follow-up visit).QoL was assessed using the Expa nded Prostate Cancer Index Composite-26(EPIC-26).The most comm on initial therapeutic regimen was LHRH agonist with an ti-androge n(78.0%),and the most commonly used LHRH agonist for combination and mono therapy was leuprolide(64.0%for combi natio n and 58.0%for monotherapy).The castration and breakthrough rates were 78.4%and 6.6%,respectively.The laboratory results related to dyslipidemia worsened after 4 weeks of hormone treatment.In addition,the mean BMD T-score was significantly lower at the last follow-up(mean:-1.950)compared to baseline(mean:-0.195).The mean total EPIC-26 score decreased from 84.8(standard deviation[s.d.]:12.2)to 78.3(s.d.:8.1),with significant deterioration only in the urinary domain(mean:23.5 at baseli ne and 21.9 at the 4-week visit).These findi ngs dem on strate the n ationwide trend of current practice setti ngs in hormone treatment for PCa in Korea.

关键词： efficacy hormonal treatment Korean population prostate cancer safety trend

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Validation of user-friendly models predicting extracapsular extension in prostate cancer patients

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Asian Journal of urology 2023年第1期10卷 81-88页

作者： Leandro Blas Masaki Shiota Shohei Nagakawa Shigehiro Tsukahara Takashi Matsumoto Ken Lee Keisuke Monji Eiji Kashiwagi Junichi Inokuchi Masatoshi Eto department of urology Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

Objective:There are many models to predict extracapsular extension(ECE)in patients with prostate cancer.We aimed to externally validate several models in a Japanese cohort.Methods:We included patients treated with robotic-assisted radical prostatectomy for prostate cancer.The risk of ECE was calculated for each patient in several models(prostate side-specific and non-side-specific).Model performance was assessed by calculating the receiver operating curve and the area under the curve(AUC),calibration plots,and decision curve analyses.Results:We identified ECE in 117(32.9%)of the 356 prostate lobes included.Patients with ECE had a statistically significant higher prostate-specific antigen level,percentage of positive digital rectal examination,percentage of hypoechoic nodes,percentage of magnetic resonance imaging nodes or ECE suggestion,percentage of biopsy positive cores,International Society of Urological Pathology grade group,and percentage of core involvement.Among the sidespecific models,the Soeterik,Patel,Sayyid,Martini,and Steuber models presented AUC of 0.81,0.78,0.77,0.75,and 0.73,respectively.Among the non-side-specific models,the memorial Sloan Kettering Cancer Center web calculator,the Roach formula,the Partin tables of 2016,2013,and 2007 presented AUC of 0.74,0.72,0.64,0.61,and 0.60,respectively.However,the 95%confidence interval for most of these models overlapped.The side-specific models presented adequate calibration.In the decision curve analyses,most models showed net benefit,but it overlapped among them.Conclusion:Models predicting ECE were externally validated in Japanese men.The side-specific models predicted better than the non-side-specific models.The Soeterik and Patel models were the most accurate performing models.

关键词： Prognosis Prostate cancer Nomogram Extracapsular extension

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46 XX karyotype during male fertility evaluation; case series and literature review

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Asian Journal of Andrology 2017年第2期19卷 168-172页

作者： Ahmad Majzoub Mohamed Arafa Christopher Starks Haitham Elbardisi Sami A1 Said Edmund Sabanegh Jr Cleveland Clinic Foundation Department of Urology Cleveland Ohio USA Hamad Medical Corporation Department of Urology Qatar Cairo University Department of Andrology Giza Egypt Reston Hospital Department of Urology Virginia USA

Forty-six XX disorder of sex development is an uncommon medical condition observed at times during the evaluation of a man＇s fertility. The following is a case series and literature review of phenotypically normal men diagnosed with this karyotype. Our goal is to comprehend the patients＇ clinical presentation as well as their laboratory results aiming to explore options available for their management. A formal literature review through PubMed and MEDLINE databases was performed using ＂46 XX man＂ as a word search. A total of 55 patients, including those conveyed in this article were diagnosed with a 46 XX karyotype during their fertility evaluation. The patients＇ mean age _＋ s.d. was 34 ＋ 10 years and their mean height ＋ s.d. was 166 ＋ 6.5 cm. Overall, they presented with hypergonadotropic hypogonadism. Sexual dysfunction, reduced hair distribution, and gynecomastia were reported in 20% （4120）, 25.8% （8/31）, and 42% （13131） of the patients, respectively. The SRYgene was detected in 36 （83.7%） and was absent in the remaining seven （16.3%） patients. We found that a multidisciplinary approach to management is preferred in 46 XX patients. Screening for remnants of the mullerian ducts and for malignant transformation in dysgenetic gonads is imperative. Hypogonadism should be addressed, while fertility options are in vitro fertilization with donor sperm or adoption.

关键词： hypogonadism infertility male sex-determining region XX disorders of sex development

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Predictors of efficacy of corticosteroid switching from abiraterone plus prednisone to dexamethasone in patients with metastatic castration-resistant prostate cancer

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Asian Journal of Andrology 2022年第2期24卷 154-160页

作者： Yu-Chao Ni Jin-Ge Zhao Meng-Ni Zhang Yi-Jun Zhang Zhen-Yu Yang Ni Chen Jun-Ru Chen Peng-Fei Shen Guang-Xi Sun Xing-Ming Zhang Yong-Hong Li Hao Zeng department of urology Institute of UrologyWest China HospitalSichuan UniversityChengdu 610041China department of Pathology West China HospitalSichuan UniversityChengdu 610041China department of Pathology Sun Yat-Sen University Cancer CenterGuangzhou 510060China department of urology Sun Yat-Sen University Cancer CenterGuangzhou 510060China

Corticosteroid switching can reverse abiraterone resistance in some patients with metastatic castration-resistant prostate cancer(mCRPC).Here,we investigated the potential biomarkers for predicting the efficacy of corticosteroid switching during treatment with abiraterone acetate(AA).We retrospectively analyzed 101 mCRPC patients receiving corticosteroid switching from West China Hospital and Sun Yat-Sen University Cancer Center between January 2016 and December 2018.All cases received AA plus prednisone as first-line therapy during mCRPC.Primary end points were biochemical progression-free survival(bPFS)and overall survival(OS).The risk groups were defined based on multivariate analysis.A total of 42(41.6%)and 25(24.8%)patients achieved 30%and 50%decline in prostate-specific antigen(PSA),respectively,after corticosteroid switching.The median bPFS and median OS on AA plus dexamethasone were 4.9(95%confidence interval[CI]:3.7–6.0)months and 18.8(95%CI:16.2–30.2)months,respectively.Aldo-keto reductase family 1 member C3(AKR1C3)expression(hazard ratio[HR]:2.15,95%Cl:1.22–3.80,P=0.008)and baseline serum alkaline phosphatase(ALP;HR:4.95,95%Cl:2.40–10.19,P160 IU l−1(HR:3.41,95%Cl:1.57–7.38,P=0.002)together with PSA level at switch≥50 ng ml−1(HR:2.59,95%Cl:1.22–5.47,P=0.013)independently predicted poorer OS.Based on the predictive factors in multivariate analysis,we developed two risk stratification tools to select candidates for corticosteroid switching.Detection of serum ALP level,PSA level,and tissue AKR1C3 expression in mCRPC patients could help make clinical decisions for corticosteroid switching.

关键词： abiraterone acetate alkaline phosphatase corticosteroid switching dexamethasone metastatic castration-resistant prostate cancer

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Recent advances in prostate cancer: WNT signaling, chromatin regulation, and transcriptional coregulators

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Asian Journal of Andrology 2023年第2期25卷 158-165页

作者： Sayuri Takahashi Ichiro Takada department of urology The Institute of Medical ScienceThe University of TokyoShirokanedaiMinato-kuTokyo 108-8639Japan department of urology The Faculty of MedicineThe University of TokyoHongoBunkyo-kuTokyo 113-8655Japan

Prostate cancer is one of the most common diseases in men worldwide.Surgery,radiation therapy,and hormonal therapy are effective treatments for early-stage prostate cancer.However,the development of castration-resistant prostate cancer has increased the mortality rate of prostate cancer.To develop novel drugs for castration-resistant prostate cancer,the molecular mechanisms of prostate cancer progression must be elucidated.Among the signaling pathways regulating prostate cancer development,recent studies have revealed the importance of noncanonical wingless-type MMTV integration site family(WNT)signaling pathways,mainly that involving WNT5A,in prostate cancer progression and metastasis;however,its role remains controversial.Moreover,chromatin remodelers such as the switch/sucrose nonfermentable(SWI/SNF)complex and chromodomain helicase DNA-binding proteins 1 also play important roles in prostate cancer progression through genome-wide gene expression changes.Here,we review the roles of noncanonical WNT signaling pathways,chromatin remodelers,and epigenetic enzymes in the development and progression of prostate cancer.

关键词： chromatin remodeling histone-modifying enzymes prostate cancer WNT5A

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Body composition changes following chemotherapy for testicular germ cell tumor:obesity is the long-term problem

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Asian Journal of Andrology 2022年第5期24卷 458-462页

作者： Yuki Takai Sei Naito Hidenori Kanno Atsushi Yamagishi Mayu Yagi Toshihiko Sakurai Hayato Nishida Takuya Yamanobe Tomoyuki Kato Norihiko Tsuchiya department of urology Yamagata University Faculty of MedicineYamagata 990-9585Japan

Metabolic syndrome is a long-term complication of systemic chemotherapy for testicular germ cell tumor(TGCT).It is believed to be caused by secondary hypogonadism or toxic medicines because of orchidectomy followed by systemic chemotherapy.In this study,changes in the body composition of patients over time were quantitatively analyzed up to 24 months after chemotherapy.This study retrospectively analyzed 44 patients with TGCT who underwent chemotherapy at our institution from January 2008 to December 2016.Subcutaneous and visceral fat areas and psoas and skeletal muscle areas were measured by computed tomography before and immediately after chemotherapy as well as 3 months,6 months,12 months,and 24 months after chemotherapy.The subcutaneous and visceral fat indices and psoas and skeletal muscle indices were calculated as each area divided by body height squared.The total fat area had already significantly increased 3 months after the initiation of chemotherapy(P=0.004).However,it did not return to prechemotherapeutic levels even at 24 months after chemotherapy.The skeletal muscle area was significantly decreased at the end of chemotherapy(P<0.001);however,the value returned to baseline within 12 months.In multivariable analysis,the prechemotherapeutic skeletal muscle index and number of chemotherapy cycles were independently associated with the reduction of skeletal muscle at the end of chemotherapy(P=0.001 and P=0.027,respectively).In patients with TGCT,skeletal muscle mass decreased during chemotherapy and recovered within 12 months,whereas fat mass progressively increased from the initiation of chemotherapy until 24 months after chemotherapy.

关键词： body composition chemotherapy obesity sarcopenia secondary hypogonadism testicular cancer

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Application of fluorescence in situ hybridization in the detection of bladder transitional-cell carcinoma: A multi-center clinical study based on Chinese population

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Asian Journal of urology 2019年第1期6卷 114-121页

作者： Liqun Zhou Kaiwei Yang Xuesong Li Yi Ding Dawei Mu Hanzhong Li Yong Yan Jinyi Li Dongwen Wang Wei Li Yulong Cong Jiangping Gao Kewei Ma Yajun Xiao Sheng Zhang Hongyi Jiang Weilie Hu Qiang Wei Xunbo Jin Zhichen Guan Qingyong Liu Danfeng Xu Xin Gao Yongguang Jiang Weimin Gan Guang Sun Qing Wang Yanhui Liu Jianquan Hou Liping Xie Xishuang Song Fengshuo Jin Jiafu Feng Ming Cai Zhaozhao Liang Jie Zhang Dingwei Ye Lin Qi Lulin Ma Jianzhong Shou Yuping Dai Jianyong Shao Ye Tian Shizhe Hong Tao Xu Chuize Kong Zefeng Kang Yuexin Liu Xun Qu Benkang Shi Shaobin Zheng Yi Lin Shujie Xia Dong Wei Jianbo Wu Weiling Fu Zhiping Wang Jianbo Liang department of urology Peking University First HospitalBeijingChina Institute of urology Peking UniversityBeijingChina National Urological Cancer Center BeijingChina Air Force General Hospital PLABeijingChina department of urology Peking Union Medical College HospitalBeijingChina department of urology Beijing Chao-Yang HospitalBeijingChina department of urology Armed-Police General HospitalBeijingChina department of urology Shanxi Medical University First HospitalTaiyuanChina department of urology Hebei Medical University Second HospitalShijiazhuangChina department of urology The General Hospital of the People’s Liberation ArmyBeijingChina department of urology First Affiliated Hospital of Jilin UniversityChangchunChina department of urology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina department of Pathology The First Affiliated Hospital of Fujian Medical UniversityFuzhouChina department of urology The Second Xiangya Hospital of Central South UniversityChangshaChina department of urology General Hospital of Guangzhou Military Command of PLAGuangzhouChina department of urology West China School of MedicineChengduChina department of urology Shangdong Province-owned HospitalJinanChina department of urology Peking University Shenzhen HospitalShenzhenChina department of urology The Central Hospital of Jinan CityJinanChina department of urology Shanghai Changzheng HospitalShanghaiChina department of urology The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina department of urology Beijing Anzhen Hospital of Capital Medical UniversityBeijingChina department of urology The Second Affiliated Hospital of Xi’an Jiaotong UniversityXi’anChina department of urology The Second Hospital of Tianjin Medical UniversityTianjinChina department of urology People’s Hospital of Xinjiang Uygur Autonomous RegionWulumuqiChina department of urology Guangdong General HospitalGuangzhouChina department of urology The First Affil

Objective:To evaluate the diagnostic value of fluorescence in situ hybridization(FISH)in bladder cancer.Methods:We enrolled healthy volunteers and patients who were clinically suspected to have bladder cancer and conducted FISH tests and cytology examinations from August 2007 to December 2008.Receiver operating characteristic(ROC)curve analysis was performed and the area under curve(AUC)values were calculated for both the FISH and urine cytology tests.Results:A cohort of 988 healthy volunteers was enrolled to establish a reference range for the normal population.A total of 4807 patients with hematuria were prospectively,randomly enrolled for the simultaneous analysis of urine cytology,FISH testing,and a final diagnosis as determined by the pathologic findings of a biopsy or a surgically-excised specimen.Overall,the sensitivity of FISH in detecting transitional-cell carcinoma was 82.7%,while that of cytology was 33.4%(p<0.001).The sensitivity values of FISH for non-muscle invasive and muscle invasive bladder transitional-cell carcinoma were 81.7%and 89.6%,respectively(p=0.004).The sensitivity values of FISH for low and high grade bladder cancer were 82.6%and 90.1%,respectively(p=0.002).Conclusion:FISH is significantly more sensitive than voided urine cytology for detecting bladder cancer in patients evaluated for gross hematuria at all cancer grades and stages.Higher sensitivity using FISH was obtained in high grade and muscle invasive tumors.

关键词： Bladder transitionalcell carcinoma Fluorescence in situ hybridization Detection Grade Stage

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The impact of intra-operative cell salvage during open nephrectomy

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Asian Journal of urology 2019年第4期6卷 346-352页

作者： Ned Kinnear Lina Hua Bridget Heijkoop Derek Hennessey Daniel Spernat department of urology The Queen Elizabeth HospitalAdelaideAustralia department of urology Craigavon Area HospitalPortadownUK

Objective:To assess the impact of intra-operative cell salvage on outcomes in open nephrectomy.Methods:A retrospective cohort study was performed of all patients undergoing open nephrectomy for suspected malignancy from 1 October 2013 to 1 October 2017.Patients were grouped and compared based on whether they received intra-operative cell salvage(ICS).Primary outcomes were allogeneic transfusion rates(ATRs),and if histology confirmed cancer,disease recurrence.Secondary outcomes were complications and transfusion-related cost.Results:Forty patients underwent open nephrectomy for suspected malignancy during the enrolment period.Sixteen patients received ICS while 24 did not(standard group).Compared with the standard group,ICS patients had similar median age(63.5 vs.61.0 years;p=0.83)but fewer females(19%vs.58%;p=0.013).The groups were similar in pre-operative and discharge haemoglobin,Charlson Comorbidity Index,length of hospital stay and proportion with thoracoabdominal surgical approach.The ICS group had a smaller proportion undergoing partial nephrectomy(19%vs.54%;p=0.025)and shorter median follow-up(278 vs.827 days;p=0.0005).Histology was malignant for 14 ICS and 15 standard patients.The ICS group had more frequentT2 disease(79%vs.27%;p=0.005).There were no positive margins.Both groups had similar ATRs(6%vs.4%;p=0.96),complication rates(19%vs.29%;p=0.46)and recurrence rates(18%vs.7%;p=0.40).Transfusion costs were higher amongst ICS patients(AUD$878.18 vs.$49.65 per patient).Conclusion:ICS appears safe,with low rates of recurrence and complication.Both groups had low ATRs,and therefore cost benefit for ICS was not seen.

关键词： Nephrectomy Cell salvage Autologous Transfusion Blood Cost

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Comparative assessment of efficacy and safety of different treatment for de novo overactive bladder children: A systematic review and network meta-analysis

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Asian Journal of urology 2019年第4期6卷 330-338页

作者： Shi Qiu Siwei Bi Tianhai Lin Zhuheng Wu Qi’an Jiang Jiwen Geng Liangren Liu Yige Bao Xiang Tu Mingjing He Lu Yang Qiang Wei department of urology Institute of UrologyWest China Hospital of Sichuan UniversityChengduChina

Objective:To compare these managements focusing on the efficacy and safety to treat overactive bladder(OAB)in children through network meta-analysis(NMA).Methods:We searched PubMed,Embase,the Cochrane Library Central Register of Controlled Trials(CENTRAL)and the reference lists up to May 1st,2017.Data from eligible randomized controlled trails(RCT)studies including three different treatment options were extracted.The primary outcome was maximal voiding volume(MVV).We performed pairwise metaanalyses by random effects model and NMA by Bayesian model.We used the Grading of Recommendations,Assessment,Development and Evaluations(GRADE)framework to assess the quality of evidence contributing to each network estimate.Results:Six RCTs(462 patients)comparing three different interventions fulfilled the inclusion criteria.A low risk of bias was shown for the majority of the study items.The results of NMA showed that compared with antimuscarinic drugs,Parasacral transcutaneous electrical nerve stimulation was associated with significant improvement in the MVV(mean difference[MD]=58.50,95% confidential interval[CI]:45.95-69.52),followed by urotherapy group(MD=21.03,95%CI:11.85-29.97).When it comes to the constipation,antimuscarinic drugs exerted significant benefit than PTENS(odds ratio[OR]:0.22,95%CI:0.01-0.46).No significant difference was found between other treatments.Conclusion:Compared with antimuscarinic drugs,PTENS was associated with significant better efficacy considering MVV,but more constipation events in de novo OAB children.Antimuscarinic drugs showed remarkably better efficacy considering MVV and comparable safety profile compared with urotherapy.Clinicians should take all known safety and compliance of patients into account when choosing an optimal strategy.

关键词： Overactive bladder Meta-analysis Anticholinergics Parasacral transcutaneous electrical nerve stimulation

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The Institute of urology, Peking University prostatectomy score： a simple preoperative classification of prostate cancer for predicting surgical difficulty and risk

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Asian Journal of Andrology 2018年第6期20卷 581-586页

作者： Bing-Lei Ma Lin Yao Wei Yu Yu Wang Hai-Feng Song Zhe-Nan Zhang Si-Meng Lu Qian Zhang Zhi-Song He Jie Jin Li-Qun Zhou department of urology Peking University First Hospital and Institute of Urology Peking University Beijing 100034 China

Traditional laparoscopic radical prostatectomy is a treatment choice in many developing countries and regions for most patients with localized prostate cancer; however, no system for predicting surgical difficulty and risk has been established. This study aimed to propose a simple and standard preoperative classification system of prostate cancer using preoperative data to predict surgical difficulty and risk and to evaluate the relationship between the data and postoperative complications. We collected data from 236 patients and divided them into three groups to evaluate and validate the relationships among preoperative, operative, and postoperative data. This new scoring system is based on the body mass index, ultrasonic prostate volume, preoperative prostate-specific antigen level, middle lobe protrusion, and clinical stage. In the scoring group, we classified 89 patients into two groups： the low-risk group （score of 〈4） and high-risk group （score of ~4）, and then compared the postoperative data between the two groups. The positive surgical margin rate was higher in the high-risk group than low-risk group. The results in validation Groups A and B were similar to those in the scoring group. The focus of our scoring system is to allow for preliminary assessment of surgical difficulty by collecting the patients＇ basic information. Urologists can easily use the scoring system to evaluate the surgical difficulty and predict the risks of a positive surgical margin and urinary incontinence in patients undergoing laparoscopic radical prostatectomy.

关键词： laparoscopic radical prostatectomy prostate cancer scoring system surgical difficulty and risk

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