SUMMER 2022
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VOL UME 21, IS SUE NUMBER 3
Study: Higher-Grade PCa On the Rise Upward trend in metastatic disease documented
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data from Surveillance, Epidemiology, and End Results (SEER) involving 438,432 men. GG1 cancers as a proportion of all prostate cancers declined from 47% in 2010 to 32% in 2018, he reported. GG1 at radical prostatectomy pathology also significantly declined from 31.5% in 2010 to 9.9% in 2018. Over the same period, the ageadjusted rate of GG1 disease dropped from 52 to 26 cases per 100,000. Concurrently, GG 2-5 prostate cancers increased, especially after 2014, according to Dr Borregales. GG3 increased as a proportion of prostate
PUL Use for BPH Increasing BY JODY A. CHARNOW PROSTATIC URETHRAL lift (PUL), which the FDA approved for use in 2013, now accounts for approximately one-third of all surgeries for benign prostatic hyperplasia (BPH), according to study data presented at the 2022 American Urological Association annual meeting in New Orleans, Louisiana.
The procedure was performed in 32.5% of all BPH surgeries in 2020, data show.
Analysis of de-identified and selfreported American Board of Urology case logs showed that PUL use increased from 1.6% of all BPH surgeries in 2015 to 32.5% in 2020, Samantha L. Thorogood, MD, of New York Presbyterian/Weill Cornell Medicine in New York, New York, reported on behalf of her research team. The study also identified factors associated with performing PUL, which included andrology subspecialization, higher surgeon BPH surgical volume, and non-academic practice types. “Given that PUL has been proposed as an alternative therapy to the gold standard TURP in the 2021 BPH surgical guidelines [from the American continued on page 18
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PROSTATE CANCER GRADE MIGRATION The age-adjusted incidence, per 100,000 men, of Gleason grade group (GG) 1 prostate cancer declined from 2010 to 2018, with a concomitant increase in the age-adjusted incidence of GG 2-5 cancers, as shown here. 25
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■ 2010 ■ 2014 ■ 2018
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BY NATASHA PERSAUD SINCE THE US Preventive Services Task Force (USPSTF) recommended against routine prostate cancer screening in 2012, prostate cancer grade at diagnosis has migrated toward higher Gleason grade groups (GGs), according to study findings presented at the American Urological Association’s 2022 annual meeting in New Orleans, Louisiana, and published recently in the Journal of the National Cancer Institute. Leonardo D. Borregales, MD, of Weill Cornell Medicine in New York, and colleagues examined 2010-2018
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9.3
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5 0
GG2
GG3
GG4
GG5
Source: Borregales L, et al. Grade migration of prostate cancer in the United States during the last decade. J Natl Cancer Inst. 2022 Mar 28:djac066. doi:10.1093/jnci/djac066
cancers from 10.7% in 2014 to 13.5% in 2018. GG4 increased from 9.6% in 2014 to 10.8% in 2018. GG5 increased from 9.3% in 2010 to 11.0% in 2018. Distant metastases as a proportion of prostate cancer diagnoses increased from 3.0% in 2010 to 5.2% in 2018,
Male LUTS May Predict Death Risk BY JOHN SCHIESZER MODERATE AND SEVERE male lower urinary tract symptoms (LUTS) may be potential markers of poor overall health and a risk factor for mortality among middle-aged and older men regardless of whether the symptoms are bothersome, a recent study suggests. “Although male LUTS have been proposed as risk factors for morbid events, the associations between LUTS and mortality should be generally considered as proxies of ill health,” corresponding author Jonne Åkerla, MD, of Tampere University in Finland, and colleagues reported in The Journal of Urology. “This indicates the importance of assessing the general health, risk factors and major comorbidities among men with LUTS.” In the Tampere Aging Male Urological Study, Dr Åkerla’s team mailed a survey that included the Danish Prostatic Symptom Score questionnaire to 3143 Finnish men (aged 50, 60, and 70 years) in 1994, with repeat continued on page 18
Dr Borregales confirmed. A 2022 study published in JAMA Network Open and a 2019 Cancer study, both using SEER data, also documented a recent increase in metastatic prostate cancers at diagnosis. continued on page 18
IN THIS ISSUE 10
Overactive bladder in men linked to visceral fat area
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Active surveillance for low-risk PCa is on the rise
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Radical cystectomy complication rates are declining in the US
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Metastatic PCa survival up in wake of treatment advances
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Albuminuria is linked to a higher risk for some cancers
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Allopurinol may decrease the risk for contrast nephropathy
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Encouraging results from kidney xenotransplantation reported
Late relapse of testicular cancer is a rare occurrence, according to a recent study. PAGE 21
