Cancer Research and Treatment

Original Articles

Genitourinary cancer

Oncological Outcomes in Men with Metastatic Castration-Resistant Prostate Cancer Treated with Enzalutamide with versus without Confirmatory Bone Scan: Chang Wook Jeong, Jang Hee Han, Dong Deuk Kwon, Jae Young Joung, Choung-Soo Kim, Hanjong Ahn, Jun Hyuk Hong, Tae-Hwan Kim, Byung Ha Chung, Seong Soo Jeon, Minyong Kang, Sung Kyu Hong, Tae Young Jung, Sung Woo Park, Seok Joong Yun, Ji Yeol Lee, Seung Hwan Lee, Seok Ho Kang, Cheol Kwak; Cancer Res Treat. 2024;56(2):634-641. Published online December 5, 2023; DOI: https://doi.org/10.4143/crt.2023.848

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Purpose
In men with metastatic castration-resistant prostate cancer (mCRPC), new bone lesions are sometimes not properly categorized through a confirmatory bone scan, and clinical significance of the test itself remains unclear. This study aimed to demonstrate the performance rate of confirmatory bone scans in a real-world setting and their prognostic impact in enzalutamide-treated mCRPC.
Materials and Methods
Patients who received oral enzalutamide for mCRPC during 2014-2017 at 14 tertiary centers in Korea were included. Patients lacking imaging assessment data or insufficient drug exposure were excluded. The primary outcome was overall survival (OS). Secondary outcomes included performance rate of confirmatory bone scans in a real-world setting. Kaplan-Meier analysis and multivariate Cox regression analysis were performed.
Results
Overall, 520 patients with mCRPC were enrolled (240 [26.2%] chemotherapy-naïve and 280 [53.2%] after chemotherapy). Among 352 responders, 92 patients (26.1%) showed new bone lesions in their early bone scan. Confirmatory bone scan was performed in 41 patients (44.6%), and it was associated with prolonged OS in the entire population (median, 30.9 vs. 19.7 months; p < 0.001), as well as in the chemotherapy-naïve (median, 47.2 vs. 20.5 months; p=0.011) and post-chemotherapy sub-groups (median, 25.5 vs. 18.0 months; p=0.006). Multivariate Cox regression showed that confirmatory bone scan performance was an independent prognostic factor for OS (hazard ratio 0.35, 95% confidence interval, 0.18 to 0.69; p=0.002).
Conclusion
Confirmatory bone scan performance was associated with prolonged OS. Thus, the premature discontinuation of enzalutamide without confirmatory bone scans should be discouraged.

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ECM-mimicking hydrogel models of human adipose tissue identify deregulated lipid metabolism in the prostate cancer-adipocyte crosstalk under antiandrogen therapy
Agathe Bessot, Joan Röhl, Maria Emmerich, Anton Klotz, Akhilandeshwari Ravichandran, Christoph Meinert, David Waugh, Jacqui McGovern, Jenni Gunter, Nathalie Bock
Materials Today Bio.2025; 30: 101424. CrossRef

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Urologic cancer

External Validation of the Long Short-Term Memory Artificial Neural Network-Based SCaP Survival Calculator for Prediction of Prostate Cancer Survival: Bumjin Lim, Kwang Suk Lee, Young Hwa Lee, Suah Kim, Choongki Min, Ju-Young Park, Hye Sun Lee, Jin Seon Cho, Sun Il Kim, Byung Ha Chung, Choung-Soo Kim, Kyo Chul Koo; Cancer Res Treat. 2021;53(2):558-566. Published online October 6, 2020; DOI: https://doi.org/10.4143/crt.2020.637

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Purpose
Decision-making for treatment of newly diagnosed prostate cancer (PCa) is complex due to the multiple initial treatment modalities available. We aimed to externally validate the SCaP (Severance Study Group of Prostate Cancer) Survival Calculator that incorporates a long short-term memory artificial neural network (ANN) model to estimate survival outcomes of PCa according to initial treatment modality. Materials and Methods The validation cohort consisted of clinicopathological data of 4,415 patients diagnosed with biopsy-proven PCa between April 2005 and November 2018 at three institutions. Area under the curves (AUCs) and time-to-event calibration plots were utilized to determine the predictive accuracies of the SCaP Survival Calculator in terms of progression to castration-resistant PCa (CRPC)–free survival, cancer-specific survival (CSS), and overall survival (OS). Results Excellent discrimination was observed for CRPC-free survival, CSS, and OS outcomes, with AUCs of 0.962, 0.944, and 0.884 for 5-year outcomes and 0.959, 0.928, and 0.854 for 10-year outcomes, respectively. The AUC values were higher for all survival endpoints compared to those of the development cohort. Calibration plots showed that predicted probabilities of 5-year survival endpoints had concordance comparable to those of the observed frequencies. However, calibration performances declined for 10-year predictions with an overall underestimation. Conclusion The SCaP Survival Calculator is a reliable and useful tool for determining the optimal initial treatment modality and for guiding survival predictions for patients with newly diagnosed PCa. Further modifications in the ANN model incorporating cases with more extended follow-up periods are warranted to improve the ANN model for long-term predictions.

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Harnessing machine learning to predict prostate cancer survival: a review
Sungun Bang, Young Jin Ahn, Kyo Chul Koo
Frontiers in Oncology.2025;[Epub] CrossRef
Application of artificial intelligence in the diagnosis and treatment of urinary tumors
Mengying Zhu, Zhichao Gu, Fang Chen, Xi Chen, Yue Wang, Guohua Zhao
Frontiers in Oncology.2024;[Epub] CrossRef
Computational Intelligence in Cancer Diagnostics: A Contemporary Review of Smart Phone Apps, Current Problems, and Future Research Potentials
Somit Jain, Dharmik Naicker, Ritu Raj, Vedanshu Patel, Yuh-Chung Hu, Kathiravan Srinivasan, Chun-Ping Jen
Diagnostics.2023; 13(9): 1563. CrossRef
Development and external validation of a machine learning-based model to classify uric acid stones in patients with kidney stones of Hounsfield units < 800
Ben H. Chew, Victor K. F. Wong, Abdulghafour Halawani, Sujin Lee, Sangyeop Baek, Hoyong Kang, Kyo Chul Koo
Urolithiasis.2023;[Epub] CrossRef
Multilayer perceptron-based prediction of stroke mimics in prehospital triage
Zheyu Zhang, Dengfeng Zhou, Jungen Zhang, Yuyun Xu, Gaoping Lin, Bo Jin, Yingchuan Liang, Yu Geng, Sheng Zhang
Scientific Reports.2022;[Epub] CrossRef

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Cancer-Specific Mortality Among Korean Men with Localized or Locally Advanced Prostate Cancer Treated with Radical Prostatectomy Versus Radiotherapy: A Multi-Center Study Using Propensity Scoring and Competing Risk Regression Analyses: Kyo Chul Koo, Jin Seon Cho, Woo Jin Bang, Seung Hwan Lee, Sung Yong Cho, Sun Il Kim, Se Joong Kim, Koon Ho Rha, Sung Joon Hong, Byung Ha Chung; Cancer Res Treat. 2018;50(1):129-137. Published online March 8, 2017; DOI: https://doi.org/10.4143/crt.2017.004

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Purpose
Studies comparing radical prostatectomy (RP) outcomes with those of radiotherapy with or without androgen deprivation therapy (RT±ADT) for prostate cancer (PCa) have yielded conflicting results. Therefore, we used propensity score-matched analysis and competing risk regression analysis to compare cancer-specific mortality (CSM) and other-cause mortality (OCM) between these two treatments.
Materials and Methods
The multi-center, Severance Urological Oncology Group registry was utilized to identify 3,028 patients with clinically localized or locally advanced PCa treated by RP (n=2,521) or RT±ADT (n=507) between 2000 and 2016. RT±ADT cases (n=339) were matched with an equal number of RP cases by propensity scoring based on age, preoperative prostate-specific antigen, clinical tumor stage, biopsy Gleason score, and Charlson Comorbidity Index (CCI). CSM and OCM were co-primary endpoints.
Results
Median follow-up was 65.0 months. Five-year overall survival rates for patients treated with RP and RT±ADT were 94.7% and 92.0%, respectively (p=0.105). Cumulative incidence estimates revealed comparable CSM rates following both treatments within all National Comprehensive Cancer Network risk groups. Gleason score ≥ 8 was associated with higher risk of CSM (p=0.009). OCM rates were comparable between both groups in the low- and intermediate-risk categories (p=0.354 and p=0.643, respectively). For high-risk patients, RT±ADT resulted in higher OCM rates than RP (p=0.011). Predictors of OCM were age ≥ 75 years (p=0.002) and CCI ≥ 2 (p < 0.001).
Conclusion
RP and RT±ADT provide comparable CSM outcomes in patients with localized or locally advanced PCa. The risk of OCM may be higher for older high-risk patients with significant comorbidities.

Citations

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External beam radiation therapy versus radical prostatectomy for high-risk prostate cancer: protocol of the RECOVER study
Caroline M. van der Starre, Chris H. Bangma, Maarten J. Bijlsma, Alfons C.M. van den Bergh, Lambertus A.L.M. Kiemeney, Wietske Kievit, Kees Vos, Diederik M. Somford, Sally M. Wildeman, Katja K.H. Aben, Igle J. de Jong, Floris J. Pos, Berdine L. Heesterman
BMC Cancer.2025;[Epub] CrossRef
Japanese clinical practice guidelines for prostate cancer 2023
Yasuo Kohjimoto, Hiroji Uemura, Masahiro Yoshida, Shiro Hinotsu, Satoru Takahashi, Tsutomu Takeuchi, Kazuhiro Suzuki, Hiroshi Shinmoto, Tsutomu Tamada, Takahiro Inoue, Mikio Sugimoto, Atsushi Takenaka, Tomonori Habuchi, Hitoshi Ishikawa, Takashi Mizowaki,
International Journal of Urology.2024; 31(11): 1180. CrossRef
Radical prostatectomy versus external beam radiotherapy with androgen deprivation therapy for high-risk prostate cancer: a systematic review
Berdine L. Heesterman, Katja K. H. Aben, Igle Jan de Jong, Floris J. Pos, Olga L. van der Hel
BMC Cancer.2023;[Epub] CrossRef
Risk factors for prostate-specific antigen persistence in pT3aN0 prostate cancer after robot-assisted laparoscopic radical prostatectomy: a retrospective study
Jun Seop Kim, Jae Hoon Chung, Wan Song, Minyong Kang, Hyun Hwan Sung, Hwang Gyun Jeon, Byong Change Jeong, Seong Il Seo, Hyun Moo Lee, Seong Soo Jeon
Journal of Yeungnam Medical Science.2023; 40(4): 412. CrossRef
Comparison of contrast-enhanced ultrasound targeted biopsies versus standard systematic biopsies for prostate cancer correction in different PSA value groups in rural China
Dian Yuan Lu, Lan Liu, Li Shen, Jian Rong Cai, Li Xu, Li Hua Xiang
Clinical Hemorheology and Microcirculation.2021; 77(3): 295. CrossRef
Comparison of Radical Prostatectomy Versus Radiation and Androgen Deprivation Therapy Strategies as Primary Treatment for High-risk Localized Prostate Cancer: A Systematic Review and Meta-analysis
Benjamin A. Greenberger, Nicholas G. Zaorsky, Robert B. Den
European Urology Focus.2020; 6(2): 404. CrossRef
Long short-term memory artificial neural network model for prediction of prostate cancer survival outcomes according to initial treatment strategy: development of an online decision-making support system
Kyo Chul Koo, Kwang Suk Lee, Suah Kim, Choongki Min, Gyu Rang Min, Young Hwa Lee, Woong Kyu Han, Koon Ho Rha, Sung Joon Hong, Seung Choul Yang, Byung Ha Chung
World Journal of Urology.2020; 38(10): 2469. CrossRef
Comparing Radiotherapy to Prostatectomy for High-Risk Prostate Cancer
Benjamin A. Greenberger, James M. Taylor, Victor E. Chen, Robert B. Den
The Cancer Journal.2020; 26(1): 29. CrossRef
Outcomes of treatment for localized prostate cancer in a single institution: comparison of radical prostatectomy and radiation therapy by propensity score matching analysis
Narihiko Hayashi, Kimito Osaka, Kentaro Muraoka, Hisashi Hasumi, Kazuhide Makiyama, Keiichi Kondo, Noboru Nakaigawa, Masahiro Yao, Yuki Mukai, Madoka Sugiura, Shoko Takano, Eiko Ito, Hisashi Kaizu, Izumi Koike, Masaharu Hata, Masataka Taguri, Yasuhide Miy
World Journal of Urology.2020; 38(10): 2477. CrossRef
Benefits and Risks of Primary Treatments for High-risk Localized and Locally Advanced Prostate Cancer: An International Multidisciplinary Systematic Review
Lisa Moris, Marcus G. Cumberbatch, Thomas Van den Broeck, Giorgio Gandaglia, Nicola Fossati, Brian Kelly, Raj Pal, Erik Briers, Philip Cornford, Maria De Santis, Stefano Fanti, Silke Gillessen, Jeremy P. Grummet, Ann M. Henry, Thomas B.L. Lam, Michael Lar
European Urology.2020; 77(5): 614. CrossRef
Updated evidence on oncological outcomes of surgery versus external beam radiotherapy for localized prostate cancer
Satoru Taguchi, Kenshiro Shiraishi, Hiroshi Fukuhara
Japanese Journal of Clinical Oncology.2020; 50(9): 963. CrossRef
Comparing effectiveness of radical prostatectomy versus external beam radiotherapy in patients with locally advanced prostate cancer
Xianghong Zhou, Kun Jin, Shi Qiu, Di Jin, Xinyang Liao, Xiang Tu, Xiaonan Zheng, Jiakun Li, Lu Yang, Qiang Wei
Medicine.2020; 99(34): e21642. CrossRef
Robot or radiation? A qualitative study of the decision support needs of men with localised prostate cancer choosing between robotic prostatectomy and radiotherapy treatment
Allan ‘Ben’ Smith, Orlando Rincones, Mark Sidhom, Pascal Mancuso, Karen Wong, Megan Berry, Dion Forstner, Leslie Bokey, Afaf Girgis
Patient Education and Counseling.2019; 102(7): 1364. CrossRef
Elective pelvic irradiation in prostate cancer patients with biochemical failure following radical prostatectomy: A propensity score matching analysis
Changhoon Song, Sang Jun Byun, Young Seok Kim, Hanjong Ahn, Seok-Soo Byun, Choung-Soo Kim, Sang Eun Lee, Jae-Sung Kim, Christopher J.D. Wallis
PLOS ONE.2019; 14(4): e0215057. CrossRef
125I low‑dose‑rate prostate brachytherapy and radical prostatectomy in patients with prostate cancer
Zhien Zhou, Weigang Yan, Yi Zhou, Fuquan Zhang, Hanzhong Li, Zhigang Ji
Oncology Letters.2019;[Epub] CrossRef
Time to Disease Recurrence Is a Predictor of Metastasis and Mortality in Patients with High-risk Prostate Cancer Who Achieved Undetectable Prostate-specific Antigen Following Robot-assisted Radical Prostatectomy
Do Kyung Kim, Kyo Chul Koo, Kwang Suk Lee, Yoon Soo Hah, Koon Ho Rha, Sung Joon Hong, Byung Ha Chung
Journal of Korean Medical Science.2018;[Epub] CrossRef

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Re-stratification of Patients with High-Risk Prostate Cancer According to the NCCN Guidelines among Patients Who Underwent Radical Prostatectomy: An Analysis Based on the K-CaP Registry: Kwang Suk Lee, Kyo Chul Koo, In Young Choi, Ji Youl Lee, Jun Hyuk Hong, Choung-Soo Kim, Hyun Moo Lee, Sung Kyu Hong, Seok-Soo Byun, Koon Ho Rha, Byung Ha Chung; Cancer Res Treat. 2018;50(1):88-94. Published online March 7, 2017; DOI: https://doi.org/10.4143/crt.2016.494

Abstract PDF PubReader ePub

Purpose
The present study aimed to re-stratify patients with high-risk prostate cancer according to the National Comprehensive Cancer Network guidelines among patients who underwent radical prostatectomy (RP).
Materials and Methods
This study used the Korean Prostate Cancer Database registry and identified 1,060 patients with high-risk prostate cancer who underwent RP between May 2001 and April 2013. All patients were categorized into risk groups, and subgroups were identified according to the type and number of high-risk factors.
Results
Of the 1,060 high-risk patients, 599 (56.5%), 408 (38.5%), and 53 (5.0%) had 1, 2, and 3 risk factors, respectively. In multivariate analysis, the Gleason score, percentage of positive biopsy cores, and number of risk factors present were identified as independent predictors of biochemical recurrence. There were significant differences in the 5-year postoperative biochemical failure-free survival (BCFFS) rate among the different high-risk factor subgroups (log-rank p < 0.001). There were no significant differences in the BCFFS rate between the subgroup of high-risk patients with a prostate-specific antigen level > 20 ng/mL alone and the intermediate-risk group with all factors (log-rank p=0.919 and p=0.781, respectively). Additionally, no significant differencewas noted in the BCFFS rate between high-risk patients having all factors and those in the very-high-risk group (p=0.566).
Conclusion
We successfully re-stratified patients with high-risk prostate cancer and identified the combinations of high-risk criteria that will help in the selection of patients for RP.

Citations

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Prostate‑specific antigen density and preoperative MRI findings as predictors of biochemical recurrence in high‑risk and very high‑risk prostate cancer
Cheng-Kuang Yang, Chi-Rei Yang, Yen-Chuan Ou, Chen-Li Cheng, Hao-Chung Ho, Kun-Yuan Chiu, Shian-Shiang Wang, Jian-Ri Li, Chuan-Shu Chen, Chi-Feng Hung, Cheng-Che Chen, Shu-Chi Wang, Chia-Yen Lin, Sheng-Chun Hung
Oncology Letters.2023;[Epub] CrossRef
Comparison of the clinicopathologic features of prostate cancer in US and Chinese populations
Lei Zhang, Xiaoyan Liu, Rong Xia, Fei Chen, Xin Wang, Jia Bao, Yongzhao Shao, Xian Lu, Yan Wang, Jili Wang, May Thu Tun, Jonathan Melamed, Hebert Lepor, Fang-Ming Deng, Dongwen Wang, Guoping Ren
Pathology - Research and Practice.2022; 234: 153933. CrossRef
Ten-Year Results From a Phase II Study on Image Guided, Intensity Modulated Radiation Therapy With Simultaneous Integrated Boost in High-Risk Prostate Cancer
Christian Ekanger, Svein Inge Helle, Daniel Heinrich, Dag Clement Johannessen, Ása Karlsdóttir, Yngve Nygård, Ole Johan Halvorsen, Lars Reisæter, Rune Kvåle, Liv Bolstad Hysing, Olav Dahl
Advances in Radiation Oncology.2020; 5(3): 396. CrossRef

9,467 View
248 Download
4 Web of Science
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