[Role of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT) in staging].

The superiority of prostate-specific membrane antigen (PSMA) positron emission tomography (PET) over conventional staging methods such as computed tomography (CT) and bone scintigraphy has now been demonstrated for almost all clinical stages of prostate cancer. In primary diagnostics, PSMA-PET/CT is therefore the new standard for risk-adapted whole-body staging. At the same time, PSMA-PET/CT provides a new risk-based classification for predicting overall survival across all early and late stages of the disease.

Immunohistochemistry-based molecular subtypes of urothelial carcinoma derive different survival benefit from platinum chemotherapy.

Distinct molecular subtypes of muscle-invasive bladder cancer (MIBC) may show different platinum sensitivities. Currently available data were mostly generated at transcriptome level and have limited comparability to each other. We aimed to determine the platinum sensitivity of molecular subtypes by using the protein expression-based Lund Taxonomy.

Spatial distribution and subtype-specific expression patterns of Nectin-4 in muscle-invasive bladder cancer.

Objective: To investigate the expression patterns of Nectin-4, the target molecule of the antibody-drug conjugate enfortumab vedotin (EV), in relation to histological and molecular subtypes of urothelial bladder cancer (UBC).

Patients And Methods: We assessed the protein expression patterns of Nectin-4 in a spatially organised tissue microarray containing 1386 tissue cores from 314 consecutive patients with UBC who underwent radical cystectomy (2005-2018). Results were correlated with clinicopathological and follow-up data, as well as with different spatial locations (tumour central vs tumour-normal interface and primary tumour vs lymph node [LN] metastases).

Incidence and Survival of Patients With Prostate Cancer in North-Rhine Westphalia, Germany.

Introduction: There is no organized prostate cancer screening in Germany. The aim of this study was to investigate the development of incidence and survival in patients with primary malignant tumors of the prostate in relation to changing recommendations of prostate-specific antigen (PSA) screening in guidelines.

Methods: Age-standardized incidence rates and 5-year relative survival (RS) (period approach) were calculated using data from the cancer registry North Rhine-Westphalia with the subset of the administrative district Münster respectively for the years 1992-2019.

Short-Term Urinary Incontinence After Radical Prostatectomy Is Still Based on Patients' Age, Nerve-Sparing Approach, and Surgical-Experience, Despite the Higher-Use of Robotic Surgery in 2022 Compared to 2016 Real-World Results of a Large Rehabilitation Center in Germany.

Background: Despite constant improvements, incontinence is one of the most relevant and quality-of-life-reducing side effects of radical prostatectomy (RP) and, in addition to patient-specific factors such as age, the experience of the surgeon/center and the surgical technique used play an important role.

Aims: To present current real-world data on short-term incontinence after RP from one of the largest German rehabilitation centers in 2022 and to compare it to the results from the same institution in 2016.

Methods And Results: Retrospective, unicentric, univariate analysis of data from 1394 men after RP in 2022 on admission and discharge from the rehabilitation clinic.

Outcomes of surgical therapy for local recurrence and oligometastatic urothelial carcinoma of the bladder: 20 years of experience in a tertiary center.

Introduction And Aim Of The Study: The impact of surgical therapy in selected patients with limited metastatic/recurrence burden have not yet been well studied. We investigated the outcome of surgical resection for patients with local recurrence only or oligometastatic UC of the bladder.

Patients And Methods: We identified patients with oligometastatic UC or local recurrence only after radical cystectomy (RC) who underwent surgical resection with curative intent between 2003 and 2022 at our center.

Factors Contributing to Early Recovery of Urinary Continence Following Radical Prostatectomy: A Narrative Review.

Stress urinary incontinence (SUI) is a common condition in patients following radical prostatectomy (RP), which has a significant impact on all aspects of quality of life and is associated with significant social stigma. The factors that improve urinary incontinence in patients following surgery remain controversial. The aim of our narrative review was to identify and synthesise the latest evidence on pre-, intra- and post-operative factors and predictors that contribute to early continence recovery after RP.

The effect of chemotherapy regimens in male germ cell tumors on the development of primary hypogonadism.

Male germ cell tumors (GCT) have excellent survival. Long-term sequelae in cancer survivors are an evolving field. We evaluated the risk of patients with GCT to develop primary hypogonadism and adherence to guideline-recommended therapy in a real-world cohort.

Enhancing risk stratification models in localized prostate cancer by novel validated tissue biomarkers.

Background: Localized prostate cancer (PCa) is a largely heterogeneous disease regarding its clinical behavior. Current risk stratification relies on clinicopathological parameters and distinguishing between indolent and aggressive cases remains challenging. To improve risk stratification, we aimed to identify new prognostic markers for PCa.

PRO-P: evaluating the effect of electronic patient-reported outcome measures monitoring compared with standard care in prostate cancer patients undergoing surgery-study protocol for a randomized controlled trial.

Background: With over 65,000 new cases per year in Germany, prostate cancer (PC) is the most common cancer in men in Germany. Localized PC is often treated by radical prostatectomy and has a very good prognosis. Postoperative quality of life (QoL) is significantly influenced by the side effects of surgery.

Head-to-head comparison of Ga-FAPI-46 PET/CT, F-FDG PET/CT, and contrast-enhanced CT for the detection of various tumors.

Objective: FAPI-PET/CT exhibits high tumor uptake and low background accumulation, enabling high-sensitivity tumor detection. We compared the diagnostic performance of  Ga-FAPI-46 PET/CT plus contrast-enhanced CT (CE-CT), F-FDG PET/CT plus CE-CT, and standalone CE-CT in patients with various malignancies.

Methods: 232 patients underwent  Ga-FAPI-46 PET/CT,F-FDG PET/CT, and CE-CT each within 4 weeks.

Prostate-specific Membrane Antigen (PSMA) Spatial Biomarker: Standardized Positron Emission Tomography Disease Maps Provide Accurate Prediction of Overall Survival in Prostate Cancer.

Next-generation prostate-specific membrane antigen (PSMA) positron emission tomography imaging provides unprecedented accuracy for prostate cancer (PC) detection and can provide detailed disease metrics, which we summarize as a PSMA spatial biomarker (PSMA-SB). Overall survival data confirm that PSMA-SB can differentiate aggressive PC from indolent PC. PSMA-SB maps could be integrated with multiomics data to improve understanding of total-body cancer heterogeneity and phenotype.

Establishing Medical Intelligence-Leveraging Fast Healthcare Interoperability Resources to Improve Clinical Management: Retrospective Cohort and Clinical Implementation Study.

Background: FHIR (Fast Healthcare Interoperability Resources) has been proposed to enable health data interoperability. So far, its applicability has been demonstrated for selected research projects with limited data.

Objective: This study aimed to design and implement a conceptual medical intelligence framework to leverage real-world care data for clinical decision-making.

Detection of tumour heterogeneity in patients with advanced, metastatic castration-resistant prostate cancer on [Ga]Ga-/[F]F-PSMA-11/-1007, [Ga]Ga-FAPI-46 and 2-[F]FDG PET/CT: a pilot study.

Purpose: In metastatic castration-resistant prostate cancer (mCRPC), some patients show low/absent PSMA expression in tumour lesions on positron emission tomography (PET) scans, indicating heterogeneity and heightened risk of non-response to PSMA-RLT (radioligand therapy). Imaging cancer-associated fibroblasts and glucose uptake may further characterise tumour heterogeneity in mCRPC patients. Here, we aimed to evaluate tumour heterogeneity and its potential implications for management in mCRPC patients assessed for PSMA-RLT using [Ga]Ga-FAPI-46, 2-[F]FDG and [Ga]Ga-/[F]F-PSMA-11/-1007 PET.

Mortality from prostate cancer in the years 2007-2021 in North Rhine-Westphalia, Germany.

Background: The crude mortality rate and the lifetime mortality risk from prostate cancer in Germany are above international average. However age-standardised mortality and years of life lost per capita from prostate cancer are declining. This study analyses the mortality-related measures for the federal state of North Rhine-Westphalia (NRW) in Germany.

[Risk-adapted early detection program for prostate cancer 2.0-position paper of the German Society of Urology 2024].

Background And Objective: Despite the proven effectiveness of organized PSA-based screening in reducing prostate cancer-related mortality, there is currently no program in Germany covered by statutory health insurance. In accordance with the EU Council Decision (2022/0290(NLE)), the German Society of Urology (DGU) has developed a concept for risk-adapted prostate cancer early detection.

Materials And Methods: Based on a literature review of current screening studies, an algorithm for PSA-based prostate cancer early detection was developed.

The impact of double-J ureteral stenting before radical cystectomy on the development of upper tract urothelial carcinoma.

Background: It is controversial whether the use of a double-J stent (DJ) in patients with bladder cancer before radical cystectomy (RC) increases the risk of tumour seeding in the upper tract and thus the risk of metachronous upper tract urothelial carcinoma (UTUC). The aim of our study is to investigate the risk of upper tract recurrence after RC in patients previously managed with a DJ stent.

Methods: A total of 699 patients who had undergone RC between January 2003 and March 2022 with complete perioperative data and pathological outcome were included in our study.

PSMA-PET follow-up to assess response in patients not receiving PSMA therapy: Is there value beyond localization of disease?

Prostate Specific Membrane Antigen Positron Emission Tomography (PSMA-PET) is routinely used for the staging of patients with prostate cancer, but data on response assessment are sparse and primarily stem from metastatic castration-resistant prostate cancer (mCRPC) patients treated with PSMA radioligand therapy. Still, follow-up PSMA-PET is employed in earlier disease stages in case of clinical suspicion of disease persistence, recurrence or progression to decide if localized or systemic treatment is indicated. Therefore, the prognostic value of PSMA-PET derived tumor volumes in earlier disease stages (i.

Value-Based Health Care for Prostate Cancer Centers by Implementing Specific Key Performance Indicators Using a Balanced Score Card.

Background: Prostate cancer (PC) is the most common cancer in men in 112 countries, and accounts for 15% of cancers. Because it cannot be prevented, the rise in cases is inevitable, and improvements in diagnostic pathways and treatments are needed, as there is still a shortage of cost-effective diagnostics and widespread oncologically safe treatment options with measurable quality. As part of the implementation of a Full Cycle of Care, instruments have been developed to achieve value-based medicine, such as consistent commitment to measurability.