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Objectives: Cabazitaxel is a next‐generation taxane that can prolong overall survival after docetaxel treatment in patients with metastatic castration‐resistant prostate cancer. However, the efficacy of cabazitaxel varies among these patients. The clinical indicators of the prognosis after cabazitaxel treatment were analyzed. Methods: A retrospective review of patients who received cabazitaxel between February 2015 and June 2021 was performed. All patients had metastatic castration‐resistant prostate cancer. Prognostic factors for prostate‐specific antigen progression‐free and overall survival were analyzed by Cox proportional‐hazards analysis and the log‐rank test. Results: The study comprised 57 patients who received cabazitaxel (median 4 cycles, range 1–27) at a starting dose of 15–25 mg/m2. The median age and follow‐up duration were 70 years and 9.2 months. The median prostate‐specific antigen progression‐free survival and overall survival were 2.6 and 10.5 months, respectively. Univariate analysis showed that previous androgen receptor‐axis‐targeted therapy before cabazitaxel treatment was the only significant risk factor (hazard ratio 2.784, p = 0.022) for prostate‐specific antigen progression‐free survival. Multivariate analysis for overall survival revealed that poor performance status (≥1) (hazard ratio 2.107, p = 0.039), low hemoglobin (hazard ratio 0.142, p = 0.010), and high neutrophil‐lymphocyte ratio (hazard ratio 9.150, p = 0.032) at baseline were significantly associated with a poor prognosis. Conclusions: Previous androgen receptor‐axis‐targeted therapy was the only risk factor for biochemical progression. Poor performance status, anemia, and high neutrophil‐lymphocyte ratio were risk factors for poor prognosis in patients with metastatic castration‐resistant prostate cancer treated with cabazitaxel. These risk factors seem useful for identifying patients with survival benefit from cabazitaxel treatment. [ABSTRACT FROM AUTHOR]

We have found that intestinal bacteria and their metabolites, short‐chain fatty acids (SCFAs), promote cancer growth in prostate cancer (PCa) mouse models. To clarify the association between gut microbiota and PCa in humans, we analyzed the gut microbiota profiles of men with suspected PCa. One hundred and fifty‐two Japanese men undergoing prostate biopsies (96 with cancer and 56 without cancer) were included in the study and randomly divided into two cohorts: a discovery cohort (114 samples) and a test cohort (38 samples). The gut microbiota was compared between two groups, a high‐risk group (men with Grade group 2 or higher PCa) and a negative + low‐risk group (men with negative biopsy or Grade group 1 PCa), using 16S rRNA gene sequencing. The relative abundances of Rikenellaceae, Alistipes, and Lachnospira, all SCFA‐producing bacteria, were significantly increased in high‐risk group. In receiver operating characteristic curve analysis, the index calculated from the abundance of 18 bacterial genera which were selected by least absolute shrinkage and selection operator regression detected high‐risk PCa in the discovery cohort with higher accuracy than the prostate specific antigen test (area under the curve [AUC] = 0.85 vs 0.74). Validation of the index in the test cohort showed similar results (AUC = 0.81 vs 0.67). The specific bacterial taxa were associated with high‐risk PCa. The gut microbiota profile could be a novel useful marker for the detection of high‐risk PCa and could contribute to the carcinogenesis of PCa. [ABSTRACT FROM AUTHOR]

Most upper tract urothelial carcinomas (UTUC) are muscle invasive at the time of diagnosis. Current standard methods for the diagnosis of UTUC are invasive. Urine cytology is the only non‐invasive test for detecting UTUC, but its sensitivity is low. A novel non‐invasive assay for UTUC detection would improve patient outcome. This study aimed to investigate the mutation of cell‐free DNA (cfDNA) in urine supernatant to develop a reliable diagnostic biomarker for UTUC patients. We studied urinary cfDNA from 153 individuals, including 56 patients with localized UTUC, and carried out droplet digital PCR assay for TERT promoter and FGFR3 hotspot mutations. We could detect mutations of TERT C228T in 22/56 (39.3%), TERT C250T in 4/56 (7.1%), and FGFR3 S249C in 9/56 (16.1%) patients. FGFR3 mutation was detected only in ≤pT1 tumors (positive predictive value: 100.0%). In combination with cytology results, the sensitivity was 78.6%, and the specificity was 96.0%. Although these data need to be validated in a larger‐scale cohort, mutation analysis of TERT promoter and FGFR3 in urinary cfDNA has the potential to be a non‐invasive diagnostic marker and reliable factor for tumor staging. [ABSTRACT FROM AUTHOR]

A unique case of ganglioneuroma mimicking a lipomatous tumor in a 73-year-old man is reported. The tumor was incidentally found on radiography performed for unrelated reasons. Because of the fat element, CT and magnetic resonance imaging suggested myelolipoma inside or outside the right adrenal gland. The laparotomy indicated that the tumor was located on the right adrenal gland. It was well circumscribed but not encapsulated, and was approximately 2 cm in diameter. Microscopically, ganglioneuromatous component was scattered in the background of a large amount of adipose tissue. Because the presence of such a large amount of adipose tissue seems to be rare in ganglioneuromas, its histogenesis is discussed. [ABSTRACT FROM AUTHOR]