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Introduction: Prostate cancer has an increasing incidence, with high survival rates in a localized stage, whereby quality of life has a high importance. Prospective studies have shown general impairment in quality of life in patients undergoing radical prostatectomy, with specific adverse effects at the urinary and sexual function. The objective of this study is to determine the alterations in quality of life in urinary and sexual function before and after radical prostatectomy, comparing the open and laparoscopic approaches. Methodology: Prospective and analytical study that included patients undergoing open or laparoscopic radical prostatectomy. Clinical variables, urinary and sexual quality of life were analyzed through patients-reported outcome measures (EPIC-CP and IIEF-EF) and social continence through the amount of pads/day. Measurements were made preoperatively and at 3, 6 and 12 months. Results: 68 patients were included (43 in PRL group and 25 in PRA group). At baseline 47.8% had alterations in urinary function and 56,7% in sexual function. In the follow-up, 73,5%, 64,6% and 62,5% of urinary incontinence were observed in the total of patients at 3, 6 and 12 months, respectively. We observed lower rates of urinary incontinence in the laparoscopic group but without a statistically significant difference. In social continence, continence rates of 69,1%, 82,8% and 89,3% were observed at 3, 6 and 12 months, respectively, with statistically significant differences between laparoscopic (90,5%) and open (69,6%) approach at 6 months (p = 0,04). In sexual function, 78,3% of erectile dysfunction were observed at 12 months of follow-up, with no difference between the laparoscopic (75%) and open (85,7%) approaches. Conclusion: Patients with prostate cancer have baseline alterations in urinary and sexual quality of life. Radical prostatectomy, open or conventional laparoscopic approach, generates an additional deterioration in quality of life in these settings. Laparoscopic approach is associated with lower rates of postoperative urinary incontinence, with significant improvement in social continence at 6 months compared to open surgery. The approach route did not show differences in erectile function at 1 year of follow-up in this series. [ABSTRACT FROM AUTHOR]

Copyright of Boletín Latinoamericano y del Caribe de Plantas Medicinales y Aromáticas is the property of Universidad de Santiago de Chile and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Chilena de Urologia is the property of Sociedad Chilena de Urologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Evaluar el potencial predictivo del valor máximo de captación estandarizada (SUVmáx) de los tumores intraprostáticos obtenidos en la PET/TC preoperatoria con [68Ga]Ga-PSMA-I&T (SUVT), así como sus relaciones con el SUVmáx en el hígado (SUVTLR) y la glándula parótida (SUVTPR) con respecto a los hallazgos histopatológicos. Se evaluaron los datos de pacientes sometidos a prostatectomía radical (PR) por cáncer de próstata (CaP) en nuestra clínica entre los años 2017-2020. Se excluyeron aquellos pacientes con una neoplasia maligna secundaria, antecedentes de resección transuretral de próstata, tratamiento previo para CaP o que fueron sometidos a una PR de rescate. Dos especialistas en medicina nuclear con más de una década de experiencia cada uno revisaron las imágenes del estudio de cuerpo completo obtenidas con el mismo equipo, según protocolo, para obtener el consenso en cada lesión. Se estudiaron las relaciones entre edad, antígeno específico de la próstata (PSA), volumen de la próstata, estadio clínico, el grado de la clasificación de la Sociedad Internacional de Anatomía Patología Urológica (ISUP, por sus siglas en inglés) en la biopsia, el grupo de riesgo de D'amico, el volumen tumoral intraprostático identificado en la revisión histopatológica final de la muestra (HPTV) y el grado HP-ISUP. Se analizó la invasión de vesículas seminales (SVI), la invasión extracapsular (ECI), el margen quirúrgico positivo (PSM), SUVT, SUVTLR y SUVTPR. La edad media de los 64 pacientes incluidos fue de 64,1 ± 5,3 años. Se observó una correlación estadísticamente significativa entre los valores de SUVT, SUVTLR, SUVTPR y los parámetros del estadio histopatológico, como el grado ISUP de la biopsia, la clasificación de riesgo D'amico, HP-ISUP, HPTV (p < 0,05). PSMATV, SUVT y SUVTLR fueron predictores estadísticamente significativos de invasión extracapsular, mientras que PSA, PSMATV y SUVTLR fueron predictores significativos de SVI (p < 0,05). Los valores estandarizados de SUVT, SUVTLR y SUVTPR podrían emplearse como marcadores no invasivos para ayudar a predecir los hallazgos histopatológicos del postoperatorio, particularmente ECI, SVI y PSM. To evaluate the predictive potential of the maximum standardized uptake value (SUVmax) value of intraprostatic tumors derived from preoperative [68Ga]Ga-PSMA-I&T PET/CT (SUVT), and its ratios to SUVmax in the liver (SUVTLR) and parotid gland (SUVTPR) with respect to histopathological findings. Data from patients who underwent radical prostatectomy (RP) for prostate cancer (PC) at our clinic between 2017-2020 were assessed. Patients with a secondary malignancy, a history of transurethral prostate resection, prior treatment for PC, or who received salvage RP were excluded. Whole-body images obtained using the same device, as per the guidelines, were reviewed by two nuclear medicine specialists with more than a decade of experience to reach a consensus for each lesion. The relationships between age, PSA, Prostate Volume, clinical T stage, biopsy International Society of Urological Pathology grade (ISUP), D'amico risk group, intraprostatic tumor volume (HPTV) identified in the final histopathological specimen review, HP-ISUP grade, seminal vesicle invasion (SVI), extracapsular invasion (ECI), positive surgical margine (PSM), SUVT, SUVTLR, and SUVTPR were analyzed. The mean age of the 64 included patients was 64.1±5.3 y-o. A statistically significant correlation was found between SUVT, SUVTLR, SUVTPR values, and histopathologic stage parameters, such as biopsy ISUP, D'amico Risk Classification, HP-ISUP, HPTV (P <.05). PSMATV, SUVT, and SUVTLR were statistically significant predictors of extracapsular invasion, while PSA, PSMATV, and SUVTLR were significant predictors of SVI (P <.05). The standardized SUVT, SUVTLR, and SUVTPR values could be employed as noninvasive markers to assist in predicting postoperative histopathological findings, particularly ECI, SVI, and PSM. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aunque estudios recientes asocian la vitamina D con el cáncer de próstata, otros estudios descartan una asociación entre esta vitamina y el cáncer de próstata o el antígeno prostático específico (PSA). Dado que no se pueden extraer conclusiones de los datos existentes, realizamos un estudio para analizar la relación entre el PSA y la 25-hidroxivitamina D [25(OH)D].

Introduction: The immunoinflammatory indices IIS and HALP have been used to predict the prognosis of various neoplasms and acute inflammatory processes. Can they differentiate prostate cancer from an acute inflammatory process such as prostatitis? Objective: To evaluate the usefulness of IIS and HALP score in the detection of prostate cancer in patients with PSA ≤ 10 ng/dL. Method: Retrospective study including prostate biopsied patients in search of cancer from December 2022 to May 2023. ROC curves were performed to calculate the area under the curve (AUC), sensitivity and specificity. Results: 25 patients had prostatitis and 25 had prostate cancer. The age range was 55 to 81 years. The median IIS was 612.85, while HALP score had a median of 47.59. The AUC of IIS was 0.616, with sensitivity of 76% and specificity of 52%. The AUC of HALP score was 0.13 with a sensitivity of 88% and specificity of 28%. Conclusions: IIS and HALP score had no efficacy in differentiating prostatitis from prostate cancer. However, prospective studies with a larger number of patients are required to validate the results. [ABSTRACT FROM AUTHOR]

Objective: To determine the effectiveness of Ca 15-3 antigen for the diagnosis of prostate cancer, to compare Ca 15-3 antigen levels with PSA and to know the usefulness of Ca 15-3 as a predictor marker of metastasis in prostate cancer. Method: This study evaluated the role of Ca 15-3 as a tumor marker in patients with elevated prostate specific antigen (PSA), patients with suspected prostate cancer, patients with histopathological diagnosis of prostate cancer and patients without colon, breast and lung neoplasia. All of them underwent Ca 15-3 quantification by IRMA, therefore 47 patients were studied and divided into four study groups: A, control group; B, suspected prostate cancer; C, prostate cancer without treatment; D, prostate cancer with treatment. Results: Of the 47 patients studied, 7 of them obtained Ca 15-3 elevation: none in group A, 1 in group B, 2 in group C, and 4 in group D. Conclusions: The Ca 15-3 antigen is not effective for the diagnosis of prostate cancer. We believe that the Ca 15-3 antigen could become a marker for the detection of metastasis in this type of cancer. [ABSTRACT FROM AUTHOR]

Introduction: The progression of 10-30% of prostate cancer (PC) to metastasis and its resistance to androgen deprivation therapy (ADT) constitutes metastatic castration-resistant prostate cancer (mCRPC), in which new therapies such as abiraterone improve survival, but with significant cardiovascular side effects such as QT prolongation and hypokalemia. The association between torsade de pointes (TdP) ventricular arrhythmias and abiraterone is rare, which is why we report this case. Clinical case: An 81-year-old man was seen in the emergency room after syncope, with an initial ECG showing a right bundle branch block, supraventricular extrasystoles with QTc prolongation, and subsequent TdP associated with severe hypokalemia and hypomagnesemia. Ventricular systolic function was slightly reduced, and he was found to have mild coronary artery disease. His management required defibrillation along with hypokalemia and hypomagnesemia correction, resulting in QTc normalization. Abiraterone was discontinued and corticosteroid supplementation was added. The adrenal axis results were compatible with hyperaldosteronism secondary to the recent use of abiraterone. The patient was discharged without any complications. Conclusions: Hormone therapy in PC has cardiovascular repercussions; therefore, a multidisciplinary approach and follow-up is essential in elderly patients with structural abnormalities that predispose them to major complications such as acquired long QTc and TdP. [ABSTRACT FROM AUTHOR]

Copyright of Revista Chilena de Urologia is the property of Sociedad Chilena de Urologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of GeSec: Revista de Gestao e Secretariado is the property of Sindicato das Secretarias e Secretarios do Estado de Sao Paulo (SINSESP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Latinoamericana de Hipertension is the property of Revista Latinoamericana de Hipertension and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction/Justification: The renal excretion of PSMA radiotracer may render PSMA PET/CT imaging interpretation difficult to identify local recurrence and lymph node metastases in prostate cancer patients. Objectives: To evaluate the best acquisition method to increase the detection rate of local recurrence and pelvic metastases on PSMA PET/CT by performing dual time-point imaging (delayed imaging) after hyperhydration, diuretics, and contrast enhancement. Materials and Methods: Patients with prior history of prostate adenocarcinoma underwent PSMA PET/CT for primary staging or due to biochemical recurrence. PSMA PET/CT acquisition consisted of delayed pelvic imaging after hyperhydration, diuretics, and excretory-phase contrast. SUV values obtained in local recurrence lesions, locoregional lymph node metastases, and bone metastases in the early and delayed PSMA PET/CT images were compared. Results: A total of 182 patients (medians: age = 66.5; Gleason score = 7.0; total PSA = 1.5) underwent PSMA PET/CT. Twenty-one patients (12%) were scanned due to primary staging, and 161 patients due to biochemical recurrence (88%). Delayed images (with only hyperhydration, without contrast or diuretics) increased diagnostic certainty in identifying local recurrence in 26.6% of patients and locoregional lymph nodes in 25%. There was a significant increase in SUV values in the delayed images compared to early images in the local recurrence (p < 0.0001), locoregional lymph node metastases (p < 0.0001), and bone metastases (p < 0.0199). Adding excretory-phase contrast to the delayed images increased diagnostic certainty in identifying local recurrence in 9.4% of patients and locoregional lymph nodes in 8.3%. The use of diuretics only in delayed images (without excretory-phase contrast) increased diagnostic certainty in identifying local recurrence in 14% of patients; while for identifying pelvic lymph nodes increase was only mild (2.8%). The association of diuretics with excretory-phase contrast increased the diagnostic certainty in identifying local recurrence in 15.6% of patients and locoregional lymph nodes in 5.6%. Conclusion: Delayed PSMA PET/CT images increase the diagnostic certainty of identifying local recurrence and locoregional metastases in prostate cancer patients. The addition of diuretics increases diagnostic certainty and may be useful in selected cases. However, the addition of excretory-phase contrast (regardless of the use of diuretics) only mildly impacted diagnostic certainty and may be omitted.

Introducción: El cáncer de próstata generalmente se diagnostica mediante un examen rectal, aunque en ocasiones es necesario el apoyo de exámenes complementarios, como la biopsia prostática. La biopsia más usada alrededor del mundo es la transrectal y sirve para obtener muestras de tejido prostático en pacientes con sospecha de cáncer de próstata. Sin embargo, este procedimiento presenta una tasa de sepsis post-procedimiento de 0.3% a 0.8%, con una tasa de hospitalización del 1.1% debido a infecciones post-biopsia. Presentación del caso: Paciente de 71 años con antecedentes de hiperplasia prostática, acude a hospital privado en Quito para someterse una a biopsia prostática transrectal de manera ambulatoria, estable en su recuperación y dado de alta posteriormente. Dos días después de la intervención, presenta cuadro clínico por lo cual es ingresado al área de emergencias, se presenta inestable e ingresa al área de terapia intensiva con el diagnóstico de shock séptico más disfunción orgánica múltiple, por lo que se inicia terapia antimicrobiana con meropenem. Sin embargo, no tiene una evolución favorable por lo cual se le adiciona linezolid al cuarto día, evidenciando una disminución de la serie blanca y compensación del paciente, quien a los 12 días se estabiliza y es transferido a hospitalización. Conclusión: La biopsia transrectal es un método invasivo en el cual la complicación séptica es frecuente. No obstante, si las mismas no son tratadas con experticia y atención, pueden comprometer gravemente la vida del paciente e incluso llevarlo a la muerte.

El cribado del cáncer de próstata mediante la medida del antígeno específico de la próstata (PSA) ha sido objeto de una intensa polémica. Los beneficios derivados en cuanto a reducción en mortalidad del cribado organizado del cáncer de próstata se han acompañado de un importante sobrediagnóstico, que se ha traducido en tratamientos innecesarios y numerosos efectos adversos. Por ello, las recomendaciones de las sociedades científicas han sido cada vez más restrictivas. En los últimos años se han hecho diversas propuestas para reconsiderar el enfoque sobre el cribado del cáncer de próstata, con objeto de superar la oposición entre cribar a todo el mundo o no cribar a nadie y a reconsiderar el PSA como una herramienta que permita un balance favorable entre beneficios y riesgos. En este contexto, hay que destacar la propuesta que la European Association of Urology dirigía a la Comisión Europea replanteando el cribado del cáncer de próstata en función de la medida de un PSA basal. Recientemente, la Comisión Europea ha recomendado la implementación de programas organizados para el cribado del cáncer de próstata para hombres de hasta 70 años basado en medidas de PSA en combinación con la resonancia magnética como prueba de seguimiento.

El antígeno prostático específico (psa, acrónimo de prostate-specific antigen) es una glicoproteína producida exclusivamente por la glándula prostática que es sintetizado con el fin de licuar el semen eyaculado y permitir un medio para que los espermatozoides se movilicen libremente. El psa es abundante en el semen, no obstante, una pequeña proporción se encuentra también en la sangre, de esta manera la concentración sérica del psa ha sido utilizada como prueba para detectar precozmente el cáncer de próstata (CaP), ya que se eleva en el 65% de los casos. El psa es uno de los pocos marcadores moleculares usados de manera rutinaria para la detección, categorización del riesgo y diagnóstico de CaP. De esta forma, es necesario revisar la utilidad de la prueba sérica de psa en sangre y su éxito como marcador molecular para detectar el CaP en México.

El cáncer de próstata es la neoplasia no cutánea más común en hombres, y al diagnosticarlo en una etapa localizada, los pacientes presentan una amplia variedad de posibles opciones terapéuticas, que van desde observación, hasta tratamientos multimodales que incluyen radioterapia, prostatectomía radical, y bloqueo androgénico total, según sea el caso. Cuando el diagnóstico se hace en estadio IV, hasta hace un par de años, la radioterapia se utilizaba como un tratamiento paliativo, solo para aliviar el dolor y evitar fracturas patológicas en huesos que soportan carga. En la actualidad se ha incorporado un nuevo concepto, el de la enfermedad oligometastásica, como un estado intermedio entre la enfermedad localizada y la sistémica o metastásica, en el que el tratamiento del cáncer primario y las lesiones secundarias tiene un potencial curativo. La radioterapia estereotáctica extracraneal es una modalidad novedosa de tratamiento, con un gran potencial en el manejo de las enfermedades neoplásicas, especialmente en las oligometastásicas, ya que se puede administrar dosis altas de radiación de una manera rápida, segura, efectiva, respetando las tolerancias de los órganos adyacentes a nuestro objetivo. El desarrollo de una revisión narrativa sobre la radioterapia estereotáctica extracraneal como tratamiento del cáncer de próstata oligometastásico, nos permite conocer la técnica, fraccionamientos y resultados, para motivar el desarrollo y uso de estas herramientas y así mejorar el pronóstico de este grupo de pacientes y difundir su aplicación en Venezuela.

Introdução: A neoplasia da próstata é considerada um câncer da terceira idade, já que cerca de três quartos dos casos no mundo ocorrem a partir dos 65 anos. Homens diagnosticados com câncer de próstata localizado têm uma variedade de opções de manejo disponíveis, incluindo prostatectomia radical, radioterapia e vigilância ativa. Até o momento não se demonstraram benefícios em sobrevida livre de recorrência a partir da introdução da técnica robótica para cirurgia de próstata, porém, a evidência é muito limitada para tirar conclusões definitivas sobre as vantagens da cirurgia robô assistida em relação a laparoscópica. Objetivos: Realizar uma avaliação econômica e impacto orçamentário do uso da prostatectomia robótica em pacientes adultos com câncer de próstata localizado. Material e Método: Uma análise de custo-efetividade foi desenvolvida com a finalidade de comparar os custos médicos diretos e os desfechos de saúde envolvidos no tratamento cirúrgico (robô assistido X laparoscópica) de pacientes com câncer de próstata localizado. Um modelo analítico de Árvore de Decisão foi estruturado para reproduzir a trajetória dos pacientes que passam pelo procedimento de prostatectomia. Os parâmetros clínicos considerados para a estruturação do modelo econômico basearam-se nos resultados dos estudos de Kieffer J.J.M., et al., 2021 e Lindenberg M., et al., 2022. Os custos referentes a cada procedimento foram estabelecidos a partir da média histórica dos preços praticados no sistema Unimed do estado do Paraná. Resultados: Os resultados sugerem que a prostatectomia robótica promove ganhos em relação às disfunções evitadas, entretanto com um incremento de custos que seria de R$ 21.860,28 por paciente, e a razão de custo efetividade incremental (RCEI) de R$ 280.980,41 por paciente com disfunções evitadas. A análise de sensibilidade probabilística mostra que 97% das interações ficaram no quadrante I, o que demonstra que os custos e a efetividade da tecnologia inovadora são superiores em relação ao comparador. Para o cálculo da população elegível, foi utilizado um funil epidemiológico com o objetivo de estimar a população que teria indicação para a utilização da postectomia robótica no sistema Unimed no Paraná. Os resultados da análise de impacto orçamentário apresentam um incremento de custo frente ao uso da prostatectomia laparoscópica, que acumulados em 5 anos seriam de aproximadamente R$17,4 milhões. Discussão e Conclusões: O custo unitário da cirurgia robótica é 2,5 vezes maior que o da cirurgia laparoscópica sendo que a diferença de risco de desenvolver disfunção erétil e/ou incontinência utilizando a técnica robótica foi menor em 7,78% quando comparada à técnica laparoscópica convencional. O número necessário para tratar (NNT) é de 12,8, ou seja, a cada 13 pacientes tratados com a cirurgia robótica se evita uma disfunção. Se demonstra um RCEI de R$280.980,41 por paciente com disfunções evitadas, ou seja, aproximadamente 7 vezes o PIB per capita nacional.

Objective: To identify the best available evidence related to interventions for the acceptance of the prostate-specific antigen test. Methodology: Rapid literature review following the steps established by Tapia-Benavente, which are: 1.- research question, for which the PICO structure limited to the definition of the problem, intervention, and result was used; 2.- bibliography search in recognized databases; 3.- study selection and data extraction; 4.- bias risk assessment, for which the CONSORT group clinical trial verification guidelines were used; and 5.- preparation of a summary and conclusion of the evidence found. Results: The rapid literature search yielded a total of 51 publications from three databases, PubMed (27), EBSCO (13), and SCOPUS (11); 11 of which met the inclusion criteria. One hundred percent of the studies indicated a significant difference between the experimental and control groups (p < .05). The most frequently used strategies included home visits, conferences, group discussions, brainstorming, question-and-answer dynamics with slides, as well as the use of educational brochures, and were carried out in a period of one day and up to six months. Conclusions: There is an evident knowledge gap in the development and implementation of strategies for Prostate Cancer prevention behavior directed to indigenous men, as well as a lack of nursing intervention models focused on this disease. [ABSTRACT FROM AUTHOR]

Copyright of Revista Chilena de Urologia is the property of Sociedad Chilena de Urologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Chilena de Urologia is the property of Sociedad Chilena de Urologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Prostate adenocarcinoma is considered one of the most frequent neoplasms in men over 60 years, and bone metastasis constitutes one of the complications with the worst prognosis. Objective: Estimate the predictive factors for bone metastasis in patients with prostate cancer. Methods: An analytic study of 73 patients with prostate cancer was carried out. They were assisted at Conrado Benítez Cancer Hospital in Santiago de Cuba during 2018-2022. The variables analyzed included: age, skin color, clinical manifestations, onset time of bone metastasis, degree of cellular differentiation, prostate-specific antigen level and imaging diagnosis. Results: In the series there was a prevalence of the 60-69 age group (50.7%) and the average age was 67 years; also, dark skinned patients, bone pain as more frequent symptom and imaging diagnosis of bone metastasis by computerized axial tomography prevailed (48.0%). A proportional increase of prostate-specific antigen values and Gleason punctuation was observed in relation to the metastasis onset. Conclusions: The predictive factors for estimating the presence of bone metastasis in patients with prostate cancer are the advanced age, black skin color and prostatespecific antigen values above 20 ng/mL. [ABSTRACT FROM AUTHOR]

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Introduction: Prostate adenocarcinoma is considered one of the most frequent neoplasms in men over 60 years, and bone metastasis constitutes one of the complications with the worst prognosis. Objective: Estimate the predictive factors for bone metastasis in patients with prostate cancer. Methods: An analytic study of 73 patients with prostate cancer was carried out. They were assisted at Conrado Benítez Cancer Hospital in Santiago de Cuba during 2018-2022. The variables analyzed included: age, skin color, clinical manifestations, onset time of bone metastasis, degree of cellular differentiation, prostate-specific antigen level and imaging diagnosis. Results: In the series there was a prevalence of the 60-69 age group (50.7%) and the average age was 67 years; also, dark skinned patients, bone pain as more frequent symptom and imaging diagnosis of bone metastasis by computerized axial tomography prevailed (48.0%). A proportional increase of prostate-specific antigen values and Gleason punctuation was observed in relation to the metastasis onset. Conclusions: The predictive factors for estimating the presence of bone metastasis in patients with prostate cancer are the advanced age, black skin color and prostate-specific antigen values above 20 ng/mL.

Caracterizadas como o crescimento desordenado de células, as neoplasias possuem a capacidade de invadir tecidos adjacentes ou órgãos que estejam distantes da origem do crescimento, provocando hemorragias, dores contínuas, hematomas frequentes, febre, caquexia, astenia, protuberância anômala, entre outros sintomas. Neste cenário, o câncer de próstata causou 15.391 mortes no Brasil em 2017 e é o segundo câncer mais comum entre a população masculina. Por essa razão, esse estudo objetivou identificar, a partir da literatura científica, tecnologias educacionais utilizadas por enfermeiro/a(s) para promoção do autocuidado de pacientes com câncer de próstata. Para tanto, foi realizado um estudo do tipo bibliográfico, mais especificadamente uma revisão integrativa da literatura. A busca de artigos foi realizada através do Portal de Periódicos Capes/Ministério da Educação (MEC) nas bases de dados LILACS, IBECS, BDENF, SciELO, CINAHL, MEDLINE, Scopus e Web of Science. Com vistas a dinamizar o processo de busca, realizou-se o cruzamento dos termos no idioma inglês, com auxílio do operador booleano AND, seguindo a seguinte sequência: Nursing AND Educational Technology AND Self Care, Nursing AND Educational Technology AND Prostatic Neoplasms, Nursing AND Self Care AND Prostatic Neoplasms. Após análise do resultado das buscas, oito artigos foram selecionados como amostra final deste estudo. Evidencia-se, portanto, que as tecnologias educativas aplicadas por profissionais de saúde a pacientes com câncer de próstata possuem um grande alcance na sua forma de apresentação, podendo ser adaptada conforme as necessidades e peculiaridades de cada paciente, comunidade, nível da prestação de serviço ofertada.

Introducción: la neoplasia de próstata se mantiene de manera asintomática por varios años y su historia natural no está bien esclarecida. Objetivo: describir la situación clínica epidemiológica del cáncer de próstata en pacientes mayores de 40 años. Método: se realizó un estudio observacional, descriptivo, prospectivo en el consejo popular Parque, perteneciente al Policlínico Juana Naranjo León, en el período 2020- 2022. La población de estudio estuvo conformada por 143 pacientes mayores de 40 años y la muestra por 31 pacientes con criterios de inclusión, por muestreo no probabilístico intencional. utilizaron métodos deivel teórico, empírico y estadístico. Resultados: predominaron las edades entre 58 años a 67 años y los factores de riesgo como la raza mestiza, el tabaquismo y el sedentarismo. Predominaron los pacientes asintomáticos ya que es una enfermedad de curso solapado, en los exámenes complementarios el PSA en los pacientes que no se encontraban alterados, siendo el tacto rectal la piedra angular de sospecha esta enfermedad, fueron evaluados por urología el 70, 9 % el 29, 1 % continua su seguimiento en la atención primaria de salud. Conclusiones: en el estudio predominan las edades más avanzadas en convergencias con los factores de riesgo como la raza mestiza, el tabaquismo y el sedentarismo. Siendo el cuadro clínico asintomático el más notado, así como el tacto rectal el examen de excelencia, piedra angular de sospecha esta enfermedad, quedando evaluada y en seguimientos la totalidad de la población en estudio.

Obiective. Cancerul de prostată este a 2-a cel mai des diagnosticat tip de cancer la bărbați cu o rată a mortalității de 4.2% în Republica Moldova. Un screening populațional este asigurat de antigenul prostatic specific, iar metoda standard de diagnosticare este biopsia ecoghidată. Scopul acestei lucrări este de a evidenția importanța clinică a nivelului de antigen prostatic specific și a biopsiei transrectale. Metode. Studiul este unul de tip retrospectiv, realizat în incinta Spitalului Clinic Republican “Timofei Moșneaga” pe un lot de 368 de pacienți în intervalul mai 2016 – decembrie 2021. S-au evaluat pacienții cărora li s-a efectuat biopsie transrectală ecoghidată a prostatei împreună cu rezultatele histopatologice. Rezultate. Studiul include pacienți cu vârste cuprinse între 50 și 90 de ani. Nivelurile antigenului prostatic specific au variat de la 1,14 la 313 ng/ml, cu o medie den 26,28 g/ml. Diagnosticul de Adenocarcinom a fost identificat la 58,15% (214) pacienți; Hiperplazia benignă de prostată la 29,62% (109) pacienți și Proliferare acinară mică atipică la 12,23% (45) pacienți. Media antigenului prostatic specific la pacienții cu adenocarcinom este de 89,4 ng/ml (3,18 - 177,00 ng/ml). Nivelul mediu al antigenului prostatic specific la pacienții cu hiperplazia benignă de prostată este de 37,16 ng/ml (0,32 - 74,00 ng/ml). O medie de 22,99 ng/ml (3,29 - 44,70 ng/ml) a fost depistată la pacienții diagnosticați cu proliferare acinară mică atipică. Au fost înregistrate 31 de cazuri de adenocarcinom la pacienți cu vârsta sub 60 de ani, cu 8,53% (7 pacienți) diagnosticați între 2016 și 2018, iar 16,67% (24) diagnosticați între 2019 și 2021. Concluzii. Nivelul de antigen prostatic specific și biopsia ecoghidată a prostatei sunt metode medicale necesare pentru un management calitativ al pacienților ce se tratează în incinta clinicii. Studiul arată, de asemenea, că rata de identificare a adenocarcinomului la pacienții cu vârsta sub 60 de ani este în creștere.

Prostate cancer (PCa) is a highly heterogeneous and rapidly progressing malignancy with a complex etiology. The presence of cancer stem cells (CSCs) within prostate tumors contributes to treatment resistance, relapses, and metastasis. Understanding the molecular mechanisms and signaling pathways involved in CSC regulation is crucial for developing effective therapies. This article highlights the role of CSCs, particularly PCa stem cells (PCSCs), in PCa initiation and progression. It discusses the cellular heterogeneity of prostate tumors, the theories of clonal evolution and CSCs, and the resistance mechanisms exhibited by CSCs. In addition, the involvement of signaling pathways such as Hedgehog, PI3K/AKT, and mitogen-activated protein kinase/extracellular regulated kinases in PCSC regulation is explored. The need for new therapies targeting CSCs is emphasized, and potential treatment approaches, including immunotherapy and genetic engineering, are discussed. Despite the challenges posed by advanced therapies, targeting PCSCs holds promise for improving patient outcomes in advanced PCa. Further research on PCSC biology is warranted to advance our understanding and develop more effective therapeutic strategies. [ABSTRACT FROM AUTHOR]

Prostate cancer is one of the most common solid tumor bases, according to data from the World Health Organization. Over the past few years, its incidence and prevalence rates have increased significantly and have become a public health concern. Mortality and financial issues are worrisome since health systems around the world consider prostate cancer a major problem in future. Based on this health threat, interest has arisen on several research fronts to get more knowledge about the therapeutic options in fields such as endocrine pathways, molecular biology, and immunology. The present work aims to report on some perspectives for prostate cancer treatment based on the role of myeloid-derived suppressor cells and its primary importance, due to the central position, it plays in the tumor microenvironment. [ABSTRACT FROM AUTHOR]

Objective. To estimate prostate cancer (PC) survival in Mexico and explore survival disparities according to the marginalization level of residence place. Materials and methods. A nationwide administrative claims database (4 110 men) whose PC treatment was financed by Seguro Popular between 2012-2016, was cross-linked to the National Mortality Registry up to December 2019. Patients were classified according to their oncological risk at diagnosis and the marginalization level of the residence municipality. Cox proportional hazards regression was used to estimate multivariable survival functions. Results. Five-years PC survival (69%; 95%CI: 68,71%) ranged from 72% to 54% at very low and very high marginalization, respectively (p for trend<0.001). The lowest PC survival was observed in men with high-risk PC (47%; 95%CI: 33,66%) residents in very high marginalization municipalities. Conclusions. Overall, PC survival was lower than that reported in other Latin American countries. The distribution of oncologic risk and survival differences across marginalization levels suggests limited early detection and cancer health disparities. [ABSTRACT FROM AUTHOR]

Objective: the purpose of this study was to assess the impact of 14 treatments including a total of 10 dietary antioxidants on the risk of prostate cancer. Material and methods: we searched PubMed, Embase, the Cochrane Library, and the Web of Science for only randomized controlled trials (RCTs) to investigate the effect of these 10 antioxidants on the risk of getting prostate cancer. Using the Cochrane Risk of Bias Assessment Tool, the methodological quality of the included studies was evaluated. Data extraction: studies were appraised by two investigators and data were extracted. Using a surface under cumulative ranking (SUCRA) probability, a Bayesian network meta-analysis was undertaken to evaluate the relative ranking of agents. Results: from the earliest accessible date through August 2022, RCTs were gathered. A total of 14 randomized controlled trials were included with a total sample size of 73,365 males. The results of the network meta-analysis showed that green tea catechins (GTCs) significantly reduced the risk of prostate cancer (SUCRA, 88.6 %) followed by vitamin D (SUCRA, 55.1 %), vitamin B6 (54.1 %), and folic acid was the lowest (22.0 %). Conclusion: based on the Ranking Plot of the Network, we can state that GTCs might have an impact on the prevention of prostate cancer compared to other dietary antioxidants, but we still need quality literature to further prove it. [ABSTRACT FROM AUTHOR]

Esta guía tiene como objetivo facilitar al médico nuclear una herramienta basada en la evidencia científica, y elaborada por consenso de expertos para realizar el procedimiento PET/TC con 18F-DCFPyL de modo seguro y eficiente para el paciente con cáncer de próstata que presenta sobreexpresión del PSMA. Para ellos se establecerán unas recomendaciones para la realización de la exploración PET/TC con 18F-DCFPyL, parámetros de reconstrucción, presentación de las imágenes e interpretación de las mismas. Se analizarán los posibles falsos positivos de la exploración, como interpretarlos y cómo evitarlos. Finalmente, toda exploración debe conducir a la elaboración de un informe que de respuesta a la pregunta del clínico. Para ello se recomienda realizar un informe estructurado en el que se incluyan los criterios PROMISE, así como la clasificación de los hallazgos según parámetros PSMA-RADS. The objective of this guide is to provide to nuclear medicine physicians a tool based on scientific evidence and prepared by consensus of experts, to perform the 18F-DCFPyL PET/CT procedure with safely and efficiently for patients with prostate cancer who present PSMA overexpression. For them, some recommendations will be established for 18F-DCFPyL PET/CT examination: reconstruction parameters, presentation of the images and their interpretation. The possible false positives of the procedure will be analysed, how to interpret them and how to avoid them. Finally, all exploration should lead to the preparation of a report that answers the clinician's question. For this, it is recommended to prepare a structured report that includes the PROMISE criteria as well as the classification of the findings according to PSMA-RADS parameters. [ABSTRACT FROM AUTHOR]

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Fundamento: el cáncer de próstata está considerado un problema de salud a nivel mundial que afecta a los hombres de edad avanzada y de la raza negra con mayor frecuencia. Objetivo: elaborar una estrategia de intervención de enfermería para mjorar la atención de salud de pacientes con el diagnóstico de neoplasias prostáticas y pene en el Centro de Salud Morete-Puyo de Ecuador. Métodos: se realizó un estudio descriptivo, transversal, prospectivo en el período mayo-octubre del 2021. Se estudiaron a 12 pacientes con cáncer de próstata con el diagnóstico de neoplasias prostáticas y pene en el Centro de Salud Morete-Puyo. Las variables analizadas fueron: distribución de pacientes con neoplasia prostática y de pene por edades; según causa de la enfermedad; relación entre el número de visitas domiciliarias y estadio de la enfermedad neoplásica. Se emplearon medidas de resumen para frecuencias absolutas y relativas. Los datos se presentaron en tablas de contingencia. Resultados: el grupo de mayor ocurrencia fue el de 63-73 años con 7 pacientes (58,33 %); la edad avanzada asociada al tabaquismo fue la principal causa presente en 9 pacientes (75 %), de los 12 pacientes 5 se encontraban en estadio IV del cáncer por lo que fue necesario realizarle 24 visitas domiciliarias, la atención domiciliaria fue la acción estratégica prioritaria para brindar un cuidado continuo. Conclusiones: la mayor ocurrencia de casos con cáncer de próstata se presentó en adultos mayores, fue la edad avanzada asociada con el tabaquismo la principal causa de la enfermedad, el estadio avanzado tuvo una relación directamente proporcional al número de visitas domiciliarias y se propusieron acciones estratégicas orientadas a un cuidado continuo para mejorar la atención de enfermería al paciente con padecimientos oncológicos.

El carcinoma prostático se encuentra entre los primeros tipos de tumores más habituales en Ecuador. El objetivo de este trabajo fue analizar los resultados de antígeno prostático específico (PSA) como marcador tumoral de adenocarcinoma prostático en pacientes atendidos en el Hospital General Portoviejo, provincia de Manabí, de enero a agosto del 2020. Se realizó un estudio retrospectivo, transversal y descriptivo de los resultados de PSA, de 1053 hombres cuyas edades eran iguales o superiores a 50 años. Se obtuvo que los hombres en edades comprendidas entre 70 a 79 años presentaron la mayor cantidad de resultados elevados de PSA, 20,89 % del total de los pacientes estudiados tuvieron valores de PSA iguales o superiores a 4 ng/mL. En 13,64 % de los pacientes con PSA elevado, se constató el diagnóstico clínico e histopatológico de cáncer de próstata, en estos pacientes el valor promedio de PSA fue de 44,1±15,4 ng/mL y la mayor cantidad de ellos tuvieron valores de PSA mayor a 25 ng/mL. El PSA resultó ser de utilidad en el diagnóstico del cáncer de próstata, sin embargo, utilizar otras pruebas podría mejorar su eficacia diagnóstica.

La terapia con radioligando que se dirige al antígeno de membrana específico de la próstata (PSMA) se ha considerado recientemente como una opción en el tratamiento del cáncer de próstata resistente a la castración metastásica (mCRPC). El objetivo de este estudio fue evaluar los datos bioquímicos, cliónicos y radiológicos de los pacientes que recibieron tratamiento con 177-Lu-PSMA-617 RLT en nuestra cliónica tras el diagnóstico de mCRPC, e investigar la relación entre el momento del tratamiento y la localización de las metástasis y la supervivencia. Este es un estudio observacional retrospectivo realizado en un único centro de diciembre de 2016 a diciembre de 2019. Los pacientes se sometieron a tratamiento con 177-Lu-PSMA-617 RLT con un diagnóstico de mCRPC. Usamos la prueba de Kaplan-Meier y la prueba de riesgo proporcional de regresión de Cox para evaluar los datos de supervivencia. Se incluyeron 95 pacientes con una edad promedio de 70,45 años (50-85). La mediana de seguimiento fue de 10,86 meses (8,15-11,94) y la mediana de las líneas de tratamiento con 177-Lu-PSMA-617 RLT fue de 4 (1-5). Se encontró que la mediana de supervivencia global fue de 17,03 ± 5,78 meses en los pacientes que recibieron el tratamiento en la tercera línea o líneas inferiores, mientras que fue de 10,30 ± 0,93 meses en los pacientes que recibieron el tratamiento en la cuarta línea o más (p ± 0,021). Al evaluar a los pacientes con metástasis únicamente óseas y a los pacientes con metástasis óseas y ganglionares, la mediana de supervivencia global fue de 11,46 ± 0,87 meses y 12,13 ± 3,02 meses (p = 0,445), respectivamente. El tratamiento con 177-Lu-PSMA-617 RLT proporciona una mejor supervivencia en el tratamiento de pacientes diagnosticados con mCRPC después de tratamientos estándar que lo recibieron anteriormente. En los pacientes con mCRPC el tratamiento con 177-Lu-PSMA-617 RLT presenta mejor supervivencia si se realiza antes de la cuarta l-nea de tratamiento est ndar. La terapia con 177-Lu-PSMA-617 RLT podr-a ser un método de tratamiento eficaz en pacientes con mCRPC con met stasis óseas y ganglionares. Radioligand therapy which targets the prostate specific membrane antigen (PSMA) has recently considered as option in the treatment of metastatic castration resistant prostate cancer (mCRPC). The aim of this study was to evaluate the biochemical, clinical and radiological data of patients received treatment with 177-Lu-PSMA-617 RLT in our clinic following the diagnosis of mCRPC, and to investigate the relationship between treatment timing and metastasis region and survival. This is a retrospective, observational, single-center study from December 2016 to December 2019. Patients underwent 177-Lu-PSMA-617 RLT with a diagnosis of mCRPC. We used the Kaplan-Meier test and the Cox regression proportional hazard test to assess survival data. 95 patients with an average age of 70.45 (50-85) were evaluated retrospectively. Median follow-up was 10.86 months (8.15-11.94 months) and the median lines of 177-Lu-PSMA-617 RLT treatment was 4 (1 to 5). Median overall survival was found to be 17.03 ± 5.78 months in the patients receiving the treatment at the third or lower lines while it was 10.30 ± 0.93 months in patients receiving the treatment at the fourth or higher lines (p = 0.021). When evaluating patients with only bone metastasis and patients with bone and lymph node metastasis, the median overall survival was 11.46 ± 0.87 months and 12.13 ± 3.02 months (p = 0.445), respectively. 177-Lu-PSMA-617 RLT treatment provides better survival in the treatment of patients diagnosed with mCRPC after standard treatments and received it earlier. 177-Lu-PSMA-617 RLT treatment could be an effective treatment method in mCRPC patients with bone and lymph node metastasis. [ABSTRACT FROM AUTHOR]

Analizar el rendimiento diagnóstico de la PET/TC con 11C-colina en el seguimiento del cáncer de próstata (CaP), especialmente en pacientes con antígeno prostático específico (PSA) > 1 ng/ml. Se evaluaron retrospectivamente 329 exploraciones PET/TC con 11C-colina de 191 pacientes (68,2 ± 7,2 años) con CaP con recaída bioquímica o en seguimiento (PSA en el momento de la PET/TC: 13,0 ± 84,2 ng/ml). El tratamiento inicial fue prostatectomía radical en 81 pacientes y otros tratamientos (radioterapia, quimioterapia, hormonoterapia) en 110. La PET/TC se adquirió 20 min después de la inyección de 555-740 MBq de 11C-colina. El seguimiento mínimo fue superior a 12 meses. Doscientas diecinueve (66,6%) de las 329 exploraciones PET/TC fueron positivas. El porcentaje de positivos fue significativamente mayor en los pacientes con otro tratamiento inicial diferente a la prostatectomía radical (85,6 frente a 43,6%, respectivamente). Ciento treinta PET/TC (59,4%) mostraron recidiva local, 48 (21,9%) a distancia y 41 (18,7%) local más a distancia. El abordaje terapéutico inicial se modificó en 139 casos (63,5%). De las 81 PET/TC con 11C-colina realizadas con PSA < 1 ng/ml, 23 (28,4%) fueron positivas. El abordaje terapéutico inicial se modificó en 9 (11,1%). Tres de 63 pacientes (4,8%) fallecieron por CaP. La PET/TC con 11C-colina demostró su eficacia en el seguimiento y la reestadificación del CaP, incluso en pacientes con PSA sérico < 1 ng/ml. El rendimiento diagnóstico fue diferente según el tratamiento inicial al que fueron sometidos los pacientes, siendo mayor en aquellos tratados inicialmente con otros tratamientos distintos de la PR prostatectomía radical. Our aim was to analyse the performance of 11C-choline PET/CT in prostate cancer (PCa) surveillance, especially in patients with prostate specific antigen (PSA) < 1 ng/ml. Three hundred and twenty-nine 11C-choline PET/CT examinations from 191 patients (68.2 ± 7.2 years) submitted for PCa surveillance or biochemical recurrence were retrospectively evaluated (PSA at study was 13.0 ± 84.2 ng/ml). Main initial treatment was radical prostatectomy in 81 patients, and other treatments (radiotherapy, chemotherapy, hormonotherapy) in 110. PET/CT was acquired 20 min after injection of 555-740 MBq of 11C-choline. Minimum follow-up was 12 months. Two hundred and nineteen (66.6%) out of the 329 PET/CT examinations were positive. The percentage of positive examinations was significantly higher in patients with other initial treatment than radical prostatectomy compared to patients with radical prostatectomy (85.6 vs. 43.6%, respectively). One hundred and thirty PET/CT (59.4%) showed local recurrence, 48 (21.9%) distant recurrence, and 41 (18.7%) local plus distant recurrence. Initial therapeutic approach was changed in 139 cases (63.5%). In the subgroup of 81 11C-choline PET/CT scans performed with PSA < 1 ng/ml, 23 (28.4%) showed a positive result. Initial therapeutic approach was changed in 9 (11.1%). Three (4.8%) out of 63 patients died as per PCa. 11C-choline PET/CT demonstrated its effectiveness in PCa surveillance and restaging, even in patients with serum PSA < 1 ng/ml. The diagnostic performance was different depending on the initial treatment, been higher in patients with non-surgical treatment. [ABSTRACT FROM AUTHOR]

Objective: To measure 3-year care costs of breast, prostate, colorectal and lung cancers disaggregated by site and clinical stage. Method: A retrospective observational design was employed to investigate care costs of cases recorded in the Registry of the Basque Country between 2010 and 2015. Data gathered included TNM stage and demographic, clinical and resource use variables. Total costs per patient with stage IV disease were calculated by combining generalized linear models with parametric survival analysis. Unit costs were obtained from the analytical accounting system of the Basque Health Service. Results: The sample comprised 23,782 cancer cases (7801 colorectal, 5530 breast, 4802 prostate and 5649 lung cancer). The mean 3-year costs per patient with stage I to III disease were €11,323, €13,727, €8,651 and €12,023 for colorectal, breast, prostate and lung cancer, respectively. The most important cost components were surgery and chemotherapy. Total survival-adjusted costs until death for patients with stage IV disease (€27,568, €26,296, €16,151 and €15,931 for breast, colorectal, lung and prostate cancer, respectively) were higher than the 3-year costs for those with earlier-stage disease. Conclusions: This study quantitatively shows the pattern of changes in the economic burden of cancer throughout its natural history and the great magnitude of this burden for the health system. The use of indicators based on real-world data from each regional health service would allow cancer care in each region to be tailored to local population needs. Resumen: Objetivo: Determinar el coste del tratamiento de los cánceres de mama, próstata, colorrectal y pulmón según la localización y el estadio clínico. Método: Se utilizó un diseño observacional retrospectivo con los casos del Registro de Euskadi entre 2010 y 2015. Los datos incluyeron el estadio TNM, variables demográficas y clínicas, y uso de recursos. Los costes totales por paciente en estadio IV se calcularon combinando modelos lineales generalizados con el análisis paramétrico de supervivencia. Los costes unitarios se obtuvieron del sistema de contabilidad analítica del Servicio Vasco de Salud. Resultados: La muestra estuvo compuesta por 23.782 casos (7801 colorrectal, 5530 de mama, 4802 de próstata y 5649 de pulmón). Los costes medios por paciente a 3 años en estadio I a III fueron 11.323 €, 13.727 €, 8651 € y 12.023 € para los cánceres colorrectal, de mama, de próstata y de pulmón, respectivamente. Los costes para el estadio IV (27.568 €, 26.296 €, 16.151 € y 15.931 € para los cánceres de mama, colorrectal, de pulmón y de próstata, respectivamente) fueron mayores que en los estadios iniciales. Conclusiones: Este estudio muestra cuantitativamente el cambio en la carga económica del cáncer a lo largo de su evolución y la gran carga que supone para el sistema de salud. El uso de datos del mundo real de cada servicio de salud permitiría adaptar la atención del cáncer a las necesidades de la población local.

En el presente escrito se destaca la importancia que tienen los biomarcadores en el área biomédica para el desarrollo de tecnologías que permiten el diagnóstico temprano y tratamiento de enfermedades como el cáncer. Se recalcan tres de los biomarcadores para el cáncer que han demostrado ser efectivos para su tratamiento: el antígeno prostático específico (PSA), el cuál es de suma importancia al determinar recurrencias de cáncer de próstata y evaluar la respuesta al tratamiento, el micro ARN (miARN), el cual se muestra alterado en células cancerígenas, y la hormona β-HCG. Este último se puede emplear como marcador tumoral para varios tipos de cáncer y se ha determinado que esta hormona puede actuar como inhibidora de la apoptosis y estimula el crecimiento de células cancerígenas. Además, existe una relación directa entre la concentración de β-HCG y la agresividad del cáncer.

Background: In the last decade, the introduction of multiparametric magnetic resonance imaging (mpMRI) and fusion ultrasound-targeted mpMRI (TBx) has generated great expectations about the diagnostic pathway for prostate cancer. This method also has better sensitivity for locating and detecting clinically significant tumors, and is used to target biopsies specifically to suspicious areas. Aim: Through an observational study, evaluate the experience of a private clinic in performing TBxguided prostate biopsies. Method: This is an observational, retrospective study, which used information from medical records already archived at the Instituto de Urologia Bragança, located in the city of Bragança Paulista - SP, Brazil, of patients treated from September 2021 to March 2023, and which performed TBx-guided prostate biopsies. Results: In the present study, it was observed that the average age of the patients was approximately 66 years old, with an average PSA of 7.70 ng/mL. Among the patients evaluated, approximately one third had an increased risk of prostate cancer based on the values of the relationship between free PSA and total PSA. The most prevalent PIRADS classification in the studied sample was 4, and among patients with PIRADS classification 3, who would not naturally be indicated for biopsy, PSAd greater than 0.15 was identified in just over a third of them, suggesting that the they should also be subjected to examination. The majority of patients evaluated in our sample presented a negative result based on the Gleason scale. Among the positives, the most prevalent was 3+4. Conclusion: This study evaluated our Service's experience in performing fusion ultrasound, describing the epidemiological profile of patients and identifying those who actually required prostate biopsy for cancer research. As the main result, it was possible to identify the superiority of fusion biopsy when compared to randomized biopsy. It is suggested that similar surveys be carried out in various regions of Brazil with a view to verifying whether the phenomenon observed in our region could be repeated on a national scale. [ABSTRACT FROM AUTHOR]

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