Hao-Lun Luo

Purpose: Among prostate cancer biomarkers, prostate-specific antigen (PSA) is the most researched and correlates with survival outcomes. This study aims to assess the initial PSA response to abiraterone in mCRPC patients and its impact on survival, using data from the Chang Gung Research Database in Taiwan. Materials and methods: This retrospective cohort study analyzed mCRPC patients who underwent abiraterone treatment from January 2005 to December 2019. Patients were further divided into prechemotherapy (prechemo) and postchemotherapy (postchemo) groups, with 114 and 181 patients, respectively. The treatment involved 1000 mg of abiraterone daily and 5 mg of prednisolone twice daily, with regular monitoring of PSA levels and tumor assessments. Results: This study enrolled 295 mCRPC patients undergoing abiraterone treatment, with a median follow-up of 54.7 months. The OS for the prechemo group was 13.4 months, while for the postchemo group was 25 months. A 90% PSA response within 3 months was a strong indicator of improved OS. In the prechemo group, 14% achieved PSA90, which was associated with improved survival outcomes. In the postchemo group, 44% reached PSA90, also correlating with better survival and fewer bone lesions. Conclusion: This study highlights the predictive value of a 90% decline in PSA levels within the initial 3 months of treatment for oncological outcomes in patients with mCRPC receiving abiraterone in chemotherapy-naive patients and those who had previously received chemotherapy.

Background: Nephrectomy inevitably reduces renal mass and increases the risk of chronic kidney disease (CKD). Identifying predictors of early renal decline after surgery is crucial for optimizing long-term outcomes. Methods: We retrospectively analyzed 1723 patients with renal cell carcinoma (RCC) or upper tract urothelial carcinoma (UTUC) from the Taiwan Cancer Database linked with the Chang Gung Research Database (2005–2024). Rapid decline was defined as a decrease in estimated glomerular filtration rate (eGFR) > 3 mL/min/1.73 m² between postoperative month 3 and month 15. Postoperative acute kidney injury (AKI) was defined according to KDIGO criteria. Logistic regression was used to evaluate demographic and clinical predictors. Risk stratification was performed according to diabetes mellitus (DM) and AKI. Results: Of 1723 patients, 720 (41.8%) experienced rapid decline. Compared with those without decline, affected patients were older, more often female, and had higher rates of hypertension, DM, and hyperlipidemia. Preoperative eGFR < 45 and postoperative AKI were also more common. In multivariate analysis, DM (OR 1.56, 95% CI 1.25–1.94, p < 0.001) and postoperative AKI (OR 1.85, 95% CI 1.43–2.38, p < 0.001) remained independent predictors. Risk stratification showed a stepwise increase in decline: 33.9% without either factor, 47.8% with DM only, 53.3% with AKI only, and 57.8% with both. Patients with both conditions had nearly a 1.7-fold higher risk compared with those without either factor, and Kaplan–Meier analysis confirmed significantly worse outcomes over time ( log-rank p < 0.05). Conclusions: DM and postoperative AKI independently predict early renal deterioration after nephrectomy. Patients with both factors represent a high-risk subgroup requiring intensified surveillance and preventive strategies.

Liu HY, et al. World J Mens Health. 2026 ;44:e46. https://doi.org/10.5534/wjmh.250053

Background To evaluate oncological outcome of external beam radiation therapy(EBRT) versus high-intensity focused ultrasound (HIFU) in patients with stage II prostate cancer. Materials and methods We retrospectively reviewed patients with stage II prostate cancer from the Chang Gung Research Database spanning the years 2005 to 2022. Inverse probability of treatment weighting (IPTW) method was performed to achieve baseline equivalence. Oncology outcomes including overall survival (OS) and cancer specific survival (CSS) were assessed using Kaplan-Meier curves before and after IPTW adjustment. Subgroup analysis of stage IIa, IIb, and IIc were also conducted. We use cox proportional hazards analyses to further evaluate the association between treatment and survival outcomes. Results Total of 176 EBRT and 244 HIFU procedures were identified. EBRT group has higher overall mortality (9.2% compared to 16.7% after IPTW; standardized difference 0.224) and cancer specific mortality (5.4% compared to 9.2% after IPTW; standardized difference 0.144) after IPTW adjustment. An overall survival benefit is observed in the HIFU group for all stage II prostate cancer cases, with a particularly significant advantage in the stage IIa subgroup after IPTW adjustment (p = 0.032). Although the cancer-specific survival benefit slightly favors the HIFU stage IIa subgroup after IPTW adjustment, it does not reach statistical significance (p = 0.069). EBRT is associated with significantly worse OS compared to HIFU across univariate, multivariate, and IPTW-adjusted Cox regression models, with hazard ratios ranging from 2.03 to 2.63 (all p 0.05). However, for CSS, a significant difference was found only in the univariate model (HR = 2.38, p = 0.032), and this association was not maintained after adjustment. Conclusions HIFU demonstrates non-inferior overall survival and cancer specific survival compared to EBRT in patients with stage II prostate cancer, particularly in the stage IIa subgroup after more than 10 years of follow-up. Further randomized prospective studies are needed to evaluate the oncological outcomes of different prostate cancer treatment modalities.

Urothelial carcinoma (UC) is a common cancer characterized by high morbidity and mortality rates. Despite advancements in treatment, challenges such as recurrence and low response rates persist. Antibody-drug conjugates (ADCs) have emerged as a promising therapeutic approach for various cancers, although their application in UC is currently limited. This review focuses on recent research regarding ADCs designed to treat UC by targeting human epidermal growth factor receptor 2 (HER2), a surface antigen expressed on tumor cells. ADCs comprise three main components: an antibody, a linker, and a cytotoxic payload. The antibody selectively binds to tumor cell surface antigens, facilitating targeted delivery of the cytotoxic drug, while linkers play a crucial role in ensuring stability and controlled release of the payload. Cleavable linkers release the drug within tumor cells, while non-cleavable linkers ensure stability during circulation. The cytotoxic payload exerts its antitumor effect by disrupting cellular pathways. HER2 is commonly overexpressed in UCs, making it a potential therapeutic target. Several ADCs targeting HER2 have been approved for cancer treatment, but their use in UC is still being tested. Numerous HER2 ADCs have demonstrated significant growth inhibition and induction of apoptosis in translational models of HER2-overexpressing bladder cancer. Ongoing clinical trials are assessing the efficacy and safety of ADCs targeting HER2 in UC, with the aim of determining tumor response and the potential of ADCs as a treatment option for UC patients. The development of effective therapies with improved response rates and long-term effectiveness is crucial for advanced and metastatic UC. ADCs targeting HER2 show promise in this regard and merit further investigation for UC treatment.

Purpose: To investigate the prognostic impact of variant histology (VH) on oncological outcomes in patients with upper urinary tract urothelial carcinoma (UTUC) who had undergone radical nephroureterectomy (RNU).Patients and methods: A total of 1239 patients with clinically localized UTUC who underwent RNU at a single institution between January 2005 and June 2020 were included. The VH was reviewed by a uro‐pathologist at our institution. The Cox regression model was used to perform multivariate analysis, including VH and other established prognostic factors for post‐RNU oncological outcomes (intravesical recurrence [IVR], non‐urothelial recurrence, and cancer‐specific death).Results: Of the 1239 patients with UTUC, 384 patients (31%) were found to have VH. Advanced tumor stage, lymph node metastasis, high tumor grade, lymphovascular invasion, open surgery, and renal pelvis had a significantly larger proportion of UTUC with VH compared to pure UTUC (all p < 0.05). VH was an independent prognostic factor associated with less IVR identified by multivariate analysis, more non‐urothelial recurrence, and more cancer‐specific mortality.Conclusion: Patients with VH account for 31% with UTUC treated with RNU in this cohort. VH was an independent prognostic factor associated with more non‐urothelial recurrence and cancer‐specific mortality but less IVR.