In this issue of the journal, we have four Review Articles, six Original Articles, one Short Communication, one Case Report and two Letters to the Editor. I would like to pay close attention to the interesting papers that reported and discussed current topics of prostate cancer.
Masuda et al. (Tokyo, Japan) explored the relationship between body mass index (BMI) and prostate cancer risk at biopsy in Japanese men, and compared the risk with that of Caucasian men. They retrospectively evaluated Japanese men with prostate-specific antigen (PSA) levels from 2.5 to 19.9 ng/mL undergoing an initial extended prostate biopsy. There was a significant positive relationship between BMI and prostate cancer risk at biopsy, with an increased risk observed in men whose BMI was ≥27.0, compared with the reference group. A significantly increased risk starting at BMI ≥25.0 was found in high-grade disease. In contrast to their results, there has been no reported increase in the risk of prostate cancer at biopsy in Caucasians within the overweight range (BMI of 25.0–29.9). The authors concluded that Japanese men within the overweight BMI range who have an elevated PSA also have a significant risk of harboring prostate cancer, especially high-grade disease, and that overweight Japanese might be at greater prostate cancer risk at biopsy than overweight Caucasians.
The accuracy of the Japan Cancer of the Prostate Risk Assessment (J-CAPRA) score, which was developed as a risk stratification instrument for patients undergoing primary androgen deprivation therapy, was externally validated for predicting cause-specific survival (CSS) among patients in the USA community-based Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) registry; however, there have been no investigations to validate the accuracy of the J-CAPRA score in predicting progression-free survival (PFS) along with analysis of clinical situation. Kitagawa et al. (Kanazawa, Japan) examined whether the clinical outcomes of patients treated by combined androgen blockade (CAB) with bicalutamide could be stratified using the J-CAPRA score. The factors used in the J-CAPRA points were significant predictors of PFS, and clinical T stage and M stage were also significant predictors of PFS. The probabilities of PFS and CSS were significantly different among the groups categorized according to the J-CAPRA risk strata. The authors concluded that the J-CAPRA score is a useful tool for predicting the clinical outcomes of patients with prostate cancer treated by CAB including bicalutamide.
Several papers of laparoendoscopic single-site surgery in urology have been published, but just a few cases of radical prostatectomy have been reported. Nakane et al. (Anjo, Japan) showed the early outcomes of an original two-port laparoendoscopic approach for radical prostatectomy. A multichannel port with three 5-mm trocars, providing easier instrument handling, was inserted extraperitoneally through a 2.5-cm lower umbilical “U” incision. An additional 12-mm port was inserted into the left fossa to allow an adequate working angle. The operation was successfully completed in all 22 patients with early-stage prostate cancer; only one patient required an additional 5-mm port to control bleeding. There were no intraoperative complications. The authors concluded that this new procedure can be safely carried out if the surgeon is familiar with conventional five-port laparoscopic radical prostatectomy.
Paraneoplastic limbic encephalitis (PLE) is a rare tumor-related syndrome, and the prognosis for neurological recovery and survival is poor. The neoplasms most frequently associated with PLE are small cell lung cancer and testicular cancer. Jakobsen et al. (Viborg, Denmark) reported a rare case of prostate cancer-related PLE. The authors showed that high-risk prostate cancer can trigger PLE, a rapidly progressive neurological syndrome with a bad prognosis.