Search

Background: Cytoreductive radical prostatectomy (cRP) has emerged as a promising therapeutic approach for low-volume metastatic hormone-sensitive prostate cancer (mHSPC), but the best candidates for cRP are still unknown. This study aims to explore the potential value of 18F-PSMA-1007 PET/CT-derived quantitative volumetric tumor parameters in cRP treatment selection among patients with low-volume mHSPC. Methods: A total of 122 patients with primary low-volume mHSPC who underwent 18F-PSMA-1007 PET/CT followed by systemic therapy alone or plus cRP were included. The whole-body PSMA-derived tumor volume (PSMA-TV) was defined as the total volume of whole-body PSMA-avid tumor lesions, and prostate PSMA-TV was defined as the volume of prostate PSMA-avid tumor lesions. Spearman's correlation was used to analyze the relationships between whole-body PSMA-TV and clinicopathological characteristics. The primary endpoint was progression-free survival (PFS), and Cox regression analyses were performed to explore the independent predictors for PFS. Results: Among 122 patients, 37 (30.32%) underwent systemic therapy plus cRP. The median and optimal cutoff values of the whole-body PSMA-TV were 71.68 cm3 (41.28–157.41 cm3) and 78.57 cm3, respectively. Whole-body PSMA-TV was positively correlated with prostate-specific antigen (PSA), and patients with nonregional lymph node (NRLN) metastases had a greater whole-body PSMA-TV (P = 0.001). Cox regression analyses revealed that cRP, lower whole-body PSMA-TV and the absence of NRLN metastases were associated with better PFS (all P < 0.05). Subgroup analyses revealed that patients with a low whole-body PSMA or no NRLN metastases had a significant improvement in PFS for cRP versus no cRP (HR: 8.26; 95% CI: 2.72–25.06, P = 0.001; HR: 2.71; 95% CI: 1.25–5.93, P = 0.018). Moreover, among patients with higher prostate PSMA-TV and prostate PSMA-TV/whole-body PSMA-TV, cRP also significantly prolonged PFS compared with those without cRP (HR: 3.49; 95% CI: 1.49–8.18, P = 0.004; HR: 8.54; 95% CI: 2.47–29.50, P = 0.013). Conclusion: In management of primary low-volume mHSPC, whole-body and prostate PSMA-TV evaluations based on 18F-PSMA-1007 PET/CT could be helpful to identify the most suitable candidates for cRP. Trial registration: Retrospectively registered. [ABSTRACT FROM AUTHOR]

Exploring novel synthesis strategies for magnetic beads to extract nucleic acids is of great significance in the field of in vitro diagnostics. In the present research, monodisperse magnetic mesoporous silica beads were synthesized via the thermolysis reaction of Fe(acac) 3 by using large-pore dendritic silica colloids as templates, and were further functionalized with a highly pH-sensitive histidine-glutamate co-oligopeptide for deoxyribonucleic acid extraction. The large-pore dendritic silica colloid scaffolds were utilized for high-density incorporation of superparamagnetic iron oxide nanoparticles within the vertical channels. The morphology and properties of the as-prepared pH-sensitive oligopeptide magnetic mesoporous silica beads were evaluated by transmission electron microscopy, scanning electron microscopy, vibrating sample magnetometry, X-ray photoelectron spectroscopy, X-ray diffraction testing and so on. The average size of the obtained magnetic beads was 370 nm in diameter with a narrow size distribution. The saturation magnetization and magnetic content of the resultant magnetic beads were 25 emu g -1 and 59%, respectively. Moreover, the magnetic mesoporous silica beads exhibited an obvious pH-responsive behavior. Due to these remarkable features, successful deoxyribonucleic acid capture using the as-prepared pH-sensitive oligopeptide magnetic mesoporous silica beads was achieved., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Purpose: To develop a deep learning (DL) model based on primary tumor tissue to predict the lymph node metastasis (LNM) status of muscle invasive bladder cancer (MIBC), while validating the prognostic value of the predicted aiN score in MIBC patients., Methods: A total of 323 patients from The Cancer Genome Atlas (TCGA) were used as the training and internal validation set, with image features extracted using a visual encoder called UNI. We investigated the ability to predict LNM status while assessing the prognostic value of aiN score. External validation was conducted on 139 patients from Renmin Hospital of Wuhan University (RHWU; Wuhan, China)., Results: The DL model achieved area under the receiver operating characteristic curves of 0.79 (95% confidence interval [CI], 0.69-0.88) in the internal validation set for predicting LNM status, and 0.72 (95% CI, 0.68-0.75) in the external validation set. In multivariable Cox analysis, the model-predicted aiN score emerged as an independent predictor of survival for MIBC patients, with a hazard ratio of 1.608 (95% CI, 1.128-2.291; p = 0.008) in the TCGA cohort and 2.746 (95% CI, 1.486-5.076; p < 0.001) in the RHWU cohort. Additionally, the aiN score maintained prognostic value across different subgroups., Conclusion: In this study, DL-based image analysis showed promising results by directly extracting relevant prognostic information from H&E-stained histology to predict the LNM status of MIBC patients. It might be used for personalized management of MIBC patients following prospective validation in the future., Competing Interests: Declarations. Competing interest: The authors have no competing interests. The manuscript has been approved by all authors for publication., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)