Artificial Intelligence (AI) is progressively remodeling our daily life. A large amount of information from “big data” now enables machines to perform predictions and improve our healthcare system. AI has the potential to reshape prostate cancer (PCa) management thanks to growing applications in the field. The purpose of this review is to provide a global overview of AI in PCa for urologists, pathologists, radiotherapists, and oncologists to consider future changes in their daily practice. A systematic review was performed, based on PubMed MEDLINE, Google Scholar, and DBLP databases for original studies published in English from January 2009 to January 2019 relevant to PCa, AI, Machine Learning, Artificial Neural Networks, Convolutional Neural Networks, and Natural-Language Processing. Only articles with full text accessible were considered. A total of 1008 articles were reviewed, and 48 articles were included. AI has potential applications in all fields of PCa management: analysis of genetic predispositions, diagnosis in imaging, and pathology to detect PCa or to differentiate between significant and non-significant PCa. AI also applies to PCa treatment, whether surgical intervention or radiotherapy, skills training, or assessment, to improve treatment modalities and outcome prediction. AI in PCa management has the potential to provide a useful role by predicting PCa more accurately, using a multiomic approach and risk-stratifying patients to provide personalized medicine.

The neutrophil to lymphocyte ratio (NLR) at baseline has been shown to have prognostic value in metastatic prostate cancer. Little is known about the importance of a change in the NLR during treatment in patients treated with Radium-223 (²²³Ra). We investigated the prognostic value of the NLR at baseline and during therapy in patients with metastatic prostate cancer treated with ²²³Ra and also in patients treated with Docetaxel. We reviewed all patients treated with ²²³Ra in our center and randomly chosen patients treated with Docetaxel. Patients were stratified according to NLR ≤ 5 and >5 at baseline and at 12 weeks of therapy. The relationship between NLR measured at baseline and at 12 weeks and overall survival (OS) were evaluated. A total of 149 patients treated with ²²³Ra and 170 with Docetaxel were evaluated. For patients treated with ²²³Ra, overall survival was significantly better in patients that had both an NLR ≤ 5 at baseline and at 12 weeks. No such effect of NLR was found in patients treated with Docetaxel. In the present study, NLR at baseline and after 12 weeks of therapy was found to be prognostic factor in patients treated with ²²³Ra but not in those treated with Docetaxel.

Background: Despite recent awareness of institutional racism, there are still important racial disparities in prostate cancer medical research. We investigated the historical development of research on racial disparities and bias. Methods: PubMed was searched for the term ‘prostate cancer race’ and added key terms associated with racial disparity. As an indicator of scientific interest in the topic, we analyzed whether the number of publications increased linearly as an indicator of growing interest. The linearity is expressed as R². Results: The general search term “prostate cancer race” yielded 4507 publications. More specific search terms with ≥12 publications showing a higher scientific interest were found after 2005. The terms with the most publications when added to the general term were “genetic” (n = 1011), “PSA” (n = 995), and “detection” (n = 861). There was a linear increase in publications for “prostate cancer race” (R² = 0.75) since 1980. Specific terms added to the general terms with a high linear increase (R² ≥ 0.7) were “screening” (R² = 0.82), “detection” (R² = 0.72), “treatment access” (R² = 0.71), and “trial underrepresentation” (R² = 0.71). However, only a few studies have investigated its association with sexual activity. A combination with “sexual” showed 157 publications but only two years with ≥12 publications/year. Conclusion: The terms “genetic”, “PSA”, and “detection” have been the focus of recent research on racial differences in prostate cancer. We found that old stereotypes are still being mentioned but seem to find little interest in the current literature. Further research interest was found in “treatment access”. Recently, interest in socioeconomic factors has decreased.

The impact of statin use on localized prostate cancer (PCa) remains controversial, especially for patients treated with radiation therapy. We assessed the impact of statin use on biochemical recurrence (BCR) in patients treated for PCa with different modalities of radiation therapy. We evaluated 3555 patients undergoing radiation therapy between January 2001 and January 2022. The impact of statin use on BCR was analyzed for three treatment groups: external beam radiotherapy (EBRT), low-dose-rate seed brachytherapy (LDR), and EBRT plus high-dose-rate brachytherapy (EBRT + HDR). Median follow-up was 52 months among 1208 patients treated with EBRT, 1679 patients treated with LDR, and 599 patients treated with EBRT + HDR. A total of 1544 (43%) patients were taking a statin at the time of treatment, and 497 (14%) patients were in the D’Amico high-risk group. Only intermediate-risk patients treated with LDR fared better with statin use in univariate analysis (p = 0.025). This association was not significant in multivariate analysis (HR 0.44, 95% CI 0.18–1.10, p = 0.06). Statin use was not associated with a reduced risk of BCR in patients treated with radiation therapy. In the era of precision medicine, further investigation is needed to assess the benefit of statins in well-defined patients.