Dietary Patterns in Relation to Prostate Cancer in Iranian Men: A Case-Control Study Prostate cancer;dietary pattern;case-control study; Background: Prostate cancer is the most frequently occurring cancer among males in economically developed countries. Among the several risk factors that have been suggested, only age, ethnicity, diabetes, and family history of prostate cancer are well-established and primary prevention of this disease is limited. Prior studies had shown that dietary intake could be modified to reduce cancer risk. We conducted a hospital-based, casecontrol study to examine the association between dietary patterns and prostate cancer risk in Iran. Materials and Methods: A total of fifty patients with prostate cancer and a hundred controls underwent face-to-face interviews. Factor analysis was used to determine the dietary patterns. Multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: We defined two major dietary patterns in this population: 'western diet'(high in sweets and desserts, organ meat, snacks, tea and coffee, French fries, salt, carbonated drinks, red or processed meat) and 'healthy diet' (high in legumes, fish, dairy products, fruits and fruit juice, vegetables, boiled potatoes, whole cereal and egg). Both Healthy and western pattern scores were divided into two categories (based on medians). Higher scores on Healthy pattern was marginally significantly related to decreased risk of prostate cancer (above median vs below median, OR =0.4, 95%CI=0.2-1.0). An increased risk of prostate cancer was observed with the higher scores on the Western pattern (above median vs below median, OR=4.0, 95%CI=1.5-11.0). Conclusions: The results of this study suggested that diet might be associated with prostate cancer among Iranian males.

Findings of epidemiologic studies on the relationship between fruit and vegetable consumption and prostate cancer (PCa) risk have been inconclusive. We therefore examined the association between intake of fruits and vegetables and PCa risk in Iran. In this hospital based, case-control study, a total of 50 patients with PCa and 100 controls underwent face-to-face interviews. Regression analysis was used to examine the relation between fruit and vegetable intake and PCa risk. A protective independent effect was observed for the highest tertile of total fruit and vegetable (OR: 0.33, CI: 0.04-0.30, p value<0.001), total fruit (OR: 0.30, CI: 0.06-0.4, p value=0.03) and total vegetable (OR: 0.31, CI: 0.02-0.21, p value<0.001) consumption. Within the group of fruits, a significant inverse association was observed for apple and pomegranate (p trends were 0.01 and 0.016, respectively). In the vegetable group, a significant inverse association was observed for tomatoes (p trend<0.001) and cabbage (p trend=0.021). The results of the present study suggested that fruits and vegetable intake might be negatively associated with PCa risk.

Objectives: To compare the success and complication rates of sonography-guided supine percutaneous nephrolithotomy (PCNL) versus prone standard technique (fluoroscopic guidance) in a randomized controlled trial. Subjects and Methods: Between April 2009 and August 2011, 92 candidates for PCNL were randomly divided into two groups: 46 B-mode sonography-guided supine PCNL (group A) and 46 standard fluoroscopic-guided prone PCNL (group B). Demographic, clinical and perioperative patient characteristics were analyzed, and complications and success rates were compared between the two approaches. Results: Preoperative parameters were comparable in the two groups. The primary success rate was 79.0 and 65.2% in groups A and B, respectively, after one session of PCNL (p = 0.485). Sonography-guided access failed in 3 cases (failure rate 6.5% in group A vs. 0% in group B). Mean hospital stay (2.48 days for group A vs. 2.95 days for group B; p = 0.039) and mean nephrostomy tube stay time (1.79 days for group A vs. 2.56 days for group B; p = 0.007) were significantly prolonged in the standard technique. Postoperative fever was more prevalent in the standard PCNL group (p = 0.024), but no significant difference was observed in other complications between the two groups. Conclusion: In this study, sonography-guided supine PCNL was presented as a safe and effective technique, similar to standard PCNL, with comparable success and complication rates. In addition, using this technique eliminates the possible harmful impacts of radiation on the surgical team and decreases postoperative fever.

Purpose: The addition of androgen receptor pathway inhibitors (ARPIs) to androgen deprivation therapy (ADT), with or without docetaxel (Doc), is currently recommended for metastatic, hormone-sensitive prostate cancer (mHSPC). Recently, the ARANOTE trial evaluated the efficacy and safety of Darolutamide + ADT in this setting. We aimed to update a network meta-analysis (NMA) of these combination therapies. Methods: We conducted a systematic search for RCTs on systemic therapies for mHSPC using MEDLINE, Embase, and the Web of Science Core Collection in September 2024. An NMA utilizing random-effects models was performed to compare progression-free survival (PFS), overall survival (OS), and adverse event (AE) incidence (PROSPERO: CRD42024591458). Results: A total of 12 RCTs (n = 11,954) were included in our NMAs. Triplet therapies were associated with significant improvements in PFS compared to ARPI-based doublet therapies (hazard ratio [HR]: 0.74; 95% confidence interval [CI]: 0.59–0.93; p = 0.01), but the difference did not reach the conventional levels of statistical significance for OS (HR: 0.82; 95% CI: 0.67–1.01; p = 0.059). In a subset analysis, compared to ARPI-based doublet therapies, triplet therapies showed a significant improvement in PFS in patients with high-volume disease (HR: 0.64; 95% CI: 0.47–0.88; p < 0.01), whereas no significant improvement was observed in those with low-volume disease (HR: 0.86; 95% CI: 0.45–1.67; p = 0.7). No significant difference in grade ≥ 3 AEs was observed between triplet therapies and ARPI-based doublet therapies. The main limitations include patient heterogeneity and limited follow-up in some studies. Conclusions: Triplet therapies can improve the oncologic outcomes of patients with mHSPC compared to ARPI-based doublet therapies, without significantly increasing severe AEs. These findings warrant further confirmation in a head-to-head trial powered for overall survival.