Publications
2026
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Statin Use and Survival in Early Breast Cancer According to Different Intrinsic Subtypes
CONCLUSIONS AND RELEVANCE: In this cohort study of patients with early breast cancer, prediagnostic statin use was not associated with higher survival; however, postdiagnostic statin use was associated with lower all-cause and breast cancer-specific mortality among patients with hormone receptor-positive intrinsic subtypes. These findings suggest that statin therapy may improve survival of patients with early hormone receptor-positive subtypes. -
Characteristics, treatment patterns, and outcomes of patients with metastatic prostate cancer during 2014-2022 in Pirkanmaa, Finland-an observational study
CONCLUSION: Since the approval of enzalutamide as a first-line treatment for mCRPC, it has become the most common first-line treatment for mCRPC in PHD. Novel therapeutics, including docetaxel, enzalutamide, and abiraterone, have been adapted into clinical practice and are being used at earlier phases of the disease. Changes in treatment practices correlate with improved outcomes in patients with mHSPC in the PHD area. -
PI-RADS v2 and Adverse Prostate Cancer Outcomes: A Cross-cohort Replication Study Across Three Centers
CONCLUSIONS AND CLINICAL IMPLICATIONS: PI-RADS score 5 is associated with elevated risk of adverse outcomes. The presented clinically strong endpoints have potential to affect decision-making in MRI-based PCa diagnosis and prognosis. -
Body composition and renal cell carcinoma prognosis in elderly patients: a retrospective cohort study
BACKGROUND: Body composition has been proposed as a prognostic factor in renal cell carcinoma (RCC), but evidence remains inconsistent, particularly in elderly patients. This study aimed to evaluate whether computed tomography (CT)-derived body composition indices are associated with overall survival (OS) in patients aged ≥ 75 years with RCC. METHODS: This retrospective cohort study included all RCC patients aged ≥ 75 years diagnosed at Tampere University Hospital between 2003 and 2017 with... -
On Cluster Structures of Finnish Cancer Incidence Data
IntroductionThe global burden of cancer is increasing. Part of this development is attributable to the estimated growth and aging of the population. In particular, aging is 1 of the main risk factors for cancer. However, there are many other risk factors beyond aging, including certain lifestyle and environmental factors. In addition, changes in diagnostic thresholds, increasing coverage of screening, and other similar factors affect cancer incidence rates. Therefore, even after excluding the... -
Correction: Renal cancer survival in clear cell renal cancer compared to other types of tumor histology: A population-based cohort study
[This corrects the article DOI: 10.1371/journal.pone.0329000.]. -
Corrigendum to "Treatment Trajectories in Metastatic Hormone-sensitive Prostate Cancer: A PIONEER+ Big Data Analysis" [Eur. Urol. Oncol. 8(5) (2025) 1340-1349]
No abstract
2025
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Corrigendum to "Treatment Trajectories in Metastatic Hormone-sensitive Prostate Cancer: A PIONEER+ Big Data Analysis" [Eur. Urol. Oncol. 8(5) (2025) 1340-1349]
No abstract -
Hyperglycemia and bladder cancer prognosis in a Finnish population-based cohort
CONCLUSIONS: Diabetes and diabetic glycemic status were associated with increased risk of both overall and BCa-specific death. -
Experiences of exercise and its significance for the quality of life among patients with advanced cancer - A qualitative study
CONCLUSION: At the onset of advanced cancer, healthcare professionals should discuss patients' exercise habits and ensure that both the quantity and type of exercise are appropriate. If necessary, patients should be offered informational and practical support for implementing healthier exercise habits. Moreover, based on the experiences of patients with advanced cancer, exercise is perceived to have exclusively beneficial consequences for quality of life. -
European Study of Prostate Cancer Screening - 23-Year Follow-up
CONCLUSIONS: Long-term follow-up confirms a sustained reduction in deaths from prostate cancer with PSA testing, alongside an improved harm-benefit ratio. Future screening strategies should adopt risk-based approaches to minimize overdiagnosis while maintaining clinical benefits. (Funded by the Dutch Cancer Society and others; ERSPC ISRCTN registry number, ISRCTN49127736.). -
Treatment Trajectories in Metastatic Hormone-sensitive Prostate Cancer: A PIONEER+ Big Data Analysis
CONCLUSIONS AND CLINICAL IMPLICATIONS: This is the largest RWD study of systemic mHSPC treatment. Despite evidence, ADT monotherapy remains the most used first-line therapy. Increased use ADT + ARPI is associated with better persistence and improved outcomes in the real-world setting, supporting its broader adoption in clinical practice. -
SNP genotypes in CYP2C9 and VKORC1 genes do not affect prostate cancer or cancer mortality among warfarin users in Finnish prostate cancer patients
The coagulation cascade is thought to contribute to cancer progression. Although in vitro studies suggest that anticoagulants, such as warfarin, might reduce cancer progression, epidemiological data indicate that warfarin users may have a higher risk of cancer mortality. However, single nucleotide polymorphisms (SNPs) that influence warfarin dosing might affect this association. We investigated the risk associations between warfarin use and prostate cancer (PCa) survival, considering the SNP... -
Renal cancer survival and use of 5alpha-reductase inhibitors or androgen deprivation therapy
CONCLUSION: Use of 5α-reductase inhibitors or androgen deprivation therapy does not consistently associate with RCC-survival following diagnosis. -
Healthcare Resource Use and Costs of Localized Prostate Cancer Patients in Finland
CONCLUSION: This study highlights significant cost variations across different treatment pathways for prostate cancer in Finland and underscores the economic impact of metastatic disease. Early detection and effective management are essential for cost containment. -
PTEN restoration and CXCR2 depletion synergistically enhance the effect of enzalutamide and inhibit bone metastatic CRPC
Rationale: Enzalutamide (Enz) is the first-line therapy for castration-resistant prostate cancer (CRPC). However, drug resistance has hindered its further application. Moreover, CRPC is frequently prone to metastasis, particularly to bone (BmCRPC). Methods: To investigate the involvement of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) deletion and C-X-C motif chemokine receptor 2 (CXCR2) overexpression in Enz-resistant CRPC and BmCRPC, we constructed a bisphosphonate (BP)... -
Renal cancer survival in clear cell renal cancer compared to other types of tumor histology: A population-based cohort study
CONCLUSION: Our results demonstrate that the histological subtype is a powerful predictor of survival. Histology should be used more in clinical decision-making. Having a histological confirmation would tailor the selection of treatment: surgical management for aggressive and ccRCC and conservative management for less aggressive histological types. -
Is Exercise During Androgen Deprivation Therapy Effective and Safe? A Randomized Controlled Trial
To explore the benefits and safety of supervised and unsupervised exercise among localized and metastatic prostate cancer patients (PCa) during long-term androgen deprivation therapy (ADT). A total of 44 PCa patients were enrolled in this randomized controlled trial (RCT). Participants were randomized in a 1:1 ratio into the supervised exercise sessions group or the unsupervised home-based exercise group for three months. The primary outcomes assessed included quality of life (QoL), body... -
The association between intrinsic breast cancer subtypes, mammography screening and prognosis: a large population-based real world cohort study
CONCLUSION: In this real-world dataset, triple-negative tumors had the highest risk of death and majority of these tumors were found after the screening age. In screening-aged females, patients with screen-detected tumors had the best survival, while patients with interval tumors and patients not attending screening had the worst prognosis. -
Do differences in secondary treatment explain mortality impact of prostate cancer screening? - A randomized screening trial
CONCLUSIONS: Although limited by small sample size and a single-center scope, our findings suggest the mortality result of the FinRSPC is not attributable to differing treatment for castration-resistant PC between the trial arms. -
Effect of NSAID Consumption on Renal Cell Carcinoma Prognosis: A Population-Based Study
CONCLUSION: Prediagnostic NSAID consumption slightly elevated RCC mortality. Among women, both pre- and postdiagnostic NSAID use is associated with heightened RCC mortality. -
Testosterone levels at diagnosis: A key predictor of overall survival among patients with prostate cancer
CONCLUSION: Low testosterone at the time of PCa diagnosis is an independent predictor of overall survival. Findings highlight the potential of testosterone for prognostic evaluation in PCa. -
The Impact of Atorvastatin on Intraprostatic Biomarkers - Prognostic Value of 3LS-score - Follow-up of ESTO1-Trial
CONCLUSION: Higher atorvastatin lactone concentrations in the prostate tissue were linked to improved pathological variables. Pre-surgery statin intervention reduced MACE risk but no impact on other clinical outcomes was observed. The 3LS from prostate tissue does not seem to be prognostic marker in localized Pca. -
Long-term Risk of Prostate Cancer Mortality Among Men with Baseline Prostate-specific Antigen Below 3 ng/ml: Evidence from the Finnish Randomized Study of Screening for Prostate Cancer
CONCLUSIONS AND CLINICAL IMPLICATIONS: Our findings highlight the importance of a nuanced approach to PSA in PCa screening, suggesting utility for combining PSA with other tests at low levels and indicating minimal risk associated with discontinuing screening at ages 67-71 yr when PSA is low. -
PIONEER big data platform for prostate cancer: lessons for advancing future real-world evidence research
Prostate Cancer Diagnosis and Treatment Enhancement through the Power of Big Data in Europe (PIONEER) is a European network of excellence for big data in prostate cancer. PIONEER brings together 34 private and public stakeholders from 9 countries in one multidisciplinary research consortium with the aim of positively transforming the field of prostate cancer clinical care by answering pressing questions related to prostate cancer screening, diagnosis and treatment. PIONEER has developed a unique...
2024
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PI-RADS v2 and Adverse Prostate Cancer Outcomes: A Cross-cohort Replication Study Across Three Centers
CONCLUSIONS AND CLINICAL IMPLICATIONS: PI-RADS score 5 is associated with elevated risk of adverse outcomes. The presented clinically strong endpoints have potential to affect decision-making in MRI-based PCa diagnosis and prognosis. -
Long-term Risk of Prostate Cancer Mortality Among Men with Baseline Prostate-specific Antigen Below 3 ng/ml: Evidence from the Finnish Randomized Study of Screening for Prostate Cancer
CONCLUSIONS AND CLINICAL IMPLICATIONS: Our findings highlight the importance of a nuanced approach to PSA in PCa screening, suggesting utility for combining PSA with other tests at low levels and indicating minimal risk associated with discontinuing screening at ages 67-71 yr when PSA is low. -
Single cell and spatial transcriptomics highlight the interaction of club-like cells with immunosuppressive myeloid cells in prostate cancer
Prostate cancer treatment resistance is a significant challenge facing the field. Genomic and transcriptomic profiling have partially elucidated the mechanisms through which cancer cells escape treatment, but their relation toward the tumor microenvironment (TME) remains elusive. Here we present a comprehensive transcriptomic landscape of the prostate TME at multiple points in the standard treatment timeline employing single-cell RNA-sequencing and spatial transcriptomics data from 120 patients.... -
Elevated Levels of Serum Thymidine Kinase 1 Predict Poor Survival for Patients with Metastatic Prostate Cancer
CONCLUSIONS AND CLINICAL IMPLICATIONS: sTK1 predicted OS in mHSPC and mCRPC, demonstrating additional value over established clinical risk factors. sTK1 should be measured in randomized clinical trials of treatments for advanced PC to validate its predictive value. -
PIONEER big data platform for prostate cancer: lessons for advancing future real-world evidence research
Prostate Cancer Diagnosis and Treatment Enhancement through the Power of Big Data in Europe (PIONEER) is a European network of excellence for big data in prostate cancer. PIONEER brings together 34 private and public stakeholders from 9 countries in one multidisciplinary research consortium with the aim of positively transforming the field of prostate cancer clinical care by answering pressing questions related to prostate cancer screening, diagnosis and treatment. PIONEER has developed a unique... -
Previous inguinal hernia surgery does not limit the likelihood of choosing prostatectomy as primary prostate cancer therapy
We evaluated whether previous inguinal hernia repair may affect the choice of prostate carcinoma treatment in a population-based cohort. It has been suggested that previous laparoscopic inguinal hernia repair (LIHR) could limit the subsequent possibility of performing a prostatectomy. Several small studies have suggested otherwise. The study cohort included all new prostate cancer cases in Finland 1998-2015 identified through the Finnish cancer registry. Data on the treatment of prostate cancer... -
Transdermal oestradiol and exercise in androgen deprivation therapy (ESTRACISE): protocol
CONCLUSION: The ESTRACISE study's innovative design can offer novel insights about the benefits of E2 gel, and the substudy can reinforce the benefits resistance training and deliver valuable new novel insights into the synergistic benefits of E2 gel and exercise, which are currently unknown. -
Prostate Cancer Screening With PSA, Kallikrein Panel, and MRI: The ProScreen Randomized Trial
CONCLUSIONS AND RELEVANCE: In this preliminary descriptive report from an ongoing randomized clinical trial, 1 additional high-grade cancer per 196 men and 1 low-grade cancer per 909 men were detected among those randomized to be invited to undergo a single prostate cancer screening intervention compared with those not invited to undergo screening. These preliminary findings from a single round of screening should be interpreted cautiously, pending results of the study's primary mortality... -
MiR26a reverses enzalutamide resistance in a bone-tumor targeted system with an enhanced effect on bone metastatic CRPC
Resistance to androgen receptor (AR) inhibitors, including enzalutamide (Enz), as well as bone metastasis, are major challenges for castration-resistant prostate cancer (CRPC) treatment. In this study, we identified that miR26a can restore Enz sensitivity and inhibit bone metastatic CRPC. To achieve the highest combination effect of miR26a and Enz, we developed a cancer-targeted nano-system (Bm@PT/Enz-miR26a) using bone marrow mesenchymal stem cell (BMSC) membrane and T140 peptide to co-deliver... -
Prognostic factors of renal cell cancer in elderly patients: a population-based cohort study
Mortality in renal cell cancer (RCC) is high in the elderly population. Comorbidities have a greater impact on overall prognosis of RCC among elderly patients than in younger patients. All new RCC cases were collected in people over 74 years of age between 1995 and 2018 from the Finnish cancer registry. The comorbidities were identified from the Care Registry for Healthcare. Charlson Comorbidity Index (CCI) was used to evaluate the risk of death based on comorbidities. The overall risk of death... -
Protocol of a randomised, controlled trial comparing immediate curative therapy with conservative treatment in men aged ≥75 years with non-metastatic high-risk prostate cancer (SPCG 19/GRand-P)
BACKGROUND: Older men (aged ≥75 years) with high risk, non-metastatic prostate cancer (PCa) are increasingly treated with curative therapy (surgery or radiotherapy). However, it is unclear if curative therapy prolongs life and improves health-related quality of life (HRQoL) in this age group compared to conservative therapy, which has evolved considerably during the last decade. -
Survivorship Data in Prostate Cancer: Where Are We and Where Do We Need To Be?
Cancer survivorship was recently identified as a prostate cancer (PCa) research priority by PIONEER, a European network of excellence for big data in PCa. Despite being a research priority, cancer survivorship lacks a clear and agreed definition, and there is a distinct paucity of patient-reported outcome (PRO) data available on the subject. Data collection on cancer survivorship depends on the availability and implementation of (validated) routinely collected patient-reported outcome measures... -
Management of functional outcomes after radical prostatectomy in the Nordic countries: A survey of uro-oncological centers
We aimed to describe the clinical practice regarding erectile dysfunction and urinary incontinence after radical prostatectomy in the Nordic countries. A 37-item survey about pre- and post-prostatectomy evaluation and rehabilitation of sexual and urinary function was sent to 42 uro-oncology centers. Reporting was done according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Twenty-seven centers in Denmark (n = 6), Norway (n = 8), Finland (n = 7), and Sweden (n = 6)... -
Allopurinol and prostate cancer survival in a Finnish population-based cohort
CONCLUSIONS: We found no marked difference in CSS by allopurinol use. Allopurinol users had lower OS but there were no significant differences by duration or intensity of allopurinol use. Allopurinol use may not have anticancer effects against prostate cancer; instead, it may be a surrogate for metabolic problems causing shorter OS among men with PCa.
2023
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Statin Use and Survival in Early Breast Cancer According to Different Intrinsic Subtypes
CONCLUSIONS AND RELEVANCE: In this cohort study of patients with early breast cancer, prediagnostic statin use was not associated with higher survival; however, postdiagnostic statin use was associated with lower all-cause and breast cancer-specific mortality among patients with hormone receptor-positive intrinsic subtypes. These findings suggest that statin therapy may improve survival of patients with early hormone receptor-positive subtypes. -
On Cluster Structures of Finnish Cancer Incidence Data
IntroductionThe global burden of cancer is increasing. Part of this development is attributable to the estimated growth and aging of the population. In particular, aging is 1 of the main risk factors for cancer. However, there are many other risk factors beyond aging, including certain lifestyle and environmental factors. In addition, changes in diagnostic thresholds, increasing coverage of screening, and other similar factors affect cancer incidence rates. Therefore, even after excluding the... -
Experiences of exercise and its significance for the quality of life among patients with advanced cancer - A qualitative study
CONCLUSION: At the onset of advanced cancer, healthcare professionals should discuss patients' exercise habits and ensure that both the quantity and type of exercise are appropriate. If necessary, patients should be offered informational and practical support for implementing healthier exercise habits. Moreover, based on the experiences of patients with advanced cancer, exercise is perceived to have exclusively beneficial consequences for quality of life. -
Transdermal oestradiol and exercise in androgen deprivation therapy (ESTRACISE): protocol
CONCLUSION: The ESTRACISE study's innovative design can offer novel insights about the benefits of E2 gel, and the substudy can reinforce the benefits resistance training and deliver valuable new novel insights into the synergistic benefits of E2 gel and exercise, which are currently unknown. -
Prostate Cancer Screening With PSA, Kallikrein Panel, and MRI: The ProScreen Randomized Trial
CONCLUSIONS AND RELEVANCE: In this preliminary descriptive report from an ongoing randomized clinical trial, 1 additional high-grade cancer per 196 men and 1 low-grade cancer per 909 men were detected among those randomized to be invited to undergo a single prostate cancer screening intervention compared with those not invited to undergo screening. These preliminary findings from a single round of screening should be interpreted cautiously, pending results of the study's primary mortality... -
Protocol of a randomised, controlled trial comparing immediate curative therapy with conservative treatment in men aged ≥75 years with non-metastatic high-risk prostate cancer (SPCG 19/GRand-P)
BACKGROUND: Older men (aged ≥75 years) with high risk, non-metastatic prostate cancer (PCa) are increasingly treated with curative therapy (surgery or radiotherapy). However, it is unclear if curative therapy prolongs life and improves health-related quality of life (HRQoL) in this age group compared to conservative therapy, which has evolved considerably during the last decade. -
Survivorship Data in Prostate Cancer: Where Are We and Where Do We Need To Be?
Cancer survivorship was recently identified as a prostate cancer (PCa) research priority by PIONEER, a European network of excellence for big data in PCa. Despite being a research priority, cancer survivorship lacks a clear and agreed definition, and there is a distinct paucity of patient-reported outcome (PRO) data available on the subject. Data collection on cancer survivorship depends on the availability and implementation of (validated) routinely collected patient-reported outcome measures... -
Research protocol to identify progression and death amongst patients with metastatic hormone-sensitive prostate cancer treated with available treatments: PIONEER IMI's "big data for better outcomes" program
Androgen deprivation therapy-based with or without first-generation anti-androgens, was the standard of care for patients with metastatic hormone-sensitive prostate cancer (mHSPC) for decades. However, the development of docetaxel chemotherapy and new androgen receptor-targeted agents, abiraterone acetate and prednisolone, apalutamide , enzalutamide and darolutamide (in combination with docetaxel chemotherapy) has proven that combination of treatments is more effective. Recently, intensification... -
Statin Use, Cholesterol Level, and Mortality Among Females With Breast Cancer
CONCLUSIONS AND RELEVANCE: Results of this cohort study showed that postdiagnostic use of statins was associated with reduced BC mortality compared with nonuse, and the risk was associated with subsequent change in serum cholesterol level. This finding suggests that cholesterol-lowering interventions with statins may be beneficial for patients with BC. -
Testosterone replacement therapy is not associated with increased prostate cancer incidence, prostate cancer-specific, or cardiovascular disease-specific mortality in Finnish men
CONCLUSION: Men using TRT were not associated to increased risk for PCa and did not experience increased PCa- or CVD-specific mortality compared to non-users. Further studies considering blood testosterone levels are warranted. -
Statin use and outcomes of oncological treatment for castration-resistant prostate cancer
To compare the effect of statin use in relation to castration-resistant prostate cancer (CRPC) treatment, we assessed the risk of ADT-treated PCa-patients to initiate CRPC treatment by statin use and the outcomes of CRPC treatment by statin use. Our study cohort consisted of 1169 men who participated in the Finnish Randomized Study of Screening for Prostate Cancer (FinRSPC) and initiated androgen deprivation therapy (ADT) during the follow-up (1996-2017). Statin use was associated with slightly... -
Cancer origin tracing and timing in two high-risk prostate cancers using multisample whole genome analysis: prospects for personalized medicine
CONCLUSIONS: PrCa evolutionary analysis allows tracking of anatomic site of origin, timing of cancer origin and spread, and distinction of metastatic-capable from non-metastatic subclones. This enables better identification of actionable targets for therapy. If extended to larger cohorts, it appears likely that similar analyses could add substantial biological insight and clinically relevant value. -
Management of functional outcomes after radical prostatectomy in the Nordic countries: A survey of uro-oncological centers
We aimed to describe the clinical practice regarding erectile dysfunction and urinary incontinence after radical prostatectomy in the Nordic countries. A 37-item survey about pre- and post-prostatectomy evaluation and rehabilitation of sexual and urinary function was sent to 42 uro-oncology centers. Reporting was done according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Twenty-seven centers in Denmark (n = 6), Norway (n = 8), Finland (n = 7), and Sweden (n = 6)... -
Robot-assisted versus three-dimensional laparoscopic radical prostatectomy: 12-month outcomes of a randomised controlled trial
CONCLUSION: We were unable to demonstrate a difference between the RALP and 3D-LRP groups for functional and oncological outcomes at 12 months after surgery. -
Nationwide analysis of survival after radical cystectomy for bladder cancer in Finland
CONCLUSION: RC survival results have improved in contemporary series and are associated with the pTNM-status. The nationwide results from Finland demonstrate outcome comparable to high volume single-center series. -
Visual Analogue Scale and Expanded Prostate Cancer Index Composite-26 in the Evaluation of Urinary Continence Recovery After Three-Dimensional Laparoscopic Radical Prostatectomy, a Single-Center Prospective Registered Study
CONCLUSION: The VAS can be utilized as an easy-to-use alternative to the EPIC-26 when evaluating UC recovery after 3D-LRP. -
Identification of long noncoding RNAs with aberrant expression in prostate cancer metastases
Prostate cancer (PCa) is the second-most common cause of male cancer-related death in western industrialized countries, and the emergence of metastases is a key challenge in the treatment of PCa. Accumulating studies have shown that long noncoding RNAs (lncRNAs) play an important role in the regulation of diverse cellular and molecular processes during the development and progression of cancer. Here, we utilized a unique cohort of castration-resistant prostate cancer metastases (mCRPC) and... -
Unanswered questions in prostate cancer - findings of an international multi-stakeholder consensus by the PIONEER consortium
PIONEER is a European network of excellence for big data in prostate cancer consisting of 37 private and public stakeholders from 9 countries across Europe. Many progresses have been done in prostate cancer management, but unanswered questions in the field still exist, and big data could help to answer these questions. The PIONEER consortium conducted a two-round modified Delphi survey aiming at building consensus between two stakeholder groups - health-care professionals and patients with... -
Adaptive and non-adaptive gene expression responses in prostate cancer during androgen deprivation
Androgen deprivation therapy is the cornerstone treatment of advanced prostate cancer. Eventually prostate cancer cells overcome androgen deprivation therapy, giving rise to castration resistant prostate cancer (CRPC) characterized by increased androgen receptor (AR) activity. Understanding the cellular mechanisms leading to CRPC is needed for development of novel treatments. We used long-term cell cultures to model CRPC; a testosterone-dependent cell line (VCaP-T) and cell line adapted to grow... -
Incidence of erectile dysfunction treatment after radical prostatectomy by Statin use in Finnish Nationwide Cohort Study
CONCLUSION: Statin users have a slightly increased risk of ED treatment initiation after RP, which probably reflects the effect of the underlying vascular insufficiency. -
Visual Analogue Scale (VAS) in the Evaluation of Functional Outcomes After Three-dimensional Laparoscopic Prostatectomy
CONCLUSION: Our study shows a strong correlation between VAS and EPIC-26 urinary incontinence and sexual domains. In daily clinical practice VAS-scale may serve as a simple tool to evaluate the key functional outcomes of radical prostatectomy. -
Antidiabetic drugs, glycemic control and risk of benign prostatic hyperplasia
CONCLUSIONS: Diabetic BGL and antidiabetic medication use, especially insulin, are associated with an elevated risk of BPH surgery compared to nondiabetic men. These findings support the roles of insulin use and untreated hyperglycemia as possible BPH risk factors. -
How Well do Polygenic Risk Scores Identify Men at High Risk for Prostate Cancer? Systematic Review and Meta-Analysis
CONCLUSION: Typically, PRS accuracy is comparable to PSA or family history with a pooled AUC value 0.63 indicating mediocre performance for PRS alone. -
Prostate cancer incidence in men with prostate-specific antigen below 3 ng/mL: The Finnish Randomized Study of Screening for Prostate Cancer
Prostate-specific antigen (PSA)-based screening for prostate cancer (PCa) can reduce PCa mortality, but also involves overdetection of low-risk disease with potential adverse effects. We evaluated PCa incidence among men with PSA below 3 ng/mL and no PCa diagnosis at the first screening round of the Finnish Randomized Study of Screening for PCa. Follow-up started at the first screening attendance and ended at PCa diagnosis, emigration, death or the common closing date (December 2016), whichever...
2022
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Characteristics, treatment patterns, and outcomes of patients with metastatic prostate cancer during 2014-2022 in Pirkanmaa, Finland-an observational study
CONCLUSION: Since the approval of enzalutamide as a first-line treatment for mCRPC, it has become the most common first-line treatment for mCRPC in PHD. Novel therapeutics, including docetaxel, enzalutamide, and abiraterone, have been adapted into clinical practice and are being used at earlier phases of the disease. Changes in treatment practices correlate with improved outcomes in patients with mHSPC in the PHD area. -
Statin Use, Cholesterol Level, and Mortality Among Females With Breast Cancer
CONCLUSIONS AND RELEVANCE: Results of this cohort study showed that postdiagnostic use of statins was associated with reduced BC mortality compared with nonuse, and the risk was associated with subsequent change in serum cholesterol level. This finding suggests that cholesterol-lowering interventions with statins may be beneficial for patients with BC. -
Visual Analogue Scale (VAS) in the Evaluation of Functional Outcomes After Three-dimensional Laparoscopic Prostatectomy
CONCLUSION: Our study shows a strong correlation between VAS and EPIC-26 urinary incontinence and sexual domains. In daily clinical practice VAS-scale may serve as a simple tool to evaluate the key functional outcomes of radical prostatectomy. -
Antidiabetic drugs, glycemic control and risk of benign prostatic hyperplasia
CONCLUSIONS: Diabetic BGL and antidiabetic medication use, especially insulin, are associated with an elevated risk of BPH surgery compared to nondiabetic men. These findings support the roles of insulin use and untreated hyperglycemia as possible BPH risk factors. -
How Well do Polygenic Risk Scores Identify Men at High Risk for Prostate Cancer? Systematic Review and Meta-Analysis
CONCLUSION: Typically, PRS accuracy is comparable to PSA or family history with a pooled AUC value 0.63 indicating mediocre performance for PRS alone. -
Allopurinol and prostate cancer survival in a Finnish population-based cohort
CONCLUSIONS: We found no marked difference in CSS by allopurinol use. Allopurinol users had lower OS but there were no significant differences by duration or intensity of allopurinol use. Allopurinol use may not have anticancer effects against prostate cancer; instead, it may be a surrogate for metabolic problems causing shorter OS among men with PCa. -
Role of Lipids and Lipid Metabolism in Prostate Cancer Progression and the Tumor's Immune Environment
Modulation of lipid metabolism during cancer development and progression is one of the hallmarks of cancer in solid tumors; its importance in prostate cancer (PCa) has been demonstrated in numerous studies. Lipid metabolism is known to interact with androgen receptor signaling, an established driver of PCa progression and castration resistance. Similarly, immune cell infiltration into prostate tissue has been linked with the development and progression of PCa as well as with disturbances in... -
Prostate cancer incidence in men with prostate-specific antigen below 3 ng/mL: The Finnish Randomized Study of Screening for Prostate Cancer
Prostate-specific antigen (PSA)-based screening for prostate cancer (PCa) can reduce PCa mortality, but also involves overdetection of low-risk disease with potential adverse effects. We evaluated PCa incidence among men with PSA below 3 ng/mL and no PCa diagnosis at the first screening round of the Finnish Randomized Study of Screening for PCa. Follow-up started at the first screening attendance and ended at PCa diagnosis, emigration, death or the common closing date (December 2016), whichever... -
Use of α1-adrenoceptor antagonists tamsulosin and alfuzosin and the risk of Alzheimer's disease
CONCLUSION: Our findings, especially the lack of dose-response-relationship and attenuation after mediator adjustment, do not provide strong support for the previous hypothesis on α1-adrenoceptor antagonists as a risk factor for dementia. -
Inverse Association between Statin Use and Cancer Mortality Relates to Cholesterol Level
Statins have been associated with a decreased cancer mortality. However, cholesterol level as such may modify the risk of cancer death. To clarify the complex interplay between statins, cholesterol level, and cancer mortality, we conducted a comprehensive analysis to separate the effects of cholesterol level and statin medication on cancer mortality. Our study population consisted of 16,924 men participating in the Finnish Randomized Study of Screening for Prostate Cancer with at least one... -
3D laparoscopic prostatectomy: results of multicentre study
CONCLUSIONS: 3D LRP shows promising results, comparable to similar studies published on RALP. -
Anti-epileptic drugs and prostate cancer-specific mortality compared to non-users of anti-epileptic drugs in the Finnish Randomized Study of Screening for Prostate Cancer
CONCLUSIONS: AED usage is associated with elevated PCa mortality compared to non-users, likely reflecting the differences between men with epilepsy and those without. No benefit was observed from HDACi drugs compared to other AEDs. -
Randomised double-blind phase 3 clinical study testing impact of atorvastatin on prostate cancer progression after initiation of androgen deprivation therapy: study protocol
INTRODUCTION: Blood cholesterol is likely a risk factor for prostate cancer prognosis and use of statins is associated with lowered risk of prostate cancer recurrence and progression. Furthermore, use of statins has been associated with prolonged time before development of castration resistance (CR) during androgen deprivation therapy (ADT) for prostate cancer. However, the efficacy of statins on delaying castration-resistance has not been tested in a randomised placebo-controlled setting.This... -
The risk of inguinal hernia repair after radical prostatectomy - a population-based cohort study
CONCLUSION: Prostate cancer treatment with prostatectomy is associated with an increased risk of inguinal hernia surgery than external beam radiation therapy treatment. This risk should be taken into account when planning PCa treatment. -
Improved renal cancer prognosis among users of drugs targeting renin-angiotensin system
CONCLUSION: ACE-inhibitors and ARBs in high dose associated with improved RCC specific survival. This may reflect overall benefit of treating hypertension with medication targeting renin-angiotensin system (RAS) system among RCC patients. Further studies are needed to explore the role of RAS in RCC. -
Reply to: Comments on: Antiepileptic drugs and prostate cancer risk in the Finnish Randomized Study of Screening for Prostate Cancer
No abstract -
Outcomes of Screening for Prostate Cancer Among Men Who Use Statins
CONCLUSION AND RELEVANCE: In this post hoc subgroup analysis of a cohort from a population-based randomized clinical trial, PSA screening among statin users was associated with a decreased incidence of advanced prostate cancer that was similar among statin nonusers, but with less increase in detection of low-grade localized tumors in statin users than in nonusers. These findings suggest that statin use does not materially compromise benefits of PSA-based screening. -
Tumor margins that lead to reoperation in breast cancer: A retrospective register study of 4,489 patients
CONCLUSIONS: Individual assessment as opposed to rigid adherence to guidelines was used in the decision on reoperation.
2021
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PI-RADS v2 and Adverse Prostate Cancer Outcomes: A Cross-cohort Replication Study Across Three Centers
CONCLUSIONS AND CLINICAL IMPLICATIONS: PI-RADS score 5 is associated with elevated risk of adverse outcomes. The presented clinically strong endpoints have potential to affect decision-making in MRI-based PCa diagnosis and prognosis. -
Healthcare Resource Use and Costs of Localized Prostate Cancer Patients in Finland
CONCLUSION: This study highlights significant cost variations across different treatment pathways for prostate cancer in Finland and underscores the economic impact of metastatic disease. Early detection and effective management are essential for cost containment. -
Visual Analogue Scale and Expanded Prostate Cancer Index Composite-26 in the Evaluation of Urinary Continence Recovery After Three-Dimensional Laparoscopic Radical Prostatectomy, a Single-Center Prospective Registered Study
CONCLUSION: The VAS can be utilized as an easy-to-use alternative to the EPIC-26 when evaluating UC recovery after 3D-LRP. -
Prostate Cancer-specific Survival After Radical Prostatectomy Is Improved Among Metformin Users but Not Among Other Antidiabetic Drug Users
CONCLUSIONS: Among surgically treated PCa patients, use of metformin was associated with improved disease-specific survival, while insulin and insulin secretagogues were associated with poor survival. Metformin might be a favorable diabetes treatment among men with PCa. -
Improved renal cancer prognosis among users of drugs targeting renin-angiotensin system
CONCLUSION: ACE-inhibitors and ARBs in high dose associated with improved RCC specific survival. This may reflect overall benefit of treating hypertension with medication targeting renin-angiotensin system (RAS) system among RCC patients. Further studies are needed to explore the role of RAS in RCC. -
Reply to: Comments on: Antiepileptic drugs and prostate cancer risk in the Finnish Randomized Study of Screening for Prostate Cancer
No abstract -
Outcomes of Screening for Prostate Cancer Among Men Who Use Statins
CONCLUSION AND RELEVANCE: In this post hoc subgroup analysis of a cohort from a population-based randomized clinical trial, PSA screening among statin users was associated with a decreased incidence of advanced prostate cancer that was similar among statin nonusers, but with less increase in detection of low-grade localized tumors in statin users than in nonusers. These findings suggest that statin use does not materially compromise benefits of PSA-based screening. -
Tumor margins that lead to reoperation in breast cancer: A retrospective register study of 4,489 patients
CONCLUSIONS: Individual assessment as opposed to rigid adherence to guidelines was used in the decision on reoperation. -
The Key Role of Patient Involvement in the Development of Core Outcome Sets in Prostate Cancer
Patients are the stewards of their own care and hence their voice is important when designing and implementing research. Patients should be involved not only as participants in research that impacts their care, as the recipients of that care and any associated harms, but also as research collaborators in prioritising important questions from the patient perspective and designing the research and the ways in which is it most appropriate to involve patients. The PIONEER Consortium, an... -
Combined Longitudinal Clinical and Autopsy Phenomic Assessment in Lethal Metastatic Prostate Cancer: Recommendations for Advancing Precision Medicine
CONCLUSIONS: The study identified novel outcome subgroups for future validation and provides "vision for mPC precision oncology 2020-2050" draft recommendations for future data collection and biomarker studies. -
Human Prostate Tissue MicroRNAs and Their Predicted Target Pathways Linked to Prostate Cancer Risk Factors
MicroRNAs are important in prostate cancer development, progression and metastasis. The aim of this study was to test microRNA expression profile in prostate tissue obtained from prostate cancer patients for associations with various prostate cancer related factors and to pinpoint the predicted target pathways for these microRNAs. Prostate tissue samples were obtained at prostatectomy from patients participating in a trial evaluating impact of pre-operative atorvastatin on serum prostate... -
Statins for Prostate Cancer: When and How Much?
Statins have plausible biological effects against prostate cancer cells and are associated with improved disease-specific mortality. In current randomized placebo-controlled trial, low-dose atorvastatin caused no difference in relapses after radical prostatectomy in Asian men. Future trials should study higher statin doses at later disease stages with survival as the endpoint.See related article by Jeong et al., p. 5004. -
Atorvastatin induces adrenal androgen downshift in men with prostate cancer: A post Hoc analysis of a pilot adaptive Randomised clinical trial
BACKGROUND: Prostate cancer (PCa) progression depends on androgen receptor activity. Cholesterol is required for biosynthesis of all steroid hormones, including androgens. Impact of cholesterol-lowering statins on androgens is unknown. We explored atorvastatin influence on serum and prostatic tissue steroidomic profiles (SP) to expose novel pathways for limiting androgen concentration in men with PCa. -
Antihypertensive Drug Use and the Risk of Ovarian Cancer Death among Finnish Ovarian Cancer Patients-A Nationwide Cohort Study
Ovarian cancer (OC) has a poor prognosis. Hypertension may be a prognostic factor for OC, but it is unclear whether antihypertensive (anti-HT) drug use of modifies OC prognosis. We performed a population-based analysis assessing the effect of anti-HT drug use on OC mortality. A cohort of 12,122 women identified from the Finnish Cancer Registry with OC in 1995-2013 was combined with information on their anti-HT drug use during the same time period. Use of each anti-HT drug was analysed as a... -
Outcomes of prostate cancer screening among men using antidiabetic medication
Diabetic men have decreased risk for prostate cancer (PCa) overall and lower PSA compared to non-diabetics. This may affect the outcomes of PSA-based screening. We investigated the effect of PSA-based screening at 4-year intervals on PCa incidence and mortality separately among users and non-users of antidiabetic medication with the hypothesis that screening would detect less low-grade cancer and more high-grade cancer in diabetic men. A cohort of 80,458 men from the Finnish Randomized Study of... -
Prostate cancer prognosis after initiation of androgen deprivation therapy among statin users. A population-based cohort study
CONCLUSION: Statin use after initiation of ADT, but not before, was associated with improved prostate cancer prognosis. -
3D laparoscopic prostatectomy: A prospective single-surgeon learning curve in the first 200 cases with oncologic and functional results
CONCLUSION: The learning curve for 3D laparoscopic prostatectomy is comparable to RALP, which makes it a cost-effective alternative with comparable oncological and functional results. -
Antidiabetic Drugs and Prostate Cancer Prognosis in a Finnish Population-Based Cohort
CONCLUSIONS: Men with prostate cancer using antidiabetic medication are generally at increased risk of dying from prostate cancer compared with nonusers. The risk association is driven by underlying diabetes, as adjustment for blood glucose level ameliorates the risk increase. -
Antiepileptic drugs and prostate cancer risk in the Finnish Randomized Study of Screening for Prostate Cancer
Antiepileptic drugs (AEDs) with histone deacetylase (HDAC) inhibitor properties decrease prostate cancer (PCa) cell proliferation in vitro. A population-based cohort of 78 615 men was used to evaluate the risk of PCa among users of AEDs. Study population was linked to the Finnish national prescription database to obtain information on individual medication reimbursements in 1996 to 2015. Cox regression with antiepileptic medication use as a time-dependent variable was used to analyze PCa risk... -
Hyperuricemia Is Not an Independent Predictor of Erectile Dysfunction
CONCLUSIONS: Elevated SUA was not found to be an independent risk factor for ED. Metabolic syndrome, glomerular filtration rate, or cardiovascular risk factors did not modify this result. ED cannot be predicted based on the level of SUA. A Tuokko, T Murtola, P Korhonen, et al. Hyperuricemia Is Not an Independent Predictor of Erectile Dysfunction. Sex Med 2021;9:100319. -
Pharmacoepidemiological Evaluation in Prostate Cancer-Common Pitfalls and How to Avoid Them
Pharmacoepidemiologic research provides opportunities to evaluate how commonly used drug groups, such as cholesterol-lowering or antidiabetic drugs, may affect the prostate cancer risk or mortality. This type of research is valuable in estimating real-life drug effects. Nonetheless, pharmacoepidemiological studies are prone to multiple sources of bias that mainly arise from systematic differences between medication users and non-users. If these are not appreciated and properly controlled for,... -
Diagnostic and prognostic factors in patients with prostate cancer: a systematic review protocol
INTRODUCTION: As part of the PIONEER (Prostate Cancer Diagnosis and Treatment Enhancement Through the Power of Big Data in Europe) Consortium, we will explore which diagnostic and prognostic factors (DPFs) are currently being researched to previously defined clinical and patient-reported outcomes for prostate cancer (PCa). -
Preservation of Endopelvic Fascia: Effects on Postoperative Incontinence and Sexual Function - A Randomized Clinical Trial
CONCLUSION: Endopelvic fascia-preserving RALP does not improve urinary continence or sexual function as compared with the standard surgical technique. Future studies aiming to improve functional outcomes after RALP should focus on evaluating other technique modifications. Siltari A, Riikonen J, Murtola TJ. Preservation of Endopelvic Fascia: Effects on Postoperative Incontinence and Sexual Function - A Randomized Clinical Trial. J Sex Med 2021;18:327-338.
2020
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Treatment Trajectories in Metastatic Hormone-sensitive Prostate Cancer: A PIONEER+ Big Data Analysis
CONCLUSIONS AND CLINICAL IMPLICATIONS: This is the largest RWD study of systemic mHSPC treatment. Despite evidence, ADT monotherapy remains the most used first-line therapy. Increased use ADT + ARPI is associated with better persistence and improved outcomes in the real-world setting, supporting its broader adoption in clinical practice. -
Prostate Cancer Screening With PSA, Kallikrein Panel, and MRI: The ProScreen Randomized Trial
CONCLUSIONS AND RELEVANCE: In this preliminary descriptive report from an ongoing randomized clinical trial, 1 additional high-grade cancer per 196 men and 1 low-grade cancer per 909 men were detected among those randomized to be invited to undergo a single prostate cancer screening intervention compared with those not invited to undergo screening. These preliminary findings from a single round of screening should be interpreted cautiously, pending results of the study's primary mortality... -
Randomised double-blind phase 3 clinical study testing impact of atorvastatin on prostate cancer progression after initiation of androgen deprivation therapy: study protocol
INTRODUCTION: Blood cholesterol is likely a risk factor for prostate cancer prognosis and use of statins is associated with lowered risk of prostate cancer recurrence and progression. Furthermore, use of statins has been associated with prolonged time before development of castration resistance (CR) during androgen deprivation therapy (ADT) for prostate cancer. However, the efficacy of statins on delaying castration-resistance has not been tested in a randomised placebo-controlled setting.This... -
Combined Longitudinal Clinical and Autopsy Phenomic Assessment in Lethal Metastatic Prostate Cancer: Recommendations for Advancing Precision Medicine
CONCLUSIONS: The study identified novel outcome subgroups for future validation and provides "vision for mPC precision oncology 2020-2050" draft recommendations for future data collection and biomarker studies. -
Preservation of Endopelvic Fascia: Effects on Postoperative Incontinence and Sexual Function - A Randomized Clinical Trial
CONCLUSION: Endopelvic fascia-preserving RALP does not improve urinary continence or sexual function as compared with the standard surgical technique. Future studies aiming to improve functional outcomes after RALP should focus on evaluating other technique modifications. Siltari A, Riikonen J, Murtola TJ. Preservation of Endopelvic Fascia: Effects on Postoperative Incontinence and Sexual Function - A Randomized Clinical Trial. J Sex Med 2021;18:327-338. -
Angiotensin Receptor Blockers Associated with Improved Breast Cancer Survival-A Nationwide Cohort Study from Finland
CONCLUSIONS: Only ATR-blockers were associated with improved breast cancer survival in both prediagnostic and postdiagnostic use. The association was dose dependent and supported by a biological rationale as a causal explanation. In postdiagnostic use, similar reduction was found also for other antihypertensives, supporting a prognostic role of hypertension control. -
Circulatory and prostatic tissue lipidomic profiles shifts after high-dose atorvastatin use in men with prostate cancer
Prostate cancer patients using cholesterol-lowering statins have 30% lower risk of prostate cancer death compared to non-users. The effect is attributed to the inhibition of the mevalonate pathway in prostate cancer cells. Moreover, statin use causes lipoprotein metabolism changes in the serum. Statin effect on serum or intraprostatic lipidome profiles in prostate cancer patients has not been explored. We studied changes in the serum metabolomic and prostatic tissue lipidome after high-dose 80... -
Antihypertensive drug use and prostate cancer-specific mortality in Finnish men
The aim of this study was to investigate pre- and post-diagnostic use of antihypertensive drugs on prostate cancer (PCa)-specific survival and the initiation of androgen deprivation therapy (ADT). The cohort investigated 8,253 PCa patients with 837 PCa-specific deaths during the median follow-up of 7.6 years after diagnosis. Information on drug use, cancer incidence, clinical features of PCa, and causes of death was collected from Finnish registries. Hazard ratios with 95% confidence intervals... -
Author Correction: Introducing PIONEER: a project to harness big data in prostate cancer research
An amendment to this paper has been published and can be accessed via a link at the top of the paper. -
Introducing PIONEER: a project to harness big data in prostate cancer research
Prostate Cancer Diagnosis and Treatment Enhancement Through the Power of Big Data in Europe (PIONEER) is a European network of excellence for big data in prostate cancer, consisting of 32 private and public stakeholders from 9 countries across Europe. Launched by the Innovative Medicines Initiative 2 and part of the Big Data for Better Outcomes Programme (BD4BO), the overarching goal of PIONEER is to provide high-quality evidence on prostate cancer management by unlocking the potential of big... -
Urine colour as an indicator for anastomotic leakage after robot-assisted radical prostatectomy
Objectives: To determine whether macroscopic haematuria predicts urethrovesical anastomotic leakage after robot-assisted laparoscopic radical prostatectomy (RALP) as well as a cystogram.Patients and methods: Participants were recruited before cystogram and catheter removal 5-14 days after RALP surgery. Urine colour in the collection bag was classified according to a three-step scale (clear, light red and dark red) and leakages in cystogram were graded with a four-step scale (Grade 0-3).... -
Anticoagulants and Breast Cancer Survival: A Nationwide Cohort Study
CONCLUSIONS: Anticoagulant use provides no clinical benefit for breast cancer survival; however, the association between thrombosis and cancer might mask potential survival benefits. -
Reply to: Calcium channel blockers therapy and the risk of prostate cancer death
No abstract