ObjectiveTo evaluate the efficacy of docetaxel and androgen receptor axis-targeted (ARAT) agents in patients with castrationresistant prostate cancer (CRPC) with intraductal carcinoma of the prostate (IDC-P) using a propensity score-matched analysis. ConclusionAdministration of ARAT as the first-line treatment for CRPC may prolong OS more than that of docetaxel, especially in patients with IDC-P.

Aims To compare the efficacy of cernitin pollen extract (cernitin) or tadalafil for treating persistent chronic pelvic pain despite α1‐blocker monotherapy in men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and lower urinary tract symptoms (LUTS). Methods A total of 100 patients with refractory CP/CPPS despite ongoing α1‐blocker monotherapy were randomized to receive add‐on therapy with either cernitin (4 capsules/day) or tadalafil (5 mg/d) for 12 weeks. At week 12, changes from baseline in the patients’ CP/CPPS, LUTS, and voiding function, as assessed using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH‐CPSI), the International Prostate Symptom Score (IPSS), and uroflowmetry, respectively, were compared between the groups. Results The final analysis included 42 and 45 patients in the cernitin and tadalafil groups, respectively. Although the NIH‐CPSI total, NIH‐CPSI pain sub‐score, and NIH‐CPSI quality of life sub‐score significantly improved in both groups, the cernitin (vs tadalafil) group showed significantly greater improvements in the NIH‐CPSI total score (−6.8 vs −4.6; P = .02) and NIH‐CPSI pain sub‐score (−4.1 vs −1.5; P < .001). Half (50%) of the patients in the cernitin group showed a reduction greater than 50% in their NIH‐CPSI pain sub‐score; in the tadalafil group, only four patients (8.9%) showed ≥50% improvement (P < .001). In contrast, the improvement in LUTS was significantly superior in the tadalafil group. Conclusion Both cernitin and tadalafil significantly ameliorated chronic pelvic pain in patients with refractory CP/CPPS. The add‐on of cernitin was more effective than tadalafil for pelvic pain and discomfort.

Objectives Many studies have shown a good prognostic association with a large number of lymph node dissections. However, most of these studies did not include patients who have received neoadjuvant chemotherapy. The purpose of this study was to verify the relationship between survival outcomes and the number of lymph nodes removed during radical cystectomy in patients with muscle‐invasive bladder cancer in the era of neoadjuvant chemotherapy. Methods This retrospective study considered patients who were diagnosed with clinical ≥T2N0M0 muscle‐invasive bladder cancer and treated with radical cystectomy at the Nagoya University Hospital and affiliated hospitals from January 2004 to December 2019. We excluded patients who had a history of upper tract urothelial cancer or non‐urothelial carcinoma. The association between prognosis and the number of lymph nodes removed was investigated. Results We retrospectively enrolled a total of 477 patients. The mean number of lymph nodes dissected was 14. Two hundred and twenty‐six patients (47.4%) received neoadjuvant chemotherapy. More extensive lymphadenectomy (≥15 lymph nodes) correlated with better 5‐year overall survival across all patients (68% vs. 57%, p = 0.01). In patients who received neoadjuvant chemotherapy, there was no difference in overall survival according to the number of dissected lymph nodes (66% vs. 71%, p = 0.433). In patients who did not receive neoadjuvant chemotherapy, ≥15 lymph nodes dissected was associated with significantly better overall survival (70.3% vs. 46.9%, p < 0.01). Conclusions No association between more aggressive lymph node dissection and prognosis was found in patients who underwent neoadjuvant chemotherapy. Conversely, extended lymph node dissection is desirable for patients who have not received neoadjuvant chemotherapy.

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