Purpose: The nuclear transcription factor nuclear factor-B (NFB) and its inhibitor, IB, regulate the transcription of various genes involved in cell proliferation, adhesion, and survival. The NFB transcription factor complex plays a role in cancer development and progression through its influence on apoptosis. More recently, NFB has been shown to be activated in human and androgen-independent prostate cancer cells. To our knowledge, this is the first study demonstrating the prognostic significance of NFB immunoreactivity in prostate adenocarcinomas (PACs).Experimental Design: Using prostatectomy specimens, we performed immunohistochemical staining for NFB and IB␣ (Santa Cruz Biotechnology) on formalin-fixed, paraffin-embedded sections obtained from 136 patients with PAC. Cytoplasmic and nuclear immunoreactivity was scored for intensity and distribution, and results were correlated with preoperative serum prostate-specific antigen, tumor grade, stage, DNA ploidy (Feulgen spectroscopy), and biochemical disease recurrence.Results: Forty-nine percent of PACs overexpressed cytoplasmic NFB, and 63% showed decreased IB expression. Cytoplasmic NFB overexpression correlated with advanced tumor stage (P ‫؍‬ 0.048), aneuploidy (P ‫؍‬ 0.022), and biochemical disease recurrence (P ‫؍‬ 0.001). When we compared the means for the NFB-positive and -negative subgroups, NFB overexpression correlated with preoperative serum prostate-specific antigen (P ‫؍‬ 0.04) and DNA index (P ‫؍‬ 0.05). Fifteen percent of PACs expressed nuclear NFB, which correlated with high tumor grade (P ‫؍‬ 0.001) and advanced stage (P ‫؍‬ 0.05). Decreased IB␣ expression correlated with high tumor grade (P ‫؍‬ 0.015). On multivariate analysis, tumor stage (P ‫؍‬ 0.043) and NFB overexpression (P ‫؍‬ 0.006) were independent predictors of biochemical recurrence.Conclusion: These results support a role for NFB pathway proteins in the tumorigenesis of PACs. The findings are also consistent with reported experimental studies suggesting a new strategy of combined chemotherapy and specific NFB blockade in decreasing the rate of disease relapse.

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This study prospectively examined whether I.V. lidocaine could affect the return of bowel function after radical prostate surgery. Lidocaine-treated patients had shorter hospital stays, less pain, and faster return of bowel function. In this population, lidocaine infusion can be a useful adjunct in anesthetic management.

Surgical prostate resection using Aquablation showed noninferior symptom relief compared to transurethral prostate resection but with a lower risk of sexual dysfunction. Larger prostates (50 to 80 ml) demonstrated a more pronounced superior safety and efficacy benefit. Longer term followup would help assess the clinical value of Aquablation.

HGPIN found in the contemporary extended biopsy does not warrant repeat biopsy. ASAP continues to be associated with a high risk of cancer and requires at least 1 repeat biopsy using the extended biopsy scheme.