Ethnic disparities in renal cell carcinoma (RCC) subtypes have been well documented in the United States (US), but no comparable data exist for Afro-descendant populations living within a European healthcare system. In the US, several studies have shown a significantly higher incidence of papillary renal cell carcinoma among populations of African descent. The aim of this study is to analyze the epidemiology of kidney cancer in a French Caribbean population, mainly of African descent. This retrospective study included all patients who underwent total or partial nephrectomy, or renal biopsy at the University Hospital of Guadeloupe between January 2016 and October 2022. Data on clinical features, tumor characteristics, biology, histology and survival were collected. Statistical analyses were performed using StatView version 5.0 software. A total of 126 patients had been included between January 2016 and October 2022. The median age at diagnosis was 66.0 years [IQR: 57.2–71.8]. Overall, 70

BACKGROUND:The diagnostic accuracy of prostate cancer has been improved by the use of multiparametric magnetic resonance imaging (MRI). However, the role of the Prostate Imaging-Reporting and Data System (PI-RADS) score in combination with MRI in predicting issues after local prostate cancer treatment remains unclear. The aim of this study was to evaluate the PI-RADS score as a predictive factor for biochemical recurrence or progression (BCR) of prostate cancer. METHODS:This retrospective monocentric study included 304 men who underwent targeted prostate biopsies plus standard biopsies after MRI between 2017 and 2020. All the included patients had a PI-RADS score of at least 3. Survival probabilities were estimated by the Kaplan-Meier method. The hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between individual characteristics and BCR or progression were estimated using the Cox proportional hazards regression model for univariate and multivariate analyses. All tests were two-sided, and P<0.05 was considered to indicate statistical significance. All analyses were performed using StatView software version 5.0 and MedCalc software version 17.5. RESULTS:In total, 283 patients were included in our study. The median age at biopsy was 67.8 years, and the median follow-up was 4.9 years. The median time to BCR or progression after active surveillance (AS) was 4.7 years. A total of 22.3% of the patients experienced biochemical recurrence. No risk factors for biochemical recurrence according to the MRI PI-RADS score were significantly identified by univariate or multivariate analyses. Biochemical-free survival was 87% for the PI-RADS 5 group, 90% for the PI-RADS 4 and 80% for the PI-RADS 3 group at 3 years. There were no significant differences among these three groups in terms of BCR-free survival (P=0.4). CONCLUSION:In the present study, MRI lesion description with PI-RADS or the usual risk group did not seem to be sufficient to predict biochemical recurrence after local prostate cancer treatment, especially in our particular population. Future studies could pair the PI-RADS with histologic data of the prostatic index lesion to predict recurrence. LEVEL OF EVIDENCE: 4:

INTRODUCTION:In Guadeloupe, prostate cancer (PCa) shows very high incidence rates. This over-incidence is associated with the historical use of chlordecone in banana plantations. Since December 2021, PCa has been recognized as an occupational disease for agricultural workers exposed to this pesticide. However, patient identification and referral to compensation mechanisms remain limited. The aim of this study was to estimate the proportion of PCa patients in Guadeloupe eligible for occupational disease recognition. MATERIALS AND METHODS:We conducted a retrospective study based on the prospective KP Caraïbes cohort, including patients newly diagnosed at the University Hospital of Pointe-à-Pitre between June 2022 and December 2024. Clinical, geographical, and occupational data were collected through medical records and structured telephone interviews. Eligibility for occupational disease recognition was assessed according to current regulatory criteria. RESULTS:Among the 267 patients in the cohort, 59 (22.1%) were identified as potentially eligible, of whom 18 (30.5%) met the official criteria. By extrapolation, this would represent nearly 140 cases per year in Guadeloupe, more than three times the number of cases actually submitted for compensation over the same period (n=44). Employment in the agriculture/fishing/livestock sectors was significantly associated with occupational exposure (P=0.001). DISCUSSION AND CONCLUSION:This study reveals a major discrepancy between the number of eligible patients and those actually recognized. A decision-support algorithm has been proposed to enhance systematic screening and referral of exposed patients. LEVEL OF EVIDENCE: 4:

BACKGROUND:Since prostate cancer (PCa) risk is associated with ethnicity, it is crucial to investigate ethno-geographic variations in PCa studies. Periprostatic adipose tissue (PPAT) has been involved in cancer aggressiveness through the release of lipids and inflammatory mediators, and we previously reported a different lipid composition of PPAT according to the ethno-geographic origin. We aimed to analyze the expression of a panel of adipokines in PPAT from African-Caribbean and Caucasian patients, in correlation with features of PCa aggressiveness and lipid composition. METHODS:Adipokines expression was analyzed by RTqPCR in PPAT from 110 Caucasians and 50 African-Caribbeans patients, in parallel with the characterization of fatty acids and cholesterol content. RESULTS:The most expressed cytokines were IL10, leptin and IL8. The expression of most adipokines was higher in PPAT from Caucasians compared to African-Caribbean patients. IL6 was associated with features of PCa aggressiveness in Caucasians, with a difference close to significance. Most cytokines were associated with the lipid composition of PPAT, mainly with arachidonic acid and free cholesterol content. CONCLUSIONS:The differential cytokines expression in PPAT from African-Caribbean patients compared to Caucasians probably reflects a different inflammatory status. The close relationship between adipokines expression and lipid composition highlights the importance of diet and lipid metabolism in adipose tissue inflammation.

INTRODUCTION:Early salvage radiotherapy is indicated for patients with biochemical recurrence after radical prostatectomy. However, for various reasons, certain patients do not benefit from this treatment (OBS) or only at a late stage (LSR). There are few studies on this subject and none on a "high-risk" population, such as patients of African descent. Our objective was to estimate the metastasis-free (MFS) and overall survival (OS) of patients who did not receive salvage radiotherapy, and to identify risk factors of disease progression. PATIENTS AND METHODS:This was a single-center retrospective study that included 154 patients, 99 in the OBS group and 55 in the LSR group. All were treated by total prostatectomy for localized prostate cancer between January 2000 and December 2020 and none received early salvage radiotherapy after biochemical recurrence. RESULTS:Baseline characteristics were similar between groups, except for the time to biochemical recurrence. The median follow-up was 10.0 and 11.8 years for the OBS and LSR groups, respectively. The median time from surgery to LSR was 5.1 years. The two groups did not show a significant difference in MFS: 90.6% at 10 years for the OBS group and 93.3% for the LSR group. The median MFS was 19.8 and 19.6 years for the OBS and LSR groups respectively. OS for the OBS group was significantly higher than that for the LSR group (HR: 2.14 [1.07-4.29]; p = 0.03), with 10-year OS of 95.9% for the OBS group and 76.1% for the LSR group. Median OS was 16 and 15.6 years for the OBS and LSR groups, respectively. CONCLUSION:In this study, we observed satisfactory metastasis-free and OS rates relative to those reported in the scientific literature. The challenge is not to question the benefit of early salvage radiotherapy, but to improve the identification of patients at risk of progression through the development of molecular and genomic tests for more highly personalized medicine.

Few studies have focused on the infectious complications in kidney transplant recipients in tropical regions, particularly in the Caribbean. The primary objective of this study was to determine the incidence of bacterial, fungal, and parasitic infections in kidney transplant recipients in the French Caribbean and French Guiana. We included all patients who received a kidney transplant at the University Hospital of Guadeloupe between January 2014 and October 2016, with post-transplant follow-up in the French Caribbean. A total of 91 patients were included, of whom 57 developed an infectious event during follow-up. When infections were documented (94/111), bacterial infections were the most frequent (79/94), followed by fungal (11/94) and parasitic infections (4/94). Four cases of nocardiosis were identified (4/79). Phaeohyphomycosis was the most common fungal infection (7/11). In a multivariate analysis, the female gender and diabetes mellitus at the time of transplant were significantly associated with a higher risk of infection. This study is the first to describe the epidemiology of infections in kidney transplant recipients in the Caribbean and to analyze the potential risk factors. We reported a similar profile of bacterial infections to that which were observed in the European and American studies. However, we found a higher incidence of tropical infections, such as nocardiosis and phaeohyphomycosis, which highlights the need for heightened awareness among healthcare teams to ensure earlier and more appropriate treatment. Further studies focusing on these rare tropical infections are necessary to better understand their risk factors

BACKGROUND:Visceral metastases are known to occur in advanced prostate cancer, usually when the tumour is resistant to androgen deprivation and, have worse outcomes regardless of therapies. OBJECTIVE:To analyse genomic alterations in tumour samples according to their lymphatic, bone, and visceral metastatic stages and overall survival. DESIGN, SETTING, AND PARTICIPANTS:We selected 200 patients with metastatic prostate cancer. Genomic profiling of 111 genes and molecular signatures (homologous recombination deficiency [HRD], microsatellite instability, and tumour burden mutation) was performed with the MyChoice test (Myriad Genetics, Inc, Salt Lake City, UT, USA). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:The association between genomic profiles and visceral metastatic evolution was evaluated using logistic regression. Kaplan-Meier and Cox proportional hazard analyses were used for analyses of early death. RESULTS AND LIMITATIONS:A total of 173 (87%) genomic profiles were obtained. Eighty-four (49%) patients died during the follow-up period (median duration = 76 mo). TP53 was the most frequently mutated gene, followed by FANC genes, including BRCA2, and those of the Wnt-pathway (APC/CTNNB1). TP53 gene mutations were more frequent in patients of European (42%) than in those of African (16%) ancestry. An HRD score of >25 was predictive of FANC gene mutations. The mutational status of TP53 (p < 0.001) and APC (p = 0.002) genes were significantly associated with the risk of visceral metastases. The mutational status of CTNNB1 (p = 0.001), TP53 (p = 0.015), BRCA2 (p = 0.027), and FANC (p = 0.005) genes were significantly associated with an earlier age at death. The limitations are the retrospective study design based on a selection of genes and the low frequency of certain molecular events. CONCLUSIONS:Mutations in the TP53 gene and genes (APC/CTNNB1) related to the Wnt pathway are associated with metastatic visceral dissemination and early death. These genomic alterations could be considered as markers to identify prostate cancer patients at a high risk of life-threatening disease who might benefit from more intensified treatment or new targeted therapies. PATIENT SUMMARY:In this report, we evaluated the relationships between genomic profiles (gene mutations and molecular signatures) of tumour samples from patients with metastatic prostate cancer and early death. We found that mutations of specific genes, notably TP53 and APC/CTNNB1 related to the Wnt pathway, are associated with visceral metastatic progression and an earlier age at death.

Purpose: A simplified therapeutic guideline (STG) was established in our urology ward in 2019 for urinary infections. Our aim was to describe the level of physician adherence to STG and the impact of a limited number of antibiotic compounds on the rate of multidrug-resistant (MDR) bacteria. As guidelines should improve patient care, unfavorable outcomes were also reported.Methods: The STG for community-acquired and nosocomial urinary infections, including six antibiotics, was established in November 2019 and has been officially applied since January 2020. Treatment duration has to be <= 14 days. We conducted a before-after study to measure physician adherence to the STG for bacteremia treatment between January 2017 and December 2022. Adherence was defined as exclusive use of STG antibiotics. All isolated bacteria from blood cultures were recorded, including MDR Enterobacterales, defined as AmpC b-lactamase- or ESBL-producing strains. Unfavorable outcomes were defined as uncontrolled infection, a second surgical procedure, ICU requirement, and/or death.Results: Seventy-six cases of bacteremia occurred between January 2017 and December 2019, and ninety between January 2020 and December 2022. The main comorbid condition was urological cancer (46%). The main reason for surgery was ureteral stent (32%). Antibiotic management in accordance with STG increased from 18% to 52%, p < 0.001, and treatments > 14 days decreased from 53% to 28%, p < 0.001. MDR Enterobacterales bacteremia was reduced from 52% to 35%, p = 0.027. The rate of unfavorable outcomes was unchanged. Conclusion: STG adherence in urology was satisfactory and associated with reduced MDR Enterobacterales bacteremia.

The transferability and clinical value of genetic risk scores (GRSs) across populations remain limited due to an imbalance in genetic studies across ancestrally diverse populations. Here we conducted a multi-ancestry genome-wide association study of 156,319 prostate cancer cases and 788,443 controls of European, African, Asian and Hispanic men, reflecting a 57% increase in the number of non-European cases over previous prostate cancer genome-wide association studies. We identified 187 novel risk variants for prostate cancer, increasing the total number of risk variants to 451. An externally replicated multi-ancestry GRS was associated with risk that ranged from 1.8 (per standard deviation) in African ancestry men to 2.2 in European ancestry men. The GRS was associated with a greater risk of aggressive versus non-aggressive disease in men of African ancestry ( P = 0.03). Our study presents novel prostate cancer susceptibility loci and a GRS with effective risk stratification across ancestry groups.

Background: There is an increasing body of evidence linking the exposure of an individual to pesticides such as organochlorine pesticides (OPCs) and an increased risk of developing diseases such as cancer. Exposure to OPCs has been suggested to increase the risk of developing hormone-dependant cancers such as prostate cancer (PCa). However, there is a relative paucity of information about the influence of exposure to these pesticides on the evolution of PCa, including risk of tumour development, progression to metastasis, and disease recurrence following therapy. Methods: We used several databases such as PubMed MEDLINE Database, Web of Science, and Scopus, in order to conduct a systematic review of the available epidemiological data implicating an association between exposure to OCPs and biochemical recurrence (BCR) of PCa. We searched all peer-reviewed articles published up to July 31 st 2020. Pre-defined eligibility criteria for the inclusion of studies were that they be original studies, reviews, previous meta-analyses, or case–control or cohort studies. Results: Agent Orange is the most widely-studied

Background: Genetic factors play an important role in prostate cancer (PCa) susceptibility.Objective: To discover common genetic variants contributing to the risk of PCa in men of African ancestry.Design, setting, and participants: We conducted a meta-analysis of ten genome-wide association studies consisting of 19 378 cases and 61 620 controls of African ancestry. Outcome measurements and statistical analysis: Common genotyped and imputed variants were tested for their association with PCa risk. Novel susceptibility loci were identified and incorporated into a multiancestry polygenic risk score (PRS). The PRS was evaluated for associations with PCa risk and disease aggressiveness.Results and limitations: Nine novel susceptibility loci for PCa were identified, of which seven were only found or substantially more common in men of African ancestry, including an African-specific stop-gain variant in the prostate-specific gene anoctamin 7 (ANO7). A multiancestry PRS of 278 risk variants conferred strong associations with PCa risk in African ancestry studies (odds ratios [ORs] >3 and >5 for men in the top PRS decile and percentile, respectively). More importantly, compared with men in the 40-60% PRS category, men in the top PRS decile had a significantly higher risk of aggressive PCa (OR = 1.23, 95% confidence interval = 1.10-1.38, p = 4.4 x 10-4). Conclusions: This study demonstrates the importance of large-scale genetic studies in men of African ancestry for a better understanding of PCa susceptibility in this high -risk population and suggests a potential clinical utility of PRS in differentiating between the risks of developing aggressive and nonaggressive disease in men of African ancestry.Patient summary: In this large genetic study in men of African ancestry, we discovered nine novel prostate cancer (PCa) risk variants. We also showed that a multiancestry polygenic risk score was effective in stratifying PCa risk, and was able to differentiate risk of aggressive and nonaggressive disease.& COPY; 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Prostate biopsy is the gold standard to confirm prostate cancer. In addition to standard 12-core biopsies, magnetic resonance imaging (MRI)-guided prostate biopsies have recently been introduced to improve the detection of clinically significant prostate cancer. The present study aimed to compare the complications after standard transrectal ultrasound-guided and standard plus targeted (MRI-guided) prostate biopsies, to study the impact of the number of biopsy cores on complication rates, and to compare complication rates after transrectal ultrasound-guided prostate biopsies with those following transperineal prostate biopsies from the literature. A prospective study was performed, which included 135 patients who underwent transrectal ultrasound-guided prostate biopsies between April 1 and June 30, 2022, at the Urology Department of the University Hospital of Pointe à Pitre (Pointe à Pitre, Guadeloupe). A total of 51 patients were excluded because of missing information concerning their post-biopsy surveillance. The median age at the time of biopsy was 69 years, median prostate-specific antigen value was 8.9 ng/ml, median prostate volume was 57.5 ml, and median number of cores was 15. A total of 35 of the 84 included patients (41.7%) had a standard biopsy only and 49 (58.3%) had targeted (MRI-guided) plus standard biopsies. A total of 53 patients (63.1%) experienced early side effects, whereas only 24 patients (28.6%) experienced late side effects. Three patients (3.6%) required hospitalization for post-biopsy complications. Early side effects, especially hematuria and hematospermia, occurred significantly more frequently in the targeted plus standard group, with more cores taken, with no significant difference concerning late side effects or infectious complications between the standard and standard plus targeted groups. The admission rate for sepsis after transperineal biopsy has been reported to vary between 0 and 1%, whereas the present study had an admission rate of 2.29% using the transrectal approach. Further studies are required to analyze the complications requiring hospitalization after transrectal and transperineal biopsies.

Les scores prédictifs de récidive biologique après prostatectomie couramment utilisés sont moins performants chez les patients d’ascendance Africaine opérés pour un cancer de prostate localisé. L’intelligence artificielle (IA) prend une place de plus en plus importante dans la santé. L’objectif était d’étudier l’apport de l’IA dans la prédiction de la récidive biologique après prostatectomie dans une cohorte de patients d’ascendance africaine. Nous avons réalisé une étude rétrospective entre janvier 2000 et décembre 2017 incluant 1759 patients traité une prostatectomie pour cancer de prostate localisé. Les données oncologiques préopératoires étaient recueillies. La récidive biologique (BCR) était l’évènement à étudier par les modèles d’IA. A l’aide de Python (langage de référence dans l’analyse de données), plusieurs modèles de Machine Learning et Deep Learning ont été créés : Random Forest, Support Vector Machine ou Machine à vecteurs de support (SVM), K-Nearest Neighbours (KNN) et le Réseau de neurones. Pour chaque modèle, des paramètres pour évaluer leur robustesse étaient estimés : Précision, Score F1, Accuracy, AUC de la ROC Curve. Les variables d’entrée retenues selon leur pertinence clinique étaient l’Age, le poids, la taille, les antécédents de diabète et d’HTA, le pourcentage de biopsies positives, le stade clinique, la densité du PSA, le score ISUP et le PSA total. Les variables ayant le plus de poids dans la classification du model Random Forest étaient le PSA, la densité du PSA et le score ISUP. Ils représentaient t à eux trois 52 % de la valeur décisionnelle (Fig. 1). L’évènement récidive biologique survenait chez 24 % des patients traités. Les AUC étaient de 0,65, 0,64, 0,57, 0,65 respectivement pour les modèles Random, Forest, SVM, KNN, réseaux de neurones. Les scores F1 ne dépassaient pas 1 % (Tableau 1). Les résultats de modèles utilisant l’intelligence artificielle pour prédire la récidive biologique du cancer de prostate après prostatectomie montrent des résultats comparables aux principaux score prédictifs utilisés. L’IA reste une piste prometteuse puisque les données IRM, et histopathologiques pourraient améliorer la performance prédictive des différents modèles d’intelligence artificielle.

INTRODUCTION:Preoperative polymicrobial urine cultures are common, but the associated risk of nosocomial infection is currently unknown. We aimed to analyze the risk of postoperative infection in patients with preoperative polymicrobial urine cultures.METHODS:This was a prospective cohort study conducted from November 2018 to October 2020. Polymicrobial urine cultures were defined by at least the presence of 3 bacteria without leukocyturia threshold on two consecutive samples in the month preceding the surgical procedure. Data on postoperative infections were collected during hospitalization until day 30. A postoperative infection was defined by the occurrence of clinical signs (fever, chills, and suppurated process on the surgical site) associated with the prescription of an antibiotic therapy.RESULTS:Sixty-eight patients were included, and seven developed a postoperative infection with a microbe identified in blood or urine cultures. There was a significant association between leukocyturia ≥104 (p = 0.02) and the administration of intraoperative antibiotic prophylaxis (p < 0.001). In contrast, there was no significant association between postoperative infections for patients with polymicrobial preoperative urine cultures and having received or not an empirical antibiotic therapy.CONCLUSION:The rate of postoperative infection in patients with polymicrobial urine culture before urological procedure was 10.2%. Further studies are needed to assess the antibiotic prophylaxis to be used in this situation.

Introduction Several studies in the Caucasian population have shown the benefit of using docetaxel, abiraterone, or enzalutamide for patients with metastatic prostate cancer at the castration-resistant stage (mCRPC). However, there are no strong data for men of African ancestry. The objective of this study was to estimate the overall and progression-free survival of patients according to these treatments at the mCRPC stage. Patients and Methods This was a monocentric retrospective study that consecutively included 211 men with mCRPC between June 1, 2009 and August 31, 2020. The primary end point was overall survival (OS). The secondary end point was progression-free survival. Kaplan-Meier survival and Cox proportional hazard analyses were performed. Results The present study included 180 patients for analyses. There was no difference in OS (log-rank test = 0.73), with a median follow-up of 20.7 months, regardless of the treatment administered in the first line. Men with mCRPC who received hormonotherapy (abiraterone or enzalutamide) showed better progression-free survival than those who received docetaxel (log-rank test = 0.004), with a particular interest for abiraterone hazard ratio (HR) = 0.51 (95% confidence interval: 0.39-0.67). The patient characteristics were similar, except for bone lesions, irrespective of the treatment administered in the first line. After univariate then multivariate analysis, only World Health Organization status and metastases at diagnosis were significantly associated with progression. Conclusion Our results suggest the use of hormonotherapy (abiraterone or enzalutamide) with a tendency for abiraterone in first line for men with African ancestry at the mCRPC stage.

La prévention des infections postopératoires par le traitement des ECBU préopératoires positifs est quotidienne en urologie. L'antibioprophylaxie doit tenir compte du germe isolé par l'ECBU, variable en genre et en résistance aux antibiotiques. Elle implique des protocoles d'antibioprophylaxie pour une observance optimale des patients. L'objectif était d'évaluer le nombre d'infections postopératoires survenues dans une population de patients qui ont reçu de l'amikacine comme antibioprophylaxie préopératoire. Il s'agissait d'une étude descriptive, prospective et monocentrique, incluant des patients opérés dans le service d'urologie entre octobre 2020 et octobre 2021. Le critère de jugement principal était la survenue d'une infection postopératoire. Les patients bénéficiaient d'une prophylaxie par amikacine lorsque la bactérie isolée avant la chirurgie y était sensible, avec une administration de 25 mg/kg la veille et le jour de l'intervention. Une infection postopératoire était définie par l'association d'une fièvre à une sémiologie d'infection urinaire ou à l'identification d'un ou plusieurs germes isolé(s) par hémocultures et/ou l'ECBU postopératoire, et ce dans les 30 jours suivant l'intervention. Au total, 76 patients ont été inclus, et 7 ont été exclu. Parmi les 69 patients, 45 % étaient porteurs de matériel endo-urinaire, et 94 % des ECBU préopératoires présentaient une leucocyturie supérieure à 104/mL. Les bactéries isolées étaient majoritairement Klebsiella pneumoniae (36 %) et Escherichia coli (35 %). Parmi les 69 patients, 4 (5,8 %) ont présenté une infection postopératoire. Aucun échec microbiologique n'a été observé. Aucun patient n'a décrit de toxicité à l'amikacine. Dans notre population, on note un faible taux d'infection postopératoire est observé, correspondant aux taux d'infection chez les patients non colonisés (ECBU préopératoire stérile) retrouvés dans la littérature. Aucun échec microbiologique n'a été démontré. Ces données restent à confirmer lors d'une étude de plus grande envergure avec un groupe contrôle.

Introduction and Objectives Metabolic syndrome (MetS) is a group of risk factors that increases the likelihood of developing cardiovascular diseases. Although suggested, the relationship between MetS and prostate cancer (PCa) is still inconclusive. Very few studies have addressed this question in populations of African descent, which are disproportionately affected by PCa. This study aimed to assess the prevalence of MetS among incident cases of Afro-Caribbean PCa and estimate its association with adverse clinicopathological features and the risk of biochemical recurrence (BCR) after radical prostatectomy (RP). Materials and Methods We included 285 consecutive patients with incident cases of PCa attending the University Hospital of Guadeloupe (French West Indies). MetS was evaluated at the time of diagnosis by collecting information on blood pressure, glycaemic status, triglyceride and high-density lipoprotein cholesterol levels, and obesity through various surrogates, including two waist circumference indicators (<= 94 cm, >= 102 cm), the waist-to-hip ratio (>= 0.95), and body mass index (BMI; >= 30 kg/m(2)). We followed 245 patients who underwent RP as primary treatment of localized PCa. Results The prevalence of MetS varied greatly, from 31.6% to 16.4%, when a waist circumference >= 94 cm or BMI were used as obesity surrogates, respectively. No significant associations were found between MetS, regardless of the obesity criteria employed, and the risk of adverse pathological features or BCR. Conclusions The high variability in MetS resulting from the diversity of obesity criteria used may explain the discordant associations reported in the literature. Further studies using strict and uniform criteria to define MetS on homogeneous ethnic groups are encouraged to clarify the association, if any, between MetS and PCa outcomes.

A rare African ancestry-specific germline deletion variant in HOXB13 (X285K, rs77179853) was recently reported in Martinican men with early-onset prostate cancer. Given the role of HOXB13 germline variation in prostate cancer, we investigated the association between HOXB13 X285K and prostate cancer risk in a large sample of 22 361 African ancestry men, including 11 688 prostate cancer cases. The risk allele was present only in men of West African ancestry, with an allele frequency in men that ranged from 0.40% in Ghana and 0.31% in Nigeria to 0% in Uganda and South Africa, with a range of frequencies in men with admixed African ancestry from North America and Europe (0-0.26%). HOXB13 X285K was associated with 2.4-fold increased odds of prostate cancer (95% confidence interval [CI] = 1.5-3.9, p = 2 x 10(-4)), with greater risk observed for more aggressive and advanced disease (Gleason >= 8: odds ratio [OR] = 4.7, 95% CI = 2.3-9.5, p = 2 x 10(-5); stage T3/T4: OR = 4.5, 95% CI = 2.0-10.0, p = 2 x 10(-4); metastatic disease: OR = 5.1, 95% CI = 1.9-13.7, p = 0.001). We estimated that the allele arose in West Africa 1500-4600 yr ago. Further analysis is needed to understand how the HOXB13 X285K variant impacts the HOXB13 protein and function in the prostate. Understanding who carries this mutation may inform prostate cancer screening in men of West African ancestry. Patient summary: A rare African ancestry-specific germline deletion in HOXB13, found only in men of West African ancestry, was reported to be associated with an increased risk of overall and advanced prostate cancer. Understanding who carries this mutation may help inform screening for prostate cancer in men of West African ancestry. (C) 2022 Published by Elsevier B.V. on behalf of European Association of Urology.

Although several studies have examined the relationship between organochlorine pesticides (OCPs) and prostate cancer (PCa) risk, no data are available concerning the association between OCPs concentrations in periprostatic adipose tissue (PPAT), which reflects cumulative exposure, and PCa aggressiveness. Moreover, no previous study has compared OCPs exposure in two distinct ethno-geographical populations. The objectives were to analyze OCPs in PPAT of PCa patients from either Mainland France or French West Indies in correlation with features of tumor aggressiveness, after adjusting for potential confounders such age, BMI, and polyunsaturated fatty acid (PUFA) content of PPAT. PPAT was analyzed in 160 patients (110 Caucasians and 50 African-Caribbeans), 80 with an indolent tumor (ISUP group 1 + pT2), and 80 with an aggressive tumor (ISUP group more than 3 + pT3). The concentrations of 29 OCPs were measured in PPAT concomitantly with the characterization of PUFA content.Exposure patterns of OCPs differed according to the ethno-geographical origin. Most OCPs were found at higher concentration in Caucasian patients, whereas pp'-DDE content was twice as high in African-Caribbeans. Chlordecone was only detected in PPAT from African-Caribbean patients. Most OCP concentrations were posi-tively correlated with age, and some with BMI. After adjusting for age, BMI, and PUFA composition of PPAT, no significant association was found between OCPs content and risk of aggressive disease, except of mirex which appeared inversely associated with aggressive features of PCa in Caucasian patients.These results highlight a significant ethno-geographic variation in internal exposure to OCPs, which likely reflects differences in consumption patterns. The inverse relationship observed between mirex concentration and markers of PCa aggressiveness need to be further investigated.