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Open research questions in Prostate Cancer Diagnosis and Treatment

943 gap statements mined from Prostate Cancer Diagnosis and Treatment papers in our 7.9M-paper local library, which holds 5,273 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • However, select high-risk or very high-risk PCa patients may undergo cryotherapy despite clear lack of guidelines endorsement for such practice. Despite its occasional use, the association between cryotherapy and CSM relative to EBRT remains insufficiently characterized.

    Cancer-specific mortality in high-risk or very high-risk prostate cancer patients treated with cryotherapy vs. external beam radiation therapy · 2026 · DOI

  • In addition to limited knowledge, fear-related concerns hinder treatment uptake.

    Barriers to post-prostatectomy stress incontinence care: knowledge gaps, patient concerns, and urologist communication · 2026 · DOI

  • Some previous studies investigated the association between ttBCR and CSM and reported conflicting results, especially regarding patients who experienced BCR after RP.

    Time to BCR and cancer-specific mortality after radiotherapy or prostatectomy: implications for risk stratification and follow-up · 2026 · DOI

  • Finally, the proposed volume-adapted cut-offs have not been tested in an independent cohort, and external validation in prospective multicenter data — particularly in TRUS-based or screening populations — is required before incorporation into guideline recommendations.

    PSA density for clinically significant prostate cancer detection: a retrospective cohort study on the influence of age and prostate volume · 2026 · DOI

  • The most important limitations of this study are its retrospective design and the limited sample size. In addition, pathological and clinical follow-up data after curative treatments were not available for the patients included in the study; therefore, the impact of a history of TURP on long-term oncological outcomes could not be evaluated.

    Does prior TURP affect mpMRI findings or tumor grade in patients with prostate cancer? · 2026 · DOI

  • This within-subject paired comparison addresses a crucial gap in the literature, as previous studies of MPS (post-DRE) and EPI (non-DRE) tests utilized different cohorts and methodologies that prevented direct comparisons.

    Comparison of prostate cancer diagnostic models based on PCA3 and TMPRSS2:ERG RNA biomarkers from post-DRE and non-DRE urine specimens · 2026 · DOI

  • The role of DCE in AS follow-up also remains to be clarified, defining more precisely when it provides added value over T2-weighted and DWI sequences and when it may be safely omitted.

    The role of magnetic resonance imaging in the active surveillance of prostate cancer: state of the art · 2026 · DOI

  • Standardized quality assurance (including image quality scoring), reader calibration, and outcome-based feedback loops are essential not because PI-RADS is insufficient, but because these processes help the framework perform as intended across diverse practices.

    Navigating PI-RADS v2.1 in clinical practice: pitfalls, variability, and the supportive role of AI · 2026 · DOI

  • Looking forward, several key directions can be identified that will determine its impact on practice and patient outcomes.

    Current status and future directions of AI in prostate cancer detection on MRI: a special report from the ESUR prostate MRI working group authors · 2026 · DOI

  • To date, few prospective randomized Phase III trials have compared PORT with ENI in clinically N0 HR patients, and their findings remain largely conflicting.

    Omitting Elective Pelvic Nodes Irradiation in High Risk Prostate Cancer: Report on 43 Consecutive Elderly Patients · 2026 · DOI

  • Given the limited available evidence, the role of the pubococcygeus muscle and other components of the LAM complex in postoperative continence recovery warrants further investigation.

    Association of Preoperative MRI-Derived Anatomical Parameters with Urinary Continence Recovery After Robot-Assisted Radical Prostatectomy · 2026 · DOI

  • Finally, although we identified clinically meaningful DVH thresholds, these parameters should be validated in external cohorts before being adopted as universal planning constraints.

    Moderately hypofractionated intensity-modulated radiation therapy for intermediate- or high-risk prostate cancer: five-year results from a single-institution study in Japan · 2026 · DOI

  • The study had to make several assumptions concerning the potential scale of some variables influencing screening cost-effectiveness. The costs of PRSs and their accuracy in general and in relation to different ancestral backgrounds are unknown. The study had to account for the untargeted nature of the population screening strategies modelled.

    Modelling the potential contributions of polygenic risk stratification to cost-effective screening for prostate cancer · 2026 · DOI

  • Stereotactic body radiotherapy boost functions as a non-invasive ‘virtual BT’, providing similar radiobiological advantages with favourable early toxicity, shorter overall treatment time and attractive cost-effectiveness, although long-term randomised data are still limited.

    Local dose escalation strategies in unfavourable intermediate- and high-risk prostate cancer: a comparative review of brachytherapy, SBRT and focal boost · 2026 · DOI

  • Although its role in population-based prostate cancer (PCa) screening has not been established, accumulating evidence from recent clinical trials has suggested that MRI-based screening strategies may mitigate some of the major limitations of serum prostate-specific antigen (PSA)based screening, particularly by reducing overdiagnosis while maintaining csPCa detection.

    The PRISM Consensus: The First Major Step Towards Standardizing MRI for Population-Based Prostate Cancer Screening · 2026 · DOI

  • Firstly, regarding PSMA-RGS, the lack of standardized protocols for imaging agents such as tracer selection and dosing intervals may introduce variability and limit its reproducibility.

    The Role of Robot-Assisted, Imaging-Guided Surgery in Prostate Cancer Patients · 2025 · DOI

  • An important limitation of most current AS protocol for PCa is their reliance on a one-size-fits-all approach with repeated PSA measurements, MRI, and prostate biopsies at fixed and predetermined intervals, irrespective of the individual’s risk.

    A Personalized, Risk-Based Approach to Active Surveillance for Prostate Cancer with Takeaways from Broader Oncology Practices: A Mixed Methods Review · 2025 · DOI

  • Surgical therapy, particularly RARP, is considered a viable treatment option for select patients; however, its effectiveness in controlling HR/VHR-PCa remains unclear. Despite adopting various therapeutic strategies, there is no consensus on the optimal multidisciplinary approach for HR/VHR-PCa management.

    Neoadjuvant Chemohormonal Therapy Versus Pelvic Lymphadenectomy on Biochemical Recurrence in Patients with High- or Very-High-Risk Prostate Cancer Undergoing Robot-Assisted Radical Prostatectomy · 2025 · DOI

  • Finally, while the clinical significance of unifocal HGPIN in biopsies remains uncertain, there is stronger evidence for multifocal isolated HGPIN as a predictor of subsequent cancer detection.

    International Society of Urological Pathology Consensus on Cancer Precursor Lesions. Working Group 1 · 2025 · DOI

  • The grading of intraductal carcinoma of the prostate (IDC-P) associated with conventional prostatic adenocarcinoma (CPA) remains controversial, particularly regarding whether IDC-P exhibiting a solid nest pattern is prognostically equivalent to Gleason grade 5 CPA.

    Intraductal Carcinoma of the Prostate With a Solid Nest Pattern May Be More Aggressive Than Gleason Grade 5 Conventional Prostatic Adenocarcinoma · 2025 · DOI

  • The study highlights the need to address systemic barriers and develop strategies to support Black men in navigating prostate cancer care.

    Exploring the Vision of an Equitable Prostate Cancer Care Delivery System: Perspectives of Black Men in Charleston, South Carolina · 2025 · DOI

  • Prospective phase III trials are warranted to further refine patient selection, 1 3European Journal of Nuclear Medicine and Molecular…

    PSMA PET/CT-guided salvage elective nodal radiotherapy for nodal metastases after radical prostatectomy: a bi-institutional long-term outcome analysis · 2026 · DOI

  • Prospective validation of AI tools before clinical translation - Investigation of the role of AI in supporting specific steps emphasized by PI-RADS and quality assurance…

    Navigating PI-RADS v2.1 in clinical practice: pitfalls, variability, and the supportive role of AI · 2026 · DOI

  • Investigation of an affordable, highly predictive, and widely available polygenic risk score, - Research on the potential of PRSs to supplement existing tests, - Study of the impact of PRSs on aggressive or fatal…

    Modelling the potential contributions of polygenic risk stratification to cost-effective screening for prostate cancer · 2026 · DOI

  • Developing educational programs - Addressing systemic barriers - Providing early education on prostate cancer risk - Implementing training for providers - Creating support groups - Revisiting national guidelines for Black…

    Exploring the Vision of an Equitable Prostate Cancer Care Delivery System: Perspectives of Black Men in Charleston, South Carolina · 2025 · DOI

Most-cited papers in Prostate Cancer Diagnosis and Treatment

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Open questions raised by papers listed on this page include: (1) Select high-risk or very high-risk PCa patients may undergo cryotherapy despite clear lack of guidelines endorsement for such practice (“Cancer-specific mortality in high-risk or very high-risk prostate cancer…”, 2026); (2) The role of DCE in AS follow-up also remains to be clarified, defining more precisely when it provides added value over T2-weighted and DWI sequences and when it may be safely omitted (“The role of magnetic resonance imaging in the active surveillance of prostate…”, 2026); (3) The costs of PRSs and their accuracy in general and in relation to different ancestral backgrounds are unknown (“Modelling the potential contributions of polygenic risk stratification to…”, 2026); (4) Regarding PSMA-RGS, the lack of standardized protocols for imaging agents such as tracer selection and dosing intervals may introduce variability and limit its reproducibility (“The Role of Robot-Assisted, Imaging-Guided Surgery in Prostate Cancer Patients”, 2025); (5) Surgical therapy, particularly RARP, is considered a viable treatment option for select patients; however, its effectiveness in controlling HR/VHR-PCa remains unclear (“Neoadjuvant Chemohormonal Therapy Versus Pelvic Lymphadenectomy on Biochemical…”, 2025). 943 gap statements have been mined from Prostate Cancer Diagnosis and Treatment papers in our 7.9M-paper local library, which holds 5,273 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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