Five-fraction prostate radiotherapy matched conventional treatment on urinary, bowel and sexual function at five years

The edition in brief

Five-year patient-reported outcomes from the phase 3 PACE-B trial (European Urology, July 2026) showed stereotactic body radiotherapy and conventionally fractionated radiotherapy for localised prostate cancer gave similar results: pad-free rates 91% vs 90%, moderate or big bowel problems 5% in both, and intercourse-adequate erections falling to 17% vs 20%. In 691 Australian patients with haematuria (BJU International, 18 October 2026), the Cxbladder Triage Plus urine test had 89% sensitivity and 99% negative predictive value against cystoscopy, missing five low-grade Ta tumours and one urachal adenocarcinoma. At the prostate segment level, mpMRI and PSMA-PET/CT each had high specificity but sensitivity under 20%, with combined imaging raising sensitivity to 25.8%. In a single-centre cohort, nerve-sparing robotic prostatectomy in selected high-risk patients was not associated with worse margins or 12-month biochemical recurrence. Pearl: visible haematuria needs both cystoscopy and upper-tract imaging.