{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:27:20Z","timestamp":1791487640873,"version":"4.3.4"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe the incidence, characteristics and mortality of men who present with complications of metastatic prostate cancer, a previously under\u2010reported population. We investigate men who present with and without malignant ureteric obstruction (MUO) and skeletal\u2010related events (SREs), collectively termed \u2018metastatic\u2010related events\u2019 (MREs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>We used the English Cancer Registry linked to hospital administrative data to identify men diagnosed with metastatic prostate cancer between January 2015 and December 2022. Poisson regression models estimated adjusted relative risks (aRRs) of presenting with MREs. The cumulative incidences of overall and prostate cancer\u2010specific death were estimated for each MRE subgroup (metastatic without MRE, MUO, SRE, and MUO and SRE in combination).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 48\u2009171 men diagnosed with primary metastatic disease, 4272 (8.9%) presented with MREs. Of these men, 2453 (57.4%) had MUO, 1738 (40.7%) had a SRE, and 81 (1.9%) had both. Men aged \u226580\u2009years had the highest risk (9.8% [1604\/16452]) of presenting with MREs. Men aged 70\u201379\u2009years (8.0% [1470\/18397]) (aRR 0.82, 95% confidence interval [CI] 0.77\u20130.88) and men aged 60\u201369\u2009years (8.9% [916\/10297]) (aRR 0.91, 95%CI 0.84\u20130.98) had lower risks. Men from the most deprived neighbourhoods (9.3% [706\/7609]) (aRR 1.27, 95% CI 1.15\u20131.40) had greater risks of presenting with MREs than those from the least deprived neighbourhoods (8.0% [868\/10865]). The proportion of men presenting with MREs varied across geographical regions, ranging from 4.6% (288\/6233) to 11.7% (461\/3951). The 5\u2010year overall mortality for men presenting without MREs was 57.8% (95% CI 57.2\u201358.4%), compared to 77.1% (95% CI 74.9\u201379.2%) with MUO, 66.8% (95% CI 64.1\u201369.4%) with a SRE and 84.4% (95% CI 74.1\u201394.7%) with both.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The risk of presenting with metastatic prostate cancer and MREs varies according to age, socioeconomic deprivation, and residential region. These men have poorer survival outcomes than men diagnosed without MREs at diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70179","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T05:14:35Z","timestamp":1771391675000},"page":"840-848","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics and outcomes of men presenting with complications of metastatic prostate cancer"],"prefix":"10.1111","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8572-2832","authenticated-orcid":false,"given":"Arjun","family":"Nathan","sequence":"first","affiliation":[{"name":"Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine  London UK"},{"name":"National Cancer Audit Collaborating Centre, Clinical Effectiveness Unit Royal College of Surgeons of England  London UK"},{"name":"Department of Surgery and Interventional Science University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9695-6052","authenticated-orcid":false,"given":"Matthew G.","family":"Parry","sequence":"additional","affiliation":[{"name":"National Cancer Audit Collaborating Centre, Clinical Effectiveness Unit Royal College of Surgeons of England  London UK"},{"name":"Department of Surgery and Interventional Science University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Cook","sequence":"additional","affiliation":[{"name":"National Cancer Audit Collaborating Centre, Clinical Effectiveness Unit Royal College of Surgeons of England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Mayne","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine  London UK"},{"name":"National Cancer Audit Collaborating Centre, Clinical Effectiveness Unit Royal College of Surgeons of England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Dodkins","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine  London UK"},{"name":"National Cancer Audit Collaborating Centre, Clinical Effectiveness Unit Royal College of Surgeons of England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3278-9491","authenticated-orcid":false,"given":"Marina","family":"Parry","sequence":"additional","affiliation":[{"name":"National Cancer Audit Collaborating Centre, Clinical Effectiveness Unit Royal College of Surgeons of England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghav","family":"Varma","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine  London UK"},{"name":"National Cancer Audit Collaborating Centre, Clinical Effectiveness Unit Royal College of Surgeons of England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9645-6659","authenticated-orcid":false,"given":"Ajay","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine  London UK"},{"name":"National Cancer Audit Collaborating Centre, Clinical Effectiveness Unit Royal College of Surgeons of England  London UK"},{"name":"Guy's Cancer Centre Guy's and St Thomas\u2019 NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9451-2335","authenticated-orcid":false,"given":"Jan","family":"van der Meulen","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine  London UK"},{"name":"National Cancer Audit Collaborating Centre, Clinical Effectiveness Unit Royal College of Surgeons of England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S. 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