{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:16:21Z","timestamp":1788185781101,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to evaluate the prognostic utility of subclassifying patients with intermediate\u2010risk prostate cancer into favorable and unfavorable subgroups in a large Japanese cohort undergoing radical prostatectomy, focusing on adverse pathology and oncologic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 1485 intermediate\u2010risk patients from the MICAN (Medical Investigation Cancer Network) study registry who underwent radical prostatectomy between 2010 and 2020 in Ehime Prefecture, Japan. Patients were categorized into favorable or unfavorable intermediate\u2010risk groups based on the National Comprehensive Cancer Network (NCCN) guideline. We examined up\u2010grading, up\u2010staging, and adverse pathology defined as pathological \u2265T3, grade group \u2265\u20094, or lymph node involvement. Kaplan\u2013Meier analysis was used to evaluate prostate\u2010specific antigen (PSA) failure\u2010free survival and overall survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1485 patients, 590 (40.2%) were classified as having favorable intermediate risk and 879 (59.8%) as having unfavorable intermediate risk. Up\u2010grading and up\u2010staging were observed more frequently in the unfavorable group. Adverse pathology was more frequent in the unfavorable group (64.8%) than that in the favorable group (39.4%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The 5\u2010year PSA failure\u2010free survival rates were 92.1% for the favorable group and 80.1% for the unfavorable group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Although the 5\u2010year overall survival rate did not reach statistical significance (98.4% vs. 97.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.085), the favorable group showed a trend toward better survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The subclassification of intermediate\u2010risk prostate cancer into favorable and unfavorable groups is prognostically meaningful in Japanese patients undergoing radical prostatectomy. Higher rates of adverse pathological findings and inferior PSA failure\u2010free survival in the unfavorable group support the clinical utility of this subclassification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70592","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T05:57:13Z","timestamp":1786427833000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Validation of the\n                    <scp>NCCN<\/scp>\n                    Subclassification for Intermediate\u2010Risk Prostate Cancer in a Japanese Radical Prostatectomy Cohort: Results From the\n                    <scp>MICAN<\/scp>\n                    Study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2470-4341","authenticated-orcid":false,"given":"Tsuyoshi","family":"Oono","sequence":"first","affiliation":[{"name":"Department of Urology Uwajima City Hospital  Uwajima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Terashita","sequence":"additional","affiliation":[{"name":"Department of Urology Uwajima City Hospital  Uwajima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinsuke","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Urology Uwajima City Hospital  Uwajima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Oka","sequence":"additional","affiliation":[{"name":"Department of Urology Uwajima City Hospital  Uwajima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Matsuzaki","sequence":"additional","affiliation":[{"name":"Department of Urology Matsuyama Red Cross Hospital  Matsuyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Urology Matsuyama Red Cross Hospital  Matsuyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Matsumura","sequence":"additional","affiliation":[{"name":"Department of Urology Ehime Prefectural Central Hospital  Matsuyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iku","family":"Ninomiya","sequence":"additional","affiliation":[{"name":"Department of Urology Ehime Prefectural Central Hospital  Matsuyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kensuke","family":"Shinomori","sequence":"additional","affiliation":[{"name":"Department of Urology Sumitomo Besshi Hospital  Niihama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Urology Yawatahama City General Hospital  Yawatahama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoya","family":"Onishi","sequence":"additional","affiliation":[{"name":"Department of Urology Yawatahama City General Hospital  Yawatahama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akitomi","family":"Shirato","sequence":"additional","affiliation":[{"name":"Department of Urology Saiseikai Matsuyama Hospital  Matsuyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Urology Jyuzen General Hospital  Niihama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3031-7258","authenticated-orcid":false,"given":"Katsuyoshi","family":"Hashine","sequence":"additional","affiliation":[{"name":"Department of Urology National Hospital Organization Shikoku Cancer Center  Matsuyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natsumi","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Division of Clinical Biostatistics, Section of Cancer Prevention and Epidemiology Clinical Research Center, National Hospital Organization Shikoku Cancer Center  Matsuyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6656-4261","authenticated-orcid":false,"given":"Ryuta","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Urology Ehime University  Matsuyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2229-0948","authenticated-orcid":false,"given":"Noriyoshi","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Urology Ehime University  Matsuyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Saika","sequence":"additional","affiliation":[{"name":"Department of Urology Ehime University  Matsuyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer. 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