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prostate surgery vs radiotherapy

Junchao Chen, Clara Oromendia, Joshua A Halpern, Karla V Ballman
PURPOSE: Recent years have brought many changes in the management of localized prostate cancer as national screening guidelines have been updated and diagnostic practice patterns evolved. We sought to better understand how the changing landscape influenced treatment utilization in the United States. METHODS: We used the SEER database in this retrospective analysis of patients with clinically localized prostate cancer between 2004 and 2013. We evaluated utilization of primary treatment modalities over time with descriptive and trend analyses, and examined treatment utilization by cancer risk group and age at diagnosis...
March 14, 2018: Prostate
Bernadette Brown, Jane Young, David P Smith, Andrew B Kneebone, Andrew J Brooks, Sam Egger, Miranda Xhilaga, Amanda Dominello, Dianne L O'Connell, Mary Haines
BACKGROUND: This study assessed whether a theoretically conceptualised tailored intervention centred on multidisciplinary teams (MDTs) increased clinician referral behaviours in line with clinical practice guideline recommendations. METHODS: Nine hospital Sites in New South Wales (NSW), Australia with a urological MDT and involvement in a state-wide urological clinical network participated in this pragmatic stepped wedge, cluster randomised implementation trial...
March 12, 2018: Implementation Science: IS
Trevor J Bledsoe, Henry S Park, Charles E Rutter, Sanjay Aneja, Paul L Nguyen, James B Yu
OBJECTIVES: A variety of treatment modalities are available for the management of clinically localized prostate cancer in the United States. In addition to clinical factors, treatment modality choice may be influenced by a patient's insurance status. Using a national data set, we investigated the relationship between insurance status and prostate cancer treatment modality selection among nonelderly men in the United States. METHODS: Nonelderly men age 18 to 64 years treated for localized prostate cancer from 2010 to 2014 were identified within the National Cancer Database...
March 7, 2018: American Journal of Clinical Oncology
Mark Douglas Tyson, Tatsuki Koyama, Dan Lee, Karen E Hoffman, Matthew J Resnick, Xiao-Cheng Wu, Matthew R Cooperberg, Michael Goodman, Sheldon Greenfield, Ann S Hamilton, Mia Hashibe, Lisa E Paddock, Antoinette Stroup, Vivien Chen, Ralph Conwill, Dan McCollum, David F Penson, Daniel A Barocas
BACKGROUND: Whether prostate cancer severity modifies patient-reported functional outcomes after radical prostatectomy (RP) or external beam radiotherapy (EBRT) for localized cancer is unknown. OBJECTIVE: The purpose of this study was to determine whether differences in predicted function over time between RP and EBRT varied by risk group. DESIGN, SETTING, AND PARTICIPANTS: The Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study is a prospective, population-based, observational study that enrolled men with localized prostate cancer in 2011-2012...
February 28, 2018: European Urology
William L Hwang, Rahul D Tendulkar, Andrzej Niemierko, Shree Agrawal, Kevin L Stephans, Daniel E Spratt, Jason W Hearn, Bridget F Koontz, W Robert Lee, Jeff M Michalski, Thomas M Pisansky, Stanley L Liauw, Matthew C Abramowitz, Alan Pollack, Drew Moghanaki, Mitchell S Anscher, Robert B Den, Anthony L Zietman, Andrew J Stephenson, Jason A Efstathiou
Importance: Prostate cancer with adverse pathological features (ie, pT3 and/or positive margins) after prostatectomy may be managed with adjuvant radiotherapy (ART) or surveillance followed by early-salvage radiotherapy (ESRT) for biochemical recurrence. The optimal timing of postoperative radiotherapy is unclear. Objective: To compare the clinical outcomes of postoperative ART and ESRT administered to patients with prostate cancer with adverse pathological features...
January 25, 2018: JAMA Oncology
Bruce E Hillner, Lucy Hanna, Rajesh Makineni, Fenghai Duan, Anthony F Shields, Rathan M Subramaniam, Ilana Gareen, Barry A Siegel
We have previously reported that PET with18 F-fluoride (NaF PET) for assessment of osseous metastatic disease led to changes in intended management in a substantial fraction of patients with prostate or other types of cancer participating in the National Oncologic PET Registry. This study was performed to assess the concordance of intended patient management after NaF PET and inferred management based on analysis of Medicare claims. Methods: We analyzed linked post-NaF PET data of consenting National Oncologic PET Registry participants age 65 y or older from 2011 to 2014 and their corresponding Medicare claims...
March 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Giorgio Gandaglia, Derya Tilki, Emanuele Zaffuto, Nicola Fossati, Raisa S Pompe, Paolo Dell'Oglio, Markus Graefen, Francesco Montorsi, Alberto Briganti
The Prostate Testing for Cancer and Treatment (ProtecT) trial reported excellent outcomes for patients with localized prostate cancer (PCa) managed with radical prostatectomy (RP), radiotherapy, or active monitoring. We aimed at assessing the generalizability of the ProtecT trial to contemporary patients undergoing RP at two high-volume institutions. Overall, 29147 PCa patients treated with RP between 1999 and 2016 were included. We evaluated changes in disease characteristics over time. Competing-risk analyses estimated the 10-yr cancer-specific mortality (CSM) and other-cause mortality (OCM) rates...
November 16, 2017: European Urology Focus
Stephen J Ramey, Shree Agrawal, Matthew C Abramowitz, Drew Moghanaki, Thomas M Pisansky, Jason A Efstathiou, Jeff M Michalski, Daniel E Spratt, Jason W D Hearn, Bridget F Koontz, Stanley L Liauw, Alan Pollack, Mitchell S Anscher, Robert B Den, Kevin L Stephans, Anthony L Zietman, W Robert Lee, Andrew J Stephenson, Rahul D Tendulkar
BACKGROUND: Outcomes with postprostatectomy salvage radiation therapy (SRT) are not ideal. Little evidence exists regarding potential benefits of adding whole pelvic radiation therapy (WPRT) alone or in combination with androgen deprivation therapy (ADT). OBJECTIVE: To explore whether WPRT and/or ADT added to prostate bed radiation therapy (PBRT) improves freedom from biochemical failure (FFBF) or distant metastases (DM). DESIGN, SETTING, AND PARTICIPANTS: A database was compiled from 10 academic institutions of patients with postprostatectomy prostate-specific antigen (PSA) >0...
November 8, 2017: European Urology
R Di Franco, V Borzillo, V Ravo, G Ametrano, F Cammarota, S Rossetti, F J Romano, C D'Aniello, C Cavaliere, G Iovane, M A Porricelli, M Muto, M Berretta, G Facchini, P Muto
OBJECTIVE: The aim of our report was to review the literature concerning the toxicity of radiation therapy in patients treated for high-risk prostate cancer, and to evaluate the differences in toxicity between conventional fractionation and hypofractionated treatments, in view of different techniques used in high-risk prostate cancer patients. MATERIALS AND METHODS: PubMed database has been explored for studies concerning acute and late urinary/gastrointestinal toxicity in high-risk prostate cancer patients treated with radiotherapy...
August 2017: European Review for Medical and Pharmacological Sciences
Aaron A Laviana, Stephanie C Pannell, Kathy H Y Huen, Jonathan Bergman
BACKGROUND: By 2022, there will be 18 million predicted cancer survivors, which is an estimated 30% more than the number of survivors in 2012. In prostate cancer alone, the most common cancer in American men other than skin cancer, 1 in 7 men will be diagnosed during their lifetime. Nevertheless, only approximately 1 in 39 will actually die of the disease. Although life expectancy is often good, these men have multiple treatment management options to choose from, including active surveillance, surgery, or radiotherapy, each of which carries its own array of long-term adverse effects...
September 2017: Urologic Oncology
Omar Abdel-Rahman
BACKGROUND: Population-based data on the risk of cardiac death among cancer survivors are needed. This scenario was evaluated in cancer survivors (>5 years) registered within the Surveillance, Epidemiology and End Results (SEER) database. METHODS: The SEER database was queried using SEER*Stat to determine the frequency of cardiac death compared to other causes of death; and to determine heart disease-specific and cancer-specific survival rates in survivors of each of the 10 most common cancers in men and women in the SEER database...
September 2017: Expert Review of Anticancer Therapy
Berardino De Bari, Bradley Stish, Mark Wayne Ball, Yacob Habboush, Paul Sargos, Marco Krengli, Alberto Bossi, Armando Stabile, Claudio Sole Pesutic, Laëtitia Lestrade, Robert Jan Smeenk, Barbara Alicja Jereczek-Fossa, Thomas Zilli, Gilles Créhange, Filippo Alongi, Nicholas Zaorsky, Mahmut Ozsahin
INTRODUCTION: Adult prostatic sarcoma (PS) is a rare disease. While surgery is considered the standard approach, the role of other therapies is not completely established. We report results of the largest multicentric contemporary cohort of PS patients. MATERIALS AND METHODS: This study included 61 adult PS patients treated in 16 American and European Institutions. Median age was 64.4 years (range: 22-87). Curative surgery was delivered in 48 patients (prostatectomy = 26, cystoprostatectomy = 22), usually with lymphadenectomy (n = 40)...
July 2017: Prostate
Diletta Bianchini, David Lorente, Pasquale Rescigno, Zafeiris Zafeiriou, Elena Psychopaida, Hazel O'Sullivan, Mervyn Alaras, Michael Kolinsky, Semini Sumanasuriya, Mariane Sousa Fontes, Joaquin Mateo, Raquel Perez Lopez, Nina Tunariu, Nikolaos Fotiadis, Pardeep Kumar, Alison Tree, Nicholas Van As, Vincent Khoo, Chris Parker, Rosalind Eeles, Alan Thompson, David Dearnaley, Johann S de Bono
BACKGROUND: The optimal management of the primary tumor in metastatic at diagnosis (M1) prostate cancer (PCa) patients is not yet established. We retrospectively evaluated the effect of locoregional treatment (LRT) on overall survival (OS) hypothesizing that this could improve outcome through better local disease control and the induction of an antitumor immune response (abscopal effect). PATIENTS AND METHODS: M1 at diagnosis PCa patients referred to the Prostate Targeted Therapy Group at the Royal Marsden between June 2003 and December 2013 were identified...
October 2017: Clinical Genitourinary Cancer
Daniel Olvera-Posada, Blayne Welk, J Andrew McClure, Jennifer Winick-Ng, Jonathan I Izawa, Stephen E Pautler
OBJECTIVE: To evaluate the impact of multiple transrectal ultrasound-guided prostate biopsies (TRUS-Bx) before radical prostatectomy (RP) on surgical outcomes. MATERIALS AND METHODS: Administrative databases were used to identify all patients who had a RP performed in the province of Ontario from April 1, 2002, to March 31, 2013. TRUS-Bx prior to RP were identified and patients were categorized as having one or more than one prior TRUS-Bx. The primary end point was a composite index of serious surgical complications...
August 2017: Urology
Sarah Abramson, Daniel Walker, Lindsey Sova, Jenny J Lin, Kezhen Fei, Rebeca Franco, Ann Scheck McAlearney
186 Background: Prostate cancer is the most common cancer for men in the US, yet the burden of this disease falls disproportionately on African Americans (AAs). The disparity's etiology is complex. Surgery and radiotherapy offer similar survival but historically have different rates of performance with younger and white men more likely to undergo surgery and AAs more likely to experience underuse. This study aims to examine treatment decision-making (TDM) processes for AA men from patient and physician perspectives...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
David Horovitz, Changyong Feng, Edward M Messing, Jean V Joseph
INTRODUCTION: During robot-assisted radical prostatectomy (RARP), the prostate may be approached extraperiteoneally (extraperitoneal robot-assisted radical prostatectomy [eRARP]) or transperitoneally (transperitoneal robot-assisted radical prostatectomy [tRARP]). The former avoids the abdominal cavity, which might be of benefit in patients who have had prior abdominal or pelvic surgery (PAPS). Our objective was to compare the outcomes of patients with PAPS undergoing either technique...
April 2017: Journal of Endourology
Mirko Nitsche, Werner Brannath, Matthias Brückner, Dirk Wagner, Alexander Kaltenborn, Nils Temme, Robert M Hermann
OBJECTIVE: The objective of this retrospective planning study was to find a contouring definition for the rectum as an organ at risk (OAR) in curative three-dimensional external beam radiotherapy (EBRT) for prostate cancer (PCa) with a predictive correlation between the dose-volume histogram (DVH) and rectal toxicity. METHODS: In a pre-study, the planning CT scans of 23 patients with PCa receiving definitive EBRT were analyzed. The rectum was contoured according to 13 different definitions, and the dose distribution was correlated with the respective rectal volumes by generating DVH curves...
February 2017: British Journal of Radiology
Arie Carneiro, Willy Baccaglini, Felipe P A Glina, Paulo P Kayano, Victor M Nunes, Oren Smaletz, Wanderley Marques Bernardo, Icaro Thiago de Carvalho, Gustavo Caserta Lemos
CONTEXT: Currently, standard treatment of metastatic prostatic cancer (MPCa) is androgen-deprivation therapy (ADT). Recent studies suggested that local treatment of MPCa is related to increase of survival of those patients, as observed in other tumors. OBJECTIVE: To evaluate the impact of local treatment on overall survival and cancer specific survival in 3 and 5 years in patients with MPCa. MATERIALS AND METHODS: Systematic review and meta-analysis of population studies published at PubMed, Scielo, Lilacs, Cochrane and EMBASE databases until June 2016...
July 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Simone Albisinni, Fouad Aoun, Simon Bellucci, Ibrahim Biaou, Ksenija Limani, Eric Hawaux, Alexandre Peltier, Roland van Velthoven
INTRODUCTION: Although still experimental, focal treatment is being increasingly implemented in the management of prostate cancer (PCa). Aim of the current study was to compare functional and oncologic outcomes of high-intensity focal ultrasound (HIFU) hemiablation of the prostate to robot-assisted laparoscopic prostatectomy (RALP) in the management of unilateral PCa. MATERIALS: Fifty-five men with unilateral, clinically localized PCa underwent HIFU hemiablation of the affected prostatic lobe between 2007 and 2015...
January 2017: Journal of Endourology
Shuang G Zhao, S Laura Chang, Daniel E Spratt, Nicholas Erho, Menggang Yu, Hussam Al-Deen Ashab, Mohammed Alshalalfa, Corey Speers, Scott A Tomlins, Elai Davicioni, Adam P Dicker, Peter R Carroll, Matthew R Cooperberg, Stephen J Freedland, R Jeffrey Karnes, Ashley E Ross, Edward M Schaeffer, Robert B Den, Paul L Nguyen, Felix Y Feng
BACKGROUND: Postoperative radiotherapy has an important role in the treatment of prostate cancer, but personalised patient selection could improve outcomes and spare unnecessary toxicity. We aimed to develop and validate a gene expression signature to predict which patients would benefit most from postoperative radiotherapy. METHODS: Patients were eligible for this matched, retrospective study if they were included in one of five published US studies (cohort, case-cohort, and case-control studies) of patients with prostate adenocarcinoma who had radical prostatectomy (with or without postoperative radiotherapy) and had gene expression analysis of the tumour, with long-term follow-up and complete clinicopathological data...
November 2016: Lancet Oncology
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