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prostate surgery vs radiotherapy

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. 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...
April 21, 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...
November 2, 2016: 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
Virginia Becerra, Mónica Ávila, Jorge Jimenez, Laura Cortes-Sanabria, Yolanda Pardo, Olatz Garin, Angels Pont, Jordi Alonso, Francesc Cots, Montse Ferrer
BACKGROUND: Our objective was to assess the efficiency of treatments in patients with localized prostate cancer, by synthesizing available evidence from European economic evaluations through systematic review. METHODS: Articles published 2000-2015 were searched in MEDLINE, EMBASE and NHS EED (Prospero protocol CRD42015022063). Two authors independently selected studies for inclusion and extracted the data. A third reviewer resolved discrepancies. We included European economic evaluations or cost comparison studies, of any modality of surgery or radiotherapy treatments, regardless the comparator/s...
October 3, 2016: BMC Health Services Research
Emanuele Zaffuto, Giorgio Gandaglia, Nicola Fossati, Paolo Dell'Oglio, Marco Moschini, Vito Cucchiara, Nazareno Suardi, Vincenzo Mirone, Marco Bandini, Shahrokh F Shariat, Pierre I Karakiewicz, Francesco Montorsi, Alberto Briganti
PURPOSE: The effect of time between radical prostatectomy and radiation therapy on postoperative functional outcomes is still unclear in patients with surgically managed prostate cancer. We hypothesized that a shorter time between radical prostatectomy and radiotherapy might be associated with worse functional recovery rates after radical prostatectomy. MATERIALS AND METHODS: We retrospectively evaluated 2,190 patients treated with radical prostatectomy and stratified according to radiotherapy schedule (adjuvant radiotherapy, salvage radiotherapy, no radiotherapy)...
March 2017: Journal of Urology
Stephen B Williams, Zhigang Duan, Karim Chamie, Karen E Hoffman, Benjamin D Smith, Jim C Hu, Jay B Shah, John W Davis, Sharon H Giordano
OBJECTIVE: To compare the risk of hospitalisation and associated costs in patients after treatment for prostate cancer. PATIENTS AND METHODS: We identified 29 571 patients aged 66-75 years without significant comorbidity from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database who were diagnosed with localised prostate cancer between 2004 and 2009. We compared the rates of all-cause and treatment-related hospitalisation that occurred within 365 days of the initiation of definitive therapy...
August 25, 2016: BJU International
Allison Lipitz-Snyderman, Camelia S Sima, Coral L Atoria, Elena B Elkin, Christopher Anderson, Victoria Blinder, Chiaojung Jillian Tsai, Katherine S Panageas, Peter B Bach
Importance: Interventions to address overuse of health care services may help reduce costs and improve care. Understanding physician-level variation and behavior patterns can inform such interventions. Objective: To assess patterns of physician ordering of services that tend to be overused in the treatment of patients with cancer. We hypothesized that physicians exhibit consistent behavior. Design, Setting, and Participants: Retrospective study of patients 66 years and older diagnosed with cancer between 2004 and 2011, using population-based Surveillance, Epidemiology, and End Results (SEER)-Medicare data to assess physician-level variation in 5 nonrecommended services...
October 1, 2016: JAMA Internal Medicine
Thomas P Shakespeare, Stephen Chin, Lucy Manuel, Shelly Wen, Matthew Hoffman, Shea W Wilcox, Noel J Aherne
INTRODUCTION: Decision regret (DR) may occur when a patient believes their outcome would have been better if they had decided differently about their management. Although some studies investigate DR after treatment for localised prostate cancer, none report DR in patients undergoing surgery and post-prostatectomy radiotherapy. We evaluated DR in this group of patients overall, and for specific components of therapy. METHODS: We surveyed 83 patients, with minimum 5 years follow-up, treated with radical prostatectomy (RP) and post-prostatectomy image-guided intensity-modulated radiotherapy (IG-IMRT) to 64-66 Gy following www...
August 16, 2016: Journal of Medical Imaging and Radiation Oncology
Jean-Philippe Adam, Quentin Denost, Maylis Capdepont, Bart van Geluwe, Eric Rullier
BACKGROUND: Urogenital dysfunctions after rectal cancer treatment are well recognized, although incidence and evolution over time are less well known. OBJECTIVE: We aimed to assess the evolution of urogenital functions over time after the treatment for rectal cancer. DESIGN: This is a prospective, longitudinal cohort study. SETTINGS: This study was conducted at a quaternary referral center for colorectal surgery. PATIENTS: A total of 250 consecutive patients treated for rectal cancer were prospectively enrolled for urogenital assessment...
September 2016: Diseases of the Colon and Rectum
Jae Y Lee, Daniel E Spratt, Adam L Liss, Patrick W McLaughlin
Treatment selection for men undergoing curative treatment for prostate cancer is often a challenging decision in view of the goal of maximising cure while maintaining quality of life. Previous quality-of-life comparisons suggest that specific outcomes are associated with type of treatment (surgery vs radiation); however, the functional anatomy approach, starting with nerve-sparing prostatectomy, assumes that quality-of-life outcomes are established by anatomic preservation. Emerging applications of the functional anatomy approach for prostate radiation will ultimately allow for individualised treatments that address the normal tissue variants visible on MRI...
May 2016: Lancet Oncology
Kathryn L Taylor, Richard M Hoffman, Kimberly M Davis, George Luta, Amethyst Leimpeter, Tania Lobo, Scott P Kelly, Jun Shan, David Aaronson, Catherine A Tomko, Amy J Starosta, Charlotte J Hagerman, Stephen K Van Den Eeden
BACKGROUND: Due to the concerns about the overtreatment of low-risk prostate cancer, active surveillance (AS) is now a recommended alternative to the active treatments (AT) of surgery and radiotherapy. However, AS is not widely utilized, partially due to psychological and decision-making factors associated with treatment preferences. METHODS: In a longitudinal cohort study, we conducted pretreatment telephone interviews (N = 1,140, 69.3% participation) with newly diagnosed, low-risk prostate cancer patients (PSA ≤ 10, Gleason ≤ 6) from Kaiser Permanente Northern California...
August 2016: Cancer Epidemiology, Biomarkers & Prevention
Michel Zimmermann, Guila Delouya, Abdullah M Alenizi, Emad Rajih, Kevin C Zorn, Daniel Taussky
INTRODUCTION: We aimed to evaluate the predictive value of the Cancer of the Prostate Risk Assessment Postsurgical Score (CAPRA-S) for patients treated with radical prostatectomy followed by subsequent external beam radiotherapy (EBRT). METHODS: A total of 373 patients treated with EBRT between January 2000 and June 2015 were identified in the institutional database. Followup and complete CAPRA-S score were available for 334 (89.5%) patients. CAPRA-S scores were sorted into previously defined categories of low- (score 0-2), intermediate- (3-5), and high-risk (6-12)...
March 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Gita Suneja, Chun Chieh Lin, Edgar P Simard, Xuesong Han, Eric A Engels, Ahmedin Jemal
BACKGROUND: Patients with cancer who are infected with the human immunodeficiency virus (HIV) are less likely to receive cancer treatment compared with HIV-uninfected individuals. However, to the authors' knowledge, the impact of insurance status and comorbidities is unknown. METHODS: Data from the National Cancer Data Base were used to study nonelderly adults diagnosed with several common cancers from 2003 to 2011. Cancer treatment was defined as chemotherapy, surgery, radiotherapy, or any combination during the first course of treatment...
August 1, 2016: Cancer
Deepansh Dalela, Björn Löppenberg, Akshay Sood, Jesse Sammon, Firas Abdollah
We performed a systematic literature search to identify original articles and editorials about the Decipher(®) Prostate Cancer Test (GenomeDx Biosciences, San Diego, CA) to provide an overview of the current literature and its present role in urologic clinical practice. The Decipher test, which uses the expression of 22 selected RNA markers (from a total of over 1.4 million), showed a very high discrimination in predicting clinical metastasis (0.75-0.83) and cancer-specific mortality (0.78) in external validation studies, outperforming all routinely available clinicopathologic characteristics...
2016: Reviews in Urology
Aaron D Falchook, Ronald C Chen
Prostate cancer patients with adverse pathologic factors (i.e., positive surgical margin, pT3 disease) after radical prostatectomy are more likely not cured (>60%) than cured by surgery alone. Adjuvant radiotherapy compared with observation reduces recurrence by 49% to 57%, may improve overall survival, and improves long-term quality of life without increased long-term patient-reported urinary or gastrointestinal tract symptoms. Despite these results, adjuvant radiotherapy is uncommonly received by patients with these adverse factors...
November 2015: Urologic Oncology
Hong Xian Wang, Lin Yu Tao, K E Qi, Hao Yun Zhang, Duo Feng, Wen Jun Wei, Heng Kong, Tian Wen Chen, Qiu Sheng Lin, Dao Jin Chen
Upregulated expression of the CXC chemokine receptor type 7 (CXCR7) promotes breast, lung and prostate cancer progression and metastasis. However, the role of CXCR7 in colon cancer has not been determined. We hypothesized that increased CXCR7 expression may contribute to human colon cancer occurrence and progression. Reverse transcription quantitative polymerase chain reaction and western blot analysis were performed on 34 malignant and 18 normal colon tissue specimens. The specimens were obtained from 19 male and 15 female patients, with a mean age of 52 years (range, 34-79 years)...
November 2015: Molecular and Clinical Oncology
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