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Active surveillance prostate

Jacques Klein, Arachk de Górski, Daniel Benamran, Jean-Paul Vallee, Thomas De Perrot, Gregory J Wirth, Christophe E Iselin
INTRODUCTION: The study aimed to evaluate 3 different modalities of transrectal ultrasound (TRUS)-guided prostate biopsies (PBs; 2D-, 3D- and targeted 3D-TRUS with fusion to MRI - T3D). Primary end point was the detection rate of prostate cancer (PC). Secondary end point was the detection rate of insignificant PC according to the Epstein criteria. PATIENTS AND METHODS: Inclusion of 284 subsequent patients who underwent 2D-, 3D- or T3D PB from 2011 to 2015. All patients having PB for initial PC detection with a serum prostate-specific antigen value ≤20 ng/ml were included...
October 27, 2016: Urologia Internationalis
Jung Jae Park, Byung Kwan Park
PURPOSE: To evaluate the role of Prostate Imaging Reporting and Data System v. 2 (PI-RADSv2) in triaging patients with prostate cancer according to Prostate Cancer Research International: Active Surveillance (PRIAS). MATERIALS AND METHODS: Between January 2012 and December 2014, 456 patients with biopsy-proven cancer underwent multiparametric 3T magnetic resonance imaging (MRI) using T2 -weighted, diffusion-weighted, and dynamic contrast-enhanced MRI sequences, and then radical prostatectomy...
October 26, 2016: Journal of Magnetic Resonance Imaging: JMRI
Adriana C Vidal, Stephen J Freedland
CONTEXT: In 2012, we published a detailed review on obesity and prostate cancer. Since then, new studies have brought further understanding regarding the role of obesity in selecting active surveillance candidates, and differing associations between obesity and prostate cancer as a function of race and molecular subtype of prostate cancer. OBJECTIVE: To review new manuscripts on these new concepts for which there were limited data before 2012. EVIDENCE ACQUISITION: A PubMed search from July 2012 to March 2016 was performed using the terms "prostate cancer" and "obesity"...
October 19, 2016: European Urology
(no author information available yet)
No abstract text is available yet for this article.
October 20, 2016: BMJ: British Medical Journal
Stacy Loeb, Yasin Folkvaljon, Caitlin Curnyn, David Robinson, Ola Bratt, Pär Stattin
Importance: Active surveillance is an important option to reduce prostate cancer overtreatment, but it remains underutilized in many countries. Models from the United States show that greater use of active surveillance is important for prostate cancer screening to be cost-effective. Objectives: To perform an up-to-date, nationwide, population-based study on use of active surveillance for localized prostate cancer in Sweden. Design, Setting, and Participants: Cross-sectional study in the National Prostate Cancer Register (NPCR) of Sweden from 2009 through 2014...
October 20, 2016: JAMA Oncology
Matthew R Cooperberg
No abstract text is available yet for this article.
October 20, 2016: JAMA Oncology
Peter Hammarsten, Tove Dahl Scherdin, Christina Hägglöf, Pernilla Andersson, Pernilla Wikström, Pär Stattin, Lars Egevad, Torvald Granfors, Anders Bergh
In the present study we have investigated whether Caveolin-1 expression in non-malignant and malignant prostate tissue is a potential prognostic marker for outcome in prostate cancer patients managed by watchful waiting. Caveolin-1 was measured in prostate tissues obtained through transurethral resection of the prostate from 395 patients diagnosed with prostate cancer. The majority of the patients (n = 298) were followed by watchful waiting after diagnosis. Tissue microarrays constructed from malignant and non-malignant prostate tissue were stained with an antibody against Caveolin-1...
2016: PloS One
Xavier Cathelineau, Rafael Sanchez-Salas
Focal therapy (FT) represents a potential shift in clinical practice by featuring a tissue-sparing approach for prostate cancer (PCa) treatment. It stands midway between active surveillance (AS) and more aggressive options like radical prostatectomy (RP) or radiotherapy. The field has enormously evolved in the last few years but there are still pending questions to answer in the future. The manuscript overlooks FT in terms of indications, available energies, situation of tumor microenvironment, follow-up, re-interventions, and the future of this approach for PCa...
December 2016: Current Urology Reports
Andrew Keller, Christian Gericke, Jennifer A Whitty, John Yaxley, Boon Kua, Geoff Coughlin, Troy Gianduzzo
BACKGROUND AND OBJECTIVES: The Göteborg randomised population-based prostate cancer screening trial demonstrated that prostate-specific antigen (PSA)-based screening reduces prostate cancer deaths compared with an age-matched control group. Utilising the prostate cancer detection rates from this study, we investigated the clinical and cost effectiveness of a similar PSA-based screening strategy for an Australian population of men aged 50-69 years. METHODS: A decision model that incorporated Markov processes was developed from a health system perspective...
October 18, 2016: Applied Health Economics and Health Policy
Michael S Leapman, Peter R Carroll
INTRODUCTION: Selective treatment approaches for prostate cancer (PCa) are warranted given the highly varied nature of the disease and the consequences associated with definitive therapy. MATERIALS AND METHODS: We present a stepwise overview of strategies to not treat PCa, ranging from improved early detection practices that seek to improve the yield at initial diagnosis, as well as refinements to risk prediction and the performance of active surveillance. RESULTS: Adherence to screening guidelines is non-uniform...
October 13, 2016: Urologic Oncology
Kei Mizuno, Takahiro Inoue, Hidefumi Kinoshita, Toshifumi Yano, Hiroaki Kawanishi, Hideki Kanda, Naoki Terada, Takashi Kobayashi, Tomomi Kamba, Yoshiki Mikami, Taizo Shiraishi, Yoshiko Uemura, Yukihiro Imai, Gen Honjo, Tomoyuki Shirase, Kazuhiro Okumura, Mutsushi Kawakita, Keiji Ogura, Yoshiki Sugimura, Tadashi Matsuda, Osamu Ogawa
OBJECTIVE: Active surveillance has emerged as an alternative to immediate treatment in men with favorable-risk prostate cancer; however, consensus about defining the appropriate candidates is still lacking. To examine the factors predicting unfavorable pathology among active surveillance candidates, we assessed low-risk radical prostatectomy specimens. METHODS: This retrospective study included 1753 men who had undergone radical prostatectomy at six independent institutions in Japan from 2005 to 2011...
October 15, 2016: Japanese Journal of Clinical Oncology
Akhil Muthigi, Abhinav Sidana, Arvin K George, Michael Kongnyuy, Mahir Maruf, Subin Valayil, Bradford J Wood, Peter A Pinto
INTRODUCTION AND OBJECTIVE: Multiparametric magnetic resonance imaging (MRI) and magnetic resonance (MR) -targeted biopsy have a growing role in the screening and evaluation of prostate cancer. We aim to evaluate the current knowledge, attitude, and practice patterns of urologists regarding this new technique. METHODS: An anonymous online questionnaire was designed to collect information on urologists' beliefs and use of prostate multiparametric MRI and MR-targeted biopsy...
October 12, 2016: Urologic Oncology
Tristan Barrett, Masoom A Haider
OBJECTIVE: Active surveillance (AS) has emerged as a management strategy for preventing overtreatment of indolent prostate cancer. Selection of patients for AS has traditionally proved challenging and resulted in 20-30% misclassification rates. MRI has potential to help overcome this limitation, broaden selection criteria to increase recruitment, and minimize the invasive nature of AS follow-up. CONCLUSION: The main issues surrounding MRI and AS are the heterogeneity of inclusion criteria, the definition of significant disease, and agreement about what constitutes radiologic progression...
October 11, 2016: AJR. American Journal of Roentgenology
Louisa G Gordon, Robbie James, Haitham W Tuffaha, Anthony Lowe, John Yaxley
PURPOSE: To evaluate the cost-effectiveness of multiparametric magnetic resonance imaging (mpMRI) to diagnose prostate cancer and direct all low-risk patients into active surveillance (AS). MATERIALS AND METHODS: A Markov cohort model was developed to assess three scenarios: 1) no mpMRI and current AS; 2) mpMRI and current AS; and 3) mpMRI and increased AS. Men were tracked from diagnosis to end-of-life. Estimates to populate the model were derived from systematic reviews, meta-analyses, epidemiological publications, and national cost reports...
October 11, 2016: Journal of Magnetic Resonance Imaging: JMRI
L Steentjes, S Siesling, F J Drummond, J G van Manen, L Sharp, A Gavin
We identified patient and disease characteristics associated with (1) "current" physical side-effects of any severity; and (2) "severe" physical side-effects "ever" experienced by 3,348 (54%) prostate cancer (PCa) survivors in Ireland diagnosed 2-18 years previously. Postal questionnaires collected symptoms at diagnosis, post-biopsy complications, comorbidities, primary treatments and physical side-effects post-treatment (urinary incontinence, erectile dysfunction, libido loss, bowel problems, breast changes, hot flushes, and fatigue, "ever" and "current" at time of questionnaire completion)...
October 10, 2016: European Journal of Cancer Care
Fred Saad, Mathieu Latour, Jean-Baptiste Lattouf, Hugues Widmer, Kevin C Zorn, Anne-Marie Mes-Masson, Veronique Ouellet, Genevieve Saad, Amol Prakash, Sibgat Choudhury, Gang Han, Pierre Karakiewicz, Jerome P Richie
PURPOSE: Current clinicopathologic parameters are insufficient to predict the likelihood of biochemical recurrence in patients with prostate cancer after radical prostatectomy. Such information may help to identify patients who would likely benefit from adjuvant radiotherapy rather than active surveillance. A multiplex proteomic assay, previously tested on biopsies and found to be predictive of favorable or unfavorable pathology at radical prostatectomy, was assessed for its predictive value to identify patients at higher risk of biochemical relapse...
October 7, 2016: Journal of Urology
Liz Edmund, Katherine L Rotker, Nelli S Lakis, Joseph M Brito, Marcos Lepe, Kara A Lombardo, Joseph F Renzulli, Andres Matoso
Prostate cancer management changed in recent times given the recommendation against PSA-screening, adherence to active surveillance, and "cytoreductive" surgery. We hypothesized that radical prostatectomy (RP) findings changed as well. All consecutive RPs (n=1348), and first time prostate needle biopsies (n=1719) in a period of 9 years were reviewed. The cohort was separated into 3 groups: 1) from 5/2006 to 4/2009; 2) from 5/2009 to 4/2012; 3) from 5/2012 to 4/2015.The number of RPs decreased 15% from 551 in group-1 to 476 in group-2 and decreased further 35% to 311 in group-3...
October 5, 2016: Human Pathology
Silvia Villa, Friederike Kendel, Lionne Venderbos, Tiziana Rancati, Chris Bangma, Peter Carroll, Louis Denis, Laurence Klotz, Ida J Korfage, Athene J Lane, Tiziana Magnani, Ken Mastris, Antti Rannikko, Monique Roobol, Bruce Trock, Roderick Van den Bergh, Hendrik Van Poppel, Riccardo Valdagni, Lara Bellardita
BACKGROUND: Literature on the health-related quality of life (HRQoL) for men with localized prostate cancer (PCa) on active surveillance (AS) shows a need for methodological guidance regarding HRQoL issues and how to address them. OBJECTIVE: The European School of Oncology Task Force (ESO TF) aimed to identify a core set of research questions and related measures to include in AS HRQoL studies. DESIGN, SETTING, AND PARTICIPANTS: A modified Delphi study was used to reach consensus on AS HRQoL research topics and tools between 2014 and 2015...
October 6, 2016: European Urology
Claudia Repetto, Tiziana Rancati, Tiziana Magnani, Maria Francesca Alvisi, Barbara Avuzzi, Fabio Badenchini, Cristina Marenghi, Silvia Stagni, Massimo Maffezzini, Sergio Villa, Silvia Villa, Roberto Salvioni, Riccardo Valdagni, Lara Bellardita
PURPOSE: To investigate the presence of regret in patients about having followed an active surveillance (AS) protocol. The secondary aim was to identify variables that influence regret. METHODS: From February 2006 to May 2014, 204 patients discontinued the AS protocols and were invited to enter the study. Sociodemographic variables were collected at AS enrollment, together with health-related quality of life (Functional Assessment of Cancer Therapy-Prostate version [FACT-P]) and coping (Mini-Mental Adjustment to Cancer)...
September 22, 2016: Tumori
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
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