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high risk prostate cancer

Matthew R Sydes, Melissa R Spears, Malcolm D Mason, Noel W Clarke, David P Dearnaley, Johann S de Bono, Gert Attard, Simon Chowdhury, Bill Cross, Silke Gillessen, Zaf Malik, Rob Jones, Chris Parker, Alastair W S Ritchie, J Martin Russell, Robin Millman, David Matheson, Claire Amos, Clare Gilson, Alison Birtle, Susannah Brock, Lisa Capaldi, Prabir Chakraborti, Ananya Choudhury, Linda Evans, Daniel Ford, Joanna Gale, Stephanie Gibbs, Duncan Gilbert, Robert Hughes, Duncan McLaren, Jason Lester, Ashok Nikapota, Joe O'Sullivan, Omi Parikh, Clive Peedell, Andrew Protheroe, Sarah M Rudman, Richard Shaffer, Denise Sheehan, Matthew Simms, Narayanan Srihari, Räto Strebel, Santhanam Sundar, Shaun Tolan, David Tsang, Mohini Varughese, John Wagstaff, Mahesh K B Parmar, Nicholas D James
Background: Adding abiraterone acetate with prednisolone (AAP) or docetaxel with prednisolone (DocP) to standard-of-care (SOC) each improved survival in STAMPEDE: a multi-arm multi-stage platform randomised controlled protocol recruiting patients with high-risk locally advanced or metastatic PCa starting long-term androgen deprivation therapy (ADT). The protocol provides the only direct, randomised comparative data of SOC+AAP vs SOC+DocP. Method: Recruitment to SOC+DocP and SOC+AAP overlapped Nov-2011─Mar-2013...
February 26, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Veronica L Cox, Anas A Saeed Bamashmos, Wai Chin Foo, Shiva Gupta, Sireesha Yedururi, Naveen Garg, Hyunseon Christine Kang
Lynch syndrome is the most common hereditary cancer syndrome, the most common cause of heritable colorectal cancer, and the only known heritable cause of endometrial cancer. Other cancers associated with Lynch syndrome include cancers of the ovary, stomach, urothelial tract, and small bowel, and less frequently, cancers of the brain, biliary tract, pancreas, and prostate. The oncogenic tendency of Lynch syndrome stems from a set of genomic alterations of mismatch repair proteins. Defunct mismatch repair proteins cause unusually high instability of regions of the genome called microsatellites...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Alice F Yan, Yang Wang, Alexander V Ng
Multiple chronic conditions in cancer survivors are highly prevalent and may increase health care costs for both patients and the health care system. Studies of cancer survivors reveal positive effects of physical activity (PA) on reducing risk of cancer recurrence, other chronic conditions, and secondary cancer. Few nationally representative studies have examined how physical activity levels have affected survivors' annual economic burden in the United States. Leisure-time physical activity data from the National Health Interview Survey was linked to health care expenditure data from the Medical Expenditure Panel Survey data (2008-2012)...
March 2018: Preventive Medicine Reports
Juan Gómez Rivas, Francesco Giganti, Mario Álvarez-Maestro, María Jose Freire, Veeru Kasivisvanathan, Luis Martinez-Piñero, Mark Emberton
CONTEXT: The indeterminate multiparametric prostate magnetic resonance image (mpMRI) lesion is one which cannot be classified as "positive" or "negative" for suspected cancer. Currently, there is no consensus on how to manage patients with indeterminate mpMRIs where areas cannot be classified as positives or negatives (Prostate Imaging Reporting and Data System [PI-RADS] 3 or Likert 3). OBJECTIVE: To define the concept of indeterminate lesion and describe the management strategies that may be adopted for these patients...
March 7, 2018: European Urology Focus
Daniele A Pizzuto, Julian Müller, Urs Mühlematter, Niels J Rupp, Antonia Töpfer, Ashkan Mortezavi, Hannes Nagel, Benedikt Kranzbühler, Daniel Eberli, Irene A Burger
PURPOSE: Given the good correlation between PSMA expression and intraglandular tumour aggressiveness based on immunohistochemistry, there is increasing interest in68 Ga-PSMA-11 PET/MRI for staging prostate cancer (PCA). Therefore, accurate knowledge of prostate anatomy as well as normal distribution of PSMA within the prostate gland is becoming essential. The aim of this study was to investigate the physiological intraprostatic distribution of68 Ga-PSMA-11. METHODS: We retrospectively analysed all patients who underwent a staging68 Ga-PSMA-11 PET/MRI scan between June 2016 and January 2018 for high-risk PCA, underwent radical prostatectomy in our institution, and gave written consent for further data analysis...
March 9, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Sara Bravaccini, Maurizio Puccetti, Martine Bocchini, Sara Ravaioli, Monica Celli, Emanuela Scarpi, Ugo De Giorgi, Maria Maddalena Tumedei, Giandomenico Raulli, Loredana Cardinale, Giovanni Paganelli
Prostate cancer (PCa) patients are risk-stratified on the basis of clinical stage and PSA level at diagnosis and the Gleason Score (GS) in prostate biopsy. However, these parameters are not completely accurate in discriminating between high- and low-risk disease, creating a need for a reliable marker to determine aggressiveness. Prostate-specific membrane antigen (PSMA) appears to fulfill this need. We analyzed 79 prostate biopsies and 28 prostatectomies to assess whether PSMA expression detected by immunohistochemistry is related to GS...
March 9, 2018: Scientific Reports
Valerie Gausman, Pujan Kandel, Priscilla A Van Riet, Maria Moris, Maia Kayal, Catherine Do, John M Poneros, Amrita Sethi, Frank G Gress, Beth A Schrope, Lyndon Luk, Elizabeth Hecht, Manol Jovani, Marco J Bruno, Djuna L Cahen, Michael B Wallace, Tamas A Gonda
OBJECTIVES: Our aim was to identify baseline characteristics associated with disease progression and malignant transformation in low-risk suspected intraductal papillary mucinous neoplasms (IPMNs). METHODS: This is a retrospective cohort study of prospectively maintained databases of pancreatic cysts at 3 international, academic institutions. Five hundred fifty-nine adult patients with clinically suspected asymptomatic IPMN evaluated by radiologic studies or endoscopic ultrasound between 2003 and 2013 without worrisome features and under surveillance for 12 months or longer were included...
April 2018: Pancreas
Juan Guillermo Cataño, Carlos Gustavo Trujillo, Juan Ignacio Caicedo, Alejandra Bravo-Balado, Daniela Robledo, Angela Marcela Mariño-Alvarez, Adriana Pedraza, María Juliana Arcila, Mauricio Plata
OBJECTIVE: To evaluate the efficacy of lycopene intake in primary prevention of prostate cancer (PCa). METHODS: A systematic search of the literature was conducted in March 2015 and the articles published between the years 1990-2015 were reviewed. The following search terms were used: prostate cancer, prostatic neoplasm, lycopene, prevention, effectiveness and efficacy (MeSH). Publications including research in humans, written in English and whose texts were accessible were reviewed...
March 2018: Archivos Españoles de Urología
Jonathan Hayman, Ryan Phillips, Di Chen, Jamie Perin, Amol K Narang, Janson Trieu, Noura Radwan, Stephen Greco, Curtiland Deville, Todd McNutt, Daniel Y Song, Theodore L DeWeese, Phuoc T Tran
BACKGROUND: Undetectable End of Radiation PSA (EOR-PSA) has been shown to predict improved survival in prostate cancer (PCa). While validating the unfavorable intermediate-risk (UIR) and favorable intermediate-risk (FIR) stratifications among Johns Hopkins PCa patients treated with radiotherapy, we examined whether EOR-PSA could further risk stratify UIR men for survival. METHODS: A total of 302 IR patients were identified in the Johns Hopkins PCa database (178 UIR, 124 FIR)...
March 9, 2018: Prostate
Catrin von Below, Cecilia Wassberg, Rafael Grzegorek, Joel Kullberg, Charlotta Gestblom, Jens Sörensen, Mauritz Waldén, Håkan Ahlström
Background: The aim of the study was to examine the value of quantitative and qualitative MRI and11 C acetate PET/CT parameters in predicting regional lymph node (LN) metastasis of newly diagnosed prostate cancer (PCa). Patients and methods: Patients with intermediate (n = 6) and high risk (n = 47) PCa underwent 3T MRI (40 patients) and11 C acetate PET/CT (53 patients) before extended pelvic LN dissection. For each patient the visually most suspicious LN was assessed for mean apparent diffusion coefficient (ADCmean), maximal standardized uptake value (SUVmax), size and shape and the primary tumour for T stage on MRI and ADCmean and SUVmax in the index lesion...
March 2018: Radiology and Oncology
Alessandro Magli, Eugenia Moretti, Annarita Tullio, Gianluca Giannarini, Fabrizio Tonetto, Mauro Urpis, Margherita Crespi, Claudio Foti, Agnese Prisco, Margherita Polsinelli, Gioacchino De Giorgi, Giulia Bravo, Paolo Scalchi, Marco Trovò
OBJECTIVE: The approach for treating high-risk prostate cancer still presents different unresolved issues. We report the safety and efficacy of a radiation therapy strategy based on the combination of moderate hypofractioned simultaneous integrated boost (SIB) and Image Guidance. MATERIALS AND METHODS: In this phase II trial of patients with high-risk prostate cancer, Image Guided SIB-IMRT plans (Simultaneous Intensity Modulated - Intensity Modulated Radiotherapy) were delivered between 2009 and 2012...
March 8, 2018: Prostate Cancer and Prostatic Diseases
Sunil W Dutta, Kristine Bauer-Nilsen, Jason C Sanders, Daniel M Trifiletti, Bruce Libby, Donna H Lash, Melody Lain, Deborah Christodoulou, Constance Hodge, Timothy N Showalter
PURPOSE: To evaluate the delivery cost of frequently used radiotherapy options offered to patients with intermediate- to high-risk prostate cancer using time-driven activity-based costing and compare the results with Medicare reimbursement and relative value units (RVUs). METHODS AND MATERIALS: Process maps were created to represent each step of prostate radiotherapy treatment at our institution. Salary data, equipment purchase costs, and consumable costs were factored into the cost analysis...
March 5, 2018: Brachytherapy
Stéphane Supiot, Caroline Rousseau, Mélanie Dore, Catherine Cheze-Le-Rest, Christine Kandel-Aznar, Vincent Potiron, Stéphane Guerif, François Paris, Ludovic Ferrer, Loïc Campion, Philippe Meingan, Gregory Delpon, Mathieu Hatt, Dimitris Visvikis
Purpose: Hypoxia is a major factor in prostate cancer aggressiveness and radioresistance. Predicting which patients might be bad candidates for radiotherapy may help better personalize treatment decisions in intermediate-risk prostate cancer patients. We assessed spatial distribution of18 F-Misonidazole (FMISO) PET/CT uptake in the prostate prior to radiotherapy treatment. Materials and Methods: Intermediate-risk prostate cancer patients about to receive high-dose (>74 Gy) radiotherapy to the prostate without hormonal treatment were prospectively recruited between 9/2012 and 10/2014...
February 9, 2018: Oncotarget
Liang Cao, Sha Zhang, Cheng-Ming Jia, Wei He, Lei-Tao Wu, Ying-Qi Li, Wen Wang, Zhe Li, Jing Ma
BACKGROUND: Due to the lack of strong evidence to identify the relationship between antihypertensive drugs use and the risk of prostate cancer, it was needed to do a systematic review to go into the subject. METHODS: We systematically searched PubMed, Web of Science and Embase to identify studies published, through May 2015. Two evaluators independently reviewed and selected articles involving the subject. We used the Newcastle-Ottawa Scale (NOS) to assess the quality of the studies...
March 7, 2018: BMC Urology
Hatem Abou-Ouf, Mohammed Alshalalfa, Mandeep Takhar, Nicholas Erho, Bryan Donnelly, Elai Davicioni, R Jeffrey Karnes, Tarek A Bismar
PURPOSE: To validate a previously characterized 10-gene signature in prostate cancer with implication to distinguish aggressive and indolent disease within low and intermediate patients' risk groups. METHODS: A case-control study design used to select 545 patients from the Mayo clinic tumor registry who underwent radical prostatectomy. A training set from this cohort (n = 359) was used to build a 10-gene model, based on high-dimensional discriminant analysis (HDDA10) to predict several endpoints of clinical patients' outcome...
March 6, 2018: Journal of Cancer Research and Clinical Oncology
Yohann Foucher, Marine Lorent, Philippe Tessier, Stéphane Supiot, Véronique Sébille, Etienne Dantan
BACKGROUND: Patients with prostate cancer (PC) may be ready to make trade-offs between their quantity and their quality of life. For instance, elderly patients may prefer the absence of treatment if it is associated with a low-risk of disease progression, compared to treatments aiming at preventing disease progression but with a substantial deterioration of their Health-Related Quality of Life (HRQoL). Therefore, it seems relevant to compare the treatments by considering both survival and HRQoL...
March 5, 2018: Health and Quality of Life Outcomes
Mohammed Shahait, Samer Nassif, Hani Tamim, Deborah Mukherji, Maya Hijazi, Marwan El Sabban, Raja Khauli, Muhammad Bulbul, Wassim Abou Kheir, Albert El Hajj
BACKGROUND: Positive surgical margin (PSM) is a predictor of biochemical recurrence (BCR) following radical prostatectomy (RP). Attempts to stratify PSM based on linear length, Gleason score, location and number have failed to add to predictive models using margin status alone. We evaluated the prognostic significance of Ki-67 expression in this setting. METHODS: Immunohistochemical staining for Ki-67 was done on prostatectomy specimens from 117 patients who had a PSM...
March 5, 2018: BMC Urology
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
Nina-Sophie Schmidt-Hegemann, Wolfgang Peter Fendler, Harun Ilhan, Annika Herlemann, Alexander Buchner, Christian Stief, Chukwuka Eze, Paul Rogowski, Minglun Li, Peter Bartenstein, Ute Ganswindt, Claus Belka
BACKGROUND: PSMA PET/CT visualises prostate cancer residual disease or recurrence at lower PSA levels compared to conventional imaging and results in a change of treatment in a remarkable high number of patients. Radiotherapy with dose escalation to the former prostate bed has been associated with improved biochemical recurrence-free survival. Thus, it can be hypothesised that PSMA PET/CT-based radiotherapy might improve the prognosis of these patients. METHODS: One hundred twenty-nine patients underwent PSMA PET/CT due to biochemical persistence (52%) or recurrence (48%) after radical prostatectomy without evidence of distant metastases (February 2014-May 2017) and received PSMA PET/CT-based radiotherapy...
March 2, 2018: Radiation Oncology
Jonas Schiffmann, Pierre I Karakiewicz, Michael Rink, L Manka, Georg Salomon, Derya Tilki, Lars Budäus, Raisa Pompe, Sami-Ramzi Leyh-Bannurah, Alexander Haese, P Hammerer, Hartwig Huland, Markus Graefen, Pierre Tennstedt
INTRODUCTION: Obesity might negatively affect prostate cancer (PCa) outcomes. However, evidence according to the associations between obesity and metastases-free survival after radical prostatectomy (RP) is still inconsistent. METHODS: We relied on PCa patients treated with RP at the Martini-Klinik Prostate Cancer Center between 2004 and 2015. First, multivariable Cox regression analyses examined the impact of obesity on metastases after RP. Last, in a propensity score matched cohort, Kaplan-Meier analyses assessed metastases-free survival according to body mass index (kg/m2 ) (BMI) strata (≥ 30 vs...
March 2, 2018: World Journal of Urology
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