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PSA post nadir

Yaw A Nyame, Ahmad Elshafei, Daniel Greene, Hans C Arora, Robert W Given, Kae Jack Tay, Thomas J Polascik, Ashley Ross, Vladimir Mouraviev, Franco Lugnani, J Stephen Jones
PURPOSE: To assess factors that affect prostate biopsy results following salvage whole gland cryoablation Patients and Methods: 174 patients underwent prostate biopsy following salvage whole gland cryoablation of the prostate in the Cryo OnLine Database registry. Wilcoxon rank-sum, χ2 tests, and logistic regression analysis were used to assess predictors of positive biopsy. PSA nadir was divided into a statistical tertile for comparisons between different nadir PSA cutpoints. RESULTS: 52/174 (29...
February 11, 2017: Journal of Endourology
Michael Kongnyuy, Michael J Lipsky, Shahidul Islam, Dennis J Robins, Shaun Hager, Daniel M Halpern, Kaitlin E Kosinski, Jeffrey T Schiff, Anthony T Corcoran, Sven Wenske, Aaron E Katz
BACKGROUND: The Phoenix definition (PD) and Stuttgart definition (SD) designed to determine biochemical recurrence (BCR) in patients with postradiotherapy and high-intensity focused ultrasound organ-confined prostate cancer are being applied to follow patients after cryosurgery. We sought to identify predictors of BCR using the PD and SD criteria in patients who underwent primary focal cryosurgery (PFC). MATERIALS AND METHODS: We performed a retrospective review of patients who underwent PFC (hemiablation) at 2 referral centers from 2000 to 2014...
April 11, 2017: Urologic Oncology
Mark D Hurwitz, Jonathan Harris, Oliver Sartor, Ying Xiao, Bobby Shayegan, Paul W Sperduto, Kasra R Badiozamani, Colleen A F Lawton, Eric M Horwitz, Jeff M Michalski, Kevin Roof, David C Beyer, Qiang Zhang, Howard M Sandler
BACKGROUND: Phase 3 trials have demonstrated a benefit from adjuvant radiation therapy (ART) for men who have adverse factors at radical prostatectomy (RP). However, some patients have a high risk of progression despite ART. The role of systemic therapy with ART in this high-risk group remains to be defined. METHODS: Patients who had either a post-RP prostate-specific antigen (PSA) nadir > 0.2 ng/mL and a Gleason score ≥7 or a PSA nadir ≤0.2 ng/mL, a Gleason score ≥8, and a pathologic tumor (pT) classification ≥ pT3 received 6 months of androgen-deprivation therapy (ADT) plus radiotherapy and 6 cycles of docetaxel...
March 21, 2017: Cancer
Joe Yeong, Rehena Sultana, Jonathan Teo, Hong Hong Huang, John Yuen, Puay Hoon Tan, Li Yan Khor
AIM: The International Society of Urological Pathology made recommendations for the use of Grade Groups (GG) originally described by Epstein and colleagues over Gleason score (GS) alone in 2014, which was subsequently adopted by the WHO classification in 2016. The majority of studies validating this revision have been in Caucasian populations. We therefore asked whether the new GG system was retrospectively associated with biochemical disease-free survival in a mixed-ethnicity cohort of Asian men...
March 13, 2017: Journal of Clinical Pathology
Sebastien Crouzet, Andreas Blana, Francois J Murat, Gilles Pasticier, Stephen C W Brown, Giario N Conti, Roman Ganzer, Olivier Chapet, Albert Gelet, Christian G Chaussy, Cary N Robertson, Stefan Thuroff, John F Ward
OBJECTIVE: To report the oncological outcome of salvage high-intensity focused ultrasound (S-HIFU) for locally recurrent prostate cancer after external beam radiotherapy (EBRT) from a multicentre database. PATIENTS AND METHODS: This retrospective study comprises patients from nine centres with local recurrent disease after EBRT treated with S-HIFU from 1995 to 2009. The biochemical failure-free survival (bFFS) rate was based on the 'Phoenix' definition (PSA nadir + 2 ng/mL)...
January 7, 2017: BJU International
George Hruby, Thomas Eade, Andrew Kneebone, Louise Emmett, Lesley Guo, Bao Ho, Ed Hsiao, Geoff Schembri, Julia Hunter, Carol Kwong
BACKGROUND AND PURPOSE: We investigated the role of (68)Ga-PSMA-PET (PSMA) to determine the location of disease recurrence in those with a rising PSA following definitive external beam radiation treatment (EBRT). MATERIALS AND METHODS: 538men were treated with image guided EBRT to a dose of 78 or 82Gy between 2007 and 2014. Patients at least 24months post EBRT with biochemical failure (nadir+2) underwent PSMA scanning. Local recurrence (LR) was defined as increased uptake within the prostate or seminal vesicles...
January 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Christopher R King
PURPOSE/OBJECTIVES: To date neither the optimal radiotherapy dose nor the existence of a dose-response has been established for salvage RT (SRT). MATERIALS/METHODS: A systematic review from 1996 to 2015 and meta-analysis was performed to identify the pathologic, clinical and treatment factors associated with relapse-free survival (RFS) after SRT (uniformly defined as a PSA>0.2ng/mL or rising above post-SRT nadir). A sigmoidal dose-response curve was objectively fitted and a non-parametric statistical test used to determine significance...
November 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Louise Dickinson, Hashim U Ahmed, Richard G Hindley, Neil McCartan, Alex Freeman, Clare Allen, Mark Emberton, Alex P Kirkham
INTRODUCTION: Focal therapy for localized prostate cancer has the potential for oncological control without the side effects of radical therapies. However, there is currently no validated method for monitoring treatment success. We assessed the diagnostic performance of prostate-specific antigen (PSA) parameters and MRI compared to histological outcomes following focal therapy. PATIENTS AND METHODS: Patients from 3 Ethics Review Board approved prospective studies of focal high intensity-focused ultrasound (HIFU) (Sonablate 500) for localized prostate cancer (T1c-T3a, Gleason grade≤4+3, and PSA≤20)...
January 2017: Urologic Oncology
T T Shah, M Peters, A Kanthabalan, N McCartan, Y Fatola, J van der Voort van Zyp, M van Vulpen, A Freeman, C M Moore, M Arya, M Emberton, H U Ahmed
BACKGROUND: Treatment options for radio-recurrent prostate cancer are either androgen-deprivation therapy or salvage prostatectomy. Whole-gland high-intensity focussed ultrasound (HIFU) might have a role in this setting. METHODS: An independent HIFU registry collated consecutive cases of HIFU. Between 2005 and 2012, we identified 50 men who underwent whole-gland HIFU following histological confirmation of localised disease following prior external beam radiotherapy (2005-2012)...
September 2016: Prostate Cancer and Prostatic Diseases
Khurram M Siddiqui, Michele Billia, Andrew Arifin, Fan Li, Philippe Violette, Joseph L Chin
PURPOSE: In this prospective registry we prospectively assessed the oncologic, functional and safety outcomes of salvage high intensity focused ultrasound for radiorecurrent prostate cancer. MATERIALS AND METHODS: A total of 81 men were prospectively recruited and evaluated at regular scheduled study visits to 6 months after high intensity focused ultrasound and thereafter as per standard of care. Transrectal ultrasound guided biopsy was performed at 6 months. The primary end point was absence or histological persistence of disease at 6-month biopsy...
January 2017: Journal of Urology
J Cordes, J Broschk, M Sommerauer, D Jocham, A S Merseburger, C Melchert, G Kovács
BACKGROUND: We prospectively examined the effect and the safety of intensity-modulated HDR brachytherapy (IMBT) with focal dose escalation. MATERIALS AND METHODS: A total of 139 patients undergoing primary therapy for prostate cancer and 11 patients with recurrence were included. Data analysis focused on the following factors: date of primary diagnosis, Gleason score, initial prostate-specific antigen (PSA) value, PSA nadir, volume of the prostate in the transrectal ultrasound, biopsy of the prostate gland, androgen deprivation, chemotherapy, uroflowmetry, pre- and postoperative post-void residual urine (PVR), number of the needles in the prostate lobes and analysis of follow-up data...
February 2017: Der Urologe. Ausg. A
Yu-Jen Wang, Chao-Yuan Huang, Wei-Hsien Hou, Chia-Chun Wang, Keng-Hsueh Lan, Hong-Jen Yu, Ming-Kuen Lai, Shihh-Ping Liu, Yeong-Shau Pu, Jason Chia-Hsien Cheng
We investigated the outcomes and the associated clinical-pathological factors in patients with prostate cancer (PCa) undergoing salvage intensity modulated radiation therapy (IMRT) for post-radical-prostatectomy (RP) biochemical failure. We report clinical outcomes of post-RP salvage IMRT, and describe chronic toxicity in these patients.Fifty patients with PCa underwent post-RP salvage IMRT. The median dose of IMRT was 70 Gy to the prostatic and seminal vesicle bed. Clinical-pathological and toxicity information were collected...
July 12, 2016: Oncotarget
Masahiko Nakayama, Hisanori Kobayashi, Tomihiro Takahara, Ryo Oyama, Keiichiro Imanaka, Kazutake Yoshizawa
BACKGROUND: Previous studies have demonstrated an association between prostate-specific antigen (PSA) kinetics and predictive value for treatment outcomes. Abiraterone acetate (AA) is a newly approved cytochrome-P450C17 inhibitor for treatment of metastatic castration-resistant prostate cancer (mCRPC), and few studies have evaluated PSA kinetics using AA so far. Results of a study evaluating PSA kinetics in the beginning of AA and enzalutamide responded chemotherapy-treated patients suggested different trends between the drugs...
June 8, 2016: BMC Urology
Hideyasu Tsumura, Takefumi Satoh, Hiromichi Ishiyama, Ken-Ichi Tabata, Shouko Komori, Akane Sekiguchi, Masaomi Ikeda, Shinji Kurosaka, Tetsuo Fujita, Masashi Kitano, Kazushige Hayakawa, Masatsugu Iwamura
PURPOSE: To evaluate the prognostic value of prostate-specific antigen nadir (nPSA) after high-dose-rate (HDR) brachytherapy in clinically non-metastatic high-risk prostate cancer patients. MATERIAL AND METHODS: Data from 216 patients with high-risk or locally advanced prostate cancer who underwent HDR brachytherapy and external beam radiation therapy with long-term androgen deprivation therapy (ADT) between 2003 and 2008 were analyzed. The median prostate-specific antigen (PSA) level at diagnosis was 24 ng/ml (range: 3-338 ng/ml)...
April 2016: Journal of Contemporary Brachytherapy
Dae Keun Kim, Kyo Chul Koo, Ali Abdel Raheem, Ki Hong Kim, Byung Ha Chung, Young Deuk Choi, Koon Ho Rha
PURPOSE/OBJECTIVES: To investigate pN1 prostate cancer (PCa) patients treated surgically without immediate adjuvant treatment. MATERIALS AND METHODS: We analyzed the database of 2316 patients at our institution who underwent robot-assisted radical prostatectomy (RARP)/radical prostatectomy (RP) between July 2005 and November 2012. 87 patients with pN1 PCa and received no neoadjuvant and immediate adjuvant therapy were included in the study. Included pN1 PCa patients were followed up for median of 60 months...
2016: PloS One
Craig Wilson, David Waterhouse, Stephen E Lane, Annette Haworth, John Stanley, Tom Shannon, David Joseph
INTRODUCTION: To report long-term prostate-specific antigen (PSA) and toxicity outcomes for patients with localised prostate cancer treated with Iodine-125 permanent implantation at a single Australian centre. METHODS: Between September 1994 and November 2007, 207 patients at Sir Charles Gairdner Hospital with localised prostate cancer were consecutively treated with Iodine-125 permanent interstitial implantation. Post-therapy assessment was performed three times a month and included clinical review and biochemical (PSA) evaluation...
August 2016: Journal of Medical Imaging and Radiation Oncology
Jeong Hoon Phak, Hun Jung Kim, Woo Chul Kim
BACKGROUND: Stereotactic body radiotherapy (SBRT) has emerged as an effective treatment for localized prostate cancer. The purpose of this study was to compare the prostate-specific antigen (PSA) kinetics between conventionally fractionated external beam radiotherapy (CF-EBRT) and SBRT boost after whole pelvis EBRT (WP-EBRT) in localized prostate cancer. METHODS: A total of 77 patients with localized prostate cancer [T-stage, T1-T3; Gleason score (GS) 5-9; PSA < 20 ng/mL] were enrolled...
March 2016: Prostate International
T M Morgan, S R Hawken, K R Ghani, D C Miller, F Y Feng, S M Linsell, J A Salisz, Y Gao, J E Montie, M L Cher
BACKGROUND: We used data from the Michigan Urological Surgery Improvement Collaborative (MUSIC) to investigate the use of adjuvant and salvage radiotherapy (ART, SRT) among patients with high-risk pathology following radical prostatectomy (RP). METHODS: For patients with pT3a disease or higher and/or positive surgical margins, we examined post-RP radiotherapy administration across MUSIC practices. We excluded patients with <6 months follow-up, and those that failed to achieve a postoperative PSA nadir ⩽0...
June 2016: Prostate Cancer and Prostatic Diseases
Evan Kovac, Ahmed ElShafei, Kae Jack Tay, Melissa Mendez, Thomas J Polascik, J Stephen Jones
BACKGROUND AND OBJECTIVES: Salvage prostate cryoablation is an effective treatment for patients with localized prostate cancer relapse following primary radiotherapy. The postsalvage prostate-specific antigen (PSA) nadir that best predicts long-term biochemical progression-free survival (bPFS) is not yet defined. We sought to determine what nadir PSA best predicted success following salvage whole-gland cryoablation. PATIENTS AND METHODS: We retrospectively reviewed a cohort of 486 hormone-naive patients who underwent salvage whole-gland cryoablation from the Cryo On-Line Database (COLD)...
June 2016: Journal of Endourology
Charles Van Praet, Sylvie Rottey, Fransien Van Hende, Gino Pelgrims, Wim Demey, Filip Van Aelst, Wim Wynendaele, Thierry Gil, Peter Schatteman, Bertrand Filleul, Dennis Schallier, Jean-Pascal Machiels, Dirk Schrijvers, Els Everaert, Lionel D'Hondt, Patrick Werbrouck, Joanna Vermeij, Jeroen Mebis, Marylene Clausse, Marika Rasschaert, Joanna Van Erps, Jolanda Verheezen, Jan Van Haverbeke, Jean-Charles Goeminne, Nicolaas Lumen
BACKGROUND: Abiraterone acetate (AA) is licensed for treating metastatic castration-resistant prostate cancer (mCRPC). Real-world data on oncological outcome after AA are scarce. The current study assesses efficacy and safety of AA in mCRPC patients previously treated with docetaxel who started treatment during the Belgian compassionate use program (January 2011-July 2012). PATIENTS AND METHODS: Records from 368 patients with mCRPC from 23 different Belgian hospitals who started AA 1000mg per day with 10mg prednisone or equivalent were retrospectively reviewed (September 2013-December 2014)...
June 2016: Urologic Oncology
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