1958 PRE-TREATMENT PSA LEVEL AND GLEASON SCORE ARE NOT ASSOCIATED WITH CANCER-SPECIFIC ANXIETY PRIOR TO SURGICAL TREATMENT FOR NEWLY DIAGNOSED PROSTATE CANCER

2010 ◽  
Vol 183 (4S) ◽  
Author(s):  
Alexander Parker ◽  
Andrea Tavlarides ◽  
Rebecca McNeil ◽  
Krisitin Green ◽  
Steven Ames ◽  
...  
2012 ◽  
Vol 6 (2) ◽  
Author(s):  
George Rodrigues ◽  
Padraig Warde ◽  
Tom Pickles ◽  
Juanita Crook ◽  
Michael Brundage ◽  
...  

Introduction:  The use of accepted prostate cancer risk stratification groups based on prostate-specific antigen, T stage and Gleason score assists in therapeutic treatment decision-making, clinical trial design and outcome reporting. The utility of integrating novel prognostic factors into an updated risk stratification schema is an area of current debate. The purpose of this work is to critically review the available literature on novel pre-treatment prognostic factors and alternative prostate cancer risk stratification schema to assess the feasibility and need for changes to existing risk stratification systems. Methods:  A systematic literature search was conducted to identify original research publications and review articles on prognostic factors and risk stratification in prostate cancer. Search terms included risk stratification, risk assessment, prostate cancer or neoplasms, and prognostic factors. Abstracted information was assessed to draw conclusions regarding the potential utility of changes to existing risk stratification schema. Results:  The critical review identified three specific clinically relevant potential changes to the most commonly used three-group risk stratification system: (1) the creation of a very-low risk category; (2) the splitting of intermediate-risk into a low- and highintermediate risk groups; and (3) the clarification of the interface between intermediate- and high-risk disease. Novel pathological factors regarding high-grade cancer, subtypes of Gleason score 7 and percentage biopsy cores positive were also identified as potentially important risk-stratification factors. Conclusions:  Multiple studies of prognostic factors have been performed to create currently utilized prostate cancer risk stratification systems. We propose potential changes to existing systems.


2019 ◽  
Vol 14 (11) ◽  
Author(s):  
Erdogan Aglamis ◽  
Cavit Ceylan ◽  
Mustafa Akin

Introduction: We evaluated the correlation between the International Society of Urological Pathology (ISUP) grades and the aggressiveness grades of prostate inflammation in newly diagnosed prostate cancer patients with chronic asymptomatic prostatitis National Institiutes of Health (NIH) category IV (CAPNIHIV). Methods: The study comprised 357 consecutive patients with prostate cancer in whom a cancer diagnosis had been made via a prostate needle biopsy. Histological sections of the prostate biopsy specimens of the patients were reviewed and scored. Prostatic inflammation was scored using the aggressiveness grade of inflammation. The associations between the ISUP grades and the aggressiveness grades of inflammation were analyzed using logistic regression. The limitations of the study were its retrospective design and the limited number of cases. Results: In 110 (31%) patients, CAPNIHIV was detected: 56 (51%) patients had a grade 0 aggressiveness score, 34 (31%) patients had a grade 1 aggressiveness score, and 20 (18%) patients had a grade 2 aggressiveness score. The patients who had prostatic inflammation had a 1.65 times (95% confidence interval [CI] 1.05–2.61) greater likelihood of a high ISUP grade (grade ≥3) compared with the patients who did not have prostatic inflammation. The association between the ISUP grade and the aggressiveness grade of inflammation was more pronounced for a grade 2 aggressiveness score (n= 20; odds ratio 2.97; 95% CI 1.14–7.71). Conclusions: In prostate cancer patients with CAPNIHIV, there was a positive correlation between the inflammation aggressiveness grade and the ISUP grade. The aggressiveness of intraprostatic inflammation may be an important morphological factor affecting the Gleason score.


2021 ◽  
Vol 15 (9) ◽  
Author(s):  
Asher Khan ◽  
R. Trafford Crump ◽  
Kevin V. Carlson ◽  
Richard J. Baverstock

Introduction: The relationship between prostate cancer (PCa) and overactive bladder (OAB) is poorly understood. PCa and OAB are frequently diagnosed in elderly populations, so it could be expected that both conditions would be observed in older patients. Whether PCa and OAB occur independently with age, or the presence of PCa leads to the onset of OAB/lower urinary tract symptoms (LUTS) has not been explored. This review aimed to investigate whether men newly diagnosed with prostate cancer (PCa) are more likely to have overactive bladder (OAB) compared to the general population, and if the various treatment modalities for PCa are likely to impact the incidence or exacerbation of OAB. Methods: The University of Calgary’s databases for Medline and PubMed were searched for relevant publications. No restrictions were placed on the study design reported. Any publications reporting OAB and a PCa diagnosis and/or observation relating to PCa diagnosis and rates of OAB/LUTS in an adult population were included for full review. Results: Of the studies examining the relationship between PCa and LUTS, results varied, but frequently indicated an inverse association between PCa and LUTS in which patients newly diagnosed with prostate cancer were more unlikely to have LUTS compared to the general population. Following treatment, brachytherapy resulted in a higher prevalence of OAB symptoms compared to surgical treatment and external beam radiation therapy. Conclusions: Diverse evidence was found regarding the relationship between the prevalence of pre-treatment OAB and PCa diagnosis. However, limited evidence, as well as uncertainty regarding pre-treatment symptoms and their impact on post-treatment outcomes, restricts potential conclusions.


2009 ◽  
Vol 9 ◽  
pp. 1040-1045 ◽  
Author(s):  
Chad W. M. Ritenour ◽  
John T. Abbott ◽  
Michael Goodman ◽  
Naomi Alazraki ◽  
Fray F. Marshall ◽  
...  

Utilization of nuclear bone scans for staging newly diagnosed prostate cancer has decreased dramatically due to PSA-driven stage migration. The current criteria for performing bone scans are based on limited historical data. This study evaluates serum PSA and Gleason grade in predicting positive scans in a contemporary large series of newly diagnosed prostate cancer patients. Eight hundred consecutive cases of newly diagnosed prostate cancer over a 64-month period underwent a staging nuclear scan. All subjects had histologically confirmed cancer. The relationship between PSA, Gleason grade, and bone scan was examined by calculating series of crude, stratified, and adjusted odds ratios with corresponding 95% confidence intervals. Four percent (32/800) of all bone scans were positive. This proportion was significantly lower in patients with Gleason score ≤7 (1.9%) vs. Gleason score ≥8 (18.8%,p< 0.001). Among patients with Gleason score ≤7, the rate of positive bones scans was 70-fold higher when the PSA was >30 ng/ml compared to ≤30 ng/ml (p< 0.001). For Gleason score ≥8, the rate was significantly higher (27.9 vs. 0%) when PSA was >10 ng/ml compared to ≤10 ng/ml (p= 0.002). The combination of Gleason score and PSA enhances predictability of bone scans in newly diagnosed prostate cancer patients. The PSA threshold for ordering bone scans should be adjusted according to Gleason score. For patients with Gleason scores ≤7, we recommend a bone scan if the PSA is >30 ng/ml. However, for patients with a high Gleason score (8–10), we recommend a bone scan if the PSA is >10 ng/ml.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. TPS5097-TPS5097 ◽  
Author(s):  
Karim Fizazi ◽  
Julie S. Larsen ◽  
Shannon Matheny ◽  
Arturo Molina ◽  
Jinhui Li ◽  
...  

TPS5097 Background: Patients (pts) who initially present with metastatic prostate cancer (MPC) (up to 30% of men in Europe; 4% in US) typically progress to metastatic castration-resistant prostate cancer (mCRPC) with a poor prognosis. Prognostic factors impacting survival include high PSA concentration, high Gleason score, high volume of metastatic disease, and bone symptoms. AA decreases testosterone via CYP17 inhibition and is approved for treatment of mCRPC before and after docetaxel-based chemotherapy. Two recent reports (J Clin Oncol. 2012: 30 [suppl. abstr 4521 and 4556]) showed that AA + P in addition to ADT (LHRH agonist) in the neoadjuvant setting led to higher rates of undetectable PSA and complete pathologic response (cPR) or near-cPR in pts undergoing prostatectomy for high risk-localized prostate cancer than with ADT alone, suggesting a potential role for inhibiting extragonadal androgen synthesis prior to emergence of castration-resistance. Because of its benefit in mCRPC, as well as early activity in high risk-localized prostate cancer, AA is being evaluated in high risk mHNPC. Methods: Approximately 1,270 men with newly diagnosed (within 3 months of randomization) high risk mHNPC with at least 2 of 3 high risk factors (≥ 3 bone lesions, presence of visceral metastases or Gleason score ≥ 8) are being randomized to AA 1000 mg + P 5 mg daily + ADT or ADT alone. Pts are stratified by presence of visceral disease and ECOG PS (0-1 vs 2). Distant metastatic disease must be documented by positive bone scan or CT/MRI. ADT or orchiectomy within 3 mos of randomization is allowed. Continued use of anti-androgens after randomization is not allowed on study. The primary endpoint is overall survival. Secondary endpoints include radiographic PFS, time to next skeletal-related event, PSA progression, and subsequent therapy. Two interim analyses and a final analysis are planned. 300 sites from 36 countries will participate. As of February 4, 2013, one patient has entered screening. Clinical trial information: NCT01715285.


2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 145-145 ◽  
Author(s):  
Jasmir G. Nayak ◽  
Nicholas Scalzo ◽  
Alice Chu ◽  
Geolani Dy ◽  
Liam Connor Macleod ◽  
...  

145 Background: The prostate biopsy pathology report is a critical decision-making document for men newly-diagnosed with prostate cancer, yet the content may be beyond the health literacy of most patients. We compare the effectiveness of a patient-centered prostate biopsy report developed through patient-centered outcomes research methods with standard synoptic reports. Methods: Using a modified Delphi approach, a multidisciplinary group of prostate cancer experts provided consensus for the critical components of a prostate biopsy report for treatment decision-making. Patient focus groups provided input for syntax and formatting to inform the design of a patient-centered pathology report. 94 patients with recent prostate biopsies were block randomized to receive the standard report with or without the patient-centered report. We evaluated patient self-efficacy, provider communication and empathy, and prostate cancer knowledge at pathology disclosure. We compared study groups with descriptive statistics. Results: Experts selected primary and secondary Gleason score and number of positive cores as the important elements of a prostate biopsy report. Patients prioritized a narrative word structure, clear language, a tabular format for histologic grade, and information on risk classification. Initial assessments were completed by 84% (79/94) of participants including 40/46 in the standard report group and 39/48 in the patient-centered report group. Patients who received the patient-centered report had significantly improved ability to recall their Gleason score (100% vs. 85%, p = 0.03) and number of positive cores (90% vs. 65%, p = 0.01). Provider communication and patient self-efficacy were uniformly high and did not differ between groups. 88% of patients who received the patient-centered report felt that it helped them better understand their pathology results. Conclusions: A patient-centered prostate biopsy pathology report is associated with significantly higher knowledge about a new prostate cancer diagnosis. These health information documents may help facilitate shared decision-making among patients newly diagnosed with prostate cancer.


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