scholarly journals Male Pattern Baldness in Relation to Prostate Cancer–Specific Mortality: A Prospective Analysis in the NHANES I Epidemiologic Follow-up Study

2016 ◽  
Vol 183 (3) ◽  
pp. 210-217 ◽  
Author(s):  
Cindy Ke Zhou ◽  
Paul H. Levine ◽  
Sean D. Cleary ◽  
Heather J. Hoffman ◽  
Barry I. Graubard ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prospective Analysis ◽  
Male Pattern Baldness ◽  
Follow Up Study ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Nhanes I ◽  
Male Pattern

scholarly journals Prospective Study of Prostate Tumor Angiogenesis and Cancer-Specific Mortality in the Health Professionals Follow-Up Study

2009 ◽  
Vol 27 (33) ◽  
pp. 5627-5633 ◽  
Author(s):  
Lorelei A. Mucci ◽  
Anna Powolny ◽  
Edward Giovannucci ◽  
Zhiming Liao ◽  
Stacey A. Kenfield ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Microvessel Density ◽  
Health Professionals ◽  
Prostate Cancer Mortality ◽  
Follow Up Study ◽  
Vessel Lumen ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
And Function

Purpose Tumor growth requires the development of independent vascular networks that are often primitive in morphology and function. We examined whether microvessel morphology contributes to the considerable biologic heterogeneity of prostate cancer. Methods We evaluated microvessel morphology as a predictor of prostate cancer mortality among 572 men in the Health Professionals Follow-Up Study diagnosed with cancer during 1986 to 2000. We immunostained prostatectomy tumor block sections for endothelial marker CD34 and assessed microvessel density, vessel size (area and diameter), and irregularity of vessel lumen using image analysis. Proportional hazards models were used to assess microvessel density and morphology in relation to lethal prostate cancer. Results Poorly differentiated tumors exhibited greater microvessel density, greater irregularity of the vessel lumen, and smaller vessels. During 20 years of follow-up, 44 men developed bone metastases or died of cancer. Men with tumors exhibiting the smallest vessel diameter, based on quartiles, were 6.0 times more likely (95% CI, 1.8 to 20.0) to develop lethal prostate cancer. Men with the most irregularly shaped vessels were 17.1 times more likely (95% CI, 2.3 to 128) to develop lethal disease. Adjusting for Gleason grade and prostate-specific antigen levels did not qualitatively change the results. Microvessel density was not linked to cancer-specific mortality after adjusting for clinical factors. Conclusion Aggressive tumors form vessels that are primitive in morphology and function, with consequences for metastases. Vascular size and irregularity reflect the angiogenic potential of prostate cancer and may serve as biomarkers to predict prostate cancer mortality several years after diagnosis.

The association of very low PSA with increased cancer-specific death in men with high-grade prostate cancer.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 62-62
Author(s):  
Brandon Arvin Virgil Mahal ◽  
Ayal Aaron Aizer ◽  
Jason Alexander Efstathiou ◽  
Paul Linh Nguyen
Keyword(s):  
Prostate Cancer ◽  
Reference Group ◽  
High Grade ◽  
Specific Mortality ◽  
National Cohort ◽  
Poorly Differentiated ◽  
Cancer Specific Mortality ◽  
Prostate Cancers ◽  
Very High

62 Background: It has been hypothesized that very low PSAs in men with high-grade prostate cancer could reflect dedifferentiation and a poorer prognosis, but clinical evidence to support this is limited. We sought to determine whether a very low-presenting PSA was associated with greater prostate cancer-specific mortality (PCSM) among men with Gleason score (GS) 8-10 disease. Methods: The Surveillance, Epidemiology and End Results Program was used to identify a national cohort of 328,904 men diagnosed with cT1-4N0M0 prostate cancer between 2004 and 2010. Multivariable Fine-Gray competing-risks regression analysis was used to determine PCSM as a function of PSA level (<2.5 ng/mL, 2.6-4 ng/mL, 4.1-10 ng/mL, 10.1-20 ng/mL, 20.1-40 ng/mL, or >40ng/mL) and GS (8-10 vs. <=7). Results: Median follow-up was 38 months. Among men with GS 8-10 disease, using PSA 4.1-10 as the reference group, the Adjusted HR (AHR) for PCSM for men with PSA level <2.5 was 1.86 (95% CI 1.51-2.29; P<0.001), PSA 2.6-4 was1.44 (1.17-1.78; P<0.001), PSA 10.1-20 was 1.58 (1.39-1.78; P<0.001), PSA 20.1-40 was 2.04 (1.78-2.33; P<0.001), and PSA>40 was 3.19 (2.83-3.59; P<0.001), suggesting a U-shaped distribution. There was a significant interaction between PSA level and GS (Pinteraction<0.001) such that PSA <2.5 only significantly predicted for poorer PCSM among patients with high grade GS 8-10 disease. Conclusions: Among patients with high grade GS 8-10 disease, patients with PSA <2.5 and 2.6-4 appear to have a higher risk for cancer-specific death compared to patients with a 10.1-20 PSA level, supporting the notion that low PSA in GS 8-10 disease may be a sign of underlying aggressive and extremely poorly differentiated or anaplastic low PSA-producing tumors. Patients with low PSA GS 8-10 disease should be considered for clinical trials studying the use of chemotherapy and other novel agents in very-high risk prostate cancers.

scholarly journals Predicting prostate cancer specific-mortality with artificial intelligence-based Gleason grading

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Ellery Wulczyn ◽  
Kunal Nagpal ◽  
Matthew Symonds ◽  
Melissa Moran ◽  
Markus Plass ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Artificial Intelligence ◽  
Risk Groups ◽  
Risk Scores ◽  
Pathology Report ◽  
Gleason Grading ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Open Question

Abstract Background Gleason grading of prostate cancer is an important prognostic factor, but suffers from poor reproducibility, particularly among non-subspecialist pathologists. Although artificial intelligence (A.I.) tools have demonstrated Gleason grading on-par with expert pathologists, it remains an open question whether and to what extent A.I. grading translates to better prognostication. Methods In this study, we developed a system to predict prostate cancer-specific mortality via A.I.-based Gleason grading and subsequently evaluated its ability to risk-stratify patients on an independent retrospective cohort of 2807 prostatectomy cases from a single European center with 5–25 years of follow-up (median: 13, interquartile range 9–17). Results Here, we show that the A.I.’s risk scores produced a C-index of 0.84 (95% CI 0.80–0.87) for prostate cancer-specific mortality. Upon discretizing these risk scores into risk groups analogous to pathologist Grade Groups (GG), the A.I. has a C-index of 0.82 (95% CI 0.78–0.85). On the subset of cases with a GG provided in the original pathology report (n = 1517), the A.I.’s C-indices are 0.87 and 0.85 for continuous and discrete grading, respectively, compared to 0.79 (95% CI 0.71–0.86) for GG obtained from the reports. These represent improvements of 0.08 (95% CI 0.01–0.15) and 0.07 (95% CI 0.00–0.14), respectively. Conclusions Our results suggest that A.I.-based Gleason grading can lead to effective risk stratification, and warrants further evaluation for improving disease management.

scholarly journals Relationship Between Male Pattern Baldness and the Risk of Aggressive Prostate Cancer: An Analysis of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial

2015 ◽  
Vol 33 (5) ◽  
pp. 419-425 ◽  
Author(s):  
Cindy Ke Zhou ◽  
Ruth M. Pfeiffer ◽  
Sean D. Cleary ◽  
Heather J. Hoffman ◽  
Paul H. Levine ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Aggressive Prostate Cancer ◽  
Male Pattern Baldness ◽  
Increased Risk ◽  
Cancer Screening Trial ◽  
Screening Trial ◽  
Pathophysiologic Mechanisms ◽  
Male Pattern

Purpose Male pattern baldness and prostate cancer appear to share common pathophysiologic mechanisms. However, results from previous studies that assess their relationship have been inconsistent. Therefore, we investigated the association of male pattern baldness at age 45 years with risks of overall and subtypes of prostate cancer in a large, prospective cohort—the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. Methods We included 39,070 men from the usual care and screening arms of the trial cohort who had no cancer diagnosis (excluding nonmelanoma skin cancer) at the start of follow-up and recalled their hair-loss patterns at age 45 years. Hazard ratios (HRs) and 95% CIs were estimated by using Cox proportional hazards regression models with age as the time metric. Results During follow-up (median, 2.78 years), 1,138 incident prostate cancer cases were diagnosed, 571 of which were aggressive (biopsy Gleason score ≥ 7, and/or clinical stage III or greater, and/or fatal). Compared with no baldness, frontal plus moderate vertex baldness at age 45 years was not significantly associated with overall (HR, 1.19; 95% CI, 0.98 to 1.45) or nonaggressive (HR, 0.97; 95% CI, 0.72 to 1.30) prostate cancer risk but was significantly associated with increased risk of aggressive prostate cancer (HR, 1.39; 95% CI, 1.07 to 1.80). Adjustment for covariates did not substantially alter these estimates. Other classes of baldness were not significantly associated with overall or subtypes of prostate cancer. Conclusion Our analysis indicates that frontal plus moderate vertex baldness at age 45 years is associated with an increased risk of aggressive prostate cancer and supports the possibility of common pathophysiologic mechanisms.

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