scholarly journals What is the risk of prostate cancer mortality following negative systematic TRUS-guided biopsies? A systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040965
Author(s):  
Sandra Miriam Kawa ◽  
Signe Benzon Larsen ◽  
John Thomas Helgstrand ◽  
Peter Iversen ◽  
Klaus Brasso ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Data Extraction ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Population Based ◽  
Free Text ◽  
Medical Subject Headings ◽  
Prognostic Information ◽  
Prostate Biopsies

ObjectiveTo investigate the risk of prostate cancer-specific mortality (PCSM) following initial negative systematic transrectal ultrasound-guided (TRUS) prostate biopsies.DesignSystematic review.Data sourcesPubMed and Embase were searched using a string combination with keywords/Medical Subject Headings terms and free text in the search builder. Date of search was 13 April 2020.Study selectionStudies addressing PCSM following initial negative TRUS biopsies. Randomised controlled trials and population-based studies including men with initial negative TRUS biopsies reported in English from 1990 until present were included.Data extractionData extraction was done using a predefined form by two authors independently and compared with confirm data; risk of bias was assessed using the Newcastle–Ottawa Scale for cohort studies when applicable.ResultsFour eligible studies were identified. Outcomes were reported differently in the studies as both cumulative incidence and Kaplan-Meier estimates have been used. Regardless of the study differences, all studies reported low estimated incidence of PCSM of 1.8%–5.2% in men with negative TRUS biopsies during the following 10–20 years. Main limitation in all studies was limited follow-up.ConclusionOnly a few studies have investigated the risk of PCSM following initial negative biopsies and all studies included patients before the era of MRI of the prostate. However, the studies point to the fact that the risk of PCSM is low following initial negative TRUS biopsies, and that the level of prostate-specific antigen before biopsies holds prognostic information. This may be considered when advising patients about the need for further diagnostic evaluation.PROSPERO registration numberCRD42019134548.

Randomised Trial of Prostate Cancer Screening in the Netherlands: Assessment of Acceptance and Motives for Attendance

1997 ◽  
Vol 4 (2) ◽  
pp. 102-106 ◽  
Author(s):  
H G T Nijs ◽  
D M R Tordoir ◽  
J H Schuurman ◽  
W J Kirkels ◽  
F H Schroder
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Prostate Specific Antigen ◽  
Prostate Cancer Screening ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Digital Rectal Examination ◽  
Population Based ◽  
Personal Benefit ◽  
Screening Procedures

Abstract Objectives— To assess motives for attending a randomised population based prostate cancer screening trial, and to assess acceptance of screening and invitation procedures. Methods— First pilot of the European Randomised Study of Screening for Prostate Cancer (ERSPC; 1992/1993). Men aged 55–75 years, randomly selected from the population register of four city districts of Rotterdam, were invited by a single invitation for screening. Screening consisted of prostate specific antigen prescreening followed by either (1) digital rectal examination, transrectal ultrasound, and, on indication, biopsy, or (2) no additional screening. After screening, or in the case of non-attendance, a questionnaire was sent to a random sample of 600 attenders and 400 non-attenders, with a reminder after three weeks. Outcome measures— In both attenders and non-attenders: Knowledge of prostate cancer, attitudes towards screening, motives for attending, procedural aspects and sociodemographic characteristics. In attenders, acceptance of screening procedures. Results— The response rate for the questionnaire was 76%: 94% in attenders and 42% in non-attenders. The main reasons for attending were expected personal benefit (76%) and scientific value (39%), and those for not attending were the absence of urological complaints (41%) and anticipated pain or discomfort (24%). Uptake of screening was 32%, which increased to a sustained 42% in following years. Attenders, compared with non-attenders, were significantly younger, more often married, better educated, and had higher perceived health status, more knowledge about prostate cancer, and a more positive attitude towards screening. Information materials and invitation procedure were adequate. Screening procedures were well accepted (high report marks and satisfaction, and 95% would attend for rescreening). A single prostate specific antigen determination was liked less than a combination of all three screening modalities. Conclusions— (1) The main reasons for attending are personal benefit and science, and those for not attending were absence of urological complaints and anticipated pain or discomfort; (2) knowledge, attitudes, and motives for attending are comparable with other screening programmes; hence, for population based prostate cancer screening, known health promotional aspects should be carefully considered; (3) prostate specific antigen, digital rectal examination and transrectal ultrasound are acceptable to attenders.

scholarly journals Magnetic Resonance Image-Guided Biopsies with a High Detection Rate of Prostate Cancer

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Dirk G. Engehausen ◽  
Karl Engelhard ◽  
Siegfried A. Schwab ◽  
Michael Uder ◽  
Sven Wach ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Magnetic Resonance Image ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Ultrasound Guided ◽  
High Detection Rate ◽  
Prostate Biopsies ◽  
Mri Guided ◽  
Total Psa

Aim. To explore the potential of transrectal magnetic resonance image- (MRI-) guided biopsies of the prostate in a patient cohort with prior negative ultrasound guided biopsies.Patients and Methods. Ninety-six men with suspected prostate cancer underwent MRI-guided prostate biopsies under real-time imaging control in supine position.Results. Adenocarcinoma of the prostate was detected in 39 of 96 patients. For individual core biopsies, MRI yielded a sensitivity of 93.0% and a specificity of 94.4%. When stratifying patients according to the free-to-total prostate-specific antigen (PSA) ratio, the prostate cancer discovery rate was significantly higher in the group with ratios less than 0.15 (57.1%).Conclusion. MRI-guided biopsy of the prostate is a diagnostic option for patients with suspected prostate cancer and a history of repeatedly negative transrectal ultrasound-guided biopsies. Combined with the free-to-total PSA ratio, it is a highly effective method for detecting prostate cancer.

scholarly journals Components of the full blood count as risk factors for colorectal cancer detection: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032759 ◽  
Author(s):  
Pradeep S Virdee ◽  
Shona Kirtley ◽  
Leena Elhussein ◽  
Peter J Watkinson ◽  
Tim A Holt ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Systematic Review ◽  
Early Detection ◽  
Blood Count ◽  
Data Extraction ◽  
Full Blood Count ◽  
Free Text ◽  
Medical Subject Headings ◽  
Ongoing Research

IntroductionColorectal cancer is the fourth most common type of cancer and the second most common cause of cancer-related deaths in the UK. The full blood count (FBC) is a blood test that may play a role in early detection of the disease. Previous studies have aimed to identify how levels of individual components, such as haemoglobin, can be used to assist the diagnosis. We aim to systematically review studies to identify whether components of the FBC are risk factors for diagnosis of colorectal cancer, critically appraise the methods used to assess the association and assess performance of the components.Methods and analysisThe MEDLINE (via OVID), EMBASE (via OVID), CINAHL (via EBSCOhost) and Web of Science databases will be searched to identify studies reporting the association between the levels of at least one FBC component and the risk of a future diagnosis of colorectal cancer in undiagnosed individuals. Clincialtrials.gov and the WHO registry will be searched to identify relevant ongoing research. Search terms will include relevant Medical Subject Headings and Emtree headings, and free-text terms relating to FBC, colorectal cancer and diagnosis. No date or language restrictions will be applied. Two reviewers will independently identify the studies for inclusion and perform data extraction. Time intervals between the blood tests and diagnosis will form the subgroups for analysis.Ethics and disseminationThere is no direct patient involvement and only published articles will be reviewed; no ethical approval is required. Results from this review will set a foundation for intended future work on developing a new risk score for early detection of colorectal cancer, derived using FBC data. This systematic review will also provide guidance on the analysis of time to diagnosis. The model will be freely available to UK primary care practices.PROSPERO registration numberCRD42019134400.

scholarly journals Systematic and MRI-Cognitive Targeted Transperineal Prostate Biopsy Accuracy in Detecting Clinically Significant Prostate Cancer after Previous Negative Biopsy and Persisting Suspicion of Malignancy

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 57
Author(s):  
Alvydas Vėželis ◽  
Gediminas Platkevičius ◽  
Marius Kinčius ◽  
Liutauras Gumbys ◽  
Ieva Naruševičiūtė ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Targeted Biopsy ◽  
Negative Biopsy ◽  
Prostate Biopsies ◽  
Clinically Significant ◽  
Systematic Biopsy ◽  
Targeted Biopsies

Background and objectives: Overdiagnosis, overtreatment, and the need for repeated procedures caused by transrectal ultrasound guided prostate biopsies and their related complications places a heavy burden on healthcare systems. This was a prospective cohort validating study to access the clinical accuracy of systematic and MRI-cognitive targeted transperineal prostate biopsies in detecting clinically significant prostate cancer after a previous negative biopsy and persistent suspicion of malignancy. The primary goal was to assess the ability of multiparametric magnetic resonance imaging (mpMRI) to detect clinically significant prostate cancer with an additional goal to assess the diagnostic value of systematic and MRI-cognitive transperineal biopsies. Materials and Methods: In total, 200 patients were enrolled who had rising serum prostate specific antigen (PSA) levels for at least 4 months after a previous negative transrectal ultrasound (TRUS) biopsy. All eligible men underwent 1.5T prostate mpMRI, reported using the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2), followed by a 20-region transperineal prostate systematic biopsy and additional targeted biopsies. Results: Systematic 20-core transperineal prostate biopsies (TPBs) were performed for 38 (19%) patients. Systemic 20-core TPB with additional cognitive targeted biopsies were performed for 162 (81%) patients. Clinically significant prostate cancer (csPC) was detected for 31 (15.5%) patients, of which 20 (64.5%) cases of csPC were detected by systematic biopsy, eight (25.8%) cases were detected by targeted biopsy, and three (9.7%) both by systematic and targeted biopsies. Conclusions: Cognitive mpMRI guided transperineal target biopsies increase the detection rate of clinically significant prostate cancer after a previously negative biopsy. However, in a repeat prostate biopsy setting, we recommend applying a cognitive targeted biopsy with the addition of a systematic biopsy.

scholarly journals Overlap Between Genetic Variants Associated With Schizophrenia and Intelligence Quotient: Protocol for a Systematic Review

2021 ◽  
Author(s):  
Nancy Murillo-García ◽  
Sara Barrio-Martínez ◽  
Esther Setién-Suero ◽  
Rosa Ayesa-Arriola
Keyword(s):  
Systematic Review ◽  
Genetic Variants ◽  
Intelligence Quotient ◽  
Selection Process ◽  
Data Extraction ◽  
Free Text ◽  
Medical Subject Headings ◽  
Genetic Overlap ◽  
Premorbid Intelligence ◽  
Human Adults

Abstract BackgroundPeople with schizophrenia often exhibit a premorbid intelligence quotient (IQ) deficit. A genetic overlap between schizophrenia and IQ has been found, indicating shared genetic variants underlying the risk of schizophrenia and a low IQ. However, literature has emerged that offers contradictory findings about this issue. The aim of this systematic review will be to analyse and summarize the evidence that explores genetic variants associated with schizophrenia and IQ. MethodsA search will be carried out in four electronic databases (MEDLINE via PubMed, PsycINFO, Web of Science and Scopus). The search strategy will include terms related to “schizophrenia”, “genetic variants” and “intelligence quotient”, which will be adapted to medical subject headings (Mesh) format, Thesaurus format and free text. The team of reviewers will record the results in a bibliographic manager software and conduct the selection process. Observational studies examining human adults with schizophrenia that explore the association between genetic variants and the IQ of the participants will be considered. The risk of bias of the primary studies will be assessed using the genetic study quality tool (Q-Genie). After data extraction, the main results will be presented in a narrative synthesis.DiscussionThe findings of this systematic review may help us understand if there is genetic overlap between schizophrenia and IQ, and to identify specific genetic factors involved. Systematic review registrationPROSPERO CRD42020218842.

scholarly journals Effect of different visual presentations on the comprehension of prognostic information: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eman Abukmail ◽  
Mina Bakhit ◽  
Chris Del Mar ◽  
Tammy Hoffmann
Keyword(s):  
Systematic Review ◽  
Survival Curve ◽  
Data Extraction ◽  
Meta Analysis ◽  
Visual Presentation ◽  
Free Text ◽  
Cochrane Central Register ◽  
Prognostic Information ◽  
Study Selection ◽  
Central Register

Abstract Background Understanding prognostic information can help patients know what may happen to their health over time and make informed decisions. However, communicating prognostic information well can be challenging. Purpose To conduct a systematic review to identify and synthesize research that has evaluated visual presentations that communicate quantitative prognostic information to patients or the public. Data sources MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC and the Cochrane Central Register of Controlled Trials (CENTRAL) (from inception to December 2020), and forward and backward citation search. Study selection Two authors independently screened search results and assessed eligibility. To be eligible, studies required a quantitative design and comparison of at least one visual presentation with another presentation of quantitative prognostic information. The primary outcome was comprehension of the presented information. Secondary outcomes were preferences for or satisfaction with the presentations viewed, and behavioral intentions. Data extraction Two authors independently assessed risk of bias and extracted data. Data synthesis Eleven studies (all randomized trials) were identified. We grouped studies according to the presentation type evaluated. Bar graph versus pictograph (3 studies): no difference in comprehension between the groups. Survival vs mortality curves (2 studies): no difference in one study; higher comprehension in survival curve group in another study. Tabular format versus pictograph (4 studies): 2 studies reported similar comprehension between groups; 2 found higher comprehension in pictograph groups. Tabular versus free text (3 studies): 2 studies found no difference between groups; 1 found higher comprehension in a tabular group. Limitations Heterogeneity in the visual presentations and outcome measures, precluding meta-analysis. Conclusions No visual presentation appears to be consistently superior to communicate quantitative prognostic information.

Survival in men diagnosed with castration resistant prostate cancer: A population-based observational study in Sweden.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e16555-e16555
Author(s):  
Markus Aly ◽  
Frida Schain ◽  
Amy Leval ◽  
Johan Liwing ◽  
Joe Lawson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cox Regression ◽  
Specific Antigen ◽  
Population Level ◽  
Population Based ◽  
Calendar Period ◽  
Castration Resistant Prostate Cancer ◽  
Castration Resistance ◽  
Prostate Biopsies ◽  
Castration Resistant

e16555 Background: Data focusing on the castration resistant phase of prostate cancer (PC) outside clinical trial settings are scarce. This study aims to investigate PC-specific and overall survival (OS) in men with castration resistant prostate cancer (CRPC) on a population level. Methods: The STHLM-0 cohort (n = 400 000) with data on all prostate specific antigen (PSA) values and prostate biopsies taken in Stockholm, Sweden, from 2003 to 2015 were linked to other population registries. All men with a PC diagnosis and rising PSA after three months consecutive use of gonadotropin-releasing hormone or surgical castration were defined as CRPC (n = 1712). Kaplan-Meier was used to estimate median time-to-event and 95% confidence intervals (CI). Patients were stratified by metastasis status at PC diagnosis and multivariable Cox regression was used to adjust for clinical subgroups, including Gleason, age, T stage and calendar period (2006-2011 vs 2012-2015). Results: Metastasis at PC diagnosis was associated with shorter OS from castration resistance. From CRPC onset the median OS was 22.8 months (95% CI 21.2-25.5) and 13.1 (95% CI 11.5-14.2) months for patients without and with metastasis at PC diagnosis, respectively. The median PC-specific survival from CRPC was 30.7 (95% CI 27.9-34.7) months and 13.5 (95% CI 12.3-16.1) months for patients without and with metastasis at PC diagnosis, respectively. For patients with metastasis at PC diagnosis, factors influencing OS from CRPC were; entering CRPC stage in the later vs earlier calendar period (HR 0.61 95% CI 0.48-0.78, p < 0.001), age > 80 vs < 70 (HR 1.46, 95% CI 1.05-2.02, p < 0.02), T4 vs T1 stage (HR 1.56, 95% CI:1.02-2.37, p < 004). For patients without metastasis at PC diagnosis, developing CRPC in the later vs the earlier calendar period was associated with superior survival from CRPC (HR 0.78 95% CI 0.65-0.92, p < 0.004). Conclusions: Metastasis at PC diagnosis was associated with worse survival outcomes in CRPC patients. Individuals who became castration resistant in the later calendar period survived longer compared to those in the same stage in the earlier calendar period, most likely due to the introduction of novel agents for CRPC patients and more accurate staging methods.

ZOE Paste Pulpectomies Outcome in Primary Teeth: A Systematic Review

2011 ◽  
Vol 35 (3) ◽  
pp. 241-248 ◽  
Author(s):  
R Barcelos ◽  
MPA Santos ◽  
LG Primo ◽  
RR Luiz ◽  
LC Maia
Keyword(s):  
Systematic Review ◽  
Primary Teeth ◽  
Data Extraction ◽  
Research Question ◽  
Free Text ◽  
Inclusion Criteria ◽  
Medical Subject Headings ◽  
Filling Materials ◽  
Radiographic Outcomes

Objective: To perform a systematic review in which the clinical research question for primary teeth with irreversible pulpal pathosis was "how pulpectomies with zinc oxide eugenol (ZOE) paste performed compared to other materials in their clinical and radiographic outcomes after twelve months or more follow-up period.Study design: A literature survey of the electronic database (1950-2010) used the Medical Subject Headings and free text terms. Forty three references were retrieved and inclusion criteria were applied; 15 articles remained for full-text evaluation. From these, two were selected for data extraction regarding quality characteristics and results. Results: Selected studies showed moderate or high risk of bias. The overall success of pulpectomy was 80.0% (Calcicur), 60.0% (Sealapex) and varied from 85.0% to 100.0% (ZOE) and 89.0% to 100.0% (Vitapex). Solely Calcicur presented success rate significantly lower when compared to ZOE and Vitapex. These pastes lead to overfilled canals and particles of extruded ZOE were still evident even after the evaluation period. Resorption of Vitapex, Calcicur and Sealapex within the root canal was also reported. Conclusions: In primary teeth with irreversible pulpal changes ZOE pulpectomies yielded similar outcome than Vitapex and Sealapex, although there was no agreement with regard to filling materials' resorption.

Is a sampling transition zone important to increase the detection of prostate cancer in systematic prostatic biopsies?

2020 ◽  
pp. 028418512093836
Author(s):  
Marcos RG Queiroz ◽  
Priscila M Falsarella ◽  
Leonardo G Moreira Valle ◽  
Guilherme Cayres Mariotti ◽  
Gustavo C Lemos ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Transition Zone ◽  
Active Surveillance ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Complication Rates ◽  
Treatment Change ◽  
Detection Rates ◽  
Prostate Biopsies ◽  
Biopsy Protocol

Background Use of transrectal ultrasound (US)-guided biopsies improved diagnosis and treatment for patients with high prostate-specific antigen (PSA) or abnormal digital rectal exam (DRE). Purpose To investigate whether taking two transition zone (TZ) biopsies in addition to routine prostate double-sextant biopsies (12-cores) would improve detection rates of prostate cancer (PCa). Material and Methods A retrospective analysis of 1107 in a single institution database after Institutional Review Board approval, which underwent US-guided prostate biopsies from January 2014 to June 2016. All patients with suspected PCa based on positive DRE or high PSA submitted to US-guided prostate biopsy (double-sextant 12-cores alone and 12-cores with two TZ extra cores) were included. Results A total of 1107 patients were included; 120 patients underwent double-sextant 12-cores alone and 987 underwent 12-cores with two TZ extra cores. Among patients submitted to two TZ extra cores, TZs of 755 (76.5%) patients were negative to neoplasia and 232 (23.5%) were positive to neoplasia. Among these patients, 26 (2.6%) had their final Gleason score increased with TZ core; TZ fragments of 20 (2.0%) patients led to a treatment change (re biopsy, active surveillance or from active surveillance to radiation therapy or radical prostatectomy). When the complication rate is analyzed (with or without hospital admission), among the patients submitted to TZ cores, 259 (26.2%) complications were observed; between those submitted to double-sextant 12-cores, 26 (21.7%) complications were observed ( P=0.279). Conclusion Extended core biopsy protocol with two TZ extra fragments improves detection rates of cancer when compared to double-sextant biopsy protocol without increasing complication rates. TZ routine cores should be considered.

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