Primary hormonal therapy for patients with localized or locally advanced prostate cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14630-14630
Author(s):  
Z. Shklar ◽  
R. Rubinov ◽  
M. Steiner ◽  
A. Rabkin ◽  
M. Leviov ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Gleason Score ◽  
Hormonal Therapy ◽  
Locally Advanced ◽  
High Gleason Score ◽  
Clinical Difference ◽  
Median Serum ◽  
Radical Therapy ◽  
Psa Recurrence

14630 Background: During 1998–2000, 68 patients with localized or locally advanced prostate carcinoma who were not suitable for radical therapy received primary hormonal therapy as the only treatment modality. The group consisted 15.8% of all prostate cancer patients referred to our center during the three years period. Methods: Their median age was 76.7 years (65–89). 42.4% had T1c disease, 30.3% T2a, 15.2% stage T2b and 12.1% T3. 78.4% had Gleason score 4–6, 10.8% Gleason 7 and 10.8% Gleason 8–10 prostate cancer. Median serum PSA level before starting therapy was 15.8 ng/ml (3.4–289). 76% received LHRH agonists monotherapy while 24% had complete androgen blockade. Patients were followed using repeated serum PSA level during 39–95 months (median 79.5). Results: 32/68 patients (47%) experienced PSA recurrence during the study period. Median time to PSA failure was 38.9 months (13–77). No clinical difference was observed between recurrent and non recurrent patients as regarding stage of disease or type of hormonal therapy. In relapsing patients high Gleason score (7–10) was more common (32.3% vs 11.6%) and median initial serum PSA value was higher (22.4 vs 14.5 ng/ml) than in the non recurrent group. During the study period, only 4/68 patients (5.9%) developed clinical disease, 10/68 patients (14.7%) died of unrelated causes and no patient died of prostate cancer. Conclusions: We conclude that primary hormonal therapy is a safe option for prostate cancer patients not suitable for more radical procedures. As expected, high Gleason score and higher initial serum PSA value are predictive for earlier relapse. No significant financial relationships to disclose.

Clinical significance of plasma fibrinogen level in patients with prostate cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16077-e16077
Author(s):  
Xiao-Kun Ma ◽  
Jing-Yun Wen ◽  
Zhan-Hong Chen ◽  
Qu Lin ◽  
Xing Li ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Gleason Score ◽  
Locally Advanced ◽  
Specific Antigen ◽  
Tnm Stage ◽  
Plasma Fibrinogen ◽  
T State ◽  
Coagulation Analyzer ◽  
Worse Prognosis

e16077 Background: Most of malignant tumor patients have hypercoagulable state with plasma fibrinogen (Fib) levels increased. In this study, we aimed to investigate correlation of plasma Fib with routine prognostic factors of prostate cancer patients, including Gleason score, prostate specific antigen (PSA), TNM 7th Stage. Methods: From January 2007 to December 2012, 107 patients with prostate cancer and 44 cases of benign prostatic hyperplasia (BPH) were included in our study. Automated coagulation analyzer was used to determine the plasma fibrinogen levels. Results: The patients presented a mean age of 70.6 years, a mean PSA level of 28.73 ng/ml, clinically localized prostate cancer in 47 cases, locally advanced condition in 27cases, and distant metastatic disease in 33 cases. The fibrinogen levels were increased in cancer patients compared to that in patients with BPH (P = 0.031). Higher fibrinogen levels related to metastasis, higher TNM stage and increased PSA (p = 0.000, 0.041 and 0.004 respectively). Fib levels were irrelevant to T state, N state, and Gleason score. Conclusions: Prostate cancer patients displayed increased Fib levels. Plasma Fib is significantly increased in patients with higher PSA level,worse TNM stage and distant metastasis. The patients with high Fib might presented relative worse prognosis and should be monitored closely. [Table: see text]

scholarly journals The Utilization of Gleason Grade as the Primary Criterion for Ordering Nuclear Bone Scan in Newly Diagnosed Prostate Cancer Patients

2009 ◽  
Vol 9 ◽  
pp. 1040-1045 ◽  
Author(s):  
Chad W. M. Ritenour ◽  
John T. Abbott ◽  
Michael Goodman ◽  
Naomi Alazraki ◽  
Fray F. Marshall ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Gleason Score ◽  
Bone Scan ◽  
Stage Migration ◽  
Gleason Grade ◽  
Newly Diagnosed ◽  
High Gleason Score ◽  
Bone Scans ◽  
The Relationship

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.

Neoadjuvant Chemotherapy and Hormonal Therapy Followed by Radical Prostatectomy: Feasibility and Preliminary Results

2000 ◽  
Vol 18 (5) ◽  
pp. 1050-1050 ◽  
Author(s):  
Curtis A. Pettaway ◽  
Louis L. Pisters ◽  
Patricia Troncoso ◽  
Joel Slaton ◽  
Laury Finn ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Neoadjuvant Chemotherapy ◽  
Gleason Score ◽  
Hormonal Therapy ◽  
Advanced Prostate Cancer ◽  
Intraoperative Complications ◽  
Locally Advanced ◽  
Locally Advanced Prostate Cancer ◽  
Androgen Ablation

PURPOSE: We assessed the feasibility and efficacy of integrating chemotherapy and androgen ablation with radical prostatectomy in patients with locally advanced prostate cancer. The neoadjuvant approach was adopted because it allows an in situ assessment of antitumoral activity.PATIENTS AND METHODS: Thirty-three patients were enrolled who met the clinical criteria of stage T1–2, Gleason score of ≥ 8 or T2b-T2c, Gleason score of 7 and prostate-specific antigen (PSA) level greater than 10 ng/mL (n = 15), or clinical stage T3 (n = 18). Therapy consisted of 12 weeks of ketoconazole and doxorubicin alternating with vinblastine, estramustine, and androgen ablation followed by prostatectomy. The ability of neoadjuvant chemotherapy and hormonal therapy to induce a 20% rate of pT0 in the prostatectomy specimen as well as surgical feasibility were assessed.RESULTS: Chemotherapy complications were comparable to those reported with this regimen previously. No major intraoperative complications occurred. Postoperative complications occurred in 10 (33%) of 30 patients. One patient died at home after discharge (postoperative day 17; no autopsy was performed). Ten (33%) of the 30 patients had organ-confined disease, and 20 (70%) of 30 had extraprostatic extension; 11 (37%) of the 30 had positive lymph nodes. Only five (17%) of 30 exhibited positive surgical margins. All patients achieved an undetectable PSA level postoperatively, and 20 of the surviving 29 patients remain without disease recurrence with a median follow-up of 13 months (range, 9 to 18 months).CONCLUSION: Chemotherapy and androgen ablation followed by radical prostatectomy was feasible in patients with locally advanced prostate cancer. Although the goal of achieving a 20% rate for pT0 status was not achieved, we believe this type of integrated therapeutic strategy should be investigated further for its ability to alter the course of regionally advanced prostate cancer.

scholarly journals MP64-04 SLCO2B1 HIGH EXPRESSED TUMOR IN HIGH GLEASON SCORE PROSTATE CANCER PATIENTS RECUR EARLIER AFTER RADICAL PROSTATECTOMY

2018 ◽  
Vol 199 (4S) ◽  
Author(s):  
Tomoaki Terakawa ◽  
Eriko Katsuta ◽  
Khurshid Guru ◽  
Kazuaki Takabe ◽  
Masato Fujisawa
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Gleason Score ◽  
High Gleason Score

Significance of the expression of thymidylate synthase in prostate cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16163-e16163
Author(s):  
Y. Mizutani ◽  
Y. Li ◽  
T. Shiraishi ◽  
T. Nakamura ◽  
K. Mikami ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Gleason Score ◽  
Hormonal Therapy ◽  
Postoperative Recurrence ◽  
Cancer Tissue ◽  
Neoadjuvant Hormonal Therapy ◽  
Prostate Cancer Tissue ◽  
Tissue Specimens

e16163 Background: Thymidylate synthase ( TS ) is an important enzyme in de novo DNA synthesis pathway. 5-Fluorouracil ( 5-FU ), an anticancer chemotherapeutic agent used clinically against a variety of cancers including prostate cancer, inhibits DNA synthesis by binding TS. In the present study, we examined TS expression in prostate cancer and investigated its prognostic significance. Methods: Fifty-two prostate cancer tissue specimens were obtained from patients who underwent radical prostatectomy for prostate cancer without neoadjuvant hormonal therapy. Forty-eight prostate cancer tissue specimens were also obtained from patients who underwent radical prostatectomy for prostate cancer with neoadjuvant hormonal therapy. We examined prostate cancer tissue and normal prostate tissue for TS expression by immunohistochemistry. Results: TS was expressed at higher levels in prostate cancer without neoadjuvant hormonal therapy, compared with normal prostate.TS expression in stage T3 prostate cancer was higher than that in stage T2 prostate cancer. In addition, the level of TS expression in Gleason score 7 or greater prostate cancer was higher than that in Gleason score less than 7 prostate cancer. Patients with prostate cancer with negative TS expression without neoadjuvant hormonal therapy had a longer postoperative recurrence-free rate than those with positive expression in the 5 year follow-up. In addition, patients with Gleason score less than 7 prostate cancer with negative TS expression had a much longer postoperative recurrence-free rate than those with positive expression in the 5-year follow-up. TS expression was significantly decreased in prostate cancer patients who received neoadjuvant hormonal therapy, especially stage T2 prostate cancer patients. Conclusions: The current study has demonstrated for the first time that TS expression may be a prognostic parameterr for prostate cancer patients undergoing radical prostatectomy. No significant financial relationships to disclose.

scholarly journals Hypoxia-Inducible Factor 2a Expression Is Positively Correlated With Gleason Score in Prostate Cancer

2021 ◽  
Vol 20 ◽  
pp. 153303382199001
Author(s):  
Dimitrios Pavlakis ◽  
Spyridon Kampantais ◽  
Konstantinos Gkagkalidis ◽  
Victoras Gourvas ◽  
Dimitrios Memmos ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Locally Advanced ◽  
Hypoxia Inducible Factor ◽  
Immunohistochemical Expression ◽  
Locally Advanced Prostate Cancer ◽  
Grade Group ◽  
Main Factors ◽  
Hif Pathway ◽  
Lower Expression

Background: One of the main factors in response to hypoxia in the tumor microenvironment is the hypoxia-inducible factor (HIF) pathway. Although its role in other solid tumors, particularly renal cell carcinoma, has been sufficiently elucidated, it remains elusive in prostate cancer. The aim of the present study was to investigate the expression of main proteins involved in this pathway and determine the correlation of the results with clinicopathological outcomes of patients with prostate cancer. Methods: The immunohistochemical expression of HIF-1a, HIF-2a and their regulators, prolyl hydroxylase domain (PHD)1, PHD2 and PHD3 and factor inhibiting HIF (FIH), was assessed on a tissue microarray. This was constructed from radical prostatectomy specimens, involving both tumor and corresponding adjacent non-tumoral prostate tissues from 50 patients with localized or locally advanced prostate cancer. Results: In comparison with non-tumoral adjacent tissue, HIF-1a exhibited an equal or lower expression in 86% of the specimens (P = 0.017), while HIF-2a was overexpressed in 52% (P = 0.032) of the cases. HIF-1a protein expression was correlated with HIF-2a (P < 0.001), FIH (P = 0.004), PHD1 (P < 0.001), PHD2 (P < 0.001) and PHD3 (P = 0.035). HIF-2a expression was positively correlated with Gleason score (P = 0.017) and International Society of Urological Pathologists (ISUP) grade group (P = 0.022). Conclusions: The findings of the present study suggest a key role for HIF-2a in prostate cancer, as HIF-2a expression was found to be correlated with Gleason score and ISUP grade of the patients. However, further studies are required to validate these results and investigate the potential value of HIF-2a as a therapeutic target in prostate cancer.

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