Risk factors for significant prostate cancer in radical cystoprostatectomy specimen: A retrospective analysis.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 136-136
Author(s):  
Andrea Katharina Thissen ◽  
Daniel Porres ◽  
David J. K. P. Pfister ◽  
Axel Heidenreich
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Bladder Cancer ◽  
Retrospective Analysis ◽  
Potential Risk ◽  
Common Finding ◽  
Considerable Proportion ◽  
Radical Cystoprostatectomy ◽  
Potential Risk Factors

136 Background: Prostate cancer (Pca) has been found incidentally in radical cystoprostatectomy (RCP) specimens in 27-70%. We evaluated histopathological features and clinical outcome of patients with incidental Pca undergoing RCP for urothelial bladder cancer and identified potential risk factors for the presence of significant Pca, being defined as Gleason Score ≥7b, primary tumor ≥T2c or Pca volume ≥0.5cm3. Methods: A retrospective analysis of patients who underwent RCP between 01/2005-03/2015 was performed with regard to clinical data and pathohistological features. Whole mount serial sections of specimens were examined in the same urological and pathological institution. Pca grade, p-stage, cancer volume and surgical margins were recorded. Preoperative PSA values and follow-up were analysed. Results: We identified 71 patients with incidental Pca with a mean age of 71.7 years (47-84 years). 33/71 patients (46.5%) had significant Pca (28.2% ≥T2c, 4.2% GS ≥7b [+≥T2c], 14.1% cancer volume ≥0.5cm3[+≥T2c]). Other features were as follows: pT2a, n=36 (50.7%); pT2b, n=2 (2.8%); GS 6, n=50 (70.4%); GS 7a, n=18 (25,3%). All patients were R0 and N0 for Pca. Mean preoperative PSA level was 2.7ng/ml. None of the patients developed biochemical recurrence (median follow-up: 29.5 [1-124 months]). Patients with significant Pca were older than those with insignificant Pca (median age 71.2 years vs 70.1 years) and had higher preoperative PSA levels: 90% of patients with a PSA level of 4-10ng/ml had a ≥T2c Pca, while 81.5% of patients with PSA levels of 0-1ng/ml had a pT2a Pca. P-stages in patients with PSA values between 1-4ng/ml were found to be equally distributed between pT2a-pT2c. Conclusions: The occurence of incidental Pca is a common finding in patients undergoing RCP, with a considerable proportion having the characteristics of significant Pca. Potential risk factors for significant Pca are older age and PSA levels >4ng/ml. However, none of the patients experienced biochemical relapse or Pca-related death during the follow-up. In line with published data, incidental Pca does not impact on the oncological outcome of patients undergoing RCP. The prognosis is primarily determined by bladder cancer.

Epidemiology of prostate cancer

2017 ◽  
Author(s):  
Timothy J. Key ◽  
Alison J. Price
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Potential Risk ◽  
African Ancestry ◽  
Prostate Cancer Risk ◽  
Positive Association ◽  
Incidence Rates ◽  
Nutritional Factors ◽  
Incidence And Mortality ◽  
Potential Risk Factors

Prostate cancer is the second most common malignancy and the sixth most common cause of cancer death for men worldwide. The highest incidence and mortality rates are in populations that originated in Africa, such as African Americans. Rates are also high in Western countries and generally low in East and South Asia. Incidence rates are increasing in some countries which until recently had low rates, but are not changing much in countries which already have high rates. The only well-established risk factors are increasing age, African ancestry, family history of the disease, and certain genetic factors, none of which is modifiable. Many potential risk factors have been investigated in epidemiological studies and randomized trials. Observational studies have shown that prostate cancer risk is positively associated with the plasma concentration of insulin-like growth factor-I, but is not strongly associated with testosterone or other sex hormones. Studies of nutritional factors suggest that risk may be higher in men with a high intake of animal foods and dairy products, but this relationship is not clear enough to be considered as established. Some studies of other nutritional factors such as fat, lycopene and other carotenoids, vitamin D, vitamin E and selenium have suggested possible associations, but overall do not show any clear relationships. Research on other possible risk factors has shown a small positive association of risk with height, but little association with obesity, smoking or alcohol intake, and evidence on sexual behaviour and sexually transmitted infections is inconclusive. Further research is needed, particularly to determine whether potential risk factors may be related more to aggressive than to indolent prostate cancer.

scholarly journals Incidence of Anxiety in Latest Life and Risk Factors. Results of the AgeCoDe/AgeQualiDe Study

2021 ◽  
Vol 18 (23) ◽  
pp. 12786
Author(s):  
Franziska Dinah Welzel ◽  
Melanie Luppa ◽  
Alexander Pabst ◽  
Michael Pentzek ◽  
Angela Fuchs ◽  
...  
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
Potential Risk ◽  
Oldest Old ◽  
Anxiety Symptoms ◽  
Subjective Memory Complaints ◽  
Subjective Memory ◽  
Memory Complaints ◽  
Potential Risk Factors

Research on anxiety in oldest-old individuals is scarce. Specifically, incidence studies based on large community samples are lacking. The objective of this study is to assess age- and gender-specific incidence rates in a large sample of oldest-old individuals and to identify potential risk factors. The study included data from N = 702 adults aged 81 to 97 years. Anxiety symptoms were identified using the short form of the Geriatric Anxiety Inventory (GAI-SF). Associations of potential risk factors with anxiety incidence were analyzed using Cox proportional hazard models. Out of the N = 702 older adults, N = 77 individuals developed anxiety symptoms during the follow-up period. The incidence rate was 51.3 (95% CI: 41.2–64.1) per 1000 person-years in the overall sample, compared to 58.5 (95% CI: 43.2–72.4) in women and 37.3 (95% CI: 23.6–58.3) in men. Multivariable analysis showed an association of subjective memory complaints (HR: 2.03, 95% CI: 1.16–3.57) and depressive symptoms (HR: 3.20, 95% CI: 1.46–7.01) with incident anxiety in the follow-up. Incident anxiety is highly common in late life. Depressive symptoms and subjective memory complaints are major risk factors of new episodes. Incident anxiety appears to be a response to subjective memory complaints independent of depressive symptoms.

scholarly journals Configuration of Primary and Recurrent Aggressive Fibromatosis on Contrast-Enhanced MRI with an Evaluation of Potential Risk Factors for Recurrences in MRI Follow-Up

2019 ◽  
Vol 192 (05) ◽  
pp. 448-457
Author(s):  
Sam Sedaghat ◽  
Alexey Surov ◽  
Sebastian Krohn ◽  
Maya Sedaghat ◽  
Benjamin Reichardt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Contrast Enhancement ◽  
Potential Risk ◽  
Primary Tumor ◽  
Tumor Resection ◽  
Aggressive Fibromatosis ◽  
Primary Tumor Resection ◽  
Potential Risk Factors ◽  
Muscle Edema

Purpose To analyze the appearance of primary and recurrent aggressive fibromatosis (AF) on MRI with a focus on configuration and to determine potential risk factors for recurrences detected on MRI follow-up scans. Methods From 79 consecutive patients with histologically proven diagnosis of AF, 39 patients underwent a minimum of four 1.5 T MRI follow-up scans after resection of primary AF between 2008 and 2018. The primary and recurrent tumors were radiographically examined for configuration, limitation and extent on MRI. Epidemiological data and loco-regional subcutaneous edema, muscle edema and post-operative seroma were included. Results The mean age of the patients was 39 ± 2.6 years. Primary and recurrent AF most often occurred in the thigh. The main appearance of primary AF was significantly most often fascicular (p = 0.001–0.01) with heterogeneous and marked contrast enhancement. 21 % (n = 8) of the patients developed recurrences of AF. A fascicular configuration with homogeneous/heterogeneous contrast enhancement was the main appearance of recurrent AF, but recurrent AF appeared nodular, polycyclic, ovoid or streaky/flat as well. Recurrent AF significantly most often occurred within the first 9 months after primary tumor resection (p = 0.009), especially in patients up to 25 years of age (RR = 6.1; 95 % CI: 1.8–20.9; p = 0.004). The cases of recurrent AF were altogether significantly smaller than the primary tumors (p = 0.001). Post-treatment subcutaneous and muscle edema were present in 77 % and 56 %, respectively. Patients with muscle edema after primary tumor resection had a significantly higher risk for AF recurrences (relative risk ratio (RR) = 1.8; 95 % CI: 1.16–2.8; p = 0.0096). There was no significant difference detected in patients with complete or incomplete resection of the primary tumor. Conclusion Primary and recurrent aggressive fibromatosis has a mostly fascicular configuration, but may appear ovoid, nodular, streaky/flat or polycyclic as well. High risks for tumor recurrences are detected for patients up to 25 years of age, patients within the first 9 post-operative months and patients with muscle edema after primary tumor resection. Key points:  Citation Format

Predicting late fecal incontinence risk after RT for prostate cancer: External independent validation.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 116-116
Author(s):  
Alessandro Cicchetti ◽  
Barbara Avuzzi ◽  
Federica Palorini ◽  
Tiziana Rancati ◽  
Claudio Stucchi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Fecal Incontinence ◽  
Abdominal Surgery ◽  
Average Score ◽  
Calibration Plot ◽  
Clear Trend ◽  
Logistic Analysis ◽  
Potential Risk Factors

116 Background: To validating a predictive model for late fecal incontinence (FI) on a recent population (pop) of prostate cancer patients (pts) treated with radical radiotherapy. NTCP model was derived from literature. Methods: Pop included 267 pts treated with IMRT in 2010-2014. Prescribed dose was between 68 and 80 Gy with conventional and hypo-fractionated (HF, from 2.2 to 2.8 Gy) treatment. Rectal toxicity was scored using the LENT/SOMA. Follow-up (FU) was considered up to 2 years. We chose to validate a model for prediction of chronic FI through multiple measures during FU. Mean FI was defined as the average score during the FU period after RT (Mean incontinence > 1). Literature based multivariate model included: mean rectal dose (Dmean), previous diseases of colon (COLO) and previous abdominal surgery (SURG). Dose distributions were corrected EQD in 2 Gy fractions. Results: 186 pts were available. Mean grade > 1 FI was scored in 18 patients (〜10%). Univariate logistic analysis confirmed the risk factors reported in literature. Similar Odds Ratios (OR) were found for Dmean (1.04vs1.05) and SURG (1.90vs1.50). COLO was not a risk factor for this pop. As consequence, NTCP models including Dmean and Dmean+SURG were evaluated through calibration plot. The models showed a clear trend (increasing observed toxicity rates with predicted risk), but the observed toxicity rates were underestimated (slope〜3, R2〜0.7). Including HF (OR = 2.20, 8.6% vs 17.6%) as a variable into the previous model the calibrations improved significantly (slope〜1, R2〜0.9). Conclusions: The study confirms formerly published results on effect of abdominal surgery and dose to large rectal volumes as potential risk factors for late FI. The overfitting in calibrations could be due to an effect of HF, not included in previous models developed on normofractionated treatments. This effect goes beyond the applied standard correction using LQ model for late effects and also beyond the time recovery correction (slope〜2, R^2〜0.8). Probably we should found a more suitable alpha/beta value for the longitudinal definition (toxicity starting in acute phase and persisting during follow-up) instead of using the assumption settled on incidence of late peak events.

scholarly journals Assessment of the Potential Risk Factors of Prostate Cancer: A Comparative Study

2017 ◽  
Vol 13 (03) ◽  
pp. 41-45
Author(s):  
Rayyan Ibrahim Mukhtar Ahmed ◽  
Ahmed Mohamed Abdalla Hamdi ◽  
Altaiyb Omer Ahmed Mohmmed
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Comparative Study ◽  
Potential Risk ◽  
Potential Risk Factors

scholarly journals The lack of retropatellar resurfacing at index surgery is significantly associated with failure in patients following patellofemoral inlay arthroplasty: a multi-center study of more than 260 patients

2021 ◽  
Author(s):  
Andreas B. Imhoff ◽  
Eva Bartsch ◽  
Christoph Becher ◽  
Peter Behrens ◽  
Gerrit Bode ◽  
...  
Keyword(s):  
Risk Factors ◽  
Patient Satisfaction ◽  
Clinical Outcomes ◽  
Potential Risk ◽  
Young Patients ◽  
Womac Score ◽  
Potential Risk Factors ◽  
Multi Center Study ◽  
Center Study

Abstract Purpose To evaluate the clinical outcomes of patients with a minimum 2-year follow-up following contemporary patellofemoral inlay arthroplasty (PFIA) and to identify potential risk factors for failure in a multi-center study. Methods All patients who underwent implantation of PFIA between 09/2009 and 11/2016 at 11 specialized orthopedic referral centers were enrolled in the study and were evaluated retrospectively at a minimum 2-year follow-up. Clinical outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Tegner Scale, the visual analogue scale (VAS) for pain, and subjective patient satisfaction. Pre- and perioperative risk factors were compared among failures and non-failures to determine potential risk factors. Results A total of 263 patients (85% follow-up rate) could be enrolled. The mean age at the time of index surgery was 49 ± 12 years with a mean postoperative follow-up of 45 ± 18 months. The overall failure rate was 11% (28 patients), of which 18% (5 patients) were patients with patella resurfacing at index surgery and 82% (23 patients) were patients without initial patella resurfacing. At final follow-up, 93% of the patients who did not fail were satisfied with the procedure with a mean transformed WOMAC Score of 84.5 ± 14.5 points, a mean KOOS Score of 73.3 ± 17.1 points, a mean Tegner Score of 3.4 ± 1.4 points and a mean VAS pain of 2.4 ± 2.0 points. An increased BMI was significantly correlated with a worse postoperative outcome. Concomitant procedures addressing patellofemoral instability or malalignment, the lack of patellofemoral resurfacing at the index surgery and a high BMI were significantly correlated with failure in our patient cohort. Conclusion Patellofemoral inlay arthroplasty shows high patient satisfaction with good functional outcomes at short-term follow-up and thus can be considered a viable treatment option in young patients suffering from isolated patellofemoral arthritis. Patellar resurfacing at index surgery is recommended to decrease the risk of failure. Level of evidence Retrospective case series, Level IV.

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