Baseline differences in characteristics of a racially diverse group of men electing active surveillance.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 103-103
Author(s):  
Allison H. Feibus ◽  
Nora M. Haney ◽  
James Liu ◽  
Jason H Chiang ◽  
Elisa M. Ledet ◽  
...  
Keyword(s):  
Racial Differences ◽  
Active Surveillance ◽  
Gleason Score ◽  
Clinical Stage ◽  
Univariate Analysis ◽  
Clinical Staging ◽  
European Ancestry ◽  
Social Characteristics ◽  
Inclusion Criteria ◽  
Large Populations

103 Background: To date, large populations of men from European ancestry have been prospectively evaluated on Active Surveillance (AS), a strategy reserved for low risk prostate cancer (PCa). African Americans (AA) deemed to be candidates for AS have yet to be fully characterized. We sought to determine the similarities and differences of our AS cohort stratified by race. Methods: We identified 308 men from our multi-institutional, prospective AS database were analyzed. Inclusion criteria was PSA < 20ng/mL, Gleason score ≤ 7, and clinical stage ≤ T2a. Men who sought treatment for their PCa or refused subsequent imaging and biopsy were excluded. Univariate analysis was done to analyze racial differences in demographic, clinical and pathologic variables. Results: We identified 308 men, 131 (43%) AA and 177 nonAA (57%). The groups were not significantly different with respect to age; 65 years, BMI 28.4, family history of PCa (22%), prior negative biopsy (21%) and clinical staging (87% T1c). Median follow-up is 25 months (IQR 12-44). Significant differences between the AA and nonAA cohorts did exist at baseline with respect to overall health, suggesting AA having worse overall health. More AA had diabetes (29 vs 14%; p = .03), were smokers (55 vs 29%; p < .01), cardiovascular disease (21 vs 9%) and erectile dysfunction (43 vs 18%; p < .01). Social characteristics also differed within the groups, with AA less likely to be married (47 vs 51%; p = .01). Despite a lack of difference with respect to biopsy Gleason score, AA had higher PSA (5.7 vs 5.0 ng/mL; p = 0.02), lower testosterone levels (250 vs 334 ng/dL; p = 0.05), greater PSA density (0.15 vs 0.12; p < 0.01), and greater linear length of cancer per biopsy core (16 vs 13mm; p < 0.01) at time of diagnosis and initiation of AS. Conclusions: Within our AS cohort, AA have worse overall health and more aggressive PCa features despite meeting inclusion criteria and selecting AS. Further prospective study is needed to determine how these competing factors may impact long term outcomes.

Outcomes of men who underwent treatment for prostate cancer from a prospective follow up of a racially diverse, multi-institutional active surveillance cohort.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. e536-e536
Author(s):  
Nora M. Haney ◽  
Allison H. Feibus ◽  
James Liu ◽  
Gabriel Leinwand ◽  
Elisa M. Ledet ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Treatment Group ◽  
Active Surveillance ◽  
Gleason Score ◽  
Smoking Status ◽  
Univariate Analysis ◽  
Clinical Staging ◽  
Low Grade ◽  
Racially Diverse ◽  
Entire Cohort

e536 Background: Active surveillance (AS) is an increasingly accepted alternative to treatment for low-grade prostate cancer (PCa). However, it remains unclear what factors may predict which patients will upgrade to a higher grade cancer. We sought to analyze the characteristics at time of diagnosis and outcomes of those men in our racially diverse AS cohort who underwent treatment for PCa. Methods: Men from our AS database were analyzed. Inclusion criteria was PSA < 20 ng/mL, Gleason Score ≤ 7, and clinical stage ≤ T2a. Men who elected active treatment for their PCa at diagnosis or refused subsequent imaging and biopsy were excluded from this cohort. Univariate analysis was done to compare the clinical variables of the treatment group with the entire cohort. Results: We identified 56 men who were treated for PCa from the 308 men currently enrolled in our AS cohort. All 56 men in the treatment group had low risk PCa at diagnosis and initiation of AS. At diagnosis, the treatment group was not significantly different in comparison with our entire cohort with respect to age, BMI, family history of PCa, PSA at diagnosis, prior negative biopsy, TRUS volume, PSAD, smoking status and clinical staging. However the eventual treatment group did differ at diagnosis with respect to greater linear length of cancer per core (p < 0.01), greater % involvement of disease (p = 0.03), and greater number of total cores at time of diagnosis (p = 0.04). The men in this group underwent treatment for PCa for the following reasons: 36 for Gleason Score upgrading, 5 due to increased volume of disease, 6 due to rising PSA, 1 due to MRI findings, 1 due to rising PSA on Avodart and 7 elected treatment despite no significant changes in disease. 31 of the men had RARPs, 17 XRT, 4 had XRT + ADT, 3 had Brachytherapy, and 1 with XRT + salvage RP. Conclusions: Within our prospectively enrolled racially diverse AS cohort, the patients who underwent treatment for PCa had clinical factors that differed in comparison to the whole cohort. Further prospective study is needed to determine how these factors may ultimately impact long term outcomes.

scholarly journals Estudio Clínico y Epidemiológico de Cáncer de Próstata en el Hospital de Especialidades José Carrasco Arteaga de Cuenca - Ecuador, 2010 - 2015

2018 ◽  
Vol 10 (2) ◽  
pp. 110-115
Author(s):  
María Paz Orellana Jara ◽  
Juana Carolina Cordero Garate ◽  
Galo Rubén Duque Proaño
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Correlation Coefficient ◽  
Gleason Score ◽  
Clinical Stage ◽  
Specific Antigen ◽  
Positive Association ◽  
Clinical Staging ◽  
The Media ◽  
Total Psa

BACKGROUND: Prostate cancer is the fifth most common neoplasms worldwide and the second in man. In Cuenca, according to the sixth epidemiology of cancer, it is the second cause of death in males. METHODS: Observational descriptive study the sample was for convenience, made up with 315 patients with positive biopsy. The established variables were: Signs and symptoms, histopathological type, total prostate specific antigen (PSA) measure, risk factors, Gleason score, differentiation grade and clinical staging. The media and median were obtained as the crossing of variables using Pearson and Spearman correlation coefficient. The software used was STATA 12 version. RESULTS: The most common symptoms were urinary frequency (56.2 %) and dysuria (36.8 %). 312 patients presented adenocarcinoma as histopathology type. The total PSA had a median of 4.4 ng/ml and a media of 34 ng/ml. The media of age was 69 years old. 141 patients presented hypertension. About the Gleason Grading system most of people were moderately differentiated (43.6 %). 67 % of cases were diagnosed during stages I and II. The Rho correlation coefficient was 0.44 between clinical stage and Gleason score; it was of 0.36 between PSA and clinical stage. CONCLUSIONS: It was found a moderately positive association between clinical stage and Gleason score. There is no minimal measure of total PSA that could assure us there is no risk of prostate cancer. More prospective studies are needed in order to find the relation between prostate cancer and risk factors.

scholarly journals First Danish Single-Institution Experience with Radical Prostatectomy: Biochemical Outcome in 1200 Consecutive Patients

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
M. Andreas Røder ◽  
Kasper D. Berg ◽  
Lisa Gruschy ◽  
Klaus Brasso ◽  
Peter Iversen
Keyword(s):  
Gleason Score ◽  
Biochemical Recurrence ◽  
Clinical Stage ◽  
Univariate Analysis ◽  
Radical Retropubic Prostatectomy ◽  
Single Institution ◽  
Free Survival ◽  
Curative Therapy ◽  
Age At Surgery ◽  
Risk Patients

Radical retropubic prostatectomy (RRP) as intended curative therapy for patients with clinically localized prostate cancer (PC) was initiated in 1995 in Denmark. This paper reports single-institution results from the first 1200 consecutive patients operated during a 15-year period. Median age at surgery was 63 years. Median PSA was 9 ng/mL. Palpable tumors (≤cT2) were present in 48% of patients. Gleason score at biopsy was ≤7 for 85% of patients. In sixty-five percent of patients, histopathology revealed localized PCa after RRP. Positive surgical margins were found in 39.2% of the cases. Biochemical recurrence (BR) occurred for 214 (18%) of patients. The estimated biochemical recurrence free survival (BRFS) was 71.7% and 63.2% after 5 and 10 years, respectively. When patients were stratified according to the D'Amico criteria, BRFS after 10 years was 75.3%, 59.7%, and 39.3% for low-, medium- and high-risk patients, respectively. In univariate analysis, clinical stage, PSA at diagnosis and type of surgery were significant predictors of BR. In multivariate analysis, Gleason score > 7, PSA > 10, and higher clinical stage were significant predictors of BR. Early Danish results in a population not subjected to screening demonstrate BRFS rates comparable with earlier reports from the prescreening era.

scholarly journals Assessment of PSIM (Prostatic Systemic Inflammatory Markers) Score in Predicting Pathologic Features at Robotic Radical Prostatectomy in Patients with Low-Risk Prostate Cancer Who Met the Inclusion Criteria for Active Surveillance

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 355
Author(s):  
Matteo Ferro ◽  
Gennaro Musi ◽  
Deliu Victor Matei ◽  
Alessandro Francesco Mistretta ◽  
Stefano Luzzago ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Active Surveillance ◽  
Inflammatory Markers ◽  
Low Risk ◽  
Inclusion Criteria ◽  
Robotic Radical Prostatectomy ◽  
Lymphocyte Ratio ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer

Background: circulating levels of lymphocytes, platelets and neutrophils have been identified as factors related to unfavorable clinical outcome for many solid tumors. The aim of this cohort study is to evaluate and validate the use of the Prostatic Systemic Inflammatory Markers (PSIM) score in predicting and improving the detection of clinically significant prostate cancer (csPCa) in men undergoing robotic radical prostatectomy for low-risk prostate cancer who met the inclusion criteria for active surveillance. Methods: we reviewed the medical records of 260 patients who fulfilled the inclusion criteria for active surveillance. We performed a head-to-head comparison between the histological findings of specimens after radical prostatectomy (RP) and prostate biopsies. The PSIM score was calculated on the basis of positivity according to cutoffs (neutrophil-to-lymphocyte ratio (NLR) 2.0, platelets-to-lymphocyte ratio (PLR) 118 and monocyte-to-lymphocyte-ratio (MLR) 5.0), with 1 point assigned for each value exceeding the specified threshold and then summed, yielding a final score ranging from 0 to 3. Results: median NLR was 2.07, median PLR was 114.83, median MLR was 3.69. Conclusion: we found a significantly increase in the rate of pathological International Society of Urological Pathology (ISUP) ≥ 2 with the increase of PSIM. At the multivariate logistic regression analysis adjusted for age, prostate specific antigen (PSA), PSA density, prostate volume and PSIM, the latter was found the sole independent prognostic variable influencing probability of adverse pathology.

Adverse Disease Features in Gleason Score 3 + 4 “Favorable Intermediate-Risk” Prostate Cancer: Implications for Active Surveillance

2017 ◽  
Vol 72 (3) ◽  
pp. 442-447 ◽  
Author(s):  
Alessandro Morlacco ◽  
John C. Cheville ◽  
Laureano J. Rangel ◽  
Derek J. Gearman ◽  
R. Jeffrey Karnes
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Gleason Score ◽  
Intermediate Risk ◽  
Risk Prostate Cancer

AIDS-Related Kaposi’s Sarcoma: Evaluation of Potential New Prognostic Factors and Assessment of the AIDS Clinical Trial Group Staging System in the Haart Era—the Italian Cooperative Group on AIDS and Tumors and the Italian Cohort of Patients Naïve From Antiretrovirals

2003 ◽  
Vol 21 (15) ◽  
pp. 2876-2882 ◽  
Author(s):  
Guglielmo Nasti ◽  
Renato Talamini ◽  
Andrea Antinori ◽  
Ferdinando Martellotta ◽  
Gaia Jacchetti ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Survival Rate ◽  
Survival Data ◽  
Highly Active Antiretroviral Therapy ◽  
Kaposi's Sarcoma ◽  
Systemic Disease ◽  
Univariate Analysis ◽  
Kaposi’S Sarcoma ◽  
Staging System ◽  
Clinical Staging

Purpose: To assess potential new prognostic factors and to validate the AIDS Clinical Trials Group (ACTG) for AIDS-related Kaposi’s sarcoma (AIDS-KS) staging system in the highly active antiretroviral therapy (HAART) era. Patients and Methods: We collected epidemiologic, clinical, staging, and survival data from 211 patients with AIDS-KS enrolled in two prospective Italian human immunodeficiency virus (HIV) cohort studies. We included in the analysis all patients with the diagnosis of KS made from January 1996, the time at which HAART became available in Italy. Results: In the univariate analysis, survival was not influenced by sex, age, level of HIV viremia at KS diagnosis, HAART at KS diagnosis (HAART-naïve v HAART-experienced), or type of HAART combination. Regarding ACTG classification, the 3-year survival rate was 85% for T0 patients and 69% for T1 patients (P = .007), 83% for S0 patients and 63% for S1 patients (P = .003), and 83% for I0 patients and 71% for I1 patients (P = .06). In the multivariate analysis, only the combination of poor tumor stage (T1) and poor systemic disease (S1) risk identified patients with unfavorable prognosis. The 3-year survival rate of patients with T1S1 was 53%, which was significantly lower compared with the 3-year survival rates of patients with T0S0, T1S0, and T0S1, which were 88%, 80%, and 81%, respectively (P = .0001). Conclusion: In the era of HAART, a refinement of the original ACTG staging system is needed. CD4 level does not seem to provide prognostic information. Two different risk categories are identified: a good risk (T0S0, T1S0, T0S1) and a poor risk (T1S1).

AN INDIAN PROSPECTIVE STUDY OF DOCETAXEL THERAPY IN CRPC: CAN PRETREATMENT FACTORS PREDICT THE RESPONSE

2021 ◽  
pp. 78-81
Author(s):  
Devashish Kaushal ◽  
Rajeev Sood
Keyword(s):  
Overall Survival ◽  
Alkaline Phosphatase ◽  
Multivariate Analysis ◽  
Gleason Score ◽  
Univariate Analysis ◽  
Progression Free Survival ◽  
Castration Resistant Prostate Cancer ◽  
Poor Overall Survival ◽  
Free Survival ◽  
Carcinoma Prostate

Introduction: Studies on the effects of chemotherapy in Indian Castration-Resistant Prostate Cancer (CRPC) patients are very limited and world data is inconsistent. The purpose of the present study is to assess the effects of Docetaxel therapy in CRPC in Indian patients in terms of survival benet, both progression-free survival, and overall survival. This study also analyzes the effects of various factors on the survival of CRPC patients. Methodology: This is a single institutional prospective observational study. CRPC patients were treated with Docetaxel and followed till death as the primary endpoint or till the end of the study. Survivals were calculated with the Kaplan Meier method. Factors affecting survival were analyzed with univariate and multivariate analysis by log-rank t-test and Cox proportion hazard regression analysis. Result: Out of enrolled 101 patients, 78 were treated with Docetaxel. A decline in PSA (>50% reduction) was observed in 61.54%. Radiological response of regression noted in 40 % Nuclear Bone Scan and 19.23% CT/MRI by RECIST criteria. Progression-free survival and overall survival with Docetaxel (n=78) were 11.8 and 21 months respectively. Hemoglobin less than 11 gm%, Alkaline phosphatase more than 115 IU/dl, PSAmore than 14 ng/ml, Gleason score more than 7 and duration from diagnosis of carcinoma prostate to CRPC less than 24 months, the number of chemotherapy cycles less than 6 were all found to be signicantly associated with poor overall survival in univariate analysis while only Hemoglobin (P=0.0159) showed an independent association with overall survival in multivariate analysis. Conclusion: Overall and progression-free survival of CRPC patients with Docetaxel is 21 & 11.8 months respectively. Hemoglobin, Alkaline phosphatase, PSA, Gleason score, Docetaxel cycle, and duration from diagnosis of carcinoma prostate to CRPC were found to be signicantly associated with poor overall survival.

scholarly journals Impact of superselective intra-arterial and systemic chemoradiotherapy for gingival carcinoma; analysis of treatment outcomes and prognostic factors

2020 ◽  
Author(s):  
Yuki Mukai ◽  
Yuichiro Hayashi ◽  
Izumi Koike ◽  
Toshiyuki Koizumi ◽  
Madoka Sugiura ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Clinical Stage ◽  
Performance Status ◽  
Univariate Analysis ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Late Toxicity ◽  
Free Survival

Abstract Background: We compared outcomes and toxicities between concurrent retrograde super-selective intra-arterial chemoradiotherapy (IACRT) and concurrent systemic chemoradiotherapy (SCRT) for gingival carcinoma (GC).　Methods: We included 84 consecutive patients who were treated for non-metastatic GC ≥ stage III, from 2006 to 2018, in this retrospective analysis (IACRT group: n=66; SCRT group: n=18).Results: The median follow-up time was 24 (range: 1–124) months. The median prescribed dose was 60 (6–70.2) Gy (IACRT: 60 Gy; SCRT: 69 Gy). There were significant differences between the two groups in terms of 3-year overall survival (OS; IACRT: 78.8%, 95% confidence interval [CI]: 66.0–87.6; SCRT: 50.4%, 95% CI: 27.6–73.0; P = 0.039), progression-free survival (PFS; IACRT: 75.6%, 95% CI: 62.7–85.2; SCRT: 42.0%, 95% CI: 17.7–70.9; P = 0.028) and local control rates (LC; IACRT: 77.2%, 95% CI: 64.2–86.4; SCRT: 42.0%, 95% CI: 17.7–70.9; P = 0.015). In univariate analysis, age ≥ 65 years, decreased performance status (PS) and SCRT were significantly associated with worse outcomes (P < 0.05). In multivariate analysis, age ≥ 65 years, clinical stage IV, and SCRT were significantly correlated with a poor OS rate (P < 0.05). Patients with poorer PS had a significantly worse PFS rate. Regarding acute toxicity, 22 IACRT patients had grade 4 lymphopenia, and osteoradionecrosis was the most common late toxicity in both groups.Conclusions: This is the first report to compare outcomes from IACRT and SCRT among patients with GC. ALL therapy related toxicities were manageable. IACRT is an effective and safe treatment for GC.

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