scholarly journals Oncoguía de cáncer de próstata 2020

2020 ◽  
Vol 2 (2) ◽  
pp. 157-163
Author(s):  
Miguel Ángel Jiménez Ríos ◽  
Anna Scavuzzo ◽  
Diego Antonio Preciado Estrella
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Treatment Guidelines ◽  
Digital Rectal Examination ◽  
Treatment Monitoring ◽  
Grading System ◽  
Imaging Diagnosis ◽  
Gleason Grading ◽  
Cáncer De Próstata

In Mexico, prostate cancer is the first cause of death in men. Instituto Nacional de Cancerología has developed health-care protocols for the main neoplasms. Members of its Urology Department framed Oncoguía de cáncer de próstata 2020, based on a bibliographic revision and a consensus they conducted. It includes the analysis of the risk factors and the central diagnostic elements: specific prostatic antigen (SPA), digital rectal examination (DRE), imaging diagnosis, biopsy, and Gleason grading system. Oncoguía also contains the role of the clinical assessment and life expectancy as treatment guidelines, which, according to the case, are radical prostatectomy, lymph-node treatment, hormone blockade, and treatment monitoring.

Prostate cancer risk calculators for healthy population: A systematic review (Preprint)

2021 ◽  
Author(s):  
Antonio Bandala-Jacques ◽  
Kevin Daniel Castellanos Esquivel ◽  
Fernanda Pérez-Hurtado ◽  
Cristobal Hernández-Silva ◽  
Nancy Reynoso-Noverón
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Systematic Review ◽  
Cancer Risk ◽  
Digital Rectal Examination ◽  
Prostate Cancer Risk ◽  
Individual Risk ◽  
Healthy Population ◽  
Risk Of Cancer ◽  
The Impact

BACKGROUND Screening for prostate cancer has long been a debated, complex topic. The use of risk calculators for prostate cancer is recommended for determining patients’ individual risk of cancer and the subsequent need for a prostate biopsy. These tools could lead to a better discrimination of patients in need of invasive diagnostic procedures and for optimized allocation of healthcare resources OBJECTIVE To systematically review available literature on current prostate cancer risk calculators’ performance in healthy population, by comparing the impact factor of individual items on different cohorts, and the models’ overall performance. METHODS We performed a systematic review of available prostate cancer risk calculators targeted at healthy population. We included studies published from January 2000 to March 2021 in English, Spanish, French, Portuguese or German. Two reviewers independently decided for or against inclusion based on abstracts. A third reviewer intervened in case of disagreements. From the selected titles, we extracted information regarding the purpose of the manuscript, the analyzed calculators, the population for which it was calibrated, the included risk factors, and the model’s overall accuracy. RESULTS We included a total of 18 calculators across 53 different manuscripts. The most commonly analyzed ones were they PCPT and ERSPC risk calculators, developed from North American and European cohorts, respectively. Both calculators provided high precision for the diagnosis of aggressive prostate cancer (AUC as high as 0.798 for PCPT and 0.91 for ERSPC). We found 9 calculators developed from scratch for specific populations, which reached diagnostic precisions as high as 0.938. The most commonly included risk factors in the calculators were age, PSA levels and digital rectal examination findings. Additional calculators included race and detailed personal and family history CONCLUSIONS Both the PCPR and the ERSPC risk calculators have been successfully adapted for cohorts other than the ones they were originally created for with no loss of diagnostic accuracy. Furthermore, designing calculators from scratch considering each population’s sociocultural differences has resulted in risk tools that can be well adapted to be valid in more patients. The best risk calculator for prostate cancer will be that which was has been calibrated for its intended population and can be easily reproduced and implemented CLINICALTRIAL CRD42021242110

scholarly journals Patient Assessment: Clinical Presentation, Imaging Diagnosis, Risk Stratification, and the Role of Pulmonary Embolism Response Team

2018 ◽  
Vol 35 (02) ◽  
pp. 116-121 ◽  
Author(s):  
Tamir Friedman ◽  
Keith Quencer ◽  
David Madoff ◽  
Ronald Winokur
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Presentation ◽  
Treatment Guidelines ◽  
The United States ◽  
Imaging Diagnosis ◽  
Patient Assessment ◽  
Timely Manner ◽  
Response Team ◽  
Hospital Deaths

AbstractPulmonary embolism (PE) is currently the third leading cause of death and moreover is likely underdiagnosed. PE remains the most common preventable cause of hospital deaths in the United States, which may be attributable to its diagnostic challenges. Although difficult to diagnose, patient mortality rates are time-dependent, and thus, the suspicion and diagnosis of PE in a timely manner is imperative. Diagnosis based on several criteria which may dictate imaging workup as well as laboratory tests and clinical parameters are discussed. The evolution of treatment guidelines via various clinical trials and recommendations is outlined, setting the stage for the use of fibrinolytics, whether systemic or catheter directed. Treatment, including fibrinolytics, is predicated on patient triage into three large categories—massive, submassive, or low-risk PE. Additionally, a relatively new concept of a multidisciplinary team composed of several subspecialty experts known as the PE response team (PERT) is discussed. PERT's timely and unified recommendations have been shown to optimize care and decrease mortality while tailoring treatment to each individual afflicted by PE.

Abstract 5033: Relationship between microRNA expression and Gleason grading system in prostate cancer

2012 ◽  
Author(s):  
Katsuki Tsuchiyama ◽  
Hideaki Ito ◽  
Minekatsu Taga ◽  
Konosuke Oshinoya ◽  
Kenichi Nagano ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Microrna Expression ◽  
Grading System ◽  
Gleason Grading

Should the Gleason grading system for prostate cancer be modified to account for high-grade tertiary components? A systematic review and meta-analysis

2007 ◽  
Vol 8 (5) ◽  
pp. 411-419 ◽  
Author(s):  
Patricia Harnden ◽  
Mike D Shelley ◽  
Bernadette Coles ◽  
John Staffurth ◽  
Malcom D Mason
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Meta Analysis ◽  
Grading System ◽  
High Grade ◽  
Gleason Grading

scholarly journals Biases in Recommendations for and Acceptance of Prostate Biopsy Significantly Affect Assessment of Prostate Cancer Risk Factors: Results From Two Large Randomized Clinical Trials

2016 ◽  
Vol 34 (36) ◽  
pp. 4338-4344 ◽  
Author(s):  
Catherine M. Tangen ◽  
Phyllis J. Goodman ◽  
Cathee Till ◽  
Jeannette M. Schenk ◽  
M. Scott Lucia ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Risk Factor ◽  
Cancer Prevention ◽  
Specific Antigen ◽  
Medication Use ◽  
Digital Rectal Examination ◽  
Prostate Cancer Prevention ◽  
Prevention Trials ◽  
Statin Use

Purpose To identify factors related to who undergoes a prostate biopsy in a screened population and to estimate the impact of biopsy verification on risk factor–prostate cancer associations. Patients and Methods Men who were screened regularly from the placebo arms of two large prostate cancer prevention trials (Prostate Cancer Prevention Trial [PCPT] and Selenium and Vitamin E Cancer Prevention Trial [SELECT]) were examined to define incident prostate cancer cohorts. Because PCPT had an end-of-study biopsy, prostate cancer cases were categorized by a preceding prostate-specific antigen/digital rectal examination prompt (yes/no) and noncases by biopsy-proven negative status (yes v no). We estimated the association of risk factors (age, ethnicity, family history, body mass index, medication use) with prostate cancer and quantified differences in risk associations across cohorts. Results Men 60 to 69 years of age, those with benign prostatic hyperplasia, and those with a family history of prostate cancer were more likely, and those with a higher body mass index (≥ 25), diabetes, or a smoking history were less likely, to undergo biopsy, adjusting for age and longitudinal prostate-specific antigen and digital rectal examination. Medication use, education, and marital status also influenced who underwent biopsy. Some risk factor estimates for prostate cancer varied substantially across cohorts. Black ( v other ethnicities) had odds ratios (ORs) that varied from 1.20 for SELECT (community screening standards, epidemiologic-like cohort) to 1.83 for PCPT (end-of-study biopsy supplemented with imputed end points). Statin use in SELECT provided an OR of 0.65 and statin use in in PCPT provided an OR of 0.99, a relative difference of 34%. Conclusion Among screened men enrolled in prostate cancer prevention trials, differences in risk factor estimates for prostate cancer likely underestimate the magnitude of bias found in other cohorts with varying screening and biopsy recommendations and acceptance. Risk factors for prostate cancer derived from epidemiologic studies not only may be erroneous but may lead to misdirected research efforts.

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