scholarly journals The Relationship Between Prostate Cancer Aggressiveness and Glycemic Levels in Patients Submitted to Radical Prostatectomy

2013 ◽  
Author(s):  
Goncalves
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Cancer Aggressiveness ◽  
The Relationship

scholarly journals Associations Between Serum Vitamin D and Adverse Pathology in Men Undergoing Radical Prostatectomy

2016 ◽  
Vol 34 (12) ◽  
pp. 1345-1349 ◽  
Author(s):  
Yaw A. Nyame ◽  
Adam B. Murphy ◽  
Diana K. Bowen ◽  
Gregory Jordan ◽  
Ken Batai ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Vitamin D ◽  
Radical Prostatectomy ◽  
Univariate Analysis ◽  
Serum Vitamin ◽  
Serum Vitamin D ◽  
Cancer Aggressiveness ◽  
Increased Risk ◽  
Vitamin D Levels ◽  
The Relationship

Purpose Lower serum vitamin D levels have been associated with an increased risk of aggressive prostate cancer. Among men with localized prostate cancer, especially with low- or intermediate-risk disease, vitamin D may serve as an important biomarker of disease aggression. The aim of this study was to assess the relationship between adverse pathology at the time of radical prostatectomy and serum 25-hydroxyvitamin D (25-OH D) levels. Methods This cross-sectional study was carried out from 2009 to 2014, nested within a large epidemiologic study of 1,760 healthy controls and men undergoing prostate cancer screening. In total, 190 men underwent radical prostatectomy in the cohort. Adverse pathology was defined as the presence of primary Gleason 4 or any Gleason 5 disease, or extraprostatic extension. Descriptive and multivariate analyses were performed to assess the relationship between 25-OH D and adverse pathology at the time of prostatectomy. Results Eighty-seven men (45.8%) in this cohort demonstrated adverse pathology at radical prostatectomy. The median age in the cohort was 64.0 years (interquartile range, 59.0 to 67.0). On univariate analysis, men with adverse pathology at radical prostatectomy demonstrated lower median serum 25-OH D (22.7 v 27.0 ng/mL, P = .007) compared with their counterparts. On multivariate analysis, controlling for age, serum prostate specific antigen, and abnormal digital rectal examination, serum 25-OH D less than 30 ng/mL was associated with increased odds of adverse pathology (odds ratio, 2.64; 95% CI, 1.25 to 5.59; P = .01). Conclusion Insufficiency/deficiency of serum 25-OH D is associated with increased odds of adverse pathology in men with localized disease undergoing radical prostatectomy. Serum 25-OH D may serve as a useful biomarker in prostate cancer aggressiveness, which deserves continued study.

Association of calcium channel blocker use with prostate cancer aggressiveness, progression-free survival, and overall survival.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15204-e15204
Author(s):  
Michael Adam Poch ◽  
Diana Mehedint ◽  
Alexandra Curtis ◽  
Kristopher Attwood ◽  
Gregory E. Wilding ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Radical Prostatectomy ◽  
Calcium Channel ◽  
Cox Regression ◽  
Medication Use ◽  
Progression Free Survival ◽  
Channel Blockers ◽  
Free Survival ◽  
Cancer Aggressiveness

e15204 Background: Epidemiological studies indicate that the use of calcium channel blockers (CCB) is inversely related to prostate cancer (PCa) incidence. The goal of this study was to examine the association between CCB use and PCa aggressiveness at the time of radical prostatectomy (RP) or outcome after RP. Methods: Information on medication use, PCa aggressiveness and outcome after RP was retrieved from a prospective database that contains clinical and follow-up (FU) data for all men that have undergone RP at the Department of Urology at Roswell Park Cancer Institute since 1992. The database was queried for anti-hypertensive medication use at the time of diagnosis for all patients with ≥ 1 year FU. Prostate cancer aggressiveness (risk status) and recurrence were defined using NCCN guideline definitions. Cox regression models were performed to compare the distribution of progression-free survival (PFS) and overall survival (OS) with adjustment for covariates. Chi-Square test was used to assess the relationship between CCB use and PCa aggressiveness. Results: 875 men were included in the study. At diagnosis, mean age was 60 (SD ± 7) years and mean serum PSA value was 7.4 (SD ±7.4) ng/ml. 48%, 37%, and 15% of patients had low risk, intermediate risk, or high risk PCa, respectively. 104 (12%) had a history of CCB use. CCB users and non-users were similar by PSA at diagnosis (p=0.97) and tumor aggressiveness (p=0.88). Patients taking CCB were more likely to be older (p=0.023), have a higher BMI (p=0.006) and use additional anti-hypertensive medications (p<0.01). Margin status after radical prostatectomy was similar (p=0.30) between the two groups. Median FU was 42 months. PFS (p=0.82, HR 95% CI: 0.63-1.44) and OS (p=0.72, HR 95% CI: 0.42-3.52) did not differ between the 2 groups. Adjusting for age and PCa aggressiveness did not alter the results observed for PFS (p=0.44, HR 95% CI: 0.62–1.41) and OS (p=0.50, HR 95% CI: 0.04-3.48). PCa aggressiveness was associated with PFS (p=0.001) in the multivariate model. Conclusions: CCB use does not affect PCa aggressiveness at time of diagnosis or improve PFS or OS.

Among men with low-grade prostate cancer on prostate biopsy, the 4Kscore to predict prostate cancer aggressiveness at prostatectomy.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 65-65
Author(s):  
Bruno Nahar ◽  
Sanoj Punnen ◽  
Stephen M Zappala ◽  
Daniel Sjoberg ◽  
Dipen Parekh
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Radical Prostatectomy ◽  
Prostate Biopsy ◽  
The United States ◽  
Low Grade ◽  
Surgical Specimen ◽  
Aggressive Prostate Cancer ◽  
Free Psa ◽  
Cancer Aggressiveness

65 Background: Most men diagnosed with prostate cancer in the United States have low-grade tumors. While many of these men are good candidates for active surveillance, a proportion will have a bad outcome due to the presence of a more aggressive prostate cancer that was missed on initial biopsy. A recent study confirmed the 4Kscore accurately predicts the likelihood of aggressive cancer on prostate biopsy. We analyzed if the 4Kscore could predict the presence of more significant cancer in men with low-grade tumors on the diagnostic biopsy. Methods: A recent prospective validation of the 4Kscore was conducted at 26 sites throughout the United States. We selected men who were found to have low-grade (Gleason 6) cancer on biopsy for this analysis. The 4Kscore calculates the risk of aggressive prostate cancer on prostate biopsy by a blood test that measures levels of four kallikrein biomarkers (total PSA, free PSA, intact PSA, and human kallikrein-2) plus age, DRE findings, and prior biopsy status. We investigated whether the 4Kscore was associated with more significant cancer among men found to have Gleason 6 cancer on prostate biopsy. We also looked at a subset of these men who underwent radical prostatectomy to see if the 4Kscore was associated with prostate cancer being upgraded in the surgical specimen. Results: Among the 1,312 men enrolled in this trial, 306 men were found to have Gleason 6 cancer on prostate biopsy. The 4Kscore was significantly associated with the number of positive cores (p=0.001) and the millimeters of cancer seen (p=0.0002), with higher 4Kscores relating to more extensive cancer present on biopsy. In the subpopulation of 51 men who underwent radical prostatectomy, the median 4Kscore was significantly higher among men who had an upgrade to Gleason 7 or higher [15% (8,25)] compared to men who did not experience an upgrade [7% (4,14)] (p=0.032) in their final pathology. Conclusions: Among men with Gleason 6 prostate cancer on biopsy, the 4Kscore was associated with the prostate cancer being upgraded in the surgical specimen at radical prostatectomy. The 4Kscore test may facilitate the selection of men who can be observed versus those who should undergo immediate treatment.

scholarly journals Impact of tertiary Gleason pattern 5 on prostate cancer aggressiveness: Lessons from a contemporary single institution radical prostatectomy series

2015 ◽  
Vol 2 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Zachary B. Koloff ◽  
Daniel A. Hamstra ◽  
John T. Wei ◽  
Jeffrey S. Montgomery ◽  
Scott A. Tomlins ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Single Institution ◽  
Gleason Pattern ◽  
Cancer Aggressiveness

scholarly journals Preoperative Prostate Health Index predicts adverse pathology and Gleason score upgrading after radical prostatectomy for prostate cancer

2020 ◽  
Author(s):  
Vojtěch Novák ◽  
Štěpán Veselý ◽  
Hana Lukšanová ◽  
Richard Průša ◽  
Otakar Čapoun ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Specific Antigen ◽  
Surgical Margin ◽  
Positive Surgical Margin ◽  
Health Index ◽  
Cancer Aggressiveness ◽  
Prostate Health Index ◽  
Prostate Health

Abstract Background: We aimed to explore the utility of prostate specific antigen (PSA) isoform [-2]proPSA and its derivatives for prediction of pathological outcome after radical prostatectomy (RP).Methods: Preoperative blood samples were prospectively and consecutively analyzed from 472 patients treated with RP for clinically localized prostate cancer at four medical centers. Measured parameters were PSA, free PSA (fPSA), fPSA/PSA ratio, [-2]proPSA (p2PSA), p2PSA/fPSA ratio and Prostate Health Index (PHI) (p2PSA/fPSA)*√PSA]. Logistic regression models were fitted to determine the accuracy of markers for prediction of pathological Gleason score (GS) ≥7, Gleason score upgrading, extracapsular extension of the tumor (pT3) and the presence of positive surgical margin (PSM). Results: Of 472 patients undergoing RP, 339 (72%) were found to have pathologic GS ≥ 7, out of them 178 (53%) experienced an upgrade from their preoperative GS=6. The findings of pT3 and PSM were present in 132 (28%) and 133 (28%) cases, respectively. At univariable analysis of all the preoperative parameters, PHI was the most accurate predictor of pathological GS ≥7, GS upgrading, pT3 disease and the presence of PSM. Adding of PHI into the base multivariable model increased significantly the accuracy for prediction of pathological GS and GS upgrading by 4.4% (p=0.015) and 5.0% (p=0.025), respectively. Conclusion: We found that PHI provides the highest accuracy in predicting prostate cancer aggressiveness and expansion of the tumor detected at final pathology. The ability of PHI to predict the risk of Gleason score upgrade may help to identify potentially high-risk patients among men with biopsy proven insignificant prostate cancer.

843: PSA Velocity Predicts Gleason Grade in the Radical Prostatectomy Specimen: A Marker for Prostate Cancer Aggressiveness

2007 ◽  
Vol 177 (4S) ◽  
pp. 281-281
Author(s):  
Stacy Loeb ◽  
Douglas E. Sutherland ◽  
Anthony V. D'Amico ◽  
Kimberly A. Roehl ◽  
William J. Catalona
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Grade ◽  
Radical Prostatectomy Specimen ◽  
Cancer Aggressiveness ◽  
Psa Velocity ◽  
Prostatectomy Specimen

Can PSA testing stop 10 years after radical prostatectomy?

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 179-179
Author(s):  
S. Loeb ◽  
Z. Feng ◽  
A. Ross ◽  
B. J. Trock ◽  
E. B. Humphreys ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Cancer Specific Survival ◽  
Psa Testing ◽  
Pathologic Features ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Multivariable Models ◽  
The Relationship ◽  
Subsequent Risk

179 Background: Biochemical recurrence (BCR) most frequently occurs within the first five years following radical prostatectomy. Prior studies have suggested an association between lower-risk disease features and BCR at 5 years postoperatively. The objective of our study was to determine predictors of BCR ≥10 years after radical prostatectomy, and to examine the relationship between timing of BCR with the subsequent risk of metastases and cancer-specific mortality. Methods: Among 10,609 men from our institutional radical prostatectomy database, we identified 1684 men with BCR (PSA >0.2 ng/ml) without prior hormonal or radiation therapy. These men were classified into by the time of BCR: early (<5 years), intermediate (5-10 years), and late (>10 years). Univariable and multivariable models were used to examine the association of clinico-pathologic variables with the timing of BCR. We also examined metastasis-free and cancer-specific survival based upon the timing of BCR. Results: Of BCR, 77.0%, 16.6%, 4.9%, and 1.5% occurred at <5, 5-10, 10-15, and >15 years postoperatively. Late recurrences were associated with more favorable pathologic features, and were unlikely to develop metastases or prostate cancer-specific mortality. Conclusions: The majority of BCR occurs within 10 years of surgery. Although 6.4% of BCR occurred at ≥10 years, these patients were unlikely to subsequently develop metastases or die from prostate cancer. Patients who remain free from progression at 10 years postoperatively should be counseled that their risk of subsequent cancer-related morbidity and mortality is low. No significant financial relationships to disclose.

The relationship between pre‐radiation therapy testosterone levels and prostate cancer aggressiveness

Andrologia ◽  
2020 ◽  
Vol 52 (10) ◽  
Author(s):  
Daniel Taussky ◽  
Guila Delouya ◽  
Carole Lambert ◽  
Jean‐Paul Bahary ◽  
Fred Saad
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Testosterone Levels ◽  
Cancer Aggressiveness ◽  
The Relationship

The relationship between body-mass index, physical activity, and pathologic and clinical outcomes after radical prostatectomy for prostate cancer

2018 ◽  
Vol 37 (5) ◽  
pp. 789-798 ◽  
Author(s):  
Michel Wissing ◽  
Simone Chevalier ◽  
Ginette McKercher ◽  
Claudie Laprise ◽  
Saro Aprikian ◽  
...  
Keyword(s):  
Physical Activity ◽  
Prostate Cancer ◽  
Body Mass Index ◽  
Radical Prostatectomy ◽  
Clinical Outcomes ◽  
Body Mass ◽  
The Relationship
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