TY - JOUR. T1 - Clinical Significance of Benign Glands at Surgical Margins in Robotic Radical Prostatectomy Specimens. AU - Kohl, Shane K.. AU - Balaji, Kethandapatti C.. AU - Smith, Lynette M. AU - Wilson, Nicholas P.. AU - Johansson, Sonny L.. AU - Sterrett, Samuel P.. AU - Abrahams, Neil A.. PY - 2007/6/1. Y1 - 2007/6/1. N2 - Objectives: Completion of robotic radical prostatectomy compared with conventional open retropubic radical prostatectomy can result in different alterations in the prostatectomy specimens. One difference appears to be an increased incidence of benign glands at the margins, which has been associated with an increase in postoperative prostatic-specific antigen (PSA) levels. We compared the frequency and clinical significance of benign prostate glands at the surgical margins in radical prostatectomy specimens obtained by robotic versus open retropubic prostatectomy. Methods: We reviewed 38 consecutive prostatectomy specimens from patients with biopsy-proven prostate cancer. ...
BACKGROUND: The aim of this study is to investigate the cumulative incidence and risk factors of postoperative inguinal hernia (PIH) in patients undergoing radical prostatectomy, i.e., laparoscopic prostatectomy (LRP) and robot-assisted laparoscopic prostatectomy (RARP). METHODS: This study included 1124 patients who had undergone radical prostatectomy or transurethral resection of bladder tumor from 2011-2016. We compared the cumulative incidence of PIH in the radical prostatectomy groups (460; LRP 341, RARP 119) and the control group (664; transurethral resection of bladder tumor), and we then analyzed the risk factors (age, operative methods, previous abdominal operative history, thickness and width of external oblique muscle and rectus muscle, thickness of abdominal subcutaneous fat layer at Hesselbachs triangle level, body mass index, prostate-specific antigen, operative time, specimen weight, Gleason score, and pathology T-stage) of PIH in the radical prostatectomy groups ...
TY - JOUR. T1 - Effect of statin use on biochemical outcome following radical prostatectomy. AU - Ritch, Chad R.. AU - Hruby, Greg. AU - Badani, Ketan K.. AU - Benson, Mitchell C.. AU - McKiernan, James M.. PY - 2011/10/1. Y1 - 2011/10/1. N2 - Study Type - Prognosis (retrospective cohort) Level of Evidence 2b Whats known on the subject? and What does the study add? Statin use may reduce the risk of developing prostate cancer. Studies also suggest that the protective effect of statins may be beneficial for prostate cancer patients following treatment. Statin users may also have lower PSA than non-users. Our study agrees with the findings that statin users may have lower PSA than non-users. Contrary to the findings that statins are protective in prostate cancer this study shows no benefit and possible worse biochemical outcome after radical prostatectomy. OBJECTIVE • To determine the relationship between statin use and biochemical recurrence (BCR) following radical prostatectomy (RP). PATIENTS ...
TY - JOUR. T1 - Erectile Function Recovery After Nerve-Sparing Radical Prostatectomy for Prostate Cancer. T2 - Is Back to Baseline Status Enough for Patient Satisfaction?. AU - Rossi, Martina Sofia. AU - Moschini, Marco. AU - Bianchi, Marco. AU - Gandaglia, Giorgio. AU - Fossati, Nicola. AU - DellOglio, Paolo. AU - Schiavina, Riccardo. AU - Brunocilla, Eugenio. AU - Farina, Elena. AU - Picozzi, Marta. AU - Salonia, Andrea. AU - Montorsi, Francesco. AU - Briganti, Alberto. PY - 2016/4/1. Y1 - 2016/4/1. N2 - Introduction Several definitions of erectile function (EF) recovery after bilateral nerve-sparing radical prostatectomy (BNSRP) have been proposed based on the results of the International Index of EF (IIEF). Aim We aimed at evaluating overall satisfaction (OS) after BNSRP according to the ability to achieve the pretreatment EF. Methods We evaluated data of 652 patients treated with BNSRP for clinically localized prostate cancer (PCa). Erectile dysfunction (ED) was classified according to the ...
TY - JOUR. T1 - Evaluation of MDM2, p16, and p53 staining levels as biomarkers of biochemical recurrence following salvage radiation therapy for recurrent prostate cancer. AU - Heckman, Michael G.. AU - Parker, Alexander S.. AU - Wu, Kevin J.. AU - Hilton, Tracy W.. AU - Ko, Stephen J.. AU - Pisansky, Thomas M.. AU - Schild, Steven E.. AU - Khor, Li Yan. AU - Hammond, Elizabeth H.. AU - Pollack, Alan. AU - Buskirk, Steven J.. PY - 2012/12/1. Y1 - 2012/12/1. N2 - Background. AND PURPOSE The selection of appropriate candidates for salvage radiation therapy (SRT) to address a rising PSA following radical prostatectomy remains challenging. Herein, we provide the first evaluation of the ability of staining levels of the tumor based biomarkers MDM2, p16, and p53 to aid in prediction of biochemical recurrence (BCR) among men undergoing SRT for recurrent prostate cancer. Material And Methods. We identified 152 patients who were treated with SRT between July 1987 and July 2003. Staining levels of MDM2, ...
TY - JOUR. T1 - Transfer of laparoscopic radical prostatectomy skills from bench model to animal model. T2 - A prospective, single-blind, randomized, controlled study. AU - Sabbagh, Robert. AU - Chatterjee, Suman. AU - Chawla, Arun. AU - Hoogenes, Jen. AU - Kapoor, Anil. AU - Matsumoto, Edward D.. PY - 2012/5/1. Y1 - 2012/5/1. N2 - Purpose: Learning laparoscopic urethrovesical anastomosis is a crucial step in laparoscopic radical prostatectomy. Previously we noted that practice on a low fidelity urethrovesical model was more effective for trainees than basic suturing drills on a foam pad when learning laparoscopic urethrovesical anastomosis skills. We evaluated learner transfer of skills, specifically whether skills learned on the urethrovesical model would transfer to a high fidelity, live animal model. Materials and Methods: A total of 28 senior residents, fellows and staff surgeons in urology, general surgery and gynecology were randomized to 2 hours of laparoscopic urethrovesical anastomosis ...
Objectives: To compare two different approaches in learning laparoscopic radical prostatectomy , with or without using an online video simulator Design : Prospective randomized multicentric study. Methods: 20 surgeons considered as naive concerning their experience in laparoscopic radical prostatectomy will be randomized into two groups :1 group will use the online video simulator, 1 group will use usual learning methods except the online video simulator.. All procedures will be recorded from the beginning till the end.A video review will be preformed concerning all the videos in order to identify the total operative time and time to perform each one of the operative steps of the procedure.Clinical , biological and histological data will be collected in order to compare the two arms. ...
The risk of metastatic progression for prostate cancer patients who undergo radical prostatectomy is best estimated presently based on prostate-specific antigen (PSA) doubling time (PSADT). However, additional markers of risk are needed to identify patients who may benefit from aggressive salvage treatment. A decrease in zinc-alpha2-glycoprotein (AZGP1) mRNA levels in malignant prostate epithelium was previously shown to predict biochemical recurrence, as defined by rising levels of serum PSA after radical prostatectomy. We assessed the reliability with which AZPG1 expression could predict clinical recurrence and metastatic progression. Using immunohistochemical methods, we analyzed AZPG1 expression in malignant prostate epithelium in prostatectomy specimens from 228 prostate cancer patients. Low (i.e., absent or weak) AZGP1 expression was associated with clinical recurrence (defined as confirmed localized recurrence, metastasis, or death from prostate cancer; hazard ratio [HR] = 4.8, 95% confidence
OBJECTIVE: The aim of this study was to compare oncological and functional outcomes between robot-assisted laparoscopic radical prostatectomy (RALP) and retropubic radical prostatectomy (RRP) during the initial phase with RALP at a large university hospital. MATERIAL AND METHODS: Patient and tumour characteristics, surgeon, nerve sparing, surgical margins and blood loss were recorded prospectively in patients who underwent RRP or RALP between April 2008 and May 2012. Patients filled out the Danish Prostate Symptom Score (DAN-PSS) and International Index of Erectile Function 5 (IIEF-5) questionnaires before surgery and at follow-up and they were asked to report their use of pads/diapers. Potency was defined as an IIEF-5 score of at least 17 with or without phosphodiesterase-5 inhibitors. Patients using up to one pad daily for security reasons only were considered continent. Positive surgical margins, blood loss and functional outcomes were compared between groups. RESULTS: Overall, 453 patients ...
TY - JOUR. T1 - Predictors of survival for prostate carcinoma patients treated with salvage radical prostatectomy after radiation therapy. AU - Cheng, Liang. AU - Sebo, Thomas J.. AU - Slezak, Jeff. AU - Pisansky, Thomas M.. AU - Bergstralh, Erik J.. AU - Neumann, Roxann M.. AU - Iczkowski, Kenneth A.. AU - Zincke, Horst. AU - Bostwick, David G.. PY - 1998/11/15. Y1 - 1998/11/15. N2 - BACKGROUND. Salvage radical prostatectomy is a treatment option for patients with recurrent cancer following radiation therapy. This study was conducted to identify predictors of survival for patients treated with salvage radical prostatectomy. METHODS. The authors studied 86 prostate carcinoma patients who underwent salvage radical prostatectomy for locally persistent or recurrent prostate carcinoma at Mayo Clinic between 1967 and 1996. The mean interval from radiation therapy to biopsy-proven recurrence was 3.7 years (range, 6 months to 17 years). Patient age at surgery ranged from 51 to 78 years (median, 66 ...
TY - JOUR. T1 - Impact of a family history of prostate cancer on clinicopathologic outcomes and survival following radical prostatectomy. AU - Westerman, Mary E.. AU - Gershman, Boris. AU - Karnes, Robert Jeffrey. AU - Thompson, R. Houston. AU - Rangel, Laureano. AU - Boorjian, Stephen A.. PY - 2015/12/9. Y1 - 2015/12/9. N2 - Purpose: While a family history (FH) of prostate cancer represents an established risk factor for prostate cancer diagnosis, conflicting data exist regarding the oncologic importance of FH. Herein, we evaluated the association of FH with clinicopathologic outcomes among men undergoing radical prostatectomy (RP). Methods: We identified 16,472 men who underwent RP between 1987 and 2010 at Mayo Clinic. Patients were considered to have a positive FH if at least one first-degree relative had been diagnosed with prostate cancer. Survival was estimated using the Kaplan-Meier method. The associations of FH with clinicopathologic features and survival were evaluated using logistic ...
1] Ahlering TE, Woo D, Eichel L, Lee DI, Edwards R, Skarecky DW. Robot-assisted versus open radical prostatectomy: a comparison of one surgeons outcomes. Urology. 2004 May;63(5):819-22. p. 821 table III.. [2] Scardino PT. Open Radical Retropubic Prostatectomy. Presented at the American Urological Associations Carcinoma of the Prostate Course, San Francisco, California, Sept. 30 - Oct. 1 2005. [3] Touijer K, Kuroiwa K, Saranchuk JW, Hassen WA, Trabulsi EJ, Reuter VE, Guillonneau B. Quality improvement in laparoscopic radical prostatectomy for pT2 prostate cancer: impact of video documentation review on positive surgical margin. J Urol. 2005 Mar;173(3):765-8. p. 766 (Results). [4] Bhandari, A., McIntire, L., Kaul, S.A., Hemal, A.K., Peabody, J.O., and Menon, M. (2005). Perioperative complications of robotic radical prostatectomy after the learning curve. J Urol 174, 915-918.. [5] Brown, J.A., Garlitz, C., Gomella, L.G., McGinnis, D.E., Diamond, S.M., and Strup, S.E. (2004). Perioperative ...
STUDY TYPE Therapy (case series). LEVEL OF EVIDENCE 4. Whats known on the subject? and What does the study add? Despite excellent surgical cancer control, up to 40% of patients will have biochemical recurrence following radical prostatectomy (RP) for localized prostate cancer. Positive surgical margins (PSM) have been clearly demonstrated to be one of the main predictive factors for biochemical failure, disease progression and cancer mortality. However, decision of further management (adjuvant or salvage therapy) in patients with PSM remains controversial, and many debatable questions arise concerning the incidence of clinical progression and the impact of systematic adjuvant treatment on the cancer specific and overall survival. Analysis of the pathological and disease recurrence outcomes of our large cohort of patients treated by RP provides evidence that PSMs are associated with a poor prognosis in terms of PSA failure and need for salvage therapy. However, such a distinction between negative or
Prostate cancer is the most common cancer in American men. Surgical removal of the entire prostate (prostatectomy) is one option among the various ways to treat prostate cancer. The use of robot assistance for prostatectomy has become common place, but its effectiveness has not been compared to standard open prostatectomy in trials carried out at more than one medical institution in which participants are identified and followed forward in time. Robot assisted and standard open prostatectomy health related quality of life (HRQOL) outcomes have not been compared in a prospective, multi-centered study. Prostatectomy can have side effects that can change with time. This research study seeks to determine how common and how long-lasting such side effects are; to find out what features of individual mens cancers and what features of the treatments affect those side effects. This study also seeks to identify factors that affect the quality of prostate cancer care by looking at how satisfied men are ...
Among men with prostate cancer who underwent radical prostatectomy (RP), those who were obese had a higher risk of biochemical recurrence
Treatment of prostate cancer with nerve-sparing radical prostatectomy (costs for program #65245) ✔ Multispecialty Hospital Lindberg ✔ Department of Urology ✔ BookingHealth.com
To establish a robotic-assisted laparoscopic radical prostatectomy programme at the University of Western Ontario/London Health Sciences Centre and to critically evaluate the role of this programme in the management of localized prostate cancer in surgical candidates Details of surgical procedure, operative outcome, patient outcome including quality of life will be collected ...
Robot-assisted laparoscopic prostatectomy and open radical retropubic prostatectomy are associated with similar functional outcomes at 12 weeks.
Background: We vigorously reviewed patients operation record who had adhesion of the Denonvilliers fascia and found out most of these patients had prostatic bleeding after prostatic gland biopsies. We examined the magnitude of prostatic bleeding and frequency after biopsies and the relationship with oncological outcomes. Materials and Methods: A total of 285 patients were selected for the final analyses. Inclusion criteria were as follows: receiving MRI three weeks after biopsiesand laparoscopic radical prostatectomy within 300 days after biopsy. We divided the patients into two groups with (group A) or without (group B) prostatic bleeding. We examined the magnitude of prostatic bleeding after biopsies and the relationship with operation time (OT), positive surgical margin (PSM), biochemical recurrence (BCR) and other factors. Furthermore, we created a logistic-regression model to derive a propensity score for prostatic bleeding after biopsies, which included all patient and hospital characteristics
The popularity of minimally invasive radical prostatectomy (MIRP) has risen despite lack of data on outcomes and higher costs compared with open retropubic radical prostatectomy (RRP), say US researchers
BACKGROUND: Adjuvant chemotherapy is standard treatment for other solid tumours, but to date has not proven effective in prostate cancer.. OBJECTIVE: o evaluate whether six cycles of docetaxel alone improve biochemical disease-free survival after radical prostatectomy for high-risk prostate cancer.. DESIGN, SETTING, AND PARTICIPANTS: Open-label, randomised multinational phase 3 trial. Enrolment of 459 patients after prostatectomy.. INCLUSION CRITERIA: high-risk pT2 margin positive or pT3a Gleason score ≥4+3, pT3b, or lymph node positive disease Gleason score ≥3+4. Patients assigned (1:1) to either six cycles of adjuvant docetaxel 75mg/m2 every 3 wk without daily prednisone (Arm A) or surveillance (Arm B) until endpoint was reached. Primary endpoint was prostate-specific antigen progression ≥0.5 ng/ml.. INTERVENTION: Docetaxel treatment after prostatectomy.. RESULTS AND LIMITATIONS: Median time to progression, death, or last follow-up was 56.8 mo. Primary endpoint was reached in 190/459 ...
Summary of Article from the Journal Urology:. Quality of Life After Open or Robotic Prostatectomy, Cryoablation or Brachytherapy for Localized Prostate Cancer.. J Urol. 2010 Mar 17 [Epub ahead of print]. Malcolm JB, Fabrizio MD, Barone BB, et al.. 785 patients were included in a study by the authors to compare quality of life outcomes after being treated for prostate cancer. The study was conducted between February 2000 and December 2008 and all patients treated with open radical prostatectomy, robot assisted laparoscopic prostatectomy, brachytherapy or cryotherapy were asked to complete a quality of life survey for up to 36 months after treatment. The article states that all health related quality of life symptoms were negatively affected by all treatments and recovery profiles varied significantly by treatment type. However, urinary function scores were significantly higher after brachytherapy and cryotherapy compared to radical prostatectomy and robotic assisted laparoscopic prostatectomy. In ...
TY - JOUR. T1 - Re. T2 - The natural history of metastatic progression in men with prostate-specific antigen recurrence after radical prostatectomy: Long-term follow-up. AU - Walsh, Patrick C.. PY - 2012/9/1. Y1 - 2012/9/1. UR - http://www.scopus.com/inward/record.url?scp=84864913578&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=84864913578&partnerID=8YFLogxK. U2 - 10.1016/j.juro.2012.05.064. DO - 10.1016/j.juro.2012.05.064. M3 - Comment/debate. C2 - 22883757. AN - SCOPUS:84864913578. VL - 188. JO - Journal of Urology. JF - Journal of Urology. SN - 0022-5347. IS - 3. ER - ...
A radical prostatectomy is a procedure to remove the prostate gland. It is performed to treat prostate cancer. At Brisbane Urology Clinic, our urologist perform robotic radical prostatectomy using the daVinci robotic surgical system. ...
Methods: We reviewed 76 patients with pT2-3N0M0 prostate cancer who underwent salvage radiotherapy for post-prostatectomy biochemical recurrence at the following three timings: ultra-early salvage radiotherapy (n = 20) delivered before meeting a current definition of biochemical recurrence (two consecutive prostate-specific antigen [PSA] values ≥0.2 ng/mL); early salvage radiotherapy (n = 40) delivered after meeting the definition but before PSA reached 0.5 ng/mL; and delayed salvage radiotherapy (n = 16) delivered after PSA reached 0.5 ng/mL. The primary endpoint was failure of salvage radiotherapy, defined as a PSA value ≥0.2 ng/mL. The log-rank test and Cox proportional hazards model were used for univariate and multivariate analyses, respectively ...
By 2015, prostate cancer will become the most commonly diagnosed cancer in men. Radical prostatectomy reduces disease-specific mortality in patients with localized prostate cancer; however, the invasiveness of surgery and its resultant side effects cause many men to seek other treatments. In 2000, laparoscopic radical prostatectomy emerged as a minimally invasive alternative to open surgery; it has been refined recently by the addition of robotic technology. To examine the outcomes of robotic radical prostatectomy and compare them with those from open and conventional laparoscopic radical prostatectomy, we prospectively collected baseline demographic data on all patients undergoing surgery for prostate cancer over a 4-year period at our center. Urinary function and sexual function were evaluated using standardized criteria as well as a questionnaire preoperatively and at 1, 3, 6, 12, and 18 months after their procedure. Operative and postoperative outcomes were compared using values for open ...
A few good studies exist looking at open versus laparoscopic versus laparoscopic and robotic radical prostatectomy in cancer as of 2011.[1] There is a robotic and non robotic version.[2] These two versions have unclear differences in cancer related outcomes[2] The American Cancer Society states that success with laparoscopic technique is determined by surgeon experience and focus. There is a long learning curve for the robotic procedure. It is estimated that about 60 cases need to be performed by a surgeon to be comfortable with the procedure and about 250 cases to be an expert. The procedure takes at least five hours and as long as eight hours for the average urologist, without a bilateral lymph node dissection, compared to 2.5-3 hours when done by an open technique with an incision, with a completed lymph node dissection. There is a greater risk of accidentally incising into the prostate, resulting in "margin positivity," i.e. leaving cancer within the patient, in otherwise organ confined ...
To evaluate the influence of posterior musculofascial plate reconstruction (PR) on early return of continence after radical prostatectomy (RP); an updated systematic review of the literature. A systematic review of the literature was performed in June 2015, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and searching Medline, Embase, Scopus and Web of Science databases. We searched the terms posterior reconstruction prostatectomy, double layer anastomosis prostatectomy across the Title and Abstract fields of the records, with the following limits: humans, gender (male), and language (English). The authors reviewed the records to identify studies comparing cohorts of patients who underwent RP with or without restoration of the posterior aspect of the rhabdosphincter. A meta-analysis of the risk ratios estimated using data from the selected studies was performed. In all, 21 studies were identified, including three randomised controlled ...
Liu, W., Xie, C. C., Thomas, C. Y., Kim, S.-T., Lindberg, J., Egevad, L., Wang, Z., Zhang, Z., Sun, J., Sun, J., Koty, P. P., Kader, A. K., Cramer, S. D., Bova, G. S., Zheng, S. L., Grönberg, H., Isaacs, W. B. and Xu, J. (2013), Genetic markers associated with early cancer-specific mortality following prostatectomy. Cancer, 119: 2405-2412. doi: 10.1002/cncr.27954 ...
The addition of two years of anti-androgen therapy (AAT) to radiation therapy reduces the risk of death caused by prostate cancer among men treated for a recurrence following a prostatectomy.. Treatment for early prostate cancer often includes the surgical removal of the prostate (prostatectomy). Unfortunately, some patients will experience a cancer recurrence following surgery.. Treatment for a recurrence following a prostatectomy may include radiation therapy and/or AAT. Since prostate cancer cells are stimulated to grow from exposure to testosterone, AAT creates anti-cancer effects by decreasing the bodys production of testosterone.. Researchers continue to explore optimal treatment combinations among men with recurrent prostate cancer to ensure optimal survival without unnecessary side effects.. Researchers of the Radiation Therapy Oncology Group (RTOG) conducted a phase III clinical trial to evaluate whether the addition of long-term AAT would improve survival among patients with prostate ...
Material & Methods: Using the database of the European study on radical prostatectomy (653(DQG PHQ ZKR XQGHUZHQW UDGLFDO UHWURSXELF SURVWDWHFWRP\ EHWZHHQ DQGDWRWDORISDWLHQWVZHUHLGHQWLᚏHGZKRKDGXQGHUJRQHELODWHUDOQHUYHVSDULQJ and preservation of the tip of the seminal vesicle (GROUP 1). Potency and continence results were compared to a matched group of 1424 men who also underwent a bilateral nerve sparing procedure without preservation of the seminal vesicle tip during the same period (GROUP 2). Results: 2YHUDOOFRQWLQHQFHUDWHSDGDW\HDUZDVZLWKD&,&RQWLQHQFH WLPHNLQHWLFVDWPRDWPRDWPRDQGDWPR$ GLᚎHUHQFHZDVVHHQZKHQFRPSDULQJSK\VLFLDQDQGSDWLHQWJXLGHGTXHVWLRQQDLUHVZLWK respect to continence (physicians judging rates more favourably).A constant relative increase in Nerve-sparing (uni- and bilateral) procedures was observed with highest rates 1998-2000, and reaching a steady state thereafter (at 71,4% of all cases). Potency results and time kinetics in both groups are: Potency GROUP 1* GROUP 2 PR 8-15% ...
Abstract Context Membranous urethral length (MUL) measured prior to radical prostatectomy (RP) has been identified as a factor that is associated with the recovery of continence following surgery. Objective To undertake a systematic review and meta-analysis of all studies reporting the effect of MUL on the recovery of continence following RP. Evidence acquisition A comprehensive search of PubMed, EMBASE, and Scopus databases up to September 2015 was performed. Thirteen studies comprising one randomized controlled trial and 12 cohort studies were selected for inclusion. Evidence synthesis Four studies (1738 patients) that reported hazard ratio results. Every extra millimeter (mm) of MUL was associated with a faster return to continence (hazard ratio: 1.05; 95% confidence interval [CI]: 1.02-1.08, p
Conservative therapies for post-prostatectomy incontinence (PPI) are often the initial therapy offered to patients after radical prostatectomy. Lifestyle modifications have been shown to have some...
Issuu is a digital publishing platform that makes it simple to publish magazines, catalogs, newspapers, books, and more online. Easily share your publications and get them in front of Issuus millions of monthly readers. Title: Robotic Assisted Radical Prostatectomy: Surgical Techniquesand Outcomes, Author: urovideo urovideo, Name: Robotic Assisted Radical Prostatectomy: Surgical Techniquesand Outcomes, Length: 7 pages, Page: 1, Published: 2011-03-14
Positive surgical margins in pt2 tumors after radical prostatectomy for localized prostate cancer-can nerve-sparing technique increase the risk of a positive margin? ...
TY - JOUR. T1 - Impact of hormonal therapy prior to radical prostatectomy on the recovery of quality of life. AU - Namiki, Shunichi. AU - Saito, Seiichi. AU - Tochigi, Tatsuo. AU - Kuwahara, Masaaki. AU - Ioritani, Naomasa. AU - Yoshimura, Koji. AU - Terai, Akito. AU - Koinuma, Nobuo. AU - Arai, Yoichi. PY - 2005/2/1. Y1 - 2005/2/1. N2 - Background: We investigated the changes in health-related quality of life (HRQOL) in patients who underwent prostatectomy (RP) with or without neoadjuvant hormonal therapy (NHT). Methods: A total of 72 patients undergoing direct RP (DRP group) and 26 patients receiving neoadjuvant hormonal therapy (NHT group) were enrolled in the present study. The baseline interview was conducted before RP (not initiation of therapy). Follow-up interviews were conducted in person at scheduled study visits of 3, 6, and 12 months after surgery. We measured general and disease specific HRQOL with the Medical Outcomes Study 36-Item Short Form and University of California, Los ...
Objective: The ARO 96-02 trial primarily compared wait-and-see (WS, arm A) with adjuvant radiation therapy (ART, arm B) in prostate cancer patients who achieved an undetectable prostate-specific antigen (PSA) after radical prostatectomy (RP). Here, we report the outcome with up to 12 years of follow-up of patients who retained a post-RP detectable PSA and received salvage radiation therapy (SRT, arm C). Methods and Materials: For the study, 388 patients with pT3-4pN0 prostate cancer with positive or negative surgical margins were recruited. After RP, 307 men achieved an undetectable PSA (arms A + B). In 78 patients the PSA remained above thresholds (median 0.6, range 0.05-5.6 ng/mL). Of the latter, 74 consented to receive 66 Gy to the prostate bed, and SRT was applied at a median of 86 days after RP. Clinical relapse-free survival, metastasis-free survival, and overall survival were determined by the Kaplan-Meier method. Results: Patients with persisting PSA after RP had higher preoperative PSA ...
nomogram 2 can evaluate low risk cancers...candidates for brachytherapy or watchful waiting (active surveillance) to predict likelihood that findings in prostatectomy of that case would cause a postop Gleason upgrade (nomogram helps avoid potential under-treatment). NOTE: the nomograms do not know how to "back out" the inflammatory portion of elevated PSA, if the case has significant prostatitis [S07-6946]. (2) Or find authoritative discussions...with tables of pros & cons...of each treatment option by Mayo Clinic: click on treatment decisions at the page top...scroll down to Prostate Cancer Guide and click through about prostate cancer & chose treatment decisions. Currently operable only via Internet Explorer browsers. The Center for Prostate Disease Research (CPDR) has an online calculator to help indicate prognosis AFTER biochemical recurrence following radical prostatectomy. Lexington Medical Center has a comprehensive array of services and interests in prostate cancer: ...
Preoperative multiparametric magnetic resonance imaging (mpMRI) of the prostate is not routinely recommended as standard practice for men with high-risk prostate cancer, but new findings suggest that it could lead to changes in surgical planning that improve outcomes, according to investigators. "Preoperative mpMRI may lead to improved decision making regarding nerve-sparing and bladder neck dissection with the potential for decreasing positive surgical margin rates when obtained prior to radical prostatectomy for high-risk prostate cancer," Brian F. Chapin, MD, of the University of Texas MD Anderson Cancer Center in Houston, and colleagues concluded in a paper published in Prostate Cancer and Prostatic Diseases. Dr Chapins team explored how 6 fellowship-trained urologic oncologists would manage 41 high-risk prostate cancer cases. The investigators administered 2 surveys to the urologic oncologists. The first one included a case description with clinical data only (including physical exam, ...
The authors report a case of prostate cancer recurrence in the bladder wall after radical prostatectomy studied by magnetic resonance imaging with diffusion weighted and dynamic contrast-enhanced sequences.
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Recent reports have suggested the shedding of cancer cells during radical extirpation of tumors. Prostate cells can be expressed from the prostate ex vivo and found in the expressed prostatic secretions. We conducted an in vivo study to determine if prostate epithelial cells can be found in the operative site as determined by RT-PCR targeted at prostate specific antigen (PSA) and to correlate this with pathologic stage and outcome. We analyzed 14 consecutive radical retropubic prostatectomy procedures with a minimum 1-year follow-up. Intraoperatively, 5-10 ml of fluid (representing blood, urine, and irrigant) was aspirated from the operative field at three time points: after transaction of the dorsal vein complex, urethra, and bladder neck. Ficoll gradient fractionation was carried out on the specimens, and RNA was extracted from the cell pellet. Quality of RNA and presence of the PSA mRNA was determined by RT-PCR targeted at actin and PSA, respectively, using previously published primers. The medical
Prostate-specific antigen recurrence (PSA-R) may be overdetected after radical prostatectomy (RP), especially for those over the age of 70.
The purpose of this clinical guideline on Adjuvant and Salvage Radiotherapy after Prostatectomy: ASTRO/AUA Guideline is to provide a clinical framework for the use of radiotherapy after prostatectomy in patients with and without evidence of prostate cancer recurrence.
Prostate and kidney cancer, female urology including colposuspension, interstitial cystitis and TVT - tension-free vaginal tape procedure, laparoscopic radical prostatectomy including single 1cm port prostatectomy, benign prostate conditions - BPH and prostatitis, kidney and ureteric stones including Holmium laser - HoLEP, laparoscopic pyeloplasty, laparoscopic nephrectomy, laparoscopic partial nephrectomy, hand assisted laparoscopic surgery ...
I had a radical prostatectomy in Feb 2006. My Gleason Score from the removed specimen was a 3+4=7. The slides were reviewed by Dr. Jonathan Epstein of Johns Hopkins who also came up with my Gleason Sco...
Abstract. Background: Cancer stem cells (CSCs) are involved in tumor progression and drug resistance. We hypothesized that variants in CSC marker genes influence treatment outcomes in prostate cancer.. Methods: Ten potentially functional single nucleotide polymorphisms (SNPs) in seven prostate CSC marker genes, TACSTD2, PROM1, ITGA2, POU5F1, EZH2, PSCA, and CD44, were selected for analysis of their association with disease recurrence by Kaplan-Meier analysis and Cox regression in a cohort of 320 patients with localized prostate cancer receiving radical prostatectomy.. Results: We identified one independent SNP, rs2394882, in POU5F1 that was associated with prostate cancer recurrence (hazard ratio 0.32, 95% confidence interval 0.14-0.71, P = 0.005) after adjustment for known clinical predictors. Further in silico functional analyses revealed that rs2394882 affects POU5F1 expression, which in turn is significantly correlated with prostate cancer aggressiveness and patient prognosis.. Conclusion: ...
The objective of our study was to evaluate the clinical significance of invisible prostate cancer (iPCa) on multiparametric magnetic resonance imaging (mpMRI) by analyzing clinical parameters and oncologic outcomes. We retrospectively reviewed the records of patients treated with radical prostatectomy (RP) from 2010 to 2015 at our institution. Before RP, all patients were confirmed to have prostate cancer based on prostate biopsy. We excluded patients who underwent neoadjuvant therapy. Additionally, we excluded patients who had incomplete mpMRI based on PI-RADS (Prostate Imaging Reporting and Data System). iPCa was defined as having no grade 3 or higher region of interests using a scoring system established by PI-RADS without limitations on interpretation from mpMRI by radiologists. We selected patients with iPCa using this protocol. We analyzed data using univariate and multivariate cox regression analysis, logistic analysis, Kaplan-Meier curves, and receiver operator characteristic curves to predict
PURPOSE: To compare toxicity and biochemical control in post-prostatectomy patients treated with conventional (66 Gy) or dose-intensified (72 Gy) radiotherapy. METHODS: Patients who had stage pT3-4, positive surgical margins, or rising PSA ≥ 0.2 ng/mL following radical prostatectomy were randomly assigned to receive either 66 Gy in 33 fractions or 72 Gy in 36 fractions. A primary endpoint was to assess the difference in biochemical progression-free survival (bPFS) between these two cohorts, and secondary endpoints were to assess differences in genitourinary (GU), gastrointestinal (GI), and hematologic (HT) toxicities between these two cohorts. bPFS was estimated by the Kaplan-Meier method and toxicities were compared using the χ2 test. RESULTS: Between September 2011 and November 2016, 144 patients were enrolled: 71 patients to the 66 Gy cohort and 73 patients to the 72 Gy cohort. The median follow-up time was 48.5 months (range: 14-79 months). There was no difference in 4-year bPFS between ...
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