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NCI CANCERLIT® Search: Therapy of Prostate Cancer - October 2001
National Cancer Institute®
Last Modified: November 21, 2001
Table of Contents
1
UI - 20259108
AU - Anonymous
TI -
Maximum androgen blockade in advanced prostate cancer: an overview of
the randomised trials. Prostate Cancer Trialists' Collaborative Group.
SO - Lancet 2000 Apr 29;355(9214):1491-8
BACKGROUND: In advanced prostate cancer, androgen suppression (AS) by
surgery or drugs controls testicular hormone secretion, and the further
addition of an antiandrogen such as nilutamide, flutamide, or
cyproterone acetate is referred to as maximum androgen blockade (MAB).
The aim of this overview was to compare the effects on the duration of
survival of MAB and of AS alone. METHODS: The collaborative
meta-analysis of 27 randomised trials involved central reanalysis of the
data on each of 8275 men (98% of those ever randomised in trials of MAB
vs AS) with metastatic (88%) or locally advanced (12%) prostate cancer.
Half were over 70 years of age, and follow-up was typically for about 5
years. FINDINGS: 5932 (72%) men have died; of the deaths for which
causes were provided, about 80% were attributed to prostate cancer.
5-year survival was 25.4% with MAB versus 23.6% with AS alone, a
non-significant gain of 1.8% (SE 1.3; logrank 2p=0.11). There was no
significant heterogeneity in the treatment effect (MAB vs AS) with
respect to age or disease stage. The results for cyproterone acetate,
which accounted for only a fifth of the evidence, appeared slightly
unfavourable to MAB (5-year survival 15.4% MAB vs 18.1% AS alone;
difference -2.8% [SE 2.4]; logrank 2p=0.04 adverse), whereas those for
nilutamide and flutamide appeared slightly favourable (5-year survival
27.6% MAB vs 24.7% AS alone; difference 2.9% [SE 1.3]; logrank
2p=0.005). Non-prostate-cancer deaths (although not clearly
significantly affected by treatment) accounted for some of the
apparently adverse effects of cyproterone acetate. INTERPRETATION: In
advanced prostate cancer, addition of an antiandrogen to AS improved the
5-year survival by about 2% or 3% (depending on whether the analysis
includes or excludes the cyproterone acetate trials), but the range of
uncertainty as to the true size of this benefit runs from about 0% to
about 5%.
2
UI - 20520896
AU - Labrie F; Candas B
TI -
Androgen blockade in prostate cancer.
SO - Lancet 2000 Jul 22;356(9226):341-2
3
UI - 21203620
AU - Weckermann D; Wawroschek F; Hamm M; Haude K; Harzmann R
TI -
Biochemical course after radical retropubic prostatectomy: preliminary
results.
SO - Eur Urol 2001 Apr;39(4):418-24
AD - Department of Urology, Augsburg, Germany.
OBJECTIVE: To investigate prognostic factors in localized and
lymphatically spread prostate cancer. METHODS: The biochemical course
after radical retropubic prostatectomy in 306 patients was subject to a
retrospective analysis. RESULTS: Prostate-specific antigen (PSA),
Gleason score (prostatectomy specimen) and pathological stage proved to
be prognostically relevant (p < 0.0001). PSA, Gleason score and tumor
stage also were to be considered as (independent) prognostic factors by
means of a multivariate analysis (p < 0.001), whereas perineural
invasion (prostatectomy specimen) and preoperative bone marrow findings
(CK 2) had no impact on the course of the disease. After a median
follow-up of 1,307 days (3.6 years), a biochemical relapse occurred in
41.8%. CONCLUSION: High preoperative PSA values and the resulting high
portion of advanced tumor stages are a possible basis for the high
biochemical relapse rate in our collective. The learning curves of
several surgeons and the previously more restrictive pelvic
lymphadenectomy (surgical understaging) may also be considered causes.
4
UI - 21203621
AU - Vanuytsel L; Janssens G; Van Poppel H; Rijnders A; Baert L
TI -
Radiotherapy for PSA recurrence after radical prostatectomy.
SO - Eur Urol 2001 Apr;39(4):425-9
AD - Department of Radiotherapy, University Hospitals, Leuven, Belgium.
Lucien.Vanuytsel@uz.kuleuven.ac.be
OBJECTIVES: The treatment of patients presenting with an isolated PSA
recurrence after radical prostatectomy (RP) remains controversial. The
present study aims at assessing the results of salvage radiotherapy
(RT), to define prognostic factors and to identify subgroups of patients
most suitable for RT with curative intent. MATERIALS AND METHODS: A
retrospective study was performed of 53 patients, diagnosed with a
rising PSA after RP, and treated with RT to the prostate bed, between
determinants to obtain and maintain a nondetectable PSA (< 0.02 ng/ml)
were Gleason grade (< or = III vs. < or = IV), pre-RT PSA, considered as
categorical or continuous variable, and pathological stage, pT (2 vs.
3). Pre-RP PSA (< or = 10 vs. >10), time interval between surgery and
moment of rising PSA and pathological section margin status were not
significant. On multivariate analysis, only Gleason grade and pre-RT PSA
remained significant. For the patient group with a Gleason grade < or =
III the PSA-free survival at 3 years was 75% (+/- 11%) compared to 27%
(+/- 9%) for the patients with a Gleason grade > or = IV (p = 0.002).
Pre-RT PSA significantly influenced PSA-free survival in the first
group, but not in the latter. CONCLUSION: From the group of RP patients
with rising PSA following a postsurgery PSA-free period, subgroups can
be defined with a distinctly different probability of obtaining and
maintaining nondetectable PSA levels after salvage RT.
5
UI - 21267671
AU - Kumi-Diaka J; Sanderson NA; Hall A
TI -
The mediating role of caspase-3 protease in the intracellular mechanism
of genistein-induced apoptosis in human prostatic carcinoma cell lines,
DU145 and LNCaP.
SO - Biol Cell 2000;92(8-9):595-604
AD - Department of Biology, College of Liberal Arts and Sciences, Florida
Atlantic University, Davie 33314, USA. jdiaka@acc.fau.edu
A series of in vitro studies were carried out to investigate
genistein-induced cell death, and the nature of cell death, in two human
prostate cancer cell lines (LNCaP and Du145), and the possible
involvement of caspase-3 protease in genistein-induced apoptosis in the
target cells. The major findings of these studies are: i) genistein
inhibits growth and proliferation of both LNCaP and DU145 cells via
apoptosis mainly, and necrosis at higher concentrations; ii) genistein
induces activation and expression of caspase-3 (CPP32) in both target
cells; iii) genistein-induced apoptosis and CPP32 activation could be
significantly inhibited by the caspase-3 inhibitor, z-VAD-fmk
(N-benzyloxycarbonyl-Val-Asp-fluoromethyl-ketone), thus confirming a
mediator role of CPP32 in the genistein-induced apoptotic pathway in the
target cells. The potency of most known chemopreventive drugs for cancer
is due to induction of apoptosis in solid tumors (Thompson, Science 267
(1995) 1456; Gurney et al., Science 288 (2000) 283). Inevitably, agents
that increase transcription of caspase-3 protease could reinforce cell
death via CPP32-mediated apoptosis. In this regard, genistein may find
an application in the treatment of human prostate carcinoma,
independently of hormone sensitivity.
6
UI - 21336417
AU - Miyake H; Hara I; Kamidono S; Gleave ME
TI -
Novel therapeutic strategy for advanced prostate cancer using antisense
oligodeoxynucleotides targeting anti-apoptotic genes upregulated after
androgen withdrawal to delay androgen-independent progression and
enhance chemosensitivity.
SO - Int J Urol 2001 Jul;8(7):337-49
AD - The Prostate Center, Vancouver General Hospital, Vancouver, Canada.
hideakimiyake@hotmail.com
Progression to androgen-independence remains the main obstacle to
improving survival for patients with advanced prostate cancer. In this
review, findings are summarized that have recently been demonstrated to
establish novel therapeutic strategy targeting several genes playing
functionally important roles after androgen withdrawal and during
androgen-independent progression. The authors initially characterized
changes in gene expression after androgen withdrawal in the
androgen-dependent Shionogi and LNCaP tumor models using cDNA arrays.
Based on these results, they focused on genes highly upregulated after
androgen ablation (i.e. bcl-2, bcl-xL, TR.PM-2, IGFBP-5), which have
anti-apoptotic or mitogenic activities, and thereby confer a resistance
to androgen withdrawal as well as cytotoxic chemotherapy. The authors
further demonstrated the efficacy of an antisense oligodeoxynucleotide
(ODN) strategy for patients with advanced prostate cancer through the
inhibition of target gene expression, resulting in a delay in the
progression to androgen-independence by enhancing apoptotic cell death
induced by androgen ablation and chemotherapy. The authors also showed
the effectiveness of combined antisense ODN therapy and cytotoxic
chemotherapy by achieving additive or synergistic effects. These
findings provide a basic significance for the design of clinical studies
using antisense ODN either alone or in combination with chemotherapeutic
agents in patients with advanced prostate cancer.
7
UI - 21336434
AU - Arai Y
TI -
Radical prostatectomy: time trends, morbidity and quality of life.
SO - Int J Urol 2001 Jul;8(7):S15-8
AD - Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan.
ya6143@kchnet.or.jp
In recent years, increased screening for prostate cancer, primarily with
prostate-specific antigen testing, has led to an apparent increase in
the incidence of prostate cancer and resulted in a shift to an earlier
patient age and tumor stage at diagnosis. From the early 1980s, there
have been great advances in surgical technique. In the 1990s, radical
prostatectomy gained popularity among Japanese urologists. Time trends
and morbidity of contemporary anatomical radical prostatectomy in Japan
are reported here. In addition, the quality of life in men undergoing
radical prostatectomy is discussed.
8
UI - 21336435
AU - Naito S
TI -
Androgen deprivation in combination with radical prostatectomy for
localized prostate cancer.
SO - Int J Urol 2001 Jul;8(7):S19-21
AD - Department of Urology, Graduate School of Medical Sciences, Kyushu
University, Fukuoka, Japan. naito@uro.med.kyushu-u.ac.jp
Radical prostatectomy is the only potential modality for cure in
patients with localized prostate cancer. However, the lack of reliable
and accurate clinical staging frequently leads to incomplete excision of
tumor, with the consequences of early local recurrence or distant
metastasis. Thus, the role of neoadjuvant or adjuvant hormonal treatment
has been investigated in improving disease-free or cause-specific
survival. This review reports the current status and problems of such
androgen deprivation in combination with radical prostatectomy for
localized prostate cancer.
9
UI - 21336432
AU - Yoshimura I; Suzuki S; Tadakuma T; Hayakawa M
TI -
Suicide gene therapy on LNCaP human prostate cancer cells.
SO - Int J Urol 2001 Jul;8(7):S5-8
AD - Department of Urology, National Defense Medical College, Tokorozawa,
Japan. ichiro-y@me.ndmc.ac.jp
The efficacy of combination suicide gene therapy was evaluated using a
Herpes simplex virus-thymidine kinase/ganciclovir (HSV-TK/GCV) system
and an Escherichia coli cytosine deaminase/5-fluorocytosine (CD/5-FC)
system on the LNCaP human prostate cancer cell model. Two types of
plasmid vectors with the HSV-TK gene were constructed. A constitutive
chicken beta-actin promoter drove one and a prostate-specific antigen
(PSA) promoter drove the other. Similarly, a pair of plasmids with the
CD gene under a cytomegalovirus (CMV) promoter and the PSA promoter was
also constructed. LNCaP cells were transfected in vitro with either or
both of those plasmids using a cationic lipid reagent. Transfected cells
were treated with GCV and/or 5-FC. The percentage of viable LNCaP cells
7 days after treatment with HSV-TK/GCV or CD/5-FC under a constitutive
promoter was 40% and 41% of controls, respectively. The cell viability
when two suicide genes were combined was 23%. The cell viabilities after
four days with PSA promoter-HSV-TK vectors, CD vectors and a combination
of both were 79%, 88% and 88%, respectively. Suicide gene therapy using
either HSV-TK/GCV, CD/5-FC, or both, was effective in the LNCaP model.
An additive effect was observed when the two suicide genes were used
together. The PSA promoter did not seem to be effective enough to elicit
cytotoxicity under the experimental conditions used here.
10
UI - 21336433
AU - Myers RP
TI -
Radical prostatectomy: making it a better operation in the new
millennium.
SO - Int J Urol 2001 Jul;8(7):S9-14
AD - Department of Urology, Mayo Clinic, Rochester, Minnesota 55905, USA.
myers.robert@mayo.edu
Radical prostatectomy provides the best hope for long-term survival,
free of disease, for organ-confined adenocarcinoma of the prostate. The
operation is performed successfully only by understanding the remarkable
anatomic variability of the prostate apex and the cylindrical nature of
the striated urethral sphincter. When surgical techniques are used that
take into account variations at the apex, with preservation of (i)
neurovascular structures; (ii) the sphincteric urethra; and (iii) the
adjacent levator ani, patients can look forward to a cure and the rapid
return of urinary control and erectile function.
11
UI - 21381868
AU - Petrylak DP
TI -
Combination therapy in hormone-refractory prostate cancer.
SO - Curr Oncol Rep 2001 Sep;3(5):417
12
UI - 21381869
AU - Rini BI; Small EJ
TI -
Immunotherapy for prostate cancer.
SO - Curr Oncol Rep 2001 Sep;3(5):418-23
AD - University of California at San Francisco Comprehensive Cancer Center,
1600 Divisidero Street, 3rd floor, San Francisco, CA 94115, USA.
brini@medicine.ucsf.edu
The components of an effective immune response have been elucidated in
recent years. An understanding of the dysfunction of the immune response
in cancer in one or more of these components has led to a variety of
immunotherapeutic approaches. These therapeutic strategies are designed
to stimulate dendritic cell proliferation, promote antigen uptake and
processing, stimulate an effector cell response via direct antigen
presentation, or target tumor cells via antibody therapy. Many
approaches in prostate cancer have demonstrated successful induction of
the desired immune response. Limited clinical success has also been
seen.
13
UI - 21381872
AU - Gingrich JR; Chauhan RD; Steiner MS
TI -
Gene therapy for prostate cancer.
SO - Curr Oncol Rep 2001 Sep;3(5):438-47
AD - Department of Urology, University of Tennessee Medical Center, 956 Court
Avenue, H216, Memphis, TN 38163, USA. Jgingrich@utmem.edu
Basic research continues to unravel the molecular complexity of normal
and abnormal biologic processes. The development of means to affect the
expression level of genes that promote or contribute to cellular
transformation, invasion, and metastasis has spawned the concept of gene
therapy. This relatively new field seeks to reverse or suspend the
pathologic progression of a variety of diseases including the malignant
transformation of prostatic epithelial cells. Initial clinical trials
for prostate cancer have thus far shown gene therapy to be relatively
safe, although definitive evidence of durable therapeutic efficacy
remains to be demonstrated. In this article, recent preclinical
research, current therapeutic strategies, and recent results of gene
therapy clinical trials for the treatment of prostate cancer are
reviewed.
14
UI - 21381873
AU - Jacobson JS; Chetty AP
TI -
Complementary and alternative medicine in prostate cancer.
SO - Curr Oncol Rep 2001 Sep;3(5):448-52
AD - Department of Epidemiology, PH18-105, Mailman School of Public Health
and Herbert Irving Cancer Center, Columbia University, 600 West 168th
Street, New York, NY 10032, USA. jsj4@columbia.edu
Prostate cancer patients, like other cancer patients as well as the
general population, are increasingly exploring the use of complementary
and alternative medicine (CAM). This paper describes the use of CAM in
this patient population and the evidence regarding some CAM treatments
in the setting of prostate cancer. Some herbal agents and micronutrients
have demonstrated biologic activity that may benefit patients with
prostate cancer. The clinical effects of these and others and the
potential interactions among CAM treatments and with conventional
treatment remain an appropriate target for further investigation.
15
UI - 21382117
AU - Templeton HR; Coates VE
TI -
Adaptation of an instrument to measure the informational needs of men
with prostate cancer.
SO - J Adv Nurs 2001 Aug;35(3):357-64
AD - University of Ulster, Coleraine, UK. hrm.templeton@ulst.ac.uk
AIM OF THE STUDY: The aim of this study is to adapt an instrument
suitable for assessment of the informational needs of men with prostate
cancer. BACKGROUND: In recent years prostate cancer has become an
important public health problem world-wide with considerable social and
economic consequences. It is reported that it is the most common cancer
affecting British men, with an average lifetime risk of occurrence of
one in twelve. DESIGN/METHODS: Methodological research was conducted to
develop an instrument to assess the informational needs of men with
prostate cancer on hormonal manipulation therapy (HMT) regarding their
disease and treatment. The Toronto Informational Needs Questionnaire
(TINQ-BC) (Galloway et al. 1997) was modified for use with this client
group and was applied to a sample of 90 men generated from three urology
centres in Northern Ireland. RESULTS/FINDINGS: Construct and content
validity of the instrument was established. Internal consistency
reliability using Cronbach's alpha was calculated and found to be
satisfactory (0.92). Using confirmatory factor analysis, factor loadings
ranging from 0.37 to 0.90 were obtained and considered satisfactory. The
subsections of the TINQ-BC categorized as Disease, Investigative tests,
Treatment, Psychosocial and Physical needs were confirmed as individual
factors. These results indicate that this instrument can be validly
applied to this client group. As the instrument was initially developed
in Canada and successfully used in the United Kingdom (UK), it is
suggested that this instrument also has the potential for cross-cultural
application. It has the potential to be used as a clinical reference
instrument to assess the informational needs of this patient group.
Health care professionals must be aware of the domains of information
that these men perceive important so that educational interventions can
be accurately and appropriately planned.
16
UI - 21382655
AU - Anscher MS
TI -
Re: The development of erectile dysfunction in men treated for prostate
cancer.
SO - J Urol 2001 Sep;166(3):1010-1
17
UI - 21382691
AU - Tymchuk CN; Barnard RJ; Heber D; Aronson WJ
TI -
Evidence of an inhibitory effect of diet and exercise on prostate cancer
cell growth.
SO - J Urol 2001 Sep;166(3):1185-9
AD - Department of Physiological Science, University of California-Los
Angeles, Los Angeles, CA, USA.
PURPOSE: A high fat diet and sedentary lifestyle may predispose men to
prostate cancer through effects on serum factors such as hormones. We
evaluated the effects of a low fat, high fiber diet and exercise
intervention on serum stimulated growth of established prostate cancer
cell lines. MATERIALS AND METHODS: Fasting serum was obtained from 13
overweight men before and after undergoing an 11-day low fat, high fiber
diet and exercise intervention. Serum was also obtained from 8 men who
had complied with the regimen for a mean of 14.2 years. Hormone
dependent LNCaP and independent PC-3 prostate cancer cell lines were
grown in culture medium containing 10% of subject pre-intervention or
post-intervention serum and viable cells were counted after 48 hours.
Anthropometry, serum free testosterone, lipids and glucose were measured
in all subjects. RESULTS: Post-intervention serum from each of the
11-day intervention subjects reduced LNCaP cell growth by a mean of 30%
compared with pre-intervention serum from each (p <0.01). LNCaP cell
growth in serum from long-term subjects was 15% below that of
post-intervention serum (p <0.01). There was no difference in the growth
of PC-3 cells when cultured with serum from either intervention group.
Serum free testosterone, body weight, glucose and lipids were
significantly reduced in 11-day subjects. CONCLUSIONS: A low fat, high
fiber diet and exercise intervention resulted in serum changes that
significantly reduced the growth of androgen responsive LNCaP prostate
cancer cells in vitro.
18
UI - 21382608
AU - Zelefsky MJ; Fuks Z; Hunt M; Lee HJ; Lombardi D; Ling CC; Reuter VE;
TI -
Venkatraman ES; Leibel SA
High dose radiation delivered by intensity modulated conformal
radiotherapy improves the outcome of localized prostate cancer.
SO - J Urol 2001 Sep;166(3):876-81
AD - Department of Radiation Oncology, Memorial Sloan-Kettering Cancer
Center, 1275 York Avenue, New York, NY 10021, USA.
PURPOSE: We present the long-term outcome and tolerance of 3-dimensional
(D) conformal and intensity modulated radiation therapy for localized
cancer were treated with 3-D conformal or intensity modulated radiation
therapy. Patients were categorized into prognostic risk groups based on
pretreatment prostate specific antigen (PSA), Gleason score and clinical
stage. Sextant biopsies were performed 2.5 years or greater after
treatment to assess local control. PSA relapse was defined according to
the consensus guidelines of the American Society for Therapeutic
Radiation Oncology. Late toxicity was classified according to the
Radiation Therapy Oncology Group morbidity grading scale. Median
followup was 60 months. RESULTS: At 5 years the PSA relapse-free
survival rate in patients at favorable, intermediate and unfavorable
risk was 85% (95% confidence interval [CI] +/- 4), 58% (95% CI +/- 6)
and 38% (95% CI +/- 6), respectively (p <0.001). Radiation dose was the
most powerful variable impacting PSA relapse-free survival in each
prognostic risk group. The 5-year actuarial PSA relapse-free survival
rate for patients at favorable risk who received 64.8 to 70.2 Gy. was
77% (95% CI +/- 8) compared to 90% (95% CI +/- 8) for those treated with
75.6 to 86.4 Gy. (p = 0.05). The corresponding rates were 50% (95% CI
+/- 8) versus 70% (95% CI +/- 6) in intermediate risk cases (p = 0.001),
and 21% (95% CI +/- 8) versus 47% (95% CI +/- 6) in unfavorable risk
cases (p = 0.002). Only 4 of 41 patients (10%) who received 81 Gy. had a
positive biopsy 2.5 years or greater after treatment compared with 27 of
119 (23%) after 75.6, 23 of 68 (34%) after 70.2 and 13 of 24 (54%) after
64.8 Gy. The incidence of toxicity after 3-D conformal radiation therapy
was dose dependent. The 5-year actuarial rate of grade 2 rectal toxicity
in patients who received 75.6 Gy. or greater was 14% (95% CI +/- 2)
compared with 5% (95% CI +/- 2) in those treated at lower dose levels (p
<0.001). Treatment with intensity modulated radiation therapy
significantly decreased the incidence of late grade 2 rectal toxicity
since the 3-year actuarial incidence in 189 cases managed by 81 Gy. was
2% (95% CI +/- 2) compared with 14% (95% CI +/- 2) in 61 managed by the
same dose of 3-D conformal radiation therapy (p = 0.005). The 5-year
actuarial rate of grade 2 urinary toxicity in patients who received 75.6
Gy. or greater 3-D conformal radiation therapy was 13% compared with 4%
in those treated up to lower doses (p <0.001). Intensity modulated
radiation therapy did not affect the incidence of urinary toxicity.
CONCLUSIONS: Sophisticated conformal radiotherapy techniques with high
dose 3-D conformal and intensity modulated radiation therapy improve the
biochemical outcome in patients with favorable, intermediate and
unfavorable risk prostate cancer. Intensity modulated radiation therapy
is associated with minimal rectal and bladder toxicity, and, hence,
represents the treatment delivery approach with the most favorable
risk-to-benefit ratio.
19
UI - 21382609
AU - Goluboff ET; Prager D; Rukstalis D; Giantonio B; Madorsky M; Barken I;
TI -
Weinstein IB; Partin AW; Olsson CA; UCLA Oncology Research Network
Safety and efficacy of exisulind for treatment of recurrent prostate
cancer after radical prostatectomy.
SO - J Urol 2001 Sep;166(3):882-6
AD - Department of Urology, Columbia University, Columbia-Presbyterian
Medical Center, Allen Pavilion, 5141 Broadway, New York, NY 10034, USA.
PURPOSE: We evaluated the safety and efficacy of exisulind for delaying
disease progression in men with increasing prostate specific antigen
(PSA) after radical prostatectomy. MATERIALS AND METHODS: A total of 96
men with increasing PSA after radical prostatectomy were randomized to
receive placebo (49) or 250 mg. exisulind twice daily (47) for 12
months. The primary efficacy parameter was the difference in change from
baseline PSA between the placebo and exisulind groups. The PSA doubling
time was also evaluated before and during study. A subgroup analysis
classified patients based on the risk of developing metastatic disease.
RESULTS: Compared with placebo, exisulind significantly suppressed the
increase in PSA in all patients (p = 0.017). The results were also
statistically significant in men at high risk for metastasis (p =
0.0003) and those who could not be classified according to risk (p =
0.0009). In addition, median PSA doubling time was lengthened in high
risk patients on exisulind (2.12 month increase) compared with those on
placebo (3.37 month decrease, p = 0.048). Exisulind was well tolerated.
CONCLUSIONS: Exisulind inhibited the increase in PSA overall and
prolonged PSA doubling time in high risk patients compared with placebo.
These results suggest that Exisulind has the potential to extend the
time from biochemical recurrence to the need for androgen deprivation
therapy. Exisulind was well tolerated in this patient population. Our
results support further study of Exisulind in the treatment of patients
with prostate cancer.
20
UI - 21382623
AU - Davis JW; Kuban DA; Lynch DF; Schellhammer PF
TI -
Quality of life after treatment for localized prostate cancer:
differences based on treatment modality.
SO - J Urol 2001 Sep;166(3):947-52
AD - Department of Urology, Virginia Prostate Center, Eastern Virginia
Medical School, Norfolk, VA, USA.
PURPOSE: Brachytherapy with 103palladium (103Pd) is an increasingly
administered treatment modality for localized prostate cancer. We
compared general and disease specific health related quality of life
after 103Pd treatment, radical prostatectomy and external beam radiation
therapy given during the same time frame. MATERIALS AND METHODS: We
performed a retrospective cross-sectional survey study of patients
treated at a single community medical center between 1995 and 1999. We
mailed 5 validated health related quality of life survey instruments to
269, 142 and 222 men who underwent radical prostatectomy, 103Pd
treatment and external beam radiation therapy, respectively, with a
response rate of greater than 80% in all groups. RESULTS: General health
related quality of life assessed by the SF-36 showed the same scores in
patients who underwent prostatectomy and 103Pd treatment. The University
of California-Los Angeles Prostate Cancer Index was used to assess
bowel, urinary and sexual function/bothersomeness. External beam
radiation therapy reported was associated with worse bowel function and
greater bowel bothersomeness. Prostatectomy was associated with worse
urinary function compared to 103Pd and external beam radiation therapy.
Prostatectomy was associated with worse sexual function than 103Pd or
external beam radiation therapy, although nerve sparing surgery and
erectile aids minimized the difference. American Urological Association
symptom scores were initially higher for 103Pd but became equal to those
in the other groups in patients treated greater than 12 months from
survey time. Disease-free men who underwent prostatectomy and 103Pd
brachytherapy were equally confident that cancer would not recur in the
future. Satisfaction rates were equivalent and biochemical failure
significantly decreased satisfaction in all groups. CONCLUSIONS: While
general health related quality of life was mostly unaffected by the 3
most common treatments for prostate cancer, there were differences in
bowel, urinary and sexual function. This information may aid patients in
the decision making process.
21
UI - 21382624
AU - Han BH; Demel KC; Wallner K; Ellis W; Young L; Russell K
TI -
Patient reported complications after prostate brachytherapy.
SO - J Urol 2001 Sep;166(3):953-7
AD - Department of Radiation Oncology, University of Washington, Seattle, WA,
USA.
PURPOSE: Prostate brachytherapy has gained popularity due partly to the
low rates of short-term complications shown in studies from highly
select clinical practices. These series rely on medical records
generated by the treating physician and are prone to underreport
complications. We summarize the complication reports obtained directly
from patients to establish a more realistic incidence of treatment
related problems. MATERIALS AND METHODS: In 1997, 160 consecutive
patients treated with prostate brachytherapy at the University of
Washington were studied. A questionnaire was designed to determine the
rate of complications occurring within 1 year of the procedure. The
questions were formulated for ease of use and conciseness, while
accounting for easily recalled events associated with complications. A
total of 147 (92%) patients completed the questionnaire. RESULTS: There
were 8 (5%) patients who required hospital admission for an average of 2
days (range 1 to 7) as a result of the procedure. A total of 56 (38%)
patients required nonroutine visits with a physician in an office
setting or at an emergency room. Radiation proctitis diagnosed by
endoscopy developed in 8 (5%) patients but no one needed surgical
intervention. A total of 47 (32%) patients required urinary
catheterization at some point after implantation. CONCLUSIONS: We
demonstrated a higher rate of short-term complications than those
previously reported. Fortunately, the majority of side effects were
self-limited and no treatment related mortality or cardiovascular
morbidity was seen. Our findings may provide a more realistic account of
the complications likely to occur after implantation than might be
surmised from previous reports.
22
UI - 21382626
AU - Adolfsson J
TI -
Quality of life.
SO - J Urol 2001 Sep;166(3):962-3
23
UI - 21382627
AU - Lodding P; Bergdahl C; Nyberg M; Pileblad E; Stranne J; Hugosson J
TI -
Inguinal hernia after radical retropubic prostatectomy for prostate
cancer: a study of incidence and risk factors in comparison to no
operation and lymphadenectomy.
SO - J Urol 2001 Sep;166(3):964-7
AD - Department of Urology, Sahlgrenska University Hospital, Goteborg,
Sweden.
PURPOSE: The incidence, mechanisms and risk factors of inguinal hernia
after radical retropubic prostatectomy are sparsely elucidated in the
literature. We determined the rate of inguinal hernia after radical
retropubic prostatectomy and compared it to the incidence in patients
with prostate cancer who did not undergo operation or underwent only
pelvic lymph node dissection. MATERIALS AND METHODS: We followed 375,
184 and 65 men who underwent radical retropubic prostatectomy plus
pelvic lymph node dissection, pelvic lymph node dissection only and no
surgery with respect to inguinal hernia for a mean of 39, 47 and 45
months, respectively. The prostatectomy group was also evaluated in
regard to the potential risk factors of previous hernia surgery and
post-prostatectomy anastomotic stricture. RESULTS: The incidence of
hernia was 13.6%, 7.6% and 3.1% in the prostatectomy, lymph node
dissection and unoperated group, respectively. The difference was
statistically significant in the prostatectomy and unoperated groups
according to the Mantel-Cox log rank test and Cox proportional hazards
rate. Previous hernial surgery and post-prostatectomy anastomotic
stricture were more common in patients with an inguinal hernia after
prostatectomy. CONCLUSIONS: The incidence of inguinal hernia is clearly
increased in men who have undergone radical retropubic prostatectomy
plus pelvic lymph node dissection compared with those who undergo no
surgery for prostate cancer. Inguinal hernia appears to develop more
often in men with prostate cancer who undergo radical retropubic
prostatectomy and pelvic lymph node dissection than in those who undergo
pelvic lymph node dissection only. While surgical factors trigger
hernial development, previous hernial surgery and post-prostatectomy
anastomotic stricture may be important risk factors. In fact, the latter
may largely explain the difference in the incidence of inguinal hernia
in our lymph node dissection and prostatectomy groups. Prophylactic
surgical procedures must be evaluated to address this problem.
24
UI - 21382641
AU - Young MD; Dahm P; Robertson CN
TI -
Prostatic sarcoma with rapid tumor progression after nerve sparing
radical cystoprostatectomy.
SO - J Urol 2001 Sep;166(3):994
AD - Division of Urology, Department of Surgery, Duke University Medical
Center, Durham, NC, USA.
25
UI - 21382642
AU - Wiersinga WJ; De Reijke TM; Blank LE
TI -
Local tract metastasis of prostatic adenocarcinoma 8 years after
(125)iodine brachytherapy.
SO - J Urol 2001 Sep;166(3):995
AD - Department of Urology and Radiation Oncology, Academic Medical Center,
Amsterdam, The Netherlands.
26
UI - 21385143
AU - Kasahara K; Taguchi T; Yamasaki I; Karashima T; Kamada M; Yuri K; Shuin
TI -
T
Fluorescence in situ hybridization to assess transitional changes of
aneuploidy for chromosomes 7, 8, 10, 12, 16, X and Y in metastatic
prostate cancer following anti-androgen therapy.
SO - Int J Oncol 2001 Sep;19(3):543-9
AD - Department of Urology, Kochi Medical School, Nankoku, Kochi 783-8505,
Japan.
There have been few detailed studies conducted on the cell population in
relation to cytogenetic changes between the pre- and post-treatment
periods in patients with prostate cancer. We investigated numerical
chromosome changes associated with anti-androgen therapy, using
fluorescence in situ hybridization (FISH). FISH using
chromosome-specific centromeric probes was used to assess transitional
changes in the frequency of aneuploidy for chromosomes 7, 8, 10, 12, 16,
X, and Y in prostate cancer during the pre- and post-treatment periods.
Gains of chromosomes 7, 8 and 12 were notable in the pre-treatment
samples (8 out of 9 cases in chromosome 7; 8 out of 9 cases in
chromosome 8; 7 out of 9 cases in chromosome 12), while a notable
reduction in the number of cells with extra copies of these chromosomes
was observed in post-treatment specimens. Other chromosomes did not show
noticeable change in their FISH signals at each phase of clinical
treatment in all 9 cases. Changes in cell number with high ploidies of
chromosome 7, 8 and 12 reflect the clinical effects of anti-androgen
therapy at the early phase, which might explain the androgen dependency
of metastatic prostate cancer cells.
27
UI - 21414850
AU - Hara I; Miyake H; Hara S; Gotoh A; Eto H; Arakawa S; Kamidono S
TI -
Long-term results of neoadjuvant hormonal therapy prior to radical
prostatectomy in patients with clinically localized prostate cancer:
biochemical and pathological effects.
SO - Hinyokika Kiyo 2001 Jul;47(7):453-8
AD - Department of Urology, Kobe University School of Medicine.
The objective of this study was to evaluate the long-term biochemical
and pathological effects induced by neoadjuvant hormonal therapy (NHT)
NHT for 3 to 11 months (median: 5 months) using luteinizing
hormone-releasing hormone analogue prior to radical prostatectomy and
pelvic lymphadenectomy. The clinical stage was T1 in 1 patient, T2 in 17
and T3 in 6, the pretreatment serum prostate-specific antigen (PSA)
value was < or = 10 ng/ml in 5 patients, 10 to 20 ng/ml in 4 and > 20
ng/ml in 15 (mean: 34.7 micrograms/l), and the Gleason score was < or =
4 in 9 patients, 5 to 7 in 11 and > 8 in 3. The mean prostate specific
antigen (PSA) value 3 months after NHT had reduced below 2 ng/ml in 18
of the 24 patients (67%), and finally decreased by an average of 95%
(i.e., 1.9 ng/ml) prior to surgery. The pathological stage was pT0 in 2
patients, pT2 in 10 and pT3 in 12. The incidence of organ-confined
disease (OCD) was significantly higher in patients with clinical stage
T1 or T2a than with T2b or T3, with pretreatment PSA values < or = 10
ng/ml than with PSA values > 10 ng/ml, and with PSA values < or = 2 than
with PSA values > 2 at 3 months after NHT; in contrast, the Gleason
score had no significant impact on the rate of OCD. After a median
follow-up of 49 months (range 34 to 85 months), 6 patients (25%) had a
recurrence evidenced by rising PSA, and the 3-year recurrence-free
survival rate was 79%. These results suggest that NHT appears not to be
of significant additional benefit to patients who have a higher clinical
T stage, higher pretreatment PSA values and/or in patients whose PSA
values do not normalize early in the treatment process.
28
UI - 21414861
AU - Yumura Y; Hara Y; Ida T
TI -
[Mucinous adenocarcinoma of the prostate: a case report]
SO - Hinyokika Kiyo 2001 Jul;47(7):505-8
AD - Department of Urology, National Atami Hospital.
A 64-year-old man presented to our department with urinary retention.
Rectal examination revealed a small and soft prostate. PSA was within
the normal limits. Computed tomography showed a low-density area around
the prostatic urethra and urethrography revealed an irregular prostatic
urethra compressed by the prostate. We performed transurethral resection
of prostate (TUR-P). On resectoscopy, jelly-like round substances were
seen in the bladder. Prostatic urethra and bladder neck were covered
with a jelly-like substance. Pathological diagnosis was mucinous
adenocarcinoma of the prostate with bladder neck involvement. One month
later after TUR-P, we performed radical cystoprostatectomy. Histological
findings showed the cancer, of which 70-80% was composed of
extracellular mucin lakes containing floating clumps of tumor cells.
Mucin lake was stained with alcian blue and PAS. Immunohistochemical
study revealed the tumor cells positive for carcinoembryonic antigen
(CEA) and negative for prostatic specific antigen (PSA).
29
UI - 21430292
AU - Matzkin H; Kaver I; Stenger A; Agai R; Esna N; Merimsky O
TI -
[I125 prostate brachytherapy--short-term results of the first 150
patients in Israel]
SO - Harefuah 2001 Aug;140(8):694-8, 807
AD - Departments of Urology and Oncology, E. S
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