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1.
Int Braz J Urol ; 40(3): 316-21, 2014.
Article in English | MEDLINE | ID: mdl-25010297

ABSTRACT

OBJECTIVE: To analyze patients from an underserved area who presented initially with metastatic prostate cancer in order to identify patients in our population who would suffer greatly if PSA screening was eliminated. MATERIALS AND METHODS: A prospectively maintained androgen deprivation therapy database from an inner city municipal hospital was queried to identify patients who presented with metastatic prostate cancer. We identified 129 individuals from 1999 to 2009 eligible for study. Those who underwent previous treatment for prostate cancer were excluded. We examined metastatic distribution and analyzed survival using Kaplan Meier probability curves. RESULTS: The median age of presentation was 68 with a median Gleason sum of 8 per prostate biopsy. Thirty-two patients presented with hydronephrosis with a median creatinine of 1.79, two of whom required emergent dialysis. Of those patients who underwent radiographic imaging at presentation, 35.5% (33/93) had lymphadenopathy suspicious for metastasis, 16.1% (15/93) had masses suspicious for visceral metastases. Of the patients who underwent a bone scan 93% (118/127) had positive findings with 7.9% (10/127) exhibiting signs of cord compression. The 2 and 5- year cancer specific survival was 92.1% and 65.6%, respectively. CONCLUSIONS: In this study we have highlighted a group of men in an underserved community who presented with aggressive and morbid PCa despite widespread acceptance of PSA screening.


Subject(s)
Mass Screening/methods , Prostate-Specific Antigen/blood , Prostatic Neoplasms/pathology , Vulnerable Populations/statistics & numerical data , Black or African American , Aged , Biopsy , Creatinine/analysis , Follow-Up Studies , Humans , Kaplan-Meier Estimate , Male , Neoplasm Grading , Prostatic Neoplasms/mortality , Risk Factors , Socioeconomic Factors , Time Factors
2.
Int. braz. j. urol ; 40(3): 316-321, may-jun/2014. tab, graf
Article in English | LILACS | ID: lil-718268

ABSTRACT

Objective To analyze patients from an underserved area who presented initially with metastatic prostate cancer in order to identify patients in our population who would suffer greatly if PSA screening was eliminated. Materials and Methods A prospectively maintained androgen deprivation therapy database from an inner city municipal hospital was queried to identify patients who presented with metastatic prostate cancer. We identified 129 individuals from 1999 to 2009 eligible for study. Those who underwent previous treatment for prostate cancer were excluded. We examined metastatic distribution and analyzed survival using Kaplan Meier probability curves. Results The median age of presentation was 68 with a median Gleason sum of 8 per prostate biopsy. Thirty-two patients presented with hydronephrosis with a median creatinine of 1.79, two of whom required emergent dialysis. Of those patients who underwent radiographic imaging at presentation, 35.5% (33/93) had lymphadenopathy suspicious for metastasis, 16.1% (15/93) had masses suspicious for visceral metastases. Of the patients who underwent a bone scan 93% (118/127) had positive findings with 7.9% (10/127) exhibiting signs of cord compression. The 2 and 5- year cancer specific survival was 92.1% and 65.6%, respectively. Conclusions In this study we have highlighted a group of men in an underserved community who presented with aggressive and morbid PCa despite widespread acceptance of PSA screening. .


Subject(s)
Aged , Humans , Male , Mass Screening/methods , Prostate-Specific Antigen/blood , Prostatic Neoplasms/pathology , Vulnerable Populations/statistics & numerical data , Black or African American , Biopsy , Creatinine/analysis , Follow-Up Studies , Kaplan-Meier Estimate , Neoplasm Grading , Prostatic Neoplasms/mortality , Risk Factors , Socioeconomic Factors , Time Factors
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