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1.
Medicine (Baltimore) ; 100(14): e25397, 2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33832133

RESUMEN

ABSTRACT: Decision-making to stop cancer treatment in patients with advanced cancer is stressful, and it significantly influences subsequent end-of-life palliative treatment. However, little is known about the extent to which the patient's self-decisions influenced the prognostic period. This study focused on the patient's self-decision and investigated the impact of the self-decision to stop cancer treatment on their post-cancer treatment survival period and place of death.We retrospectively analyzed 167 cases of advanced genitourinary cancer patients (kidney cancer: 42; bladder cancer: 68; prostate cancer: 57) treated at the University of Fukui Hospital (UFH), who later died because of cancer. Of these, 100 patients decided to stop cancer treatment by themselves (self-decision group), while the families of the remaining 67 patients (family's decision group) decided to stop treatment on their behalf because the patient's decision-making ability was already impaired. Differences in the post-cancer-treatment survival period and place of death between the 2 groups were examined. The association between place of death and survival period was also analyzed.The median survival period after terminating cancer treatment was approximately 6 times longer in the self-decision group (145.5 days in self-decision group vs 23.0 days in family's decision group, P < .001). Proportions for places of death were as follows: among the self-decision group, 42.0% of patients died at UFH, 45.0% at other medical institutions, and 13.0% at home; among the family's decision group, 62.7% died at UFH, 32.8% at other medical institutions, and 4.5% at home. The proportion of patients who died at UFH was significantly higher among the family's decision group (P = .011). The median survival period was significantly shorter for patients who died at UFH (UFH: 30.0 days; other institutions/home: 161.0 days; P < .001).Significantly longer post-cancer-treatment survival period and higher home death rate were observed among patients whose cancer treatment was terminated based on their self-decision. Our results provide clinical evidence, especially in terms of prognostic period and place of death that support the importance of discussing bad news, such as stopping cancer treatment with patients.


Asunto(s)
Familia/psicología , Enfermo Terminal/psicología , Neoplasias Urogenitales/mortalidad , Neoplasias Urogenitales/terapia , Privación de Tratamiento/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Actitud Frente a la Muerte , Estudios de Casos y Controles , Toma de Decisiones/fisiología , Femenino , Humanos , Japón/epidemiología , Neoplasias Renales/epidemiología , Neoplasias Renales/mortalidad , Neoplasias Renales/psicología , Neoplasias Renales/terapia , Masculino , Persona de Mediana Edad , Cuidados Paliativos/ética , Cuidados Paliativos/psicología , Pronóstico , Neoplasias de la Próstata/epidemiología , Neoplasias de la Próstata/mortalidad , Neoplasias de la Próstata/psicología , Neoplasias de la Próstata/terapia , Estudios Retrospectivos , Tasa de Supervivencia/tendencias , Cuidado Terminal/ética , Cuidado Terminal/psicología , Neoplasias de la Vejiga Urinaria/epidemiología , Neoplasias de la Vejiga Urinaria/mortalidad , Neoplasias de la Vejiga Urinaria/psicología , Neoplasias de la Vejiga Urinaria/terapia , Neoplasias Urogenitales/patología , Neoplasias Urogenitales/psicología
5.
FP Essent ; 503: 11-17, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33856178

RESUMEN

Prostate cancer is the second most common nondermatologic cancer in males in the United States. The median age at diagnosis is 66 years and median age at death is 80 years, with most patients diagnosed between ages 55 and 74 years. Black men are at greatest risk of developing and dying of prostate cancer. The U.S. Preventive Services Task Force (USPSTF) and American Urological Association (AUA) guidelines recommend shared decision-making in consideration of screening for men ages 55 to 69 years. Currently, digital rectal examination alone is not recommended for prostate cancer screening. The serum prostate-specific antigen (PSA) test remains the most common screening tool. Novel formulas and algorithms, including the Prostate Health Index (phi) and the 4Kscore, which use total PSA, free PSA, and other information to estimate risk, have shown greater predictive values for detection than the PSA test. Risk assessment with magnetic resonance imaging (MRI) study with or without MRI/transrectal ultrasonography (TRUS) targeted biopsy requires fewer biopsy specimens than traditional TRUS-guided biopsy, and is associated with higher detection rates. Studies of specific lifestyle modifications to minimize prostate cancer risk have shown inconclusive results; however, high carbohydrate and animal fat intakes may increase the risk.


Asunto(s)
Antígeno Prostático Específico , Neoplasias de la Próstata , Anciano , Biopsia , Detección Precoz del Cáncer , Humanos , Masculino , Tamizaje Masivo , Salud del Hombre , Persona de Mediana Edad , Neoplasias de la Próstata/diagnóstico
6.
Pan Afr Med J ; 38: 56, 2021.
Artículo en Francés | MEDLINE | ID: mdl-33854685

RESUMEN

The purpose of this study was to assess outcomes of radical prostatectomy in patients with prostate cancer. We conducted a retrospective single-center study in the Department of Urology and Andrology at the Aristide Le Dantec Hospital in Dakar from June 1, 2010 to May 31, 2016. We collected data of 60 patients undergoing radical retropubic prostatectomy associated with dissection of the iliac and obturator nodes. After radical prostatectomy, prostate specific antigen (PSA) levels were undetectable (<0.1 ng/mL) in 20 patients (33.3%). Eleven patients (18.3%), who had biochemical relapse, received complementary hormone therapy. Patients achieved a response after initiation of treatment, and total PSA became undetectable again after an 8-month follow-up period. Mean overall survival was 17.5 months, with a median of 9.49. Cumulative overall survival rates at 1 year, 3 years and 4 years were 42.4, 13.6 and 6.8%, respectively. Mean relapse-free survival was 17.3 months, with a median biochemical relapse-free survival of eleven (11) months. The mean duration of specific survival was 8.1 months, with a median of 3 months. Seven patients had positive resection margins (11.6%). Four patients had lymph node involvement. Radical prostatectomy, suggested in some patients with prostate cancer in our practice, has been shown to be an effective therapeutic method leading to good outcomes.


Asunto(s)
Antígeno Prostático Específico/sangre , Prostatectomía/métodos , Neoplasias de la Próstata/cirugía , Supervivencia sin Enfermedad , Estudios de Seguimiento , Hospitales Universitarios , Humanos , Escisión del Ganglio Linfático , Metástasis Linfática , Masculino , Márgenes de Escisión , Neoplasias de la Próstata/patología , Estudios Retrospectivos , Senegal , Tasa de Supervivencia , Resultado del Tratamiento
7.
Wiad Lek ; 74(1): 35-38, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33851583

RESUMEN

OBJECTIVE: The aim: To determine prognostic significance of mpMRI in prostate intraepithelial neoplasia (PIN) diagnostics. PATIENTS AND METHODS: Materials and methods: The results of examination of 52 patients with PIN were assessed in mpMRI using PIRADS criteria. The total number of samples with PIN amounted 166. According to PIRADS MRI assessment of central and peripherial zones was made separately. The use of T2WI, DWI, DCE in patients with high grade and low grade PIN was studied. MRI was performed before prostate biopsy (MRI cognitive fusion biopsy). During 3-year follow-up rebiopsies were performed with prostate cancer detection. PIRADS values of PIN lesions with malignisation were compared with those without following tumor transformation. RESULTS: Results: There was a difference in values of PIRADS characteristics between PIN and benign prostatic tissue. The mean of PIRADS gradation in samples with PIN was 2,1. Among them 47 (28,3 %) PIN samples had gradation 3 (the presence of clinically significant cancer is equivocal), in 8 (4,8 %) cases - gradation 4 (clinically significant cancer is likely to be present). The mean of PIRADS gradation was in 24 % larger in cases with subsequent PC detection than in cases without malignisation. CONCLUSION: Conclusions: MRI parameters in PIN cases differ from normal prostate tissue. PIRADS assessment has prognostic significance of following malignisation of PIN pieces that have similar properties on MRI as prostate cancer. Further study is required to stratify all PIN patients into groups of high malignisation risk in order to perform detailed examination and treatment.


Asunto(s)
Biopsia Guiada por Imagen , Neoplasias de la Próstata , Humanos , Imagen por Resonancia Magnética , Masculino , Pronóstico , Neoplasias de la Próstata/diagnóstico por imagen
9.
Arkh Patol ; 83(3): 38-45, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33822553

RESUMEN

OBJECTIVE: To discuss the possibilities and prospects of using artificial intelligence (AI) in the diagnosis of prostate cancer (PC). The laboratory diagnosis of PC is considered and prostate images are analyzed according to transrectal ultrasound and magnetic resonance imaging using AI algorithms. Particular emphasis is placed on prostate histologic evaluation.


Asunto(s)
Inteligencia Artificial , Neoplasias de la Próstata , Algoritmos , Humanos , Imagen por Resonancia Magnética , Masculino , Neoplasias de la Próstata/diagnóstico
10.
Anticancer Res ; 41(4): 2101-2110, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33813420

RESUMEN

BACKGROUND/AIM: To evaluate if topical support therapy during static-intensity modulated radiotherapy (sIMRT) course is able to equal the characteristic minimum risk for radiation proctitis of Image-guided volumetric modulated arc therapy (IG-VMAT) treatment among localized prostate cancer patients. PATIENTS AND METHODS: Rectal toxicity data of the above patients were retrospectively collected throughout three different clinical periods at our Radiotherapy Deparment: from October 2011 to December 2012, prostate cancer patients were treated with sIMRT and in advance supported by means of daily topical corticosteroids; from January 2013 to November 2016, topical corticosteroids were replaced by daily hyaluronic acid enemas; from December 2016 to May 2018 eligible patients were treated with newly introduced IG-VMAT supported by only on-demand topical corticosteroids. RESULTS: Among 359 eligible patients, IG-VMAT was proven generally more effective than sIMRT supported by topical medications in terms of proctitis reduction, although without clinical and practical relevance. CONCLUSION: Topical medications might have a role in radiation proctitis prevention.


Asunto(s)
Antiinflamatorios/administración & dosificación , Proctitis/prevención & control , Neoplasias de la Próstata/tratamiento farmacológico , Neoplasias de la Próstata/radioterapia , Radioterapia de Intensidad Modulada , Administración Tópica , Anciano , Anciano de 80 o más Años , Beclometasona/administración & dosificación , Enema/métodos , Humanos , Ácido Hialurónico/administración & dosificación , Italia , Masculino , Persona de Mediana Edad , Tratamientos Conservadores del Órgano/métodos , Proctitis/etiología , Neoplasias de la Próstata/patología , Hipofraccionamiento de la Dosis de Radiación , Traumatismos por Radiación/prevención & control , Planificación de la Radioterapia Asistida por Computador/métodos , Radioterapia Guiada por Imagen/efectos adversos , Radioterapia Guiada por Imagen/métodos , Radioterapia de Intensidad Modulada/efectos adversos , Radioterapia de Intensidad Modulada/métodos , Estudios Retrospectivos
11.
Anticancer Res ; 41(4): 2183-2186, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33813431

RESUMEN

BACKGROUND/AIM: The aim of this study was to identify simple and reliable factors to detect clinically insignificant prostate cancer (PC) for avoiding immediate prostate biopsies using biparametric magnetic resonance imaging (MRI), which consists of T2-weighted and diffusion-weighted imaging. PATIENTS AND METHODS: We retrospectively evaluated 427 men with suspected PC, who underwent biparametric MRI and standard 12-core transrectal prostate biopsy. MRI and prostate specific antigen density (PSAD) were analysed. To evaluate the combination of the two parameters, patients were divided into three groups (Group A: MRI negative and PSAD <0.23, Group B: MRI positive or PSAD ≥0.23, Group C: MRI positive and PSAD ≥0.23). A grade of ≥2 was defined as clinically significant PC. RESULTS: Clinically significant PC was detected in 46.5% of men with positive MRI findings, and 60.0% of men with PSAD ≥0.23. When combining MRI and PSAD, detection rates of clinically significant PC were 10.0%, 28.4% and 65.3% in group A, B and, C, respectively. CONCLUSION: Negative biparametric MRI findings with PSAD <0.23 might be a reliable evidence for avoiding immediate prostate biopsies.


Asunto(s)
Imagen por Resonancia Magnética/métodos , Antígeno Prostático Específico/análisis , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/patología , Adulto , Anciano , Anciano de 80 o más Años , Biopsia con Aguja Gruesa/métodos , Imagen de Difusión por Resonancia Magnética , Humanos , Biopsia Guiada por Imagen , Pruebas Inmunológicas , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Cuidados Preoperatorios , Próstata/patología , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/metabolismo , Estudios Retrospectivos , Carga Tumoral , Ultrasonografía Intervencional
12.
Int J Mol Sci ; 22(6)2021 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-33799604

RESUMEN

Prostate cancer (PCa) is the second leading cause of cancer-related deaths in men in Western countries, and there is still an urgent need for a better understanding of PCa progression to inspire new treatment strategies. Skp2 is a substrate-recruiting component of the E3 ubiquitin ligase complex, whose activity is regulated through neddylation. Slug is a transcriptional repressor involved in the epithelial-to-mesenchymal transition, which may contribute to therapy resistance. Although Skp2 has previously been associated with a mesenchymal phenotype and prostate cancer progression, the relationship with Slug deserves further elucidation. We have previously shown that a high Gleason score (≥8) is associated with higher Skp2 and lower E-cadherin expression. In this study, significantly increased expression of Skp2, AR, and Slug, along with E-cadherin downregulation, was observed in primary prostate cancer in patients who already had lymph node metastases. Skp2 was slightly correlated with Slug and AR in the whole cohort (Rs 0.32 and 0.37, respectively), which was enhanced for both proteins in patients with high Gleason scores (Rs 0.56 and 0.53, respectively) and, in the case of Slug, also in patients with metastasis to lymph nodes (Rs 0.56). Coexpression of Skp2 and Slug was confirmed in prostate cancer tissues by multiplex immunohistochemistry and confocal microscopy. The same relationship between these two proteins was observed in three sets of prostate epithelial cell lines (PC3, DU145, and E2) and their mesenchymal counterparts. Chemical inhibition of Skp2, but not RNA interference, modestly decreased Slug protein in PC3 and its docetaxel-resistant subline PC3 DR12. Importantly, chemical inhibition of Skp2 by MLN4924 upregulated p27 and decreased Slug expression in PC3, PC3 DR12, and LAPC4 cells. Novel treatment strategies targeting Skp2 and Slug by the neddylation blockade may be promising in advanced prostate cancer, as recently documented for other aggressive solid tumors.


Asunto(s)
Proteína NEDD8/genética , Neoplasias de la Próstata/genética , Procesamiento Proteico-Postraduccional , Proteínas Quinasas Asociadas a Fase-S/genética , Factores de Transcripción de la Familia Snail/genética , Antígenos CD/genética , Antígenos CD/metabolismo , Antineoplásicos/farmacología , Cadherinas/genética , Cadherinas/metabolismo , Línea Celular Tumoral , Supervivencia Celular/efectos de los fármacos , Inhibidor p27 de las Quinasas Dependientes de la Ciclina/genética , Inhibidor p27 de las Quinasas Dependientes de la Ciclina/metabolismo , Ciclopentanos/farmacología , Docetaxel/farmacología , Transición Epitelial-Mesenquimal/genética , Regulación Neoplásica de la Expresión Génica , Humanos , Metástasis Linfática , Masculino , Proteína NEDD8/metabolismo , Clasificación del Tumor , Células PC-3 , Próstata/metabolismo , Próstata/patología , Neoplasias de la Próstata/metabolismo , Neoplasias de la Próstata/patología , Pirimidinas/farmacología , ARN Interferente Pequeño/genética , ARN Interferente Pequeño/metabolismo , Receptores Androgénicos/genética , Receptores Androgénicos/metabolismo , Proteínas Quinasas Asociadas a Fase-S/antagonistas & inhibidores , Proteínas Quinasas Asociadas a Fase-S/metabolismo , Factores de Transcripción de la Familia Snail/metabolismo
13.
Anticancer Res ; 41(4): 1921-1926, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33813397

RESUMEN

BACKGROUND/AIM: Methionine addiction is a general and fundamental hallmark of cancer due to the excess use of methionine for transmethylation reactions, termed the "Hoffman Effect". Methionine addiction has been shown to be a highly-effective target for cancer therapy by methionine restriction with oral recombinant methioninase (o-rMETase) in preclinical studies, including patient- derived orthotopic xenograft (PDOX) mouse models of cancer. A clinical study of o-rMETase as a supplement showed a 70% reduction of PSA levels in a patient with bone-metastatic prostate cancer. MATERIALS AND METHODS: In the present study, two advanced prostate-cancer patients took o-rMETase as a supplement for approximately one month. RESULTS: One of the patients taking o-rMETase showed a 38% reduction of PSA levels and the second patient showed a 20% PSA reduction. CONCLUSION: o-rMETase shows promise for treating patients with advanced prostate cancer.


Asunto(s)
Liasas de Carbono-Azufre/administración & dosificación , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/tratamiento farmacológico , Administración Oral , Anciano de 80 o más Años , Neoplasias Óseas/tratamiento farmacológico , Neoplasias Óseas/secundario , Progresión de la Enfermedad , Regulación hacia Abajo/efectos de los fármacos , Terapia de Reemplazo Enzimático , Humanos , Masculino , Metionina/sangre , Metionina/efectos de los fármacos , Persona de Mediana Edad , Proyectos Piloto , Antígeno Prostático Específico/efectos de los fármacos , Neoplasias de la Próstata/sangre , Neoplasias de la Próstata/patología , Proteínas Recombinantes/administración & dosificación
14.
Asia Pac J Clin Oncol ; 17 Suppl 3: 48-54, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33860643

RESUMEN

AIM: In response to the fast-developing coronavirus disease 2019 (COVID-19) pandemic, special arrangement and coordination are urgently required in the interdisciplinary care of patients across different medical specialties. This article provides recommendations on the management of different stages of localized or metastatic prostate cancer (PC) amid this pandemic. METHODS: The Hong Kong Urological Association and Hong Kong Society of Uro-oncology formed a joint discussion panel, which consisted of six urologists and six clinical oncologists with extensive experience in the public and private sectors. Following an evidence-based approach, the latest relevant publications were searched and reviewed, before proceeding to a structured discussion of relevant clinical issues. RESULTS: The joint panel provided recommendations for PC management during the pandemic, in terms of general considerations, diagnostic procedures, different disease stages, treatment modules, patient support, and interdisciplinary collaboration. The overall goal was to minimize the risk of infection while avoiding unnecessary delays and compromises in management outcomes. Practical issues during the pandemic were addressed such as the use of invasive diagnostic procedures, robotic-assisted laparoscopic prostatectomy, hypofractionated radiotherapy, and prolonged androgen deprivation therapy. The recommendations were explicated in the context of Hong Kong, a highly populated international city, in relation to the latest international guidelines and evidence. CONCLUSION: A range of recommendations on the management of PC patients during the COVID-19 pandemic was developed. Urologists, oncologists, and physicians treating PC patients may refer to them as practical guidance.


Asunto(s)
/epidemiología , Neoplasias de la Próstata/terapia , Antagonistas de Andrógenos/uso terapéutico , Hong Kong/epidemiología , Humanos , Masculino , Oncología Médica , Prostatectomía , Neoplasias de la Próstata/patología , Sociedades Médicas
15.
Cancer Imaging ; 21(1): 35, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33863390

RESUMEN

BACKGROUND: Recent studies reported metabolic uptake in at least one of the evaluated ganglia in 98.5% of patients undergoing 68Ga -PSMA-11 and in 96.9% of patients undergoing 18F-DCFPyL PET/CT examination. We have observed different patterns of ganglion visualization with 18F-DCFPyL compared to 68Ga-PSMA-11. This includes more frequent visualization of cervical and sacral ganglia, which may be attributable to better imaging characteristics with 18F PET imaging. CASE PRESENTATION: This pictorial essay is to illustrate and compare, in the same patient, various representative cases of 68Ga-PSMA-11 and 18F-DCFPyL PET/CT uptake in ganglia at different anatomic locations, with different patterns and distribution of metabolic activity. CONCLUSION: Reading physicians should be aware of the frequently encountered and occasionally different physiologic uptake of 68Ga-PSMA-11 and 18F DCFPyL in different ganglia.


Asunto(s)
Ácido Edético/análogos & derivados , Ganglios/metabolismo , Oligopéptidos/metabolismo , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/fisiopatología , Ácido Edético/metabolismo , Humanos , Masculino
16.
Int J Mol Sci ; 22(5)2021 Mar 08.
Artículo en Inglés | MEDLINE | ID: mdl-33800517

RESUMEN

A new PSMA ligand (PSMA-D4) containing the Glu-CO-Lys pharmacophore connected with a new linker system (L-Trp-4-Amc) and chelator DOTA was developed for radiolabeling with therapeutic radionuclides. Herein we describe the synthesis, radiolabeling, and preliminary biological evaluation of the novel PSMA-D4 ligand. Synthesized PSMA-D4 was characterized using TOF-ESI-MS, NMR, and HPLC methods. The novel compound was subject to molecular modeling with GCP-II to compare its binding mode to analogous reference compounds. The radiolabeling efficiency of PSMA-D4 with 177Lu, 90Y, 47Sc, and 225Ac was chromatographically tested. In vitro studies were carried out in PSMA-positive LNCaP tumor cells membranes. The ex vivo tissue distribution profile of the radioligands and Cerenkov luminescence imaging (CLI) was studied in LNCaP tumor-bearing mice. PSMA-D4 was synthesized in 24% yield and purity >97%. The radio complexes were obtained with high yields (>97%) and molar activity ranging from 0.11 to 17.2 GBq mcmol-1, depending on the radionuclide. In vitro assays confirmed high specific binding and affinity for all radiocomplexes. Biodistribution and imaging studies revealed high accumulation in LNCaP tumor xenografts and rapid clearance of radiocomplexes from blood and non-target tissues. These render PSMA-D4 a promising ligand for targeted therapy of prostate cancer (PCa) metastases.


Asunto(s)
Sistemas de Liberación de Medicamentos , Calicreínas , Antígeno Prostático Específico , Neoplasias de la Próstata , Radiofármacos , Animales , Humanos , Calicreínas/química , Calicreínas/farmacología , Masculino , Ratones , Ratones Endogámicos BALB C , Ratones Desnudos , Células PC-3 , Antígeno Prostático Específico/química , Antígeno Prostático Específico/farmacología , Neoplasias de la Próstata/metabolismo , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/radioterapia , Radiofármacos/síntesis química , Radiofármacos/química , Radiofármacos/farmacología , Ensayos Antitumor por Modelo de Xenoinjerto
17.
Artículo en Inglés | MEDLINE | ID: mdl-33803629

RESUMEN

Conceptualized using critical race theory as a theoretical underpinning, this study analyzed the lived experiences of older, rural, African American male prostate cancer (hereafter referenced as PrCA) survivors' faith and health promotion practices within Northeast Louisiana. Qualitative data from journaling, observations, and semi-structured interviews were obtained from ten older, African American male PrCA survivors residing in four rural parishes of Louisiana. The data analysis employed a two-stage approach known as Polkinghorne's analysis of narratives and narrative analysis using an art-based methodological approach. Framed as composite character counterstories, survivors' narratives revealed how survivors made sense of and gave meaning to their PrCA diagnosis, treatment, recovery, and survivorship. Specifically, their counterstories indicate that centering and honoring the unique and often taken-for-granted perspectives of older, rural, African American male PrCA survivors offered a deeper understanding of the multiple factors influencing their quality of life, as well as the sociostructural mechanisms impacting their survivorship care. Faith was examined as both a secular and sacred source of support that these men viewed as central to the acceptance of their diagnosis, treatment, recovery, and survivorship.


Asunto(s)
Supervivientes de Cáncer , Neoplasias de la Próstata , Afroamericanos , Promoción de la Salud , Humanos , Louisiana , Masculino , Investigación Cualitativa , Calidad de Vida , Sobrevivientes
18.
Medicine (Baltimore) ; 100(15): e25237, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33847621

RESUMEN

OBJECTIVE: This study aimed to investigate the clinicopathological features and the survival outcomes of neuroendocrine prostate cancer (NEPC). METHODS: Within the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute, we identified a total of 510 patients with NEPC between 2006 and 2015. Age-adjusted incidence rates were evaluated in the study by the SEER∗Stat Software version 8.3.6. Kaplan-Meier analysed assessed overall survival (OS) after stratification according to marital status, age, histologic subtype, metastatic status, and treatment. The significant differences were assessed in a log-rank test. Univariate and multivariate cox hazard regression analysis were performed to determine independent predictors of OS. RESULTS: From a total of 560,124 patients with prostate cancer diagnosed between 2006 and 2015, we identified 510 cases of de novo NEPC. Regarding histology, among all the NEPC, 329 (64.5%) patients were diagnosed as small cell carcinoma, 181 (39.8%) were nonsmall cell carcinoma. The overall age-adjusted incidence of NEPC statistically significantly increased from 0.321/1,000,000 person-years in 2006 to 0.587/1,000,000 person-years in 2015. The median OS in our study cohort was 9 months (95% CI, 8-10 months). Multivariate cox regression analysis showed that age, histologic subtype, and stage were independent prognostic factors for NEPC patients. The majority of NEPC (78.2%) were metastatic at diagnosis. In terms of treatment, for metastatic tumor patients, chemotherapy was the most effective therapy. Chemotherapy increased the OS of patients with regional (distant) metastases from 8 months (5 months) to 13.5 months (9 months). CONCLUSION: NEPC is extremely rare but the incidence of NEPC has been increasing in the past years. The prognosis of NEPC is poor because most cases are diagnosed at metastatic stage. The patients with metastases are typically treated with chemotherapy and chemotherapy shows survival benefits in both regional and distant metastatic tumor patients.


Asunto(s)
Carcinoma Neuroendocrino/mortalidad , Carcinoma Neuroendocrino/patología , Neoplasias de la Próstata/mortalidad , Neoplasias de la Próstata/patología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Carcinoma Neuroendocrino/terapia , Humanos , Incidencia , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Estadificación de Neoplasias , Pronóstico , Neoplasias de la Próstata/terapia , Programa de VERF , Factores Socioeconómicos
19.
Medicine (Baltimore) ; 100(15): e25417, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33847640

RESUMEN

BACKGROUND: 68Ga-PSMA-PET/CT (positron emission tomography/computed tomography) is a promising method for prostate cancer (PC) detection. However, the ability of 68Ga-PSMA-PET/CT to detect malignant bone lesions, and whether this method is superior to the existing bone imaging methods are still lack of systematic analysis. PURPOSE: To evaluate the value of 68Ga-PSMA-PET/CT and bone scan in clinical diagnosis of prostatic cancer from the perspective of evidence-based medicine. METHODS: PubMed, The Cochrane Library, EMBASE, Springer Link, Sinomed, CNKI, Wanfang database, and CQVIP database were searched to find the satisfactory studies that needed systematic review of trials and compared the value of 68Ga-PSMA-PET/CT and bone scan. All studies published from inception to March 31, 2020. According to the inclusion and exclusion criteria, 2 reviewers independently evaluated and extracted the literature. Review Manager 5.3 was applied to evaluate the included literature quality. The heterogeneity of the included literature was tested by Meta Disc 1.4, and the effect model was selected according to the heterogeneity test results, and the sensitivity (SEN), specificity (SPE), PLR, NLR and diagnostic odds ratio (DOR) were analyzed. After testing the heterogeneity results of literature by using the 95% confidence interval and the forest map. RESULTS: A total of 4 studies were eligible for inclusion in the meta-analysis, which included 318 patients, 120 cases with bone metastasis and 198 cases without bone metastasis. The results of summary evaluation for 68Ga-PSMA-PET/CT and bone scan in diagnosis of prostatic cancer as follow respectively: The SEN were 0.97 and 0.86; the SPE were 1.00 and 0.87; the DOR were 1468.33 and 36.23; PLR were 88.45 and 6.67; NLR were 0.05 and 0.19; and the area under curve (AUC) and 95% CI were 0.9973 (1.0000-0.9927) and 0.8838 (0.9584-0.8092). CONCLUSION: By comparing the diagnostic results of 68Ga-PSMA-PET/CT and bone scan imaging diagnosis methods, the 68Ga-PSMA-PET/CT has a higher SEN and SPE than bone scan, and it has a higher diagnostic efficiency for prostate cancer bone metastasis, which is worthy of clinical application.


Asunto(s)
Neoplasias Óseas/secundario , Ácido Edético/análogos & derivados , Oligopéptidos/administración & dosificación , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Neoplasias de la Próstata/patología , Radiofármacos/administración & dosificación , Tomografía Computarizada por Rayos X/métodos , Neoplasias Óseas/diagnóstico por imagen , Combinación de Medicamentos , Ácido Edético/administración & dosificación , Fluoruros , Humanos , Masculino , Nitratos , Fosfatos , Neoplasias de la Próstata/diagnóstico por imagen
20.
BMJ Case Rep ; 14(4)2021 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-33811092

RESUMEN

A 66-year-old man with pulmonary sarcoidosis was referred to the urology team for assessment of troublesome lower urinary tract symptoms. An elevated blood serum prostate-specific antigen raised concern for prostate cancer. An MRI of the prostate demonstrated a potentially aggressive prostate lesion, along with low T1 signal skeletal lesions, suggestive of metastatic disease. Subsequent bone scan and MRI whole spine demonstrated further skeletal lesions. In cases of known prostate cancer, sometimes a presumptive diagnosis of skeletal metastases is made without histological diagnosis from the skeletal lesions. However, there were certain factors in this case whereby skeletal biopsy was deemed prudent prior to further therapy. Factors included atypical MRI signal characteristics for metastatic disease, absence of a positive tissue diagnosis from the prostate and the clinical background of sarcoidosis. The biopsy confirmed skeletal sarcoid rather than metastatic disease, thereby avoiding inappropriate and potentially toxic treatment for the patient.


Asunto(s)
Neoplasias de la Próstata , Sarcoidosis , Anciano , Humanos , Imagen por Resonancia Magnética , Masculino , Neoplasias de la Próstata/diagnóstico , Cintigrafía , Sarcoidosis/diagnóstico por imagen , Cráneo
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