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1.
Stud Health Technol Inform ; 264: 1506-1507, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438204

RESUMO

In this study, we built a multi-center integrated database platform of localized prostate cancer and developed biochemical recurrence (BCR) prediction system with Gradient Boosted Regression model using Korean Prostate Cancer Registry (KPCR) database. This platform will facilitate clinical management of patients with prostate cancer, and it will also help develop appropriate treatment of prostate cancer.


Assuntos
Neoplasias da Próstata , Bases de Dados Factuais , Humanos , Masculino , Recidiva Local de Neoplasia , Antígeno Prostático Específico , Prostatectomia
2.
Anticancer Res ; 39(8): 4411-4414, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366538

RESUMO

BACKGROUND/AIM: Cabazitaxel use has usually been limited to up to 10 cycles in most countries according to the protocol in the TROPIC trial. Therefore, clinical data on cabazitaxel use beyond 10 cycles is limited. The aim of this study was to report the therapeutic outcome of cabazitaxel chemotherapy administered for >10 cycles. PATIENTS AND METHODS: This study included 74 Japanese patients with prostate cancer between 2014 and 2017. Patients background, and treatment outcomes including PSA decline, progression-free survival, treatment-failure-free survival, overall survival, and adverse events were investigated, comparing patients treated with ≤10 and >10 cycles. RESULTS: Patients characteristics were favorable as indicated by the higher number of cycles of prior docetaxel chemotherapy, absence of pain, and absence of bony and visceral metastases among men who received >10 cycles of cabazitaxel. PSA response, progression-free survival, treatment-failure-free survival and overall survival were better among patients treated with >10 cycles of cabazitaxel compared to those treated with ≤10 cycles. The incidence of severe adverse events was similar between the two groups. CONCLUSION: Taken together, this study suggested that continuous chemotherapy with cabazitaxel beyond 10 cycles may be beneficial.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Docetaxel/administração & dosagem , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Taxoides/administração & dosagem , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Docetaxel/efeitos adversos , Esquema de Medicação , Humanos , Masculino , Pessoa de Meia-Idade , Intervalo Livre de Progressão , Antígeno Prostático Específico/sangue , Neoplasias de Próstata Resistentes à Castração/sangue , Neoplasias de Próstata Resistentes à Castração/patologia , Taxoides/efeitos adversos , Resultado do Tratamento
3.
Medicine (Baltimore) ; 98(27): e16351, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277192

RESUMO

RATIONAL: How to manage patients with prostate cancer (PCa) with biochemical recurrence (BCR) following primary curative treatment is a controversial issue. Multiple disciplinary team (MDT) mechanism may propose an appropriate treatment plan for patients and can effectively improve patient prognosis and survival, reduce patient diagnosis and treatment waiting time, and greatly improve patient satisfaction. PATIENT CONCERNS: Here, we presented a case of a 77-year-old man with a persistently elevated serum level of prostate-specific antigen (PSA), who had a history of radical prostatectomy (RP) and of 9 years endocrine therapy. DIAGNOSES: Castration-resistant prostate cancer and locally recurrent prostate cancer. INTERVENTIONS: Androgen-deprivation therapy was first utilized 2 months after RP, due to the consideration of BCR on May 5, 2007. And during the next 9 years, he was treated with different endocrine agents but failed to maintain serum levels of PSA stable. Finally, the MDT suggested patient to perform salvage radiation therapy (SRT). Under MDT mechanism, we avoid secondary surgery, so as to reduce the patients' mental suffering and cost of patient care. OUTCOMES: EPIC26 scale assessment revealed leak-free urine, good urine control, no defecation abnormalities or blood in the stool, no breast tenderness and breast enlargement significantly improved. The patient now has no adjuvant therapy, including endocrine therapy. The patient achieved good prognosis through local RT. LESSONS: Pelvic SRT for patients with locally recurrent PCa may restore the same radical effect as RP. And more importantly, MDT mechanism plays an important role in making the most appropriate decisions for patients.


Assuntos
Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/terapia , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/terapia , Idoso , Terapia Combinada , Humanos , Masculino , Prostatectomia , Terapia de Salvação
4.
Clin Biochem ; 71: 58-66, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31295477

RESUMO

OBJECTIVES: Replacements are required for the WHO International Standards (IS) for free PSA, coded 96/668 and total PSA (90:10), coded 96/670, which were established in 1999 to support efforts to harmonise PSA assays and address non-equimolarity. An important consideration is that the introduction of the replacements should have minimal impact on PSA measurements. DESIGN AND METHODS: We report the development of a replacement strategy, informed by field assessment of preparations through an external quality assessment scheme and the subsequent evaluation of the candidate ISs in worldwide collaborative studies. RESULTS: By immunoassay, data from participants confirmed the value assigned to the current standards. Robust geometric mean estimates of the free PSA content of the candidate replacement for 96/668 coded 17/102 was 0.533 µg/ampoule (n = 21). The ratio of the content estimates of 17/102:96/668 was 0.516 (GCV 12.5%, n = 21). Robust geometric mean estimates of the total PSA content of the candidate replacement for 96/670, coded 17/100, was 0.505 µg/ampoule (n = 22). The ratio of the content estimates of 17/100:96/670 was 0.490 (GCV 5.3%, n = 22). Through concomitant measurement of a panel of 15 representative patient samples, the candidate ISs were shown to exhibit commutability with patient samples that was comparable with that of the current ISs. CONCLUSION: On the basis of these results, the preparations coded 17/102 and 17/100 were established by the WHO Expert Committee on Biological Standardization as the 2nd ISs for free and total PSA (PSA-ACT+free PSA) respectively, with assigned contents of 0.53 µg/ampoule and 0.50 µg/ampoule.


Assuntos
Antígeno Prostático Específico/normas , Humanos , Padrões de Referência , Organização Mundial da Saúde
5.
Anticancer Res ; 39(7): 3879-3885, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31262916

RESUMO

BACKGROUND/AIM: There are few reports that verify the relationship between the therapeutic effects of flutamide and novel androgen receptor-targeted agents. We aimed to evaluate the benefits of flutamide as an alternative anti-androgen agent and its effects on the efficacy of novel androgen receptor-targeted agents. PATIENTS AND METHODS: Patients with castration-resistant prostate cancer on novel androgen receptor-targeted agents without prior docetaxel therapy were included. Changes in prostate-specific antigen (PSA) level were recorded. RESULTS: Patients who responded well to flutamide (Flutamide effective) following initial maximum androgen blockade (MAB) showed significantly higher changes in serum PSA levels (p=0.039) and PSA-progression-free survival (PFS) rate (p=0.016) following enzalutamide therapy compared to those who did not respond well to flutamide. Multivariate analysis showed that the factor of Flutamide effective was significantly associated with a good PSA-PFS rate following enzalutamide therapy (HR=7.36, 95%CI=1.4-38.71, p=0.018). CONCLUSION: Patients showing good response to flutamide following initial MAB may achieve a satisfactory PSA-PFS rate with subsequent enzalutamide therapy.


Assuntos
Antagonistas de Androgênios/uso terapêutico , Flutamida/uso terapêutico , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Acetato de Abiraterona/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Docetaxel/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Feniltioidantoína/análogos & derivados , Feniltioidantoína/uso terapêutico , Antígeno Prostático Específico/sangue , Neoplasias de Próstata Resistentes à Castração/sangue , Receptores Androgênicos , Resultado do Tratamento
6.
Medicine (Baltimore) ; 98(26): e16289, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261602

RESUMO

To improve the detection of prostate cancer (PCa) by combining the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) and prostate-specific antigen-age volume (PSA-AV), especially among those in gray zone with PI-RADS v2 score 3 or serum total prostate-specific antigen (tPSA) 4 to 10 ng/mL.The 357 patients were enrolled in this study. The PI-RADS v2 scoring system was used to represent characteristics on multiparametric magnetic resonance imaging (mpMRI). PI-RADS v2 score 3 or tPSA 4 to 10 ng/mL were defined as the gray zone in detecting PCa. The formula equates to the patient age multiplied by the prostate volume, which is divided by the tPSA level. Univariate and multivariate analyses were done to ascertain significant predictors of prostate cancer.In all, 174 (48.7%) were benign prostatic hyperplasia, 183 (51.3%) had PCa. The results showed that PI-RADS v2, tPSA, and PSA-AV were significant independent predictors of prostate cancer. PI-RADS v2 score ≥4 could detect PCa with rate of 82.1%. Serum tPSA ≥10 ng/mL could detect PCa with rate of 66.2%, PSA density (PSAD) ≥0.15 ng/mL/cc with rate of 62.8%, and PSA-AV ≤250 with rate of 83.5%. Combining with PSA-AV ≤250, patients those with tPSA 4 to 10 ng/mL could improve the detection from 36.0% up to 81%, those with PI-RADS v2 score 3 from 28.6% up to 60.0%.PI-RADS v2 and PSA-AV are faithful variables for detecting PCa. And for patients, those in gray zones of PI-RADS v2 and tPSA, PSA-AV can improve detection rate of PCa.


Assuntos
Imagem por Ressonância Magnética , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico por imagem , Fatores Etários , Idoso , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Próstata/patologia , Neoplasias da Próstata/diagnóstico , Estudos Retrospectivos
7.
J Comput Assist Tomogr ; 43(4): 645-651, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31268875

RESUMO

OBJECTIVE: To develop regression models using Prostate Imaging Reporting and Data System (PI-RADS), histogram analysis, and prostate-specific antigen density (PSAD) to predict prostate cancer (PCa) and clinically significant PCa (CSPCa) in patients with prostate-specific antigen of 4 to 20 ng/mL. METHODS: In total, 195 PCa and 386 noncancer patients with prostate-specific antigen of 4 to 20 ng/mL were divided into development and validation cohorts. Magnetic resonance imaging results of them were assessed by PI-RADS scores and histogram analysis-corrected PI-RADS (PI-RADSh) scores. Diagnostic efficiencies for PCa and CSPCa of these scores plus PSAD were evaluated with logistic regression and receiver operating characteristic curve analysis. RESULTS: Prostate-specific antigen density + PI-RADSh score showed significantly higher area under the receiver operating characteristic curve for PCa (0.956) and CSPCa (0.960), which were higher than PI-RADS (0.909 and 0.926), PI-RADSh (0.921 and 0.940), and PSAD + PI-RADS (0.943 and 0.949) (all P < 0.05). CONCLUSIONS: Incorporation of PSAD and histogram analysis raised the diagnosis efficiencies of PI-RADS for PCa and CSPCa.


Assuntos
Bases de Dados Factuais , Imagem por Ressonância Magnética , Antígeno Prostático Específico/sangue , Próstata/diagnóstico por imagem , Neoplasias da Próstata , Idoso , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/epidemiologia , Estudos Retrospectivos , Risco
8.
Urologiia ; (2): 73-81, 2019 Jun.
Artigo em Russo | MEDLINE | ID: mdl-31162906

RESUMO

Prostate cancer (PCa) is the 4th most commonly diagnosed cancer in the male population and incidence of different stages is increasing every year. The efficiency of PCa treatment is strongly dependent on the its stage. Prostate Specific Antigen (PSA) is the most widely used and universal biomarker of PCa worldwide. Considering its limited predictive value, particularly in patients older than 50 with PSA level ranging from 4.5 to 10 ng/ml, there is a need to introduce new serum biomarkers of PCa. Current data on different PCa biomarkers are reviewed in the article as well as a role of angiotensin-converting enzyme (ACE) as a novel PCa biomarker.


Assuntos
Biomarcadores Tumorais/sangue , Peptidil Dipeptidase A/sangue , Hiperplasia Prostática/sangue , Neoplasias da Próstata/sangue , Humanos , Masculino , Próstata/metabolismo , Antígeno Prostático Específico/sangue , Hiperplasia Prostática/diagnóstico , Neoplasias da Próstata/diagnóstico
9.
Arch Esp Urol ; 72(5): 463-470, 2019 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-31223124

RESUMO

OBJECTIVES: To evaluate the current clinical practice for patients with Prostate Cancer (CP) in the Health Areas of Castilla y León (CyL) in 2014. METHODS: A retrospective multicenter study was designed to provide data on the diagnosis and treatment of PC in CyL: 87.8% of patients were screened. Descriptive statistics on variables related to characteristics of the patient, the tumor and the treatment modality of the first line to which it was submitted are provided. RESULTS: A total of 1156 new cases of PC were analyzed with a mean age of 68.2 years and a mean PSA of 8.40 ng/ml. The Gleason score (GS) showed 538 (46.2%), 418 (35.9 %) and 200 (17.1%) patients for GS ≤ 6, 7 and  ≥ 8 respectively. 91% of patients (1053 patients) are diagnosed at a localized stage. 56 (4.8%) patients received treatment with active surveillance/ watchful waiting, 423 (36.6%) radical prostatectomy (PR), 348 (30.1%) radiotherapy (RT), 98 (8.4%) brachytherapy (BT) and 170 (14.7%) hormone therapy (HT) respectively. CONCLUSIONS: Differed strategies still accounted for a small percentage of treatments. PR and RT/BT were of choice in patients with localized stages of the disease and younger than 70 years. More advanced stages and older patients were treated with HT mainly. Age is postulated as the main factor involved in therapeutic decision making.


Assuntos
Antígeno Prostático Específico , Neoplasias da Próstata , Idoso , Humanos , Masculino , Gradação de Tumores , Prostatectomia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/cirurgia , Estudos Retrospectivos
10.
Arch Esp Urol ; 72(5): 471-482, 2019 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-31223125

RESUMO

INTRODUCTION: Minimal residual disease (MRD) is that which remains after curative therapy for prostate cancer. It has the potential for growth and later cause metastasis. After radical prostatectomy, the detection of circulating prostate cells (CPCs) and bone marrow micro-metastasis could represent different types of MRD. We proposed to determine the biochemical failure free survival rates, the time to biochemical failure after 10 years of follow-up and the presence of CPCs and micro-metastasis in patients treated with RP for pathologically organ confined prostate cancer. METHODS AND PATIENTS: One month after RP monotherapy for prostate cancer, blood and bone marrow samples were taken to detect CPCs and micro-metastasis. Men were classified as: group A (CPC negative and micro-metastasis negative), group B (CPC negative and micro-metastasis positive), group C (CPC positive and micro-metastasis negative), and group D (CPC positive and micro-metastasis positive). All subjects were followed with serial total PSA levels, recording the time at which failure occurred defined as a serum PSA > 0.2ng/ ml on two separate occasions. After ten years of follow- up for each group Kaplan-Meier survival curves were determined and using an adjusted flexible parametric model (FP), the Restricted Mean Survival Times for groups A, B, C and D were calculated. RESULTS: 191 men participated, 10-year biochemical failure survival rates were; group A (N=114) with a Kaplan-Meier of 98.7%; group B (N=39) 65.1%; group C (N=12) 10.4% and in group D (N=28) 12.8%. The Restricted Mean Survival Times (years) were group A: 9.95; group B: 9.45, group C: 5.11 and group D: 6.18 (p-value <0.001 between groups: A versus C, Aversus D, B versus C and B versus D). Frequency and time to failure was dependent on the type of MRD, those men CPC positive had a significantly higher failure rate and early failure. Those men only micro-metastasis positive had lower failure rate and late failure when compared with men negative for MRD. CONCLUSIONS: CPC positive men have a more aggressive disease with increased early failure; those men who are only positive for micro-metastasis are at risk for late or delayed failure. These two forms of measuring MRD represent different stages in the disease progression and may be used to guide clinical treatment decisions before increases in PSA levels.


Assuntos
Células Neoplásicas Circulantes , Prostatectomia , Neoplasias da Próstata , Medula Óssea , Progressão da Doença , Humanos , Masculino , Micrometástase de Neoplasia , Recidiva Local de Neoplasia , Estudos Prospectivos , Antígeno Prostático Específico , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia
11.
Stud Health Technol Inform ; 261: 193-198, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31156115

RESUMO

The rapidly growing number of health-related Discrete Choice Experiments (DCEs) has not been matched by studies of their impact on decision or policymaking. However, it is widely assumed that this impact has been very limited, despite the potential relevance of the resulting average preferences to group policy development. The main, but at the moment essentially speculative, explanation offered, focuses on the methodological quality of the DCEs and their reporting. An alternative explanation, equally speculative, lies in the research-practice gap created by the conceptualisation of the DCE as a purely research exercise, not supplemented by any attempt to translate the findings into analytic decision support form. This also applies in the clinical decision context, where there are frequent claims that DCE results can assist in an individual's decision making. In the absence of suggestions as to how group results can analytically facilitate preference-sensitive care (and legally informed consent), we propose a generic add-on for DCEs with 'real' options, attributes, and attribute levels. This takes the form of a multi-criteria analysis-based decision support tool. Exemplars, showing how preference-sensitive individualised opinions can be derived from published DCEs for Heavy Menstrual Bleeding and Prostate Cancer Screening, may be consulted online.


Assuntos
Técnicas de Apoio para a Decisão , Neoplasias da Próstata , Telemedicina , Comportamento de Escolha , Detecção Precoce de Câncer , Humanos , Masculino , Preferência do Paciente , Antígeno Prostático Específico , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/terapia
12.
Hinyokika Kiyo ; 65(5): 175-179, 2019 May.
Artigo em Japonês | MEDLINE | ID: mdl-31247697

RESUMO

Peritoneal metastasis of prostate cancer is extremely rare, with only a few cases reported. A 78-yearold male patient was introduced to our hospital presenting with a prostate-specific antigen (PSA) level of 94.0 ng/ml at examination. He was diagnosed with poorly differentiated adenocarcinoma of the prostate, with a Gleasonscore of 9 (5+4) at cT3bN0M0. Intensity-modulated radiation therapy was performed after 6 months of combined-androgen blockade (CAB) therapy. Twenty-one months later, several lymph node metastases were observed. With the resumptionof CAB therapy, PSA levels dropped and the multiple lymph node metastasis disappeared ; however, peritoneal metastasis was observed after 43 months. We performed a laparoscopic biopsy and our diagnosis after pathological evaluation was metastasis of the prostate cancer. He was treated with Enzalutamide.


Assuntos
Adenocarcinoma , Neoplasias Peritoneais , Neoplasias da Próstata , Adenocarcinoma/secundário , Antagonistas de Androgênios/uso terapêutico , Humanos , Masculino , Neoplasias Peritoneais/secundário , Antígeno Prostático Específico , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/patologia
13.
Cochrane Database Syst Rev ; 6: CD003506, 2019 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-31194882

RESUMO

BACKGROUND: Standard androgen suppression therapy (AST) using surgical or medical castration is considered a mainstay of advanced hormone-sensitive prostate cancer treatment. AST can be initiated early when disease is asymptomatic or deferred when patients suffer symptoms of disseminated prostate cancer. OBJECTIVES: To assess the effects of early versus deferred standard AST for advanced hormone-sensitive prostate cancer. SEARCH METHODS: For this Cochrane Review update, we performed a comprehensive search of multiple databases (CENTRAL, MEDLINE, Embase, Web of Science; last searched November 2018) and two clinical trial registers, with no restrictions on the language of publication or publication status. We also searched bibliographies of included studies and conference proceedings (last searched January 2019). SELECTION CRITERIA: We included all randomised controlled trials (RCTs) with a direct comparison of early versus deferred standard AST. We excluded all other study designs. Participants included had advanced hormone-sensitive prostate cancer receiving surgical or medical castration. DATA COLLECTION AND ANALYSIS: Two review authors independently classified studies and abstracted data. The primary outcomes were time to death of any cause and serious adverse events. Secondary outcomes were time to disease progression, time to death from prostate cancer, adverse events and quality of life. We performed statistical analyses using a random-effects model and assessed the certainty of evidence according to GRADE. We performed subgroup analyses for advanced but non-metastatic disease (T2-4/N+ M0), metastatic disease (M1), and prostate-specific antigen (PSA) relapse. MAIN RESULTS: We identified seven new RCTs since publication of the original review in 2002. In total, we included 10 RCTs.Primary outcomesEarly AST probably reduces the risk of death from any cause over time (hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.75 to 0.90; moderate-certainty evidence; 4767 participants). This corresponds to 57 fewer deaths (95% CI 80 fewer to 31 fewer) per 1000 participants at 5 years for the moderate risk group and 23 fewer deaths (95% CI 32 fewer to 13 fewer) per 1000 participants at 5 years in the low risk group. We downgraded for study limitations. Early versus deferred AST may have little or no effect on serious adverse events (risk ratio (RR) 1.05, 95% CI 0.95 to 1.16; low-certainty evidence; 10,575 participants) which corresponds to 6 more serious adverse events (6 fewer to 18 more) per 1000 participants. We downgraded the certainty of evidence for study limitations and selective reporting.Secondary outcomesEarly AST probably reduces the risk of death from prostate cancer over time (HR 0.69, 95% CI 0.57 to 0.84; moderate-certainty evidence). This corresponds to 62 fewer prostate cancer deaths per 1000 (95% CI 87 fewer to 31 fewer) at 5 years for the moderate risk group and 24 fewer death from prostate cancer (95% CI 34 fewer to 12 fewer) per 1000 men at 5 years in the low risk group. We downgraded the certainty of evidence for study limitations.Early AST may decrease the rate of skeletal events (RR 0.37, 95% CI 0.17 to 0.80; low-certainty evidence) corresponding to 23 fewer skeletal events per 1000 (95% CI 31 fewer to 7 fewer). We downgraded for study limitations and imprecision. It may also increase fatigue (RR 1.41, 95% CI 1.23 to 1.62; low-certainty evidence), corresponding to 31 more men with this complaint per 1000 (95% CI 18 more to 48 more). We downgraded for study limitations and imprecision. It may increase the risk of heart failure (RR 1.90, 95% CI 1.09 to 3.33; low-certainty evidence) corresponding to 27 more events per 1000 (95% CI 3 more to 69 more). We downgraded the certainty of evidence for study limitations and imprecision.Global quality of life is probably similar after two years as assessed with the EORTC QLQ-C30 (version 3.0) questionnaire (mean difference -1.56, 95% CI -4.50 to 1.38; moderate-certainty evidence) with higher scores reflecting better quality of life. We downgraded the certainty of evidence for study limitations. AUTHORS' CONCLUSIONS: Early AST probably extends time to death of any cause and time to death from prostate cancer. It may slightly decrease the rate of skeletal events. Rates of serious adverse events and quality of life may be similar. It may increase fatigue and may increase the risk of heart failure. Better quality trials would be particularly important to better understand the outcomes related to possible treatment-related harm, for which we only found low-certainty evidence.


Assuntos
Antígeno Prostático Específico , Neoplasias da Próstata , Progressão da Doença , Humanos , Masculino , Antígeno Prostático Específico/uso terapêutico , Neoplasias da Próstata/tratamento farmacológico , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
14.
Curr Urol Rep ; 20(7): 40, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31168725

RESUMO

PURPOSE OF REVIEW: In this article, we review why patients may fail medical therapy for benign prostatic hyperplasia (BPH) and by doing so, gain a better understanding of the disease process and how to optimize the care of these patients. RECENT FINDINGS: A growing body of literature has attempted to better characterize the various mechanisms by which patients develop BPH as well as identify predictors of disease progression and treatment failure. BPH is a heterogenous disease process. A more personalized approach to treatment, including patient selection for medical or surgical management, would allow us to optimize patient care.


Assuntos
Resistência a Medicamentos , Hiperplasia Prostática/tratamento farmacológico , Falha de Tratamento , Inibidores de 5-alfa Redutase/uso terapêutico , Antagonistas Adrenérgicos alfa/uso terapêutico , Fatores Etários , Ensaios Clínicos como Assunto , Progressão da Doença , Quimioterapia Combinada , Humanos , Masculino , Obesidade/complicações , Inibidores da Fosfodiesterase 5/uso terapêutico , Antígeno Prostático Específico/análise , Prostatite/complicações
16.
Talanta ; 202: 111-122, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31171159

RESUMO

A new dual-modality immunosensor based on molecularly imprinted polymer (MIP) and a nanostructured biosensing layer has fabricated for the simultaneous detection of two important markers including prostate-specific antigen (PSA) and myoglobin (Myo) in human serum and urine samples. In the first step, 3,3'-dithiodipropionic acid di(N-hydroxysuccinimide ester) (DSP) was self-assembled on a gold screen printed electrode (SPE). Then, the target proteins were attached covalently to the DSP-SPE. The imprinted cocktail polymer ((MIP(PSA, Myo)-SPE)) was synthesized at the SPE surface using acrylamide as monomer, N,N'-methylenebisacrylamide as a crosslinker, and PSA and Myo as the templates, respectively. The MIP-SPE was specific for the impedimetric sensing of PSA and Myo. After that, a nanocomposite (NCP) was synthesized based on the decorated magnetite nanoparticles with multi-walled carbon nanotube, graphene oxide and specific antibody for PSA (Ab). Then, NCP incubated with (MIP(PSA, Myo)-SPE. The modified electrodes and synthesized nanoparticles were characterized using electrochemical impedance spectroscopy, dynamic light scattering, surface plasmon resonance and scanning electron microscopy. The limits of detections were found to be 5.4 pg mL-1 and 0.83 ng mL-1 with the linear dynamic ranges of 0.01-100 and 1-20000 ng mL-1 for PSA and Myo, respectively. The ability of proposed biosensor to detect PSA and Myo simultaneously with high sensitivity and specificity offers a powerful opportunity for the new generation of biosensors. This dual-analyte specific receptors-based device is highly desired for the integration with lab-on-chip kits to measure a wide panel of biomarkers present at ultralow levels during early stages of diseases progress.


Assuntos
Biomarcadores Tumorais/análise , Técnicas Biossensoriais , Técnicas Eletroquímicas , Mioglobina/análise , Polímeros/química , Antígeno Prostático Específico/análise , Neoplasias da Próstata/diagnóstico , Anticorpos/imunologia , Reações Antígeno-Anticorpo , Biomarcadores Tumorais/imunologia , Eletrodos , Humanos , Masculino , Impressão Molecular , Mioglobina/imunologia , Nanopartículas/química , Antígeno Prostático Específico/imunologia , Neoplasias da Próstata/imunologia
17.
Anticancer Res ; 39(6): 3089-3094, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31177153

RESUMO

BACKGROUND/AIM: Limited information is available to help physicians decide when to introduce cabazitaxel for metastatic castration-resistant prostate cancer (mCRPC) patients. The objective of this study was to assess the optimal timing of cabazitaxel introduction. PATIENTS AND METHODS: The clinical outcomes of 66 mCRPC patients receiving cabazitaxel following failure of docetaxel were retrospectively analyzed. RESULTS: Among the parameters possibly affecting the timing of cabazitaxel introduction, only an increased prostate-specific antigen (PSA) value from the diagnosis of CRPC had a significant impact on overall survival (OS) after the introduction of cabazitaxel. Furthermore, there was a significant correlation between the increased PSA value from the diagnosis of CRPC and the baseline PSA value at cabazitaxel introduction. Multivariate analysis showed that only the baseline PSA value at cabazitaxel introduction is an independent predictor of OS. CONCLUSION: A comparatively low PSA value could be an alternative index suggesting the optimal timing for cabazitaxel introduction.


Assuntos
Adenocarcinoma/tratamento farmacológico , Antineoplásicos/administração & dosagem , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Taxoides/administração & dosagem , Adenocarcinoma/sangue , Adenocarcinoma/mortalidade , Adenocarcinoma/secundário , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/efeitos adversos , Esquema de Medicação , Humanos , Japão , Calicreínas/sangue , Masculino , Pessoa de Meia-Idade , Antígeno Prostático Específico/sangue , Neoplasias de Próstata Resistentes à Castração/sangue , Neoplasias de Próstata Resistentes à Castração/mortalidade , Neoplasias de Próstata Resistentes à Castração/patologia , Estudos Retrospectivos , Taxoides/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
18.
Bratisl Lek Listy ; 120(5): 331-335, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31113194

RESUMO

BACKGROUND: It is a well-known fact, that too many men are having prostate biopsy performed with negative biopsy results. The decision to undertake prostate biopsy is usually based on prostate specific antigen (PSA) level and digital rectal examination (DRE). A risk-based strategy may reduce the numbers of unnecessary prostate biopsies. METHODS: Retrospective statistical analysis of data from 195 men undergoing their initial prostate biopsy from 1.1.2015 to 31.12.2015 based on elevated PSA ≥ 4.0 ng/ml and/or abnormal DRE were included. Subsequent risk stratification using the European Randomized study of Screening for Prostate Cancer calculator (ERSPC) was used with the intent to calculate the accuracy of ERSPC with the aim to avoid unnecessary (negative) prostate biopsies. RESULTS: The specific values of sensitivity and specificity in this cohort were 94.34 % and 24.72 %. In direct comparison of PSA and ERSPC calculator, the differences between sensitivity, specificity, negative predictive value and false omission rate as negative were statistically insignificant, but the positive predictive value was on the edge of statistical significance (p = 0.054), slightly in favor for ERSPC calculator. CONCLUSION: PSA still remains the single most predictive factor for identifying men with an increased risk of prostate cancer to be detected on prostate biopsy, but using other risk factors included in ERSPC can considerably reduce the numbers of unnecessary biopsies on initial screening (Tab. 4, Fig. 2, Ref. 23).


Assuntos
Detecção Precoce de Câncer , Neoplasias da Próstata , Medição de Risco , Biópsia , Humanos , Masculino , Programas de Rastreamento , Valor Preditivo dos Testes , Antígeno Prostático Específico , Neoplasias da Próstata/diagnóstico , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Medição de Risco/métodos
19.
Zhonghua Yi Xue Za Zhi ; 99(16): 1237-1240, 2019 Apr 23.
Artigo em Chinês | MEDLINE | ID: mdl-31060163

RESUMO

Objective: To investigate the effect of the derepression of chemokine receptor-7 (CXCR7) in prostatic tissues from patients with Castration Resistant Prostate Cancer (CRPC) on the resistance to enzalutamide (Enza). Methods: During the period of January 2015 to December 2017 all CRPC cases who underwent radical radiotherapy or androgen deprivation therapy (ADT) were evaluated. After prostatic puncture biopsy, the tissues were treated for immunostaining with CXCR7. Cox proportional hazard modeling and Kaplan-Meier analysis were used to determine PSA Progression-Free Survival (PSAP-FS) and Clinical or Radiographic Progression-Free Survival (CRP-FS) in the cohort. At last, PSA response rates and progression outcomes in CXCR7 negative cases and CXCR7 positive cases were analyzed. Results: Total 39 CRPC patients were enrolled in this study. And 23 cases derepress CXCR7, 16 cases negatively express CXCR7. The median follow-up duration was 12 months (range: 6-18) in the cohort. Chi-square analysis confirmed that PSA response rates after Enza treatment were significantly associated with CXCR7 derepression (χ(2)=22.129, P=0.000 06). Compared with CXCR7 positive expression group, CXCR7 negative expression group displayed improved median PSAP-FS (4.4 mon vs 11.7 mon, P=0.040 8) and CRP-FS (5.2 mon vs 13.1 mon, P=0.036 2) after Enza treatment. Conclusion: Derepression of CXCR7 in CRPC patients may be associated with resistance to enzalutamide. This protein may be novel target for treatment of CRPC.


Assuntos
Neoplasias de Próstata Resistentes à Castração , Receptores CXCR/metabolismo , Antagonistas de Androgênios , Intervalo Livre de Doença , Humanos , Masculino , Feniltioidantoína/análogos & derivados , Antígeno Prostático Específico
20.
Hinyokika Kiyo ; 65(3): 69-73, 2019 Mar.
Artigo em Japonês | MEDLINE | ID: mdl-31067846

RESUMO

Case 1 : A 65-year-old man visited withfrequent urination and dysuria. Pyuria and bacteriuria were observed and prostate specific antigen (PSA) was elevated to 5.69 ng/ml. Prostate cancer and urinary tract infection were suspected. A antibiotics were administered and prostate magnetic resonance imaging (MRI) was performed. Massive prostate cancer was strongly suspected from the MRI findings and prostate needle biopsy was performed. The pathological examination revealed nonspecific granulomatous prostatitis. Case 2 : A 69-year-old man visited withfrequent urination. Urinalysis was normal and PSA was elevated to 4.52 ng/ml. Diffuse prostate cancer was suspected from the MRI findings and prostate needle biopsy was performed. Pathological findings were similar to those in case 1. Case 3 : A 61-year-old man presented withno urinary symptoms. Urinalysis was normal and PSA was elevated to 11.64 ng/ml. Medical history was renal pelvic cancer and bladder cancer. He had undergone a transurethral resection of the bladder tumor (TURBT) and intravesical Bacillus Calmette-Guérin (BCG) immunotherapy. Prostate cancer was suspected from the MRI findings and prostate needle biopsy was performed. Pathological findings were granulomatous prostatitis. In these three cases, the structure of these prostate capsules was preserved although extensive prostate cancer was suspected from the findings of MRI T2-weighted and diffusion weighted images. Although histopathologic examination is mandatory for differential diagnosis between granulomatous prostatitis and diffuse prostate cancer, prostate MRI may help to distinguish these diseases.


Assuntos
Granuloma , Neoplasias da Próstata , Prostatite , Neoplasias da Bexiga Urinária , Idoso , Biópsia por Agulha , Granuloma/diagnóstico , Granuloma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Antígeno Prostático Específico , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/cirurgia , Prostatite/diagnóstico , Prostatite/cirurgia
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