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Lim J, Malek R, Jr S, Toh CC, Sundram M, Woo SYY, Yusoff NAM, Teh GC, Chui BJT, Ngu IS, Thevarajah S, Koh WJ, Lee SB, Khoo SC, Teoh BW, Zainal R, Tham TM, Omar S, Nasuha NA, Akaza H, Ong TA. Prostate cancer in multi-ethnic Asian men: Real-world experience in the Malaysia Prostate Cancer (M-CaP) Study. Cancer Med 2021; 10:8020-8028. [PMID: 34626088 PMCID: PMC8607241 DOI: 10.1002/cam4.4319] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/15/2021] [Accepted: 09/18/2021] [Indexed: 11/09/2022] Open
Abstract
Prostate cancer is the third most common cancer in Malaysia with the lifetime risk of 1 in 117 men. Here, we initiated a longitudinal Malaysia Prostate Cancer (M‐CaP) Study to investigate the clinical and tumour characteristics, treatment patterns as well as disease outcomes of multi‐ethnic Asian men at real‐world setting. The M‐CaP database consisted of 1839 new patients with prostate cancer diagnosed between 2016 and 2018 from nine public urology referral centres across Malaysia. Basic demographic and clinical parameters, tumour characteristics, primary treatment, follow‐up and vital status data were retrieved prospectively from the hospital‐based patients’ case notes or electronic medical records. Primary endpoints were overall survival (OS) and biochemical progression‐free survival (bPFS). The median age at diagnosis of M‐CaP patients was 70 years (interquartile range, IQR 65–75). Majority of patients were Chinese (831, 45.2%), followed by Malays (704, 38.3%), Indians (124, 6.7%) and other races (181, 9.8%). The median follow‐up for all patients was 23.5 months (IQR 15.9–33.6). Although 58.1% presented with late‐stage cancer, we observed ethnic and geographic disparities in late‐stage prostate cancer diagnosis. Curative radiotherapy and primary androgen deprivation therapy were the most common treatment for stage III and stage IV diseases, respectively. The median OS and bPFS of stage IV patients were 40.1 months and 19.2 months (95% CI 17.6–20.8), respectively. Late stage at presentation remains a challenge in multi‐ethnic Asian men. Early detection is imperative to improve treatment outcome and survival of patients with prostate cancer.
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Affiliation(s)
- Jasmine Lim
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rohan Malek
- Department of Urology, Selayang Hospital, Ministry of Health Malaysia, Selangor, Malaysia
| | - Sathiyananthan Jr
- Department of Urology, Selayang Hospital, Ministry of Health Malaysia, Selangor, Malaysia
| | - Charng C Toh
- Department of Urology, Selayang Hospital, Ministry of Health Malaysia, Selangor, Malaysia
| | - Murali Sundram
- Department of Urology, Kuala Lumpur Hospital, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Susan Y Y Woo
- Department of Urology, Kuala Lumpur Hospital, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Noor A M Yusoff
- Department of Urology, Kuala Lumpur Hospital, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Guan C Teh
- Department of Urology, Sarawak General Hospital, Ministry of Health Malaysia, Sarawak, Malaysia
| | - Benjamin J T Chui
- Department of Urology, Sarawak General Hospital, Ministry of Health Malaysia, Sarawak, Malaysia
| | - Ing S Ngu
- Department of Urology, Sarawak General Hospital, Ministry of Health Malaysia, Sarawak, Malaysia
| | - S Thevarajah
- Department of Urology, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Malaysia
| | - Wei J Koh
- Department of Urology, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Malaysia
| | - Say B Lee
- Department of Urology, Penang Hospital, Ministry of Health Malaysia, Penang, Malaysia
| | - Say C Khoo
- Department of Urology, Penang Hospital, Ministry of Health Malaysia, Penang, Malaysia
| | - Boon W Teoh
- Department of Urology, Penang Hospital, Ministry of Health Malaysia, Penang, Malaysia
| | - Rohana Zainal
- Department of Surgery, Sultanah Bahiyah Hospital, Ministry of Health Malaysia, Alor Setar, Malaysia
| | - Teck M Tham
- Department of Surgery, Sultanah Bahiyah Hospital, Ministry of Health Malaysia, Alor Setar, Malaysia
| | - Shamsuddin Omar
- Department of Urology, Sultanah Aminah Hospital, Ministry of Health Malaysia, Johor Bahru, Malaysia
| | - Noor A Nasuha
- Department of Surgery, Raja Perempuan Zainab II Hospital, Ministry of Health Malaysia, Kota Bahru, Malaysia
| | - Hideyuki Akaza
- Strategic Investigation on Comprehensive Cancer Network, Interfaculty Initiative in Information Studies / Graduate School of Interdisciplinary Information, University of Tokyo, Tokyo, Japan
| | - Teng A Ong
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Cutumisu M, Vasquez C, Uhlich M, Beatty PH, Hamayeli-Mehrabani H, Djebah R, Murtha A, Greiner R, Lewis JD. PROSPeCT: A Predictive Research Online System for Prostate Cancer Tasks. JCO Clin Cancer Inform 2020; 3:1-12. [PMID: 31116569 DOI: 10.1200/cci.18.00144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
PURPOSE An online clinical information system, called Predictive Research Online System Prostate Cancer Tasks (PROSPeCT), was developed to enable users to query the Alberta Prostate Cancer Registry database hosted by the Alberta Prostate Cancer Research Initiative. To deliver high-quality patient treatment, prostate cancer clinicians and researchers require a user-friendly system that offers an easy and efficient way to obtain relevant and accurate information about patients from a robust and expanding database. METHODS PROSPeCT was designed and implemented to make it easy for users to query the prostate cancer patient database by creating, saving, and reusing simple and complex definitions. We describe its intuitive nature by exemplifying the creation and use of a complex definition to identify a "high-risk" patient cohort. RESULTS PROSPeCT was made to minimize user error and to maximize efficiency without requiring the user to have programming skills. Thus, it provides tools that allow both novice and expert users to easily identify patient cohorts, manage individual patient care, perform Kaplan Meier estimates, plot aggregate PSA views, compute PSA-doubling time, and visualize results. CONCLUSION This report provides an overview of PROSPeCT, a system that helps clinicians to identify appropriate patient treatments and researchers to develop prostate cancer hypotheses, with the overarching goal of improving the quality of life of patients with prostate cancer. We have made available the code for the PROSPeCT implementation at https://github.com/max-uhlich/e-PROSPeCT .
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Affiliation(s)
| | | | | | | | | | - Rume Djebah
- University of Alberta, Edmonton, Alberta, Canada
| | | | | | - John D Lewis
- University of Alberta, Edmonton, Alberta, Canada
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Youl Lee J, Taniguchi T, Zhang K, Ng CF, Hakim L, Umbas R, Kim CS, Chung BH, Kim WJ, Aik Ong T, Lim J, Akaza H. Report of the forth Asian Prostate Cancer (A-CaP) study meeting. Jpn J Clin Oncol 2019; 49:581-586. [PMID: 31141613 DOI: 10.1093/jjco/hyz053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 04/05/2019] [Indexed: 11/14/2022] Open
Abstract
The Asian Prostate Cancer (A-CaP) Study is an Asia-wide prospective registry study for surveying the treatment outcome of prostate cancer patients who have received a histopathological diagnosis. The study aims to clarify the clinical situation for prostate cancer in Asia and use the outcomes for the purposes of international comparison. Following the first meeting in Tokyo on December 2015, the second meeting in Seoul, Korea 2016, the third meeting in Chiang Mai, Thailand, on October 2017, the fourth meeting was held in Seoul, again on August 2018 with the participation of members and collaborators from 13 countries and regions. In the meeting, participating countries and regions presented the current status of data collection and the A-CaP office presented a preliminary analysis of the registered cases received from each country and region. Participants discussed ongoing challenges relating to data cleaning and data up-dating which is the next step of the A-CaP study following the data collection phase between 2016 and 2018. There was specific difference in term of the patient characteristics, and initial treatment pattern among East Asia, Southeast Asia and Turkey, and Jordan. Finally, a close relationship between prevalence of PSA test and disease stage of the patients at diagnosis in Japan and Malaysia was discussed.
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Affiliation(s)
- Ji Youl Lee
- Department of Urology, St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Tomotaka Taniguchi
- Department of Strategic Investigation on Comprehensive Cancer Network, Graduate School of Interdisciplinary Information Studies, University of Tokyo, Tokyo, Japan
| | - Kai Zhang
- Beijing United Family Hospital and Clinics, Beijing, China
| | - Chi Fai Ng
- SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China
- Robotic Surgical System Training Programme, Jockey Club Minimally Invasive Surgical Skills Center, The Chinese University of Hong Kong, Hong Kong, China
- Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Lukman Hakim
- Department of Urology, Airlangga University/Dr Soetomo General Hospital of Surabaya, Surabaya, East Java, Indonesia
| | - Rainy Umbas
- Department of Urology, Dr Cipto Mangunkusumo Hospital/Faculty of Medicine, University of Indonesia, Depok City, West Java, Indonesia
| | - Choung-Soo Kim
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Byung Ha Chung
- Department of Urology Gangnam Severance Hospital, Yonsei University College of Medicine
| | - Wun-Jae Kim
- Department of Urology, Chugbuk National Medical University Hospital
| | - Teng Aik Ong
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jasmine Lim
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hideyuki Akaza
- Department of Strategic Investigation on Comprehensive Cancer Network, Graduate School of Interdisciplinary Information Studies, University of Tokyo, Tokyo, Japan
- Emeritus Professor, University of Tsukuba, Tsukuba, Japan
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Fang D, Zhou L. Androgen deprivation therapy in nonmetastatic prostate cancer patients: Indications, treatment effects, and new predictive biomarkers. Asia Pac J Clin Oncol 2019; 15:108-120. [PMID: 30729683 PMCID: PMC6850478 DOI: 10.1111/ajco.13108] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 10/27/2018] [Indexed: 12/17/2022]
Abstract
Men with prostate cancer with positive margins, extraprostatic extension, positive lymph nodes, high prostate‐specific antigen, or high Gleason Score are at high risk of recurrence following primary therapy. Androgen deprivation therapy (ADT), which includes medical/surgical castration, antiandrogen therapy, and combined androgen blockade, can be combined with primary therapy to shrink the tumor, reduce margin positivity, and reduce the risk of recurrence. However, many problems still remain, such as optimizing the application of ADT in the treatment of prostate cancer, for example, ideal patient population and optimal timing and duration of therapy. To investigate these problems, we searched PubMed for relevant publications on clinical studies of deprivation therapy for nonmetastatic prostate cancer. In this review, we discuss our findings on the role of ADT in the treatment of castrate‐sensitive nonmetastatic prostate cancer and the adverse effects associated with ADT. We also examine the recent advances in new predictive biomarkers for ADT, many of which are currently in the exploratory phase. Overall, the addition of ADT to primary therapy improves outcomes for patients with intermediate‐ or high‐risk prostate cancer.
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Affiliation(s)
- Dong Fang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center of China, Beijing, China
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center of China, Beijing, China
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Lojanapiwat B, Lee JY, Gang Z, Kim CS, Fai NC, Hakim L, Umbas R, Ong TA, Lim J, Letran JL, Chiong E, Lee SH, Türkeri L, Murphy DG, Moretti K, Cooperberg M, Carlile R, Hinotsu S, Hirao Y, Kitamura T, Horie S, Onozawa M, Kitagawa Y, Namiki M, Fukagai T, Miyazaki J, Akaza H. Report of the third Asian Prostate Cancer study meeting. Prostate Int 2018; 7:60-67. [PMID: 31384607 PMCID: PMC6664304 DOI: 10.1016/j.prnil.2018.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 10/25/2022] Open
Abstract
The Asian Prostate Cancer (A-CaP) study is an Asia-wide initiative that was launched in December 2015 in Tokyo, Japan, with the objective of surveying information about patients who have received a histopathological diagnosis of prostate cancer (PCa) and are undergoing treatment and clarifying distribution of staging, the actual status of treatment choices, and treatment outcomes. The study aims to clarify the clinical situation for PCa in Asia and use the outcomes for the purposes of international comparison. Following the first meeting in Tokyo in December 2015, the second A-CaP meeting was held in Seoul, Korea, in September 2016. This, the third A-CaP meeting, was held on October 14, 2017, in Chiang Mai, Thailand, with the participation of members and collaborators from 12 countries and regions. In the meeting, participating countries and regions presented the current status of data collection, and the A-CaP office presented a preliminary analysis of the registered cases received from each country and region. Participants discussed ongoing challenges relating to data input and collection, institutional, and legislative issues that may present barriers to data sharing, and the outlook for further patient registrations through to the end of the registration period in December 2018. In addition to A-CaP-specific discussions, a series of special lectures were also delivered on the situation for health insurance in the United States, the correlation between insurance coverage and PCa outcomes, and the outlook for robotic surgery in the Asia-Pacific region. Members also confirmed the principles of authorship in collaborative studies, with a view to publishing original articles based on A-CaP data in the future.
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Affiliation(s)
| | - Ji Youl Lee
- Department of Urology, St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Zhu Gang
- Department of Urology, Beijing United Family Hospital and Clinics, Beijing, China
| | - Choung-Soo Kim
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ng Chi Fai
- SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China.,Robotic Surgical System Training Programme, Jockey Club Minimally Invasive Surgical Skills Center, The Chinese University of Hong Kong, Hong Kong, China.,SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Lukman Hakim
- Department of Urology, Airlangga University/Dr. Soetomo General Hospital of Surabaya, Surabaya, East Java, Indonesia
| | - Rainy Umbas
- Department of Urology, Dr. Cipto Mangunkusumo Hospital/Faculty of Medicine, University of Indonesia, Depok City, West Java, Indonesia
| | - Teng Aik Ong
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jasmine Lim
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Jason L Letran
- Department of Urology, Cardinal Santos Medical Center, Manila, Philippines
| | - Edmund Chiong
- Department of Urology, University Surgical Cluster, National University Health System (NUHS), Singapore
| | - Seung Hwan Lee
- Department of Urology, Severance Hospital, Yonsei University School of Medicine, Seoul, Korea
| | - Levent Türkeri
- Department of Urology, Acıbadem University School of Medicine, Istanbul, Turkey
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Kim Moretti
- School of Population Health, University of South Australia, Discipline of Surgery,University of Adelaide, SA, Australia
| | - Matthew Cooperberg
- Department of Urology, School of Medicine, University of California San Francisco, San Francisco, CA, USA.,Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | - Shiro Hinotsu
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | | | | | - Shigeo Horie
- Department of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mizuki Onozawa
- International University of Health and Welfare School of Medicine, Chiba, Japan
| | | | | | - Takashi Fukagai
- Department of Urology, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Jun Miyazaki
- International University of Health and Welfare School of Medicine, Chiba, Japan
| | - Hideyuki Akaza
- Department of Strategic Investigation on Comprehensive Cancer Network, Graduate School of Interdisciplinary Information Studies, University of Tokyo, Tokyo, Japan.,Emeritus Professor, University of Tsukuba, Tsukuba, Japan
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