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Chan DY, Morris DC, Moavenzadeh SR, Lye TH, Polascik TJ, Palmeri ML, Mamou J, Nightingale KR. Multiparametric Ultrasound Imaging of Prostate Cancer Using Deep Neural Networks. ULTRASOUND IN MEDICINE & BIOLOGY 2024:S0301-5629(24)00285-0. [PMID: 39174376 DOI: 10.1016/j.ultrasmedbio.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/17/2024] [Accepted: 07/25/2024] [Indexed: 08/24/2024]
Abstract
OBJECTIVE A deep neural network (DNN) was trained to generate a multiparametric ultrasound (mpUS) volume from four input ultrasound-based modalities (acoustic radiation force impulse [ARFI] imaging, shear wave elasticity imaging [SWEI], quantitative ultrasound-midband fit [QUS-MF], and B-mode) for the detection of prostate cancer. METHODS A DNN was trained using co-registered ARFI, SWEI, MF, and B-mode data obtained in men with biopsy-confirmed prostate cancer prior to radical prostatectomy (15 subjects, comprising 980,620 voxels). Data were obtained using a commercial scanner that was modified to allow user control of the acoustic beam sequences and provide access to the raw image data. For each subject, the index lesion and a non-cancerous region were manually segmented using visual confirmation based on whole-mount histopathology data. RESULTS In a prostate phantom, the DNN increased lesion contrast-to-noise ratio (CNR) compared to a previous approach that used a linear support vector machine (SVM). In the in vivo test datasets (n = 15), the DNN-based mpUS volumes clearly portrayed histopathology-confirmed prostate cancer and significantly improved CNR compared to the linear SVM (2.79 ± 0.88 vs. 1.98 ± 0.73, paired-sample t-test p < 0.001). In a sub-analysis in which the input modalities to the DNN were selectively omitted, the CNR decreased with fewer inputs; both stiffness- and echogenicity-based modalities were important contributors to the multiparametric model. CONCLUSION The findings from this study indicate that a DNN can be optimized to generate mpUS prostate volumes with high CNR from ARFI, SWEI, MF, and B-mode and that this approach outperforms a linear SVM approach.
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Affiliation(s)
- Derek Y Chan
- Department of Biomedical Engineering, Duke University, Durham, NC, USA.
| | - D Cody Morris
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | | | - Theresa H Lye
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA; Topcon Advanced Biomedical Imaging Laboratory, Topcon Healthcare, Oakland, NJ, USA
| | - Thomas J Polascik
- Departments of Urology and Radiology, Duke University Medical Center, Durham, NC, USA
| | - Mark L Palmeri
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Jonathan Mamou
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
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Shish L, Zabell J. Digital Rectal Exam in Prostate Cancer Screening and Elevated PSA Work-up-Is there a role anymore? Curr Urol Rep 2024; 25:193-199. [PMID: 38869693 DOI: 10.1007/s11934-024-01218-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE OF REVIEW Prostate cancer (PCa) screening tools, particularly digital rectal examination (DRE), are under scrutiny. This review assesses the utility of DRE in PCa screening. RECENT FINDINGS Recent studies reaffirm the DRE's sensitivity and specificity, a higher PCa detection rate with PSA in conjunction with DRE, and a slightly elevated risk of clinically significant PCa (CSPC) in those with elevated PSA and suspicious DRE. Studies confirm high accuracy of MRI in identifying CSPC, with ongoing research exploring its screening potential. DRE alone lacks accuracy for PCa screening, often resulting in missed diagnoses and unnecessary biopsies. Its supplementary use with PSA marginally increases detection rates of identifying a small percentage of CSPC, but the benefit remains questionable. Emerging evidence suggests MRI has the potential as a superior screening tool compared to DRE, although direct comparative studies are lacking. Overall, the DRE has a limited role in current PCa screening.
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Affiliation(s)
- Lane Shish
- Department of Urology, University of Minnesota, 420 Delaware St. SE, MMC 394, Minneapolis, MN, 55455, USA
| | - Joseph Zabell
- Department of Urology, University of Minnesota, 420 Delaware St. SE, MMC 394, Minneapolis, MN, 55455, USA.
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Ko YH, Jang JY, Kim YU, Kim SW. Faster both in operative time and functional recovery by the extraperitoneal daVinci SP-based robot-assisted radical prostatectomy: a propensity score matching analysis compared to transperitoneal multiport counterpart. J Robot Surg 2024; 18:205. [PMID: 38714543 DOI: 10.1007/s11701-024-01950-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/14/2024] [Indexed: 05/10/2024]
Abstract
We aim to investigate the peri-operative outcomes after extraperitoneal single-port based robot-assisted radical prostatectomy (eSP-RARP) utilizing the da Vinci SP system compared to conventional transperitoneal multi-port counterparts (tMP-RARP), in an era when pelvic lymph node dissection (PNLD) was omitted for the node-negative case. With exclusion criteria of volume + 50 g, suspicious rectal invasion, and node-positive disease given relatively weak grasping power and limited range of motion from the current SP system, 50 consecutive patients (Since December 2021) with localized prostate cancer underwent eSP-RARP by a single urologist maintaining identical surgical technique for 100 consecutive tMP-RARP cases (Since December 2020). Given initial selection criteria, each group was matched to a 1:1 ratio based on the risk-stratification parameters and the prostate volume. The operative time, which was maintained in each group during the study period, was significantly faster in eSP-RARP groups than in tMP-RARP (149.2 vs. 163.2 min, p = 0.025), while the weight of the removed specimen (27.1 vs. 29.0 g, p = 0.420) and margin positivity (14.7% vs. 11.7% in pT2, p = 0.812) were similar. The gas-out (1.5 vs. 1.88 days, p = 0.003) and solid diet dates (2.26 vs. 3.22 days, p < 0.001) were faster in the eSP-RARP group. The single-pad continence dates (30.5 vs. 51.9 days, p = 0.145) and zero-pad continence dates (105.5 vs. 146.2 days, p = 0.210) were identical. 90-day single-pad continence rate was 92% vs. 82% (p = 0.142, 52% vs. 56% in zero-pad continence). Based on these, daVinci SP-based RARP restored bowel function faster with shorter operative time through an extraperitoneal approach than the conventional transperitoneal multi-port counterpart while maintaining similar incontinence outcomes in cases without a routine PNLD.
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Affiliation(s)
- Young Hwii Ko
- Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea.
| | - Jae Youn Jang
- Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea
| | - Yeong Uk Kim
- Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea
| | - Sang Won Kim
- College of Medicine, Medical Research Center, Yeungnam University, Daegu, Korea
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Sidahmed E, Freedland SJ, Wang M, Wu K, Albanes D, Barnett M, van den Brandt PA, Cook MB, Giles GG, Giovannucci E, Haiman CA, Larsson SC, Key TJ, Loftfield E, Männistö S, McCullough ML, Milne RL, Neuhouser ML, Platz EA, Perez-Cornago A, Sawada N, Schenk JM, Sinha R, Tsugane S, Visvanathan K, Wang Y, White KK, Willett WC, Wolk A, Ziegler RG, Genkinger JM, Smith-Warner SA. Dietary Fiber Intake and Risk of Advanced and Aggressive Forms of Prostate Cancer: A Pooled Analysis of 15 Prospective Cohort Studies. J Acad Nutr Diet 2024:S2212-2672(24)00163-1. [PMID: 38636793 DOI: 10.1016/j.jand.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/12/2024] [Accepted: 04/08/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Evidence of an association between dietary fiber intake and risk of advanced and aggressive forms of prostate cancer (PC) and PC mortality is limited. OBJECTIVE The aim of this study was to examine associations between intakes of dietary fiber overall and by food source and risk of advanced and aggressive forms of PC. DESIGN The study design was a pooled analysis of the primary data from 15 cohorts in 3 continents. Baseline dietary fiber intake was assessed using a validated food frequency questionnaire or diet history in each study. PARTICIPANTS/SETTING There were 842 149 men followed for up to 9 to 22 years between 1985 and 2009 across studies. MAIN OUTCOME MEASURES The primary outcome measures were advanced (stage T4, N1, or M1 or PC mortality), advanced restricted (excluded men with missing stage and those with localized PC who died of PC), and high-grade PC (Gleason score ≥8 or poorly differentiated/undifferentiated) and PC mortality. STATISTICAL ANALYSIS PERFORMED Study-specific multivariable hazard ratios (MVHR) were calculated using Cox proportional hazards regression and pooled using random effects models. RESULTS Intake of dietary fiber overall, from fruits, and from vegetables was not associated with risk of advanced (n = 4863), advanced restricted (n = 2978), or high-grade PC (n = 9673) or PC mortality (n = 3097). Dietary fiber intake from grains was inversely associated with advanced PC (comparing the highest vs lowest quintile, MVHR 0.84; 95% CI 0.76-0.93), advanced restricted PC (MVHR 0.85; 95% CI 0.74-0.97), and PC mortality (MVHR 0.78; 95% CI 0.68-0.89); statistically significant trends were noted for each of these associations (P ≤ .03), and a null association was observed for high-grade PC for the same comparison (MVHR 1.00; 95% CI 0.93-1.07). The comparable results were 1.06 (95% CI 1.01-1.10; P value, test for trend = .002) for localized PC (n = 35,199) and 1.05 (95% CI 0.99-1.11; P value, test for trend = .04) for low/intermediate grade PC (n = 34 366). CONCLUSIONS Weak nonsignificant associations were observed between total dietary fiber intake and risk of advanced forms of PC, high-grade PC, and PC mortality. High dietary fiber intake from grains was associated with a modestly lower risk of advanced forms of PC and PC mortality.
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Affiliation(s)
- Elkhansa Sidahmed
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Stephen J Freedland
- Department of Urology, Cedars-Sinai Medical Center, Los Angeles, California; Urology Section, Durham Veterans Affairs Medical Center, Durham, North Carolina
| | - Molin Wang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kana Wu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (at time work completed); Vertex Pharmaceuticals, Boston, Massachusetts (current)
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Matt Barnett
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Piet A van den Brandt
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Michael B Cook
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Graham G Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Edward Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Timothy J Key
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Erikka Loftfield
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Satu Männistö
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Roger L Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia; Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Marian L Neuhouser
- Cancer Prevention Program, Division of Public Health Sciences Fred Hutchinson Cancer Center, Seattle, Washington
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Jeannette M Schenk
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Ying Wang
- Department of Population Science, American Cancer Society, Atlanta, Georgia
| | - Kami K White
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Alicja Wolk
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Jeanine M Genkinger
- Department of Epidemiology, Mailman School of Public Health and Herbert Irving Comprehensive Cancer Center, Columbia University, New York, New York
| | - Stephanie A Smith-Warner
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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Dalela D, Corsi NJ, Bronkema C, Sood A, Arora S, Majdalany SE, Butaney M, Jamil M, Li P, Palma-Zamora I, Rakic N, Kovacevic N, Jeong W, Menon M, Rogers CG, Schonberg MA, Abdollah F. Prostate Specific Antigen Screening on a Nationwide Level: Featuring the Contribution of Race and Life Expectancy in Decision Making. Clin Genitourin Cancer 2024; 22:269-280.e2. [PMID: 38233279 DOI: 10.1016/j.clgc.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 11/12/2023] [Accepted: 11/13/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Estimation of life expectancy (LE) is important for the relative benefit of prostate specific antigen (PSA) screening. Limited data exists regarding screening for Black men with extended LE. The aim of the current study was to assess temporal trends in screening in United States (US) Black men with limited vs. extended LE, using a nationally representative dataset. MATERIALS AND METHODS Using the National Health Institution Survey (NHIS) 2000 to 2018, men aged ≥40 without prior history of prostate cancer (PCa) who underwent PSA screening in the last 12 months were stratified into limited LE (ie, LE <15 years) and extended LE (ie, LE≥15 years) using the validated Schonberg index. LE-stratified temporal trends in PSA screening were analyzed for all men, and then in Black men. Weighted multivariable analyses and dominance analyses identified the predictors of PSA screening. RESULTS PSA screening declined over the study period both for all eligible men with limited and extended LE, particularly between NHIS 2008 and 2013 (27.9%-20.7% in the extended). Screening increased significantly in Black men with extended LE (17.6% in 2010-25.7% in 2018). However, LE was not an independent predictor of screening in the Black cohort. Prior recipient of colonoscopy (55%-57%) and visit to health care provider (24%-32%) were the most important determinants for screening. CONCLUSION For US men with extended LE, only 1 in 4 receive PSA screening, with a decline over the study-period. Screening rates increased for Black men. However, these changes were not driven by LE consideration itself, but participation in other screenings and access to a provider.
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Affiliation(s)
- Deepansh Dalela
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI; Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation (VCORE), Henry Ford Hospital, Detroit, MI; University of Texas Southwestern Medical Center, Dallas, TX; Wayne State University School of Medicine, Detroit, MI
| | - Nicholas J Corsi
- Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation (VCORE), Henry Ford Hospital, Detroit, MI; University of Texas Southwestern Medical Center, Dallas, TX; Wayne State University School of Medicine, Detroit, MI
| | - Chandler Bronkema
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Akshay Sood
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sohrab Arora
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI; Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation (VCORE), Henry Ford Hospital, Detroit, MI
| | - Sami E Majdalany
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI; Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation (VCORE), Henry Ford Hospital, Detroit, MI
| | - Mohit Butaney
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI; Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation (VCORE), Henry Ford Hospital, Detroit, MI
| | - Marcus Jamil
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI; Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation (VCORE), Henry Ford Hospital, Detroit, MI
| | - Pin Li
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Mi
| | - Isaac Palma-Zamora
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI; Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation (VCORE), Henry Ford Hospital, Detroit, MI
| | - Nikola Rakic
- Department of Urology, Baylor College of Medicine, Houston, TX
| | - Natalija Kovacevic
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI; Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation (VCORE), Henry Ford Hospital, Detroit, MI
| | - Wooju Jeong
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI
| | - Mani Menon
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Craig G Rogers
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI; Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation (VCORE), Henry Ford Hospital, Detroit, MI
| | - Mara A Schonberg
- Division of General Medicine, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA
| | - Firas Abdollah
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI; Vattikuti Urology Institute Center for Outcomes Research, Analytics and Evaluation (VCORE), Henry Ford Hospital, Detroit, MI.
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Pyun JH, Ko YH, Kim SW, Son NH. The Short- and Long-Term Anticipation of Prostate Cancer Incidence in Korea: Based on Social Aging Trends and Prostate-Specific Antigen Testing Rate during the Last Decade. Cancers (Basel) 2024; 16:503. [PMID: 38339255 PMCID: PMC10854490 DOI: 10.3390/cancers16030503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/06/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024] Open
Abstract
The current incidence of prostate-specific antigen (PSA) testing, which plays a crucial role in detecting prostate cancer (PCa) in an aged population, is low in Korea. Reflecting these epidemiologic characteristics, we estimated the short- and long-term incidences of PCa. A regression equation model was extracted based on two critical pieces of information: (1) the distribution of newly detected PCa cases in each age group of the 50s, 60s, 70s, and over 80s from a recent period (2006-2020), and (2) the PSA testing rate (PSAr) from the previous decade (2006-2016) for each age subgroup. The incidence increased fourfold (4533 in 2006 to 16,815 in 2020), with each age subgroup accounting for 7.9% (50s), 31.4% (60s), 43.0% (70s), and 17.1% (over 80s) of cases in 2020. PSAr increased by an average of 1.08% annually. If these trends are maintained, 28,822 new cases will be diagnosed in 2030 (expected PSAr: 14.4%) and 40,478 cases in 2040 (expected PSAr: 26.4%). If a public PSA screening were implemented for men only in their 60s (assuming a PSAr of 60% in the 60s) and 70s (assuming a PSAr of 80% in the 70s) in 2030, 37,503 cases in 2030 (expected PSAr: 23.1%) and 43,719 cases in 2040 (expected PSAr: 29.9%) would be estimated. According to the projection, the incidence of PCa will increase twofold by 2034 compared to 2020. If national screening were only conducted in the 60s and 70s, a higher detection of almost threefold would be expected by 2040.
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Affiliation(s)
- Jong Hyun Pyun
- Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea;
| | - Young Hwii Ko
- Department of Urology, College of Medicine, Yeungnam University, Daegu 42114, Republic of Korea
| | - Sang Won Kim
- Medical Research Center, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea;
| | - Nak-Hoon Son
- Department of Statistics, Keimyung University, Daegu 42601, Republic of Korea;
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Huq MR, He X, Woodard N, Chen C, Knott CL. The role of community health advisors' cancer history in implementation and efficacy of a cancer control intervention. HEALTH EDUCATION RESEARCH 2023; 38:350-361. [PMID: 36892605 PMCID: PMC10558036 DOI: 10.1093/her/cyad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/24/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Community health advisors (CHAs) play a key role in promoting health in medically underserved communities, including in addressing cancer disparities. There is a need to expand the research on what characteristics make for an effective CHA. We examined the relationship between CHA personal and family history of cancer, and implementation and efficacy outcomes in a cancer control intervention trial. Twenty-eight trained CHAs implemented a series of three cancer educational group workshops for N = 375 workshop participants across 14 churches. Implementation was operationalized as participant attendance at the educational workshops, and efficacy as workshop participants' cancer knowledge scores at the 12-month follow-up, controlling for baseline scores. CHA personal history of cancer was not significantly associated with implementation, nor knowledge outcomes. However, CHAs with family history of cancer had significantly greater participant attendance at the workshops than CHAs without family history of cancer (P = 0.03) and a significant, positive association with male workshop participants' prostate cancer knowledge scores at 12 months (estimated beta coefficient = 0.49, P < 0.01) after adjusting for confounders. Findings suggest that CHAs with family history of cancer may be particularly suitable for cancer peer education, although further research is needed to confirm this and identify other factors conducive to CHA success.
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Affiliation(s)
- Maisha R Huq
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD 20742, USA
| | - Xin He
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD 20742, USA
| | - Nathaniel Woodard
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD 20742, USA
| | - Chang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD 20742, USA
| | - Cheryl L Knott
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD 20742, USA
- Community Outreach and Engagement, University of Maryland Greenebaum Comprehensive Cancer Center, 22 S Greene St, Baltimore, MD 21201, USA
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8
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Chan DY, Morris DC, Polascik TJ, Palmeri ML, Nightingale KR. Combined ARFI and Shear Wave Imaging of Prostate Cancer: Optimizing Beam Sequences and Parameter Reconstruction Approaches. ULTRASONIC IMAGING 2023; 45:175-186. [PMID: 37129257 PMCID: PMC10660585 DOI: 10.1177/01617346231171895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This study demonstrates the implementation of a shear wave reconstruction algorithm that enables concurrent acoustic radiation force impulse (ARFI) imaging and shear wave elasticity imaging (SWEI) of prostate cancer and zonal anatomy. The combined ARFI/SWEI sequence uses closely spaced push beams across the lateral field of view and simultaneously tracks both on-axis (within the region of excitation) and off-axis (laterally offset from the excitation) after each push beam. Using a large number of push beams across the lateral field of view enables the collection of higher signal-to-noise ratio (SNR) shear wave data to reconstruct the SWEI volume than is typically acquired. The shear wave arrival times were determined with cross-correlation of shear wave velocity signals in two dimensions after 3-D directional filtering to remove reflection artifacts. To combine data from serially interrogated lateral push locations, arrival times from different pushes were aligned by estimating the shear wave propagation time between push locations. Shear wave data acquired in an elasticity lesion phantom and reconstructed using this algorithm demonstrate benefits to contrast-to-noise ratio (CNR) with increased push beam density and 3-D directional filtering. Increasing the push beam spacing from 0.3 to 11.6 mm (typical for commercial SWEI systems) resulted in a 53% decrease in CNR. In human in vivo data, this imaging approach enabled high CNR (1.61-1.86) imaging of histologically-confirmed prostate cancer. The in vivo images had improved spatial resolution and CNR and fewer reflection artifacts as a result of the high push beam density, the high shear wave SNR, the use of multidimensional directional filtering, and the combination of shear wave data from different push beams.
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Affiliation(s)
- Derek Y. Chan
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - D. Cody Morris
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | | | - Mark L. Palmeri
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
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9
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Lankoff A, Czerwińska M, Kruszewski M. Nanoparticle-Based Radioconjugates for Targeted Imaging and Therapy of Prostate Cancer. Molecules 2023; 28:molecules28104122. [PMID: 37241862 DOI: 10.3390/molecules28104122] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/24/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
Prostate cancer is the second most frequent malignancy in men worldwide and the fifth leading cause of death by cancer. Although most patients initially benefit from therapy, many of them will progress to metastatic castration-resistant prostate cancer, which still remains incurable. The significant mortality and morbidity rate associated with the progression of the disease results mainly from a lack of specific and sensitive prostate cancer screening systems, identification of the disease at mature stages, and failure of anticancer therapy. To overcome the limitations of conventional imaging and therapeutic strategies for prostate cancer, various types of nanoparticles have been designed and synthesized to selectively target prostate cancer cells without causing toxic side effects to healthy organs. The purpose of this review is to briefly discuss the selection criteria of suitable nanoparticles, ligands, radionuclides, and radiolabelling strategies for the development of nanoparticle-based radioconjugates for targeted imaging and therapy of prostate cancer and to evaluate progress in the field, focusing attention on their design, specificity, and potential for detection and/or therapy.
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Affiliation(s)
- Anna Lankoff
- Centre for Radiobiology and Biological Dosimetry, Institute of Nuclear Chemistry and Technology, Dorodna 16, 03-195 Warsaw, Poland
- Department of Medical Biology, Institute of Biology, Jan Kochanowski University, Uniwersytecka 15, 25-406 Kielce, Poland
| | - Malwina Czerwińska
- Department of Dietetics, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), 159c Nowoursynowska, 02-776 Warsaw, Poland
| | - Marcin Kruszewski
- Centre for Radiobiology and Biological Dosimetry, Institute of Nuclear Chemistry and Technology, Dorodna 16, 03-195 Warsaw, Poland
- Department of Molecular Biology and Translational Research, Institute of Rural Health, Jaczewskiego 2, 20-090 Lublin, Poland
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10
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Nnate DA. Reply to "Prostate-specific antigen screening: A kind of Russian roulette regardless of race or risk". Cancer 2023; 129:968-969. [PMID: 36495025 DOI: 10.1002/cncr.34585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Daniel A Nnate
- Countess of Chester Hospital NHS Foundation Trust, Chester, UK
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11
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Takahashi T. Two conflicting guidelines on prostate specific antigen screening in Japan. Jpn J Clin Oncol 2023; 53:280-283. [PMID: 36533417 DOI: 10.1093/jjco/hyac192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022] Open
Abstract
Japanese urologists need to listen seriously to the opinions of public health physicians and it is necessary to properly inform people of prostate specific antigen screening.
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Affiliation(s)
- Takeshi Takahashi
- Health and Welfare Bureau, Kitakyushu City Office, Jyonai 1-1, Kitakyushu, Japan
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12
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Ko YH, Kim BH, Kwon SY, Jung HJ, Hah YS, Kim YJ, Kim HT, Lee JN, Kim JH, Kim TH. Trends of stratified prostate cancer risk in a single Korean province from 2003 to 2021: A multicenter study conducted using regional training hospital data. Investig Clin Urol 2023; 64:140-147. [PMID: 36882172 PMCID: PMC9995949 DOI: 10.4111/icu.20220317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/24/2022] [Accepted: 01/01/2023] [Indexed: 02/09/2023] Open
Abstract
PURPOSE To identify changes in prostate cancer (PCa) risk-stratification during the last two decades in Korea, where the social perception of PCa was limited due to a relatively low incidence but has recently been triggered by the rapidly increasing incidence of benign prostate hyperplasia. MATERIALS AND METHODS Retrospective data of patients who had received a diagnosis of PCa in a single Korean province (Daegu-Gyeongsangbuk) at all seven training hospitals in the years 2003, 2007, 2011, 2015, 2019, and 2021 were subjected to analysis. Changes in PCa risk-stratification were investigated with respect to serum prostate-specific antigen (PSA), Gleason score (GS), and clinical stage. RESULTS Of the 3,393 study subjects that received a diagnosis of PCa, 64.1% had high-risk disease, 23.0% intermediate, and 12.9% low-risk disease. The proportion diagnosed with high-risk disease was 54.8% in 2003, 30.6% in 2019, but then increased to 35.1% in 2021. The proportion of patients with high PSA (>20 ng/mL) steadily decreased from 59.4% in 2003 to 29.6% in 2021, whereas the proportion with a high GS (>8) increased from 32.8% in 2011 to 34.0% in 2021, and the proportion with advanced stage disease (over cT2c) increased from 26.5% in 2011 to 37.1% in 2021. CONCLUSIONS In this retrospective study, conducted in a single Korean province, high-risk PCa accounted for the largest proportion of newly registered Korean PCa patients during the last two decades and increased in the early 2020s. This outcome supports the adoption of nationwide PSA screening, regardless of current Western guidelines.
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Affiliation(s)
- Young Hwii Ko
- Department of Urology, Yeungnam University College of Medicine, Daegu, Korea.
| | - Byung Hoon Kim
- Department of Urology, Keimyung University School of Medicine, Daegu, Korea
| | - Se Yun Kwon
- Department of Urology, Dongguk University College of Medicine, Gyeongju, Korea
| | - Hyun Jin Jung
- Department of Urology, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Yoon Soo Hah
- Department of Urology, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Yeon-Joo Kim
- Department of Urology, Daegu Fatima Hospital, Daegu, Korea
| | - Hyun Tae Kim
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jun Nyung Lee
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Jeong Hyun Kim
- Department of Urology, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Tae-Hwan Kim
- Department of Urology, School of Medicine, Kyungpook National University, Daegu, Korea
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13
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The Gut-Prostate Axis: A New Perspective of Prostate Cancer Biology through the Gut Microbiome. Cancers (Basel) 2023; 15:cancers15051375. [PMID: 36900168 PMCID: PMC10000196 DOI: 10.3390/cancers15051375] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/03/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
Obesity and a high-fat diet are risk factors associated with prostate cancer, and lifestyle, especially diet, impacts the gut microbiome. The gut microbiome plays important roles in the development of several diseases, such as Alzheimer's disease, rheumatoid arthritis, and colon cancer. The analysis of feces from patients with prostate cancer by 16S rRNA sequencing has uncovered various associations between altered gut microbiomes and prostate cancer. Gut dysbiosis caused by the leakage of gut bacterial metabolites, such as short-chain fatty acids and lipopolysaccharide results in prostate cancer growth. Gut microbiota also play a role in the metabolism of androgen which could affect castration-resistant prostate cancer. Moreover, men with high-risk prostate cancer share a specific gut microbiome and treatments such as androgen-deprivation therapy alter the gut microbiome in a manner that favors prostate cancer growth. Thus, implementing interventions aiming to modify lifestyle or altering the gut microbiome with prebiotics or probiotics may curtail the development of prostate cancer. From this perspective, the "Gut-Prostate Axis" plays a fundamental bidirectional role in prostate cancer biology and should be considered when screening and treating prostate cancer patients.
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14
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Muacevic A, Adler JR. Prostate Cancer Presenting as Hip Pain at the Chiropractic Office: A Case Report and Literature Review. Cureus 2023; 15:e34049. [PMID: 36824534 PMCID: PMC9941037 DOI: 10.7759/cureus.34049] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2023] [Indexed: 01/23/2023] Open
Abstract
Prostate cancer is one of the most common cancers found in males, and it tends to metastasize to bony parts such as the hip, spine, and pelvis, resulting in pain and/or radicular pain, which can present similarly to musculoskeletal complaints. The lack of routine screening and musculoskeletal symptoms present challenges in the diagnosis of prostate cancer. We report the case of a 62-year-old male with no history of cancer and no previous prostate cancer screening who visited a chiropractor for the care of worsening left hip pain after a marathon. The patient visited other healthcare providers and was suggested to have degenerative conditions; he received nonsteroidal anti-inflammatory medication, physiotherapy, and acupuncture. Given the patient's limited improvement by other providers and neurological symptoms, the chiropractor requested lumbar spine radiography, which revealed suspected bone metastasis, and ordered a hip MRI accordingly. MRI findings suggested prostate cancer, and the chiropractor referred the patient to an oncologist, who performed additional imaging and testing to make a presumptive prostate cancer diagnosis. A literature search found nine cases of undiagnosed prostate cancer presenting to a chiropractor for care. All patients included in this case were older males with no previous prostate screening or bone metastasis. The study is focused on the need for a comprehensive evaluation of patients with hip pain during a chiropractic visit due to the chances of prostate cancer. There are higher chances of ignoring cancer symptoms during a hip examination. Comprehensive evaluation and advanced imaging could help chiropractors detect patients with prostate cancer.
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Affiliation(s)
- Alexander Muacevic
- Department of Chiropractic and Physiotherapy, New York Chiropractic and Physiotherapy Centre, Hong Kong, HKG
| | - John R Adler
- Department of Chiropractic and Physiotherapy, New York Chiropractic and Physiotherapy Centre, Hong Kong, HKG
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15
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Cancer statistics in Chinese older people, 2022: current burden, time trends, and comparisons with the US, Japan, and the Republic of Korea. SCIENCE CHINA LIFE SCIENCES 2022; 66:1079-1091. [PMID: 36543994 DOI: 10.1007/s11427-022-2218-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/10/2022] [Indexed: 12/24/2022]
Abstract
Largely due to population ageing, the cancer burden from older people has been rising, which imposed considerable pressure on current Chinese healthcare system. We provide comprehensive information about cancer burden of Chinese older people based on the most recent data from National Central Cancer Registry of China. The logarithmic linear regression was used to project the current cancer burden in 2022, and Joinpoint regression was used for temporal trend analysis from 2000 to 2017. We also estimated cancer statistics of older people in the US, Japan and the Republic of Korea for comparisons. It is estimated that 2.79 million cases and 1.94 million deaths occur for Chinese older people, representing 55.8% and 68.2% of cases and deaths in all population in 2022. The overall cancer incidence rate gradually increased among older women, while the mortality rates declined for both sexes. Notably, approximately 10.0% of all cases and 17.7% of all deaths are from people aged over 80 years, and cancer incidence and mortality in this age group showed upward trends for women. Lung cancer and digestive cancers are the leading cancer types for Chinese older people. Compared with other countries, China has lower incidence rates but higher mortality rates for older people. The rapidly growing burden of prostate cancer, breast cancer, colorectal cancer, and declines in esophageal cancer, stomach cancer, and liver cancer among older people indicate the cancer pattern in China is being in a transition stage to that in developed countries. Our findings imply that it should be the national health priority to meet the growing demands for cancer diagnosis, treatment and care services from the older people as the rapid population ageing in next few decades.
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16
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Kageyama S, Okinaka Y, Nishizawa K, Yoshida T, Ishitoya S, Shichiri Y, Kim CJ, Iwata T, Yokokawa R, Arai Y, Nishikawa Z, Soga H, Ushida H, Sakano Y, Naya Y, Wada A, Nagasawa M, Yoshida T, Narita M, Kawauchi A. Population‑based prostate‑specific antigen screening for prostate cancer may have an indirect effect on early detection through opportunistic testing in Kusatsu City, Shiga, Japan. Mol Clin Oncol 2022; 18:3. [PMID: 36545210 PMCID: PMC9756018 DOI: 10.3892/mco.2022.2599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/10/2022] [Indexed: 11/24/2022] Open
Abstract
Prostate cancer is the most common genitourinary cancer in men. Population-based serum prostate-specific antigen (PSA) testing is used to screen men for the early detection of asymptomatic prostate cancer. The present study compared the features of patients with prostate cancer in Kusatsu City, the only municipality in Shiga Prefecture of Japan to implement organized PSA screening, with those in other municipalities. The target population for organized PSA screening by mail invitation was men ≥50 years. Patients were pathologically diagnosed via prostate biopsy because of elevated serum PSA. This multicenter observational study was subsequently conducted in 14 hospitals. The following information was extracted from patient records: age, reason for PSA testing, initial PSA level, Gleason score, clinical stage, and place of residence. Risk classification was defined as low, intermediate, high, and advanced. Each patient was stratified according to their city/town. A total of 984 patients diagnosed with prostate cancer in Shiga in 2012 and 2017 were analyzed, of which 955 (97%) were opportunistically tested, with the remaining 29 (3%) assessed by organized screening. In Kusatsu, 93 patients were diagnosed, of whom 26 (28%) were detected by organized screening. By contrast, only three of 891 patients (0.3%) were detected by organized screening in other municipalities. Of patients in Kusatsu, cases identified by opportunistic testing had a higher initial PSA value (P=0.010) than those identified by organized screening. However, patients detected through opportunistic testing in Kusatsu City were younger (P=0.034), had a lower PSA value (P=0.001), and improved risk classification (P<0.001) than those in other municipalities. It was concluded that more patients were diagnosed with early-stage cancer by organized PSA screening. Furthermore, population-based PSA screening in Kusatsu City may have indirectly affected early detection, even by opportunistic testing.
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Affiliation(s)
- Susumu Kageyama
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan,Correspondence to: Dr Susumu Kageyama, Department of Urology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan
| | - Yuki Okinaka
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan,Department of Urology, Yasu City Hospital, Yasu, Shiga 520-2331, Japan
| | - Koji Nishizawa
- Department of Urology, Shiga General Hospital, Moriyama, Shiga 524-8524, Japan
| | - Toru Yoshida
- Department of Urology, Shiga General Hospital, Moriyama, Shiga 524-8524, Japan
| | - Satoshi Ishitoya
- Department of Urology, Japanese Red Cross Otsu Hospital, Otsu, Shiga 520-8511, Japan
| | - Yasumasa Shichiri
- Department of Urology, Otsu City Hospital, Otsu, Shiga 520-0804, Japan
| | - Chul Jang Kim
- Department of Urology, Kohka Public Hospital, Koka, Shiga 528-0074, Japan
| | - Tsuyoshi Iwata
- Department of Urology, Omihachiman Community Medical Center, Omihachiman, Shiga 523-0082, Japan
| | - Ryusei Yokokawa
- Department of Urology, Nagahama City Hospital, Nagahama, Shiga 526-8580, Japan
| | - Yutaka Arai
- Department of Urology, Kusatsu General Hospital, Kusatsu, Shiga 525-8585, Japan
| | - Zenkai Nishikawa
- Department of Urology, Hino Memorial Hospital, Hino, Shiga 529-1642, Japan
| | - Hiroki Soga
- Department of Urology, Toyosato Hospital, Toyosato, Shiga 529-1168, Japan
| | - Hiroshi Ushida
- Department of Urology, JCHO Shiga Hospital, Otsu, Shiga 520-0846, Japan
| | - Yuji Sakano
- Department of Urology, National Hospital Organization Higashi-ohmi General Medical Center, Higashiomi, Shiga 527-8505, Japan
| | - Yoshio Naya
- Department of Urology, Nagahama City Kohoku Hospital, Nagahama, Shiga 529-0493, Japan
| | - Akinori Wada
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Masayuki Nagasawa
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Tetsuya Yoshida
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Mitsuhiro Narita
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Akihiro Kawauchi
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
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17
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Orlov AV, Burenin AG, Skirda AM, Nikitin PI. Kinetic Analysis of Prostate-Specific Antigen Interaction with Monoclonal Antibodies for Development of a Magnetic Immunoassay Based on Nontransparent Fiber Structures. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27228077. [PMID: 36432177 PMCID: PMC9693269 DOI: 10.3390/molecules27228077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/22/2022]
Abstract
Prostate cancer is the second most common cancer diagnosed in men worldwide. Measuring the prostate-specific antigen (PSA) is regarded as essential during prostate cancer screening. Early diagnosis of this disease relapse after radical prostatectomy requires extremely sensitive methods. This research presents an approach to development of an ultrasensitive magnetic sandwich immunoassay, which demonstrates the limit of PSA detection in human serum of 19 pg/mL at a dynamic range exceeding 3.5 orders of concentration. Such attractive performance stems, inter alia, from the kinetic analysis of monoclonal antibodies (mAbs) against free PSA to select the mAbs exhibiting best kinetic characteristics and specificity. The analysis is carried out with a label-free multiplex spectral-correlation interferometry compatible with inexpensive single-use glass sensor chips. The high sensitivity of developed PSA immunoassay is due to electronic quantification of magnetic nanolabels functionalized by the selected mAbs and three-dimension porous filters used as an extended solid phase. The assay is promising for PSA monitoring after radical prostatectomy. The proposed versatile approach can be applied for the rational design of highly sensitive tests for detection of other analytes in many fields, including in vitro diagnostics, veterinary, food safety, etc.
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Affiliation(s)
- Alexey V. Orlov
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 38 Vavilov Street, 119991 Moscow, Russia
- Correspondence: (A.V.O.); (P.I.N.)
| | - Alexandr G. Burenin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 38 Vavilov Street, 119991 Moscow, Russia
| | - Artemiy M. Skirda
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 38 Vavilov Street, 119991 Moscow, Russia
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), 31 Kashirskoe Shosse, 115409 Moscow, Russia
| | - Petr I. Nikitin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 38 Vavilov Street, 119991 Moscow, Russia
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), 31 Kashirskoe Shosse, 115409 Moscow, Russia
- Correspondence: (A.V.O.); (P.I.N.)
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18
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Muacevic A, Adler JR. Presumptive Prostate Cancer Presenting as Low Back Pain in the Chiropractic Office: Two Cases and Literature Review. Cureus 2022; 14:e30575. [PMID: 36415398 PMCID: PMC9677512 DOI: 10.7759/cureus.30575] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2022] [Indexed: 11/29/2022] Open
Abstract
Prostate cancer is a common type of cancer in men and may metastasize to the spine and pelvis, causing back and/or radicular pain that appears to be musculoskeletal. This presents a diagnostic challenge and can be complicated by a lack of routine screening for prostate cancer. In two similar cases, elderly males (ages 78 and 82) with no known history of cancer and no previous prostate-specific antigen screening presented to a chiropractor with chronic, worsening radiating low back pain. In each case, a previous provider obtained radiographs and ascribed symptoms to a non-cancerous etiology (i.e., lumbar spondylosis, osteoporotic compression fracture), treated with nonsteroidal anti-inflammatory medications and physiotherapy. Given each patient's progressive worsening and neurologic deficits, the chiropractor ordered lumbar magnetic resonance imaging, revealing potential spinal metastasis. The chiropractor referred each patient to an oncologist who performed additional testing, making a presumptive diagnosis of prostate cancer. A literature review identified seven cases of previously undiagnosed prostate cancer presenting to a chiropractor. Including the current cases, patients were often older, presenting with thoracolumbar pain caused by spine or pelvic metastasis. The current cases and literature review illustrate that men with undiagnosed metastasis from prostate cancer may present to chiropractors complaining of spinal pain. Chiropractors should be aware of red flags warranting imaging such as older age and new or progressive symptoms and should refer patients to an oncologist when suspecting prostate cancer.
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19
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Saito T, Komatsubara S, Hara N, Nishiyama T, Katagiri A, Ishizaki F, Hatano A, Komeyama T, Hanyu S, Terunuma M, Imai T, Go H, Iida H, Kurumada S, Yamaguchi S, Takeda K, Ando T, Hoshii T, Kasahara T, Tomita Y. Significance of PSA Screening in Niigata, Japan: Survey of Actual Status of New Cases of Prostate Cancer. Res Rep Urol 2022; 13:859-866. [PMID: 34993159 PMCID: PMC8713882 DOI: 10.2147/rru.s341347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 12/10/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aims to investigate the utility of prostate-specific antigen (PSA) screening by conducting an all-case survey of newly diagnosed prostate cancer patients at Niigata Prefecture, Japan. Patients and Methods Depending on whether patients were subjected to screening, information was prospectively collected on all prostate cancer patients newly diagnosed between October 1, 2019, and September 30, 2020, at all institutions in Niigata Prefecture where urologists performing prostate biopsy routinely work and differences in clinical parameters were investigated. Results PSA was measured in 478 out of 1332 patients (35.8%) as part of a community health screening. The rate of metastatic carcinoma (M1) in all patients was 14.9%. When patients were divided into three categories of population-based screening (community health screening and workplace health screening), opportunistic screening (PSA measurements at complete medical check-ups or on patient request), and testing triggered by clinical symptoms or findings, the proportion of metastatic cancer was 4.5%, 3.7%, and 30.6%, respectively, demonstrating that the number of distant metastases was significantly lesser in all patients who underwent screening. Conclusion The one-year all-case survey of newly diagnosed prostate cancer patients demonstrated that PSA screening significantly contributed to the early diagnosis of current prostate cancer in Japan.
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Affiliation(s)
- Toshihiro Saito
- Department of Urology, Niigata Cancer Center Hospital, Niigata, Japan
| | | | - Noboru Hara
- Department of Urology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minamiuonuma, Japan
| | - Tsutomu Nishiyama
- Department of Urology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minamiuonuma, Japan
| | - Akiyoshi Katagiri
- Department of Urology, Niigata Prefectural Central Hospital, Joetsu, Japan
| | - Fumio Ishizaki
- Department of Renal and Urinary Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Akihiko Hatano
- Department of Urology, Niigata Prefectural Shibata Hospital, Shibata, Japan
| | - Takeshi Komeyama
- Department of Urology, Nagaoka Red Cross Hospital, Nagaoka, Japan
| | - Shugo Hanyu
- Department of Urology, Kashiwazaki General Hospital and Medical Center, Kashiwazaki, Japan
| | - Masahiro Terunuma
- Department of Urology, Nagaoka Chuo General Hospital, Nagaoka, Japan
| | - Tomoyuki Imai
- Department of Urology, Niigata City General Hospital, Niigata, Japan
| | - Hideto Go
- Department of Urology, Niigata Saiseikai Sanjo Hospital, Sanjo, Japan
| | - Hiroaki Iida
- Department of Urology, Joetsu General Hospital, Joetsu, Japan
| | | | - Shunsuke Yamaguchi
- Department of Urology, Niigata Prefectural Central Hospital, Joetsu, Japan.,Department of Urology, Tachikawa General Hospital, Nagaoka, Japan
| | - Keisuke Takeda
- Department of Renal and Urinary Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.,Department of Urology, Murakami General Hospital, Murakami, Japan
| | - Takashi Ando
- Department of Urology, Tachikawa General Hospital, Nagaoka, Japan.,Department of Urology, Murakami General Hospital, Murakami, Japan
| | - Tatsuhiko Hoshii
- Department of Renal and Urinary Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Takashi Kasahara
- Department of Renal and Urinary Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Yoshihiko Tomita
- Department of Renal and Urinary Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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20
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Ko YH, Roh KC, Kim BH. The national-wide incidence of prostate-specific antigen testing trend for a decade in Korea by age group. Investig Clin Urol 2022; 63:184-191. [PMID: 35244992 PMCID: PMC8902428 DOI: 10.4111/icu.20210463] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/04/2022] [Accepted: 01/11/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose To document nationwide serum prostate-specific antigen (PSA) testing trends over the past decade and to investigate the impact of testing on prostate cancer (PCa) detection. Materials and Methods Using annual National Health Insurance Service of Korea data for the period 2006 to 2016, PSA testing rates were investigated for men aged ≥40 years by decade, and associations between test rates and registered PCa cases were analyzed. Results During the study period, the incidence of PCa increased about threefold (4,415 in 2006 to 15,046 in 2016). PCa incidences increased with age (p<0.001) and about 60% of cases were over 70 years old. Despite a fourfold increase in PSA testing (246,911 in 2006 to 937,548 in 2016), the average exposure rate among all men was only 7.27% in 2016, and the mean number of repeat tests for those that did not develop PCa during the study period was 2.9. PSA test rates increased with age and in 2016 were 1.65% for those in their 40s, 4.90% for those in their 50s, 12.0% for those in their 60s, 19.2% for those in their 70s, and 21.6% for those aged ≥80. Regardless of the age groups, a significant association was found between PSA test numbers and the detection of PCas. Conclusions In contrast to the soaring incidence of PCa especially in those aged over 70 years who have a more frequent chance for PSA testing triggered by concomitant voiding symptoms, low exposure in general and among relatively younger men favors a countrywide screening policy.
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Affiliation(s)
- Young Hwii Ko
- Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea
| | - Kwon-Chan Roh
- Medical R&D Service Design Center, College of Medicine, Yeungnam University, Daegu, Korea
| | - Byung Hoon Kim
- Department of Urology, School of Medicine, Keimyung University, Daegu, Korea
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21
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Ko YH, Kim BH. Should Contemporary Western Guidelines Based on Studies Conducted in the 2000s Be Adopted for the Prostate-Specific Antigen Screening Policy for Asian Men in the 2020s? World J Mens Health 2022; 40:543-550. [PMID: 36047073 PMCID: PMC9482864 DOI: 10.5534/wjmh.220002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 11/16/2022] Open
Abstract
Though prostate cancer (PCa) is the second most common cancer world widely, there exist substantial differences exist between Asia and the west. Genetic susceptibility and lifestyle may contribute to disproportionately lower incidences and mortalities of PCa in Asian countries, but the differences in diagnostic practices are also likely to contribute, and a large part of them may be explained by the lesser chance of prostate-specific antigen (PSA) testing. In the US, about half of men aged over 50 years had been exposed to the screening test in the early 2000s. The shifts in the risk stratification from the high-risk dominant disease in the late 1980s to the low-risk dominant disease in the early 2000s led to criticism regarding the unconditional nature of PSA-based screening. Based on the conflicting outcomes from the randomized clinical trials which investigated the benefit of PSA testing, US Preventive Study Task Force recommended ceasing mass screening in 2012. Accordingly, guidelines begin to emphasize shared decision-making on the PSA testing narrowing their scopes to men aged 55 to 69 years since 2013. Though most Asian countries have not begun to recognize PCa as a major agenda item until the 2010s, a clear trend of expanding incidence of it implies that the time to come to reconsider PSA testing as a higher priority in the public health sphere in the 2020s. Concerns regarding over-diagnosis and over-treatment of insignificant diseases are imperative. However, the distinctive epidemiologic characteristics of PCa in Asia areas, such as low exposure to the repetitive PSA testing, the recent increase in its incidence driven by the elderly and super-elderly, and racial differences should be considered when it comes to the establishment of screening policy utilizing PSA test.
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Affiliation(s)
- Young Hwii Ko
- Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea
| | - Byung Hoon Kim
- Department of Urology, School of Medicine, Keimyung University, Daegu, Korea
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22
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Okinaka Y, Kageyama S, Nishizawa K, Yoshida T, Ishitoya S, Shichiri Y, Kim CJ, Iwata T, Yokokawa R, Arai Y, Nishikawa Z, Soga H, Ushida H, Sakano Y, Naya Y, Yoshida T, Narita M, Kawauchi A. Clinical, pathological, and therapeutic features of newly diagnosed prostate cancer predominantly detected by opportunistic PSA screening: A survey of Shiga Prefecture, Japan. Prostate 2021; 81:1172-1178. [PMID: 34418129 DOI: 10.1002/pros.24212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/17/2021] [Accepted: 08/06/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND In all the prefectures of Japan, with the exception of Shiga Prefecture, more than half of local governments have an organized prostate-specific antigen (PSA) screening system in place. However, in the Shiga Prefecture, only a single city performed PSA screening over the time period of this survey. The purpose of the present study was to determine the clinical, pathological, and therapeutic features of newly diagnosed prostate cancer in localities where a formally organized screening system was almost entirely absent. METHODS A multicenter observational study was conducted in the Shiga Prefecture, which has the lowest rate of population-based PSA-screening in Japan. Patients' age, initial PSA, reasons for PSA testing, Gleason score, clinical stage, and primary treatments were surveyed. We stratified patients according to the reasons for PSA measurement, and compared the differences between groups subject to organized versus opportunistic screening. RESULTS In the 2 years 2012 and 2017, 984 newly diagnosed prostate cancer patients were analyzed. Of these, 954 (97%) were opportunistically tested (i.e., not as part of an organized screening system), with the remaining 29 (3%) measured as part of an organized screening program. Patients in the former group exhibited a higher initial PSA value than in the organized screening group (median: 11.49 vs. 5.67 ng/ml). They also had worse clinical features, including higher Gleason score and TNM stage. More patients in the organized screening group were treated curatively than in the nonorganized screening group in terms of the primary treatment. The results were similar in a subanalysis of the patients of age 50-69 years. CONCLUSIONS Organized PSA screening contributes to increasing the number of patients diagnosed with early-stage cancer who can be treated curatively.
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Affiliation(s)
- Yuki Okinaka
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga, Japan
- Department of Urology, Yasu City Hospital, Yasu, Shiga, Japan
| | - Susumu Kageyama
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Koji Nishizawa
- Department of Urology, Shiga General Hospital, Moriyama, Shiga, Japan
| | - Toru Yoshida
- Department of Urology, Shiga General Hospital, Moriyama, Shiga, Japan
| | - Satoshi Ishitoya
- Department of Urology, Japanese Red Cross Otsu Hospital, Otsu, Shiga, Japan
| | | | - Chul Jang Kim
- Department of Urology, Kohka Public Hospital, Koka, Shiga, Japan
| | - Tsuyoshi Iwata
- Department of Urology, Omihachiman Community Medical Center, Omihachiman, Shiga, Japan
| | - Ryusei Yokokawa
- Department of Urology, Nagahama City Hospital, Nagahama, Shiga, Japan
| | - Yutaka Arai
- Department of Urology, Kusatsu General Hospital, Kusatsu, Shiga, Japan
| | - Zenkai Nishikawa
- Department of Urology, Hino Memorial Hospital, Hino, Shiga, Japan
| | - Hiroki Soga
- Department of Urology, Toyosato Hospital, Toyosato, Shiga, Japan
| | - Hiroshi Ushida
- Department of Urology, JCHO Shiga Hospital, Otsu, Shiga, Japan
| | - Yuji Sakano
- Department of Urology, National Hospital Organization Higashi-ohmi General Medical Center, Higashiomi, Shiga, Japan
| | - Yoshio Naya
- Department of Urology, Nagahama City Kohoku Hospital, Nagahama, Shiga, Japan
| | - Tetsuya Yoshida
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Mitsuhiro Narita
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Akihiro Kawauchi
- Department of Urology, Shiga University of Medical Science, Otsu, Shiga, Japan
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Choi EPH, Wan EYF. Attitude Toward Prostate Cancer Screening in Hong Kong: The Importance of Perceived Consequence and Anticipated Regret. Am J Mens Health 2021; 15:15579883211051442. [PMID: 34622702 PMCID: PMC8504245 DOI: 10.1177/15579883211051442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
There are long-standing debates about the benefits of prostate cancer screening. Conflicting trial results and inconsistent recommendations regarding prostate cancer screening in clinical guidelines highlight the importance of patient factors that influence decision making in prostate cancer screening. Attitude is an important factor associated with cancer screening. However, attitudes toward prostate cancer screening among Chinese men are still poorly understood. The objective of the study was to evaluate attitudes toward prostate cancer screening and their association with prostate cancer screening intention among Chinese men. In this community-based study, 340 males were randomly recruited. Three distinct concepts related to prostate cancer screening attitudes were evaluated, including perceived consequences of screening, moral obligation, and anticipated regret. The intention to have prostate cancer screening was asked. Only 5.00% of the study participants had prostate cancer screening before, while 69.71% have an intention to undergo screening in the future. Participants with a high level of anticipated regret also had a high likelihood to have screening in the future, with an adjusted odds ratio (aOR) of 1.82. Participants who had favorable attitudes toward the consequence of participating in prostate cancer screening had a high likelihood to undergo screening, with an aOR of 1.22. Participants who were more concerned about pain and invasion of privacy were less likely to have an intention to have prostate cancer screening, with aORs of 0.53 and 0.57, respectively. To enhance screening intention, public health programs should include components related to anticipated regrets and perceived consequences.
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Affiliation(s)
| | - Eric Y F Wan
- Department of Family Medicine and Primary Care, the University of Hong Kong, Hong Kong.,Department of Pharmacology and Pharmacy, the University of Hong Kong, Hong Kong
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Ko YH, Park SW, Ha US, Joung JY, Jeong SH, Byun SS, Jeon SS, Kwak C. A comparison of the survival outcomes of robotic-assisted radical prostatectomy and radiation therapy in patients over 75 years old with non-metastatic prostate cancer: A Korean multicenter study. Investig Clin Urol 2021; 62:535-544. [PMID: 34387037 PMCID: PMC8421997 DOI: 10.4111/icu.20210079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 04/21/2021] [Accepted: 06/01/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To compare overall survivals (OSs) and cancer-specific survivals (CSSs) after robotic-assisted radical prostatectomy (RARP) and radiation therapy (RT), the latter of which has long been recommended primarily for elderly patients (≥75 years) with non-metastatic prostate cancer (PCa), given the Korean male life span of 79.7 years (2018). MATERIALS AND METHODS Retrospective data for aged ≥75 years who underwent RARP or RT at seven tertiary hospitals were analyzed. To account for indication-related bias, inverse probability of treatment-weighting (IPTW) was applied before and after Cox regression. RESULTS Of the 1,110 study subjects, 883 underwent RARP and 227 RT from 2007 to 2016. The differences between groups including the age (≥80 y; 25.4% vs. 32.8%; p=0.034), concomitant diabetes (14.9% vs. 22.9%; p=0.007), coronary heart disease (3.5% vs. 7.5%; p=0.015), and PCa risk stratification (high-risk; 18.2% vs. 59.7%; p<0.001) were balanced after IPTW. During a mean follow-up of 74.5 months, OSs (91.9% vs. 91.0%) and CSSs (97.8% vs. 98.0%) were similar. After IPTW, overall mortality was associated with diabetes (hazard ratio [HR], 2.273; p<0.0001) and inversely with low-risk PCa (HR, 0.314; p<0.0001), the last of which was solely associated with cancer-specific mortality (HR, 0.245; p=0.0005). The implementation of local treatment between RARP and RT demonstrated no impact on survival, for whole and high-risk populations. CONCLUSIONS Even aged over 75 years, patients who underwent RARP for non-metastatic PCa had similar survival with RT regardless of risk stratification. However, the survival needs to be weighed with the morbidity of local treatment in a future study.
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Affiliation(s)
- Young Hwii Ko
- Department of Urology, College of Medicine, Yeungnam University, Daegu, Korea
| | - Sung-Woo Park
- Department of Urology, Pusan National University Yangsan Hospital, Pusan, Korea
| | - U-Syn Ha
- Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jae Young Joung
- Center for Urological Cancer, National Cancer Center, Goyang, Korea
| | - Seung-Hwan Jeong
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea
| | - Seok-Soo Byun
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seong Soo Jeon
- Department of Urology, Samsung Medical Center, Seoul, Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
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25
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Eckhardt C, Sbiera I, Krebs M, Sbiera S, Spahn M, Kneitz B, Joniau S, Fassnacht M, Kübler H, Weigand I, Kroiss M. High expression of Sterol-O-Acyl transferase 1 (SOAT1), an enzyme involved in cholesterol metabolism, is associated with earlier biochemical recurrence in high risk prostate cancer. Prostate Cancer Prostatic Dis 2021; 25:484-490. [PMID: 34326474 PMCID: PMC9385470 DOI: 10.1038/s41391-021-00431-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 07/06/2021] [Accepted: 07/15/2021] [Indexed: 01/04/2023]
Abstract
Background Prostate cancer (PCa) is the most frequent cancer in men. The prognosis of PCa is heterogeneous with many clinically indolent tumors and rare highly aggressive cases. Reliable tissue markers of prognosis are lacking. Active cholesteryl ester synthesis has been associated with prostate cancer aggressiveness. Sterol-O-Acyl transferases (SOAT) 1 and 2 catalyze cholesterol esterification in humans. Objective To investigate the value of SOAT1 and SOAT2 tissue expression as prognostic markers in high risk PCa. Patients and methods Formalin-fixed paraffin-embedded tissue samples from 305 high risk PCa cases treated with radical prostatectomy were analyzed for SOAT1 and SOAT2 protein expression by semi-quantitative immunohistochemistry. The Kaplan–Meier method and Cox proportional hazards modeling were used to compare outcome. Main outcome measure Biochemical recurrence (BCR) free survival. Results SOAT1 expression was high in 73 (25%) and low in 219 (75%; not evaluable: 13) tumors. SOAT2 was highly expressed in 40 (14%) and at low levels in 249 (86%) samples (not evaluable: 16). By Kaplan–Meier analysis, we found significantly shorter median BCR free survival of 93 months (95% confidence interval 23.6–123.1) in patients with high SOAT1 vs. 134 months (112.6–220.2, Log-rank p < 0.001) with low SOAT1. SOAT2 expression was not significantly associated with BCR. After adjustment for age, preoperative PSA, tumor stage, Gleason score, resection status, lymph node involvement and year of surgery, high SOAT1 but not SOAT2 expression was associated with shorter BCR free survival with a hazard ratio of 2.40 (95% CI 1.57–3.68, p < 0.001). Time to clinical recurrence and overall survival were not significantly associated with SOAT1 and SOAT2 expression Conclusions SOAT1 expression is strongly associated with BCR free survival alone and after multivariable adjustment in high risk PCa. SOAT1 may serve as a histologic marker of prognosis and holds promise as a future treatment target.
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Affiliation(s)
- Carolin Eckhardt
- University Hospital Würzburg, Department of Internal Medicine I, Division of Endocrinology and Diabetology, Würzburg, Germany
| | - Iuliu Sbiera
- University Hospital Würzburg, Department of Internal Medicine I, Division of Endocrinology and Diabetology, Würzburg, Germany
| | - Markus Krebs
- University Hospital Würzburg, Department of Urology and Pediatric Urology, Würzburg, Germany.,University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Silviu Sbiera
- University Hospital Würzburg, Department of Internal Medicine I, Division of Endocrinology and Diabetology, Würzburg, Germany
| | - Martin Spahn
- Lindenhofspital, Bern, Switzerland.,Department of Urology, University Hospital Essen, Essen, Germany
| | - Burkhard Kneitz
- University Hospital Würzburg, Department of Urology and Pediatric Urology, Würzburg, Germany
| | - Steven Joniau
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Martin Fassnacht
- University Hospital Würzburg, Department of Internal Medicine I, Division of Endocrinology and Diabetology, Würzburg, Germany.,University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Hubert Kübler
- University Hospital Würzburg, Department of Urology and Pediatric Urology, Würzburg, Germany.,University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Isabel Weigand
- University Hospital Würzburg, Department of Internal Medicine I, Division of Endocrinology and Diabetology, Würzburg, Germany.,Department of Medicine IV, University Hospital Munich, Ludwig-Maximilians-Universität München, München, Germany
| | - Matthias Kroiss
- University Hospital Würzburg, Department of Internal Medicine I, Division of Endocrinology and Diabetology, Würzburg, Germany. .,University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany. .,Department of Medicine IV, University Hospital Munich, Ludwig-Maximilians-Universität München, München, Germany.
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Abstract
Prostate cancer is a global health problem, but incidence varies considerably across different continents. Asia is traditionally considered a low-incidence area, but the incidence and mortality of prostate cancer have rapidly increased across the continent. Substantial differences in epidemiological features have been observed among different Asian regions, and incidence, as well as mortality-to-incidence ratio, is associated with the human development index. Prostate cancer mortality decreased in Japan and Israel from 2007 to 2016, but mortality has increased in Thailand, Kyrgyzstan and Uzbekistan over the same period. Genomic analyses have shown a low prevalence of ERG oncoprotein in the East Asian population, alongside a low rate of PTEN loss, high CHD1 enrichments and high FOXA1 alterations. Contributions from single-nucleotide polymorphisms to prostate cancer risk vary with ethnicity, but germline mutation rates of DNA damage repair genes in metastatic prostate cancer are comparable in Chinese and white patients from the USA and UK. Pharmacogenomic features of testosterone metabolism might contribute to disparities seen in the response to androgen deprivation between East Asian men and white American and European men. Overall, considerable diversity in epidemiology and genomics of prostate cancer across Asia defines disease characteristics in these populations, but studies in this area are under-represented in the literature. Taking into account this intracontinental and intercontinental heterogeneity, translational studies are required in order to develop ethnicity-specific treatment strategies.
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27
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Hatakeyama S, Yoneyama T, Tobisawa Y, Yamamoto H, Ohyama C. Narrative review of urinary glycan biomarkers in prostate cancer. Transl Androl Urol 2021; 10:1850-1864. [PMID: 33968674 PMCID: PMC8100853 DOI: 10.21037/tau-20-964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Prostate cancer (PC) is the second most common cancer in men worldwide. The application of the prostate-specific antigen (PSA) test has improved the diagnosis and treatment of PC. However, the PSA test has become associated with overdiagnosis and overtreatment. Therefore, there is an unmet need for novel diagnostic, prognostic, and predictive biomarkers of PC. Urinary glycoproteins and exosomes are a potential source of PC glycan biomarkers. Urinary glycan profiling can provide noninvasive monitoring of tumor heterogeneity and aggressiveness throughout a treatment course. However, urinary glycan profiling is not popular due to technical disadvantages, such as complicated structural analysis that requires specialized expertise. The technological development of glycan analysis is a rapidly advancing field. A lectin-based microarray can detect aberrant glycoproteins in urine, including PSA glycoforms and exosomes. Glycan enrichment beads can enrich the concentration of N-linked glycans specifically. Capillary electrophoresis, liquid chromatography-tandem mass spectrometry, and matrix-assisted laser desorption/ionization-time of flight mass spectrometry can detect glycans directory. Many studies suggest potential of urinary glycoproteins, exosomes, and glycosyltransferases as a biomarker of PC. Although further technological challenges remain, urinary glycan analysis is one of the promising approaches for cancer biomarker discovery.
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Affiliation(s)
- Shingo Hatakeyama
- Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tohru Yoneyama
- Department of Glycotechnology, Center for Advanced Medical Research, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yuki Tobisawa
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Chikara Ohyama
- Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Glycotechnology, Center for Advanced Medical Research, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Togashi K, Hatakeyama S, Okamoto T, Kojima Y, Iwamura H, Fujita N, Narita T, Hamano I, Hamaya T, Yoneyama T, Yamamoto H, Yoneyama T, Hashimoto Y, Ohyama C. Oncologic and patient-reported outcomes after robot-assisted radical prostatectomy in men aged ≥75 years. Urol Oncol 2020; 39:729.e17-729.e25. [PMID: 33353866 DOI: 10.1016/j.urolonc.2020.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/18/2020] [Accepted: 12/07/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The present study aimed to evaluate oncologic outcomes, patient-reported outcomes (PROs), and frailty in older adult patients aged ≥75 years who underwent robot-assisted radical prostatectomy (RARP). MATERIALS AND METHODS This retrospective study reviewed the medical records of 752 patients who underwent RARP from July 2011 to May 2020. The PROs were evaluated by Expanded Prostate Cancer Index Composite questionnaire at baseline and 1 year after RARP. Patients were divided into 3 groups according to age at RARP: <70, 70-74, and ≥75 years. Oncologic outcomes and PROs were compared between the ≥75 and 70-74 years groups and between the ≥75 and <70 years groups. RESULTS Median follow up was 47 months. Of the 752 patients, 469, 216, and 74 were classified into the <70, 70-74, and ≥75 years groups, respectively. No significant differences were observed in the biochemical recurrence-free survival, cancer-specific survival, and overall survival among the groups. No significant differences were observed in the PROs and pad-free rates at baseline and 1 year after RARP among the groups. The full satisfaction (Expanded Prostate Cancer Index Composite score = 100) at 12 months after RARP was significantly higher in the ≥75 years group (27%) than in the <70 years group (15%, P = 0.045). CONCLUSION The oncologic outcomes and PROs in select patients with prostate cancer aged ≥75 years were feasible and acceptable with RARP.
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Affiliation(s)
- Kyo Togashi
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shingo Hatakeyama
- Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
| | - Teppei Okamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yuta Kojima
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiromichi Iwamura
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Naoki Fujita
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takuma Narita
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Itsuto Hamano
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomoko Hamaya
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tohru Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takahiro Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yasuhiro Hashimoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Ko YH, Lee YG. Relevance of nationwide prostate specific antigen screening test for prostate cancer. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2020. [DOI: 10.5124/jkma.2020.63.11.652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The serum prostate specific antigen (PSA) screening test plays a pivotal role in the diagnosis of prostate cancer (PCa), especially for early detection, before symptoms of systemic spread. Even though clinical trials for the PSA screening test have demonstrated limited benefits with regard to patient survival, recent trends have shown a continuous decrease in the PCa mortality rate in Western countries. In many Asian countries where PSA screening has not yet been widely adopted, the screening strategy reduces the metastatic spread. While PCa became the 10th most common malignant disease in the Korean male population in 2000, recent national reports indicate that its increase in the last two decades have now made it the third most popular malignant condition. Due to the different epidemiologic background and limited social awareness of PCa compared to Western countries, the PSA screening test was not routinely performed in Korea, in contrast with other prevalent malignant diseases such as stomach, colon, and lung cancers. Therefore, only about a quarter of the patients newly diagnosed with PCa in Korea were found to have undergone repeated PSA screening. However, the screened population showed a higher probability of local rather than systemic treatment, which reflects an earlier disease stage at the time of diagnosis in comparison with their non-screened counterparts. Given the relatively high survival rate of PCa and the increasing lifespan of Korean males, the increase of PCa will accelerate, suggesting the clinical relevance of PSA screening as part of regular checkups for Korean males.
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Recommandations françaises du Comité de cancérologie de l’AFU – actualisation 2020–2022 : cancer de la prostate. Prog Urol 2020; 30:S136-S251. [DOI: 10.1016/s1166-7087(20)30752-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Watson L. Changements dans les pratiques de dépistage de l'antigène prostatique spécifique en Ontario entre 2003 et 2012. Can Oncol Nurs J 2020; 30:133-140. [PMID: 33118995 DOI: 10.5737/23688076302133140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectifs La présente étude analyse les changements survenus entre 2003 et 2012 dans les pratiques de dépistage de l'antigène prostatique spécifique (APS) chez les hommes âgés de 35 ans et plus en Ontario. Nous établissons des facteurs associés aux tests de l'APS, examinons si les directives de dépistage relatives à l'âge sont respectées et si les tests sont réalisés de manière opportuniste. Sont également étudiés la relation entre le revenu, le niveau d'éducation et le suivi régulier auprès d'un médecin ainsi qu'une estimation de la prévalence des tests de dépistage de l'APS en 2012. Méthodologie Nous avons utilisé des données provenant de l'Enquête sur la santé des collectivités canadiennes (ESCC) pour estimer la proportion d'hommes ayant passé un test de dépistage de l'APS en 2003, que nous avons ensuite comparée à une estimation similaire (population semblable) datant de 2012. Nous avons également étudié les liens entre le recours au dépistage et des facteurs sociodémographiques. Nous avons élaboré des analyses de tableau de contingence afin de caractériser les changements ainsi qu'une analyse de régression logistique afin d'évaluer les différences, tout en rendant compte de l'éventuel rôle confusionnel d'autres facteurs. Résultats Entre 2003 et 2012, une augmentation du recours au test de l'APS a été observée chez les hommes de 35 à 49 ans et chez ceux de 75 ans et plus. En 2003, 18 % des hommes de 35 à 49 ans et 74 % des hommes de 75 ans et plus ont dit avoir déjà passé un test de l'APS. En 2012, ces chiffres avaient augmenté de 20 % chez les répondants de 35 à 49 ans et de 84 % chez ceux de 75 ans et plus. L'analyse de régression logistique a révélé qu'en 2012 un homme dans la tranche d'âge de 70 à 74 ans affichait la plus haute probabilité d'avoir passé un test de l'APS comparativement à un homme du groupe des 35 à 49 ans (rapport des cotes [RC] = 25,9; intervalle de confiance [IC] = 19,9 - 33,8). Conclusion En Ontario, des tests de l'APS semblent être menés de manière opportuniste, touchant alors des groupes non recommandés par les directives de la province. En effet, on observe une augmentation marquée du recours au dépistage chez les personnes non comprises dans les tranches d'âge énoncées par les directives ontariennes en matière de dépistage de l'ASP, c'est-à-dire de 35 à 49 ans et 75 ans et plus. Il semble que la plupart des tests de dépistage de l'ASP en Ontario soient opportunistes et que les directives relatives à l'âge soient peu respectées.
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Watson L. Changes in the uptake of screening for prostate cancer with prostate-specific antigen in Ontario between 2003 to 2012. Can Oncol Nurs J 2020; 30:125-132. [PMID: 33118992 DOI: 10.5737/23688076302125132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives This study investigates change in prostate-specific antigen (PSA) screening uptake in Ontario among men 35 years of age and older, between 2003 and 2012. We identify factors related to PSA testing, and examine the degree to which age guidelines for PSA testing are being followed or if PSA screening is opportunistic in nature. The relationship of income, education and having a regular physician and an estimation of PSA testing prevalence in 2012 is also studied. Methods Data from the Canadian Community Health Survey (CCHS) were used to estimate the proportion of men who had a PSA test in 2003 and then compared to a similar estimate (in similar population) in 2012. We also examined associations with PSA uptake to socio-demographic factors. Contingency table analyses were performed to characterize the changes; logistic regression was also used to evaluate the differences, while taking into account the possible confounding role of other factors. Results We found among men aged 35-49 years and 75+, there was an increase in PSA utilization between 2003 and 2012. In 2003, 18% of men 35-49 years, and 74% of men aged 75+ reported ever having a PSA test. These figures increased to 20% of men aged 35-49 years, and 84% of men aged 75+ years in 2012. Logistic regression showed that a man in the 70-74 age category in 2012 had the highest likelihood of having had a PSA test compared to men in the age range of 35-49 years (odds ratio (OR)=25.9; confidence interval (CI)= 19.9-33.8). Conclusion In Ontario, PSA testing is seemingly opportunistic in nature and occurring in groups not recommended for testing by the Ontario guidelines. There is a marked increase in PSA utilization in age ranges outside of the current Ontario PSA testing guidelines (35-49 and 75+). It would appear that most PSA testing in Ontario is opportunistic and adherence to age guidelines is limited.
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Hamaya T, Hatakeyama S, Momota M, Narita T, Iwamura H, Kojima Y, Hamano I, Fujita N, Okamoto T, Togashi K, Yoneyama T, Yamamoto H, Yoneyama T, Hashimoto Y, Ohyama C. Association between the baseline frailty and quality of life in patients with prostate cancer (FRAQ-PC study). Int J Clin Oncol 2020; 26:199-206. [PMID: 33079283 DOI: 10.1007/s10147-020-01798-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/28/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND The association between baseline frailty and health-related quality of life (HRQOL) in patients with prostate cancer (PC) remains unknown. METHODS We retrospectively evaluated the association of pretreatment frailty with HRQOL in 409 patients with PC from February 2017 to April 2020. Frailty and HRQOL were evaluated using the geriatric 8 (G8) screening tool and QLQ-C30 questionnaire, respectively. The primary objective was comparison of G8 and QOL scores between the localized diseases (M0 group) and metastatic castration-sensitive PC (mCSPC group). Secondary objectives were to study the association of G8 and QOL scores in each group and effect of frailty (G8 ≤ 14) on worse QOL. RESULTS The median age of patients was 70 years. There were 369 (surgery: 196, radiotherapy: 156, androgen deprivation therapy alone: 17) patients in the M0 and 40 patients in the mCSPC groups. There was a significant difference between the M0 and mCSPC groups in the G8 score (14.5 vs. 12.5), functioning QOL (94 vs. 87), global QOL (75 vs. 58), and 100-symptom QOL (94 vs. 85) scores. G8 scores were significantly associated with functioning, global, and 100-symptom QOL scores in both M0 and mCSPC groups. The multivariable logistic regression analyses showed that frailty (G8 ≤ 14) was significantly associated with worse global QOL, functioning QOL, and 100-symptom QOL scores. CONCLUSION The baseline frailty and HRQOL were significantly different between the localized and metastatic disease. The baseline frailty was significantly associated with worse HRQOL in patients with PC.
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Affiliation(s)
- Tomoko Hamaya
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan
| | - Shingo Hatakeyama
- Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan.
| | - Masaki Momota
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan
| | - Takuma Narita
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan
| | - Hiromichi Iwamura
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan
| | - Yuta Kojima
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan
| | - Itsuto Hamano
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan
| | - Naoki Fujita
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan
| | - Teppei Okamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan
| | - Kyo Togashi
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan
| | - Tohru Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan
| | - Takahiro Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan
| | - Yasuhiro Hashimoto
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan.,Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan.,Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifu-chou, Hirosaki, 036-8562, Japan
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The comparison of the survival outcome between robotic-assisted radical prostatectomy and radiation therapy for localized prostate cancer in men over 70 years: Korean Nationwide Observational Study. J Robot Surg 2020; 15:585-592. [PMID: 32918235 DOI: 10.1007/s11701-020-01144-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022]
Abstract
This study aimed to investigate the survival after robotic-assisted radical prostatectomy (RARP) in comparison with radiation therapy (RT) in elderly patients (≥ 70 years) with non-metastatic prostate cancer (PCa), given the contemporary Korean life span of 80 years. From the National Health Insurance Sharing Service data, men aged ≥ 70 years diagnosed with PCa from 2006 through 2016 undergoing RARP or RT without systemic chemotherapy or prolonged androgen deprivation therapy (ADT) were identified, then the mortality was compared after adjusting host factors. Data revealed 13,952 patients with RARP (N = 7535) or RT (N = 6417). Patients who underwent RARP were younger (73.81 ± 3.58 vs. 75.05 ± 3.83 years) and had a higher income. While the majority of the RARP group (94.1%) received no additional therapy, 57.4% of the RT group combined ADT. The adjusted mortality rate for total patients was lower in the RARP group (HR = 0.767, 95% CI 0.072-0.818, p < 0.0001). From the age of 75 years, more patients underwent RT (n = 3239) than RARP (n = 2478). When dividing patients by this age cut-off, the adjusted mortality for the younger patient (70-74 years) was lower in the RARP group than the RT group (HR = 0.580, p < 0.0001). In contrast, the adjusted mortality rate for men older than 75 years was similar (HR = 0.98, 95% CI 0.897-1.07, p = 0.649). This study demonstrates that even the patient over 75 years old who could afford to undergo robotic-assisted radical prostatectomy for non-metastatic PCa had a similar survival in comparison with RT, which had long been a standard of care for this particular age group.
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Togashi K, Hatakeyama S, Kojima Y, Momota M, Narita T, Iwamura H, Hamano I, Hamaya T, Fujita N, Okamoto T, Yoneyama T, Yamamoto H, Yoneyama T, Hashimoto Y, Ohyama C. The effect of frailty on the quality of life and lower urinary symptoms following robot-assisted radical prostatectomy: A longitudinal analysis (FRARP-QL Study). Urol Oncol 2020; 39:192.e7-192.e14. [PMID: 32861619 DOI: 10.1016/j.urolonc.2020.08.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/08/2020] [Accepted: 08/05/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We aimed to evaluate the effect of frailty on health-related quality-of-life (HRQOL) and lower urinary symptoms (LUTS) following robot-assisted radical prostatectomy (RARP) in patients with prostate cancer (CaP). MATERIALS AND METHODS We longitudinally evaluated geriatric 8 (G8), HRQOL, and LUTS for 12 months in 118 patients with RARP from January 2017 to April 2020. Patients were divided into frail (G8 ≤14) and nonfrail (G8 >14) groups. We compared the effect of frailty on HRQOL and LUTS between the frail and nonfrail groups before and 12 months after RARP. RESULTS The median age of patients was 68 years. The number of patients in the frail and nonfrail groups were 41 and 77, respectively. No significant difference in patients' background was observed between the groups, except for the presence of cardiovascular disease (22% vs. 7.8%, P = 0.041). There was no significant difference in HRQOLs and LUTS between the groups at baseline. Similarly, HRQOLs, LUTS, and pad-free continence rates were not significantly different between the groups at 12 months after RARP. In the nonfrail group, LUTS at 12 months following RARP significantly improved compared to those at the baseline, but it did not significantly improve in the frail group. Multivariable logistic regression analysis demonstrated that frailty was not significantly associated with LUTS worsening. CONCLUSIONS Frailty was not significantly associated with the worsening of HRQOL, LUTS, and pad-free continence rates in patients treated with RARP.
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Affiliation(s)
- Kyo Togashi
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shingo Hatakeyama
- Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
| | - Yuta Kojima
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Masaki Momota
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takuma Narita
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiromichi Iwamura
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Itsuto Hamano
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomoko Hamaya
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Naoki Fujita
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Teppei Okamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tohru Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Takahiro Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yasuhiro Hashimoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Kodama H, Hatakeyama S, Momota M, Togashi K, Hamaya T, Hamano I, Fujita N, Kojima Y, Okamoto T, Yoneyama T, Yamamoto H, Yoshikawa K, Yoneyama T, Hashimoto Y, Ohyama C. Effect of frailty and comorbidity on surgical contraindication in patients with localized prostate cancer (FRART-PC Study). Urol Oncol 2020; 39:191.e1-191.e8. [PMID: 32684512 DOI: 10.1016/j.urolonc.2020.06.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/11/2020] [Accepted: 06/19/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To determine how frailty and comorbidities affect surgical contraindication in patients with localized prostate cancer (CaP). MATERIALS AND METHODS We evaluated the effects of frailty in 479 patients with localized CaP who were treated with robot-assisted radical prostatectomy (RARP), or radiotherapy (RT) eligible for surgery (RT-nonfrail), or those with RT ineligible for surgery due to frailty or comorbidity (RT-frail) from February 2017 to April 2020. We retrospectively compared the geriatric 8 screening (G8) scores between patients with surgical indications (RARP and RT-nonfrail groups) and those with surgical contraindications (RT-frail group). The effect of G8 score in the RT-frail groups was investigated using multivariate logistic regression analysis. We developed and validated a nomogram for surgical contraindication in patients with localized CaP. RESULTS The median age of patients was 70 years. There were 256, 60, and 163 patients in the RARP, RT-nonfrail, and RT-frail, respectively. The G8 score in the RARP and RT-nonfrail groups was significantly higher than in the RT-frail group (15 vs. 14, respectively, P < 0.001). Age, comorbidities (cerebrocardiovascular disease or chronic respiratory disease), and G8 score were significantly associated with the RT-frail group. The nomogram showed that the area under the curve was 0.872 and 0.923 in the training and validation sets, respectively. The cutoff for surgical contraindication was >39.5%. CONCLUSIONS The G8 score and comorbidities have a significant effect on surgical contraindication in patients with localized CaP.
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Affiliation(s)
- Hirotake Kodama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shingo Hatakeyama
- Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
| | - Masaki Momota
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Kyo Togashi
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tomoko Hamaya
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Itsuto Hamano
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Naoki Fujita
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yuta Kojima
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Teppei Okamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tohru Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | | | - Takahiro Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yasuhiro Hashimoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Momota M, Hatakeyama S, Soma O, Tanaka T, Hamano I, Fujita N, Okamoto T, Yoneyama T, Yamamoto H, Imai A, Yoshikawa K, Yoneyama T, Hashimoto Y, Ohyama C. Geriatric 8 screening of frailty in patients with prostate cancer. Int J Urol 2020; 27:642-648. [PMID: 32500621 DOI: 10.1111/iju.14256] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 03/31/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To evaluate the association between the score of the Geriatric 8 screening tool and treatment by disease stages in patients with prostate cancer. METHODS Between January 2017 and June 2019, we prospectively evaluated the Geriatric 8 in 540 prostate cancer patients who were treated with robot-assisted radical prostatectomy, radiotherapy, androgen deprivation therapy alone and standard of care for metastatic hormone-naïve prostate cancer or castration-resistant prostate cancer. The primary purpose was the association between frailty (Geriatric 8 ≤14) and robot-assisted radical prostatectomy, radiotherapy, androgen deprivation therapy alone, and metastatic diseases. Secondary purposes included a comparison of the Geriatric 8 scores among the disease status and the influence of Geriatric 8 score on overall survival. RESULTS The median age was 75 years. Geriatric 8 scores ≤14 were seen in 36% of robot-assisted radical prostatectomy (n = 78/214), 57% of radiotherapy (n = 119/209), 91% of androgen deprivation therapy alone (n = 19/21) and 70% of metastatic diseases (n = 67/96). The median Geriatric 8 score in patients treated with robot-assisted radical prostatectomy, radiotherapy, androgen deprivation therapy alone and metastatic diseases was 15.0, 14.0, 12.0 and 12.8, respectively. The median Geriatric 8 score was significantly higher in the metastatic disease than that in localized disease (14.5 vs 12.8, respectively). Robot-assisted radical prostatectomy patients had a significantly higher Geriatric 8 score than radiotherapy patients, with the cut-off value of <14.5. The overall survival was significantly different between Geriatric 8 scores ≤13 and >13 in metastatic hormone-naïve prostate cancer patients, and between Geriatric 8 scores ≤12 and >12 in castration-resistant prostate cancer patients. CONCLUSION The Geriatric 8 score is significantly associated with treatment by disease stages in patients with prostate cancer.
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Affiliation(s)
- Masaki Momota
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shingo Hatakeyama
- Department of, Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Osamu Soma
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Toshikazu Tanaka
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Itsuto Hamano
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Naoki Fujita
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Teppei Okamoto
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tohru Yoneyama
- Department of, Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hayato Yamamoto
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Atsushi Imai
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | | | - Takahiro Yoneyama
- Department of, Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yasuhiro Hashimoto
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Chikara Ohyama
- Departments of, Department of, Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of, Advanced Blood Purification Therapy, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of, Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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A cost-effective and rapid aptasensor with chemiluminescence detection for the early diagnosis of prostate cancer. Microchem J 2020. [DOI: 10.1016/j.microc.2020.104763] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Momota M, Hatakeyama S, Soma O, Hamano I, Fujita N, Okamoto T, Togashi K, Hamaya T, Yoneyama T, Yamamoto H, Yoneyama T, Hashimoto Y, Ohyama C. Frailty is a predictor of moderate to severe pain after robot‐assisted laparoscopic prostatectomy: A case‐control study (FRAP study). BJUI COMPASS 2020; 1:100-107. [PMID: 35474865 PMCID: PMC8988788 DOI: 10.1002/bco2.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/02/2020] [Accepted: 04/11/2020] [Indexed: 02/06/2023] Open
Abstract
Objective To investigate the association of pain with frailty in patients with localized prostate cancer (PC) who underwent robot‐assisted laparoscopic radical prostatectomy (RARP). Materials and Methods Between January 2017 and June 2019, we prospectively evaluated the geriatric 8 (G8) score, simplified frailty index (sFI), and numerical rating scale (NRS) of 154 patients with localized PC who underwent RARP at our institution. NRS was measured on preoperative day 0, postoperative days 1, 2, 3, and at discharge. Moderate to severe pain was defined as NRS ≥ 5, whereas frailty was defined as G8 ≤ 14. The primary objectives of this study were to investigate the effects of moderate to severe pain (NRS ≥ 5) on frailty, postoperative complications, and the use of analgesics after RARP. Our secondary objectives were the effect of frailty on postoperative complications and the use of analgesics. Results The median age of participants was 69 years. Of 154 patients, 37 (24%) and 61 (40%) were classified to have NRS ≥ 5 and G8 ≤ 14, respectively. Patients with NRS > 5 presented significantly association with G8 < 14, whereas they did not show the association with sFI, complication, or analgesics. Multivariate logistic regression analysis showed that G8 ≤ 14 was significantly associated with NRS ≥ 5. Frailty was not significantly associated with postoperative complications and analgesics. Conclusions Frailty was significantly associated with moderate to severe pain after RARP, and might be a potential predictor of postoperative pain. Frail patients require individual care to avoid painful experiences.
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Affiliation(s)
- Masaki Momota
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Shingo Hatakeyama
- Department of Advanced Blood Purification TherapyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Osamu Soma
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Itsuto Hamano
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Naoki Fujita
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Teppei Okamoto
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Kyo Togashi
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Tomoko Hamaya
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Tohru Yoneyama
- Department of Advanced Transplant and Regenerative MedicineHirosaki University Graduate School of MedicineHirosakiJapan
| | - Hayato Yamamoto
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Takahiro Yoneyama
- Department of Advanced Transplant and Regenerative MedicineHirosaki University Graduate School of MedicineHirosakiJapan
| | - Yasuhiro Hashimoto
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Chikara Ohyama
- Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
- Department of Advanced Blood Purification TherapyHirosaki University Graduate School of MedicineHirosakiJapan
- Department of Advanced Transplant and Regenerative MedicineHirosaki University Graduate School of MedicineHirosakiJapan
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Serum N-glycan profiling is a potential biomarker for castration-resistant prostate cancer. Sci Rep 2019; 9:16761. [PMID: 31727974 PMCID: PMC6856113 DOI: 10.1038/s41598-019-53384-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 10/31/2019] [Indexed: 12/20/2022] Open
Abstract
We investigated the diagnostic and prognostic potential of serum N-glycan profiling for castration-resistant prostate cancer (CRPC). We retrospectively investigated serum N-glycan structural analysis by glycoblotting for 287 patients with benign prostatic hyperplasia (BPH), 289 patients with newly diagnosed prostate cancer (PC), 57 patients with PC treated with androgen-deprivation therapy without disease progression (PC-ADT), and 60 patients with CRPC. N-Glycan profiling was compared between the non-CRPC (BPH, newly diagnosed PC and PC-ADT) and CRPC patients. We obtained the quantitative score for CRPC (CRPC N-glycan score) by discriminant analysis based on the combination of 9 N-glycans that were significantly associated with CRPC. The median CRPC N-glycan score was found to be significantly greater in CRPC patients than in non-CRPC patients. The CRPC N-glycan score could classify CRPC patients with sensitivity, specificity, and area under the curve of 87%, 69%, and 0.88, respectively. The CRPC N-glycan score >1.7 points was significantly associated with poor prognosis in patients with CRPC. The glycoprotein analysis showed that not immunoglobulins but α-1-acid glycoprotein (AGP) were a potential candidate for the carrier protein of N-glycans. The overexpression of specific N-glycans may be associated with their castration-resistant status and be a potential biomarker for CRPC.
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