Benefits of early salvage therapy on oncological outcomes in high-risk prostate cancer with persistent PSA after radical prostatectomy

BACKGROUND

Patients with prostate-specific antigen (PSA) persistence are at the increased risk of disease progression. The aim of our study was to evaluate the impact of early salvage therapy on oncological outcomes in patients with persistent PSA after radical prostatectomy (RP).

METHODS

Within a single tertiary centre database, we identified men with persistent (≥ 0.1 ng/ml) versus undetectable (< 0.1 ng/ml) PSA 4-8 weeks after RP for high-risk prostate cancer (HRPCa). The cumulative incidence function was used to estimate cancer-specific survival (CSS) and clinical progression-free survival (CPFS). The Kaplan-Meier method was used to estimate overall survival (OS). The effects on oncological outcomes of salvage radiotherapy (SRT) ± androgen deprivation therapy (ADT) vs. ADT monotherapy were tested in the subgroup of patients with persistent PSA.

RESULTS

Of 414 consecutive patients who underwent RP for HRPC, 125 (30.2%) had persistent PSA. Estimated 10-year CPFS, CSS and OS for men with persistent vs. undetectable PSA were 63.8% vs. 93.5%, 78.5% vs. 98.3% and 54% vs. 83.2% (all p < 0.0001), respectively. In men with persistent PSA, ADT alone was associated with higher risk (hazard ratio (HR) for worse CSS (HR 3.9, p = 0.005) and OS (HR 4.7, p < 0.0001) but not for CP (HR 1.6, p = 0.2) when compared with SRT ± ADT.

CONCLUSION

In patients who underwent RP for HRPCa, persistent PSA was associated with poor oncological outcomes. Early SRT ± ADT resulted in significantly improved CSS and OS in men with persistent PSA comparing with early androgen deprivation monotherapy.

Diversity, not uniformity: slaughter and electrical waterbath stunning procedures in Belgian slaughterhouses

Data on slaughter and stunning protocols in Belgian poultry abattoirs were collected, and subsequently the survival rate after electrical waterbath stunning in 1,400 animals across 7 selected slaughterhouses was determined. The majority of the abattoirs applied electrical waterbath stunning (72%), whereas the other methods were gas stunning (13%), head-only stunning (6%), and dry stunning (3%). In 6% of the slaughterhouses, the birds were killed without previous stunning, according to religious rites (i.e., ritual or religious slaughter). Although religious slaughter occurred in a substantial number of abattoirs, the customers of the majority of them allowed stunning, provided the animals were not killed by the stunning procedure. Substantial variation both in electrical waterbath devices and technical settings (electrical current type, wave type, voltage, frequency) combinations was observed. These settings did not only differ between slaughterhouses, but also between subsequent visits to the same slaughterhouse. Despite this variation, all systems comprised a constant voltage, multiple bird stunner. The minimum average electrical current that every chicken should receive at a certain frequency, as stated by the European Regulation No 1099/2009, was not achieved for each animal monitored due to the bird's characteristics and the different applied stunning settings, with the exception of all ISA laying hens and broiler breeders in one particular slaughterhouse. The survival rate ranged from 96.0 to 100%, 97.0 to 100%, 68.0%, 72.0 to 85.1%, and 5.6 to 52.4% in 5-wk-old broilers, 6-wk-old broilers, LSL laying hens, ISA laying hens, and broiler breeders, respectively. Monitoring of unconsciousness after passing through the waterbath was not always performed and when it was, there was no uniformity in the applied criteria. It was concluded that a large variation in slaughter and stunning practices exists among slaughterhouses in Belgium. Further research should explore the effect of the different settings on inducing a successful stun and on carcass quality, and assess if the observed variation also exists in other EU member states.

High seroprevalence of respiratory pathogens in hobby poultry

Seroprevalence studies on respiratory pathogens have been done extensively in commercial laying hens, broilers, and, to a lesser extent, backyard poultry. In Europe, seroprevalence studies in backyard and fancy breed poultry flocks are scarce and limited to a few pathogens, such as Mycoplasma gallisepticum (MG); others, such as Ornithobacterium rhinotracheale (ORT), are missing. A commercial ELISA for detection of antibodies against six selected pathogens was performed on 460 serum samples from chickens across Flanders. Anti-ORT antibodies were, by far, the most prevalent, with a prevalence of 95.4%. Infectious bronchitis virus, Mycoplasma synoviae, and avian metapneumovirus antibodies were found in 75.6%, 76.3%, and 63.5% of the animals, respectively. Antibodies against MG and infectious laryngotracheitis virus were found in 36.7% and 30% of the animals, respectively. These data demonstrate the high seroprevalence of respiratory pathogens among hobby poultry; therefore, it is possible that this group could act as a reservoir for commercially kept poultry.

Auxin influx activity is associated with Frankia infection during actinorhizal nodule formation in Casuarina glauca

Plants from the Casuarinaceae family enter symbiosis with the actinomycete Frankia leading to the formation of nitrogen-fixing root nodules. We observed that application of the auxin influx inhibitor 1-naphtoxyacetic acid perturbs actinorhizal nodule formation. This suggests a potential role for auxin influx carriers in the infection process. We therefore isolated and characterized homologs of the auxin influx carrier (AUX1-LAX) genes in Casuarina glauca. Two members of this family were found to share high levels of deduced protein sequence identity with Arabidopsis (Arabidopsis thaliana) AUX-LAX proteins. Complementation of the Arabidopsis aux1 mutant revealed that one of them is functionally equivalent to AUX1 and was named CgAUX1. The spatial and temporal expression pattern of CgAUX1 promoter:beta-glucuronidase reporter was analyzed in Casuarinaceae. We observed that CgAUX1 was expressed in plant cells infected by Frankia throughout the course of actinorhizal nodule formation. Our data suggest that auxin plays an important role during plant cell infection in actinorhizal symbioses.