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Hagens MJ, Ribbert LLA, Jager A, Veerman H, Barwari K, Boodt B, de Bruijn RE, Claessen A, Leter MR, van der Noort V, Smeenge M, Roeleveld TA, Rynja SP, Schaaf M, Weltings S, Vis AN, Bekers E, van Leeuwen PJ, van der Poel HG. Histopathological concordance between prostate biopsies and radical prostatectomy specimens-implications of transrectal and transperineal biopsy approaches. Prostate Cancer Prostatic Dis 2023:10.1038/s41391-023-00714-x. [PMID: 37660218 DOI: 10.1038/s41391-023-00714-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/01/2023] [Accepted: 08/18/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND This study aimed to evaluate the histopathological concordance rates between prostate biopsies and radical prostatectomy specimens according to the applied biopsy approach (transrectal or transperineal). METHODS We studied patients who had been newly diagnosed with clinically significant prostate cancer and who underwent a radical prostatectomy between 2018 and 2022. Patients were included if they underwent a prebiopsy magnetic resonance imaging and if they had not been previously treated for prostate cancer. Histopathological grading on prostate biopsies was compared with that on radical prostatectomy specimens. Univariable and multivariable logistic regression analyses were performed to assess the effect of the applied biopsy approach on histopathological concordance. Additional analyses were performed to assess the effect of the applied biopsy approach on American Urological Association risk group migration, defined as any change in risk group after radical prostatectomy. RESULTS In total, 1058 men were studied, of whom 49.3% (522/1058) and 50.7% (536/1058) underwent transrectal and transperineal prostate biopsies, respectively. Histopathological disconcordance was observed in 37.8% (400/1058) of men while American Urological Association risk group migration was observed in 30.2% (320/1058) of men. A transperineal biopsy approach was found to be independently associated with higher histopathological concordance rates (OR 1.33 [95% CI 1.01-1.75], p = 0.04) and less American Urological Association risk group migration (OR 0.70 [95% CI 0.52-0.93], p = 0.01). CONCLUSIONS The use of a transperineal biopsy approach improved histopathological concordance rates compared to the use of a transrectal biopsy approach. A transperineal biopsy approach may provide more accurate risk stratification for clinical decision-making. Despite recent improvements, histopathologic concordance remains suboptimal and should be considered before initiating management.
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Affiliation(s)
- M J Hagens
- Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
- Department of Urology, Amsterdam University Medical Centers location Boelelaan, Amsterdam, the Netherlands.
- Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands.
| | - L L A Ribbert
- Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - A Jager
- Department of Urology, Amsterdam University Medical Centers location Boelelaan, Amsterdam, the Netherlands
- Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands
| | - H Veerman
- Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Urology, Amsterdam University Medical Centers location Boelelaan, Amsterdam, the Netherlands
- Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands
| | - K Barwari
- Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands
- Department of Urology, Andros Clinics, Amsterdam, the Netherlands
| | - B Boodt
- Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands
- Department of Urology, Flevoziekenhuis, Almere, the Netherlands
| | - R E de Bruijn
- Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands
- Department of Urology, Ziekenhuis Amstelland, Amstelveen, the Netherlands
| | - A Claessen
- Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands
- Department of Urology, Rode Kruis Ziekenhuis, Beverwijk, the Netherlands
| | - M R Leter
- Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands
- Department of Urology, Dijklander Ziekenhuis, Hoorn, the Netherlands
| | - V van der Noort
- Department of Statistics, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - M Smeenge
- Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands
- Department of Urology, St Jansdal Ziekenhuis, Harderwijk, the Netherlands
| | - T A Roeleveld
- Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands
- Department of Urology, Noordwest Ziekenhuisgroep, Alkmaar, the Netherlands
| | - S P Rynja
- Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands
- Department of Urology, Spaarne Gasthuis, Hoofddorp, the Netherlands
| | - M Schaaf
- Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands
- Department of Urology, BovenIJ Ziekenhuis, Amsterdam, the Netherlands
| | - S Weltings
- Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands
- Department of Urology, Zaans Medisch Centrum, Zaandam, the Netherlands
| | - A N Vis
- Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Urology, Amsterdam University Medical Centers location Boelelaan, Amsterdam, the Netherlands
- Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands
| | - E Bekers
- Department of Pathology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - P J van Leeuwen
- Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Urology, Amsterdam University Medical Centers location Boelelaan, Amsterdam, the Netherlands
| | - H G van der Poel
- Department of Urology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Urology, Amsterdam University Medical Centers location Boelelaan, Amsterdam, the Netherlands
- Prostate Cancer Network the Netherlands, Amsterdam, the Netherlands
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Bodar Y, Koene B, Meijer D, van Leeuwen PJ, Nadorp S, Donswijk ML, Hendrikse NH, Oprea-Lager DE, Vis AN. Determining the diagnostic value of PSMA-PET/CT imaging in patients with persistent high prostate specific antigen levels and negative prostate biopsies. Urol Oncol 2021; 40:58.e1-58.e7. [PMID: 34404590 DOI: 10.1016/j.urolonc.2021.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/04/2021] [Accepted: 07/02/2021] [Indexed: 12/09/2022]
Abstract
PURPOSE To assess the diagnostic performance of prostate specific membranous antigen (PSMA) positron emission tomography/computed tomography (PET/CT) imaging to localize primary prostate cancer (PCa) in men with persistent elevated prostate-specific antigen (PSA) levels and previous prostate biopsies that were negative for PCa. METHODS In this study, 34 men with persistently elevated PSA-levels, previous negative for PCa biopsies and who subsequently underwent diagnostic PSMA-PET/CT imaging were retrospectively evaluated. Men were divided into 3 groups: 1. 12 men with a previous negative mpMRI scan (PI-RADS 1-2) 2. 17 men with a positive mpMRI scan (PI-RADS 3-5), but negative MRI-targeted biopsies and 3. Four men in whom mpMRI was contraindicated. If PSMA-avid lesions were seen, patients underwent 2-4 cognitive targeted biopsies in combination with systematic biopsies. The detection rate of PSMA-PET/CT for PCa, and the accuracy of (possible) targeted biopsies were calculated. RESULTS Included men had a median PSA-level of 22.8 ng/mL (Interquartile Range 15.6-30.0) at the time of PSMA-PET/CT. Elevated PSMA-ligand uptake in the prostate suspicious for PCa was observed in 22/34 patients (64.7%). In 18/22 patients (54.5%), PSMA-targeted prostate biopsies were performed. In 3/18 patients (16.6%), the targeted biopsies showed International Society of Urological Pathology (ISUP) score 1-2 PCa. The other men had inflammation or benign findings after histopathological examination of the biopsy cores. CONCLUSION In this study, the clinical value of PSMA-PET/CT for patients with an elevated PSA-level, and negative for PCa biopsies was low. Only very few men were diagnosed with PCa, and no clinically significant PCa was found.
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Affiliation(s)
- Yjl Bodar
- Amsterdam University Medical Center, VU University, Department of Urology, Prostate Cancer Network The Netherlands, Amsterdam, Netherland; Amsterdam University Medical Center, VU University, Department of Radiology & Nuclear Medicine, Cancer Center Amsterdam, Amsterdam, Netherland.
| | - Bpf Koene
- Amsterdam University Medical Center, VU University, Department of Urology, Prostate Cancer Network The Netherlands, Amsterdam, Netherland
| | - D Meijer
- Amsterdam University Medical Center, VU University, Department of Urology, Prostate Cancer Network The Netherlands, Amsterdam, Netherland; Amsterdam University Medical Center, VU University, Department of Radiology & Nuclear Medicine, Cancer Center Amsterdam, Amsterdam, Netherland
| | - P J van Leeuwen
- The Netherlands Cancer Institute, Department of Urology, Prostate Cancer Network The Netherlands, Amsterdam, Netherland
| | - S Nadorp
- Amstelland Hospital, Department of Urology, Prostate Cancer Network The Netherlands, Amsterdam, Netherland
| | - M L Donswijk
- The Netherlands Cancer Institute, Department of Radiology and Nuclear Medicine, Prostate Cancer Network The Netherlands, Amsterdam, Netherland
| | - N H Hendrikse
- Amsterdam University Medical Center, VU University, Department of Radiology & Nuclear Medicine, Cancer Center Amsterdam, Amsterdam, Netherland; Amsterdam University Medical Center, VU University, Department of Clinical Pharmacology and Pharmacy, Amsterdam, Netherland
| | - D E Oprea-Lager
- Amsterdam University Medical Center, VU University, Department of Radiology & Nuclear Medicine, Cancer Center Amsterdam, Amsterdam, Netherland
| | - A N Vis
- Amsterdam University Medical Center, VU University, Department of Urology, Prostate Cancer Network The Netherlands, Amsterdam, Netherland
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Hagens MJ, Veerman H, de Ligt KM, Tillier CN, van Leeuwen PJ, van Moorselaar RJA, van der Poel HG. Functional outcomes rather than complications predict poor health-related quality of life at 6 months after robot-assisted radical prostatectomy. J Robot Surg 2021; 16:453-462. [PMID: 34120255 DOI: 10.1007/s11701-021-01266-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/09/2021] [Indexed: 11/29/2022]
Abstract
The objective is to evaluate the effect of robot-assisted radical prostatectomy (RARP)-related postoperative complications on the 6-month postoperative health-related quality of life (HRQoL). A total of 1008 patients underwent a RARP with or without pelvic lymph node dissection (PLND) between 2012 and 2020 and were invited to complete questionnaires about HRQoL and functional outcomes (urinary incontinence (UI), erectile dysfunction (ED) and urinary complaints (UC)) before and 6 months after RARP. Patient characteristics and postoperative complications up to 90 days after surgery were prospectively recorded. Associations between complications and HRQoL/functional outcomes were assessed by multivariate linear regression analyses. In total, 528 patients (52.4%) were included in the analyses. Complications occurred in 165/528 (31.3%) patients, of which 30/165 (18.2%) had a Clavien-Dindo ≥ III complication. In multivariate regression analyses, postoperative complications were not significantly associated with postoperative HRQoL, UI and ED (p = 0.73, p = 0.72 and p = 0.95, respectively), but were significantly associated with a minor increase in UC (β = 1.7, p < 0.001). More specifically, infectious and urological complications were significantly associated with an increase in UC (β = 1.9, p < 0.001 and β = 0.9, p = 0.004, respectively). The presence of UTI, in particular, was significantly associated with this minor increase (β = 1.5, p = 0.002). Functional outcomes were all significantly associated with the HRQoL at 6 months postoperatively. No significant associations were found between postoperative complications and HRQoL at 6 months after RARP. However, worse functional outcomes were associated with a worse HRQoL at 6 months postoperatively. In addition, postoperative infectious and urological complications were significantly associated with a minor increase in UC.
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Affiliation(s)
- Marinus J Hagens
- Department of Urology, Antoni van Leeuwenhoek Hospital (NCI-AVL), Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. .,Department of Urology, Amsterdam University Medical Centers Location VUmc, Amsterdam, The Netherlands. .,Prostate Cancer Network, Amsterdam, The Netherlands.
| | - H Veerman
- Department of Urology, Antoni van Leeuwenhoek Hospital (NCI-AVL), Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Department of Urology, Amsterdam University Medical Centers Location VUmc, Amsterdam, The Netherlands.,Prostate Cancer Network, Amsterdam, The Netherlands
| | - K M de Ligt
- Division of Psychosocial Research and Epidemiology, Department of Psychosocial Research, Antoni van Leeuwenhoek Hospital (NCI-AVL), Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C N Tillier
- Department of Urology, Antoni van Leeuwenhoek Hospital (NCI-AVL), Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - P J van Leeuwen
- Department of Urology, Antoni van Leeuwenhoek Hospital (NCI-AVL), Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Prostate Cancer Network, Amsterdam, The Netherlands
| | - R J A van Moorselaar
- Department of Urology, Amsterdam University Medical Centers Location VUmc, Amsterdam, The Netherlands.,Prostate Cancer Network, Amsterdam, The Netherlands
| | - H G van der Poel
- Department of Urology, Antoni van Leeuwenhoek Hospital (NCI-AVL), Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.,Prostate Cancer Network, Amsterdam, The Netherlands
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van Doeveren T, van Leeuwen PJ, Aben KKH, van der Aa M, Barendrecht M, Boevé ER, Cornel EB, van der Heijden AG, Hendricksen K, Hirdes W, Kooistra A, Kroon B, Leliveld AM, Meijer RP, van Melick H, Merks B, de Reijke TM, de Vries P, Wymenga LFA, Wijsman B, Boormans JL. Reduce bladder cancer recurrence in patients treated for upper urinary tract urothelial carcinoma: The REBACARE-trial. Contemp Clin Trials Commun 2018; 9:121-129. [PMID: 29696234 PMCID: PMC5898538 DOI: 10.1016/j.conctc.2018.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 01/15/2018] [Accepted: 01/19/2018] [Indexed: 11/28/2022] Open
Abstract
Background Following radical nephro-ureterectomy for urothelial carcinoma of the upper urinary tract (UUT), the reported bladder recurrence rate of urothelial carcinoma is 22–47%. A single intravesical instillation of chemotherapy within 10 days following nephro-ureterectomy has the potential to decrease the risk of a bladder recurrence significantly. Despite recommendation by the European Association of Urology guideline to administer a single instillation postoperatively, the compliance rate is low because the risk of extravasation of chemotherapy. Aim To reduce the risk of bladder cancer recurrence by a single intravesical instillation of Mitomycin immediately (within 3 h) before radical nephro-ureterectomy or partial ureterectomy. Methods Adult patients (age ≥ 18 years) with a (suspicion of a) urothelial carcinoma of the UUT undergoing radical nephro-ureterectomy or partial ureterectomy will be eligible and will receive a single intravesical instillation of Mitomycin within 3 h before surgery. In total, 170 patients will be included in this prospective, observational study. Follow-up will be according to current guidelines. Results The primary endpoint is the bladder cancer recurrence rate up to two years after surgery. Secondary endpoints are: a) the compliance rate; b) oncological outcome; c) possible side-effects; d) the quality of life; e) the calculation of costs of a single neoadjuvant instillation with Mitomycin and f) molecular characterization of UUT tumors and intravesical recurrences. Conclusions A single intravesical instillation of Mitomycin before radical nephro-ureterectomy or partial ureterectomy may reduce the risk of a bladder recurrence in patients treated for UUT urothelial carcinoma and will circumvent the disadvantages of current therapy.
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Affiliation(s)
- T van Doeveren
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - P J van Leeuwen
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - K K H Aben
- Netherlands Comprehensive Cancer Organisation, The Netherlands.,Radboud University Medical Center, Nijmegen, The Netherlands
| | - M van der Aa
- Spaarne Medical Center, Hoofddorp, The Netherlands
| | | | - E R Boevé
- Fransiscus Medical Center, Rotterdam, The Netherlands
| | - E B Cornel
- Ziekenhuis Groep Twente, Almelo and Hengelo, The Netherlands
| | | | - K Hendricksen
- Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - W Hirdes
- Isala Medical Center, Zwolle, The Netherlands
| | - A Kooistra
- Meander Medical Center, Amersfoort, The Netherlands
| | - B Kroon
- Rijnstate Medical Center, Arnhem, The Netherlands
| | - A M Leliveld
- University Medical Center Groningen, Groningen, The Netherlands
| | - R P Meijer
- University Medical Center Utrecht, Utrecht, The Netherlands
| | - H van Melick
- Sint Antonius Medical Center, Nieuwegein, The Netherlands
| | - B Merks
- Haaglanden Medical Center, Leidschendam, The Netherlands
| | | | - P de Vries
- Zuyderland Medical Center, Heerlen, The Netherlands
| | | | - B Wijsman
- Elisabeth-TweeSteden Medical Center, Tilburg, The Netherlands
| | - J L Boormans
- Erasmus University Medical Center, Rotterdam, The Netherlands
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Zhu X, Bul M, van Leeuwen PJ, Roobol MJ, Schröder FH. Under- and upgrading of prostate cancer after radical prostatectomy in a screening setting. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
105 Background: It has been well established that there is an upward drift in assigned Gleason score (GS) to prostate cancer (PC) biopsies. However, few studies have examined the concordance between biopsy GS and pathological GS after radical prostatectomy (RP) in a screening setting over time. We assessed the proportion of under and upgrading of PC after RP by comparing the prevalence screen with the incidence screens from the European Randomized Study of Screening for Prostate Cancer (ERSPC), section Rotterdam. Methods: From 1993 to 1999, a total of 42.376 men identified from population registries in the Rotterdam region (55-74 yrs) were randomized into a screening or control arm. Men with PSA ≥3.0 ng/ml were recommended for sextant prostate biopsy, which were lateralized since 1996. The screening interval was 4 yrs. Men with screen-detected PC, who underwent RP within 1 yr, were eligible for this study. Results: In all, biopsy and pathological GS were known for 639 men who underwent RP. Of these RPs, 405 were performed between 1994 and 2000 (prevalence screen) whereas 235 cases were performed between 1998 and 2008 (incidence screens). In the prevalence screen, 49.8% of the biopsy GS matched the pathological GS ( Table ). This percentage improved to 58.3% in the incidence screens (p=0.045). The proportion of undergrading after RP was 23.0% in the prevalence screen, which declined to 16.2% in the incidence screens (p=0.049). Upgrading occurred in 27.2% of the cases in the prevalence and 25.5% in the incidence screens (p=0.71). Conclusions: We have demonstrated an improved concordance between biopsy and pathological GS over time by comparing cancers detected in the prevalence screen with those detected in the incidence screens, which is in line with the upward shift of GS classification over time. In addition, significant less undergrading occurred in the incidence screens. However, one should keep in mind that within this screening program still a quarter of the biopsy GS were upgraded after RP in the incidence screens. [Table: see text] [Table: see text]
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Affiliation(s)
- X. Zhu
- Erasmus Medical Centre, Rotterdam, Netherlands
| | - M. Bul
- Erasmus Medical Centre, Rotterdam, Netherlands
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Bul M, van Leeuwen PJ, Zhu X, Schröder FH, Roobol MJ. Prostate cancer incidence and disease-specific survival in men participating in the ERSPC with an initial PSA less than 3.0 ng/mL. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7 Background: The European Randomized Study of Screening for Prostate Cancer (ERSPC) applies a prostate- specific antigen (PSA) cut-off >3.0 ng/mL as an indication for biopsy. We analyzed the incidence and disease-specific mortality for prostate cancer (PC) within ERSPC Rotterdam for men with an initial PSA <3.0 ng/ml in a 15-year follow-up period. Methods: From 1993-1999, a total of 42,376 men identified from population registries in the Rotterdam region (55-74 yrs) were randomized to a screening or control arm. During the first screening round 19,950 men were screened, with biopsies being initially recommended in case of abnormal DRE or PSA >4.0 ng/mL. From 1997 on, solely PSA >3.0 ng/mL was used. The screening interval was 4 yrs. A total of 15,758 men (79%) had an initial PSA <3.0 ng/mL. Follow-up was complete until January 2009. Results: From 1993-2008, 915 PC cases were diagnosed in 15,758 men (5.8%, median age 62.3 yrs) with an initial PSA <3.0 ng/mL (733 screen detected and 182 interval detected). Median follow-up was 11 yrs. PC incidence increased significantly with higher initial PSA levels (Table). Aggressive PC (clinical stage >T2c, Gleason score >8, PSA >20 ng/mL, positive lymph nodes or metastases at diagnosis) was detected in 65/733 screen detected PC (8.9%) and 102/182 interval detected PC (56.0%). PC death occurred in 23 cases (5 screen detected and 18 interval detected) in the total population (0.15%), with increasing risk in men with higher initial PSA values. Conclusions: The risk of (aggressive) PC and PC mortality in a screening population with initial PSA <3.0 ng/mL increases significantly with higher PSA levels. The risk of dying of PC is minor in men with initial PSA <1.0 ng/mL. Interval detected PC is more aggressive and has a substantial influence on PC specific mortality. [Table: see text] [Table: see text]
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Affiliation(s)
- M. Bul
- Erasmus Medical Centre, Rotterdam, Netherlands
| | | | - X. Zhu
- Erasmus Medical Centre, Rotterdam, Netherlands
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Connolly D, van Leeuwen PJ, Bailie J, Black A, Murray LJ, Keane PF, Gavin A. Daily, monthly and seasonal variation in PSA levels and the association with weather parameters. Prostate Cancer Prostatic Dis 2010; 14:58-62. [PMID: 20975738 DOI: 10.1038/pcan.2010.37] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PSA levels have shown daily and seasonal variation, although data are conflicting regarding the season with higher PSA levels and the clinical relevance of this. We assessed the correlation of total PSA levels with meteorological data on a daily, weekly, monthly and seasonal basis. Data from 53,224 men aged 45-74 years, with an initial PSA <10.0 ng ml(-1) were correlated with temperature (°C), duration of bright sunshine (hours) and rainfall (mm). There was seasonal variation in PSA levels, with median PSA being higher in spring compared with other seasons (1.18 vs 1.10 ng ml(-1), P = 0.004). Seasonal variation was not apparent when PSA levels were age-adjusted (P = 0.112). Total PSA was not correlated with daily, weekly or monthly hours of sunshine, rainfall or mean temperature. In contrast, age-adjusted PSA varied with weekday, with higher PSA levels on Thursday and Friday compared with other days (1.16 vs 1.10 ng ml(-1), respectively). On multivariate analysis, only age predicted for PSA levels >3.0 ng ml(-1). In conclusion, PSA levels did show seasonal variation, although there was no direct correlation between PSA and any meteorological parameter. The degree of seasonal variation is small and the decision to proceed to prostate biopsy should be independent of season or weather parameters.
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Affiliation(s)
- D Connolly
- Department of Urology, Belfast City Hospital, Belfast, Northern Ireland, UK.
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Ridderinkhof H, van der Werf PM, Ullgren JE, van Aken HM, van Leeuwen PJ, de Ruijter WPM. Seasonal and interannual variability in the Mozambique Channel from moored current observations. ACTA ACUST UNITED AC 2010. [DOI: 10.1029/2009jc005619] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Carsin AE, Drummond FJ, Black A, van Leeuwen PJ, Sharp L, Murray LJ, Connolly D, Egevad L, Boniol M, Autier P, Comber H, Gavin A. Impact of PSA testing and prostatic biopsy on cancer incidence and mortality: comparative study between the Republic of Ireland and Northern Ireland. Cancer Causes Control 2010; 21:1523-31. [PMID: 20514514 DOI: 10.1007/s10552-010-9581-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2010] [Accepted: 05/08/2010] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To investigate the impact of different PSA testing policies and health-care systems on prostate cancer incidence and mortality in two countries with similar populations, the Republic of Ireland (RoI) and Northern Ireland (NI). METHODS Population-level data on PSA tests, prostate biopsies and prostate cancer cases 1993-2005 and prostate cancer deaths 1979-2006 were compiled. Annual percentage change (APC) was estimated by joinpoint regression. RESULTS Prostate cancer rates were similar in both areas in 1994 but increased rapidly in RoI compared to NI. The PSA testing rate increased sharply in RoI (APC = +23.3%), and to a lesser degree in NI (APC = +9.7%) to reach 412 and 177 tests per 1,000 men in 2004, respectively. Prostatic biopsy rates rose in both countries, but were twofold higher in RoI. Cancer incidence rates rose significantly, mirroring biopsy trends, in both countries reaching 440 per 100,000 men in RoI in 2004 compared to 294 in NI. Median age at diagnosis was lower in RoI (71 years) compared to NI (73 years) (p < 0.01) and decreased significantly over time in both countries. Mortality rates declined from 1995 in both countries (APC = -1.5% in RoI, -1.3% in NI) at a time when PSA testing was not widespread. CONCLUSIONS Prostatic biopsy rates, rather than PSA testing per se, were the main driver of prostate cancer incidence. Because mortality decreases started before screening became widespread in RoI, and mortality remained low in NI, PSA testing is unlikely to be the explanation for declining mortality.
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Affiliation(s)
- A-E Carsin
- National Cancer Registry Ireland, Cork, Ireland.
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van der Werf PM, van Leeuwen PJ, Ridderinkhof H, de Ruijter WPM. Comparison between observations and models of the Mozambique Channel transport: Seasonal cycle and eddy frequencies. ACTA ACUST UNITED AC 2010. [DOI: 10.1029/2009jc005633] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Palastanga V, van Leeuwen PJ, Schouten MW, de Ruijter WPM. Flow structure and variability in the subtropical Indian Ocean: Instability of the South Indian Ocean Countercurrent. ACTA ACUST UNITED AC 2007. [DOI: 10.1029/2005jc003395] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Palastanga V, van Leeuwen PJ, de Ruijter WPM. A link between low-frequency mesoscale eddy variability around Madagascar and the large-scale Indian Ocean variability. ACTA ACUST UNITED AC 2006. [DOI: 10.1029/2005jc003081] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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van Leeuwen PJ, Bos RP, Derksen JC, de Vries J. Assessment of spinal movement reduction by thoraco-lumbar-sacral orthoses. J Rehabil Res Dev 2000; 37:395-403. [PMID: 11028695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Bracing is a common modality in treating spinal fractures. Its objective is to reduce spinal movements and to stabilize the fracture. Until now, factual insight into the movement-reducing properties of Thoraco-Lumbar-Sacral Orthoses (TLSOs) has been missing. Two common TLSOs (e.g., Jewett and Voigt-Bähler) were tested for their movement-reducing properties in two small groups of healthy subjects. In the first study, maximal gross spinal movements, with and without a TLSO, were measured by means of a Portable Posture Registration Set (PPRS) in three different planes. In the second study, maximal segmental vertebral movements in the regions T10 to L4 were measured via X-rays. With few notable exceptions, wearing a TLSO, as measured by the PPRS and X-ray techniques, significantly reduced the segmental as well as gross spinal movements. However, the amount of movement reduction varied greatly from subject-to-subject and was sometimes small. Unfortunately, data are lacking on the amount of movement reduction that is clinically relevant.
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Affiliation(s)
- P J van Leeuwen
- Rehabilitation Center Blixembosch, Eindhoven, The Netherlands
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de Ruijter WPM, Biastoch A, Drijfhout SS, Lutjeharms JRE, Matano RP, Pichevin T, van Leeuwen PJ, Weijer W. Indian-Atlantic interocean exchange: Dynamics, estimation and impact. ACTA ACUST UNITED AC 1999. [DOI: 10.1029/1998jc900099] [Citation(s) in RCA: 271] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Feron RCV, De Ruijter WPM, van Leeuwen PJ. A new method to determine the mean sea surface dynamic topography from satellite altimeter observations. ACTA ACUST UNITED AC 1998. [DOI: 10.1029/97jc00389] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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van Leeuwen PJ, Heimann C, Gast P, Dekker JP, van Gorkom HJ. Flash-induced redox changes in oxygen-evolving spinach Photosystem II core particles. Photosynth Res 1993; 38:169-176. [PMID: 24317913 DOI: 10.1007/bf00146416] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/1993] [Accepted: 09/06/1993] [Indexed: 06/02/2023]
Abstract
Flash-induced redox reactions in spinach PS II core particles were investigated with absorbance difference spectroscopy in the UV-region and EPR spectroscopy. In the absence of artificial electron acceptors, electron transport was limited to a single turnover. Addition of the electron acceptors DCBQ and ferricyanide restored the characteristic period-four oscillation in the UV absorbance associated with the S-state cycle, but not the period-two oscillation indicative of the alternating appearance and disappearance of a semiquinone at the QB-site. In contrast to PS II membranes, all active centers were in state S1 after dark adaptation. The absorbance increase associated with the S-state transitions on the first two flashes, attributed to the Z(+)S1→ZS2 and Z(+)S2→ZS3 transitions, respectively, had half-times of 95 and 380 μs, similar to those reported for PS II membrane fragments. The decrease due to the Z(+)S3→ZS0 transition on the third flash had a half-time of 4.5 ms, as in salt-washed PS II membrane fragments. On the fourth flash a small, unresolved, increase of less than 3 μs was observed, which might be due to the Z(+)S0→ZS1 transition. The deactivation of the higher S-states was unusually fast and occurred within a few seconds and so was the oxidation of S0 to S1 in the dark, which had a half-time of 2-3 min. The same lifetime was found for tyrosine D(+), which appeared to be formed within milliseconds after the first flash in about 10% inactive centers and after the third and later flashes by active centers in Z(+)S3.
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Affiliation(s)
- P J van Leeuwen
- Department of Biophysics, Huygens Laboratory of the State University, P.O. Box 9504, 2300 RA, Leiden, The Netherlands
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van Leeuwen PJ, Heimann C, van Gorkom HJ. Absorbance difference spectra of the S-state transitions in Photosystem II core particles. Photosynth Res 1993; 38:323-330. [PMID: 24317986 DOI: 10.1007/bf00046757] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/1993] [Accepted: 09/15/1993] [Indexed: 06/02/2023]
Abstract
Redox changes of the oxygen evolving complex in PS II core particles were investigated by absorbance difference spectroscopy in the UV-region. The oscillation of the absorbance changes induced by a series of saturating flashes could not be explained by the minimal Kok model (Kok et al. 1970) consisting of a 4-step redox cycle, S0 → S1 → S2 → S3 → S0, although the values of most of the relevant parameters had been determined experimentally. Additional assumptions which allow a consistent fit of all data are a slow equilibration of the S3 state with an inactive state, perhaps related to Ca(2+)-release, and a low quantum efficiency for the first turnover after dark-adaptation. Difference spectra of the successive S-state transitions were determined. At wavelengths above 370 nm, they were very different due to the different contribution of a Chl bandshift in each spectrum. At shorter wavelengths, the S1 → S2 transition showed a difference spectrum similar to that reported by Dekker et al. 1984b and attributed to an Mn(III) to Mn(IV) oxidation. The spectrum of absorbance changes associated with the S2 → S3 transition was similar to that reported by Lavergne 1991 for PS II membranes. The S0 → S1 transition was associated with a smaller but still substantial absorbance increase in the UV. Differences with the spectra reported by Lavergne 1991 are attributed to electrostatic effects on electron transfer at the acceptor side associated with the S-state dependence of proton release in PS II membranes.
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Affiliation(s)
- P J van Leeuwen
- Department of Biophysics, Huygens Laboratory of the State University, P.O. Box 9504, 2300 RA, Leiden, The Netherlands
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van Leeuwen PJ, Nieveen MC, van de Meent EJ, Dekker JP, van Gorkom HJ. Rapid and simple isolation of pure photosystem II core and reaction center particles from spinach. Photosynth Res 1991; 28:149-53. [PMID: 24414974 DOI: 10.1007/bf00054128] [Citation(s) in RCA: 123] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/1991] [Accepted: 07/12/1991] [Indexed: 05/22/2023]
Abstract
Pure and active oxygen-evolving PS II core particles containing 35 Chl per reaction center were isolated with 75% yield from spinach PS II membrane fragments by incubation with n-dodecyl-β-D-maltoside and a rapid one step anion-exchange separation. By Triton X-100 treatment on the column these particles could be converted with 55% yield to pure and active PS II reaction center particles, which contained 6 Chl per reaction center.
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Affiliation(s)
- P J van Leeuwen
- Department of Biophysics, Huygens laboratory of the State University, P.O. Box 9504, 2300 RA, Leiden
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Abstract
The treatment of axillary-subclavian vein thrombosis is still controversial. Development of a post-phlebitic syndrome in patients treated conservatively occurs in many patients. Therefore more aggressive treatment is advocated. We report six patients treated with selective low-dose streptokinase infusion with excellent short-term results. Major complications did not occur. Recanalisation was observed in all patients. Long-term results are not yet available.
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