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Prostate Cancer Staging

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221. A Deep Belief Network and Dempster-Shafer-Based Multiclassifier for the Pathology Stage of Prostate Cancer Full Text available with Trip Pro

-) based multiclassifier for the pathologic prediction of prostate cancer. The DBN-DS learns prostate-specific antigen (PSA), Gleason score, and clinical T stage variable information using three DBNs. Uncertainty regarding the predicted output was removed from the DBN and combined with information from DS to make a correct decision.The new method was validated on pathology data from 6342 patients with prostate cancer. The pathology stages consisted of organ-confined disease (OCD; 3892 patients) and non (...) -organ-confined disease (NOCD; 2453 patients). The results showed that the accuracy of the proposed DBN-DS was 81.27%, which is higher than the 64.14% of the Partin table.The proposed DBN-DS is more effective than other methods in predicting pathology stage. The performance is high because of the linear combination using the results of pathology-related features. The proposed method may be effective in decision support for prostate cancer treatment.

2018 Journal of healthcare engineering

222. The performance of the new prognostic grade and stage groups in conservatively treated prostate cancer Full Text available with Trip Pro

The performance of the new prognostic grade and stage groups in conservatively treated prostate cancer We evaluated the prognosis of the new grade groups and American Joint Committee on Cancer (AJCC) stage groups in men with prostate cancer (PCa) who were treated conservatively. A total of 13 798 eligible men were chosen from the Surveillance Epidemiology and End Results database. The new grade and AJCC stage groups were investigated on prostate biopsy specimens. Kaplan-Meier survival analysis (...) and multivariable hazards models were applied to estimate the association of new grade and stage groups with overall survival (OS) and PCa-specific survival (CSS). Mean follow-up was 42.65 months (95% confidence interval: 42.47-42.84) in the entire cohort. The 3-year OS and CSS rates stepped down for grade groups 1-5 and AJCC stage groups I-IVB, respectively. After adjusting for clinical and pathological characteristics, all grade groups and AJCC stage groups were associated with higher all-cause and PCa

2018 Asian journal of andrology

223. Information Seeking and Satisfaction with Information Sources Among Spouses of Men with Newly Diagnosed Local-Stage Prostate Cancer Full Text available with Trip Pro

Information Seeking and Satisfaction with Information Sources Among Spouses of Men with Newly Diagnosed Local-Stage Prostate Cancer Information sources about prostate cancer treatment and outcomes are typically designed for patients. Little is known about the availability and utility of information for partners. The objectives of our study were to evaluate information sources used by partners to understand prostate cancer management options, their perceived usefulness, and the relationship (...) between sources used and satisfaction with treatment experience. A longitudinal survey of female partners of men newly diagnosed with local-stage prostate cancer was conducted in three different geographic regions. Partners and associated patients were surveyed at baseline (after patient diagnosis but prior to receiving therapy) and at 12 months following diagnosis. Information sources included provider, literature, friends or family members, Internet websites, books, traditional media, and support

2018 Journal of cancer education : the official journal of the American Association for Cancer Education

224. Multiparametric [11C]Acetate positron emission tomography-magnetic resonance imaging in the assessment and staging of prostate cancer. Full Text available with Trip Pro

Multiparametric [11C]Acetate positron emission tomography-magnetic resonance imaging in the assessment and staging of prostate cancer. The aim of this study was to evaluate whether MP [11C]Acetate PET-MRI enables an accurate differentiation of benign and malignant prostate tumors as well as local and distant staging.Fifty-six consecutive patients fulfilling the following criteria were included in this IRB-approved prospective study: elevated PSA levels or suspicious findings at digital rectal (...) staging of prostate cancer. We demonstrate that MP [11C]Acetate PET-MRI with two MRI-derived parameters (T2 and DWI) achieves the best diagnostic accuracy for primary prostate cancer detection and that MP [11C]Acetate PET-MRI enables an improved local and distant staging.

2017 PLoS ONE

225. The comparative effectiveness of decision aids in diverse populations with early stage prostate cancer: a study protocol for a cluster-randomized controlled trial in the NCI Community Oncology Research Program (NCORP), Alliance A191402CD. Full Text available with Trip Pro

The comparative effectiveness of decision aids in diverse populations with early stage prostate cancer: a study protocol for a cluster-randomized controlled trial in the NCI Community Oncology Research Program (NCORP), Alliance A191402CD. Treatments for localized prostate cancer present challenging tradeoffs in the face of uncertain treatment benefits. These options are best weighed in a process of shared decision-making with the patient's healthcare team. Minority men experience disparities (...) in prostate cancer outcomes, possibly due in part to a lack of optimal communication during treatment selection. Decision aids facilitate shared decision-making, improve knowledge of treatment options, may increase satisfaction with treatment choice, and likely facilitate long-term quality of life.This study will compare the effect of two evidence-based decision aids on patient knowledge and on quality of life measured one year after treatment, oversampling minority men. One decision aid

2018 BMC Cancer

226. <sup>68</sup>Ga-PSMA PET/CT vs. mpMRI for locoregional prostate cancer staging: correlation with final histopathology. (Abstract)

68Ga-PSMA PET/CT vs. mpMRI for locoregional prostate cancer staging: correlation with final histopathology. Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) can be used to locate lesions based on PSMA avidity, however guidelines on its use are limited by its infancy. We aimed to compare multiparametric magnetic resonance imaging (mpMRI) and PSMA PET/CT to prostatectomy histopathology.We conducted a chart review from February 2015 to January 2017 of 50 male (...) patients staged for prostate cancer using PSMA PET/CT and mpMRI who then underwent radical prostatectomy. Pre-operative PSMA PET/CT and mpMRI were paired with corresponding histopathology. Correlations, sensitivity, and specificity were used for comparisons.A total of 81 lesions were confirmed by histopathology. Fifty index lesions were detected by histopathology, all of which were detected by PSMA PET/CT (100% detection), and 47 by mpMRI (94% detection). Thirty-one histologically confirmed secondary

2018 Prostate cancer and prostatic diseases

227. Inverse stage migration patterns in North American patients undergoing local prostate cancer treatment: a contemporary population-based update in light of the 2012 USPSTF recommendations. (Abstract)

Inverse stage migration patterns in North American patients undergoing local prostate cancer treatment: a contemporary population-based update in light of the 2012 USPSTF recommendations. Recent studies demonstrated ongoing inverse stage migration in prostate cancer (PCa) patients towards more advanced and unfavorable tumors. The USPSTF grade D recommendation may impact this trend in North American patients. We assessed contemporary stage migration and treatment trends in a large North American (...) cohort diagnosed with PCa 2009-2014.Time-trend analyses were performed in patients within the Surveillance, Epidemiology, and End Results database, with complete data of clinical tumor stage, biopsy Gleason score, and validated PSA values, resulting in 211,645 assessable patients. Patients were stratified according to their different treatment methods [radical prostatectomy (RP), radiotherapy (RT), and no local treatment (NLT)] and according to clinical and pathological risk stratification (D'Amico

2018 World journal of urology

228. Stage T3b prostate cancer diagnosed with seminal vesicle biopsy and treated by neoadjuvant hormone therapy, permanent brachytherapy and external beam irradiation. Full Text available with Trip Pro

Stage T3b prostate cancer diagnosed with seminal vesicle biopsy and treated by neoadjuvant hormone therapy, permanent brachytherapy and external beam irradiation. To report the long-term results of prostate brachytherapy followed by external beam radiotherapy (EBRT) in men with a positive seminal vesicle biopsy (+SVB).In all, 1081 men with localised prostate cancer were treated with permanent brachytherapy, of which 615 had staging SVB and 53 (9.4%) were positive. Higher stage, Gleason score (...) metastasis, and cause-specific survival (CSS) for patients with a negative SVB (-SVB) vs +SVB at 15 years, was 76.3% vs 60.6% (P = 0.001), 95.4% vs 78.2% (P < 0.001), and 95% vs 70.4% (P < 0.001), respectively. Prostate cancer death occurred in 45 of 590 (7.6%) men with a -SVB vs eight of 25 (32%) with a +SVB (odds ratio 5.7, 95% confidence interval 2.35-13.9, P < 0.001). Cox proportion hazard rates (HRs) demonstrated Gleason score (P < 0.001, HR 1.9), stage (P = 0.010, HR 1.42), RT dose (P = 0.013, HR

2018 BJU international

229. A prospective randomised multi-centre study of the impact of Ga-68 PSMA-PET/CT imaging for staging high risk prostate cancer prior to curative-intent surgery or radiotherapy (proPSMA study): clinical trial protocol. Full Text available with Trip Pro

A prospective randomised multi-centre study of the impact of Ga-68 PSMA-PET/CT imaging for staging high risk prostate cancer prior to curative-intent surgery or radiotherapy (proPSMA study): clinical trial protocol. Accurate staging of patients with prostate cancer (PCa) is important for therapeutic decision-making. Relapse after surgery or radiotherapy of curative intent is not uncommon and, in part, represents a failure of staging with current diagnostic imaging techniques to detect disease (...) Society of Urological Pathology grade group ≥3 (primary Gleason grade 4, or any Gleason grade 5), prostate-specific antigen level ≥20 ng/mL or clinical stage ≥T3. Patients with negative, equivocal or oligometastatic disease on first line-imaging will cross over to receive the other imaging arm. The primary objective is to compare the accuracy of PSMA-PET/CT with that of conventional imaging for detecting nodal or distant metastatic disease. Histopathological, imaging and clinical follow-up at 6 months

2018 BJU international Controlled trial quality: uncertain

230. Surgeon-Led Prostate Cancer Lymph Node Staging: Pathologic Outcomes Stratified by Robot-Assisted Dissection Templates and Patient Selection. Full Text available with Trip Pro

Surgeon-Led Prostate Cancer Lymph Node Staging: Pathologic Outcomes Stratified by Robot-Assisted Dissection Templates and Patient Selection. To evaluate the perioperative, pathological, and oncological outcomes from surgeon-led pathological staging of pelvic lymph node (LN) metastases at the time of robot-assisted radical prostatectomy (RARP).Over the 6-year period of 2006-2012, three distinct pelvic LN dissection (PLND) strategies were used in chronological order at a single cancer referral (...) hospital. Strategies were characterised by both an omission of PLND (pNx) vs inclusion decision threshold, and standard vs extended templates for patients selected for PLND. The three cohorts included: (i) omission vs standard template (04/2006-10/2007), for dominant Gleason score 4-5 or a prostate-specific antigen (PSA) level of >10 ng/mL; (ii) omission/standard vs extended template (11/2007-12/2010), for dominant Gleason score 4-5, PSA level of >10 ng/mL, any single core >7 mm, or >3 ipsilateral

2018 BJU international

231. Imaging the High-Risk Prostate Cancer Patient: Current and Future Approaches to Staging. (Abstract)

Imaging the High-Risk Prostate Cancer Patient: Current and Future Approaches to Staging. Imaging is critically important for the diagnosis, staging, and management of men with high-risk prostate cancer. Conventional imaging modalities have been employed for local and metastatic staging with limited performance. Sodium fluoride positron emission tomography is recommended when there is high suspicion of bone metastases despite a negative or indeterminate bone scan. Magnetic resonance imaging has (...) advantages in local staging but its value depends on the extent of disease. Whole-body positron emission tomography/magnetic resonance imaging could provide both local and distant staging. None of the existing positron emission tomography agents are recommended in practice guidelines; however, among them, prostate-specific membrane antigen-based tracers seem to hold the most promise based on sensitivity and specificity.Copyright © 2018 Elsevier Inc. All rights reserved.

2018 Urology

232. A stage-dependent link between metabolic syndrome components and incident prostate cancer. (Abstract)

and its components have two distinct effects in prostate cancer, concealing prostate cancer in low-stage disease and promoting progression to high-stage incident, nonlocalized, and lethal prostate cancer. The concealment of prostate cancer by metabolic syndrome and its components might be related to bias mechanisms that reduce PSA level and lead to a delayed diagnosis of low-stage prostate cancer, meaning that fewer men with metabolic syndrome are diagnosed with low-stage disease. The inverse link (...) A stage-dependent link between metabolic syndrome components and incident prostate cancer. Metabolic syndrome is associated with increased cancer risk and progression at almost all sites, including the prostate in high-stage prostate cancer. However, several reports have described an inverse relationship between metabolic syndrome and its components and low-stage incident prostate cancer. Such anomalies in cancer research hamper efforts to fight cancer. Evidence suggests that metabolic syndrome

2018 Nature reviews. Urology

233. Designing a theory-based intervention to improve the guideline-concordant use of imaging to stage incident prostate cancer. (Abstract)

Designing a theory-based intervention to improve the guideline-concordant use of imaging to stage incident prostate cancer. Among US men, most new prostate cancer cases are clinically localized and do not require imaging as part of staging workup according to guidelines. Two leading specialty societies promote stewardship of health resources by encouraging guideline-concordant care, thereby limiting inappropriate and obsolete imaging. However, imaging to stage low-risk prostate cancer remains (...) high, as almost half of men with localized prostate cancer undergo wasteful imaging following diagnosis. We employed a theory-based approach, based on current evidence and data on existing practice patterns revealing that providers are the drivers to imaging decisions, to design an intervention to improve guideline -concordant prostate cancer staging imaging across populations. We conceptualized preliminary results using the theoretical domains framework and the behavior change wheel, frameworks

2018 Urologic oncology

234. A clinician-centred program for behaviour change in the optimal use of staging investigations for newly diagnosed prostate cancer. Full Text available with Trip Pro

A clinician-centred program for behaviour change in the optimal use of staging investigations for newly diagnosed prostate cancer. To improve imaging utilisation and reduce the widespread overuse of staging investigations, in the form of computed tomography (CT) and whole-body bone scans for men with newly diagnosed prostate cancer in the Hunter region of NSW, Australia, by implementation of a multifaceted clinician-centred behaviour change programme.Records of all patients with a new diagnosis (...) of prostate cancer were reviewed prior to the intervention (July 2014 to July 2015), and the results of this audit were presented to participating urologists by a clinical champion. Urologists then underwent focused education based on current guidelines. Patterns of imaging use for staging were then re-evaluated (November 2015 to July 2016). Patients were stratified into low-, intermediate- and high-risk groups as described by the D'Amico classification system.A total of 144 patients were retrospectively

2018 BJU international

235. Adding abiraterone or docetaxel to long-term hormone therapy for prostate cancer: directly randomised data from the STAMPEDE multi-arm, multi-stage platform protocol. Full Text available with Trip Pro

Adding abiraterone or docetaxel to long-term hormone therapy for prostate cancer: directly randomised data from the STAMPEDE multi-arm, multi-stage platform protocol. Adding abiraterone acetate with prednisolone (AAP) or docetaxel with prednisolone (DocP) to standard-of-care (SOC) each improved survival in systemic therapy for advanced or metastatic prostate cancer: evaluation of drug efficacy: a multi-arm multi-stage platform randomised controlled protocol recruiting patients with high-risk (...) . The patients, balanced by allocated treatment were: 342 (60%) M1; 429 (76%) Gleason 8-10; 449 (79%) WHO performance status 0; median age 66 years and median PSA 56 ng/ml. With median follow-up 4 years, 149 deaths were reported. For overall survival, HR = 1.16 (95% CI 0.82-1.65); failure-free survival HR = 0.51 (95% CI 0.39-0.67); progression-free survival HR = 0.65 (95% CI 0.48-0.88); metastasis-free survival HR = 0.77 (95% CI 0.57-1.03); prostate cancer-specific survival HR = 1.02 (0.70-1.49

2018 Annals of Oncology Controlled trial quality: predicted high

236. Preoperative staging using magnetic resonance imaging and risk of positive surgical margins after prostate-cancer surgery. (Abstract)

Preoperative staging using magnetic resonance imaging and risk of positive surgical margins after prostate-cancer surgery. It is unclear whether preoperative staging using Magnetic Resonance Imaging (MRI) reduces the risk of positive margins in prostate cancer. We aimed to assess the effect on surgical margins and degree of nerve sparing of a pelvic MRI presented at a preoperative MRI conference.Single institution, observational cohort study including 1037 men that underwent robot assisted (...) radical prostatectomy between October 2013 and June 2015. Of these, 557 underwent a preoperative MRI combined with a preoperative MRI conference and 410 did not. With whole-mount prostate specimen histopathology as gold standard we assessed the ability of MRI in finding the index tumor and the sensitivity and specificity for extra prostatic extension. We calculated relative risks for positive surgical margins and non-nerve sparing procedure, adjusting for preoperative risk factors using stabilized

2018 Prostate cancer and prostatic diseases

237. Intermittent Androgen Deprivation Therapy for Stage IV Castration Sensitive Prostate Cancer

: Yes Studies a U.S. FDA-regulated Device Product: No Product Manufactured in and Exported from the U.S.: No Keywords provided by H. Lee Moffitt Cancer Center and Research Institute: stage IV castration sensitive prostate cancer advanced castration sensitive prostate cancer Additional relevant MeSH terms: Layout table for MeSH terms Prostatic Neoplasms Adenocarcinoma Hypersensitivity Genital Neoplasms, Male Urogenital Neoplasms Neoplasms by Site Neoplasms Genital Diseases, Male Prostatic Diseases (...) Phase Prostate Cancer Stage IV Prostate Cancer Advanced Prostate Cancer Adenocarcinoma of the Prostate Drug: Adaptive Androgen Deprivation Therapy (ADT) Drug: Abiraterone Drug: Prednisone Early Phase 1 Detailed Description: Investigators proposed this pilot feasibility study to use prostate specific antigen (PSA) response and testosterone level to guide the treatment with androgen deprivation therapy (ADT) [Leuprolide, Goserelin, and Triptorelin are the most commonly used GnRH agonists for ADT

2018 Clinical Trials

238. Novel Imaging in Staging of Primary Prostate Cancer

aiming to find the most appropriate staging modality in high-risk PC at the time of initial staging. Condition or disease Intervention/treatment Phase High Risk Prostate Cancer Diagnostic Test: Whole body contrast enhanced computer tomography Diagnostic Test: 99mTC-HMDP planar bone scintigraphy (BS) Diagnostic Test: 99mTc-HMDP single photon emission computer tomography/computer tomography Diagnostic Test: Whole-body magnetic resonance imaging Diagnostic Test: Fluorine-18-prostate specific membrane (...) a U.S. FDA-regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Keywords provided by Turku University Hospital: prostate cancer imaging of prostate cancer staging of prostate cancer prostate specific membrane antigen (PSMA) positron emission tomography bone scintigraphy whole body magnetic resonance imaging whole body computer tomography single photon emission tomography (SPECT) Additional relevant MeSH terms: Layout table for MeSH terms Prostatic Neoplasms Genital Neoplasms

2018 Clinical Trials

239. Accuracy in local staging of prostate cancer by adding a three-dimensional T2-weighted sequence with radial reconstructions in magnetic resonance imaging Full Text available with Trip Pro

Accuracy in local staging of prostate cancer by adding a three-dimensional T2-weighted sequence with radial reconstructions in magnetic resonance imaging The evidence supporting the use of magnetic resonance imaging (MRI) in prostate cancer detection has been established, but its accuracy in local staging is questioned.To investigate the additional value of multi-planar radial reconstructions of a three-dimensional (3D) T2-weighted (T2W) MRI sequence, intercepting the prostate capsule (...) perpendicularly, for improving local staging of prostate cancer.Preoperative, bi-parametric prostate MRI examinations in 94 patients operated between June 2014 and January 2015 where retrospectively reviewed by two experienced abdominal radiologists. Each patient was presented in two separate sets including diffusion-weighted imaging, without and with the 3D T2W set that included radial reconstructions. Each set was read at least two months apart. Extraprostatic tumor extension (EPE) was assessed according

2018 Acta Radiologica Open

240. Staging Prostate Cancer With Hybrid C11-Choline PET/MR and mpMRI

by Ming Yang, M.D., Mayo Clinic: high risk prostate cancer C11-choline PET/MR mpMRI Additional relevant MeSH terms: Layout table for MeSH terms Adenocarcinoma Carcinoma Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms Choline Lipotropic Agents Hypolipidemic Agents Antimetabolites Molecular Mechanisms of Pharmacological Action Gastrointestinal Agents Lipid Regulating Agents Nootropic Agents (...) Study Details Study Description Go to Brief Summary: The purpose of this study is to find out if a PET/MR scan in combination with standard MRI and CT scans can improve the early detection and treatment of patients with prostate cancer. Condition or disease Intervention/treatment Phase Prostate Adenocarcinoma Drug: C-11 choline PET tracer Drug: Gadobutrol Device: PET/MR scanner Phase 3 Detailed Description: High risk prostate cancer patients will undergo C11-Choline PET/MR whole body fusion scan

2018 Clinical Trials

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