PSMA PET for primary lymph node staging of intermediate and high-risk prostate cancer: an expedited systematic review. PSMA PET is a promising method for primary lymph node staging in prostate cancer. However, recent systematic reviews have identified only a limited number of studies with histopathology as a reference test.A systematic search was performed in PubMed and the Cochrane Library. An expedited systematic review was performed where we identified diagnostic studies in prostate cancer (...) where a preoperative PSMA PET for primary lymph node staging was compared to histopathology. The trials must have diagnostic data on a patient level.Eighteen eligible clinical trials included 969 patients. The median patient number per study was 32 (range 10 to 208). Five trials were prospective, and nine trials had a consecutive enrolment of patients. Sixteen studies used Ga-68-PSMA-11; there was one study with Cu-64-PSMA and one study with F-18-DCDFPyL. Twelve studies used PET/CT, four trials used

Effect of a Behavioral Intervention to Increase Vegetable Consumption on Cancer Progression Among Men With Early-Stage Prostate Cancer: The MEAL Randomized Clinical Trial. Guidelines endorsing vegetable-enriched diets to improve outcomes for prostate cancer survivors are based on expert opinion, preclinical studies, and observational data.To determine the effect of a behavioral intervention that increased vegetable intake on cancer progression in men with early-stage prostate cancer.The Men's (...) Eating and Living (MEAL) Study (CALGB 70807 [Alliance]) was a randomized clinical trial conducted at 91 US urology and medical oncology clinics that enrolled 478 men aged 50 to 80 years with biopsy-proven prostate adenocarcinoma (International Society of Urological Pathology grade group = 1 in those <70 years and ≤2 in those ≥70 years), stage cT2a or less, and serum prostate-specific antigen (PSA) level less than 10 ng/mL. Enrollment occurred from January 2011 to August 2015; 24-month follow-up

to identify studies performing a head-to-head comparison of prostate MRI using a 1.5 or 3 T magnet with an ERC and with a BAC/PAC for staging T3 prostate cancer. Pooled sensitivity and specificity of all studies were plotted in a hierarchical summary receiver operating characteristic plot. The diagnostic performance of the two techniques in staging T3 disease was evaluated using bivariate random-effects meta-analysis.Eight studies comparing head-to-head prostate MRI with an ERC and with a BAC/PAC were (...) Head-to-head comparison of prostate MRI using an endorectal coil versus a non-endorectal coil: meta-analysis of diagnostic performance in staging T3 prostate cancer. To compare the diagnostic performance of prostate magnetic resonance imaging (MRI) with an endorectal coil (ERC) to performance without an ERC using either body-array (BAC) or pelvic phased-array coil (PAC) in staging T3 prostate cancer.An electronic search of the PUBMED and EMBASE databases was performed until 10 October 2018

, there was no statistically significant difference in the abilities of detecting or excluding prostate cancer between Ga-PSMA PET/CT and F-choline PET/CT.For staging and restaging performance in patients with prostate cancer, there was no significant difference between Ga-PSMA PET/CT and F-choline PET/CT. Ga-PSMA PET/CT and F-choline PET/CT have demonstrated high diagnostic performance for accurate staging and restaging in patients with prostate cancer, and thus both should be considered for staging in this disease. (...) Comparing the Staging/Restaging Performance of 68Ga-Labeled Prostate-Specific Membrane Antigen and 18F-Choline PET/CT in Prostate Cancer: A Systematic Review and Meta-analysis. PET/CT using prostate-specific membrane antigen (PSMA) and choline radiotracers is widely used for diagnosis of prostate cancer. However, the roles of and differences in diagnostic performance between these 2 radiotracers for prostate cancer are unclear. The aim of this study was to compare the staging and restaging

Diagnostic Performance of Radiolabeled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Primary Lymph Node Staging in Newly Diagnosed Intermediate to High-Risk Prostate Cancer Patients: A Systematic Review and Meta-A We aimed to assess the diagnostic accuracy of radiolabeled prostate-specific membrane antigen positron emission tomography (PSMA PET) or positron emission tomography/computed tomography (PET/CT) for primary lymph node (LN) staging in newly (...) diagnosed intermediate to high-risk prostate cancer (PCa) patients.The MEDLINE, PubMed, EMBASE, and Cochrane Library database from the earliest available date of indexing through May 31, 2018, were searched for studies evaluating the diagnostic performance of radiolabeled PSMA PET or PET/CT for primary LN staging in newly diagnosed intermediate to high-risk PCa. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR

histopathologic correlation data. High variation in methodology and outcomes such as sensitivity (range 33-99%) and specificity (> 90%) was seen across all studies. The ability of 68Ga-PSMA PET to detect malignant lesions was evident across studies, with most studies demonstrating increased detection rates with respect to conventional imaging modalities.In the primary staging of prostate cancer 68Ga-PSMA PET appears to outperform traditional imaging modalities. Overall, there are few high-quality studies (...) ⁶⁸Ga-prostate specific membrane antigen (PSMA) positron emission tomography (PET) for primary staging of high-risk prostate cancer: a systematic review. To systematically review currently available data on 68Ga-prostate specific membrane antigen (PSMA) positron emission tomography (PET) used for the primary staging of high-risk prostate cancer.We performed critical reviews of EMBASE, Web of Science (including MEDLINE) and Cochrane databases in October 2016 according to the Preferred

patients with early-stage prostate cancer from 11 Italian community and academic hospitals were treated with iodine-125 ((125)I) or palladium-103 LDR-BT as monotherapy and followed up for at least 2 years. (125)I seeds were implanted in 97.7% of the patients: the mean dose received by 90% of target volume was 145 Gy; the mean target volume receiving 100% of prescribed dose (V100) was 91.1%. Biochemical failure-free survival (BFFS), disease-specific survival (DSS) and overall survival (OS) were (...) Low dose rate brachytherapy (LDR-BT) as monotherapy for early stage prostate cancer in Italy: practice and outcome analysis in a series of 2237 patients from 11 institutions. Low-dose-rate brachytherapy (LDR-BT) in localized prostate cancer is available since 15 years in Italy. We realized the first national multicentre and multidisciplinary data collection to evaluate LDR-BT practice, given as monotherapy, and outcome in terms of biochemical failure.Between May 1998 and December 2011, 2237

Prostate cancer staging and imaging

Prostate cancer bone metastases on staging prostate MRI: prevalence and clinical features associated with their diagnosis Bone lesions on prostate MRI often raise concern about metastases. This study aimed to evaluate the prevalence of bone metastases on staging prostate MRI and evaluate associations between their MRI features and clinical/pathologic characteristics.Retrospective, IRB-approved study of 3765 patients undergoing prostate MRI for newly diagnosed PCa between 2000 and 2014 (...) . The reference standard to calculate the prevalence of bone metastases was bone biopsy and/or ≥1-year follow-up after MRI. In a subsample of 228 patients, the MRI characteristics of bone lesions were recorded by two radiologists independently. Associations between MRI and clinical/pathologic findings, including National Comprehensive Cancer Network (NCCN) risk categories, were calculated.57/3765 patients (1.5%, 95% CI 1.2-2.0%) had bone metastases. No patient with NCCN low-risk PCa (Gleason < 7, PSA < 10 ng

Disparities in staging prostate magnetic resonance imaging utilization for nonmetastatic prostate cancer patients undergoing definitive radiation therapy There is growing evidence supporting incorporating multiparametric (mp) magnetic resonance imaging (MRI) scans into risk stratification, active surveillance, and treatment paradigms for prostate cancer. The purpose of our study was to determine whether demographic disparities exist in staging MRI utilization for prostate cancer patients.An (...) across all risk groups and black or nonprivate insurance patients in the low risk group were less likely to undergo staging prostate MRI scans. Further research should investigate these differences to ensure equitable utilization across all demographic groups considering the burden of prostate cancer disparities.

Positron emission tomography in imaging evaluation of staging, restaging, treatment response, and prognosis in prostate cancer Prostate cancer is a prevalent public health problem worldwide. While imaging has played a major role in this disease, there still remain many challenges and opportunities. Positron emission tomography with various physiologically based radiotracers is fundamentally suited to interrogate this biologically and clinically heterogeneous disease along the course of its (...) natural history. In this article, I review briefly the published evidence for the use of positron emission tomography with 18F-fluorodeoxyglucose, 11C-acetate, and 18F- or 11C-choline in the imaging evaluation of prostate cancer. Although the focus of the article will be on these radiotracers given the accumulated experience with them, but I will also comment on the outlook for the use of other emerging PET radiotracers such as those targeted to the prostate-specific membrane antigen and the amino

Re: Laura Evangelista, Alberto Briganti, Stefano Fanti, et al. New Clinical Indications for (18)F/(11)C-choline, New Tracers for Positron Emission Tomography and a Promising Hybrid Device for Prostate Cancer Staging: A Systematic Review of the Literature. 27021795 2018 01 31 2018 01 31 1873-7560 70 4 2016 10 European urology Eur. Urol. Re: Laura Evangelista, Alberto Briganti, Stefano Fanti, et al. New Clinical Indications for 18 F/ 11 C-choline, New Tracers for Positron Emission Tomography (...) and a Promising Hybrid Device for Prostate Cancer Staging: A Systematic Review of the Literature. Eur Urol 2016;70:161-75. e112-e113 S0302-2838(16)00375-4 10.1016/j.eururo.2016.03.025 Lopci Egesta E Department of Nuclear Medicine, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, Rozzano, Milan, Italy. Chiti Arturo A Department of Nuclear Medicine, Istituto Clinico Humanitas IRCCS, Clinical and Research Hospital, Rozzano, Milan, Italy; Humanitas University, Rozzano, Milan, Italy. Lazzeri

in Ireland, 2010-2012 87 Figure 7 Five year net survival: Prostate Cancer in Ireland 88 Figure 8 Economic Literature Review Results 1377 | A National Clinical Guideline | Diagnosis, staging and treatment of patients with prostate cancer Cancer is a major healthcare challenge. Each year in Ireland, approximately 19,000 people are diagnosed with malignant cancer. Cancer is the second leading cause of death in Ireland after diseases of the circulatory system. Deaths from cancer averaged about 8,800 deaths (...) at three levels. (C) 2.4.2.1 For determining tumour extent in prostate core biopsies, when there are multiple foci of prostate cancer in a single core separated by benign intervening stroma, it is suggested that the collapsing method is used (i.e. where intervening benign tissue is excluded from the measurement). (D) 2.4.3.1 For each biopsy site the presence of biopsies positive for carcinoma and the ISUP 2005 Gleason score should be reported. The pathologists should assign a separate Gleason score

, not of it” [1], the reality is that prostate cancer is second only to lung cancer as a cause of death from malignancy in American men. Specifically, in 2015, an estimated 220,800 American men were diagnosed with prostate cancer and 27,540 died of the disease [2]. In addition to the personal toll of these deaths, the direct economic cost of prostate cancer in the Unites States has been estimated at approximately $10 billion per year [3]. As with other malignancies, the primary goal during baseline evaluation (...) of prostate cancer is disease characterization; that is, establishing disease extent, both local and distant, and aggressiveness. Determination of tumor aggressiveness is ultimately the most important factor, since this drives patient outcome. Several special circumstances make the accurate baseline evaluation of prostate cancer particularly challenging: ? The currently available standard clinical tools used to evaluate prostate cancer, such as digital rectal examination, serum prostate-specific antigen

, staging and treatment of patients with prostate cancer Cancer is a major healthcare challenge. Each year in Ireland, approximately 19,000 people are diagnosed with malignant cancer. Cancer is the second leading cause of death in Ireland after diseases of the circulatory system. Deaths from cancer averaged about 8,800 deaths per year during 2010-2012, representing about 30% of all deaths in that period (NCRI, 2014a). Cancer incidence data from the National Cancer Registry Ireland (NCRI) and population (...) ) addressed this question. However, there is a lack of consensus elucidating which patient groups should have an MRI for staging. MRI is now the most commonly used imaging technique for T-staging men with prostate cancer. (NICE, 2014) The accuracy of staging of the disease may be improved by MRI which can reduce unnecessary treatment-related morbidity when there is no possibility of cure (Sanchez-Chapado et al., 1997, Bates et al., 1997). Multiparametric MRI may add additional information and can help

Weighted Versus Unweighted Charlson Score to Predict Long-term Other-cause Mortality in Men with Early-stage Prostate Cancer Clinicians need a simple yet accurate method to predict other-cause mortality to inform medical decision making for men with prostate cancer (PCa).To compare weighted and unweighted Charlson Comorbidity Index scores in predicting long-term, other-cause mortality in men with early-stage PCa.A retrospective cohort study of 1482 men with early-stage PCa diagnosed in 1998 (...) from other causes in men with early-stage prostate cancer.Published by Elsevier B.V.

Pretreatment Tables Predicting Pathologic Stage of Locally Advanced Prostate Cancer Pretreatment tables for the prediction of pathologic stage have been published and validated for localized prostate cancer (PCa). No such tables are available for locally advanced (cT3a) PCa.To construct tables predicting pathologic outcome after radical prostatectomy (RP) for patients with cT3a PCa with the aim to help guide treatment decisions in clinical practice.This was a multicenter retrospective cohort (...) on pretreatment PSA level and biopsy GS. They can be used to guide decision making in men with locally advanced PCa.Our study might provide physicians with a useful tool to predict pathologic stage in locally advanced prostate cancer that might help select patients who may need multimodal treatment.Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Intermittent androgen deprivation is a rational standard-of-care treatment for all stages of progressive prostate cancer: results from a systematic review and meta-analysis. The optimal hormone treatment strategy in prostate cancer is uncertain, particularly in patients with metastatic disease. We aimed to compare the relative benefits and harms of intermittent androgen deprivation (IAD) to continuous androgen deprivation (CAD) in all stages of prostate cancer.We included eight randomised (...) control trials (4668 patients) in our systematic review and meta-analysis. Median follow-up ranged from 29 to 118 months. Pooled hazard ratios (HRs) were calculated for overall survival (OS), cancer-specific survival, time to cancer progression and mortality unrelated to prostate cancer. The relative effect of treatment in patients with metastatic and those with non-metastatic disease was compared using pre-planned subgroup analysis.There was no difference in OS between patients treated with IAD

(RRs) was moderately stronger for low grade (RR 0.74, 95% confidence interval (CI), 0.64-0.86) and localized disease (RR 0.72, 95% CI 0.67-0.76) compared with high grade (RR 0.78, 95% CI 0.67-0.90) and advanced disease (RR 0.85, 95% CI 0.75-0.97).This study suggests an inverse relationship between diabetes mellitus and prostate cancer of different stage or grade. Possible biases underlying this association are discussed.Copyright © 2012 Elsevier Ireland Ltd. All rights reserved. (...) Diabetes mellitus and prostate cancer risk of different grade or stage: a systematic review and meta-analysis. Prior studies have reported that diabetes mellitus might reduce the overall prostate cancer risk. We examined this association by conducting a detailed meta-analysis of the studies published in peer-reviewed literature on the association between diabetes mellitus and prostate cancer risk of different stage or grade.A comprehensive search for articles of MEDLINE and EMBASE databases

[Role of PET/CT with choline analogue radiotracers in the diagnosis and staging of prostate cancer] Papel do PET/TAC con radiofármacos análogos da colina no diagnóstico e estadificación do cancro de próstata [Role of PET/CT with choline analogue radiotracers in the diagnosis and staging of prostate cancer] Papel do PET/TAC con radiofármacos análogos da colina no diagnóstico e estadificación do cancro de próstata [Role of PET/CT with choline analogue radiotracers in the diagnosis and staging (...) of prostate cancer] Atienza Merino G Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Atienza Merino G. Papel do PET/TAC con radiofármacos análogos da colina no diagnóstico e estadificación do cancro de próstata. [Role of PET/CT with choline analogue radiotracers in the diagnosis and staging of prostate cancer] Santiago de Compostela: Galician Agency