• Title, Summary, Keyword: Prostatic neoplasms

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A Rare Presentation of Metastasis of Prostate Adenocarcinoma to the Stomach and Rectum

  • Soe, Aye Min;Bordia, Sonal;Xiao, Philip Q.;Lopez-Morra, Hernan;Tejada, Juan;Atluri, Sreedevi;Krishnaiah, Mahesh
    • Journal of Gastric Cancer
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    • v.14 no.4
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    • pp.271-274
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    • 2014
  • Prostate cancer is the second most common cause of cancer death in men in the United States. The most common sites of metastasis include the bone, lymph nodes, lung, liver, pleura, and adrenal glands, whereas metastatic prostate cancer involving the gastrointestinal tract has been rarely reported. A 64-year-old African-American man with a history of prostate cancer presented with anemia. He reported the passing of dark colored stools but denied hematemesis or hematochezia. Colonoscopy revealed circumferential nodularity, and histology demonstrated metastatic carcinoma of the prostate. Esophagogastroduodenoscopy showed hypertrophic folds in the gastric fundus, and microscopic examination revealed tumor cells positive for prostate-specific antigen. Bone scanning and computed tomography of the abdomen and pelvis did not show metastasis. It is crucial to distinguish primary gastrointestinal cancer from metastatic lesions, especially in patients with a history of cancer at another site, for appropriate management.

Magnetic resonance imaging-transrectal ultrasound fusion image-guided prostate biopsy: Current status of the cancer detection and the prospects of tailor-made medicine of the prostate cancer

  • Shoji, Sunao
    • Investigative and Clinical Urology
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    • v.60 no.1
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    • pp.4-13
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    • 2019
  • Multi-parametric magnetic resonance imaging (mpMRI) has been increasingly used to diagnose clinically significant prostate cancer (csPCa) because of its growing availability and its ability to combine anatomical and functional data. Magnetic resonance imaging (MRI)-transrectal ultrasound (TRUS) fusion imaging provides MRI information with TRUS images for prostate biopsies. This technique combines the superior sensitivity of MRI for targeting suspicious lesions with the practicality and familiarity of TRUS. MRI-TRUS fusion image-guided prostate biopsy is performed with different types of image registration (rigid vs. elastic) and needle tracking methods (electromagnetic tracking vs. mechanical position encoders vs. image-based software tracking). A systematic review and meta-analysis showed that MRI-targeted biopsy detected csPCa at a significantly higher rate than did TRUS-guided biopsy, while it detected significantly fewer cases of insignificant PCas. In addition to the high accuracy of MRI-targeted biopsy for csPCa, localization of csPCa is accurate. The ability to choose the route of biopsy (transperineal vs. transrectal) is required, depending on the patients' risk and the location and size of suspicious lesions on mpMRI. Fusion image-guided prostate biopsy has the potential to allow precise management of prostate cancer, including active surveillance, radical treatment, and focal therapy.

The association of family history of prostate cancer with the diagnosis of clinically significant prostate cancer in Korean population

  • Park, Jee Soo;Koo, Kyo Chul;Chung, Byung Ha;Lee, Kwang Suk
    • Investigative and Clinical Urology
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    • v.60 no.6
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    • pp.442-446
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    • 2019
  • Purpose: The impact of family history on the diagnosis of the prostate cancer among Asian population remains controversial. We evaluated whether a positive family history of the prostate cancer in Korean men is associated with the diagnosis and aggressiveness of the prostate cancer. Materials and Methods: Patients who underwent a transrectal ultrasound-guided prostate biopsy from March 2015 to September 2017 were evaluated. Information on family history was obtained via a self-administered questionnaire. The presence of prostate cancer and clinically significant prostate cancer (Gleason score ≥7) was evaluated according to the presence of a family history. Results: Of 602 patients (median age, 68.3 years; median prostate-specific antigen level, 6.28 ng/mL), 41 (6.8%) patients had a family history of prostate cancer. Family history was a significant factor for detecting prostate cancer (odds ratio [OR], 2.99; 95% confidence interval [CI], 1.330-6.704; p=0.008). In multivariate analysis for predicting clinically significant prostate cancer, family history was a significant predictor (OR, 6.32; 95% CI; 2.790-14.298; p<0.001). Conclusions: A family history of prostate cancer in Korean men was a significant factor for predicting prostate cancer. Moreover, significant differences in the aggressive features of the disease were identified between patients with and without a family history.

Magnetic resonance image-based tomotherapy planning for prostate cancer

  • Jung, Sang Hoon;Kim, Jinsung;Chung, Yoonsun;Keserci, Bilgin;Pyo, Hongryull;Park, Hee Chul;Park, Won
    • Radiation Oncology Journal
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    • v.38 no.1
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    • pp.52-59
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    • 2020
  • Purpose: To evaluate and compare the feasibilities of magnetic resonance (MR) image-based planning using synthetic computed tomography (sCT) versus CT (pCT)-based planning in helical tomotherapy for prostate cancer. Materials and Methods: A retrospective evaluation was performed in 16 patients with prostate cancer who had been treated with helical tomotherapy. MR images were acquired using a dedicated therapy sequence; sCT images were generated using magnetic resonance for calculating attenuation (MRCAT). The three-dimensional dose distribution according to sCT was recalculated using a previously optimized plan and was compared with the doses calculated using pCT. Results: The mean planning target volume doses calculated by sCT and pCT differed by 0.65% ± 1.11% (p = 0.03). Three-dimensional gamma analysis at a 2%/2 mm dose difference/distance to agreement yielded a pass rate of 0.976 (range, 0.658 to 0.986). Conclusion: The dose distribution results obtained using tomotherapy from MR-only simulations were in good agreement with the dose distribution results from simulation CT, with mean dose differences of less than 1% for target volume and normal organs in patients with prostate cancer.

A Structural Equation Modeling of Prostate Cancer Screening Intention (전립선암 검진의도 구조모형)

  • Jeong, Ji Hye;Park, Nam Hee
    • Journal of Korean Academy of Community Health Nursing
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    • v.30 no.4
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    • pp.471-483
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    • 2019
  • Purpose: The purpose of this study was to identify factors associated with the intention of the prostate cancer screening (PCS). To achieve this purpose, a structural equation model was established based on the health belief model and the theory of planned behavior. Methods: The subjects of this study were 260 male participants who were between 40 and 74 years old and had not taken the PCS. Data were collected using a structured self-report questionnaire (i.e., perceived benefits, perceived barriers, attitude, subjective norms, perceived behavior control, and intention of the PCS). Descriptive statistics, reliability analysis, correlation analysis, confirmatory factor analysis, and fitness test were used to test hypotheses. Results: The intention of the PCS was directly affected by the perceived behavior control and indirectly influenced by the perceived benefits. The structural equation model also showed that the perceived behavior control explained 78% of the intention. Conclusion: To raise the intention to take the PCS, it is necessary to increase the confidence of a subject that may control its difficulties and inform the perceived benefits of the PCS to a subject.

CDC6 mRNA Expression Is Associated with the Aggressiveness of Prostate Cancer

  • Kim, Ye-Hwan;Byun, Young Joon;Kim, Won Tae;Jeong, Pildu;Yan, Chunri;Kang, Ho Won;Kim, Yong-June;Lee, Sang-Cheol;Moon, Sung-Kwon;Choi, Yung-Hyun;Yun, Seok Joong;Kim, Wun-Jae
    • Journal of Korean Medical Science
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    • v.33 no.47
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    • pp.303.1-303.10
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    • 2018
  • Background: Cell division cycle 6 (CDC6) is an essential regulator of DNA replication and plays important roles in the activation and maintenance of the checkpoint mechanisms in the cell cycle. CDC6 has been associated with oncogenic activities in human cancers; however, the clinical significance of CDC6 in prostate cancer (PCa) remains unclear. Therefore, we investigated whether the CDC6 mRNA expression level is a diagnostic and prognostic marker in PCa. Methods: The study subjects included 121 PCa patients and 66 age-matched benign prostatic hyperplasia (BPH) patients. CDC6 expression was evaluated using real-time polymerase chain reaction and immunohistochemical (IH) staining, and then compared according to the clinicopathological characteristics of PCa. Results: CDC6 mRNA expression was significantly higher in PCa tissues than in BPH control tissues (P = 0.005). In addition, CDC6 expression was significantly higher in patients with elevated prostate-specific antigen (PSA) levels (> 20 ng/mL), a high Gleason score, and advanced stage than in those with low PSA levels, a low Gleason score, and earlier stage, respectively. Multivariate logistic regression analysis showed that high expression of CDC6 was significantly associated with advanced stage (${\geq}T3b$) (odds ratio [OR], 3.005; confidence interval [CI], 1.212-7.450; P = 0.018) and metastasis (OR, 4.192; CI, 1.079-16.286; P = 0.038). Intense IH staining for CDC6 was significantly associated with a high Gleason score and advanced tumor stage including lymph node metastasis stage (linear-by-linear association, P = 0.044 and P = 0.003, respectively). Conclusion: CDC6 expression is associated with aggressive clinicopathological characteristics in PCa. CDC6 may be a potential diagnostic and prognostic marker in PCa patients.

Plasma Vascular Endothelial Growth Factors A and C in Patients undergoing Prostatic Biopsy and TURP for Suspected Prostatic Neoplasia

  • Singh, A.N.;Gautam, Kirti A.;Dalela, D.;Sankhwar, S.N.;Natu, S.M.;Sankhwar, P.L.;Srivastava, A.N.
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.2053-2058
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    • 2013
  • Background: Formation of new blood vessels is necessary for the development and spread of neoplasms more than 1 mm3 in volume, angiogenesis being responsible for formation of new from pre-existing blood vessels. Vascular endothelial growth factor (VEGF) is pivotal and the best studied angiogenic factor in all human cancers. Therefore we designed this study to investigate the role of VEGF-A and VEGF-C in prostate cancer in comparison with BPH controls in a north Indian population. Methods: In this case-control study a total of 100 subjects were included on the basis of confirmed histopathological reports, out of which 50 were prostate cancer patients and the other 50 were BPH patients with PSA levels >2 ng/ml and abnormal digital rectal examination (DRE) findings during September 2009 to August 2011 from the Department of Urology, KGMU, Lucknow, India. Plasma levels of VEGF were determined using quantitative immunoassay (ELISA-enzyme linked immunosorbent assay). Statistical analysis was carried out using SPSS 15.0 version. Results: The mean age of prostate cancer ($67.6{\pm}5.72$) patients was significantly higher (p=0.005) than BPH ($63.6{\pm}7.92$) patients. Expression of VEGF-A was not significantly higher in disease stage C1 than D1 or D2 and A or B (p=0.13) while the level of VEGF-A was significantly higher (p=0.04) in prostate cancer as compared to BPH subjects (PCa=13.0 pg/ml, BPH=6.8 pg/ml). Levels of VEGF-C were similar in both groups (PCa=832.6 pg/ml, BPH=823.7 pg/ml). In ROC curve, the area under curve (AUC) was 0.70 (95%CI: 0.60-0.80) and the cut-off value for which a higher proportion of patients was correctly classified (20%) was 26.0 pg/mL. Conclusion: Although VEGF-A is increased in cancer prostate patients a statistically significant correlation could not be established in this study. VEGF-C was not found to be a useful biomarker.

Bicalutamide-induced Interstitial Lung Disease (전립선 암에서 Bicalutamide 사용으로 생긴 간질성 폐질환 1예)

  • Kim, Yang-Kyun;Kim, Yee-Hyung;Lee, Jae-Jin;Choi, Cheon-Woong;Yoo, Jee-Hong;Park, Myung-Jae;Kang, Hong-Mo
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.4
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    • pp.226-230
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    • 2010
  • Androgen deprivation therapy, which is the standard treatment for metastatic prostate cancer, includes nonsteroidal antiandrogenic drugs, such as flutamide, nilutamide and bicalutamide. Of them, bicalutamide rarely induces interstitial pneumonia. We report a case of bicalutamide-induced interstitial pneumonia. A 68-year old male diagnosed with prostate cancer and multiple bone metastases presented with dry cough and low grade fever for 3 days. He had taken bicalutamide (50 mg/day) for 13 months. High resolution computed tomography revealed ground glass opacity in his right upper lung. The laboratory studies showed no eosinophilia in the serum and bronchoalveolar lavage fluid. Despite the use of antimicrobial agents for 2 weeks, the extent of the lung lesions increased to the left upper and right lower lung. He had no environmental exposure, collagen vascular disease and microbiological causes. Under the suspicion of bicalutamide-induced interstitial pneumonia, bicalutamide was stopped and prednisolone (1 mg/kg/ day) was initiated. The symptoms and radiologic abnormalities were resolved with residual minimal fibrosis.

Economic Evaluation of Prostate Cancer Screening Test as a National Cancer Screening Program in South Korea

  • Shin, Sangjin;Kim, Youn Hee;Hwang, Jin Sub;Lee, Yoon Jae;Lee, Sang Moo;Ahn, Jeonghoon
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3383-3389
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    • 2014
  • Background: Prostate cancer is rapidly increasing in Korea and professional societies have requested adding prostate specific antigen (PSA) testing to the National Cancer Screening Program (NCSP), but this started a controversy in Korea and neutral evidence on this issue is required more than ever. The purpose of this study was to provide economic evidence to the decision makers of the NCSP. Materials and Methods: A cost-utility analysis was performed on the adoption of PSA screening program among men aged 50-74-years in Korea from the healthcare system perspective. Several data sources were used for the cost-utility analysis, including general health screening data, the Korea Central Cancer Registry, national insurance claims data, and cause of mortality from the National Statistical Office. To solicit the utility index of prostate cancer, a face-to-face interview for typical men aged 40 to 69 was conducted using a Time-Trade Off method. Results: As a result, the increase of effectiveness was estimated to be very low, when adopting PSA screening, and the incremental cost effectiveness ratio (ICER) was analyzed as about 94 million KRW. Sensitivity analyses were performed on the incidence rate, screening rate, cancer stage distribution, utility index, and treatment costs but the results were consistent with the base analysis. Conclusions: Under Korean circumstances with a relatively low incidence rate of prostate cancer, PSA screening is not cost-effective. Therefore, we conclude that adopting national prostate cancer screening would not be beneficial until further evidence is provided in the future.

Geographic Disparities in Prostate Cancer Outcomes - Review of International Patterns

  • Baade, Peter D.;Yu, Xue Qin;Smith, David P.;Dunn, Jeff;Chambers, Suzanne K.
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1259-1275
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    • 2015
  • Background: This study reviewed the published evidence as to how prostate cancer outcomes vary across geographical remoteness and area level disadvantage. Materials and Methods: A review of the literature published from January 1998 to January 2014 was undertaken: Medline and CINAHL databases were searched in February to May 2014. The search terms included terms of 'Prostate cancer' and 'prostatic neoplasms' coupled with 'rural health', 'urban health', 'geographic inequalities', 'spatial', 'socioeconomic', 'disadvantage', 'health literacy' or 'health service accessibility'. Outcome specific terms were 'incidence', 'mortality', 'prevalence', 'survival', 'disease progression', 'PSA testing' or 'PSA screening', 'treatment', 'treatment complications' and 'recurrence'. A further search through internet search engines was conducted to identify any additional relevant published reports. Results: 91 papers were included in the review. While patterns were sometimes contrasting, the predominate patterns were for PSA testing to be more common in urban (5 studies out of 6) and affluent areas (2 of 2), higher prostate cancer incidence in urban (12 of 22) and affluent (18 of 20), greater risk of advanced stage prostate cancer in rural (7 of 11) and disadvantaged (8 of 9), higher survival in urban (8 of 13) and affluent (16 of 18), greater access or use of definitive treatment services in urban (6 of 9) and affluent (7 of 7), and higher prostate mortality in rural (10 of 20) and disadvantaged (8 of 16) areas. Conclusions: Future studies may need to utilise a mixed methods approach, in which the quantifiable attributes of the individuals living within areas are measured along with the characteristics of the areas themselves, but importantly include a qualitative examination of the lived experience of people within those areas. These studies should be conducted across a range of international countries using consistent measures and incorporate dialogue between clinicians, epidemiologists, policy advocates and disease control specialists.