scholarly journals Increased risk of high-grade prostate cancer among infertile men

Cancer ◽  
2010 ◽  
pp. NA-NA ◽  
Author(s):  
Thomas J. Walsh ◽  
Michael Schembri ◽  
Paul J. Turek ◽  
June M. Chan ◽  
Peter R. Carroll ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Grade ◽  
Infertile Men ◽  
Increased Risk

Early detection of high-grade prostate cancer using digital rectal examination in men with a normal PSA and risk of death.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 147-147
Author(s):  
Jona Ashok Hattangadi ◽  
Ming-Hui Chen ◽  
Leon Sun ◽  
Anthony Victor D'Amico
Keyword(s):  
Prostate Cancer ◽  
Locally Advanced ◽  
Digital Rectal Examination ◽  
High Grade ◽  
White Race ◽  
Factors Associated ◽  
Rectal Examination ◽  
Risk Of Death ◽  
Increased Risk ◽  
Multivariable Regression

147 Background: A digital rectal examination (DRE) is less commonly practiced in the PSA screening era. Whether detection of high-grade prostate cancer (PC) while still clinically localized on DRE can improve survival in men with a normal PSA is unknown. Methods: From the Surveillance, Epidemiology and End Results database, 166,498 men with PC diagnosed between 2004-2008 were identified. Logistic regression was used to identify factors associated with the occurrence of palpable, PSA-occult (PSA <2.5 ng/ml) and Gleason score (GS) 8-10 PC. Factors examined included age at and year of diagnosis and race. Fine and Grays and Cox multivariable regression were performed to analyze whether these factors, treatment and known prognostic factors were associated with the risk of PC-specific mortality (PCSM) and all-cause mortality (ACM), respectively. Results: Of 166,498, 685 men (0.4%) had palpable, PSA-occult and GS 8 to 10 PC. Median age and PSA at diagnosis in this group were 68 years [IQR: 61-75] and 1.5 ng/ml [IQR: 1-2], respectively. Most (83%) men were white. Both increasing age (adjusted odds ratio (AOR): 1.02 [95% confidence interval (CI) 1.01-1.03]; p<0.0001) and white race (AOR: 1.26 [95% CI 1.03-1.54]; p =0.03) were associated with palpable, Gleason 8 to 10 PC with normal PSA. Significant factors associated with an increased risk of PCSM and ACM in this cohort are shown in the table. For these 685 men, detecting locally advanced as compared to localized PC on DRE was associated with a significantly lower survival (p = 0.0001). Conclusions: Detecting PSA-occult high-grade PC with DRE while disease remains clinically localized amongst high-risk men (over age 68 and white race) has the potential to improve survival. [Table: see text]

scholarly journals Vasectomy and Risk of Aggressive Prostate Cancer: A 24-Year Follow-Up Study

2014 ◽  
Vol 32 (27) ◽  
pp. 3033-3038 ◽  
Author(s):  
Mohummad Minhaj Siddiqui ◽  
Kathryn M. Wilson ◽  
Mara M. Epstein ◽  
Jennifer R. Rider ◽  
Neil E. Martin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Treatment ◽  
Specific Antigen ◽  
Prostate Cancer Risk ◽  
The United States ◽  
Low Grade ◽  
High Grade ◽  
Follow Up Study ◽  
Increased Risk

Purpose Conflicting reports remain regarding the association between vasectomy, a common form of male contraception in the United States, and prostate cancer risk. We examined prospectively this association with extended follow-up and an emphasis on advanced and lethal disease. Patients and Methods Among 49,405 US men in the Health Professionals Follow-Up Study, age 40 to 75 years at baseline in 1986, 6,023 patients with prostate cancer were diagnosed during the follow-up to 2010, including 811 lethal cases. In total, 12,321 men (25%) had vasectomies. We used Cox proportional hazards models to estimate the relative risk (RR) and 95% CIs of total, advanced, high-grade, and lethal disease, with adjustment for a variety of possible confounders. Results Vasectomy was associated with a small increased risk of prostate cancer overall (RR, 1.10; 95% CI, 1.04 to 1.17). Risk was elevated for high-grade (Gleason score 8 to 10; RR, 1.22; 95% CI, 1.03 to 1.45) and lethal disease (death or distant metastasis; RR, 1.19; 95% CI, 1.00 to 1.43). Among a subcohort of men receiving regular prostate-specific antigen screening, the association with lethal cancer was stronger (RR, 1.56; 95% CI, 1.03 to 2.36). Vasectomy was not associated with the risk of low-grade or localized disease. Additional analyses suggested that the associations were not driven by differences in sex hormone levels, sexually transmitted infections, or cancer treatment. Conclusion Our data support the hypothesis that vasectomy is associated with a modest increased incidence of lethal prostate cancer. The results do not appear to be due to detection bias, and confounding by infections or cancer treatment is unlikely.

The Combined Percentage of Gleason Patterns 4 and 5 Is the Best Predictor of Cancer Progression After Radical Prostatectomy

2005 ◽  
Vol 23 (13) ◽  
pp. 2911-2917 ◽  
Author(s):  
Liang Cheng ◽  
Michael O. Koch ◽  
Beth E. Juliar ◽  
Joanne K. Daggy ◽  
Richard S. Foster ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Gleason Score ◽  
Cancer Progression ◽  
Tumor Volume ◽  
High Grade ◽  
Cox Regression Analysis ◽  
Total Tumor Volume ◽  
Increased Risk

Purpose Clinical outcome is variable in prostate cancer patients treated with radical prostatectomy. The Gleason histologic grade of prostatic adenocarcinoma is one of the strongest predictors of biologic aggressiveness of prostate cancer. We evaluated the significance of the relative proportion of high-grade cancer (Gleason patterns 4 and/or 5) in predicting cancer progression in prostate cancer patients treated with radical prostatectomy. Patients and Methods Radical prostatectomy specimens from 364 consecutive prostate cancer patients were totally embedded and whole mounted. Various clinical and pathologic characteristics were analyzed. All pathologic data, including Gleason grading variables, were collected prospectively. Results A multiple-factor analysis was performed that included the combined percentage of Gleason patterns 4 and 5, Gleason score, tumor stage, surgical margin status, preoperative prostate-specific antigen (PSA), extraprostatic extension, and total tumor volume. Using Cox regression analysis with bootstrap resampling for predictor selection, we identified the combined percentage of Gleason patterns 4 and 5 (P < .0001) and total tumor volume (P = .009) as significant predictors of PSA recurrence. Conclusion The combined percentage of Gleason patterns 4 and 5 is one of the most powerful predictors of patient outcome, and appears superior to conventional Gleason score in identifying patients at increased risk of disease progression. On the basis of our results, we recommend that the combined percentage of Gleason patterns 4 and 5 be evaluated in radical prostatectomy specimens. The amount of high-grade cancer in a prostatectomy specimen should be taken into account in therapeutic decision making and assessment of patient prognosis.

Positive surgical margins and biochemical recurrence in obese patients with intermediate- and high-grade prostate cancer with radical prostatectomy.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 50-50
Author(s):  
Emma Holliday Ramahi ◽  
Katherine Cox Ansley ◽  
Matthew W. Jackson ◽  
Joseph W. Basler ◽  
Fei Du ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Technical Difficulty ◽  
Biochemical Failure ◽  
Study Cohort ◽  
High Grade ◽  
Positive Margins ◽  
Primary Endpoints ◽  
Increased Risk ◽  
Pre Treatment

50 Background: The relationship between obesity and prostate cancer outcomes is unclear. We performed a retrospective cohort study to determine the effect of body mass index (BMI) on a cohort of patients with intermediate to high grade prostate cancer treated with radical prostatectomy (RP). Methods: Our retrospective study cohort included 582 men diagnosed with Gleason 7-10 prostate cancer between 1998 and 2008 and treated with RP at a single institution. Patients were stratified into four groups on the basis of their BMI at the time of prostate cancer diagnosis (<25, 25-30, 30-35 or >35). The primary endpoints for comparison were biochemical failure free survival (BFFS) and the incidence of positive margins. PSA >0.2 ng/dl was used to define biochemical failure. Results: After adjusting for age, Gleason score, pre-treatment PSA and the presence of diabetes, we found patients with increasing BMI had an increased frequency of biochemical failure after RP. Compared to patients with a normal BMI (<25), patients with BMI 25-30, 30-35, and >35 had 1.82 (1.12, 2.97; p = 0.02), 2.14 (1.33, 3.45; p = 0.002) and 2.29 (1.1, 4.78; p = 0.03) times higher rates of biochemical failure, respectively. We additionally found increased positive margins after RP in patients with a BMI 30-35 and >35 (41.4% and 45.5%, respectively) when compared to patients with a BMI of <25 and 25-30 (33.3% and 28.9%, respectively); p = 0.02. Conclusions: Patients with increasing BMI seem to be at significantly increased risk for biochemical failure following RP potentially due to the increased technical difficulty of the surgery and increased incidence of positive margins. [Table: see text]

scholarly journals Grade 2 and 3 Obesity and Diagnosed Prostate Cancer in Middle-Aged and Elderly Men: An Epidemiologic Study with Stratified Multistage Sampling Design

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Xuefeng Liu ◽  
Amal Khoury ◽  
Joshua Longcoy ◽  
Joseph Ikekwere
Keyword(s):  
Prostate Cancer ◽  
Epidemiologic Study ◽  
High Grade ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Health And Nutrition ◽  
Increased Risk ◽  
Grade 3 ◽  
Multistage Sampling ◽  
Design And Methods

Background. The association of obesity with the odds of diagnosed prostate cancer (DPC) is inconclusive. Whether grade 2 or grade 3 obesity is associated with increased odds of DPC has not been investigated. Design and Methods. Cross-sectional data of 7,974 subjects aged ≥40 years were collected from the National Health and Nutrition Examination Survey 2001–2010. Odds ratios (ORs) of DPC associated with grade 2 or grade 3 obesity were estimated by conducting weighted logistic regression models. Results. The unadjusted rates of DPC did not differ significantly over grades of BMI (P=0.7044). After adjustment for different groups of potential confounding factors, grade 2 or grade 3 obesity was not significantly associated with the odds of DPC with ORs changing from 0.62 to 0.69 for grade 2 obesity and from 0.81 to 1.09 for grade 3 obesity. Moreover, morbid obesity (grade 2 and 3 obesity combined) was not linked to the odds of DPC. Conclusion. Grade 2 or grade 3 obesity was not associated with the odds of DPC. Whether they are associated with a substantially increased risk of high-grade DPC needs to be further investigated as accumulating evidence has shown that obesity increases the risk of high-grade disease.

Lower risk of prostate cancer in patients with sedentary occupations presenting for a prostate biopsy: Analysis of a Veterans Affairs cohort.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 257-257
Author(s):  
Rimaz M. Khadir ◽  
Rashid K. Sayyid ◽  
Martha K. Terris
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Specific Antigen ◽  
High Volume ◽  
Veterans Affairs ◽  
High Grade ◽  
Increased Risk ◽  
Patient Reported

257 Background: Sedentary behavior has been associated with increased serum prostate-specific antigen (PSA) levels. It is currently unknown whether this correlates with an increased risk of underlying prostate cancer (PCa). Our objective was to determine whether patients with sedentary occupations presenting for a prostate biopsy were at increased risk of PCa diagnosis. Methods: A prospectively collected registry of patients undergoing a prostate biopsy between July 1995 and June 2016 at the Veterans Affairs Medical Center in Augusta, GA was utilized. The occupation was classified as sedentary if it was associated with prolonged periods of sitting (i.e. >50% work hours). This was determined via patient reported history at time of biopsy. The associations between a sedentary lifestyle and risk of a positive prostate biopsy, high grade cancer (i.e. Gleason score 8 or higher), and high volume cancer (i.e. at least 50% of total cores were positive) were evaluated using multivariable logistic regression analyses, controlling for age, race, body mass index, PSA level, free PSA ratio, clinical stage, prostate volume, and family history of prostate cancer. Statistical significance was set at p<0.05. All statistical analyses were performed using R version 3.6.1. Results: Our cohort included 1,914 patients. 271 (14.2%) patients had sedentary jobs. Median patient age was 61.0 years (Interquartile range [IQR] 57.0 – 66.0). Median PSA at time of biopsy was 5.7 ng/ml (IQR 4.4 – 8.2). Of the 1,914 initial biopsies performed, 974 (50.9%) were positive for malignancy. Of patients diagnosed with PCa, 229 (23.5%) had high-grade disease and 316 (32.4%) had high volume disease. On multivariable analysis, patients with a sedentary job had a significantly decreased risk of PCa diagnosis (Odds ratio [OR] 0.43, 95% confidence interval [CI] 0.18-1.03, p= 0.058), but no difference in odds of high grade (OR 0.63, 95% CI 0.089-2.99, p= 0.60) or high volume disease (OR 1.07, 95% CI 0.93-1.21, p= 0.89). Conclusions: Patients with sedentary occupations presenting for a prostate biopsy are at a lower apparent risk for a positive prostate biopsy. These results suggest that the serum PSA levels in such patients may be artificially elevated secondary to increased recumbence with no corresponding increase in risk of malignancy. [Table: see text]

Results of a phase I trial administering Zyflamend to subjects with high-grade prostatic intraepithelial neoplasia

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14575-14575 ◽  
Author(s):  
A. E. Katz ◽  
P. M. Pierorazio ◽  
P. Masson ◽  
E. T. Goluboff ◽  
B. A. Stone ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Adverse Events ◽  
Phase I ◽  
Intraepithelial Neoplasia ◽  
Prostatic Intraepithelial Neoplasia ◽  
Progression Rate ◽  
High Grade ◽  
The Novel ◽  
Increased Risk ◽  
Anti Inflammatory

14575 Background: Subjects diagnosed with prostatic intraepithelial neoplasia (PIN) at prostate biopsy are at increased risk of developing prostate cancer on later biopsies. We initiated a phase I clinical trial to asses the safety and efficacy of the novel herbal anti-inflammatory, Zyflamend, to prevent prostate cancer in high-risk subjects with PIN. Methods: Men ages 40–75 diagnosed with high-grade PIN (without prostate cancer) on biopsy within the last six months were enrolled. Patients were assigned to one of eight treatment groups, with successive dose-escalation occurring in each group. Patients were evaluated every three months for 18 months; at which time they had a physical exam and blood samples drawn to monitor for toxicity, to check for fluctuations in PSA and testosterone, and monitor a battery of inflammatory serum. At 6, 12 and 18 months, 12-core transrectal ultrasound guided biopsy of the prostate was performed. Biopsy tissue was evaluated for the presence of PIN and/or prostate cancer then stained for inflammatory biomarkers. A NCI common terminology criteria for adverse events (v3.0) based questionnaire was used to monitor side effects. Endpoints are completion of the 18 month protocol without adenocarcinoma or diagnosis of adenocarcinoma prior to 18 months. Results: To date 25 patients have been enrolled; the expected closure date is March, 2006. The median patient age is 65.1 years with a median PSA level of 6.8. There have been no adverse events reported or toxicities apparent. Five patients (20%) have complained of grade I dyspepsia resolving spontaneously without intervention. Preliminary results include a total of 22 biopsies performed in 19 patients. 18 of the 22 biopsies were performed per protocol at scheduled visits, the remaining four were performed between scheduled visits. Of 22 biopsies completed seven returned positive for PIN (31.8%) and three have returned with adenocarcinoma (13.6%). Conclusions: The novel herbal anti-inflammatory, Zyflamend, appears to be associated with minimal toxicity and no serious adverse events when administered orally. Short term biopsy results indicate a low progression rate, although long-term efficacy awaits further studies. No significant financial relationships to disclose.

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