scholarly journals Association of very low prostate-specific antigen levels with increased cancer-specific death in men with high-grade prostate cancer

Cancer ◽  
2015 ◽  
Vol 122 (1) ◽  
pp. 78-83 ◽  
Author(s):  
Brandon A. Mahal ◽  
Ayal A. Aizer ◽  
Jason A. Efstathiou ◽  
Paul L. Nguyen
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
High Grade

scholarly journals Survival outcomes of low prostate-specific antigen levels and T stages in patients with high-grade prostate cancer: a population-matched study

2020 ◽  
Vol 11 (22) ◽  
pp. 6484-6490
Author(s):  
Yongming Kang ◽  
Pan Song ◽  
Kun Fang ◽  
Bo Yang ◽  
Luchen Yang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Survival Outcomes ◽  
High Grade ◽  
Matched Study

Identification of low prostate-specific antigen, high Gleason prostate cancer as a unique hormone-resistant entity with poor survival: A contemporary analysis of 640,000 patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 5080-5080
Author(s):  
David Dewei Yang ◽  
Brandon Arvin Virgil Mahal ◽  
Christopher Sweeney ◽  
Quoc-Dien Trinh ◽  
Felix Yi-Chung Feng ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Prostate Specific Antigen ◽  
Locally Advanced ◽  
Specific Antigen ◽  
Molecular Classification ◽  
High Grade ◽  
Biological Insight ◽  
Cancer Specific Mortality ◽  
New Treatment

5080 Background: The clinical implications of a low prostate-specific antigen (PSA) in high-grade prostate cancer are unclear. We examined the prognostic and predictive value of a low PSA in high-grade prostate cancer. Methods: We identified 642,975 patients in the National Cancer Database (n = 491,505) and Surveillance, Epidemiology, and End Results program (n = 151,470) with localized or locally advanced prostate cancer from 2004-2013. Patients were stratified by Gleason score (8-10 vs. ≤7) and PSA (≤2.5, 2.6-4.0, 4.1-10.0, 10.1-20.0, and > 20.0 ng/mL) for analyses. Multivariable Fine-Gray competing risks and Cox regressions were used to analyze prostate-cancer specific mortality (PCSM) and all-cause mortality (ACM), respectively. Results: 5.6% of Gleason 8-10 tumors were diagnosed with PSA ≤2.5 ng/mL. Among Gleason 8-10 disease using PSA 4.1-10.0 ng/mL as referent, PCSM was U-shaped with respect to PSA, with adjusted hazard ratio (AHR) of 1.75 (95% CI 1.05-2.92, P = 0.032) for PSA ≤2.5 ng/mL vs. 1.31, 0.88, and 1.60 for PSA 2.6-4.0, 10.1-20.0, and > 20.0 ng/mL. In contrast, PCSM was linear for Gleason ≤7 disease with AHR of 0.32 (95% CI 0.10-1.00, P = 0.050) for PSA ≤2.5 ng/mL vs. 1.13, 1.69, and 3.22 for PSA 2.6-4.0, 10.1-20.0, and > 20.0 ng/mL (PGleason*PSA interaction< 0.001). Gleason 8-10 disease with PSA ≤2.5 ng/mL had a much higher risk of PCSM than standard NCCN high-risk disease (AHR 1.92, 95% CI 1.18-3.14, P = 0.009; 47-month PCSM 14.0% vs. 10.5%). For Gleason 8-10 tumors treated with definitive radiotherapy, androgen deprivation therapy (ADT) was associated with decreased ACM for PSA > 2.5 ng/mL (AHR 0.87, 95% CI 0.81-0.94, P < 0.001) but trended toward increased ACM for PSA ≤2.5ng/mL (AHR 1.27, 95% CI 0.89-1.81, P = 0.194; PADT*PSA interaction= 0.026). Conclusions: Low PSA, high-grade prostate cancer appears to be a unique hormone-resistant entity with a high risk of PCSM that responds poorly to standard treatment. Further molecular classification and trials are urgently needed to develop biological insight into this entity and establish new treatment paradigms, potentially including chemotherapy or novel systemic agents.

Effects of Lycopene Supplementation in Patients with Localized Prostate Cancer

2002 ◽  
Vol 227 (10) ◽  
pp. 881-885 ◽  
Author(s):  
Omer Kucuk ◽  
Fazlul H. Sarkar ◽  
Zora Djuric ◽  
Wael Sakr ◽  
Michael N. Pollak ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Growth Factor ◽  
Dietary Intake ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Intervention Group ◽  
Intraepithelial Neoplasia ◽  
Prostatic Intraepithelial Neoplasia ◽  
Control Group ◽  
High Grade

Epidemiological studies have shown an inverse association between dietary intake of lycopene and prostate cancer risk. We conducted a clinical trial to investigate the biological and clinical effects of lycopene supplementation in patients with localized prostate cancer. Twenty-six men with newly diagnosed prostate cancer were randomly assigned to receive a tomato oleoresin extract containing 30 mg of lycopene (n = 15) or no supplementation (n = 11) for 3 weeks before radical prostatectomy. Biomarkers of cell proliferation and apoptosis were assessed by Western blot analysis in benign and cancerous prostate tissues. Oxidative stress was assessed by measuring the Peripheral blood lymphocyte ONA oxidation product 5-hydroxymethyl-deoxyuridine (5-OH-mdU). Usual dietary Intake of nutrients was assessed by a food frequency questionnaire at baseline. Prostatectomy specimens were evaluated for pathologic stage, Gleason score, volume of cancer, and extent of high-grade prostatic intraepithelial neoplasia. Plasma levels of lycopene, insulin-like growth factor-1, insulin-like growth factor binding protein-3, and prostate-specific antigen were measured at baseline and after 3 weeks of supplementation or observation. After intervention, subjects in the intervention group had smaller tumors (80% vs 45%, less than 4 ml), less involvement of surgical margins and/or extra-prostatic tissues with cancer (73% vs 18%, organ-confined disease), and less diffuse involvement of the prostate by high-grade prostatic intraepithelial neoplasia (33% vs 0%, focal involvement) compared with subjects in the control group. Mean plasma prostate-specific antigen levels were lower in the intervention group compared with the control group. This pilot study suggests that lycopene may have beneficial effects in prostate cancer. Larger clinical trials are Warranted to investigate the potential preventive and/or therapeutic role of lycopene in prostate cancer.

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