Identification of prostate cancer risk categories according to surgical margins status, pathological stage and Gleason score

2013 ◽  
Vol 20 (11) ◽  
pp. 1097-1103 ◽  
Author(s):  
Riccardo Schiavina ◽  
Marco Borghesi ◽  
Michelangelo Fiorentino ◽  
Eugenio Brunocilla ◽  
Fabio Manferrari ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Risk ◽  
Gleason Score ◽  
Prostate Cancer Risk ◽  
Surgical Margins ◽  
Pathological Stage ◽  
Risk Categories

scholarly journals Pre-treatment risk stratification of prostate cancer patients:A critical review

2012 ◽  
Vol 6 (2) ◽  
Author(s):  
George Rodrigues ◽  
Padraig Warde ◽  
Tom Pickles ◽  
Juanita Crook ◽  
Michael Brundage ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prognostic Factors ◽  
Cancer Risk ◽  
Risk Stratification ◽  
Gleason Score ◽  
Critical Review ◽  
Specific Antigen ◽  
Prostate Cancer Risk ◽  
Original Research ◽  
Pre Treatment

Introduction:  The use of accepted prostate cancer risk stratification groups based on prostate-specific antigen, T stage and Gleason score assists in therapeutic treatment decision-making, clinical trial design and outcome reporting. The utility of integrating novel prognostic factors into an updated risk stratification schema is an area of current debate. The purpose of this work is to critically review the available literature on novel pre-treatment prognostic factors and alternative prostate cancer risk stratification schema to assess the feasibility and need for changes to existing risk stratification systems. Methods:  A systematic literature search was conducted to identify original research publications and review articles on prognostic factors and risk stratification in prostate cancer. Search terms included risk stratification, risk assessment, prostate cancer or neoplasms, and prognostic factors. Abstracted information was assessed to draw conclusions regarding the potential utility of changes to existing risk stratification schema. Results:  The critical review identified three specific clinically relevant potential changes to the most commonly used three-group risk stratification system: (1) the creation of a very-low risk category; (2) the splitting of intermediate-risk into a low- and highintermediate risk groups; and (3) the clarification of the interface between intermediate- and high-risk disease. Novel pathological factors regarding high-grade cancer, subtypes of Gleason score 7 and percentage biopsy cores positive were also identified as potentially important risk-stratification factors. Conclusions:  Multiple studies of prognostic factors have been performed to create currently utilized prostate cancer risk stratification systems. We propose potential changes to existing systems.

The importance of surgical margins for biochemical recurrence in high-risk prostate cancer patients.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 75-75
Author(s):  
Victor Srougi ◽  
Rafael Sanchez-Salas ◽  
Fernando P. Secin ◽  
Igor Nunes-Silva ◽  
Mohammed Baghdadi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Gleason Score ◽  
Biochemical Recurrence ◽  
Surgical Margins ◽  
Pathological Stage ◽  
Free Survival ◽  
Positive Surgical Margins ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer

75 Background: High-risk prostate cancer (PCa) is associated with greater risk of biochemical recurrence and cancer specific lethality. A multi-modal treatment is required for this group of patients, comprising surgery as part of it. However, the role of surgery as monotherapy is still under investigation. The purpose of this study is to analyze the influence of surgical margins on biochemical recurrence (BCR) among patients with high-risk prostate cancer (PCa) treated with robot assisted radical prostatectomy (RARP) since the start of our robotic program. Methods: We retrospectively analyzed our prospectively collected database of 5695 minimally invasive prostatectomies performed between 2000 and 2015. Clinical, pathological and oncological outcomes were evaluated in patients fulfilling Damico´s high risk characteristics. Primary endpoint was BCR, defined as post-operative PSA ≥ 0,2. Patients with neoadjuvant or adjuvant therapy were excluded. BCR was estimated with Kaplan-Meier curves. Cox proportional hazards regression was used to estimate variables associated with BCR. Results: We identified 199 high-risk PCa patients treated with RARP during the study period. Gleason score ≥ 8, PSA ≥ 20 and clinical stage ≥ T2c were present in 44%, 35% and 11% of the patients, respectively. The rate of positive surgical margins was 25%. With a median follow-up of 23 months (interquartile 12 – 34 months), 31% of the patients had BCR. Five-year BCR-free survival was 34,5%. Gleason score ≥ 8, PSA ≥ 20 and positive surgical margins were not predictors of BCR. A positive correlation of pathological stage ≥ T3 and BCR was found with (HR = 2.9; 95% CI = 1.2-6.9). Conclusions: The 5-years BCR-free survival was poor despite a low rate of positive surgical margins, when compared to historical series. We found that pathological stage ≥ T3 has a significant correlation with the BCR and that negative surgical margins do not assure good prognosis for high-risk patients.

Systematic Review Links the Prevalence of Intraductal Carcinoma of the Prostate to Prostate Cancer Risk Categories

2017 ◽  
Vol 72 (4) ◽  
pp. 492-495 ◽  
Author(s):  
Laura H. Porter ◽  
Mitchell G. Lawrence ◽  
Dragan Ilic ◽  
David Clouston ◽  
Damien M. Bolton ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Cancer Risk ◽  
Prostate Cancer Risk ◽  
Intraductal Carcinoma ◽  
Carcinoma Of The Prostate ◽  
Risk Categories

scholarly journals An examination of clinical differences between carriers and non-carriers of chromosome 8q24 risk alleles in a New Zealand Caucasian population with prostate cancer

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e1731 ◽  
Author(s):  
Karen S. Bishop ◽  
Dug Yeo Han ◽  
Nishi Karunasinghe ◽  
Megan Goudie ◽  
Jonathan G. Masters ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Environmental Factors ◽  
Cancer Risk ◽  
Gleason Score ◽  
Risk Score ◽  
Genetic Risk ◽  
Genetic Risk Score ◽  
Prostate Cancer Risk ◽  
Link Type ◽  
Chromosome 8Q24

Background.Prostate cancer makes up approximately 15% of all cancers diagnosed in men in developed nations and approximately 4% of cases in developing nations. Although it is clear that prostate cancer has a genetic component and single nucleotide polymorphisms (SNPs) can contribute to prostate cancer risk, detecting associations is difficult in multi-factorial diseases, as environmental and lifestyle factors also play a role. In this study, specific clinical characteristics, environmental factors and genetic risk factors were assessed for interaction with prostate cancer.Methods.A total of 489 prostate cancer cases and 427 healthy controls were genotyped for SNPs found on chromosome 8q24 and a genetic risk score was calculated. In addition the SNPs were tested for an association with a number of clinical and environmental factors.Results.Age and tobacco use were positively associated, whilst alcohol consumption was negatively associated with prostate cancer risk. The following SNPs found on chromosome 8q24 were statistically significantly associated with prostate cancer:rs10086908,rs16901979;rs1447295andrs4242382. No association between Gleason score and smoking status, or between Gleason score and genotype were detected.Conclusion.A genetic risk score was calculated based on the 15 SNPs tested and found to be significantly associated with prostate cancer risk. Smoking significantly contributed to the risk of developing prostate cancer, and this risk was further increased by the presence of four SNPs in the 8q24 chromosomal region.

scholarly journals Association between baseline serum glucose, triglycerides and total cholesterol, and prostate cancer risk categories

2016 ◽  
Vol 5 (6) ◽  
pp. 1307-1318 ◽  
Author(s):  
Rhonda Arthur ◽  
Henrik Møller ◽  
Hans Garmo ◽  
Lars Holmberg ◽  
Pår Stattin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Risk ◽  
Total Cholesterol ◽  
Prostate Cancer Risk ◽  
Serum Glucose ◽  
Baseline Serum ◽  
Risk Categories

scholarly journals Automating the Determination of Prostate Cancer Risk Strata From Electronic Medical Records

2017 ◽  
pp. 1-8 ◽  
Author(s):  
Justin R. Gregg ◽  
Maximilian Lang ◽  
Lucy L. Wang ◽  
Matthew J. Resnick ◽  
Sandeep K. Jain ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Risk ◽  
Risk Stratification ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Gleason Score ◽  
Cancer Care ◽  
Clinical Stage ◽  
Prostate Cancer Risk ◽  
Risk Stratum

Purpose Risk stratification underlies system-wide efforts to promote the delivery of appropriate prostate cancer care. Although the elements of risk stratum are available in the electronic medical record, manual data collection is resource intensive. Therefore, we investigated the feasibility and accuracy of an automated data extraction method using natural language processing (NLP) to determine prostate cancer risk stratum. Methods Manually collected clinical stage, biopsy Gleason score, and preoperative prostate-specific antigen (PSA) values from our prospective prostatectomy database were used to categorize patients as low, intermediate, or high risk by D’Amico risk classification. NLP algorithms were developed to automate the extraction of the same data points from the electronic medical record, and risk strata were recalculated. The ability of NLP to identify elements sufficient to calculate risk (recall) was calculated, and the accuracy of NLP was compared with that of manually collected data using the weighted Cohen’s κ statistic. Results Of the 2,352 patients with available data who underwent prostatectomy from 2010 to 2014, NLP identified sufficient elements to calculate risk for 1,833 (recall, 78%). NLP had a 91% raw agreement with manual risk stratification (κ = 0.92; 95% CI, 0.90 to 0.93). The κ statistics for PSA, Gleason score, and clinical stage extraction by NLP were 0.86, 0.91, and 0.89, respectively; 91.9% of extracted PSA values were within ± 1.0 ng/mL of the manually collected PSA levels. Conclusion NLP can achieve more than 90% accuracy on D’Amico risk stratification of localized prostate cancer, with adequate recall. This figure is comparable to other NLP tasks and illustrates the known tradeoff between recall and accuracy. Automating the collection of risk characteristics could be used to power real-time decision support tools and scale up quality measurement in cancer care.

scholarly journals The quantitative Gleason score improves prostate cancer risk assessment

Cancer ◽  
2012 ◽  
Vol 118 (24) ◽  
pp. 6046-6054 ◽  
Author(s):  
Adam C. Reese ◽  
Janet E. Cowan ◽  
Jonathan S. Brajtbord ◽  
Catherine R. Harris ◽  
Peter R. Carroll ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Assessment ◽  
Cancer Risk ◽  
Gleason Score ◽  
Prostate Cancer Risk ◽  
Cancer Risk Assessment
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