Carcinoma prostata gleason 7 survival

carcinoma prostata gleason 7 survival

Per carcinoma della prostata si intende una categoria diagnostica che annovera le neoplasie maligne che si originano dalle cellule epiteliali della prostatauna ghiandola dell' apparato carcinoma prostata gleason 7 survival maschile. Il tumore alla prostata si sviluppa più frequentemente negli ultracinquantenni; è il secondo più comune Cura la prostatite di tumore negli Stati Unitidove è responsabile del maggior numero di morti da tumore, dopo il tumore del polmone. Il tumore prostatico viene più spesso scoperto all' esame obiettivo o per il tramite di esami ematicicome la misurazione del PSA antigene prostatico specifico. Un sospetto tumore alla prostata è tipicamente carcinoma prostata gleason 7 survival tramite l'asportazione biopsia di un frammento di tessutoe il successivo esame istologico. Inizialmente venne classificato come malattia rara, per gli scarsi metodi di indagine e la ridotta speranza di vita media dell'epoca. I carcinoma prostata gleason 7 survival trattamenti messi in atto furono interventi chirurgici per risolvere l'ostruzione urinaria. La rimozione chirurgica dei testicoli, orchiectomiacome trattamento venne eseguita nel infra Terapia ormonalema con successo limitato. La prostatectomia radicale retropubica venne messa a punto nel da Patrick Walsh. Nel Charles B. La scoperta di questa terapia valse a Huggins nel il Nobel per la Medicina. Schally e Roger Guilleminche per questo vinsero il Nobel per la Medicina nel ; vennero quindi sviluppati e utilizzati in terapia gli agonisti per i recettori del GnRH. La radioterapia per il tumore prostatico venne sviluppata agli inizi carcinoma prostata gleason 7 survival XX secolo e inizialmente consisteva nell'impianto intraprostatico di radio. La radioterapia a fascio esterno fu più utilizzata quando alla metà del XX secolo divennero disponibili fonti di radiazioni più potenti. Al protocollo iniziale con ciclofosfamide 5-fluorouracile ben presto si aggiunsero molteplici altri con un'ampia gamma di farmaci sistemici. Nessun dato. La frequenza del carcinoma prostatico nel mondo è largamente variabile. Le cause specifiche carcinoma prostata gleason 7 survival neoplasia sono sconosciute.

NEJM ; 19 Bill-Axelson et al. Bishoff et al. Cancer incidence and mortality in the European Union: cancer registry data and estimates of national incidence for Eur J Cancer ;33 7 Blana et al.

carcinoma prostata gleason 7 survival

Management carcinoma prostata gleason 7 survival locally advanced prostate cancer: a European Consensus. Int J Clin Pract ;57 3 Radical prostatectomy for prostate cancer: the perineal approach increases the risk of surgically carcinoma prostata gleason 7 survival positive margins and capsular incisions. J Urol ; 4 Bolla et al. Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer an EORTC study : a phase III randomised trial.

Lancet Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial EORTC trial Bratt O.

carcinoma prostata gleason 7 survival

Hereditary prostate cancer: clinical aspects. Estimates of cancer incidence and mortality in Europe in Eur J Cancer ;38 1 Latent carcinoma of prostate at autopsy in seven areas. Int J Cancer ;20 5 Validation of a nomogram predicting the probability of lymph node invasion based on the extent of pelvic lymphadenectomy in patients with clinically localized prostate cancer. BJU Int ;98 4 Epub ahead of print Jun 26, Complications and other surgical outcomes associated with extended pelvic Cura la prostatite in men carcinoma prostata gleason 7 survival localized prostate cancer.

Eur Urol ;50 5 Epub ahead of print Aug 31, The role of lymphadenectomy in prostate cancer. Nat Clin Pract Urol ;2 7 Burnett, Burren et al. Cancer incidence in Sweden Mendelian inheritance of familial prostate cancer. Carter et al. Catalona et al. J Urol ; 5 Pt 2 Chang et al. Chapelon et al. Chaussy and Thuroff, Chen carcinoma prostata gleason 7 survival Wood, Cheng et al.

Risk of prostate carcinoma death in patients with lymph node metastasis. Cancer ;91 1 carcinoma prostata gleason 7 survival Choo et al. Ciancio and Kim, Survival of men carcinoma prostata gleason 7 survival clinically localized prostate cancer detected in the eighth decade of life.

J Urol ; 5 Cox et al. Cox, Cozzarini et al. Critz et al. Critz, Cytron et al. Combination of preoperative PSA level, biopsy Gleason score, percentage of positive biopsies and MRI T-stage to predict early failure in men with clinically localized prostate cancer. Urology ;55 4 Da Silva et al. Abstract D'Amico et al. Radical prostatectomy: prospective assessment of mortality and morbidity.

Eur Urol ;29 2 De La Taille et al. Diet and its preventive role in prostatic disease. Eur Urol ;35 Di Muzio et al.

carcinoma prostata gleason 7 survival

Draisma et al. Variations among individual surgeons in the rate of positive surgical margins in radical prostatectomy specimens. J Urol ; 6 Impotenza 1 Eastham, Impalpable invisible stage T1c prostate cancer: characteristics and clinical relevance in radical prostatectomy specimens — a different view.

J Urol ; 1 Epstein et al. J Urol ; 6 Pt 2 Epstein JI, Herawi M. Prostate needle biopsies containing prostatic intraepithelial neoplasia or atypical foci suspicious for carcinoma: implications for patient care. J Urol ; 3 Pt 1 The significance of low grade prostate cancer on needle biopsy. A radical prostatectomy study of tumour grade, volume, and stage of the biopsied and multifocal tumour. Cancer ;66 9 Radical prostatectomy for impalpable prostate cancer: the Johns Hopkins experience with tumours found on transurethral resection stages T1A and T1B and on needle biopsy stage T1C.

Epstein JI. Gleason score adenocarcinoma of the prostate on needle biopsy: a diagnosis that should not carcinoma prostata gleason 7 survival made. Am J Surg Pathol ;24 4 The role of tomato products and lycopenes in the prevention of prostate cancer: a meta-analysis of observational studies.

Cancer Epidemiol Biomarkers Prev ;13 3 Etzioni et al. Fallon B, Williams RD. Current options in the management of clinical stage C prostatic carcinoma. Urol Clin North Am ;17 4 Fraass, Carcinoma prostata gleason 7 survival et al.

Gelet et al. Results carcinoma prostata gleason 7 survival radical prostatectomy in men with locally advanced prostate cancer: multi-institution pooled analysis. Eur Urol ;32 4 J Urol ; 4discussion Gibbons RP. Total prostatectomy for clinically localized prostatic cancer: long-term surgical results and current morbidity.

NCI Monogr ; 7 Long-term functional and oncological results after retroperitoneal laparoscopic prostatectomy according to prospective evaluation of patients. World J Urol ;4 3 Gontero P, Trattiamo la prostatite RS. Nerve-sparing radical retropubic prostatectomy: techniques and clinical considerations.

Prostate Cancer Prostatic Dis ;8 2 Radical prostatectomy versus expectant primary treatment in stages I and II prostatic cancer. A fifteen-year follow-up. Urology ;36 6 Gretzer et al. Familial prostate cancer in Sweden. A nationwide register cohort study. Cancer ;77 1 Grossfeld et al. Han et al. The year Johns Hopkins experience. Long-term carcinoma prostata gleason 7 survival disease-free and cancerspecific survival following anatomic radical retropubic prostatectomy.

Urol Clin North Am ;28 3 Hanks et al. Radical retropubic prostatectomy: morbidity and urinary continence in consecutive cases. Urology ;43 2 Suppl Heidenreich A et carcinoma prostata gleason 7 survival. J Urol ; a Extended pelvic lymphadenectomy in patients undergoing radical prostatectomy: high incidence of lymph node metastasis.

The management of locally advanced prostate cancer. Carcinoma prostata gleason 7 survival Oncol ; Outcome of surgery for clinical unilateral T3a prostate cancer: a single-institution experience.

Eur Urol ;51 1discussion Huland H.

Carcinoma della prostata

Hull et al. Cancer control with radical prostatectomy alone in 1, consecutive patients. J Urol ; 2 Pt 1 Jemal et al. Johansson et al. Deferred treatment in localized prostatic cancer. Acta Oncol ;30 2 A pretreatment table for the prediction of final histopathology after radical prostatectomy in clinical unilateral T3a prostate cancer. Eur Urol.

I pazienti che sono stati sottoposti a trattamenti potenzialmente curativi come la prostatectomia radicale o la radioterapia radicale sono a rischio di recidiva. Incidenza, sede e tempo della recidiva dipendono dal Gleason score, dal PSA basale e dallo stadio clinico o patologico. I pazienti sottoposti ad ormono-terapia dovrebbero essere seguiti, durante il trattamento, ad intervalli di mesi sulla base dei fattori prognostici con PSA, esami ematobiochimici, DRE, eventuale ecografia trans-rettale e Prostatite dei sintomi specialmente dolore osseo.

Analysis of risk factors associated with prostate cancer extension to the surgical margin and pelvic node metastasis at radical prostatectomy.

J Urol ; [ Medline ]. Long-term impotenza among men with conservatively treated localized prostate cancer. JAMA ; [ Medline ]. Competing risk analysis of men aged 55 to 74 years at diagnosis managed conservatively for clinically localized prostate cancer. Long-term hazard of progression after radical prostatectomy for clinically localized prostate Prostatite cronica continued risk of biochemical failure after 5 years.

Consensus statement: guidelines for PSA following radiation therapy. Hormonal treatment before radical prostatectomy: a 3-year followup. Infection after transrectal core biopsies of the prostate—risk factors and antibiotic prophylaxis. Br J Urol ; [ Medline ]. Diagnosis of prostate cancer: optimal number carcinoma prostata gleason 7 survival prostate biopsies related to serum prostate-specific antigen and findings on digital rectal examination. Scand J Urol Nephrol ; [ Medline ]. Disease progression and survival of patients with positive lymph nodes after radical prostatectomy.

Carcinoma prostata gleason 7 survival there a chance of carcinoma prostata gleason 7 survival Relationship between perineural tumor invasion on needle biopsy and radical prostatectomy capsular penetration in clinical stage B adenocarcinoma of carcinoma prostata gleason 7 survival prostate.

Am J Surg Pathol ; [ Medline ]. Late rectal bleeding following combined X-ray and proton high dose irradiation for patients with stages T3-T4 prostate carcinoma. Prostate specific antigen density: a means of distinguishing benign prostatic hypertrophy and prostate cancer.

Quality of life studies and genito-urinary tumors. Ann Oncol. Ann Oncol ; 14 Suppl 5 [Medline]. Pelvic lymphadenectomy can be omitted in carcinoma prostata gleason 7 survival patients with carcinoma of the prostate: development of a system of patient selection.

Urology ; [ Medline ]. Radiother Oncol ; carcinoma prostata gleason 7 survival Medline ]. Brachytherapy for carcinoma of the prostate: techniques, patient selection, and clinical outcomes. Semin Radiat Oncol ; [ Medline ]. Eliminating the need for bilateral pelvic lymphadenectomy in select patients with prostate cancer. Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer an EORTC study : a phase III randomised trial.

Lancet ; [ Carcinoma prostata gleason 7 survival ]. Bookstein R. Tumor suppressor genes in prostate cancer. Prostae cancer: biology genetics and the new therapeutics. Staging of prostate cancer. Semin Surg Carcinoma prostata gleason 7 survival ; [ Medline ]. Bostwick DG. Progression of prostatic intraepithelial neoplasia to early invasive adenocarcinoma. Eur Urol ; [ Medline ]. Screening for prostatic carcinoma with prostate specific antigen.

Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease. Potency, continence and complication rates in 1, consecutive radical retropubic prostatectomies. Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: results of a multicenter clinical trial of 6, men.

Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med ; [ Medline ]. Evaluation of percentage of free serum prostate-specific antigen to improve specificity carcinoma prostata gleason 7 survival prostate cancer screening. Adjuvant and salvage radiation therapy after radical prostatectomy for adenocarcinoma of the prostate.

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Risk of prostate carcinoma death in patients with lymph node metastasis. Cancer ; [ Medline ]. Results of conservative management of clinically localized prostate cancer.

Chodak GW. Early detection and screening for prostatic cancer. Re: Prostate cancer and the androgen receptor. J Natl Cancer Inst ; [ Medline ]. Studies in medical and population subjects No. London: The Stationary Office. Multiple transrectal ultrasound-guided prostatic biopsies—true morbidity and patient acceptance. Cotran, Kumar, Collins. The male genital tract. In: Robbins Pathologic basis of disease, 6th Ed. Philadelphia: Prostatite Saunders ; pp.

Biochemical outcome after carcinoma prostata gleason 7 survival prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. DNA ploidy, Gleason score, pathological stage and serum PSA levels as predictors Trattiamo la prostatite disease-free survival in C-D1 prostatic cancer patients submitted to radical retropubic prostatectomy.

Survival of cancer patients in Finland Acta Oncol ; 38 Suppl carcinoma prostata gleason 7 survival Risk factors for urinary incontinence carcinoma prostata gleason 7 survival radical prostatectomy. The role of prostate secific antigen in the management of prostate cancer. Berlin: Springer-Verlag.

Eleven-year management of prostate cancer patients on active surveillance: what have we learned?

Impalpable invisible stage T1c prostate cancer: characteristics and clinical relevance in radical prostatectomy specimens—a different view. Impotenza of prostatic carcinoma: the yield of serum prostate specific antigen, digital rectal examination and transrectal ultrasonography.

Carcinoma prostata gleason 7 survival prostatectomy for impalpable prostate cancer: the Johns Hopkins experience with tumors found carcinoma prostata gleason 7 survival transurethral resection stages T1A and T1B and on needle biopsy stage T1C. Epstein JI. Pathologic assessment of the surgical specimen.

Urol Clin North Am ; [ Medline ]. Cancer incidence, mortality and prevalence worldwide, version 1. Cancer surveillance series: interpreting trends in prostate cancer—part II: Cause of death misclassification and the recent rise and fall in prostate cancer mortality. Prostate specific antigen decline following the discontinuation of flutamide in patients with stage D2 prostate cancer. Am J Carcinoma prostata gleason 7 survival ; [ Medline ].

Fowler FJ, Jr. Patient-reported complications and follow-up treatment after radical prostatectomy. The National Medicare Experience: updated June Does radical prostatectomy in the presence of positive Cura la prostatite lymph nodes enhance survival?

For this investigation, we included the following variables abstracted related to PCa aggressiveness: pT stage, Gleason score, tumor volume, seminal vesicle involvement, margin status and extracapsular extension. For those patients with multiple foci, we added together the estimated volumes from each individual foci.

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Our primary analysis focused on estimating the association of standard measures of PCa aggressiveness that is, Gleason grade, pT stage, extracapsular involvement with case vs control status that is, obese vs non-obese. For extra-capsular extension, seminal vesicle involvement and surgical margins, we used dichotomized categories of no reference and yes.

Finally, tumor volume and prostatic volume were treated as continuous, modeled using a log2 transformation and reported as the association with a doubling in those variables. We employed logistic regression models to estimate the magnitude of the association of obesity status with our pathologic measures of PCa aggressiveness in a univariate setting and after adjusting for residual confounding by screening PSA level and age that is, we already matched on these two variables as well as potential confounding by year of surgery and prostate volume.

In Table 1 we provide comparisons of demographic and clinical features between our cases and controls at both sites. As a result of our frequency matching efforts, cases and controls are of similar age at the time of surgery and have comparable pre-operative PSA levels. Similarly, the median age for cases carcinoma prostata gleason 7 survival Mayo Clinic in Rochester is In Table 1 we also provide distributions for surgery year to show that cases and controls have similar distributions within each institution with respect to when the surgeries were performed.

We also provide in Table 1 the carcinoma prostata gleason 7 survival of BMI within our cases and controls from each site. Finally, we carcinoma prostata gleason 7 survival information on surgery type to underscore that, although a higher percentage of the surgeries are performed laparoscopically at Mayo Clinic in Florida compared with Mayo Clinic in Rochester, carcinoma prostata gleason 7 survival each institution the cases and controls had similar distributions with respect to type of surgery.

In the Mayo Clinic in Rochester patient population, we noted consistent evidence of increased risk of more aggressive pathologic features in cases vs controls. That is, after controlling for age and PSA level, the odds of an obese patient a case having more aggressive pathologic features were elevated compared with a non-obese patient control.

Given that we model each variable as a log2 transformation, both of the carcinoma prostata gleason 7 survival ORs are interpreted as the impact of a doubling in prostate and tumor volume, respectively, on the odds of being obese vs non-obese.

As independent validation, our analysis carcinoma prostata gleason 7 survival the patients from Mayo Clinic in Florida generated ORs that are consistent with the results obtained for the Mayo Clinic in Rochester patients, albeit with less power to detect these associations as statistically significant because of the smaller sample size Table 2. Although the results from the Mayo Florida population did not achieve conventional statistical significance for most of these variables, the magnitude and direction of the ORs are strikingly similar to that of the Mayo Rochester population.

Finally, further adjustment in our models for year of surgery and prostate volume did not alter our findings. For these analyses, we only report the data from the Mayo Clinic in Rochester population given that this more conservative definition of obesity resulted in a smaller case group and therefore more limited power in the validation set carcinoma prostata gleason 7 survival Mayo Carcinoma prostata gleason 7 survival in Florida.

Interestingly, we noted continued evidence of increased risk of more aggressive pathologic features in cases vs controls. Most notably, the OR from these new analysis for Gleason grade 8—10 increased from 1.

Of interest, several investigators have reported data supporting the existence of an inverse association between BMI and PSA levels in men. Indeed, if the impact is clinically significant, then we would expect that obese men would present with more advanced and more aggressive PCa compared with normal-weight men after matching on age and PSA level.

Herein, we provide evidence from two independent nested case-control studies that after adjusting for PSA and age, obese men present with more advanced that is, later stage and more aaggressive that is, higher grade PCa compared with non-obese men. There is a key distinction that needs to be made between the research question we address in this investigation and one that has been previously reported by several investigators.

Indeed, there are a number of reports in the literature addressing Trattiamo la prostatite more etiologic question of whether obesity itself is a risk factor for PCa. Although several cohort studies suggest a positive association between increasing BMI and PCa risk, there are a number of studies reporting no association as well.

Recently, Banez et al. Although these results support carcinoma prostata gleason 7 survival lack of a need to adjust PSA levels for obese men with regard to simply detecting the presence of PCa, they do not inform the larger question of whether PSA screening levels should be adjusted to avoid delaying diagnosis and allowing unnecessary advancement of PCa in obese men.

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L' abstract della relazione ha impotenza che: "I nostri risultati suggeriscono che la frequenza di eiaculazione non prostatite correlata a un aumento del rischio di cancro alla prostata". Altri progetti. MedlinePlus : ; eMedicine :.

carcinoma prostata gleason 7 survival

Da Wikipedia, l'enciclopedia libera. URL consultato il 7 gennaio archiviato dall' url originale il 4 carcinoma prostata gleason 7 survival URL consultato il 26 dicembre The case of scirrhous of the prostate gland with corresponding affliction of the lymphatic glands in the lumbar region and in the pelvis. Lancet 1, Prostate cancer: a brief history and the discovery of hormonal ablation treatment. Four cases of radical prostatectomy. Johns Hopkins Bull. Radical prostatectomy with preservation of sexual function: anatomical and pathological impotenza. Prostate 4, Studies on prostate cancer: 1.

The effects of castration, of estrogen and androgen injection on serum phosphatases in metastatic carcinoma of the prostate. Cancer Res. Schally, AJ. Kastin; A.

Arimura, Hypothalamic follicle-stimulating hormone FSH and luteinizing hormone LH -regulating hormone: structure, physiology, and clinical studies. Tolis, D. Ackman; A. Stellos; A. Mehta; F. Labrie; AT. Fazekas; AM. Comaru-Schally; AV. Schally, Tumor growth inhibition in patients with prostatic carcinoma treated with luteinizing hormone-releasing hormone agonists. Denmeade, JT. Isaacs, A history of prostate cancer treatment. Scott, DE. Johnson; JE. Schmidt; RP. Gibbons; GR. Prout; JR.

Joiner; J. Saroff; GP. Murphy, Chemotherapy of advanced prostatic carcinoma with cyclophosphamide or 5-fluorouracil: results of first national randomized study. URL consultato l'11 novembre Hoffman, FD. Gilliland; JW. Eley; LC.

Harlan; RA. Stephenson; JL. Stanford; PC. Carcinoma prostata gleason 7 survival AS. Carcinoma prostata gleason 7 survival WC. Hunt; AL. Potosky, Racial and ethnic differences in advanced-stage prostate cancer: the Prostate Cancer Outcomes Study.

URL consultato il 27 gennaio Cancer Prev. Hsing and Anand P. Cancer Inst. Hankey, EJ. Feuer; LX. Clegg; RB. Hayes; Carcinoma prostata gleason 7 survival.

Legler; PC. Prorok; LA. Ries; RM. Merrill; RS. Kaplan, Cancer surveillance series: interpreting trends in prostate cancer--part I: Evidence of the effects of screening in recent prostate cancer incidence, mortality, and survival rates. Breslow, CW.

Tumore della prostata

Chan; G. Dhom; RA. Drury; LM. Franks; B. Gellei; YS. Lee; S. Lundberg; B. Sparke; NH. Sternby; H. Tulinius, Latent carcinoma of prostate at autopsy in seven areas. Jemal, T. Murray; E. Ward; A. Samuels; RC. Tiwari; A. Ghafoor; EJ. Feuer; MJ. Thun, Cancer statistics, Steinberg, BS. Carter; TH. Beaty; B. Childs; PC. Walsh, Family carcinoma prostata gleason 7 survival and the risk of prostate cancer. Lichtenstein, NV. Holm; PK. Verkasalo; A. Iliadou; J.

Kaprio; M. Koskenvuo; E. Pukkala; A. Carcinoma prostata gleason 7 survival K. Hemminki, Environmental and heritable factors in the causation of cancer--analyses of cohorts of twins from Sweden, Denmark, and Finland. Struewing, P. Hartge; S. Wacholder; SM. Baker; M. Berlin; M. McAdams; MM. Timmerman; LC. Brody; MA. Schulman, S. Ekane; AR. Zlotta, Nutrition and prostate cancer: evidence or suspicion? Jacobs, C.

Rodriguez; AM. Mondul; CJ. Connell; SJ. Henley; EE. Thank you for visiting nature. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser or turn off compatibility mode in Internet Explorer.

In the meantime, to ensure continued support, we are displaying the carcinoma prostata gleason 7 survival without styles and JavaScript. Help us improve carcinoma prostata gleason 7 survival products. Sign up to take part. It remains unclear whether the hemodilution effect of body mass index BMI on PSA levels translates to inappropriate prostate cancer PCa screening in obese men. To address this, we conducted two nested case—control studies within prospective cohorts of men undergoing radical prostatectomy for newly diagnosed PCa.

Cases and controls were frequency matched on age and PSA level. In a similar manner, we identified cases and controls treated at Mayo Clinic in Florida between and We employed logistic regression models to evaluate the association of pathologic features of aggressiveness with obesity status.

Results from the smaller Florida population supported these same associations but did not achieve conventional statistical significance. Obese men present with more aggressive PCa tumors compared with non-obese men of similar age and PSA screening values.

If confirmed, this would support the need to explore PSA-based screening in obese men to possibly account for a hemodilution effect. The use carcinoma prostata gleason 7 survival PSA as a screening tool for prostate cancer detection remains a controversial issue.

Although lower PSA levels in obese men are well prostatite, what remains in question is whether this results in a need to adjust PSA screening levels among obese men.

That is, a carcinoma prostata gleason 7 survival clinical question centers on whether obese men present with more aggressive PCa when compared with non-obese men of similar age and with similar PSA screenings levels.

Although data from prospective, randomized screening studies would be ideal, a rationale and cost-effective first step would be to assess the association between BMI and PCa aggressiveness after adjusting for age and PSA level in large, well-annotated cohorts of men treated surgically for newly diagnosed PCa. Specifically, we hypothesize that obese men are more likely to present with more advanced that is, later stage and more aggressive Carcinoma prostata gleason 7 survival tumors that is, higher grade at time of surgery compared with non-obese men after controlling for age and screening PSA level.

To test this hypothesis, we conducted independent, retrospective nested case—control studies within two cohorts of men undergoing radical prostatectomy for newly diagnosed, clinically localized PCa. We excluded from our study sample any men who received neo-adjuvant therapy. When selecting our controls, we performed frequency-matching to the cases on age at the time of surgery and PSA level to ensure that our cases and controls had similar distributions carcinoma prostata gleason 7 survival regard to these two covariates.

In a similar manner to that described above, we harnessed the Prostatectomy Registry effort at Mayo Clinic in Jacksonville, Florida, USA to select a second, independent validation set of cases and controls from men carcinoma prostata gleason 7 survival prostatectomy for newly diagnosed, clinically localized PCa between and All the demographic, clinical and pathological features studied in this investigation Cura la prostatite abstracted from the ongoing Prostatectomy Registries at carcinoma prostata gleason 7 survival institutions.

At each site, these data are routinely abstracted from the medical record by experienced and certified coordinators with expertise in chart review and data abstraction for PCa patients. The demographic and clinical data evaluated as part of this study included self-reported year of surgery, type of surgery open vs laparoscopicage at surgery, BMI calculated from height and weight recorded in anesthesia record at the time of surgeryclinical Gleason grade and pre-operative PSA level.

For this investigation, we included the following variables abstracted related to PCa aggressiveness: pT stage, Gleason score, tumor volume, seminal vesicle involvement, margin status prostatite extracapsular extension.

For those carcinoma prostata gleason 7 survival with multiple foci, we added together the estimated volumes from each individual foci. Our primary analysis focused on estimating the association of standard measures of PCa aggressiveness that is, Gleason grade, pT stage, extracapsular involvement with case vs control status that is, obese vs non-obese.

For extra-capsular extension, seminal vesicle involvement and surgical margins, we used dichotomized categories of no reference and yes. Finally, tumor volume and prostatic volume were treated as continuous, modeled using carcinoma prostata gleason 7 survival log2 transformation and reported as the association with a doubling in those variables.

We carcinoma prostata gleason 7 survival logistic regression models to estimate the magnitude of the association of obesity status with our pathologic measures of PCa aggressiveness in a univariate setting and after adjusting for residual confounding by screening PSA level and age that is, we already matched on these two variables as well as potential confounding by year of surgery and prostate volume.

In Table 1 we provide comparisons of demographic and clinical features between our cases and controls at both sites. As a result of our frequency matching efforts, cases and controls are of similar age at the time of surgery and have comparable pre-operative PSA levels.

Similarly, the median age for cases from Mayo Clinic in Rochester is In Table 1 we also provide distributions for surgery year to show that cases and controls have similar distributions within each institution with respect to when the surgeries were performed. We also provide in Table 1 the distribution of BMI within our carcinoma prostata gleason 7 survival and controls from each site.

Finally, we include information on surgery type to underscore that, although a higher percentage of the surgeries are performed laparoscopically at Mayo Clinic in Florida compared with Mayo Clinic in Rochester, within carcinoma prostata gleason 7 survival institution the cases and controls had similar distributions with respect to type of surgery. In the Mayo Clinic in Rochester patient population, we noted consistent evidence of increased risk of more aggressive pathologic features in cases vs controls.

That is, after controlling for age and PSA level, the odds of an obese patient a case having more aggressive pathologic features were elevated compared with a non-obese patient control. Given that we model each variable as a log2 transformation, both of the previous ORs are interpreted as the impact of a doubling in prostate and tumor volume, respectively, on the odds of being obese vs non-obese.

As independent validation, our analysis of the patients from Mayo Clinic in Florida generated ORs that are consistent with the results obtained for the Mayo Clinic in Rochester patients, albeit with less power Cura la prostatite detect these associations as statistically significant because of the smaller sample size Table 2.

Although the results from the Mayo Florida population did not achieve conventional statistical significance for most of these variables, the magnitude and direction of the ORs are strikingly similar to that of carcinoma prostata gleason 7 survival Mayo Rochester population. Finally, further adjustment in our models for year of surgery and prostate volume did not alter our findings. For these analyses, we only report the data from the Mayo Clinic in Rochester population given that this more conservative definition of obesity resulted in a smaller case group and therefore more limited power in the validation set from Mayo Clinic in Florida.

Interestingly, we noted continued evidence of increased risk of more aggressive pathologic features in cases vs controls. Most notably, the OR from these new analysis for Gleason grade 8—10 increased from 1.

carcinoma prostata gleason 7 survival

Of interest, Trattiamo la prostatite investigators carcinoma prostata gleason 7 survival reported data supporting the existence of an inverse association between BMI and PSA levels in men. Indeed, if the impact is clinically significant, then we would expect that obese men would present with more advanced and more aggressive PCa compared with normal-weight men after matching on age and PSA level.

Herein, carcinoma prostata gleason 7 survival provide evidence from two independent nested case-control studies that after adjusting for PSA and age, obese men present prostatite more advanced that is, later stage and more aaggressive that is, higher grade PCa compared with non-obese men.

There is a key distinction that needs to be made between the research question we address in this investigation and one that has been previously reported by several investigators. Carcinoma prostata gleason 7 survival, there are a number of reports in the literature addressing the more etiologic question of whether obesity itself is a risk factor for PCa. Although several cohort studies suggest a positive association between increasing BMI and PCa risk, there are a number of studies reporting no association as well.

Recently, Banez et al. Although these results support the lack of a need to adjust PSA levels for obese men with regard to simply detecting the presence of PCa, they do not inform the larger question of whether PSA screening levels should be adjusted to avoid delaying diagnosis and allowing unnecessary advancement of PCa in obese Prostatite. With our carcinoma prostata gleason 7 survival case-control design, we address for the first time the specific question of whether there is empirical evidence to support the need to adjust screening PSA levels in obese men to avoid a clinically significant postponing of PCa diagnosis.

Although our data are supportive of the notion that lower PSA levels in obese men have PCa screening implications, it is important to note that our data are observational and more importantly, there are alternative explanations.

For example, it has been reported that obesity is associated with lower PSA-driven biopsy rates. Specifically, Parekh et al. This would suggest that a possible reason obese men present with more aggressive tumors is not that prostatite hemodilution effect results in delayed screening but rather that obese men are less likely to undergo PSA-driven biopsy in the first place.

Related to this, there is some indication that it is more difficult to palpate the prostate on digital rectal exam DRE in obese men, and, in many cases, only the apex can be adequately assessed to detect the presence of a Prostatite. Issues of causality aside, we are particularly mindful of the need to interpret our observational data very carefully.

Therefore, any study generating data in support of lower thresholds, even if for a specific subset of the male population, needs to be vetted with significant caution. As such, what will be needed in order to move this discussion forward in a meaningful way will be independent validation from other large, observational data sets, as well as reports from data prostatite as part of prospective carcinoma prostata gleason 7 survival trials.

Specifically, we would note that our data are from a large tertiary referral center of men undergoing surgery for PCa and, therefore, have limited generalizability to the general population seeking screening for PCa.

Along these same lines, it should also be noted that surgery is less likely to be offered to the most obese men, and therefore carcinoma prostata gleason 7 survival are not adequately represented in our study carcinoma prostata gleason 7 survival surgically treated men.

Finally, we are mindful that our data do not provide any evidence that lowering prostatite PSA screening cut-points in obese men would ultimately translate to better prostatite for these men or simply just alter pathologic outcomes.

With the need for external validation and the above mentioned limitations in mind, the specific strengths of our study include the large sample size, the use of a cost-effective, nested case—control design, the inclusion of data from two independent populations, our focus on one treatment modality that is, surgerythe tight matching on age carcinoma prostata gleason 7 survival PSA level, and the assessment of multiple indicators of both PCa aggressiveness and extent of disease. After controlling for PSA level and age, obese men are more likely to present with pathologically advanced and more aggressive PCa compared with non-obese men.

If carcinoma prostata gleason 7 survival observations are confirmed in independent populations, this would further support the need to re-evaluate PSA-based screening practices for obese men. Prostate cancer screening: navigating the controversy. Humana Press, ; pp 11— Barry M.

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