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Asian Journal of Andrology 2021We aimed to confirm the predictive ability of the presence of intraductal carcinoma of the prostate (IDC-P) for prognosis and the associations between IDC-P and... (Meta-Analysis)
Meta-Analysis
We aimed to confirm the predictive ability of the presence of intraductal carcinoma of the prostate (IDC-P) for prognosis and the associations between IDC-P and clinicopathological parameters. Studies were identified in PubMed, Cochrane Library, EMBASE, Web of Science, and SCOPUS up to December 1, 2019. Hazard ratios (HRs) for survival data and odds ratios for clinicopathological data with 95% confidence intervals (CIs) were extracted. Heterogeneity was evaluated by the I value, and quality was assessed by the Newcastle-Ottawa Scale criteria. A total of 4179 patients from 13 studies were included. The results showed that IDC-P presence was significantly associated with poor progression-free survival (PFS; HR = 2.31; 95% CI: 1.96-2.73), cancer-specific survival (HR = 1.89; 95% CI: 1.28-2.77), and overall survival (HR = 2.14; 95% CI: 1.53-3.01). In the subgroup analysis, IDC-P presence was significantly associated with poor PFS in prostate cancer treated by radical prostatectomy (HR = 2.48; 95% CI: 2.05-3.00) and treated by radiotherapy (HR = 2.83; 95% CI: 1.65-4.85). Regarding clinicopathological characteristics, patients with IDC-P presence had significantly higher tumor clinical stages, Gleason scores, probabilities of lymph node invasion, positive surgical margins, and positive extraprostatic extension. Our meta-analysis indicates that the presence of IDC-P is closely associated with poor prognosis and adverse clinicopathological characteristics. Our data support the value and clinical utility of the routine detection of IDC-P by pathological examination. These conclusions need further validation, and prospective studies are needed to find better treatment modalities other than traditional first-line therapy for patients with IDC-P.
Topics: Carcinoma, Intraductal, Noninfiltrating; Humans; Male; Prognosis; Prostatic Neoplasms; Treatment Outcome
PubMed: 32496222
DOI: 10.4103/aja.aja_21_20 -
Advances in Nutrition (Bethesda, Md.) Aug 2022Body composition parameters are not captured by measures of body mass, which may explain inconsistent associations between body weight and prostate cancer (PC) risk. The...
Body composition parameters are not captured by measures of body mass, which may explain inconsistent associations between body weight and prostate cancer (PC) risk. The objective of this systematic review was to characterize the association between fat mass (FM) and fat-free mass (FFM) parameters and PC risk. A search of PubMed, Embase, and Web of Science identified case-control and cohort studies that measured body composition in relation to PC risk. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). Thirteen observational studies were included, of which 8 were case-control studies (n = 1572 cases, n = 1937 controls) and 5 were prospective cohort studies (n = 7854 incident cases with PC). The NOS score was 5.9 ± 1.1 for case-control studies and 8.4 ± 1.3 for cohort studies. The most common body composition technique was bioelectrical impedance analysis (n = 9 studies), followed by DXA (n = 2), computed tomography (n = 2), air displacement plethysmography (n = 1), and MRI (n = 1). No case-control studies reported differences in %FM between PC cases and controls and no consistent differences in FM or FFM (in kilograms) were observed. Two out of 5 cohort studies reported that higher %FM was associated with lower PC risk. Conversely, 3 cohort studies reported a greater risk of being diagnosed with advanced/aggressive PC with higher FM (expressed in kilograms, %FM, or fat distribution). Two out of 4 studies (both case-control and cohort) found that higher abdominal adipose tissue was associated with increased PC risk. In conclusion, although results were inconsistent, there is some evidence that FM may be negatively associated with total PC risk but positively associated with the risk of advanced/aggressive PC; modest evidence suggests that abdominal adipose tissue may increase the risk of PC. Future work should elucidate unique patterns of FM distribution and PC risk to triage men at risk for developing PC. This study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database as CRD42019133388.
Topics: Humans; Male; Absorptiometry, Photon; Adipose Tissue; Body Composition; Body Mass Index; Electric Impedance; Prospective Studies; Prostatic Neoplasms; Observational Studies as Topic
PubMed: 34918023
DOI: 10.1093/advances/nmab153 -
Il Giornale Di Chirurgia 2011Sarcomatoid carcinoma of the prostate is an extremely rare and highly aggressive neoplasm that accounts for less than 0.1% of primary prostate malignancies. Long-term... (Review)
Review
BACKGROUND
Sarcomatoid carcinoma of the prostate is an extremely rare and highly aggressive neoplasm that accounts for less than 0.1% of primary prostate malignancies. Long-term survival rates for adult patients with prostate sarcomatoid carcinoma are poor. Surgical treatment seems to be the most effective therapeutic approach. In contrast radiation therapy alone has shown limited efficacy.
AIM
The purpose of the study is to present a case of sarcomatoid carcinoma of the prostate treated with a combination of radiotherapy and TURP.
CASE REPORT
A 76-year-old man treated with TURP due to acute urinary retention was finally diagnosed with sarcomatoid carcinoma upon pathology examination of the surgical specimen. Patient was initially treated with external beam radiotherapy. Six months later, he presented with urinary retention suggesting extension of the tumor into the bladder neck. Pathology report diagnosed prostate sarcomatoid carcinoma containing also large areas of necrosis. Patient underwent an extensive TURP and he received a second round radiotherapy. One year after the initial diagnosis of sarcomatoid carcinoma, patient is free of symptoms and follow up investigation shows no evidence of metastatic disease.
CONCLUSIONS
Radiation therapy in combination with extensive TURP may delay disease progression.
Topics: Aged; Carcinosarcoma; Combined Modality Therapy; Disease Progression; Humans; Incidental Findings; Male; Prostate; Prostatic Neoplasms; Transurethral Resection of Prostate; Urinary Retention
PubMed: 21352703
DOI: No ID Found -
Cancer Causes & Control : CCC Oct 2022The increasing availability of clinical imaging tests (especially CT and MRI) that directly quantify adipose tissue has led to a rapid increase in studies examining the... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The increasing availability of clinical imaging tests (especially CT and MRI) that directly quantify adipose tissue has led to a rapid increase in studies examining the relationship of visceral, subcutaneous, and overall adiposity to cancer survival. To summarize this emerging body of literature, we conducted a systematic review and meta-analysis of imaging-measured as well as anthropometric proxies for adipose tissue distribution and cancer survival across a wide range of cancer types.
METHODS
Using keywords related to adiposity, cancer, and survival, we conducted a systematic search of the literature in PubMed and MEDLINE, Embase, and Web of Science Core Collection databases from database inception to 30 June 2021. We used a random-effect method to calculate pooled hazard ratios (HR) and corresponding 95% confidence intervals (CI) within each cancer type and tested for heterogeneity using Cochran's Q test and the I test.
RESULTS
We included 203 records for this review, of which 128 records were utilized for quantitative analysis among 10 cancer types: breast, colorectal, gastroesophageal, head and neck, hepatocellular carcinoma, lung, ovarian, pancreatic, prostate, and renal cancer. We found that imaging-measured visceral, subcutaneous, and total adiposity were not significantly associated with increased risk of overall mortality, death from primary cancer, or cancer progression among patients diagnosed with these 10 cancer types; however, we found significant or high heterogeneity for many cancer types. For example, heterogeneity was similarly high when the pooled HRs (95% CI) for overall mortality associated with visceral adiposity were essentially null as in 1.03 (0.55, 1.92; I = 58%) for breast, 0.99 (0.81, 1.21; I = 71%) for colorectal, versus when they demonstrated a potential increased risk 1.17 (0.85, 1.60; I = 78%) for hepatocellular carcinoma and 1.62 (0.90, 2.95; I = 84%) for renal cancer.
CONCLUSION
Greater adiposity at diagnosis (directly measured by imaging) is not associated with worse survival among cancer survivors. However, heterogeneity and other potential limitations were noted across studies, suggesting differences in study design and adiposity measurement approaches, making interpretation of meta-analyses challenging. Future work to standardize imaging measurements and data analyses will strengthen research on the role of adiposity in cancer survival.
Topics: Adiposity; Carcinoma, Hepatocellular; Colorectal Neoplasms; Humans; Kidney Neoplasms; Liver Neoplasms; Male; Obesity
PubMed: 35971021
DOI: 10.1007/s10552-022-01613-7 -
Integrative Cancer Therapies Mar 2017The use of natural health products in prostate cancer (PrCa) is high despite a lack of evidence with respect to safety and efficacy. Fish-derived omega-3 fatty acids... (Review)
Review
BACKGROUND
The use of natural health products in prostate cancer (PrCa) is high despite a lack of evidence with respect to safety and efficacy. Fish-derived omega-3 fatty acids possess anti-inflammatory effects and preclinical data suggest a protective effect on PrCa incidence and progression; however, human studies have yielded conflicting results.
METHODS
A search of OVID MEDLINE, Pre-MEDLINE, Embase, and the Allied and Complementary Medicine Database (AMED) was completed for human interventional or observational data assessing the safety and efficacy of fish-derived omega-3 fatty acids in the incidence and progression of PrCa.
RESULTS
Of 1776 citations screened, 54 publications reporting on 44 studies were included for review and analysis: 4 reports of 3 randomized controlled trials, 1 nonrandomized clinical trial, 20 reports of 14 cohort studies, 26 reports of 23 case-control studies, and 3 case-cohort studies. The interventional studies using fish oil supplements in patients with PrCa showed no impact on prostate-specific antigen levels; however, 2 studies showed a decrease in inflammatory or other cancer markers. A small number of mild adverse events were reported and interactions with other interventions were not assessed. Cohort and case-control studies assessing the relationship between dietary fish intake and the risk of PrCa were equivocal. Cohort studies assessing the risk of PrCa mortality suggested an association between higher intake of fish and decreased risk of prostate cancer-related death.
CONCLUSIONS
Current evidence is insufficient to suggest a relationship between fish-derived omega-3 fatty acid and risk of PrCa. An association between higher omega-3 intake and decreased PrCa mortality may be present but more research is needed. More intervention trials or observational studies with precisely measured exposure are needed to assess the impact of fish oil supplements and dietary fish-derived omega-3 fatty acid intake on safety, PrCa incidence, treatment, and progression.
Topics: Animals; Case-Control Studies; Cohort Studies; Diet; Dietary Supplements; Fatty Acids, Omega-3; Fish Oils; Fishes; Humans; Male; Prostatic Neoplasms; Randomized Controlled Trials as Topic
PubMed: 27365385
DOI: 10.1177/1534735416656052 -
European Urology Jul 2023The optimal management for men with prostate cancer (PCa) with unconventional histology (UH) is unknown. The outcome for these cancers might be worse than for...
Impact of Epithelial Histological Types, Subtypes, and Growth Patterns on Oncological Outcomes for Patients with Nonmetastatic Prostate Cancer Treated with Curative Intent: A Systematic Review.
CONTEXT
The optimal management for men with prostate cancer (PCa) with unconventional histology (UH) is unknown. The outcome for these cancers might be worse than for conventional PCa and so different approaches may be needed.
OBJECTIVE
To compare oncological outcomes for conventional and UH PCa in men with localized disease treated with curative intent.
EVIDENCE ACQUISITION
A systematic review adhering to the Referred Reporting Items for Systematic Reviews and Meta-Analyses was prospectively registered on PROSPERO (CRD42022296013) was performed in July 2021.
EVIDENCE SYNTHESIS
We screened 3651 manuscripts and identified 46 eligible studies (reporting on 1 871 814 men with conventional PCa and 6929 men with 10 different PCa UHs). Extraprostatic extension and lymph node metastases, but not positive margin rates, were more common with UH PCa than with conventional tumors. PCa cases with cribriform pattern, intraductal carcinoma, or ductal adenocarcinoma had higher rates of biochemical recurrence and metastases after radical prostatectomy than for conventional PCa cases. Lower cancer-specific survival rates were observed for mixed cribriform/intraductal and cribriform PCa. By contrast, pathological findings and oncological outcomes for mucinous and prostatic intraepithelial neoplasia (PIN)-like PCa were similar to those for conventional PCa. Limitations of this review include low-quality studies, a risk of reporting bias, and a scarcity of studies that included radiotherapy.
CONCLUSIONS
Intraductal, cribriform, and ductal UHs may have worse oncological outcomes than for conventional and mucinous or PIN-like PCa. Alternative treatment approaches need to be evaluated in men with these cancers.
PATIENT SUMMARY
We reviewed the literature to explore whether prostate cancers with unconventional growth patterns behave differently to conventional prostate cancers. We found that some unconventional growth patterns have worse outcomes, so we need to investigate if they need different treatments. Urologists should be aware of these growth patterns and their clinical impact.
Topics: Humans; Male; Prostate; Prostate-Specific Antigen; Prostatectomy; Prostatic Intraepithelial Neoplasia; Prostatic Neoplasms
PubMed: 37117107
DOI: 10.1016/j.eururo.2023.03.014 -
African Journal of Reproductive Health Dec 2020Male genital schistosomiasis (MGS) may result in eggs lodged in the prostate causing persistent inflammation that may play a major role in prostate carcinogenesis.... (Review)
Review
Male genital schistosomiasis (MGS) may result in eggs lodged in the prostate causing persistent inflammation that may play a major role in prostate carcinogenesis. Globally, prostate cancer (PCa) is one of the most common cancers and the global distribution of PCa overlaps with that of schistosomiasis infections, suggesting a probable causal relationship. Objectives of this review were to assess evidence of co-existence of schistosomiasis and PCa and possible causal association between the two diseases. Relevant literature published between 1950 and 2019 yielded 20 publications on schistosomiasis and PCa co-existence. Schistosoma (S.) haematobium and S. mansoni were associated with MGS manifestation and mostly prostate adenocarcinoma diagnosis. Effects of prostatic MGS infection progressed over time with high Schistosoma egg burden thought to contribute to the development of PCa. Causal association and mechanistic pathways of MGS on PCa development and the role of Schistosoma eggs on the development of PCa remains unestablished.
Topics: Adenocarcinoma; Animals; Humans; Male; Prostatic Neoplasms; Schistosoma haematobium; Schistosomiasis
PubMed: 34077083
DOI: 10.29063/ajrh2020/v24i4.19 -
Diagnostics (Basel, Switzerland) Feb 2021to explore the diagnostic accuracy of 18F-Fluciclovine positron-emission tomography (PET) in prostate cancer (PCa), considering both primary staging prior to radical... (Review)
Review
BACKGROUND
to explore the diagnostic accuracy of 18F-Fluciclovine positron-emission tomography (PET) in prostate cancer (PCa), considering both primary staging prior to radical therapy, biochemical recurrence, and advanced setting.
METHODS
A systematic web search through Embase and Medline was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies performed from 2011 to 2020 were evaluated. The terms used were "PET" or "positron emission tomography" or "positron emission tomography/computed tomography" or "PET/CT" or "positron emission tomography-computed tomography" or "PET-CT" and "Fluciclovine" or "FACBC" and "prostatic neoplasms" or "prostate cancer" or "prostate carcinoma". Only studies reporting about true positive (TP), true negative (TN), false positive (FP) and false negative (FN) findings of 18F-fluciclovine PET were considered eligible.
RESULTS
Fifteen out of 283 studies, and 697 patients, were included in the final analysis. The pooled sensitivity for 18F-Fluciclovine PET/CT for diagnosis of primary PCa was 0.83 (95% CI: 0.80-0.86), the specificity of 0.77 (95% CI: 0.74-0.80). The pooled sensitivity for preoperative LN staging was 0.57 (95% CI: 0.39-0.73) and specificity of 0.99 (95% CI: 0.94-1.00). The pooled sensitivity for the overall detection of recurrence in relapsed patients was 0.68 (95% CI: 0.63-0.73), and specificity of 0.68 (95% CI: 0.60-0.75).
CONCLUSION
This meta-analysis showed promising results in term of sensitivity and specificity for 18F-Fluciclovine PET/CT to stage the primary lesion and in the assessment of nodal metastases, and for the detection of PCa locations in the recurrent setting. However, the limited number of studies and the broad heterogeneity in the selected cohorts and in different investigation protocols are limitation affecting the strength of these results.
PubMed: 33668673
DOI: 10.3390/diagnostics11020304 -
BMC Urology May 2010Osteoporosis could be associated with the hormone therapy for metastatic prostate carcinoma (PCa) and with PCa per se. The objective of this review is to determine the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Osteoporosis could be associated with the hormone therapy for metastatic prostate carcinoma (PCa) and with PCa per se. The objective of this review is to determine the incidence of bone loss and osteoporosis in patients with PCa who are or are not treated with hormone therapy (ADT).
METHODS
The Medline, Embase, Cancerlit, and American Society of Clinical Oncology Abstract databases were searched for published studies on prostate cancer and bone metabolism. The outcomes assessed were: fracture, osteoporosis and osteopenia.
RESULTS
Thirty-two articles (116,911 participants) were included in the meta-analysis. PCa patients under ADT had a higher risk of osteoporosis (RR, 1.30; p < 0.00001) and a higher risk of fractures (RR, 1.17; p < 0.00001) as compared to patients not under ADT. The total bone mineral density was lower in patients under ADT when compared with patients not under ADT (p = 0.031) but it was similar to bone mineral density found in healthy controls (p = 0.895). The time of androgen deprivation therapy correlated negatively with lumbar spine and total hip bone mineral density (Spearman's rho = -0.490 and -0.773; p = 0.028 and 0.001, respectively) and with total hip t score (Spearman's rho = -0.900; p = 0.037).
CONCLUSION
We found consistent evidence that the use of androgen deprivation therapy in patients with PCa reduces bone mineral density, increasing the risk of fractures in these patients.
Topics: Adenocarcinoma; Angiogenesis Inhibitors; Causality; Comorbidity; Humans; Incidence; Male; Osteoporosis; Prostatic Neoplasms; Risk Assessment; Risk Factors; Treatment Outcome
PubMed: 20482867
DOI: 10.1186/1471-2490-10-9 -
Cancer Treatment Reviews Feb 2009We performed a systematic review and meta-analysis of randomised trials of neo-adjuvant hormone therapy (NHT) in localised and locally advanced prostate cancer to assess... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
We performed a systematic review and meta-analysis of randomised trials of neo-adjuvant hormone therapy (NHT) in localised and locally advanced prostate cancer to assess the effectiveness of this therapy.
METHODS
We searched MEDLINE, The Cochrane Library, Science Citation Index, LILACS and SIGLE for randomised trials comparing NHT plus primary therapy (radiotherapy or prostatectomy) with primary therapy alone. Data included information on study design, participants, interventions, and outcomes. Comparable data were extracted from eligible studies and pooled for meta-analysis with intention to treat principle.
FINDINGS
NHT prior to prostatectomy did not improve overall or disease-free survival, but did significantly reduce positive margin rates (RR 0.49, 95% CI 0.42-0.56, p<0.00001), organ confinement (RR 1.63, 95% CI 1.37-1.95, p<0.0001) and lymph node invasion (RR 0.49, 95% CI 0.42-0.56, p<0.02). In one study NHT before radiotherapy significantly improved overall survival for men with Gleason 2-6 (p=0.015). In addition, there was a significant improvement in both clinical disease-free survival (RR 1.46, 95% CI 1.24-1.71, p<0.00001) and biochemical disease-free survival (RR 1.59, 95% CI 1.00-2.55, p=0.05). Toxicities included hot flushes, gastrointestinal, hepatic and miscellaneous adverse events.
CONCLUSIONS
NHT is associated with significant clinical benefit when given with radiotherapy and improves pathological outcome prior to prostatectomy but is of minimal value prior to radical prostatectomy. The decision to use hormone therapy should be discussed between the patient, the clinician and policy maker based on the benefits, toxicity and cost.
Topics: Androgen Antagonists; Chemotherapy, Adjuvant; Humans; Male; Neoadjuvant Therapy; Prostatic Neoplasms; Randomized Controlled Trials as Topic
PubMed: 18926640
DOI: 10.1016/j.ctrv.2008.08.002