GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Do elderly men (〉75) harbor more aggressive prostate cancer? Comparison of decipher and PAM50 TESTS among different age groups.
    American Society of Clinical Oncology (ASCO) ; 2019
    In:  Journal of Clinical Oncology Vol. 37, No. 7_suppl ( 2019-03-01), p. 38-38
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 37, No. 7_suppl ( 2019-03-01), p. 38-38
    Abstract: 38 Background: Age is an important prognostic factor in oncology. Over 20% of men diagnosed with prostate cancer (PC) are ≥ 75 years old. In the growing elderly population, objective methods for predicting outcomes beyond chronologic age are necessary in order minimize the likelihood of withholding curative treatment when warranted. Herein, we describe and analyze age-related differences in clinico-genomic prognostic indices of aggressiveness in localized PC. Methods: Clinical and genomic data for 8,355 patients from the Decipher Genomic Resource Information Database was obtained. Conventional and genomic prognostic indices including Decipher GC scores, PAM50 molecular subtypes (e.g. luminal A/B or basal) NCCN risk groups and Gleason groups (GG) were stratified by age using multivariable logistic regression analyses (MLRA). Results: With increasing decile of age, we observed a higher proportion of high GG and higher Decipher scores. There was a statistically significant increase in the proportion of patients with high Decipher scores with increasing age among GG1 and GG2 ( 〈 55-10.2%, 30.7%, 55-60-15.4%, 25.6%, 60-65-15.9%, 29.7%, 65-70-16.9%, 28.2%, 70-75-17.9%, 30%, and 〉 75-20.3%, 37.3%, respectively). Furthermore, the prevalence of the PAM50 luminal B subtype (associated with worse prognosis) increased with age among GG1 and GG2 ( 〈 60-22.2%, 40%, 60-65-29.1%, 41.7%, 65-70-28.2%, 39.2%, 70-75-30%, 43.4%, 75-80-33.5%, 44.3%, 〉 80-34.2%, 52%, respectively). Among higher grade tumors (GG 3-5), no statistically significant differences between the different age groups were observed. MLRA demonstrated that in addition to higher T stage, PSA and GG, each age decile entailed a 20% increased risk for a high Decipher score (OR 1.2, 95% C.I 1.11-1.3, p 〈 0.001). Conclusions: Older men with lower grade tumors, as opposed to higher grade tumors, harbored worse disease based on genomic risk models. The accepted paradigm of elderly PC patients being treated conservatively based solely on chronologic age, needs to be changed. We provide evidence suggesting the utility of clinical-genomic characterization for better treatment individualization decisions. (GRID; NCT02609269).
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2019.37.7_suppl.38
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2019
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    The association between physician trust and prostate specific antigen screening: Implications for shared decision making.
    American Society of Clinical Oncology (ASCO) ; 2018
    In:  Journal of Clinical Oncology Vol. 36, No. 6_suppl ( 2018-02-20), p. 13-13
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 36, No. 6_suppl ( 2018-02-20), p. 13-13
    Abstract: 13 Background: Most cancer organizations recommend shared decision making for PSA screening, a process relying on a trusting relationship between patient and physician. The objective of this study was to assess the degree to which an individual’s trust in cancer information from their physician compared to internet-based information impacts the likelihood of receiving PSA-screening. Methods: This was a cross-sectional study (2011-2014) of the Health Information National Trends Survey (HINTS), a survey of people living in the US. The primary exposure was degree of trust in cancer information from participant’s physician (CIP). The secondary exposure was degree of trust in cancer information from the internet (CII). The primary outcome was patient-reported receipt of PSA-screening. The Cochran-Armitage test was used to identify significant trends in the primary outcome, across levels of trust. A multivariable logistic regression model assessed the association between CIP and CII with PSA-screening, adjusted for a priori covariates. Results: Among 5069 eligible respondents, 3,606 (71.1%) reported trusting CIP ‘a lot’, 1,186 (23.4%) ‘some’, 219 (4.3%) ‘a little’, and 58 (1.1%) ‘not at all’. 2,655 (52.4%) men received PSA-screening. The degree of trust in CIP was strongly associated with the likelihood of receiving PSA-screening: among men who reported ‘a lot’ of trust, 54.9% underwent screening, 48.6% ‘some’ trust, 38.4% ‘a little’ trust, and 27.6% among men ‘not at all’ trusting their physician (trend p 〈 0.0001). The degree to which men trusted CII was also associated with having received PSA-screening (p = 0.005), albeit with an insignificant trend (p = 0.07). After multivariable adjustment, these significant results persisted for degree of CIP trust (vs ‘a lot’: ‘some’ OR 0.80, 95%CI 0.66-0.97; ‘a little’ OR 0.61, 95%CI 0.41-0.90; ‘not at all’ OR 0.33, 95%CI 0.15-0.73), but not for trust in CII. Conclusions: The level of trust an individual has in their physician is strongly associated with undergoing PSA-screening. As rationale implementation of PSA screening requires shared decision-making, the level of physician trust has implications for dissemination of PSA-screening guidelines.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2018.36.6_suppl.13
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2018
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    Genomic analysis for active surveillance to predict upstaging after prostatectomy.
    American Society of Clinical Oncology (ASCO) ; 2021
    In:  Journal of Clinical Oncology Vol. 39, No. 6_suppl ( 2021-02-20), p. 258-258
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 39, No. 6_suppl ( 2021-02-20), p. 258-258
    Abstract: 258 Background: Active Surveillance (AS) of prostate cancers lowers morbidity and mortality with conservative management but requires vigilance to prevent disease progression. Understanding of disease aggression through genomic analysis has enhanced AS. About one third of prostatectomies reveal a Gleason upgrade to stage T3 or node positivity, and increased risk on a single genomic analysis increases the risk of progression and Gleason upgrade. More information is needed to compare these tests and determine their roles in academic and private practice settings. Methods: The Pennsylvania Urologic Regional Collaborative (PURC), funded by participating urology practices and the Partnership for Patient Care, a quality improvement initiative supported by the Health Care Improvement Foundation, Independence Blue Cross, and southeastern PA hospitals and health systems, database was analyzed with permission to find patients who received both AS and prostatectomy for treatment of prostate cancer. Patients were then selected who had genomic analysis performed on biopsy samples using analysis from Decipher Biopsy, Oncotype Dx, or Prolaris. Patients were sorted into genomic risk categories and biopsy pathology, prostatectomy pathology, and time to surgery was compared. Results: Thirty-nine patients met criteria for the study. Nineteen were considered to be very low risk based on genomic analysis, 11 were low risk, and nine were intermediate risk. Average time of progression from AS to prostatectomy was shorter with increased genomic risk: from 1.7 years for very low genomic risk individuals, to 1.3 for low risk, to 0.8 years for intermediate risk. All three groups had a significant decrease in Gleason Grade Group from biopsy to final pathology (p 〈 0.05). Five of the 19 patients (26%) in the very low risk group were upgraded to pT3 after prostatectomy, one (9%) of the low risk group was upgraded, and four of the 9 (44%) in the intermediate risk group were upgraded. Regardless of genomic risk, 14% of patients who had analysis performed with Oncotype Dx received a Gleason upgrade, compared to 67% of patients with Decipher Biopsy analysis and 43% of patients with Prolaris genomic analysis. Conclusions: Our pilot study indicates that while higher genomic risk categorization led to a more rapid progression to treatment, Gleason Grade Group decreased from biopsy to final pathology in each risk group, suggesting more time before progression to treatment may be warranted. Very low and low risk patients had less risk of Gleason upgrade compared to intermediate risk patients. While our numbers are low, the difference in Gleason upgrade based on genomic analysis provides an interesting exploratory analysis that requires further investigation. More analysis comparing the intricacies of the reporting methods is needed to elucidate the benefits and drawbacks for each genomic test available.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2021.39.6_suppl.258
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2021
    detail.hit.zdb_id: 2005181-5
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    MRI as a screening tool for prostate cancer: current evidence and future challenges
    Springer Science and Business Media LLC ; 2022
    In:  World Journal of Urology Vol. 41, No. 4 ( 2022-02-28), p. 921-928
    Details
    In: World Journal of Urology, Springer Science and Business Media LLC, Vol. 41, No. 4 ( 2022-02-28), p. 921-928
    Abstract: Prostate cancer (PCa) screening, which relies on prostate-specific antigen (PSA) testing, is a contentious topic that received negative attention due to the low sensitivity and specificity of PSA to detect clinically significant PCa. In this context, due to the higher sensitivity and specificity of magnetic resonance imaging (MRI), several trials investigate the feasibility of “MRI-only” screening approaches, and question if PSA testing may be replaced within prostate cancer screening programs. Methods This narrative review discusses the current literature and the outlook on the potential of MRI-based PCa screening. Results Several prospective randomized population-based trials are ongoing. Preliminary study results appear to favor the “MRI-only” approach. However, MRI-based PCa screening programs face a variety of obstacles that have yet to be fully addressed. These include the increased cost of MRI, lack of broad availability, differences in MRI acquisition and interpretation protocols, and lack of long-term impact on cancer-specific mortality. Partly, these issues are being addressed by shorter and simpler MRI approaches (5–20 min bi-parametric MRI), novel quality indicators (PI-QUAL) and the implementation of radiomics (deep learning, machine learning). Conclusion Although promising preliminary results were reported, MRI-based PCa screening still lack long-term data on crucial endpoints such as the impact of MRI screening on mortality. Furthermore, the issues of availability, cost-effectiveness, and differences in MRI acquisition and interpretation still need to be addressed.
    Type of Medium: Online Resource
    ISSN: 1433-8726
    URL: Article
    DOI: 10.1007/s00345-022-03947-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1463303-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 5
    Online Resource
    Online Resource
    The who, when, and why of primary adrenal malignancies: Insights into the epidemiology of a rare clinical entity
    Wiley ; 2019
    In:  Cancer Vol. 125, No. 7 ( 2019-04), p. 1050-1059
    Details
    In: Cancer, Wiley, Vol. 125, No. 7 ( 2019-04), p. 1050-1059
    Abstract: Primary adrenal malignancies represent a rare constellation of malignancies that often are reported in isolation and as small case reports and case series. The National Cancer Institute's Surveillance, Epidemiology, and End Results data set is used to provide important insight into the presentation and clinical outcomes of the 5 histologies of major primary adrenal malignancies: adrenocortical carcinoma, pheochromocytoma and paraganglioma, neuroblastoma, non‐Hodgkin lymphoma, and sarcoma.
    Type of Medium: Online Resource
    ISSN: 0008-543X , 1097-0142
    URL: Article
    DOI: 10.1002/cncr.31916
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 1479932-7
    detail.hit.zdb_id: 2599218-1
    detail.hit.zdb_id: 2594979-2
    detail.hit.zdb_id: 1429-1
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 6
    Online Resource
    Online Resource
    Case ‒ Foamy high-grade prostatic intraepithelial neoplasia: A false positive for prostate cancer on multiparametric magnetic resonance imaging?
    Canadian Urological Association Journal ; 2018
    In:  Canadian Urological Association Journal Vol. 12, No. 5 ( 2018-02-02), p. E256-9
    Details
    In: Canadian Urological Association Journal, Canadian Urological Association Journal, Vol. 12, No. 5 ( 2018-02-02), p. E256-9
    Abstract: The introduction of multiparametric magnetic resonance imaging (mpMRI) of the prostate, and specifically the introduction of diffusion-weighted imaging (DWI), has significantly impacted the diagnosis of prostate cancer and the management of clinically localized prostate cancer. Indeed, its localizing ability has now opened up opportunities to target focal lesions in partial gland ablation therapy as a treatment option for localized prostate cancer. With negative predictive rates of mpMRI approaching 90% in certain series,1 mpMRI has the ability to discriminate between clinically significant intermediate-to-high-risk prostate cancer and low-risk indolent disease. However, false positives can occur. In recent studies, lesions observed on MRI were classified as tumour on targeted biopsy in 47.6% to over 94% for tumours larger than 0.5 ml in volume.2,3 Herein, we present a case of a rare non-cancer, but putatively pre-malignant prostatic histology that was found on biopsies directed at a category 5 Prostate Imaging Reporting and Data System (PIRADS) v2 lesion.
    Type of Medium: Online Resource
    ISSN: 1920-1214 , 1911-6470
    URL: Article
    DOI: 10.5489/cuaj.4860
    Language: Unknown
    Publisher: Canadian Urological Association Journal
    Publication Date: 2018
    detail.hit.zdb_id: 2431403-1
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 7
    Online Resource
    Online Resource
    The association between physician trust and prostate-specific antigen screening: Implications for shared decision-making
    Canadian Urological Association Journal ; 2018
    In:  Canadian Urological Association Journal Vol. 12, No. 12 ( 2018-06-19)
    Details
    In: Canadian Urological Association Journal, Canadian Urological Association Journal, Vol. 12, No. 12 ( 2018-06-19)
    Abstract: Introduction: Shared decision-making is widely recommended when men are considering prostate cancer screening with prostatespecific antigen (PSA). The role of patients’ trust in cancer information from their physician in such decisions is unknown. Methods: We identified male respondents ≥18 years of age from the Health Information National Trends Survey, a population-based survey of people living in the U.S. (2011–014). We assessed the association between degree of trust in cancer information from respondent’s physician with patient-reported receipt of PSA screening and patient-reported discussion of PSA screening with their physician. Results: Among 5069 eligible respondents, 3606 (71.1%) men reported trusting cancer information from their physician “a lot,” 1186 (23.4%) “somewhat,” 219 (4.3%) “a little,” and 58 (1.1%) “not at all.” A total of 2655 (52.4%) men reported receiving PSA screening. The degree of trust an individual had in his physician for cancer information was strongly associated with his likelihood of having received PSA screening (ptrend 〈 0.0001) (54.9% “a lot” vs. 27.6% “not at all”). These findings persisted after multivariable regression. Similarly, men who had high levels of trust in their physician were more likely to have discussed PSA screening with a strong trend across strata (ptrend 〈 0.0001). Conclusions: The level of trust an individual has in cancer information from his physician is strongly associated with his likelihood of discussing and undergoing PSA screening. As rationale, implementation of PSA screening requires shared decision-making, and the level of trust an individual has in his physician has important implications for dissemination of PSA screening guidelines.
    Type of Medium: Online Resource
    ISSN: 1920-1214 , 1911-6470
    URL: Article
    DOI: 10.5489/cuaj.5351
    Language: Unknown
    Publisher: Canadian Urological Association Journal
    Publication Date: 2018
    detail.hit.zdb_id: 2431403-1
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 8
    Online Resource
    Online Resource
    Utility of digital rectal examination in a population with prostate cancer treated with active surveillance
    Canadian Urological Association Journal ; 2020
    In:  Canadian Urological Association Journal Vol. 14, No. 9 ( 2020-01-11)
    Details
    In: Canadian Urological Association Journal, Canadian Urological Association Journal, Vol. 14, No. 9 ( 2020-01-11)
    Abstract: Introduction: Digital rectal examination (DRE) is part of the clinical evaluation of men on active surveillance (AS). The purpose of the present study is to analyze the value of DRE as a predictor of upgrading in a population of men with prostate cancer (PC) treated with AS. Methods: We used the prostate biopsy (PBx) database from an academic center, including PBx from 2006–2018, and identified 2029 confirmatory biopsies (CxPBx) of men treated with AS, of which 726 men had both diagnostic (initial) and CxPBx information available. We did a descriptive analysis and evaluated sensitivity, specificity, and predictive values of DRE for the detection of clinically significant PC (csPC). Multivariable regression analysis was done to identify predictors of csPC. The primary outcome was to evaluate DRE as a predictor of the presence of csPC at CxPBx. Results: Among the 2029 patients with a CxPBx, 75% had PC, and of these, 30.3% had upgrading to ISUP Grade ≥2. Thirteen percent of men had a suspicious DRE (done by their treating physician). Sensitivity, specificity, negative and positive predictive values of DRE to detect csPC were best with a PSA 〈 4 ng/ml (27%, 88%, 31%, and 87%, respectively). A suspicious DRE at CxPBx, particularly if the DRE at diagnosis was negative, was a predictor of csPC (odds ratio [OR] 2.34; p=0.038). The main limitation of our study is the retrospective design and the lack of magnetic resonance imaging. Conclusions: We believe DRE should still be used as part of AS and can predict the presence of csPC even with low PSA values. A suspicious nodule on DRE represents a higher risk of upgrading and should prompt further assessment.
    Type of Medium: Online Resource
    ISSN: 1920-1214 , 1911-6470
    URL: Article
    DOI: 10.5489/cuaj.6341
    Language: Unknown
    Publisher: Canadian Urological Association Journal
    Publication Date: 2020
    detail.hit.zdb_id: 2431403-1
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 9
    Online Resource
    Online Resource
    The association of statin subgroups with lower urinary tract symptoms following a prostate biopsy
    Canadian Urological Association Journal ; 2021
    In:  Canadian Urological Association Journal Vol. 16, No. 5 ( 2021-12-21)
    Details
    In: Canadian Urological Association Journal, Canadian Urological Association Journal, Vol. 16, No. 5 ( 2021-12-21)
    Abstract: Introduction: This was a secondary analysis aiming to assess whether hydrophilic or hydrophobic statins have a differential effect on urinary retention (UR) and lower urinary tract symptoms (LUTS) in men following a prostate biopsy (PB), who were at risk for prostate cancer development. Methods: This was a population-based cohort study with data incorporated from the Institute for Clinical and Evaluative Sciences database to identify all Ontarian men aged 66 and above with a history of a single negative PB between 1994 and 2016, with no drug prescription history of any of several putative chemopreventative medications (statins, proton pump inhibitors, five-alpha-reductase inhibitors, and alpha-blockers). Multivariable Cox regression models with time-dependent covariates were used to assess the association of hydrophilic and hydrophobic statins with UR and LUTS within 30 days of a PB. All models were adjusted for other known putative chemopreventive medications, age, rurality, pharmacologically treated diabetes, comorbidity score, and study inclusion year. Results: Overall, 21 512 men were included, with a median followup time of 9.4 years (interquartile range [IQR] 5.4–13.4 years). Hydrophobic and hydrophilic statins were initiated by 30.7% and 19.6% of men, respectively, after the first negative PB. UR and LUTS were experienced by 2.2% and 10% of men, respectively. Cox models demonstrated hydrophilic statins were associated with a lower risk of UR (hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.38–0.83, p=0.0038) and LUTS (HR 0.86, 95% CI 0.76–0.98, p=0.022), while no such association was shown for hydrophobic statins. Conclusions: Initiation of hydrophilic statins in men older than 66 appears to be inversely associated with the risk of UR and LUTS within 30 days of a PB.
    Type of Medium: Online Resource
    ISSN: 1920-1214 , 1911-6470
    URL: Article
    DOI: 10.5489/cuaj.7464
    Language: Unknown
    Publisher: Canadian Urological Association Journal
    Publication Date: 2021
    detail.hit.zdb_id: 2431403-1
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 10
    Online Resource
    Online Resource
    Prevalence of Suspected Hereditary Cancer Syndromes and Germline Mutations Among a Diverse Cohort of Probands Reporting a Family History of Prostate Cancer: Toward Informing Cascade Testing for Men
    Elsevier BV ; 2020
    In:  European Urology Oncology Vol. 3, No. 3 ( 2020-06), p. 291-297
    Details
    In: European Urology Oncology, Elsevier BV, Vol. 3, No. 3 ( 2020-06), p. 291-297
    Type of Medium: Online Resource
    ISSN: 2588-9311
    URL: Article
    DOI: 10.1016/j.euo.2019.06.010
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2945338-0
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...