• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4577-4580
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• 2012

Diagnostic and therapeutic strategies of prostate cancer may largely influenced by patients' age at presentation. This study is aimed to evaluate the characteristics, diagnostic and treatment strategies in prostate cancer patients in our centres. A cross-sectional analytic study of prostate cancer data in two main referral cancer centres, Cipto Mangunkusumo General Hospital and Dharmais National Cancer Centre from 1995-2010, was therefore performed. Patients were divided into 2 sub-populations; below 60 years (younger patients) and 75 years old and above (older patients). PSA levels, diagnostic modalities, Gleason score and therapeutic options were analysed for both and compared using bivariate analysis. 152 patients were <60 years and 210 were ${\geq}75$ years. There was no statistical difference in mean PSA level (797.9ng/mL vs 345.3 ng/mL, respectively; p>0.05) and diagnosis was made by biopsy in majority of patients in both groups (68.2% and 71.6% in younger and older groups respectively). Most presented with an advanced disease stage (65.1% and 66.0%, respectively) and there was no statistically significant difference in mean Gleason scores f (8.1 vs 7.7; p>0.05). Primary androgen deprivation therapy (PADT) was the main treatment for overall patients (48.0% and 50.7%, respectively). Radiotherapy and radical prostatectomy are the main therapeutic modalities for younger patients with local and locally advanced disease (39.6% and 35.4% respectively), while the majority of older patients with the same disease stage were treated with radiotherapy and PADT (45.8% and 39.0% respectively). Differences observed in treatment modalities were statistically significant (p<0.0003). We conclude that there is no difference in disease clinical aggressiveness of the two groups but significant differences were observed in therapeutic strategies utilised with younger and older patients.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.883-886
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• 2014

Background: Prostate cancer is the second leading cause of cancer death in men worldwide. Several factors such as availability of screening tests, and dietary, other lifestyle, environmental and genetic influences contribute to worldwide disparities in prostate cancer incidence and mortality rates. Our aims were to investigate patient characteristics at the time of diagnosis, common treatment strategies employed and survival in an Iranian male population with prostate cancer. Materials and Methods: Archives of Pathology Departments of five referral centers affiliated with the School of Medicine of Shahid Sadoughi University in Yazd province were reviewed. Paraffin-embedded blocks were reviewed by two independent pathologists to confirm the diagnosis. The latest modification of the Gleason Scoring System was adopted to determine pathological grading. Following pathological evaluation, patients were contacted via telephone to acquire information regarding their current status. Results: Pathology blocks were available for 113 patients. However, upon phone contacts, we were unable to determine the survival status in 23 patients (response rate=83%). Therefore, 90 patients were enrolled in the final analysis. The median follow-up time was 6.0 years (ranging from 0.3 to 8.8 years). There were 30 death attributed to prostate cancer in the study group. Kaplan-Meier analysis revealed that patient age at the time of diagnosis was a significant predictor of survival. Another significant predictor of poorer survival was higher tumor grade. Conclusions: Our observations indicate that age and pathological grade can negatively affect survival of individuals with prostate cancer in Iran.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.391-395
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• 2018

We report a case of a patient with locally advanced prostate cancer who had only lymph node involvement without bone metastasis on F-18 FDG PET/CT. A 62-year-old Korean male was admitted to our hospital due to dysuria. His PSA level on admission was 79.35 ng/mL. A transrectal ultrasound-guided prostate biopsy confirmed prostate cancer and his Gleason score was 10 (5+5). F-18 FDG PET/CT demonstrated a hypermetabolic mass lesion with SUVmax 7.0 in the prostate and hypermetabolism with SUVmax 4.7 of the abdominal and pelvic lymph nodes. Tc-99m HDP bone scan showed no significant bone metastasis. The patient underwent hormonal therapy for 9 months. Follow-up F-18 FDG PET/CT showed significantly reduced size and FDG uptake in the prostate and abdominal and pelvic lymph nodes. In this case, treatment monitoring with F-18 FDG PET/CT showed decreased mass size and FDG uptake in the prostate and abdominal and pelvic lymph nodes.

• Radiation Oncology Journal
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• 제29권2호
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• pp.71-82
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• 2011

목 적: 국소 전립선암의 영구적 근접치료 후 단기간 추적 관찰 동안의 생화학적 재발률과 부작용의 정도 및 이에 영향을 미치는 인자들에 대해 알아보고자 하였다. 대상 및 방법: 2007년 4월부터 2008년 12월까지 영구적 근접 치료를 시행 받은 환자는 67예이었다. 추적 관찰이 중단된 환자 5명, 이전에 방사선치료를 받았던 환자 2명을 제외한 60예 중 근치적으로 외부 방사선치료를 병용한 16예, 구제 요법으로 외부 방사선치료를 병용한 1예를 제외한 43예를 대상으로 종앙표지인자의 변화와 부작용의 발생 여부를 조사하였다. T1-T2a, Gleason score 6점 이하, prostate specific antigen (PSA) 10 ng/mL 미만의 조건을 모두 충족시킬 경우를 저위험군으로 정의하였으며, T2b-T2c, Gleason score 7점, PSA 10~20 ng/mL 중 한 가지 이상의 조건을 충족시키는 경우를 종간위험군으로 정의하였고, T3a 이상, Gleason score 8~10점, PSA>20 ng/mL 중 한가지 이상의 조건을 총족시키는 경우를 고위험군으로 정의하였다. 저위험군은 18명이었고, 중간위험군은 19명, 고위험군은 6명이었다. 처방선량은 145 Gy이었다. 결 과: 저위험군과 중간위험군에서 각각 1예씩 PSA가 2 ng/mL 이상 증가하여 생화학적 재발로 진단 받았으며(4.7%), 생화학적 재발률에 영향을 미치는 통계적으로 유의한 인자는 없었다. 급성 요로계 부작용의 경우 Radiation Therapy Oncology Group (RTOG) grade 1과 2가 각각 40예, 3예 있었으며, grade 2 이상의 급성 직장 부작용은 없었고 grade 1인 경우가 5예 있었다. 만성 요로계 부작용은 RTOG grade 1, 2, 3이 각각 1 예, 4예, 1예에서 나타났으며, RTOG grade 1, 2의 만성 직장 부작용이 각각 5예, 10예에서 나타났고 직장 요도간 장루가 생긴 grade 4인 경우가 3예 있었다. 부작용의 발생에 통계적으로 유의한 영향을 미치는 요인은 급성 직장염의 경우 전체 직장에서 최고 선량이 조사되는 직장 0.1 cc에 들어가는 최소 선량(p=0.041), 전체 직장 중 처방 선량의 150% 이상이 들어가는 부피(p=0.038), 치료 부위에 포함 된 직장 중 100% 선량이 들어가는 부피(p=0.047) 및 비율(p=0.019)이 있었으며, 급성 요로계 부작용의 경우 seed 개수(p=0.028)가 유의한 영향을 미쳤다. 만성 요로계 부작용에 유의한 영향을 미치는 인자는 없었으며, 만성 직장염의 경우 전체 직장의 100% 처방선량이 들어가는 부피의 비율(p=0,011), 치료 범위 직장에서 100% 처방선량이 들어가는 부피(p=0.023) 및 최고 선량이 조사되는 직장 0.1 cc에 들어가는 최소 선량(p=0.049)이 유의하게 나타났다. 결 론: 국소 전립선암 환자에서 영구적 근접치료는 저위험군 환자뿐 아니라 중간위험군이나 고위험군 환자에게도 선택적으로 적용 가능한 치료 방법이라고 생각되며 직장 부작용을 감소시키기 위한 노력이 필요하다고 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6273-6276
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• 2012

Background/Aim: Six prostate cancer (PCa) susceptibility loci were identified in a genome-wide association study (GWAS) in populations of European decent. However, the associations of these 6 single-nucleotide polymorphisms (SNPs) with PCa has remained tobe clarified in men in Northern China. This study aimed to explore the loci associated with PCa risk in a Northern Chinese population. Methods: Blood samples and clinical information of 289 PCa patients and 288 controls from Beijing and Tianjin were collected. All risk SNPs were genotyped using polymerase chain reaction (PCR)-high resolution melting curve technology and gene sequencing. Associations between PCa and clinical covariates (age at diagnosis, prostate-specific antigen [PSA], Gleason score, tumor stage, and level of aggressiveness) and frequencies of alleles and genotypes of these SNPs were analyzed using genetic statistics. Results: Among the candidate SNPs, 11p15 (rs7127900, A) was associated with PCa risk (P = 0.02, odds ratio [OR] = 1.64, 95% confidence interval [CI] = 1.09-2.46). Genotypes showed differences between cases and controls on 11p15 (rs7127900, A), 11q13 (rs7931342, T), and HNF1B (rs4430796, A) (P = 0.03, P = 0.01, and P = 0.04, respectively). The genotype TG on 11q13 (rs7931342, T) was positively associated with an increased Gleason score (P = 0.04, OR = 2.15, 95% CI = 1.02-4.55). Patients carrying TG on 17q24 (rs1859962, G) were negatively associated with an increased body mass index (BMI) (P = 0.03, OR = 0.44, 95% CI = 0.21-0.92) while those with AG on HNF1B (rs4430796, A) were more likely to have PSA increase (P = 0.002). Conclusion: Our study suggests that 11p15 (rs7127900, A) could be a susceptibility locus associated with PCa in Northern Chinese. Genotype TG on 11q13 (rs7931342, T) could be related to an increased Gleason score, AG on HNF1B (rs4430796, A) could be associated with PSA increase, and TG on 17q24 (rs1859962, G) could be negatively associated with an increased BMI in Chinese men with PCa.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1943-1948
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• 2012

Introduction: Prostate cancer in Indonesia is the $3^{rd}$ ranking cancer among males and the $5^{th}$ rank for their cancer mortality. Prognostic markers that can identify aggressive prostate cancer in early stages and help select appropriate therapy to finally reduce the mortality are therefore urgently needed. It has been suggested that stem cells in the prostate gland have a role in initiation, progression, and metastasis of cancer, although controversy continues to exist. Maintenance of normal stem cell or reserve cell populations in several epithelia including prostate has been shown to be regulated by p63 and alteration of p63 expression is considered to have an oncogenic role in prostate cancer. We hypothesize that the expression of cytoplasmic aberrance of p63 is associated with high ALDH1A1 expression as a cancer stem cell marker, thus leading to progression of prostate cancer. Methods: Using a cross-sectional study during two years (2009-2010), a total of 79 paraffin embedded tissues of benign prostatic hyperplasia, PIN prostatic intraepithelial neoplasia, low and high Gleason score prostate cancer were investigated using immunohistochemistry. Associations between cytoplasmic p63 and ALDH1A1, as well as with pathological diagnosis, were analyzed by Chi-Square test using SPSS 15.0. Links of both markers with cell proliferation rate (KI-67) and apoptotic rate (cleaved caspase 3) were also analyzed by Kruskal-Wallis test. Results: The mean age of patient at the diagnosis is 70.0 years. Cytoplasmic aberrance of p63 was associated with ALDH1A1 expression (p<0.001) and both were found to have significant relationships with pathological diagnosis (including Gleason score), (p=0.006 and p<0.001 respectively). Moreover, it was also found that higher levels of cytoplasmic p63 were significantly associated with the frequency of proliferating cells and cells undergoing apoptosis in prostate cancers (p=0.001 and p=0.016 respectively). Conclusion: p63 cytoplasmic aberrance is associated with high ALDH1A1 expression. These components are suggested to have an important role in prostate cancer progression and may be used as molecular markers.

• Journal of Yeungnam Medical Science
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• 제35권2호
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• pp.171-178
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• 2018

Background: To evaluate mid-term oncological and functional outcomes in patients with prostate cancer treated by robot-assisted laparoscopic radical prostatectomy (RALP) at our institution. Methods: We retrospectively reviewed the medical records of 128 patients with prostate cancer who underwent RALP at our institution between February 2008 and April 2010. All patients enrolled in this study were followed up for at least 5 years. We analyzed biochemical recurrence (BCR)-free survival using a Kaplan-Meier survival curve analysis and predictive factors for BCR using multivariate Cox regression analysis. Continence recovery rate, defined as no use of urinary pads, was also evaluated. Results: Based on the D'Amico risk classification, there were 30 low-risk patients (23.4%), 47 intermediaterisk patients (38.8%), and 51 high-risk patients (39.8%), preoperatively. Based on pathological findings, 50.0% of patients (64/128) showed non-organ confined disease (${\geq}T3a$) and 26.6% (34/128) had high grade disease (Gleason score ${\geq}8$). During a median follow-up period of 71 months (range, 66-78 months), the frequency of BCR was 33.6% (43/128) and the median BCR-free survival was 65.9 (0.4-88.0) months. Multivariate Cox regression analysis revealed that high grade disease (Gleason score ${\geq}8$) was an independent predictor for BCR (hazard ratio=4.180, 95% confidence interval=1.02-17.12, p=0.047). In addition, a majority of patients remained continent following the RALP procedure, without the need for additional intervention for post-prostatectomy incontinence. Conclusion: Our study demonstrated acceptable outcomes following an initial RALP procedure, despite 50% of the patients investigated demonstrating high-risk features associated with non-organ confined disease.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2527-2530
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• 2015

Background: The cancer of the prostate risk assessment (CAPRA) score has been defined to predict prostate cancer recurrence based on the pre-clinical data, then pathological data have also been incorporated. Thus, CAPRA post-surgical (CAPRA-S) score has been developed based on six criteria (prostate specific antigen (PSA) at diagnosis, pathological Gleason score, and information on surgical margin, seminal vesicle invasion, extracapsular extension and lymph node involvement) for the prediction of post-surgical recurrences. In the present study, biochemical recurrence (BCR)-free probabilities after open retropubic radical prostatectomy (RP) were evaluated by the CAPRA-S scoring system and its three-risk level model. Materials and Methods: CAPRA-S scores (0-12) of our 240 radical prostatectomies performed between January 2000-May 2011 were calculated. Patients were distributed into CAPRA-S score groups and also into three-risk groups as low, intermediate and high. BCR-free probabilities were assessed and compared using Kaplan-Meier analysis and Cox proportional hazards regression. Ability of CAPRA-S in BCR detection was evaluated by concordance index (c-index). Results: BCR was present in 41 of total 240 patients (17.1%) and the mean follow-up time was $51.7{\pm}33.0$ months. Mean BCR-free survival time was 98.3 months (95% CI: 92.3-104.2). Of the patients in low, intermediate and high risk groups, 5.4%, 22.0% and 58.8% had BCR, respectively and the difference among the three groups was significant (P = 0.0001). C-indices of CAPRA-S score and three-risk groups for detecting BCR-free probabilities in 5-yr were 0.87 and 0.81, respectively. Conclusions: Both CAPRA-S score and its three-risk level model well predicted BCR after RP with high c-index levels in our center. Therefore, it is a clinically reliable post-operative risk stratifier and disease recurrence predictor for prostate cancer.

• 한국자기공명학회논문지
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• 제23권1호
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• pp.12-19
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• 2019

A former study has shown that the spin-lattice relaxation time ($T_1$) in cancerous prostate tissue had enhanced contrast at an ultra-low magnetic field, $132{\mu}T$. To study the field dependence and the origin of the contrast we measured $T_1$ in pairs of ex-vivo prostate tissues at the Earth's magnetic field. A portable and coil-based nuclear magnetic resonance (NMR) system was adopted for $T_1$ measurements at $40{\mu}T$. The $T_1$ contrast, ${\delta}=1-T_1$ (more cancer)/$T_1$(less cancer), was calculated from each pair. Additionally, we performed pathological examinations such as Gleason's score, cell proliferation index, and micro-vessel density (MVD), to quantify correlations between the pathological parameters and $T_1$ of the cancerous prostate tissues.

• 대한영상의학회지
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• 제83권5호
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• pp.1059-1070
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• 2022

목적 계산형 확산강조영상 b2000과 실제 획득한 확산강조영상 b2000 사이에 전립선암 발견을 위한 민감도 및 관찰자 간 일치도를 비교하였다. 대상과 방법 근치적 전립선 절제술 및 확산강조영상(b, 0, 100, 1000, 2000 s/mm²)을 포함한 수술 전 3 Tesla 자기공명영상을 통해 전립선암으로 진단받은 총 88명의 환자가 연구에 포함되었다. 계산형 확산강조영상 b2000은 실제 획득한 확산강조영상 b0, 100, 1000으로부터 단일 지수 감쇠 모델에 의해 계산되었다. 두 명의 독립된 검토자가 4주 간격으로 무작위 순서로 두 영상 세트를 검토하여, 가장 큰 종양에 대해 관심 영역을 그렸고, Prostate Imaging-Reporting and Data System 2.1에 기반한 점수를 기록하였다. 전층 절편 조직 검사가 참고 기준으로 제공되었다. 결과 연구에 포함된 환자의 글리슨 점수는 6 (n = 16), 7 (n = 53), 8 (n = 9), 9 (n = 10)로 구성되었다. 두 명의 검토자 모두 계산형 확산강조영상 b2000과 실제 획득한 확산강조영상 b2000 간 전립선암 발견에 대한 민감도 차이는 없었다(검토자 1, 모두 94% [83/88]; 검토자 2, 모두 90% [79/88], 모두 p = 1.000). 관찰자 간 PI-RADS 점수에 대한 일치도는 계산형 확산강조영상에서 0.422 (95% 신뢰구간, 0.240-0.603), 실제 획득한 확산강조영상에서 0.495 (95% 신뢰구간, 0.308-0.683)였다. 결론 계산형 확산강조영상 b2000과 실제 획득한 확산강조영상 b2000은 전립선암 발견 민감도에 차이가 없고, 관찰자 간 일치도는 유지되었다.