Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0007112 (prostatic adenocarcinoma)
 2,574 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Local clinical control of the primary disease was evaluated in 209 patients with stage C adenocarcinoma of the prostate treated with definitive external beam radiation therapy and followed for a minimum of 2 years. Of these patients 92 per cent required no further prostatic operations for obstruction. Prostatectomy before therapy did not necessarily prevent later prostatic obstruction from occurring. Of 129 patients who had only a needle biopsy before irradiation 90 per cent had improvement of the obstructive and/or irritative symptoms as tumor regression occurred with therapy and these patients did not require a later prostatic operation for obstruction. Stricture formation occurred in 8 per cent of the patients and was not influenced by the type of preirradiation prostatic operation done. If transurethral resection was reuqired after irradiation it was technically more difficult but the morbidity was acceptable. The incidence of hematuria and incontinence was far less than that reported in non-irradiated patients with this disease. Most tumors exhibited a down-grading effect after irradiation. There were no deaths attributable to the treatment. Over-all, 83 per cent of the 209 patients had no urinary complaints after completion of therapy. From a urological viewpoint, good clinical local control is achieved in the patient with stage C adenocarcinoma of the prostate treated with external beam radiation therapy.
 ...
PMID:Carcinoma of the prostate: local control with external beam radiation therapy. 10 28

Radical prostatectomy was performed in 14 patients following local failure of radiation therapy for adenocarcinoma of the prostate. Ten patients were treated with external beam and 4 with interstitial radiation. The interval from beginning radiation therapy to biopsy-proved residual or recurrent disease was twenty-four to one hundred fourteen months (mean 61 months). Ten patients had significant anterior and lateral fibrosis. Five patients had loss of tissue planes between the prostate and rectum, however, no rectal injuries occurred. Estimated blood loss was 300-8,000 cc (median 1,000 cc). Operative time was one hundred ten to three hundred seventy-five minutes (median 185 minutes). Significant late complications are impotence (100%) and incontinence (55%). Tumor volume was 1.1-27.2 cc (mean 11.1 cc). Seven patients had seminal vesicle involvement, 9 had level III capsule penetration, and 6 had positive surgical margins. Follow-up ranges from one to fifty-two months (median 18 months). Currently, 6 patients are clinically without disease and have serum prostate-specific antigen (PSA) of 0.0 ng/mL. Four patients have no clinical evidence of disease but do have detectable serum PSA, and 4 patients have evidence of metastatic bone disease on bone scan with elevated serum PSA levels. Radical prostatectomy following radiation therapy has no greater immediate morbidity or mortality compared with radical prostatectomy without prior irradiation and takes only slightly longer to perform. However, there is a marked increased risk of impotence and incontinence. More patients followed for a longer time are needed to assess the benefit of radical prostatectomy on survival of patients who fail radiation therapy.
 ...
PMID:Radical prostatectomy after definitive radiation therapy for prostate cancer. 200 Jun 72

This paper describes a new technique and preliminary clinical results of remote after-loading transurethral irradiation for cancer of the prostate. As of January 1986, twelve patients with adenocarcinoma of the prostate have been treated by our radiotherapy technique. Clinically, 3 patients were in stage B2, 3 in stage C, 3 in stage D1 and 3 in stage D2. These patients have been followed up for 13 to 33 months with a median follow-up period of 20.6 months. The dose of transurethral irradiation was 9-10 Gy. to the prostatic capsule and about 2 Gy. to the rectum in one procedure. We repeated this radiotherapy 3 to 4 times within an about 1-month period. Three patients in stage D1 and one patient in stage C received an additional external beam radiation (40 Gy.) to the entire pelvis. A needle biopsy was also performed every 4-6 months after irradiation. Local tumor response proved rapid and satisfactory as verified by a rectal examination and ultrasonography. The biopsies revealed a 70% negative rate within one year. The most common side effect was transient frequency observed in 7 patients. Severe complications such as incontinence, urethral stricture, or proctitis were not evident. This study suggests that intracavitary irradiation of cancer of the prostate is effective and safe. This method may have wider application.
 ...
PMID:[Transurethral intracavitary irradiation for carcinoma of the prostate]. 204 Dec 74

We reviewed our experience with morbidity and mortality associated with clinical local failure after definitive therapy for adenocarcinoma of the prostate by interstitial 125iodine implantation, external beam radiation therapy or radical prostatectomy. Morbid complications included unilateral ureteral obstruction; bladder obstruction and/or incontinence requiring treatment by transurethral resection, or placement of a urethral or suprapubic catheter; hematuria requiring intervention for clot evacuation or fulguration, and perineal and/or pelvic pain. Lethal complications included bilateral ureteral obstruction or bowel obstruction. We treated 108 patients with 125iodine, 178 with external beam radiotherapy and 67 with radical prostatectomy. Clinical local failure occurred in 26 per cent of the 125iodine, 17 per cent of the external beam radiotherapy and 12 per cent of the radical prostatectomy groups. The total incidence of local failure with 125iodine was statistically higher than for radical prostatectomy. Stage C and poorly differentiated tumors were associated with a statistically higher incidence of local failure compared to lower stage and grade tumors. However, within each stage and grade there was no significant difference in local failure between treatment modalities. There was negligible morbidity or mortality secondary to local failure associated with stage A2, stage B1 or well differentiated tumors regardless of treatment modality. There was no difference in the morbidity and mortality between treatment modalities for stage C or poorly differentiated tumors. However, for stage B2 or moderately differentiated tumors treated by 125iodine implantation there was a statistically greater incidence of morbidity and mortality than that associated with external beam radiotherapy and radical prostatectomy. Our observations with regard to selection of primary monotherapy options that provide local tumor control are as follows. Stage A2, stage B1 or well differentiated tumors can be well controlled by all 3 treatment modalities. 125Iodine is associated with local failure-related morbidity and mortality for stage B2 or moderately differentiated tumors, which are statistically higher than for external beam radiotherapy and radical prostatectomy, and therefore, these latter are the preferred treatment. Radical prostatectomy and 125iodine for stage C tumors are associated with a trend to higher local failure, and related morbidity and mortality than is external beam radiotherapy. However, longer followup of the external beam radiotherapy series is necessary to confirm this observation.
 ...
PMID:Morbidity and mortality of local failure after definitive therapy for prostate cancer. 291 94

Twenty-five consecutive patients with localized adenocarcinoma of the prostate treated with 1,050 rad preoperative radiation therapy and Iodine-125 seed brachytherapy arreviewed. Significant long-term postoperative complications included radiation cystitis (12%), radiation proctitis (4%), genital and leg edema (12%), stress incontinence (8%), total incontinence (4%), and impotence (26%). Complications occurred in 75 per cent of patients who received additional postoperative radiation. Improved staging with CT scan, lymphangiography, and Chiba needle biopsy of any possibly abnormal lymph nodes provided excellent preoperative staging with only 1 patient (6%) upstaged at surgery to Stage D1.
 ...
PMID:Complications associated with preoperative radiation therapy and Iodine-125 brachytherapy for localized prostatic carcinoma. 687 81

Preoperative evaluation of voiding patterns and detailed urodynamic evaluation before radical retropubic prostatectomy was carried out in an attempt to identify patients at higher risk of developing urinary incontinence postoperatively. Ninety-two men, mean age 64 years (range 54-72), who completed 1 year of follow-up after radical retropubic prostatectomy for clinically localized adenocarcinoma of the prostate were included in the study. According to the preoperative urodynamic findings, patients were divided into two main groups: group 1 (n = 64) patients with normal urodynamic findings, and group 2 (n = 28) patients with abnormal urodynamic findings. The latter group was further subdivided according to the abnormality: detrusor instability (n = 12), weak sphincter mechanism (n = 9), and detrusor and sphincter instability (n = 7). The degree and incidence of urinary incontinence were evaluated in both groups at the 1-year follow-up visit. There was a substantial difference in the incidence of urinary incontinence between the two main groups with only 2 patients with incontinence in group 1 (3%) versus 11 patients in group 2 (39%). In addition, the incidence of incontinence in group 2 differed depending on the type of abnormality: the lower incidence occurred in patients with detrusor instability (17%) and the higher incidence in patients with both detrusor and sphincter instability (71%). Identification of sphincteric and bladder dysfunction preoperatively may indicate a high risk of urinary incontinence after radical prostatectomy.
 ...
PMID:Preoperative urodynamic evaluation: does it predict the degree of urinary continence after radical retropubic prostatectomy? 780 19

As of January 1986, 13 patients with adenocarcinoma of the prostate had been treated in our clinic by remote after-loading transurethral high dose rate radiotherapy using a 60Co source. Of these patients, four were at stage B2, three at stage C, three at stage D1, and three at stage D2. The mean total dose of transurethral radiotherapy was 35.2 Gy to the most distant prostatic capsule from the source. Three patients with stage D1 disease and one patient with stage C disease received additional external radiation with a total dose of 20 Gy to the prostate and 40 Gy to the pelvis. Local tumor response proved rapid and satisfactory as verified by rectal examination, ultrasonography, and needle biopsy. Serious complications such as proctitis, cystitis, incontinence, and urethral stricture were not evident during the average follow-up term of 34.9 months.
 ...
PMID:Local control of prostate cancer with transurethral intracavitary radiation therapy. 823 57

Patients with localized adenocarcinoma of the prostate gland (CaP) are frequently (approximately 50%) found at radical prostatectomy to have extracapsular disease or positive surgical margins. The management of these patients is a subject of controversy because some question the impact of this manifestation of CaP on patient survival or disease-free survival. Between 1976 and 1991, 241 patients with pathologic stage C (T3N0) were treated in this medical center. Of these 241 patients, 201 (83%) received a planned postoperative pelvic irradiation consisting of 48 Gy given to the prostatic fossa, whereas 40 (17%) patients were treated with radical prostatectomy alone. The two study urologists selected these patients not to receive postoperative irradiation based on intraoperative findings and important prognostic factors. Comparison of treatment outcomes in these two treatment groups is a subject of this report. The 201 patients treated with surgery-radiotherapy (S+RT) combination had a higher pathologic stage, greater incidence of seminal vesicle involvement, p = 0.002, and higher mean and median preoperative prostate-specific antigen level, p < 0.0001, than the 40 surgery (S) alone patients. There was no significant difference in the incidence of higher Gleason's score by the treatment group, p = 0.14. In univariate analysis, there was no significant difference in survival, disease-free survival, and time to failure between the two treatment groups. In multivariate analysis after controlling for pathologic stage and Gleason's score, the 201 adjuvant radiotherapy patients were predicted to have recurrence at 68% (95% confidence interval 39%-118%) the rate of the 40 surgery-alone patients. Local recurrence with or without metastatic disease was found in 10% of surgery-alone patients as compared to 5% in those also receiving postoperative irradiation. Treatment tolerance was very good with minor radiotherapy complications only. There was no significant difference in the incidence of incontinence between the two treatment arms. In summary: (a) The use of moderate-dose postoperative radiotherapy was of low toxicity and it did not increase the incidence of incontinence. (b) Local recurrence was 5% in S+RT and 10% in S-alone patients. (c) In multivariate analysis, S+RT patients had 68% rate of recurrence of S-alone patients. (d) Adjuvant RT probably reduces the risk of recurrence in patients with poor prognostic factors. (e) These data need to be interpreted with caution because of the nonrandomized nature of the study.
 ...
PMID:Comparison of outcomes of radical prostatectomy with and without adjuvant pelvic irradiation in patients with pathologic stage C (T3N0) adenocarcinoma of the prostate. 1044 Jan 84

In an effort to help physicians offer their patients unbiased advice on the best alternatives for treatment of localized prostate cancer, we present a retrospective comparison of the effectiveness of brachytherapy and radical retropubic prostatectomy in 1305 men with stage T1 and T2 adenocarcinoma of the prostate. Data from 1305 patients treated in our community-based private practice urology group from 1993 to 2002 were reviewed, and patients were classified by initial prostate-specific antigen (PSA) level and risk grouping. Risk grouping was defined by preoperative PSA levels and Gleason scores. We used time to PSA-indicated recurrence as the measure of efficacy. Brachytherapy and radical prostatectomy provided similar responses to treatment (no significant differences given the sample size, length of follow-up, and numerical differences observed) for localized prostate cancers. A prospective study is presently underway to evaluate the respective outcome of these procedures (including incidence of incontinence and impotence), and assess their impact on patient quality of life. The results presented here fail to show any superiority of prostatectomy over brachytherapy with palladium-103 (TheraSeed; Theregenics Corp., Buford, GA) with respect to time until relapse indicated by PSA level increase (> 0.2 ng/mL for prostatectomy and >1.5 ng/mL and rising for brachytherapy). In fact, any differences between treatments favor brachytherapy, particularly for intermediate- and high-risk groups. We conclude that both brachytherapy and prostatectomy should be offered, equally and without bias, to men with stage T1 or T2 organ-confined prostate cancer.
 ...
PMID:Brachytherapy versus radical prostatectomy in patients with clinically localized prostate cancer. 1208 97

The technique and recent experience incorporating cryosurgery into our community practice for primary treatment of localized prostate cancer is described. Between December 2000 and December 2001, a total of 93 patients underwent targeted cryoablation for localized prostate cancer. Of the 93 patients, 18 had failed radiotherapy, and cryotherapy was used as salvage therapy. The remaining 75 patients underwent targeted cryoablation of the prostate as primary therapy. A single urologist using an argon-based cryoablation system performed the procedure. Cryoprobes and thermosensors were placed under transrectal ultrasound guidance via a transperineal route. A double freeze-thaw cycle was used with anterior-to- posterior probe operation. Strategically placed thermosensors were used to monitor and control the freezing, and a warming catheter was used to protect the urethra. We achieved a nadir prostate-specific antigen level of < or =0.4 ng/mL in 84% of the entire population we studied (63 of 75 patients). Postsurgery complications were minimal. Incontinence developed in 4 patients, as did postsuprapubic catheter removal urinary retention. Erectile dysfunction developed in 28 of 34 patients who were potent preoperatively, with 6 of the 34 patients regaining potency after surgery. No rectourethral fistula formation occurred. Urethral sloughing was observed in 5 patients, 1 of whom developed a scrotal abscess during treatment of the sloughing. The use of cryoablation of the prostate for the treatment of localized adenocarcinoma of the prostate is feasible and can easily be transferred from the pioneering centers to the community hospitals without sacrificing safety or efficacy.
 ...
PMID:Cryosurgery as primary treatment for localized prostate cancer: a community hospital experience. 1220 46


1 2 Next >>