Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0178874 (tumor progression)
 40,807 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The role of staging transurethral resection of the prostate in the management of stage A prostate cancer is controversial. The accuracy of staging transurethral resection, A1/A2 substaging and probability of progression tables for predicting cancer progression was evaluated in untreated patients with stage A adenocarcinoma of the prostate who were followed for at least 5 years. Survival free of disease was predicted correctly in 93% of 52 patients who underwent staging transurethral resection of the prostate, 92% of 96 with the probability tables and in 85% of 96 using a common criteria for A1 and A2 substaging. Staging transurethral resection of the prostate upgraded patient risk in 7% of the low risk patients predicted by the probability tables and 14% of the stage A1 cancer patients. Staging transurethral prostatectomy and the probability of progression tables were more accurate in predicting survival free of disease than the A1/A2 substaging system. Comparison of the predictive accuracy of staging transurethral prostatectomy to that of the probability of progression tables showed no significant difference. There was no additional benefit from combining the 2 methods. When the probability of progression tables are used to predict cancer progression it may be unnecessary to use staging transurethral resection of the prostate in the patient with stage A prostate cancer.
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PMID:The predictive accuracy of staging transurethral resection of the prostate in the management of stage A cancer of the prostate: a comparative evaluation. 234 75

Although tumor volume is an important factor in predicting prognosis in carcinoma of the prostate, direct and accurate estimation of tumor volume is not practical clinically at present because the tumor may not always be palpable (stage A) and when palpable it is difficult to estimate volume in 3 dimensions. For this reason the clinical staging of prostate cancer currently is based on estimations of the per cent of gland involved with tumor: in stage A by per cent of tissue involved with cancer and in stage B by digital palpation (less than 1 lobe, 1 lobe and 2 lobes). In stage A prostate cancer the per cent of the specimen involved with tumor and the volume of tumor have been shown to correlate with tumor progression. Our study was designed to determine if either or both of these morphometric factors would be good predictors of pathological stage in stage B prostate cancer. We analyzed 56 step-sectioned radical prostatectomy specimens: 28 without capsular penetration, 15 with capsular penetration only and 13 with seminal vesicle involvement. The per cent of gland involved with tumor (correlation coefficient 0.67, p less than 0.001) and tumor volume (correlation coefficient 0.55, p less than 0.001) correlated well with pathological stage. Stepwise linear regression showed that the combination of the per cent of gland involved with tumor and the total Gleason grade was statistically the best predictor of pathological stage.
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PMID:Morphometric measurement of tumor volume and per cent of gland involvement as predictors of pathological stage in clinical stage B prostate cancer. 291 56

Previous studies from this institution have shown that in untreated stage A prostate cancer when 5 per cent of the specimen or less was involved by tumor (stage A1) only 2 per cent of the patients had progression at 4 years. Of the specimens with greater than 5 per cent cancer (stage A2) 33 per cent had progression at 4 years. More recently, we have shown that 16 per cent of the men with stage A1 disease who remained at risk for 8 years or longer after diagnosis had progression of disease despite a small percentage of the specimen involved by tumor. To address whether the actual volume of tumor resected may be a better predictor of progression than the percentage of the specimen involved by tumor the data from these studies were re-evaluated. We demonstrated that at 4 and 8 years of followup the percentage of the specimen and resected tumor volume were strongly associated with tumor progression, with the percentage of the specimen showing a stronger association especially at 4 years. Our study reaffirms the use of the percentage of resected tissue involved by tumor as a means to distinguish between stages A1 and A2 prostate cancer. Although at 8 years the distinction between stages A1 and A2 disease is blurred, this staging classification still is useful to identify those tumors with a relatively indolent course and a minimal short-term risk of progression from those that are more aggressive.
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PMID:Tumor volume versus percentage of specimen involved by tumor correlated with progression in stage A prostatic cancer. 336 76

The disease progression and rate of cancer death were analyzed in 52 patients with stage A prostate cancer who underwent transurethral resection of the prostate (TURP) or retropubic subcapsular prostatectomy (SCP) between 1987 and 1998. We performed immunohistochemistry on 16 patients to determine the correlation between the expression of the tumor metastasis suppressor gene KAI1 and the subsequent progression of stage A prostate cancer. Nineteen and 33 of the patients had cancer at stage A1 and stage A2, respectively, and their subsequent courses were followed for an average of 53.7 months (24-134 months). Progression to clinical cancer was found in six patients (one with stage A1, and five with stage A2). This progression was evident 40.8 months (5-80 months) after TURP or SCP. Four (66.7%) of the patients died of cancer progression (average 31 months) after prostatectomy. All four patients had stage A2, poorly differentiated adenocarcinoma, and had been followed with administration of diethylstilbestrol diphosphate (DES-P). The disease-free patients (n=10) showed overexpression of KAI1 protein, compared to those with disease progression (n=6). These results indicate that progression arose mainly in the patients with stage A2 cancer, and that poorly differentiated, focal and weak expression of KAI1 protein is highly associated with disease progression. It is suggested that patients in this group should be treated with immediate total androgen blockade, radiation, or radical prostatectomy after diagnosis.Prostate Cancer and Prostatic Diseases (2001) 4, 150-153.
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PMID:KAI1 expression can be a predictor of stage A prostate cancer progression. 1249 33