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Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have used the technique of retropubic implantation of 125I seeds, as introduced by Whitmore and associates in 1972, in 12 selected patients with prostatic cancer. Morbidity has been minimal, and the tumor has been effectively controlled. This technique delivers more radiation and has fewer side effects than external cobalt irradiation, and it should be offered to the patient as an effective alternative to radical prostatectomy. It is best suited for patients with stage A, stage B, or small stage C lesions who have negative bone scans. Edema of the penis follows the lymphadenectomy but gradually subsides.
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PMID:An alternative to radical surgery for cancer of the prostate. 66 73

A case of orbital metastasis from Whitmore stage D adenocarcinoma of the prostate is described. Clinically, it presented as rapidly progressing exophthalmos of the right eye with elevation (ptosis) and abduction paralysis. The associated clinical picture of a one-year history of prostatism prompted patient referral to our department. When a patient presents with an orbital tumor and a history of cancer localized to another site, the metastatic origin of the condition should be suspected and metastasis to other sites sought. A negative finding warrants performing orbital biopsy to confirm the diagnosis. Although excision of single metastatic tumors in this site has been described, coexisting metastasis to bone and lymph nodes, the hormone dependence that these present and prostatic cancer contraindicate resection of the orbital metastatic tumor. Following bilateral orchiectomy and hormone therapy with antiandrogens micturitional symptomatology improved, tumor size was reduced, and exophthalmos disappeared. The case described herein is not the first case of this type of metastatic lesion reported in the literature; 28 cases have been reported to date. This uncommon clinical presentation with extraurological manifestations gives us an idea of the broad clinical spectrum the biological behaviour of this tumor type can adopt.
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PMID:[Exophthalmos caused by orbital metastasis of prostatic carcinoma]. 171 62

Since 1983 to 1987, 13 patients with prostate cancer have been treated. The average age was 64.5 years. All of them were staged according to Whitmore and Jewett systems. Patients with B1, B2, C1 and C2 staging were included in this work. To evaluate the regional nodes, the patients underwent pelvic lymphadenectomy. Interstitial Au198 was performed at the time of operation. The interstitial irradiation delivered to the prostate was of 40 Gy and it was supplemented with CO60 (external beam therapy) till an equivalent of 60 Gy. When the lymphatic nodes were involved, the whole pelvic, ganglionic chain was irradiated. The results achieved with combined treatment of Au198 plus external beam therapy were the reduction of the prostate size, the disappearance of urinary symptoms and the complementary evaluation was normal for the 13 patients. Three out of 11 patients showed bone metastases in the follow up. One of them had also local relapse. Complications associated to radiotherapy were mild to moderate. Only one of the patients required diverting colostomy but he had suffered from rectal disease before radiotherapy. The results achieved until the close of this first report can be considered satisfactory if tumor regression and local control are taken into account, but the average time of follow up is too short to evaluate the survival rate.
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PMID:[Interstitial implant with Au198 in prostatic cancer]. 251 88

Clinical staging is the attempt to determine the pathologic extent of a cancer by clinical tests (Whitmore). Traditionally, staging of prostate cancer has relied on the digital rectal examination, but ultrasonography, which provides an unprecedented picture of the gland, has become a valuable adjunct. The overall sonographic pattern helps to classify a tumor as "localized" or "extensive." A more detailed analysis yields information about the volume and location of the primary tumor; the presence, location, and extent of extracapsular extension; and the presence of seminal vesicle invasion. Comparison of sonograms with corresponding sections of radical prostatectomy specimens demonstrates that ultrasound complements the digital examination in determining by clinical tests the pathologic extent of a cancer.
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PMID:Staging of prostate cancer. Value of ultrasonography. 268 1

Pasteau and Degrais in Paris used radium to treat prostatic cancer in 1907, radium was further used with different techniques including radium needles and radon seeds during twenty years. In 1951, Flock advocated colloidal radioactive gold with interesting palliative results. Permanent gold seeds implant was also used. But until 1970 with the appearance of Iodine 125 grain, brachytherapy was not widely employed. Hilaris and Whitmore treated almost 1000 cases until now, with few immediate complications. Survivals at 5 years are T1 96%, T2 76%, T3 69%. Conservation of potency and absence of late complications are the main benefits. However, the technique is a somewhat complex surgical procedure and the cases have to be carefully selected. Many others centers used iodine technique and Holm recently proposed an ingenious per-operative echography to improve the safety and accuracy of the permanent implantation. Removable implants with 192Ir wire (or nylon ribbon seeds) are obviously simpler and safer to implant through perineal route. For us, flexible plastic tubes is the technique of choice. In ten cases irradiated at 70 Gy level, no recurrences and no complications except one pulmonary embolism, but the patients were highly selected. For Syed rigid needles through perineal template is the technique of choice. External radiation is added after the implant, which delivered a dose of about 30 Gy. The results are satisfactory in the first 100 cases, but with a high level of complication. Comparative series and more follow-up are evidently requested, to know the exact place of brachytherapy in the treatment of prostatic adenocarcinoma.
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PMID:[Cancer of the prostate: technics of curietherapy. Review of the literature and experience at the Institut Gustave-Roussy]. 409 8

To compare the relative prognostic accuracy of the Gleason classification, the Whitmore staging, and the Broder grading systems, 111 patients with prostate cancer undergoing radical surgery were assessed utilizing these systems. The assessments were correlated with the presence or absence of disease six months to eight years after surgery. Of the three systems the Gleason classification system was the least accurate.
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PMID:Evaluation of gleason classification system in prostate cancer. 685 81

With the rapidly spreading enthusiasm for early detection of prostate cancer and the increasing use of serum PSA to evaluate the gland, more cancers that are not palpable on digital rectal examination are being identified. These tumors have pathologic characteristics that are very similar to those of clinically localized, palpable prostate cancers identified on digital rectal examination. Thus, the tumors detected on the basis of an elevated serum PSA value should not be disregarded as insignificant. In fact, these tumors should be given the same therapeutic consideration as the clinically localized, palpable cancers. In the TNM staging system, "PSA-detected" cancers can be classified as stage T1c, and in the Whitmore-Jewett staging system, they can be referred to as stage B0. Long-term follow-up of these prostate cancers will be necessary to establish the prognosis.
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PMID:PSA-detected (clinical stage T1c or B0) prostate cancer. Pathologically significant tumors. 750 77

All solid tumors require the induction of new blood vessels to grow. To begin to study this phenomenon in prostate cancer, we investigated the intensity of tumor associated angiogenesis in prostate non malignant and malignant tissue. Angiogenesis was measured by quantitating microvessels in a total of 67 patients: 23 non malignant biopsy specimens, and 34 malignant specimens from patients who had undergone prostatectomy. Angiogenic activity in prostatic cancer (prostatectomy) tissue (utilizing Factor VIII staining) was then correlated with pathological staging (Whitmore-Jewitt). Overall there appeared to be a trend of increasing microvessel count (MVC) from benign through the advancing stages of prostate cancer. Based on mean microvessel counts we were able to distinguish stage D from all other pathological stages (p = 0.004 between stages C and D). There was, however, no statistically significant difference between stage B and C. We conclude that tumor associated angiogenesis in prostate cancer may have both clinical and pathological significance in prostate cancer.
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PMID:Tumor-associated angiogenesis in prostate cancer. 751 Sep 38

During a 14-year period, 500 consecutive patients having localized prostate cancer were treated with external beam radiotherapy with curative intent. Patients were staged according to the Whitmore-Jewett and TNM systems. Median follow-up for all patients was 69 months. Local recurrence included failures detected by rectal examination and/or prostate biopsy. Progressively elevated prostate-specific antigen (PSA) values at follow-up with no evidence of systemic disease also was considered a local treatment failure. Overall 5- and 10-year survival rates were 65% and 37%, respectively. Cause-specific 5- and 10-year survival rates were 79% and 55%, respectively. Five- and 10-year local control rates for all patients were 72% and 52%, respectively. No patient with a T1 a tumor failed locally. When follow-up PSA data were included in control criteria, 10-year local control rates for patients with T1b, T2a, and T2b-T4 tumors were 66%, 55% and 44%, respectively. If only an abnormal rectal examination and/or a positive post-treatment biopsy was considered as evidence of local failure, control rates were significantly better. Approximately one third of the study patients had died of cancer or intercurrent disease before the PSA test was used routinely. Of the 244 patients (49%) for whom follow-up PSA values were available, 116 had a normal post-treatment PSA with no evidence of disease; 94 were alive and 22 died with no evidence of prostate cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Long-term clinical and prostate-specific antigen follow-up in 500 patients treated with radiation therapy for localized prostate cancer. 753 18

A retrospective study was performed to evaluate the clinical and pathologic characteristics of 60 patients with a palpably benign prostate gland, but with biopsy-proved prostate cancer. All patients underwent prostate biopsy because of elevated serum prostate-specific antigen (PSA) concentration, and subsequently underwent radical retropubic prostatectomy (RRP). Similar analysis was performed for a randomly selected group of 60 clinical Stage B1 prostate cancers from the same period (control cohort). Patients with nonpalpable prostate cancers had a higher preoperative PSA level as compared with the clinical Stage B1 group (median value: 12.3 ng/mL versus 4.6 ng/mL, p < 0.001). There was no significant difference between the two groups with regard to clinical parameters (voiding symptoms, hematuria, age). The nonpalpable prostate cancers exhibited a significant tumor volume (mean: 7.4 cc; range: 0.3-56 cc), and 18 (30%) demonstrated capsular perforation to involve the periprostatic tissues. Of these, three (5%) had seminal vesicle invasion, and one (2%) had pelvic lymph node involvement. There was no difference between these pathologic characteristics and those of the clinical Stage B1 prostate cancers. These findings suggest that nonpalpable prostate cancers identified by an elevated serum PSA level can be of clinical significance and warrant therapeutic consideration. Although nonpalpable, these cancers are peripherally located and were clinically suspected prior to biopsy. Therefore, we propose that these cancers be classified as clinical Stage B0 in the Whitmore-Jewett staging system; in the new TNM staging system, they are designated as clinical Stage T1c.
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PMID:Clinical Stage B0 or T1c prostate cancer: nonpalpable disease identified by elevated serum prostate-specific antigen concentration. 767 59


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