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

Transrectal ultrasonography was used to monitor the response of adenocarcinoma of the prostate to radiotherapy before and 6 to 15 months after treatment combining implantation of radioactive gold seeds with external beam irradiation. Data gathered before and after irradiation therapy suggested that the two most sensitive measures for monitoring the primary tumor are the calculated volume of the prostate and the integrity of the prostatic capsule. The calculated volume of the prostate decreased significantly in all patients by 6 months after radiotherapy. The rate and degree of reduction correlated significantly (P less than 0.05) with the histologic grade of the tumor (poorly differentiated tumors shrinking most rapidly), as well as with the outcome of treatment (P less than 0.05). However, there was no such correlation with stage. After treatment, the average number of sites of capsular disruption decreased steadily, reaching 50% of the pretreatment number by 15 months. Transrectal ultrasonography is a practical, inexpensive, noninvasive tool for monitoring the response of prostatic cancer to definitive radiotherapy, and may provide a means of identifying patients who will respond poorly to treatment.
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PMID:Transrectal ultrasonography for prostatic cancer. II. The response of the prostate to definitive radiotherapy. 351 Jul 9

In reviewing the Johns Hopkins Hospital records of over 1,000 radical prostatectomies performed since 1904, only 10 men have had a subsequent autopsy. All were managed by radical perineal prostatectomy without adjunctive therapy; 4 individuals had pathologic Stage B disease, and 6 men had pathologic Stage C cancer. The mean time interval between surgery and death was 8.9 years and 8.8 years for pathologic Stages B and C patients, respectively. Four patients (2 pathologic Stage B and 2 pathologic Stage C) had no evidence of disease, either local or distant, at autopsy. Two men (1 pathologic Stage B and 1 pathologic Stage C) had only microscopic foci of local recurrence without distant metastases. Four other patients (1 pathologic Stage B and 3 pathologic Stage C) had bulky distant metastases; of these, 1 had no local disease, and 3 patients had only microscopic recurrence in the pelvis. No patient had gross pelvic recurrence, and no individual with microscopic local disease had symptoms secondary to that recurrence. Four patients (1 pathologic Stage B and 3 pathologic Stage C) died of prostatic cancer secondary to distant metastases. These data suggest: radical prostatectomy alone provides excellent local control of the primary tumor, irrespective of the pathologic stage; in patients where bulky metastatic disease was responsible for death, distant dissemination may have occurred prior to radical prostatectomy since all patients had either no pelvic disease or only microscopic local recurrence.
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PMID:Long-term autopsy findings following radical prostatectomy. 357 81

During the years 1976 to 1982 definitive curatively aimed radiotherapy to the primary tumor was given to 53 patients with prostatic cancer confined to the true pelvis (T0, 2; T1-2, 19; T3, 24; T4, 8; N0, 18; N+, 2; Nx, 33); all patients were of the Mo-category. The pelvic lymph nodes received a total dose of 2 Gy X 25 by means of an anterior and posterior radiation field. The prostatic gland was irradiated by an additional booster dose of 2 Gy X 10 given to a perineal field. Twenty-four patients have relapsed after their prostatic radiotherapy, only three of them within the irradiated area. For the patients with T0-T2 tumors, the 5-year crude survival was 69%, whereas it was only 37% for patients with T3 tumors. Thirty-five patients developed intestinal (26 patients) and/or urogenital (23 patients) radiation side effects. In three patients a colostomy had to be performed owing to rectal stricture or fistula. The poor survival after radiotherapy in the present series is probably due to a high incidence of unrecognized pelvic lymph node metastases. In the future only prostatic cancer patients without pelvic lymph node spread will be considered candidates for definitive radiotherapy. An optimal radiation technique is mandatory in order to avoid major radiotherapy-induced toxicity.
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PMID:Definitive radiotherapy of prostatic cancer: the Norwegian Radium Hospital's experience (1976-1982). 365 30

The efficacy of cytotoxic agents in the treatment of prostatic cancer is difficult to evaluate because objective, measurable lesions, such as lung, liver, skin, subcutaneous and nodal metastasis are often not found. However, most of the patients with advanced prostatic cancer have bone involvement and elevated serum acid-phosphatase in addition to the primary tumor. Exact clinical trials on such cases, especially phase II studies can not be performed without appropriate evaluations of these three parameters. The criteria of these three parameters offered by various study groups are reviewed and the relevant response criteria are proposed. A stable category was thought to be useful to evaluate the efficacy on the patients with progressing disease. In our proposal, overall assessment of response involves all objective parameters including these three parameters as well as both measurable and unmeasurable disease described in the WHO handbook for reporting results of cancer treatment.
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PMID:[Response criteria for prostatic cancer treated by chemotherapy or antiandrogenic therapy]. 367 39

The spontaneous metastatic spread of a suspension of PAIII prostatic adenocarcinoma cells from the tail site of implantation was analyzed over a period of 5 weeks in male Lobund-Wistar (LW) rats. Following subcutaneous injection of the PAIII cells, the tumor metastasized through the primary lymphatic drainage. PAIII microfoci were evident in the gluteal and iliac lymph nodes prior to colonization of the lungs. Growth of the primary tumor was evidenced by significant weight differences of the tails of PAIII-bearing and control rats 1 week after tumor implantation. Time-dependent sequential spread of the adenocarcinoma was quantitated. Significant differences were noted between PAIII-bearing and control animals with respect to the gluteal lymph node weights (+2 weeks), iliac lymph node weights (+3 weeks), dry lung weights, and lung colony numbers (+4 weeks) after tumor implantation. During the course of these studies, the whole blood prothrombin, activated partial thromboplastin, and recalcification times for the PAIII-bearing animals were similar to those of the control group. These findings indicate that there were no gross changes in systemic blood coagulation accompanying the metastasis of PAIII cells from the primary tumor. The tumor in LW rats produced a consistent pattern of growth and metastasis that is suitable for quantitation. The PAIII prostatic adenocarcinoma is a sensitive and reproducible system that may be useful to evaluate potential antimetastatic and cytotoxic agents for the treatment of hormone-insensitive prostatic cancer.
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PMID:Metastatic spread of the PAIII prostatic adenocarcinoma after implantation in the tail of the rat. 370 46

Aspiration cytology during hormone treatment of prostatic cancer has been regularly performed at the University of Munich for 13 years and gives direct information on the primary tumor. To analyse its value in clinical practice, 919 biopsies of 187 patients were reviewed without knowledge of clinical data and the charts were analysed retrospectively. Each biopsy was classified as having good, medium, or poor therapeutic response depending on the regressive changes of the cells. Agreement between two independent observers was 89%. All but 39 of these patients have died and the surviving patients have a minimum observation period of 5.6 years. A poor therapeutic response was seen cytologically in 72 patients (38.5%) at variable times after treatment began. These patients have a statistically significant worse survival in comparison to all other patients. Forty-seven of these 72 patients had deterioration, but clinical signs developed later in 23 cases (mean 1.1 years); in 21 patients cytology and clinical signs were simultaneous and in only three cases clinical deterioration preceded aspiration cytology (mean 4.8 months). In 25 cases there was a cytologically poor therapeutic response, but no clinical signs of deterioration. These patients had the same survival rate as with good or medium treatment response. Serial aspiration cytology is a very valuable parameter in treatment monitoring and is often the early warning sign of endocrine treatment failure.
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PMID:Cytologic regression grading of hormone-treated prostatic cancer. 373 83

Multivariable analysis was used to investigate the relationship between risk of disease progression or death in patients who were treated with adjuvant therapy after definitive treatment for prostatic adenocarcinoma and the components of the National Prostatic Cancer Treatment Group (NPCTG) and Gleason systems for pathologic grading of prostatic cancer. Data were available for 203 patients who were treated on NPCTG Protocols 900 and 1,000, which involve surgical and radiation therapy as definitive treatment. Since less than 10 per cent of these patients have died, analysis of survival was not attempted. The study focus was progression-free survival, which is the minimum of time to progression or death. The analysis demonstrates that a new measure, the NPCTG score (the sum of the glandular and nuclear grades) is superior to the previously reported NPCTG grade (the maximum of the two grades). In addition, the Gleason score is somewhat superior to the new NPCTG score. All of this, however, applies only to the primary tumor and not the nature of any present or future metastatic lesions.
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PMID:Comparative evaluation of National Prostatic Cancer Treatment Group and Gleason systems for pathologic grading of primary prostatic cancer. 396 53

The risk of second primary cancer was evaluated in 29,128 patients who developed tumors of the urinary tract, including benign and malignant tumors of the renal pelvis and ureter and bladder papillomas in Denmark between 1943 and 1980. Among 9,162 persons with kidney cancer, 416 developed a second primary tumor [relative risk (RR) = 1.4]. Among 19,966 persons with bladder cancer, 1,423 developed a second primary tumor against 1,239 expected (RR = 1.1). The risk of bladder cancer was increased following kidney cancer in both men (RR = 6.3) and women (RR = 10.1), and kidney cancer was increased in both men (RR = 2.9) and women (RR = 4.5) following bladder cancer. These risks were particularly pronounced for cancers occurring in the ureter and renal pelvis. Etiologic similarities are likely explanations for these observations, which also emphasize the role of host factors and the multifocal nature of urothelial tumors. A decrease in relative risks since diagnosis of the first primary cancer was seen that may partly be attributed to a lessening of the intensity of medical surveillance with time. Among long-term survivors with kidney cancer, increased risks were observed for colon and pancreatic cancers, which may be related to treatment; approximately 25% received radiotherapy. Among bladder cancer patients, increased risks of cancers of the lung and larynx occurred, probably due to tobacco smoking. A slight elevation of prostate cancer (RR = 1.3) may be attributable to medical surveillance. Unexpected findings were the significant deficits of cancers of the stomach and rectum among patients with bladder cancer and stomach cancer among those with kidney cancer.
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PMID:Second cancer following cancer of the urinary system in Denmark, 1943-80. 408 9

Previously, histologic precision in the diagnosis of urologic cancers had, for some time, remained stable. More recently, variations in classifications of testis tumors, prostate cancer, and to some degree, bladder tumors, have been introduced. Most systems have in concurrence a desire or an attempt to infer better prognostic assessment in the overall results to treatment. With the advent of additional biological markers or direct enzymatic measurements, e.g., in prostate cancer, further improvements in identifying at risk populations, responses to treatment, and possible indications for variations in treatment, have ensued. These developments alone unquestionably mark the greatest area of change in the recent decade. The extent of disease assessment prior to definitive therapy, whether by arteriography, ultrasound, CAT scanning, or an occasional lymphangiography, has also influenced or modified treatment decisions. For continuing care and follow-up, several of these noninvasive techniques are now becoming included in the more standard approaches. Noninvasive techniques have been introduced for the therapy of renal tumors such as inducing infarction of the primary tumor. Endoscopic ultrasonic techniques have been particularly useful in assessing the size of pelvic tumors and response to treatment, even in detection of unexpected multiple primaries or metastatic extensions. Overall, the precision in urologic cancer, both for diagnostic and detection purposes, has been increased with these introductions.
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PMID:The diagnosis and detection of urogenital cancers. 616 54

Our experiments involving the use of the Dunning R3327 adenocarcinoma as an animal model of prostatic cancer as well as clinical studies on the immunocompetence of prostatic cancer patients are described. Utilizing the Dunning tumor, we have demonstrated that this transplantable adenocarcinoma of the rat prostate was similar to human prostatic cancer with respect to its macroscopic and microscopic appearances, growth rate, growth differential in male and female recipients, and some of its metastatic potential. Cryosurgery was capable of destroying the primary tumor as it can in man. Both antibody and cellular immune responses could be produced against antigens associated with the tumor cells. Tumor-bearing rats treated by cryosurgery in combination with BCG were capable of producing an antitumor immunity that protected them from rechallenge. Clinical studies of prostatic cancer patients showed a diminished in vitro immunity, but the responses of the cancer patients were not significantly different from those of patients with benign prostatic disease.
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PMID:Immunologic aspects of the prostate. 617 Sep 66


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