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

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

We divided 73 cases of pelvic nodal metastases from prostatic cancer into subgroups based upon the volume and extent of nodal disease. Of the patients with gross nodal disease 15 per cent survived 5 years without progression compared to 27 per cent of those with microscopic involvement of more than 1 node and 44 per cent with a single positive node. On the other hand, 52 per cent of the patients with gross disease died of prostatic cancer within 5 years compared to 37 per cent of those with multiple microscopic nodes and 28 per cent with a single node. Although other variables also influence prognosis, the differences in survival demonstrable within these subgroups may have important implications regarding selection of therapy and interpretation of treatment results.
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PMID:Implications of volume of nodal metastasis in patients with adenocarcinoma of the prostate. 392 Apr 6

DNA ploidy was evaluated by flow cytometry for 45 human prostate carcinomas (34 prostatectomy specimens and 11 biopsies). Twenty tumors (44.4%) contained a distinct aneuploid stem line. All 11 tumors confined to the prostate gland (pathological Stage B) were diploid. The frequency of aneuploidy increased with advancing stage, and most tumors with distant metastases were aneuploid. The degree of glandular differentiation was characterized by the Gleason score. One-third of tumors with a Gleason score of 5 to 6 were aneuploid, whereas over 70% of poorly differentiated tumors with a Gleason score of 9 to 10 were aneuploid. Among diploid tumors, 45.5% were localized carcinomas (Stage B), 36.4% were characterized by invasion outside the prostate (Stage C), and 18.2% formed pelvic nodal or distant metastases (Stages D1 and D2). In nearly two-thirds of patients with aneuploid tumors, pelvic nodal or distant metastases were found. When tumors were classified according to both DNA ploidy and degree of glandular differentiation, then subgroups of tumors with the highest and lowest degree of malignant potential became apparent. Only 7.1% of diploid tumors with a Gleason score of 5 to 6 formed metastases, but 80% of aneuploid tumors with a higher Gleason score (7 to 10) formed metastases. Diploid tumors with higher Gleason scores and aneuploid tumors with lower Gleason scores had intermediate frequencies of metastases. The presence of an aneuploid stem line in prostate carcinomas indicated that the tumor had spread outside the prostate gland or had metastasized. DNA ploidy may be an important prognostic factor for human prostate cancer. DNA ploidy and the degree of glandular differentiation considered together may improve prognostic evaluation of prostate carcinomas.
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PMID:Relationship between DNA ploidy, glandular differentiation, and tumor spread in human prostate cancer. 397 84

Thirty-nine patients with metastatic prostate cancer refractory to hormonal manipulation were treated with vinblastine by continuous infusion. The dose was 1.5 mg/m2 daily for 5 days. A 21% response rate was obtained. Eight patients, two with visceral metastasis, one with nodal disease, and five with osseous metastasis achieved objective response. The median duration of response was 28 weeks. Myelosuppression was the major side effect: the median leukocyte count nadir was 2.8 X 10(3)/ml and the median platelet count nadir was 184 X 10(3)/ml.
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PMID:Continuous infusion of vinblastine for advanced hormone-refractory prostate cancer. 401 95

Pelvic lymphadenectomy prior to radical prostatectomy is essential to detect lymph nodal extension of prostatic cancer. Accuracy obtained by means of frozen section examination of the nodes is particularly favourable. Frozen sections correspond to paraffin sections in 100% of the cases. Authors' experience in 42 consecutive patients candidates to radical prostatic procedure is herein presented.
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PMID:[Locoregional staging of prostatic neoplasms by extemporaneous histological examination of pelvic lymph nodes]. 404 10

The treatment of choice for disseminated prostate cancer remains endocrine manipulation, either bilateral orchiectomy or exogenous estrogens. The recommended dose of diethylstilbestrol is 1 mg tid. Unanswered questions include: When should endocrine manipulation be instituted for the patient with advanced prostatic cancer? At the time of diagnosis, when clinical symptoms occur, or not at all? With few exceptions those patients relapsing after initial endocrine manipulation do not respond to successive attempts at further endocrine therapy. Much of the confusion in this regard relates to the variable response criteria used, more often subjective than objective. Since the polyclonal theory of prostatic cancer is attractive, its logical extension is the evaluation of combinations of treatments including both endocrine manipulation and cytotoxic agents. Because the currently available antiandrogens and luteinizing hormone-releasing hormone agonists have mechanisms of action different from conventional estrogens or bilateral orchiectomy, they too may have a role in the multimodal treatment of advanced prostatic cancer. Therapy for stage D1 prostatic cancer implies that information is available either from pelvic lymphadenectomy or from fine-needle aspiration cytology related to abnormal findings on CT scanning, lymphangiography, or excretory urography. Some evidence exists supporting the case of potential cure by radical prostatectomy when pelvic nodal involvement is minimal. Other options include standard external beam irradiation therapy, endocrine therapy with transurethral prostatic resection, and finally, observation until distant metastases occur. Because of the increased risk of distant metastases in patients with stage D1 prostatic cancer, adjuvant chemotherapy programs are rational with clinical trials now in progress.
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PMID:The patient, disease status, and treatment options for prostate cancer: stages D1 and D2. 635 Oct 40

The results of pelvic lymph node dissections in 105 prostate cancer patients were analyzed to compare the clinical with the pathologic stages. Twenty-four per cent of patients clinically believed to be node-negative had positive nodal involvement with cancer.
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PMID:Pelvic lymph node dissection in prostate cancer. 650 92

Sixty-four patients with adenocarcinoma of the prostate and histologic evidence of pelvic nodal metastasis have been followed for at least 5 years after pelvic lymphadenectomy only. Forty-seven patients were treated with extended field irradiation, while 17 did not receive any irradiation. Only 17 per cent of the patients receiving irradiation survived free of disease for 5 years, while 40 per cent died of prostatic cancer, compared to 29 and 35 per cent, respectively, of those who did not receive irradiation. Symptomatic manifestations of local disease occurred within 5 years in 65 per cent of the patients not treated with irradiation, compared to 51 per cent of those who received pelvic irradiation. External radiation therapy imparted no discernible benefit in terms of survival free of disease in our patients. Furthermore, the impact of irradiation in preventing local symptoms in these patients seems to be slight.
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PMID:Impact of external irradiation on local symptoms and survival free of disease in patients with pelvic lymph node metastasis from adenocarcinoma of the prostate. 670 86

The inaccuracy of lymphangiography in predicting nodal involvement and the complications of pelvic lymphadenectomy prompted us to evaluate other methods of staging prostatic cancer. On the basis of the results obtained in 24 patients with carcinoma of the prostate, the authors suggest transcutaneous fluoroscopy-guided fine needle aspiration biopsy as a satisfactory alternative to lymphadenectomy. In 95-8% of patients pelvic lymphadenectomy confirmed the cytological findings of transcutaneous aspiration biopsy of pelvic lymph nodes using a "long-bevelled, side-holed" thin needle. It is considered essential to perform aspiration biopsy on most of the pelvic lymph node chains opacified, regardless of lymphographic diagnosis.
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PMID:Accuracy of transcutaneous aspiration biopsy in the definitive assessment of nodal involvement in prostatic carcinoma. 685 Feb 52

Percutaneous fluoroscopy-guided aspiration biopsy of the pelvic nodes was performed for staging in 136 nodal chains of 26 patients with clinically localized carcinoma of the prostate and in 14 patients with bladder cancer. The fine-needle aspiration biopsy had an overall accuracy of 97.5%, sensitivity of 94.11% and specificity of 100%. In the management of prostatic cancer, the positive aspiration biopsy may be considered a definitive diagnostic means for determining tumor stage. The negative aspirations may be accepted as definitive diagnostic staging procedure too, since the sensitivity of the method is of 93.3% in patients with prostatic carcinoma. As the presence or absence of nodal metastasis cannot be predicted accurately on the basis of the T or P category of the primary tumor in patients with bladder carcinoma, the fine-needle aspiration biopsy may have a prominent role in accurate clinical stage determination, for a rational application of the treatment.
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PMID:The value and role of percutaneous pelvic lymph node aspiration biopsy in definitive staging of prostatic and bladder carcinoma. 687 24


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