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Query: UMLS:C1519176 (PSA)
 5,490 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report a series of 50 radical prostatectomies and analyse and discuss the elements of: early diagnosis of adenocarcinoma: 63% of patients did not have a strictly normal digital rectal examination, 70% had abnormal ultrasonography, 73% has a PSA assay greater than 10. Suspicious signs were absent in 17% of cases, but present in 83% of cases (one sign), 63% of cases (two signs) and 40% of cases (three signs). Ultrasound guided biopsy of suspicious zones (on rectal examination or on ultrasonography) and in adjacent zones by dividing the prostate into quadrants has an increasing diagnostic yield (77% of the last thirty cases, 100% of the last fifteen cases). Staging frequently underestimates the exact volume of the tumour and the state of the prostatic capsule. MRI using a high power magnetic field apparatus seems to improve the accuracy of preoperative staging. Operative results were excellent in terms of mortality (nil), morbidity (6% of cases) and functional results for continence (recovered within one month) and sexual activity (satisfactory in 73% of cases) when Walsh's technique was able to be applied.
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PMID:[Elements of the early diagnosis and staging of prostatic cancer. Functional results of radical surgery. Apropos of 50 complete prostatectomies]. 169 80

Spread beyond the capsule is a poor prognosis factor in clinically localized carcinomas of the prostate; preoperative diagnosis is difficult and clinical evaluation usually underestimates tumor spread. This prospective study was undertaken to confront results of the conventional workup (rectal examination, transrectal ultrasonography and PSA) and of CT scan and MRI findings with findings upon the pathologic study of operative specimens following radical prostatectomy. Results show that the conventional workup remains the diagnostic gold standard and that CT scan yields no additional information. Technically faultless MRI with sections in the three planes is a good means for analyzing the capsule of the prostate.
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PMID:[Can CT scanner and MRI predict capsular invasion of local cancer of the prostate? A study of 20 radical prostatectomies]. 222 40

Diseases of the prostate are of high socioeconomic importance owing to their high incidence and prevalence rates. Benign prostatic hyperplasia (BPH) can be detected in 80% of males over the age of 80. Clinical symptoms do not correlate with organ enlargement. Only 10% of patients with BPH need surgical treatment. The decision for surgical treatment is made as a result of objective findings and the symptoms reported by the patient. Preoperative evaluation of BPH must include digital rectal examination (DRE), measurement of peak flow rate, sonographic estimation of residual urine, transrectal ultrasound (TRUS), urethrocystography and the assessment of subjective complaints using symptom scores. Prostatic carcinoma is the most common malignancy in men. An abnormal DRE, increased PSA level and/or hypoechogenic lesions in TRUS are indications for prostate biopsy. The sensitivity of TRUS is superior to that of CT and MRI. New MRI techniques are promising with regard to local tumour extent. Whereas CT and MRI are not useful in screening of patients, these methods are valuable diagnostic tools in the follow-up of prostate cancer.
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PMID:[The value of diagnostic imaging in benign prostatic hyperplasia and prostatic cancer]. 751 94

The response of advanced prostatic cancer with metastatic chest wall tumor to high-dose diethylstilbestrol diphosphate (DESP) therapy was monitored by in vivo 31P magnetic resonance spectroscopy (31P MRS) study. A eighty-three year old man with Stage D2 prostatic cancer had been treated with chlormadinone acetate and cyclophosphamide since 1984. He was admitted to our hospital with a chest wall tumor and anemia on May 9, 1992. The elevated PAP, PSA and gamma-Sm levels were also observed. Needle biopsy of the tumor revealed poorly differentiated adenocarcinoma metastatic from the prostatic cancer. The patient received 500 mg of DESP by DIV daily for 10 days, and the tumor was reduced by 54% clinically. The abnormal PAP, PSA and gamma-Sm levels returned to almost normal range by three weeks after the initiation of high-dose DESP therapy, and regression of the tumor was confirmed by the MRI. After the first administration of DESP, the MR spectra of the chest wall tumor showed elevated peaks of phosphomonoesters and phosphodiesters. These substances are related to the membrane metabolism and their increase represents the membranous degeneration of tumor cells. The same changes continued consecuitively for three weeks, and corresponded with the regression of the tumor. In conclusion, these results suggest that in vivo 31P MRS of malignant tumors can be useful for evaluating early response to therapy prior to other clinical examinations.
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PMID:[Monitoring tumor response to therapy by means of 31P magnetic resonance spectroscopy. A case of advanced prostatic cancer with metastatic chest wall tumor]. 802 47

One hundred and three patients with clinical stage C prostatic carcinoma (palpable extra-organ extension) underwent inductive chemo-hormonal treatment followed by radical retropubic prostatectomy with pelvic lymphadenectomy. First a careful noninvasive tumor staging was performed, which included a thorough digital rectal palpation, PSA, PAP, chest X-ray, bone scan, IVP, transabdominal and transrectal ultrasonography, CT and MRI. Then inductive chemo-hormonal therapy commenced. It consisted of total androgen deprivation plus the administration of cDDP or 5-FU + calcium folinate + mitomycin. After completion of chemotherapy (i.e. 4 months later), noninvasive staging was repeated. Then radical prostatectomy was carried out, followed by histologic work-up of the specimen. Postinductive, noninvasive examinations showed clinical downstaging in 49 of the original 103 patients (47.5%). Histopathology showed confinement of the tumor to the prostate in 40 specimens (38.8%). These results prove that chemo-hormonal induction is highly effective and suggest strongly but do not prove definitely histological downstaging in a significant percentage of the patients.
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PMID:Downstaging of stage C prostatic carcinoma by inductive chemo-hormonal therapy? 826 99

We described a double-site enzyme-linked immunosorbent assay (ELISA) to measure polysialic acid neural cell adhesion molecule (PSA-NCAM) level in CSF. Immunocapture of PSA-bearing molecules is first effected by means of a monoclonal antibody (anti-MenB), directed against sialic acid polymers and adsorbed into plastic wells. Linked PSA-NCAM is then revealed by means of a second antibody, directed against an aminoacid sequence of NCAM and labelled with peroxydase. The lowest amount of PSA-NCAM detectable was estimated to be 0.11 microgram/l. This value was considered as the threshold for positivity. PSA-NCAM level was measured using this method in CSF from 29 patients with medulloblastoma. CSF had been collected at different times following tumor excision and stored at--80 degrees C. At the same times, cytological examination in CSF (medulloblastoma metastatic cells) and craniospinal imaging (tomographic scan or MRI) had been performed. PSA-NCAM was never detected in control CSF. For patients in remission, beyond the post-operative period of 1 or 2 months, 18 on 21 exhibited a PSA-NCAM level below the threshold value. For refractory patients, so classified according to the positivity of cytology and/or imaging, whatever the time after the tumor excision, PSA-NCAM was always positive (23/23), while either cytology or imaging were positive less frequently (16/23 for both). For relapses, PSA-NCAM was more frequently positive (6/7) than cytology and imaging (1/7 and 5/7, respectively). We concluded that PSA-NCAM positivity in CSF may be a reliable marker to detect the invasive or metastatic feature of medulloblastoma.
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PMID:[Polysialylated NCAM in CSF, a marker for invasive medulloblastoma]. 975 72

Capromab Pendetide imaging illustrates the successful translation of monoclonal antibody technology from the laboratory to the clinic. It provides a means of identifying otherwise occult soft tissue metastases in patients with adenocarcinoma of the prostate. When utilized with other clinical, pathological and laboratory findings, Capromab Pendetide imaging enables more accurate disease staging and monitoring than is afforded by other imaging modalities such as CT and MRI. In the primary disease setting Capromab Pendetide imaging should be reserved for use in patients with negative bone scans who are at high risk for metastatic disease based on such factors as advanced clinical stage, high Gleason score and significantly elevated serum PSA or alkaline phosphatase. Due to low sensitivity for small-volume disease, a negative Mab scan may not eliminate the need for a staging lymph node dissection but should encourage further consideration of local treatment options. Capromab Pendetide should be used with caution in patients at low risk for metastatic disease. Positive scan findings in low risk patients should be confirmed before altering the treatment plan since some false positive scans should be anticipated in a population with low disease prevalence. Capromab Pendetide imaging has not been shown to be reliable in determining the local extent of the primary tumor but new techniques involving co-registration of SPECT and CT images show promise in this regard. In the patient with recurrent disease following primary therapy, the predictive value of Capromab Pendetide imaging of the prostate or prostate fossa is limited, particularly following RT. Its more important role in this setting is to identify lymph node metastases in the high risk patient with a negative bone scan who might otherwise be a candidate for local salvage therapy. A large prospective study is needed for confirmation, but preliminary data suggest that Capromab Pendetide imaging is helpful in identifying those patients with PSA elevation after radical prostatectomy who are most likely to benefit from salvage RT. As with any imaging technique, Capromab Pendetide has strengths and weaknesses that must be understood to maximize patient benefit by utilizing the scan in clinical settings where it is most likely to be useful and least likely to be misleading. Capromab Pendetide is a technically demanding procedure best performed and interpreted at sites with experience and expertise.
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PMID:Capromab Pendetide imaging of prostate cancer. 1080 17

MRI with an endorectal coil gives images of the prostate gland and seminal vesicles of higher quality than any other imaging modality. The use of an endorectal coil enables us to sample stronger radiofrequency signals from the prostate gland and seminal vesicles compared to a whole-body coil. This improves the contrast resolution in MR images and may give a higher spatial resolution by use of thin slices and a smaller slice gap. Intravenous MRI contrast is not used in our standard procedure. At Haukeland University Hospital, Norway, MRI with an endorectal coil is presently used as a tool for solving special problems in relation to detection and staging of prostate cancer, for example in patients with an abnormal s-PSA and negative sextant biopsies from the prostate gland. Furthermore, MRI with an endorectal coil may be used for the diagnosis of some benign diseases. The specific role of MRI with an endorectal coil in clinical use is not clarified; further research is needed. This article gives a short overview of technical aspects, imaging protocols, image reading, indications and diagnostic criteria for some diseases.
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PMID:[Magnetic resonance tomography with endorectal coil for examination of prostate and seminal vesicles]. 1080 82

A case of Collet-Sicard Syndrome caused by skull base metastasis of prostate carcinoma is reported. A fifty-five years old man presenting multiple lymph node and bone metastases of prostate carcinoma was treated with LH-RH agonist and Flutamide, which induced transient decrease in serum PSA levels and size of lymph node metastases. After 8 months of the treatment, the patient started complaining headache, dysphagia and dysarthria. Brain CT and MRI demonstrated a soft tissue mass replacing left pyramidal bone and occipital bone around left jugular foramen. The tumor was diagnosed as skull base metastasis of the prostate carcinoma and was treated with 50Gy of radiation. The symptom improved after the radiation but died of the disease in 4 months. The autopsy revealed the skull base metastasis of the prostate carcinoma and the tumor was proved to be poorly differentiated adenocarcinoma, which was positively stained by anti-PSA antibody. The case showed cranial nerve palsy of IX to XII, which is usually called Collet-Sicard syndrome. This is the third case report of Collet-Sicard syndrome caused by the skull base metastasis of prostate carcinoma, and it is the first case in Japan.
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PMID:[A case of Collet-Sicard syndrome caused by skull base metastasis of prostate carcinoma]. 1089 82

A radical prostatectomy for localized prostate cancer is indicated after evaluation of the disease (initial PSA, clinical stage, biopsy mapping, results of radiologic explorations with an endorectal MRI) and the patient (age, morbidity, life expectancy and wishes of potency conservation). The surgical approaches, retropubic or laparoscopic, depend on the surgeon's experience. Radical prostatectomy provides good disease-free survival for organ-confined disease close to the natural life expectancy. Post-radical prostatectomy morbidity is essentially represented by orthostatic incontinence (up to 6.8%), stress incontinence (up to 27%) and impotence (30 to 95%), depending on the published series and patient age.
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PMID:[Methods and results of radical prostatectomy for localized cancer of the prostate]. 1119 47


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