Background:Inflammatory bowel disease(IBD)has been linked to an increased risk of prostate cancer(PC)in numerous studies.However,the exact relationship between them remains conflicting.In this meta-analysis,we focus o...Background:Inflammatory bowel disease(IBD)has been linked to an increased risk of prostate cancer(PC)in numerous studies.However,the exact relationship between them remains conflicting.In this meta-analysis,we focus on determining the relationship between PC incidence and IBD.Methods:A comprehensive literature search was conducted up until January 2022,selecting 14 studies,comprising 127,323 subjects with IBD,at the beginning of the study,among which 61,985 were patients with ulcerative colitis(UC)and 37,802 were with Crohn’s disease(CD).The studies reported the differences between subjects with IBD and controls with regard to the incidence of PC.In order to investigate the relationship between IBD and the prevalence of PC,we estimated the odds ratio(OR)with 95%confidence intervals(CIs).Results:IBD significantly increased the incidence of PC(OR,3.46;95%CI,1.40-8.54,P=0.007)compared to controls.UC significantly increased the incidence of PC(OR,1.43;95%CI,1.03-1.98,P=0.03)compared to controls.Yet,no significant difference was observed between CD and controls in relation to PC incidence(OR,0.89;95%CI,0.75-1.06,P=0.18).Conclusion:IBD,particularly UC,may increase the risk of developing PC.This relationship prompts us to advocate for increased PC and IBD screening to reduce the risk for possible complications that could occur in these subjects.展开更多
Background: Obesity, type II Diabetes mellitus (DMII) and vascular damage could be implicated in prostate cancer (PCa) nevertheless no clear results has been reached. The aim of the research was to investigate the ass...Background: Obesity, type II Diabetes mellitus (DMII) and vascular damage could be implicated in prostate cancer (PCa) nevertheless no clear results has been reached. The aim of the research was to investigate the association of these alterations with PCa at initial diagnosis, without the influence of hormone therapy or chemotherapy. Methods: Retrospective analysis of 400 patients undergoing prostate biopsy at our institution between 2005 and 2012 was conducted. We examined associations of obesity, DMII and vascular damage in 200 patients with PCa diagnosis versus 200 age-matched controls. Men with history of hormone therapy or chemotherapy, prostate or bladder surgery were excluded. Results: Obesity was significantly associated (OR 2.10, p < 0.05) with aggressive PCa (Gleason Score 8 - 10). DMII was significantly associated to aggressive PCa but only in obese cases (OR 4.25). Carotid vascular disease (CVD) and coronary artery disease (CAD) were significantly linked to PCa in all cases versus controls (OR 1.88, p < 0.05). Conclusions: In our study, obesity, particularly in combination with DMII, was significantly associated with aggressive PCa. Moreover, a significant relation was found between vascular disease and PCa hormone-naive at initial diagnosis. The metabolic derangements associated to obesity and DMII may increase oxidative stress and cause a permanent pro-inflammatory state that predisposes to vascular disease and PCa.展开更多
Background:Cardiovascular disease(CVD)has emerged as the leading cause of death from prostate cancer(PCa)in recent decades,bringing a great disease burden worldwide.Men with preexisting CVD have an increased risk for ...Background:Cardiovascular disease(CVD)has emerged as the leading cause of death from prostate cancer(PCa)in recent decades,bringing a great disease burden worldwide.Men with preexisting CVD have an increased risk for major adverse cardiovascular events when treated with androgen deprivation therapy(ADT).The present study aimed to explore the prevalence and risk evaluation of CVD among people with newly diagnosed PCa in China.Methods:Clinical data of newly diagnosed PCa patients were retrospectively collected from 34 centers in China from 2010 to 2022 through convenience sampling.CVD was defined as myocardial infarction,arrhythmia,heart failure,stroke,ischemic heart disease,and others.CVD risk was estimated by calculating Framingham risk scores(FRS).Patients were accordingly divided into low-,medium-,and high-risk groups.χ2 or Fisher’s exact test was used for comparison of categorical variables.Results:A total of 4253 patients were enrolled in the present study.A total of 27.0%(1147/4253)of patients had comorbid PCa and CVD,and 7.2%(307/4253)had two or more CVDs.The enrolled population was distributed in six regions of China,and approximately 71.0%(3019/4253)of patients lived in urban areas.With imaging and pathological evaluation,most PCa patients were diagnosed at an advanced stage,with 20.5%(871/4253)locally progressing and 20.5%(871/4253)showing metastasis.Most of them initiated prostatectomy(46.6%,1983/4253)or regimens involving ADT therapy(45.7%,1944/4253)for prostate cancer.In the present PCa cohort,43.1%(1832/4253)of patients had hypertension,and half of them had poorly controlled blood pressure.With FRS stratification,as expected,a higher risk of CVD was related to aging and metabolic disturbance.However,we also found that patients with treatment involving ADT presented an originally higher risk of CVD than those without ADT.This was in accordance with clinical practice,i.e.,aged patients or patients at advanced oncological stages were inclined to accept systematic integrative therapy instead of surgery.Among patients who underwent medical castration,only 4.0%(45/1118)received gonadotropin releasing hormone antagonists,in stark contrast to the grim situation of CVD prevalence and risk.Conclusions:PCa patients in China are diagnosed at an advanced stage.A heavy CVD burden was present at the initiation of treatment.Patients who accepted ADT-related therapy showed an original higher risk of CVD,but the awareness of cardiovascular protection was far from sufficient.展开更多
Prostate cancer (PCa) is the most common malignancy in men. Prostate being an androgen responsive tissue, androgen deprivation therapy (ADT) is used in the management of locally advanced (improves survival) and ...Prostate cancer (PCa) is the most common malignancy in men. Prostate being an androgen responsive tissue, androgen deprivation therapy (ADT) is used in the management of locally advanced (improves survival) and metastatic (improves pain and quality of life) PCa. Over the past two decades, the use of ADT has significantly increased as it is also being used in patients with localized disease and those experiencing biochemical recurrences, though without any evidence of survival advantage. Hypogonadism resulting from ADT is associated with decreased muscle mass and strength, increased fat mass, sexual dysfunction, vasomotor symptoms, decreased quality of life, anemia and bone loss. Insulin resistance, diabetes and cardiovascular disease have recently been added to the list of these complications. As the majority of men with PCa die of conditions other than their primary malignancy, recognition and management of these adverse effects is paramount. Here we review data evaluating metabolic and cardiovascular complications of ADT.展开更多
AIM:To examine whether addition of 3T multiparametric magnetic resonance imaging(mp MRI)to an active surveillance protocol could detect aggressive or progressive prostate cancer.METHODS:Twenty-three patients with low ...AIM:To examine whether addition of 3T multiparametric magnetic resonance imaging(mp MRI)to an active surveillance protocol could detect aggressive or progressive prostate cancer.METHODS:Twenty-three patients with low risk disease were enrolled on this active surveillance study,all of which had Gleason score 6 or less disease.All patients had clinical assessments,including digital rectal examination and prostate specific antigen(PSA)testing,every 6 mo with annual 3T mp MRI scans with gadolinium contrast and minimum sextant prostate biopsies.The MRI images were anonymized of patient identifiers and clinical information and each scan underwentradiological review without the other results known.Descriptive statistics for demographics and follow-up as well as the sensitivity and specificity of mp MRI to identify prostate cancer and progressive disease were calculated.RESULTS:During follow-up(median 24.8 mo)11 of 23 patients with low-risk prostate cancer had disease progression and were taken off study to receive definitive treatment.Disease progression was identified through upstaging of Gleason score on subsequent biopsies for all 11 patients with only 2 patients also having a PSA doubling time of less than 2 years.All 23 patients had biopsy confirmed prostate cancer but only 10 had a positive index of suspicion on mp MRI scans at baseline(43.5% sensitivity).Aggressive disease prediction from baseline mpM RI scans had satisfactory specificity(81.8%)but low sensitivity(58.3%).Twentytwo patients had serial mp MRI scans and evidence of disease progression was seen for 3 patients all of whom had upstaging of Gleason score on biopsy(30% specificity and 100% sensitivity).CONCLUSION:Addition of mp MRI imaging in active surveillance decision making may help in identifying aggressive disease amongst men with indolent prostate cancer earlier than traditional methods.展开更多
Background:The burden of kidney,bladder,and prostate cancers has changed in recent decades.This study aims to investigate the global and regional burden of,and attributable risk factors for genitourinary cancers durin...Background:The burden of kidney,bladder,and prostate cancers has changed in recent decades.This study aims to investigate the global and regional burden of,and attributable risk factors for genitourinary cancers during the past 30 years.Methods:We extracted data of kidney,bladder,and prostate cancers from the Global Burden of Disease 2019 database,including incidence,mortality,disability-adjusted life-years(DALYs),and attributable risk factors from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to assess the changes in age-standardized incidence rate,age-standardized mortality rate(ASMR),and age-standardized DALYs rate(ASDR).The associations between cancers burden and socio-demographic index(SDI)were also analyzed.Results:Compared with 1990,the global incident cases in 2019 were higher by 154.78%,123.34%,and 169.11%for kidney,bladder,and prostate cancers,respectively.During the 30-year study period,there was a downward trend in ASMR and ASDR for bladder cancer(EAPC=–0.68 and–0.83,respectively)and prostate cancer(EAPC=–0.75 and–0.71,respectively),but an upward trend for kidney cancer(EAPC=0.35 and 0.12,respectively).Regions and countries with higher SDI had higher incidence,mortality,and DALYs for all three types of cancers.The burden of bladder and prostate cancers was mainly distributed among older men,whereas the burden of kidney cancer increased among middle-aged men.Smoking related mortality and DALYs decreased,but high body mass index(BMI)and high fasting plasma glucose(FPG)related mortality and DALYs increased among kidney,bladder,and prostate cancers during the study period.Conclusions:Kidney,bladder,and prostate cancers remain major global public health challenges,but with distinct trend for different disease entity across different regions and socioeconomic status.More proactive intervention strategies,at both the administrative and academic levels,based on the dynamic changes,are needed.展开更多
Androgen deprivation therapy has been the mainstay of treatment for management of metastatic hormone sensitive prostate cancer. Recently conducted randomized controlled trials with docetaxel based chemotherapy have sh...Androgen deprivation therapy has been the mainstay of treatment for management of metastatic hormone sensitive prostate cancer. Recently conducted randomized controlled trials with docetaxel based chemotherapy have shed light on benefit of early use chemotherapy for hormone sensitive prostate cancer. In this review, we aim to comprehensively describe recent trials which are changing the paradigm in support of up front use of docetaxel based chemotherapy for metastatic hormone sensitive prostate cancer.展开更多
Objective:Treatment delays in prostate cancer have been characterised,although not explicitly in men undergoing transperineal prostate biopsies.We aimed to determine if delays to radical prostatectomy correlate with a...Objective:Treatment delays in prostate cancer have been characterised,although not explicitly in men undergoing transperineal prostate biopsies.We aimed to determine if delays to radical prostatectomy correlate with adverse outcomes using a contemporary population-based cohort of men diagnosed by transperineal biopsies.Methods:This study analysed men with prostate cancer of the International Society for Urological Pathology grade group≥2,diagnosed by transperineal prostate biopsies who underwent prostatectomy,using the prospectively data from 1 January 2014 to 30 June 2018 Prostate Cancer Outcomes Registry-Victoria.Data were analysed according to stratified demographic and disease characteristics.Time intervals from biopsy(28,60,90,120,and 270 days)were compared using odds ratios and regression analyses for proportion of upgrading,early biochemical recurrence,pT3 disease at prostatectomy,and positive surgical margins.Results:In total,2008 men were analysed.There were 306(16.7%)men with upgrading,151(8.4%)with biochemical recurrence,1068(54.1%)with pT3 disease,and 464(23.1%)with positive surgical margins(percentages excluded patients with missing data).All adverse outcomes studied were significantly associated with higher prostate-specific antigen and grade at diagnosis.Delays of 120-270 days did not adversely alter the incidence of Gleason upgrading,pT3,or recurrence.Delays(most frequent 60-89 days,28%)were associated with positive surgical margins but not monotonically.Regression modelling demonstrated no increased likelihood of most adverse outcomes for up to 270 days.Conclusion:Men with prostate cancer of grade group≥2 diagnosed through transperineal biopsy may wait up to 270 days for a prostatectomy without a greater likelihood of upgrading,pT3 disease,positive surgical margins,or biochemical recurrence.展开更多
Low back pain remains a most common clinical entity among musculoskeletal disorders. Pain reducing modalities, Manual therapy various specific techniques were widely used physiotherapeutic means as part of treatment f...Low back pain remains a most common clinical entity among musculoskeletal disorders. Pain reducing modalities, Manual therapy various specific techniques were widely used physiotherapeutic means as part of treatment for subjects with low back pain. An emerging trend with Independent physiotherapy practice, knowing red flags, conditions requiring investigations and experts treatment were to be recognized and adhered for maximizing patients care and benefits. Prostate cancer among men above 50 years were more found to be linked with Low back pain. This original research presentation where a subject having chronic low back pain found to have prostate cancer were analyzed and discussed with scientific evidence on clinical manifestations, investigations and medical management. Underlines the importance of recognizing, directing and getting treated of the root cause of subjects suffering with Low back pain due to prostate cancer and not just keep treating the symptoms alone were major purpose of this study.展开更多
Seminal vesicle (SV) amyloidosis is a well-documented histological entity, but it is observed infrequently. Its incidence is on the rise, which is probably related to the increasing use of prostate biopsies to inves...Seminal vesicle (SV) amyloidosis is a well-documented histological entity, but it is observed infrequently. Its incidence is on the rise, which is probably related to the increasing use of prostate biopsies to investigate patients with elevated serum prostate-specific antigen levels. Here, we report seven cases of incidental SV amyloidosis over a 3-year period and consider their relationship to the previously suggested aetiological factors. Based on our series, we conclude that incidental localized SV amyloidosis observed in diagnostic prostate biopsies does not warrant formal investigations for systemic amyloidosis.展开更多
文摘Background:Inflammatory bowel disease(IBD)has been linked to an increased risk of prostate cancer(PC)in numerous studies.However,the exact relationship between them remains conflicting.In this meta-analysis,we focus on determining the relationship between PC incidence and IBD.Methods:A comprehensive literature search was conducted up until January 2022,selecting 14 studies,comprising 127,323 subjects with IBD,at the beginning of the study,among which 61,985 were patients with ulcerative colitis(UC)and 37,802 were with Crohn’s disease(CD).The studies reported the differences between subjects with IBD and controls with regard to the incidence of PC.In order to investigate the relationship between IBD and the prevalence of PC,we estimated the odds ratio(OR)with 95%confidence intervals(CIs).Results:IBD significantly increased the incidence of PC(OR,3.46;95%CI,1.40-8.54,P=0.007)compared to controls.UC significantly increased the incidence of PC(OR,1.43;95%CI,1.03-1.98,P=0.03)compared to controls.Yet,no significant difference was observed between CD and controls in relation to PC incidence(OR,0.89;95%CI,0.75-1.06,P=0.18).Conclusion:IBD,particularly UC,may increase the risk of developing PC.This relationship prompts us to advocate for increased PC and IBD screening to reduce the risk for possible complications that could occur in these subjects.
文摘Background: Obesity, type II Diabetes mellitus (DMII) and vascular damage could be implicated in prostate cancer (PCa) nevertheless no clear results has been reached. The aim of the research was to investigate the association of these alterations with PCa at initial diagnosis, without the influence of hormone therapy or chemotherapy. Methods: Retrospective analysis of 400 patients undergoing prostate biopsy at our institution between 2005 and 2012 was conducted. We examined associations of obesity, DMII and vascular damage in 200 patients with PCa diagnosis versus 200 age-matched controls. Men with history of hormone therapy or chemotherapy, prostate or bladder surgery were excluded. Results: Obesity was significantly associated (OR 2.10, p < 0.05) with aggressive PCa (Gleason Score 8 - 10). DMII was significantly associated to aggressive PCa but only in obese cases (OR 4.25). Carotid vascular disease (CVD) and coronary artery disease (CAD) were significantly linked to PCa in all cases versus controls (OR 1.88, p < 0.05). Conclusions: In our study, obesity, particularly in combination with DMII, was significantly associated with aggressive PCa. Moreover, a significant relation was found between vascular disease and PCa hormone-naive at initial diagnosis. The metabolic derangements associated to obesity and DMII may increase oxidative stress and cause a permanent pro-inflammatory state that predisposes to vascular disease and PCa.
基金National Natural Science Foundation of China(No.82071777)China Urological Cancer Research Foundation from Beijing Life Oasis Public Service Center(No.2023-Z-16)
文摘Background:Cardiovascular disease(CVD)has emerged as the leading cause of death from prostate cancer(PCa)in recent decades,bringing a great disease burden worldwide.Men with preexisting CVD have an increased risk for major adverse cardiovascular events when treated with androgen deprivation therapy(ADT).The present study aimed to explore the prevalence and risk evaluation of CVD among people with newly diagnosed PCa in China.Methods:Clinical data of newly diagnosed PCa patients were retrospectively collected from 34 centers in China from 2010 to 2022 through convenience sampling.CVD was defined as myocardial infarction,arrhythmia,heart failure,stroke,ischemic heart disease,and others.CVD risk was estimated by calculating Framingham risk scores(FRS).Patients were accordingly divided into low-,medium-,and high-risk groups.χ2 or Fisher’s exact test was used for comparison of categorical variables.Results:A total of 4253 patients were enrolled in the present study.A total of 27.0%(1147/4253)of patients had comorbid PCa and CVD,and 7.2%(307/4253)had two or more CVDs.The enrolled population was distributed in six regions of China,and approximately 71.0%(3019/4253)of patients lived in urban areas.With imaging and pathological evaluation,most PCa patients were diagnosed at an advanced stage,with 20.5%(871/4253)locally progressing and 20.5%(871/4253)showing metastasis.Most of them initiated prostatectomy(46.6%,1983/4253)or regimens involving ADT therapy(45.7%,1944/4253)for prostate cancer.In the present PCa cohort,43.1%(1832/4253)of patients had hypertension,and half of them had poorly controlled blood pressure.With FRS stratification,as expected,a higher risk of CVD was related to aging and metabolic disturbance.However,we also found that patients with treatment involving ADT presented an originally higher risk of CVD than those without ADT.This was in accordance with clinical practice,i.e.,aged patients or patients at advanced oncological stages were inclined to accept systematic integrative therapy instead of surgery.Among patients who underwent medical castration,only 4.0%(45/1118)received gonadotropin releasing hormone antagonists,in stark contrast to the grim situation of CVD prevalence and risk.Conclusions:PCa patients in China are diagnosed at an advanced stage.A heavy CVD burden was present at the initiation of treatment.Patients who accepted ADT-related therapy showed an original higher risk of CVD,but the awareness of cardiovascular protection was far from sufficient.
文摘Prostate cancer (PCa) is the most common malignancy in men. Prostate being an androgen responsive tissue, androgen deprivation therapy (ADT) is used in the management of locally advanced (improves survival) and metastatic (improves pain and quality of life) PCa. Over the past two decades, the use of ADT has significantly increased as it is also being used in patients with localized disease and those experiencing biochemical recurrences, though without any evidence of survival advantage. Hypogonadism resulting from ADT is associated with decreased muscle mass and strength, increased fat mass, sexual dysfunction, vasomotor symptoms, decreased quality of life, anemia and bone loss. Insulin resistance, diabetes and cardiovascular disease have recently been added to the list of these complications. As the majority of men with PCa die of conditions other than their primary malignancy, recognition and management of these adverse effects is paramount. Here we review data evaluating metabolic and cardiovascular complications of ADT.
基金Supported by The IGAR Initiative and the Clinical Trials Unit at the Cross Cancer Institute,which is supported in part by the Alberta Cancer Foundation
文摘AIM:To examine whether addition of 3T multiparametric magnetic resonance imaging(mp MRI)to an active surveillance protocol could detect aggressive or progressive prostate cancer.METHODS:Twenty-three patients with low risk disease were enrolled on this active surveillance study,all of which had Gleason score 6 or less disease.All patients had clinical assessments,including digital rectal examination and prostate specific antigen(PSA)testing,every 6 mo with annual 3T mp MRI scans with gadolinium contrast and minimum sextant prostate biopsies.The MRI images were anonymized of patient identifiers and clinical information and each scan underwentradiological review without the other results known.Descriptive statistics for demographics and follow-up as well as the sensitivity and specificity of mp MRI to identify prostate cancer and progressive disease were calculated.RESULTS:During follow-up(median 24.8 mo)11 of 23 patients with low-risk prostate cancer had disease progression and were taken off study to receive definitive treatment.Disease progression was identified through upstaging of Gleason score on subsequent biopsies for all 11 patients with only 2 patients also having a PSA doubling time of less than 2 years.All 23 patients had biopsy confirmed prostate cancer but only 10 had a positive index of suspicion on mp MRI scans at baseline(43.5% sensitivity).Aggressive disease prediction from baseline mpM RI scans had satisfactory specificity(81.8%)but low sensitivity(58.3%).Twentytwo patients had serial mp MRI scans and evidence of disease progression was seen for 3 patients all of whom had upstaging of Gleason score on biopsy(30% specificity and 100% sensitivity).CONCLUSION:Addition of mp MRI imaging in active surveillance decision making may help in identifying aggressive disease amongst men with indolent prostate cancer earlier than traditional methods.
文摘Background:The burden of kidney,bladder,and prostate cancers has changed in recent decades.This study aims to investigate the global and regional burden of,and attributable risk factors for genitourinary cancers during the past 30 years.Methods:We extracted data of kidney,bladder,and prostate cancers from the Global Burden of Disease 2019 database,including incidence,mortality,disability-adjusted life-years(DALYs),and attributable risk factors from 1990 to 2019.Estimated annual percentage changes(EAPC)were calculated to assess the changes in age-standardized incidence rate,age-standardized mortality rate(ASMR),and age-standardized DALYs rate(ASDR).The associations between cancers burden and socio-demographic index(SDI)were also analyzed.Results:Compared with 1990,the global incident cases in 2019 were higher by 154.78%,123.34%,and 169.11%for kidney,bladder,and prostate cancers,respectively.During the 30-year study period,there was a downward trend in ASMR and ASDR for bladder cancer(EAPC=–0.68 and–0.83,respectively)and prostate cancer(EAPC=–0.75 and–0.71,respectively),but an upward trend for kidney cancer(EAPC=0.35 and 0.12,respectively).Regions and countries with higher SDI had higher incidence,mortality,and DALYs for all three types of cancers.The burden of bladder and prostate cancers was mainly distributed among older men,whereas the burden of kidney cancer increased among middle-aged men.Smoking related mortality and DALYs decreased,but high body mass index(BMI)and high fasting plasma glucose(FPG)related mortality and DALYs increased among kidney,bladder,and prostate cancers during the study period.Conclusions:Kidney,bladder,and prostate cancers remain major global public health challenges,but with distinct trend for different disease entity across different regions and socioeconomic status.More proactive intervention strategies,at both the administrative and academic levels,based on the dynamic changes,are needed.
文摘Androgen deprivation therapy has been the mainstay of treatment for management of metastatic hormone sensitive prostate cancer. Recently conducted randomized controlled trials with docetaxel based chemotherapy have shed light on benefit of early use chemotherapy for hormone sensitive prostate cancer. In this review, we aim to comprehensively describe recent trials which are changing the paradigm in support of up front use of docetaxel based chemotherapy for metastatic hormone sensitive prostate cancer.
基金The Prostate Cancer Outcomes Registry-Victoria is supportedby the Movember Foundation (HREC/17/Alfred/33).
文摘Objective:Treatment delays in prostate cancer have been characterised,although not explicitly in men undergoing transperineal prostate biopsies.We aimed to determine if delays to radical prostatectomy correlate with adverse outcomes using a contemporary population-based cohort of men diagnosed by transperineal biopsies.Methods:This study analysed men with prostate cancer of the International Society for Urological Pathology grade group≥2,diagnosed by transperineal prostate biopsies who underwent prostatectomy,using the prospectively data from 1 January 2014 to 30 June 2018 Prostate Cancer Outcomes Registry-Victoria.Data were analysed according to stratified demographic and disease characteristics.Time intervals from biopsy(28,60,90,120,and 270 days)were compared using odds ratios and regression analyses for proportion of upgrading,early biochemical recurrence,pT3 disease at prostatectomy,and positive surgical margins.Results:In total,2008 men were analysed.There were 306(16.7%)men with upgrading,151(8.4%)with biochemical recurrence,1068(54.1%)with pT3 disease,and 464(23.1%)with positive surgical margins(percentages excluded patients with missing data).All adverse outcomes studied were significantly associated with higher prostate-specific antigen and grade at diagnosis.Delays of 120-270 days did not adversely alter the incidence of Gleason upgrading,pT3,or recurrence.Delays(most frequent 60-89 days,28%)were associated with positive surgical margins but not monotonically.Regression modelling demonstrated no increased likelihood of most adverse outcomes for up to 270 days.Conclusion:Men with prostate cancer of grade group≥2 diagnosed through transperineal biopsy may wait up to 270 days for a prostatectomy without a greater likelihood of upgrading,pT3 disease,positive surgical margins,or biochemical recurrence.
文摘Low back pain remains a most common clinical entity among musculoskeletal disorders. Pain reducing modalities, Manual therapy various specific techniques were widely used physiotherapeutic means as part of treatment for subjects with low back pain. An emerging trend with Independent physiotherapy practice, knowing red flags, conditions requiring investigations and experts treatment were to be recognized and adhered for maximizing patients care and benefits. Prostate cancer among men above 50 years were more found to be linked with Low back pain. This original research presentation where a subject having chronic low back pain found to have prostate cancer were analyzed and discussed with scientific evidence on clinical manifestations, investigations and medical management. Underlines the importance of recognizing, directing and getting treated of the root cause of subjects suffering with Low back pain due to prostate cancer and not just keep treating the symptoms alone were major purpose of this study.
文摘Seminal vesicle (SV) amyloidosis is a well-documented histological entity, but it is observed infrequently. Its incidence is on the rise, which is probably related to the increasing use of prostate biopsies to investigate patients with elevated serum prostate-specific antigen levels. Here, we report seven cases of incidental SV amyloidosis over a 3-year period and consider their relationship to the previously suggested aetiological factors. Based on our series, we conclude that incidental localized SV amyloidosis observed in diagnostic prostate biopsies does not warrant formal investigations for systemic amyloidosis.