Incidentally Found Prostate Cancer and Influence on Overall Survival after Radical Cystoprostatectomy

Objectives. To determine incidentally found prostate cancer frequency and impact on overall survival after RCP. Patients and Methods. The records of 81 men who underwent cystoprostatectomy from January 2000 to December 2009 were reviewed. The vital status of the study group was assessed as on September 1, 2009, by passive followup, using data from the population registry. Results. The 81 men underwent RCP. The incidental prostate cancer was found in the specimens of 27 (33.3%) patients. 13 (48.1%) of 27 prostate cancer cases were clinically significant. For 3 patients (11.1%) an extraprostatic extension was found. For 2 patients (7.4%)—positive margins, for 1 patient (3.7%)—Gleason sum 8, and for the rest 7 patients bigger than 0.5 cm3 volume tumor, and Gleason sum 7 was found. The mean follow-up time was 39.2 ± 33.8 months (varies from 0.8 to 131.2 months). The patients with bladder cancer and incidentally found prostate cancer lived shorter (28.1 ± 27.5 and 45.5 ± 35.40 months). Higher overall survival (P = 0.03) was found in the patient group with bladder cancer without incidentally diagnosed prostate cancer. Conclusion. There are indications that in this small study prostate cancer has influenced on patients' survival with bladder cancer after radical cystoprostatectomy

Didelės rizikos prostatos vėžio gydymas taikant radikalią prostatektomiją arba spindulinę terapiją: dviejų centrų patirtis

Background/objectiveThere are no randomized trials on the comparative effectiveness of radical prostatectomy (RP) and radiotherapy (RT) for high-risk prostate cancer. Our aim was to compare treatment outcomes of high-risk prostate cancer after RP and RT, including overall survival (OS), biochemical-progression-free survival (bPFS) and disease-progression-free survival (dPFS), using two cancer treatments centers’ patient data.MethodsData on high-risk prostate cancer patients between 2005 and 2009 were retrospectively reviewed in two cancer centers: National Cancer Institute, Vilnius, Lithuania and N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; 210 patients were included in the study group treated with RP (n = 174) or RT (n = 36). The mean follow-up time was 5.6 and 6.6 years, respectively.ResultsLower T stage was an independent predictor of better OS (p = 0.01) and bPFS (p = 0.03). Only the highest Gleason score ≥8 was significantly predictive of a worse OS (p = 0.05), bPFS (p = 0.02) and dPFS (p = 0.001). A high PSA level was predictive of a worse bPFS (p = 0.007 for PSA ≥20) and dPFS (p = 0.008 for ≥20). The treatment modality in this study was insignificant after T stage, Gleason score and PSA level adjustment for OS, bPFS survival and dPFS survival (p = 0.17, p = 0.39, p = 0.20).ConclusionsThe T stage, Gleason score and pretreatment PSA level are significant factors for OS, bPFS survival, and dPFS survival of highrisk prostate cancer patients. Treatment option (RP or RT) was not an independent predictor of survival in this study.Įvadas / tikslasIki šiol nėra atlikta atsitiktinės atrankos klinikinių tyrimų siekiant palyginti radikalios prostatektomijos (RP) ir spindulinės terapijos (ST) efektyvumą gydant didelės rizikos prostatos vėžį. Šio tyrimo tikslas – naudojant dviejų gydymo centrų duomenis įvertinti didelės rizikos prostatos vėžiu sergančių ir RP arba ST gydytų pacientų bendrąjį išgyvenamumą, išgyvenamumą ikibiocheminio progresavimo ir iki ligos progresavimo.Pacientai ir metodai2005–2009 metų duomenys apie didelės rizikos prostatos vėžio ligonius buvo retrospektyviai surinkti dviejuose gydymo centruose: Nacionaliniame vėžio institute (Vilnius, Lietuva) ir N. N. Aleksandrovo nacionaliniame vėžio centre (Minskas, Baltarusija). Tyrimo grupę sudarė 210 pacientų, iš kurių 174 taikyta RP, 36 – ST. Vidutinis stebėjimo laikas buvo atitinkamai 5,6 ir 6,6 metų.RezultataiPirminis naviko išplitimas (T) buvo susijęs su geresniu bendruoju išgyvenamumu (p = 0,01) ir geresniu išgyvenamumu iki biocheminio progresavimo (p = 0,03). Esant didžiausiam naviko diferenciacijos laipsniui (pagal Gleason ≥8) nustatytas reikšmingai blogesnis bendrasis išgyvenamumas (p = 0,05), išgyvenamumas iki biocheminio progresavimo (p = 0,02) ir išgyvenamumas iki ligos progresavimo (p = 0,001). Blogesnis išgyvenamumas iki biocheminio progresavimo (p = 0,007) ir iki ligosprogresavimo (p = 0,008) taip pat buvo susijęs su aukštu PSA lygiu (≥ 20 ng/mL). Šioje tyrimo grupėje taikytas gydymas neturėjo reikšmingos įtakos bendrajam išgyvenamumui, išgyvenamumui iki biocheminio progresavimo ir iki ligos progresavimo (atitinkamai p = 0,17, p = 0,39, p = 0,20) atsižvelgus į pirminį naviko išplitimą, naviko diferenciaciją ir PSA lygį.IšvadosPirminis naviko išplitimas (T), naviko diferenciacijos laipsnis (pagal Gleason) ir PSA lygis iki gydymo turėjo reikšmingos įtakos bendrajam išgyvenamumui, išgyvenamumui iki biocheminio progresavimo ir iki ligos progresavimo didelės rizikos prostatos vėžiu sergančių pacientų grupėje. Šiame tyrime taikytas gydymas (RP arba ST) nebuvo nepriklausomas išgyvenamumui įtakądarantis veiksnys

Radical prostatectomy vs radiotherapy in high-risk prostate cancer patients: two centre experience

Background/objective There are no randomized trials on the comparative effectiveness of radical prostatectomy (RP) and radiotherapy (RT) for high-risk prostate cancer. Our aim was to compare treatment outcomes of high-risk prostate cancer after RP and RT, including overall survival (OS), biochemical-progression-free survival (bPFS) and disease-progression-free survival (dPFS), using two cancer treatments centers’ patient data. Methods Data on high-risk prostate cancer patients between 2005 and 2009 were retrospectively reviewed in two cancer centers: National Cancer Institute, Vilnius, Lithuania and N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Belarus; 210 patients were included in the study group treated with RP (n = 174) or RT (n = 36). The mean follow-up time was 5.6 and 6.6 years, respectively. Results Lower T stage was an independent predictor of better OS (p = 0.01) and bPFS (p = 0.03). Only the highest Gleason score ≥8 was significantly predictive of a worse OS (p = 0.05), bPFS (p = 0.02) and dPFS (p = 0.001). A high PSA level was predictive of a worse bPFS (p = 0.007 for PSA ≥20) and dPFS (p = 0.008 for ≥20). The treatment modality in this study was insignificant after T stage, Gleason score and PSA level adjustment for OS, bPFS survival and dPFS survival (p = 0.17, p = 0.39, p = 0.20). Conclusions The T stage, Gleason score and pretreatment PSA level are significant factors for OS, bPFS survival, and dPFS survival of highrisk prostate cancer patients. Treatment option (RP or RT) was not an independent predictor of survival in this study

Cancer mortality differences among urban and rural residents in Lithuania

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to describe and to compare the cancer mortality rates in urban and rural residents in Lithuania.</p> <p>Methods</p> <p>Cancer mortality has been studied using the materials of the Lithuanian cancer registry. For the period 1993–2004 age-standardized urban and rural population mortality rates (World standard) were calculated for all malignant neoplasm's and for stomach, colorectal, lung, prostate, breast and cervical cancers. The annual percentage change (APC) was calculated using log-linear regression model, two-sided Mantel-Haenzel test was used to evaluate differences in cancer mortality among rural and urban populations.</p> <p>Results</p> <p>For males in rural population cancer mortality was higher than in urban (212.2 and 197.0 cases per 100000) and for females cancer mortality was higher in urban population (103.5 and 94.2 cases per 100000, p < 0.05). During the study period the age-standardized mortality rates decreased in both sexes in urban residents. The decreasing mortality trend in urban population was contributed by decline of the rates of lung and stomach cancer in male and breast, stomach and colorectal cancer in female. Mortality rates in both urban and rural population were increasing for prostate and cervical cancers.</p> <p>Conclusion</p> <p>This study shows that large rural and urban inequalities in cancer mortality exist in Lithuania. The contrast between the health of residents in urban and rural areas invites researchers for research projects to develop, implement, and enhance cancer prevention and early detection intervention strategies for rural populations.</p

Increasing thyroid cancer incidence in Lithuania in 1978–2003

BACKGROUND: The aim of this paper is to analyze changes in thyroid cancer incidence trends in Lithuania during the period 1978–2003 using joinpoint regression models, with special attention to the period 1993–2003. METHODS: The study was based on all cases of thyroid cancer reported to the Lithuanian Cancer Registry between 1978 and 2003. Age group-specific rates and standardized rates were calculated for each gender, using the direct method (world standard population). The joinpoint regression model was used to provide estimated annual percentage change and to detect points in time where significant changes in the trends occur. RESULTS: During the study period the age-standardized incidence rates increased in males from 0.7 to 2.5 cases per 100 000 and in females from 1.5 to 11.4 per 100 000. Annual percentage changes during this period in the age-standardized rates were 4.6% and 7.1% for males and females, respectively. Joinpoint analysis showed two time periods with joinpoint in the year 2000. A change in the trend occurred in which a significant increase changed to a dramatic increase in thyroid cancer incidence rates. Papillary carcinoma and stage I thyroid cancer increases over this period were mainly responsible for the pattern of changes in trend in recent years. CONCLUSION: A moderate increase in thyroid cancer incidence has been observed in Lithuania between the years 1978 and 2000. An accelerated increase in thyroid cancer incidence rates took place in the period 2000–2003. It seems that the increase in thyroid cancer incidence can be attributed mainly to the changes in the management of non palpable thyroid nodules with growing applications of ultrasound-guided fine needle aspiration biopsy in clinical practice

Rare thyroid malignancies in Europe : data from the information network on rare cancers in Europe (RARECAREnet)

Data will be made available on requestPeer reviewedPostprin

All-Cause Mortality Risk in National Prostate Cancer Cohort: An Impact of Population-Based Prostate Cancer Screening

The aim of this study is to evaluate all-cause mortality risk differences before and during prostate cancer screening, with a profound focus on the differences between screened and not-screened patient groups. Prostate cancer cases diagnosed between 1998 and 2016 were identified from the population-based Lithuanian Cancer Registry and linked with screening status in the National Health Insurance Fund database. The analysis was stratified by a period of diagnosis and screening status. Standardized mortality ratios (SMRs) were used to assess all-cause and cause-specific mortality risk. The SMRs were calculated by dividing the observed number of deaths among prostate cancer patients by the expected number of deaths from the general population. All-cause SMR (1.45 (95% CI 1.42–1.48)) in the pre-screening period was higher compared to the screening period (SMR = 1.17 (95% CI 1.15–1.19)). An increased all-cause mortality risk among prostate cancer patients was observed in the not-screened patient population (SMR = 1.76 (95% CI 1.71–1.82)), while all-cause mortality risk in the screened patient population was similar to the general population (SMR = 1.00 (95% CI 0.97–1.02)). Screened patients with localized stage of disease had lower all-cause mortality risk than the general population (SMR = 0.72 (95% CI 0.70–0.75)). In conclusion, men with prostate cancer in Lithuania had excess all-cause mortality risk compared to the general population. The all-cause mortality risk among screened patients was not higher than expected