11 research outputs found
Urinary and Sexual Function Outcomes among Different Age Groups after Robot-Assisted Laparoscopic Prostatectomy
486: Increased Erythrocyte Membrane (EM) Linoleic Acid Levels Correlate with Increased Tumor Volume and Gleason Score
A Contemporary Report of Low-Dose-Rate Brachytherapy for Prostate Cancer Using MRI for Risk Stratification: Disease Outcomes and Patient-Reported Quality of Life
Purpose: We examined a prospective consecutive cohort of low dose rate (LDR) brachytherapy for prostate cancer to evaluate the efficacy of monotherapy for unfavorable-intermediate risk (UIR) disease, and explore factors associated with toxicity and quality of life (QOL). Methods: 149 men with prostate cancer, including 114 staged with MRI, received Iodine-125 brachytherapy alone (144–145 Gy) or following external beam radiation therapy (110 Gy; EBRT). Patient-reported QOL was assessed by the Expanded Prostate Index Composite (EPIC) survey, and genitourinary (GU) and gastrointestinal (GI) toxicity were prospectively recorded (CTC v4.0). Global QOL scores were assessed for decline greater than the minimum clinically important difference (MCID). Univariate analysis (UVA) was performed, with 30-day post-implant dosimetry covariates stratified into quartiles. Median follow-up was 63 mo. Results: Men with NCCN low (n = 42) or favorable-intermediate risk (n = 37) disease were treated with brachytherapy alone, while most with high-risk disease had combined EBRT (n = 17 of 18). Men with UIR disease (n = 52) were selected for monotherapy (n = 42) based on clinical factors and MRI findings. Freedom from biochemical failure-7 yr was 98%. Of 37 men with MRI treated with monotherapy for UIR disease, all 36 men without extraprostatic extension were controlled. Late Grade 2+/3+ toxicity occurred in 55/3% for GU and 8/2% for GI, respectively. Fifty men were sexually active at baseline and had 2 yr sexual data; 37 (74%) remained active at 2 yr. Global scores for urinary incontinence (UC), urinary irritation/obstruction (UIO), bowel function, and sexual function (SF) showed decreases greater than the MCID (p 5 yr. Analysis did not reveal any significant associations with any examined rectal or urethral dosimetry for late toxicity or QOL. Conclusion: Disease outcomes and patient-reported QOL support LDR brachytherapy, including monotherapy for UIR disease
Robotic Radical Prostatectomy in Patients with High-Risk Disease: A Review of Short-Term Outcomes from a High-Volume Center
Early Laparoscopic Management of Acute Postoperative Hemorrhage after Initial Laparoscopic Surgery
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Dietary Fatty Acids Correlate With Prostate Cancer Biopsy Grade and Volume in Jamaican Men
Jamaica has the highest incidence of prostate cancer in the world. Dietary fat is associated with prostate cancer. The Ω6 polyunsaturated fatty acids have been shown to stimulate prostate carcinogenesis and the Jamaican diet is rich in linoleic acid. We hypothesized positive correlations between Ω6 polyunsaturated fatty acid, prostate specific antigen and prostate biopsy pathology.
A total of 148 men were enrolled in Kingston, Jamaica. Serum prostate specific antigen and erythrocyte membrane polyunsaturated fatty acids were analyzed. Men with prostate specific antigen 2.6 ng/ml or greater underwent biopsy. Histopathological and statistical analyses were performed on available data.
Of the 54 men who underwent biopsy 24 had prostate cancer, 17 had a Gleason score of 7 or greater and 11 had a tumor volume of 50% or greater. There were significant positive correlations between linoleic acid and Gleason score (p = 0.009), and the linoleic acid-to-docosahexaenoic acid (Ω3) ratio and tumor volume (p = 0.03). There was a significant negative correlation between the arachidonic acid (Ω6)-to-docosapentanoic acid (Ω3) ratio and Gleason score (p = 0.04). Statistical correlations between prostate specific antigen and polyunsaturated fatty acids were inconsistent.
The positive correlations between linoleic acid and Gleason score, and the linoleic acid-to-docosahexaenoic acid ratio and tumor volume support studies showing that Ω6 polyunsaturated fatty acids stimulate and Ω3 polyunsaturated fatty acids inhibit prostate cancer growth. The negative correlation between the arachidonic acid-to-docosapentanoic acid ratio and Gleason score supports studies that demonstrate increased metabolism of arachidonic acid in prostate cancer to form carcinogenic metabolites, namely prostaglandin E2. Our findings support the association between dietary fatty acids and prostate cancer, and they warrant further dietary and tissue studies in high risk populations