4 research outputs found

    Supporting Prostate Cancer Focal Therapy: A Multidisciplinary International Consensus Of Experts ("ice")

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    Prostate cancer is a common malignancy among men, and the current screening, imaging and sampling approaches aim to detect early-stage, organ-confined disease. In such scenario, focal prostate cancer therapy currently relies on the index lesion concept as the dominant lesion that drives the disease natural history. Focal therapy demands the essential imaging and sampling techniques to strategically locate and qualify the disease, but, despite advances in technology, prostate imaging and biopsy have several limitations that need to be overcome if focal therapy is to be developed further. The I Prostate Cancer Focal Treatment International Symposium was convened to foster discussion on this topic that sits at the crossroads of multiple disciplines (Urology, Pathology, Radiology, Radiation Oncology and Medical Oncology) all of which were represented for this comprehensive multidisciplinary review of the current literature. © 2014 Informa UK Ltd.1726671Stamen, T.A., Freiha, F.S., McNeal, J.E., Localized prostate cancer relationship of tumor volume to clinical significance fotr treatment of prostate cacer (1993) Cancer, 71, pp. 933-938Ahmed, H., The index lesion and the origin of the prostate cancer (2009) N Eng J Med, 361, pp. 1704-1706Karavitakis, M., Winkler, M., Abel, P., Histological characteristics of the index lesion in whole mountain radical prostatectomy specimens: Implications for focal therapy (2001) Prostate Cancer Prostatic Dis, 14, pp. 46-52Van Der Kwast, T.H., Amin, M.B., Billis, A., International society of urological pathology (isup) consensus conference 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cancer (2003) Am J Clin Pathol, 120, pp. 386-389Mouraviev, V., Villers, A., Bostwick, D.G., Understanding the pathological features of focality, grade and tumour volume of earlystage prostate cancer as a foundation for parenchyma-spearing prostate cancer therapies: Active surveillance and focal targeted therapy (2011) BJU Int, 108, pp. 1074-1085Noguchi, M., Stamey, T.A., McNeal, J.E., Nolley, R., Prognostic factors for multifocal prostate cancer in radical prostatectomy specimens: Lack of significance of secondary cancers (2003) Journal of Urology, 170, pp. 459-463Billis, A., Magna, L.A., Ferreira, U., Correlation between tumor extent in radical prostatectomies and preoperative PSA, histological grade, surgical margins, and extraprostatic extension: Application of a new practical method for tumor extent evaluation (2003) Int Braz J Urol, 29, pp. 113-119Turkbey, B., Pinto, P.A., Choyke, P.L., Imaging techniques for prostate cancer: Implications for focal therapy (2009) Nat Rev Urol, 6, 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    Prognostic factors in de novo metastatic renal cell carcinoma : A report from the latin american renal cancer group

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    Altres ajuts: Janssen Biotech, Merck, Pharmacyclics, Incyte, Taiho Pharmaceutical.PURPOSE To assess the effect of clinical and pathological variables on cancer-specific and overall survival (OS) in de novo metastatic patients from a collaborative of primarily Latin American countries. PATIENTS AND METHODS Of 4,060 patients with renal cell carcinoma diagnosed between 1990 and 2015, a total of 530 (14.5%) had metastasis at clinical presentation. Relationships between clinical and pathological parameters and treatment-related outcomes were analyzed by Cox regression and the log-rank method. RESULTS Of 530 patients, 184 (90.6%) had died of renal cell carcinoma. The median OS of the entire cohort was 24 months. American Society of Anesthesiology classification 3-4 (hazard ratio [HR]: 1.64), perirenal fat invasion (HR: 2.02), and ≥ 2 metastatic organ sites (HR: 2.19) were independent prognostic factors for 5-year OS in multivariable analyses. We created a risk group stratification with these variables: no adverse risk factors (favorable group), median OS not reached; one adverse factor (intermediate group), median OS 33 months (HR: 2.04); and two or three adverse factors (poor risk group), median OS 14 months (HR: 3.58). CONCLUSION Our study defines novel prognostic factors that are relevant to a Latin American cohort. With external validation, these easily discerned clinical variables can be used to offer prognostic information across low- and middle-income countries
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