The Efficacy of Mirodenafil for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Middle-Aged Males

PURPOSE: The aim of this study was to investigate the efficacy of mirodenafil in middle-aged male patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). MATERIALS AND METHODS: Eighty-eight males with CP/CPPS were randomized to receive either levofloxacin (500 mg/d) (group L, 40 patients) or levofloxacin (500 mg/d) and mirodenafil (50 mg/d) (group ML, 48 patients) for six weeks. The International Prostate Symptom Score (IPSS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), and erectile function (EF) domain scores of the International Index of Erectile Function (IIEF) questionnaire were used to grade symptoms at baseline and 6 weeks after treatment. RESULTS: The mean change in total IPSS from baseline was higher in group ML than that in group L (group L, -1.1 vs. group ML, -4.3; p<0.05). Significant improvements were also seen in the IPSS voiding subscore (group L, -0.7 vs. group ML, -3.0; p<0.05). Changes observed in the NIH-CPSI of group ML at six weeks were greater than those at baseline (group L, -3.2 vs. group ML, -7.2; p<0.05). Significant improvements were seen in the NIH-CPSI voiding (group L, -0.5 vs. group ML, -1.7; p<0.05) and quality of life domains (group L, -1.0 vs. group ML, -1.8; p<0.05). Group ML showed a significantly greater increase in the IIEF-EF score than did group ML (group L, +0.2 vs. group ML, +7.8; p<0.05). CONCLUSIONS: Mirodenafil (50 mg once daily) was well tolerated and resulted in significant symptomatic improvement in middle-aged males with CP/CPPS.

Prediction of Perineural Invasion and Its Prognostic Value in Patients with Prostate Cancer

PURPOSE: The prognostic significance of perineural invasion by prostate cancer is debated. We investigated the association between perineural invasion and clinicopathological factors and the effect of perineural invasion on survival in patients with prostate cancer. MATERIALS AND METHODS: A total of 361 patients with prostate cancer without any neoadjuvant therapies prior to surgery from 1999 to 2010 were analyzed retrospectively. Whole-mount sections of surgical specimens from all patients who underwent radical prostatectomy were evaluated. Positive perineural invasion was defined as infiltration of cancer cells in the perineurium or neural fascicles. The relationship of perineural invasion with clinicopathological features and prognosis of prostate cancer was studied. We also researched preoperative factors that were associated with perineural invasion. RESULTS: Perineural invasion in a prostatectomy specimen (PNIp) was positive in 188 of 361 patients (52.1%). In the multivariate analysis of the preoperative variables, PNIp was related to the primary Gleason grade (p=0.020), the number of positive cores (p=0.008), and the percentage of tumor cells in positive cores (p=0.021), but not to perineural invasion of a prostate biopsy. In the evaluation between PNIp and pathologic findings of the prostatectomy specimen, PNIp was related to the Gleason score (p=0.010), T-stage (p=0.015), and lymphovascular invasion (p=0.019). However, by multivariate analysis, the PNIp was not an independent prognostic factor of biochemical serum recurrence (p=0.364) or cancer-specific survival (p=0.726). CONCLUSIONS: PNIp was significantly related to biologically aggressive tumor patterns but was not a prognostic factor for biochemical serum PSA recurrence or cancer-specific survival in patients with prostate cancer.

Survival Rates and Related Factors in Men with Hormone-Refractory Prostate Cancer

PURPOSE: We evaluated survival rate in patients with hormone-refractory prostate cancer (HRPC) and the clinical factors that influenced survival rate and time. MATERIALS AND METHODS: The medical records of 96 patients who had HRPC and were not treated with chemotherapy from 2000 to 2008 were reviewed. We evaluated the survival rates at the 1st, 3rd, and 5th year by using Kaplan-Meier survival curves. We also evaluated survival differences according to clinical variables (clinical T stage, Gleason score, nadir prostate-specific antigen [PSA], PSA doubling time, and PSA velocity) by using the log-rank test and the relations between survival rates and these variables by using Cox proportional hazards models. RESULTS: The mean age of the patients was 67.8+/-7.5 years and the mean follow-up period was 23.3+/-13.7 months. Cancer-specific survival rates at the 1st, 3rd, and 5th year were 57.8%, 16.8%, and 10.1%, respectively, and survival differences were significantly related to nadir PSA (p=0.002) and PSA velocity (p=0.019). In the univariate analysis, nadir PSA (p=0.004) and PSA velocity (p=0.024) were related to survival rate, but only nadir PSA remained as a significant variable for survival rate in patients with HRPC in the multivariate analysis (p=0.044). CONCLUSIONS: Cancer-specific survival rates in patients with HRPC at the 1st, 3rd, and 5th year were 57.8%, 16.8%, and 10.1%, respectively, and they were related to nadir PSA. These results may be useful in determining a therapeutic approach in patients with HRPC.