Attitudes of prostate cancer patients towards postoperative penile rehabilitation and their influencing factors / 中华男科学杂志

Objective@#To investigate the attitudes of prostate cancer (PCa) patients towards postoperative penile rehabilitation and their influencing factors.@*METHODS@#Seventy-nine PCa patients underwent radical prostatectomy from January through June 2017 and all received a questionnaire investigation before surgery on IIEF-5 and their attitudes towards postoperative penile rehabilitation. We analyzed the reasons for the patients' rejection of postoperative penile rehabilitation.@*RESULTS@#Totally 56 (71%) of the patients accepted and the other 23 (29%) refused postoperative penile rehabilitation. The factors influencing their attitudes towards penile rehabilitation mainly included age (P = 0.023), income (P = 0.040), tumor stage (P = 0.044), and preoperative sexual activity (P = 0.004). The patients who accepted penile rehabilitation had significantly higher IIEF-5 scores than those who refused it (14.75 ± 0.88 vs 8.48 ± 1.16, P = 0.000 2). During the follow-up period, only 29 (36.7%) of the patients bought the vacuum erection device but not the other 50 (63.3%). The tumor stage (P = 0.004), income (P < 0.01) and preoperative androgen-deprivation therapy (P = 0.039) significantly influenced the patients' decision on the purchase of the device. Relevant admission education achieved a 45% decrease in the number of the patients unwilling to accept penile rehabilitation for worrying about its negative effect on cancer treatment, a 25% decrease in those rejecting penile rehabilitation because of age, and a 20% decrease in those refusing it due to the tumor stage. The cost of treatment was an important reason for the patients' rejection of postoperative penile rehabilitation.@*CONCLUSIONS@#The tumor stage and income are the main factors influencing PCa patients' decision on postoperative penile rehabilitation. Relevant admission education and reduced cost of rehabilitation are important for popularization of postoperative penile rehabilitation in PCa patients.

Clinical activity of abiraterone plus prednisone in docetaxel-naïve and docetaxel-resistant Chinese patients with metastatic castration-resistant prostate cancer / 亚洲男科学杂志(英文版)

This study investigated the clinical activity of abiraterone plus prednisone in docetaxel-naïve and docetaxel-resistant Chinese patients with metastatic castration-resistant prostate cancer (mCRPC). A total of 146 patients with docetaxel-naïve group (103 cases) and docetaxel-resistant group (43 cases) were enrolled from the Shanghai Cancer Center (Shanghai, China) in this retrospective cohort study. The efficacy endpoints were prostate-specific antigen response rate, prostate-specific antigen progression-free survival, clinical/radiographic progression-free survival, and overall survival in response to abiraterone plus prednisone. Significantly higher prostate-specific antigen response rate was found in docetaxel-naïve group (54.4%, 56/103) compared to docetaxel-resistant group (34.9%, 15/43) (P = 0.047). In addition, significantly higher median prostate-specific antigen progression-free survival (14.0 vs 7.7 months, P = 0.005), clinical or radiographic progression-free survival (17.0 vs 12.5 months, P = 0.003), and overall survival (27.0 vs 18.0 months, P = 0.016) were found in docetaxel-naïve group compared to docetaxel-resistant group, respectively. The univariate and multivariate analyses indicated that lower albumin and visceral metastases were independent significant predictors for shorter overall survival. To sum up, our data suggested that abiraterone plus prednisone was efficient in both docetaxel-naïve and docetaxel-resistant Chinese patients. Moreover, higher PSA response rate and longer overall survival were observed in the docetaxel-naïve group, which suggested that abiraterone was more effective for docetaxel- naïve patients than for docetaxel failures.

Clinical activity of abiraterone plus prednisone in docetaxel-naοve and docetaxel-resistant Chinese patients with metastatic castration-resistant prostate cancer / 亚洲男科学杂志(英文版)

This study investigated the clinical activity of abiraterone plus prednisone in docetaxel-naïve and docetaxel-resistant Chinese patients with metastatic castration-resistant prostate cancer (mCRPC). A total of 146 patients with docetaxel-naïve group (103 cases) and docetaxel-resistant group (43 cases) were enrolled from the Shanghai Cancer Center (Shanghai, China) in this retrospective cohort study. The efficacy endpoints were prostate-specific antigen response rate, prostate-specific antigen progression-free survival, clinical/radiographic progression-free survival, and overall survival in response to abiraterone plus prednisone. Significantly higher prostate-specific antigen response rate was found in docetaxel-naïve group (54.4%, 56/103) compared to docetaxel-resistant group (34.9%, 15/43) (P = 0.047). In addition, significantly higher median prostate-specific antigen progression-free survival (14.0 vs 7.7 months, P = 0.005), clinical or radiographic progression-free survival (17.0 vs 12.5 months, P = 0.003), and overall survival (27.0 vs 18.0 months, P = 0.016) were found in docetaxel-naïve group compared to docetaxel-resistant group, respectively. The univariate and multivariate analyses indicated that lower albumin and visceral metastases were independent significant predictors for shorter overall survival. To sum up, our data suggested that abiraterone plus prednisone was efficient in both docetaxel-naïve and docetaxel-resistant Chinese patients. Moreover, higher PSA response rate and longer overall survival were observed in the docetaxel-naïve group, which suggested that abiraterone was more effective for docetaxel- naïve patients than for docetaxel failures.

External validation and newly development of a nomogram to predict overall survival of abiraterone-treated, castration-resistant patients with metastatic prostate cancer / 亚洲男科学杂志(英文版)

Abiraterone acetate is approved for the treatment of castration-resistant prostate cancer (CRPC); however, its effects vary. An accurate prediction model to identify patient groups that will benefit from abiraterone treatment is therefore urgently required. The Chi model exhibits a good profile for risk classification, although its utility for the chemotherapy-naive group is unclear. This study aimed to externally validate the Chi model and develop a new nomogram to predict overall survival (OS). We retrospectively analyzed a cohort of 110 patients. Patients were distributed among good-, intermediate-, and poor-risk groups, according to the Chi model. The good-, intermediate-, and poor-risk groups had a sample size of 59 (53.6%), 34 (30.9%), and 17 (15.5%) in our dataset, and a median OS of 48.4, 29.1, and 10.5 months, respectively. The C-index of external validation of Chi model was 0.726. Univariate and multivariate analyses identified low hemoglobin concentrations (<110 g l-1), liver metastasis, and a short time interval from androgen deprivation therapy to abiraterone initiation (<36 months) as predictors of OS. Accordingly, a new nomogram was developed with a C-index equal to 0.757 (95% CI, 0.678-0.836). In conclusion, the Chi model predicted the prognosis of abiraterone-treated, chemotherapy-naive patients with mCRPC, and we developed a new nomogram to predict the overall survival of this group of patients with less parameters.

ADAM9 decreases in castration resistant prostate cancer and is a prognostic factor for overall survival / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A disintegrin and metalloprotease 9 (ADAM9) is a membrane-anchored enzyme which is considered to be involved in some diseases including tumor. However, the role of ADAM9 in castration resistant prostate cancer (CRPC) is not clear. This study aimed to explore the different expressions on protein and messenger RNA (mRNA) level of ADAM9 between hormonal sensitive prostate cancer (HSPC) and CRPC tissue, and find the correlation with prognosis.</p><p><b>METHODS</b>Clinicopathologic characteristics of 106 HSPC and 76 CRPC cases were collected. The ADAM9 expressions were analyzed using immunohistochemistry. ADAM9 mRNA of 32 additional cases (16 HSPC and 16 CRPC patients) were analyzed via quantitative real-time polymerase chain reaction (RT-PCR). The prediction values of variables for overall survival (OS) of CRPC patients were analyzed using Cox regression.</p><p><b>RESULTS</b>ADAM9 protein expression was significantly downregulated in CRPC compared with HSPC tissue (31.6% vs. 81.1%, P < 0.001). The relativity transcription level of ADAM9 mRNA was 0.45 for CRPC tissue and 1.0 for HSPC tissue (P = 0.002). In the CRPC group, patients with low ADAM9 protein expression were significantly associated with shorter OS than patients with high expression (38.6 months vs. 57.8 months, hazard rate (HR) = 2.638, P = 0.023).</p><p><b>CONCLUSION</b>ADAM9 expression was low in CRPC, correlated with poor prognosis and might be involved in the succession from HSPC to CRPC by various functions.</p>

The survival analysis of metastatic prostate cancer / 中华外科杂志

<p><b>OBJECTIVES</b>To analyze the clinical and pathological informations of metastatic prostate cancer patients to find the predictive factors of the survival.</p><p><b>METHODS</b>To filter 364 cases of metastatic prostate cancer in the 940 cases of prostate cancer that were treated in Cancer Hospital Fudan University in Shanghai from March 1998 to June 2009, the cases had hormonal therapy and full clinical and pathological records. All the 364 cases were followed up and the clinical and pathological informations were analyzed, to find the predictive factors that related to the prognosis. Statistic software SPSS 15.0 was used for analysis. Cumulative survival was analyzed by the method of Kaplan-Meier. Cox regression was used for univariate and multivariate analysis. Log-rank method was used for the significance test.</p><p><b>RESULTS</b>The last follow-up date was 30th June 2009 and the median follow-up time was 24 months. At the final follow-up, 240 cases were alive, 109 cases were dead and 15 cases were lost to follow up. The median survival time of metastatic prostate cancer was 64 months, and the one-year, two-year, three-year, four-year, five-year survival rate was 92%, 78%, 66%, 60%, 54%. The univariate analysis indicated that Gleason score (P = 0.033), clinical stage (P < 0.001), the effectiveness of hormonal therapy (P < 0.001), the prostate specific antigen (PSA) nadir during hormonal therapy (P < 0.001) and the time from the start of hormonal therapy to the PSA nadir (P = 0.002) were predictive factors for the survival time of metastatic prostate cancer. The multivariate analysis indicated that the PSA nadir during hormonal therapy (P < 0.001) and the time from the start of hormonal therapy to the PSA nadir (P < 0.001) were independent factors that predict the survival time of metastatic prostate cancer.</p><p><b>CONCLUSION</b>The PSA nadir during hormonal therapy and the time from the start of hormonal therapy to the PSA nadir are independent factors that predict the survival time of metastatic prostate cancer.</p>

External validation of the Partin tables 2007 in Chinese prostate cancer patients / 中华外科杂志

<p><b>OBJECTIVE</b>To validate the 2007 Partin tables externally, which are based on the population of United States, using a cohort of Chinese prostate cancer patients.</p><p><b>METHODS</b>All of the patients enrolled and underwent radical prostatectomy between January 2006 and February 2010 were reviewed. The cases without preoperative hormone therapy and pelvic lymph node involvement according to radiologic tests were used for the external validation of the 2007 Partin tables. A comparative analysis of the clinical and pathological parameters of this Chinese cohort and Partin tables cohort was performed. Values of areas under the receiver operating characteristic (ROC) curve were used to assess predictive accuracy for the Chinese cohort.</p><p><b>RESULTS</b>The mean age of the whole cohort was 67 years. The serum prostate specific antigen level, Gleason score and clinical stage of this cohort were higher than the Partin tables cohort. The pathological outcomes analysis revealed that the rates of organ confined disease, capsular penetration, seminal vesicle involvement and lymph node involvement were 62.3%, 16.7%, 12.3% and 8.8%, respectively. The area under the ROC curve (AUC) for organ confined disease, capsular penetration, seminal vesicle involvement and lymph node involvement were 0.735, 0.653, 0.601 and 0.845.</p><p><b>CONCLUSIONS</b>The Partin tables discriminate well for Chinese patients at risk for positive lymph node. The discrimination of organ confined disease is also acceptable and the discrimination of capsular penetration and seminal vesicle involvement is more limited.</p>

The survival analysis of the advanced metastatic castration-resistant prostate cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze predictive factors of advanced metastatic castration-resistant prostate cancer.</p><p><b>METHODS</b>From December 1996 to March 2008, 250 cases of advanced metastatic prostate cancer progressed into the stage of hormonal independent prostate cancer. The last follow-up date was 31 March 2008 and the median follow-up time was 24 months. During the follow-up, 131 cases were alive, 105 cases were dead and 14 cases were lost to follow-up. Clinical and pathological information of the cases was analyzed to find the predictive factors that related to the prognosis.</p><p><b>RESULTS</b>The median survival time of advanced metastatic castration-resistant prostate cancer was 30 months, and the one-year, two-year, three-year survival rate was 79%, 59%, and 41%. The univariate analysis indicated that prostate specific antigen (PSA) at diagnosis, clinical stage, the PSA nadir during hormonal therapy, the time form the start of hormonal therapy to the PSA nadir, the time of response duration during hormonal therapy, PSA velocity (PSAV) and PSA doubling time (PSADT) at the emergency of castration-resistant prostate cancer, age and PSA at the diagnosis of castration-resistant prostate cancer were factors that predicted the survival time of advanced metastatic castration-resistant prostate cancer. The multivariate analysis indicated that the PSA nadir during hormonal therapy, the time form the start of hormonal therapy to the PSA nadir, PSAV at the emergency of castration-resistant prostate cancer, the time of response duration during hormonal therapy were independent factors that predicted the survival time of advanced metastatic castration-resistant prostate cancer.</p><p><b>CONCLUSION</b>The PSA nadir during hormonal therapy, the time form the start of hormonal therapy to the PSA nadir, PSAV at the emergency of castration-resistant prostate cancer and the time of response duration during hormonal therapy are independent factors that predict the survival time of advanced metastatic castration-resistant prostate cancer.</p>