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Metastatic prostate cancer in the modern era of PSA screening
Fontenot J, Philip A; Nehra, Avinash; Parker, William; Wyre, Hadley; Mirza, Moben; Duchene, David A; Holzbeierlein, Jeffrey; Thrasher, James Brantley; Veldhuizen, Peter Van; Lee, Eugene K.
  • Fontenot J, Philip A; University of Kansas Medical Center. Department of Urology. Kansas City. US
  • Nehra, Avinash; University of Kansas Medical Center. Department of Urology. Kansas City. US
  • Parker, William; University of Kansas Medical Center. Department of Urology. Kansas City. US
  • Wyre, Hadley; University of Kansas Medical Center. Department of Urology. Kansas City. US
  • Mirza, Moben; University of Kansas Medical Center. Department of Urology. Kansas City. US
  • Duchene, David A; University of Kansas Medical Center. Department of Urology. Kansas City. US
  • Holzbeierlein, Jeffrey; University of Kansas Medical Center. Department of Urology. Kansas City. US
  • Thrasher, James Brantley; University of Kansas Medical Center. Department of Urology. Kansas City. US
  • Veldhuizen, Peter Van; University of Kansas Medical Center. Department of Urology. Kansas City. US
  • Lee, Eugene K; University of Kansas Medical Center. Department of Urology. Kansas City. US
Int. braz. j. urol ; 43(3): 416-421, May.-June 2017. tab, graf
Article in English | LILACS | ID: biblio-840855
ABSTRACT
ABSTRACT Introduction To characterize initial presentation and PSA screening status in a contemporary cohort of men treated for metastatic prostate cancer at our institution. Materials and methods We reviewed records of 160 men treated for metastatic prostate cancer between 2008-2014 and assessed initial presentation, categorizing patients into four groups. Groups 1 and 2 presented with localized disease and received treatment. These men suffered biochemical recurrence late (>1 year) or earlier (<1 year), respectively, and developed metastases. Groups 3 and 4 had asymptomatic and symptomatic metastases at the outset of their diagnosis. Patients with a first PSA at age 55 or younger were considered to have guideline-directed screening. Results Complete records were available on 157 men for initial presentation and 155 men for PSA screening. Groups 1, 2, 3 and 4 included 27 (17%), 7 (5%), 69 (44%) and 54 (34%) patients, respectively. Twenty (13%) patients received guideline-directed PSA screening, 5/155 (3%) patients presented with metastases prior to age 55 with their first PSA, and 130/155 (84%) had their first PSA after age 55, of which 122/130 (94%) had metastasis at the time of diagnosis. Conclusion Despite widespread screening, most men treated for metastatic prostate cancer at our institution presented with metastases rather than progressed after definitive treatment. Furthermore, 25 (16%) patients received guideline-directed PSA screening at or before age 55. These data highlight that, despite mass screening efforts, patients treated for incurable disease at our institution may not have been a result of a failed screening test, but a failure to be screened.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Prostatic Neoplasms / Neoplasm Metastasis Type of study: Diagnostic study / Etiology study / Practice guideline / Incidence study / Observational study / Prognostic study / Risk factors / Screening study Limits: Aged / Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2017 Type: Article Affiliation country: United States Institution/Affiliation country: University of Kansas Medical Center/US

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Full text: Available Index: LILACS (Americas) Main subject: Prostatic Neoplasms / Neoplasm Metastasis Type of study: Diagnostic study / Etiology study / Practice guideline / Incidence study / Observational study / Prognostic study / Risk factors / Screening study Limits: Aged / Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2017 Type: Article Affiliation country: United States Institution/Affiliation country: University of Kansas Medical Center/US