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1.
Prostate Cancer Prostatic Dis ; 19(3): 264-70, 2016 09.
Article in English | MEDLINE | ID: mdl-27136741

ABSTRACT

BACKGROUND: Expanding interest in and use of active surveillance for early state prostate cancer (PC) has increased need for prognostic biomarkers. Using a multi-institutional tissue microarray resource including over 1000 radical prostatectomy samples, we sought to correlate Ki67 expression captured by an automated image analysis system with clinicopathological features and validate its utility as a clinical grade test in predicting cancer-specific outcomes. METHODS: After immunostaining, the Ki67 proliferation index (PI) of tumor areas of each core (three cancer cores/case) was analyzed using a nuclear quantification algorithm (Aperio). We assessed whether Ki67 PI was associated with clinicopathological factors and recurrence-free survival (RFS) including biochemical recurrence, metastasis or PC death (7-year median follow-up). RESULTS: In 1004 PCs (∼4000 tissue cores) Ki67 PI showed significantly higher inter-tumor (0.68) than intra-tumor variation (0.39). Ki67 PI was associated with stage (P<0.0001), seminal vesicle invasion (SVI, P=0.02), extracapsular extension (ECE, P<0.0001) and Gleason score (GS, P<0.0001). Ki67 PI as a continuous variable significantly correlated with recurrence-free, overall and disease-specific survival by multivariable Cox proportional hazard model (hazards ratio (HR)=1.04-1.1, P=0.02-0.0008). High Ki67 score (defined as ⩾5%) was significantly associated with worse RFS (HR=1.47, P=0.0007) and worse overall survival (HR=2.03, P=0.03). CONCLUSIONS: In localized PC treated by radical prostatectomy, higher Ki67 PI assessed using a clinical grade automated algorithm is strongly associated with a higher GS, stage, SVI and ECE and greater probability of recurrence.


Subject(s)
Ki-67 Antigen/metabolism , Prostatic Neoplasms/metabolism , Prostatic Neoplasms/mortality , Cell Proliferation , Humans , Kaplan-Meier Estimate , Male , Neoplasm Grading , Neoplasm Staging , Prognosis , Proportional Hazards Models , Prostate-Specific Antigen , Prostatectomy , Prostatic Neoplasms/pathology , Prostatic Neoplasms/surgery , Recurrence , Tissue Array Analysis
2.
Int J Impot Res ; 14 Suppl 2: S48-53, 2002 Aug.
Article in English | MEDLINE | ID: mdl-12161768

ABSTRACT

This open-label, multi-center study from Mexico compared the efficacy and safety of oral sildenafil and phentolamine in men with erectile dysfunction. Patients received sildenafil (25-100 mg; n=123) or phentolamine (40 mg; n=119) for 8 weeks, and efficacy was assessed using the International Index of Erectile Function (IIEF) as well as two global efficacy questions. Mean scores for the erectile function domain of the IIEF were significantly higher for sildenafil (27.23 +/- 0.62; P=0.0001) than for phentolamine (19.35 +/- 0.66). Approximately twice as many men receiving sildenafil had successful attempts at sexual intercourse (88% vs 42%), improved erections (95% vs 51.1%), and improved ability to have sexual intercourse (94.4% vs 46.4%) compared with phentolamine. The most common adverse events included rhinitis, headache, tachycardia, and nausea, with a higher frequency reported in patients receiving phentolamine than sildenafil (41% vs 33%), with the exception of headache, which was reported more frequently in sildenafil users. Overall, sildenafil was more effective and appeared to be better tolerated than phentolamine for the treatment of erectile dysfunction.


Subject(s)
Adrenergic alpha-Antagonists/administration & dosage , Erectile Dysfunction/drug therapy , Phentolamine/administration & dosage , Piperazines/therapeutic use , Vasodilator Agents/therapeutic use , Administration, Oral , Adolescent , Adrenergic alpha-Antagonists/adverse effects , Adrenergic alpha-Antagonists/therapeutic use , Adult , Aged , Aged, 80 and over , Coitus , Erectile Dysfunction/physiopathology , Humans , Male , Mexico , Middle Aged , Phentolamine/adverse effects , Phentolamine/therapeutic use , Piperazines/adverse effects , Purines , Sildenafil Citrate , Sulfones , Treatment Outcome , Vasodilator Agents/adverse effects
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