Long term prostate-specific antigen trends following subcapsular prostatectomy.

INTRODUCTION: The purpose of this study was to evaluate the utility of prostate-specific antigen (PSA) screening for prostate cancer after subcapsular prostatectomy. MATERIALS AND METHODS: Data from 41 consecutive patients who underwent subcapsular prostatectomy at a single institution over a 15 year period were collected retrospectively. Patients were categorized into benign and malignant groups based on a diagnosis of prostate cancer identified in the surgical specimen or during subsequent follow up. Collected data included patient age, preoperative and postoperative PSA values, prostate volume determined by surgical specimen weight, and pathologic diagnosis. Preoperative and postoperative PSA velocities were calculated for patients with adequate data and average values were compared to determine factors that were predictive of a confirmed prostate cancer diagnosis. RESULTS: Thirty-one patients had adequate PSA values and follow up and were included in the analysis. Six (19%) were ultimately diagnosed with prostate cancer and 25 (81%) were never diagnosed with prostate cancer. Postoperative PSA velocity was found to be significantly higher for patients in the malignant group (1.22 ± 1.32 ng/mL/yr) as compared to patients in the benign group (0.06 ± 0.15 ng/mL/yr) (p = 0.003). CONCLUSIONS: After subcapsular prostatectomy, patients with prostate cancer in the surgical specimen or who developed prostate cancer during long term follow up had elevated PSA velocity compared to patients who had no evidence of cancer in the surgical specimen or in follow up.

Randomized trial evaluating a new 0.5% fluorouracil formulation demonstrates efficacy after 1-, 2-, or 4-week treatment in patients with actinic keratosis.

The efficacy and safety of a new 0.5% fluorouracil topical cream were compared with vehicle control for the treatment of actinic keratosis (AK). Active treatment applied once daily for 1, 2, or 4 weeks was more effective than vehicle control in achieving reduction from baseline in lesion counts and lesion clearance. Active treatment also resulted in significantly better global assessments of overall improvement. Treatment was effective regardless of the number of baseline lesions. Although longer treatment duration correlated with greater efficacy, treatment for 1, 2, or 4 weeks was effective. This new microsphere-based fluorouracil formulation was generally well tolerated; adverse events were primarily limited to facial irritation that resolved quickly after treatment. This new treatment provides a safe alternative to the topical fluorouracil formulations currently available for the 1-, 2-, or 4-week treatment of AK.