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A high degree of variability in the definition of biochemical recurrence exists following treatment for localized prostate cancer. Strict definitions for biochemical recurrence are necessary to identify men at risk for disease progression and to allow meaningful comparisons among patients treated similarly. The Panel acknowledges the American Society for Therapeutic Radiology and Oncology criteria and future modifications thereof for those receiving radiation therapy and recommends the newly developed American Urological Association criteria for those treated with radical prostatectomy. The purpose for the establishment of this standard is for data reporting purposes and for comparison of similarly treated patients. It is not intended to represent a threshold value for which to initiate treatment. The Panel acknowledges that the clinical decision to initiate treatment will be dependent on multiple factors including patient and physician interaction rather than a specific prostate specific antigen threshold value.

BACKGROUNDRecent studies of men with prostate carcinoma suggest that obesity may be associated with more advanced‐stage disease and lower overall survival rates. One possible link between body mass index (BMI) and prostate carcinoma prognosis may be disease ascertainment. Prostate‐specific antigen (PSA) is widely used to screen for prostate carcinoma.METHODSThe authors examined the association between BMI and PSA in a population‐based study of 2779 men without prostate carcinoma. Between 2001 and 2004, these men were enrolled in a study sponsored by the San Antonio Center of Biomarkers of Risk, a clinical and epidemiologic center of the Early Detection Research Network of the National Cancer Institute.RESULTSThe mean PSA value decreased in a linear fashion with an increase in BMI category, from 1.01 ng/mL in normal weight men to 0.69 ng/mL in obese (Class III) men, after adjusting for race/ethnicity and age.CONCLUSIONSLower levels of PSA in obese and overweight men could mask biologically consequential prostate carcinoma. Cancer 2005. Published 2005 by the American Cancer Society.

Objective To review the literature and collect expert advice for proposing preventive and curative treatments of mouth and dental involvement in patients with systemic sclerosis (SSc; scleroderma). Methods The literature pertaining to mouth and/or dental involvement related to SSc was reviewed, and recommendations were developed according to the suggestions of a French multidisciplinary working group of experts and validated by a lecture committee. Results Dentists face 3 main issues in caring for SSc patients: oral mucosa involvement, manducatory apparatus and mouth involvement responsible for limitations in mouth opening, and treatment‐related adverse events. An increased risk of tongue carcinoma has been noted. In patients with severe limitation in mouth opening (<30 mm), recommended treatments are a specific mouth‐opening rehabilitation program, flexible sectional dentures, and splint therapy. Indications for dental implants depend on the severity of SSc, comorbidities, and/or ongoing bisphosphonate treatment. Prevention of mouth infections and caries implies patient education and teaching about mouth and dental hygiene, periodontal maintenance, and treatment of sicca syndrome. Cessation of tobacco use is mandatory. Patient‐tailored rehabilitation may improve limitations in mouth opening. Systematic dental panoramic radiography allows for the early detection of dental caries. Conclusion Prevention of oral and dental complications is a major issue in patients with SSc. Dental treatment should be tailored to limitations in mouth opening, disease severity, and ongoing treatments.

OBJECTIVES To modify the Prostate Cancer Prevention Trial Risk Calculator (PCPTRC) to predict low- versus high-grade (Gleason grade ≥ 7) prostate cancer and incorporate percent free PSA. METHODS Data from 6664 PCPT placebo arm biopsies [5826 individuals] where prostate-specific antigen (PSA) and digital rectal examination (DRE) results were available within one year prior to the biopsy and PSA was ≤ 10 ng/mL were used to develop a nominal logistic regression model to predict the risk of no versus low-grade (Gleason grade < 7) versus high-grade (Gleason grade ≥ 7) cancer. Percent free PSA was incorporated into the model based on likelihood ratio (LR) analysis of a San Antonio Biomarkers of Risk cohort. Models were externally validated on ten Prostate Biopsy Collaborative Group cohorts and one Early Detection Research Network (EDRN) reference set. RESULTS 5468 (82.1%) of the PCPT biopsies were negative for prostate cancer, 942 (14.1%) detected low-grade and 254 (3.8%) high-grade disease. Significant predictors were (log-base-2) PSA (OR for low-grade versus no cancer: 1.29*, high-grade versus no cancer: 2.02*, high-grade versus low-grade cancer: 1.57*), DRE (0.96, 1.49*, 1.55*, respectively), age (1.02*, 1.05*, 1.03*), African American race (1.13, 2.83*, 2.51*), prior biopsy (0.63*, 0.81, 1.27), and family history (1.31*, 1.25, 0.95), where * indicates p-value < 0.05. The new PCPTRC 2.0 either with or without percent free PSA (also significant by the LR method) validated well externally. CONCLUSIONS By differentiating risk of low- versus high-grade disease on biopsy, PCPTRC 2.0 better enables physician-patient counseling concerning whether to proceed to biopsy.