Incidence of prostatic carcinoma in the elderly

Rullis, Ilga; Shaeffer, James; Lilien, Otto M.

doi:10.1016/0090-4295(75)90749-9

Cited by 38 publications

(19 citation statements)

References 6 publications

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“…11 In studies on incidental PCa at autopsy, cancer was present in 2, 29, 32, 55 and 64% of men in their third, fourth, fifth, sixth and seventh decades, respectively. 12 Despite years of research, the exact number of PB to be taken to detect PCa and to predict the actual tumor volume is still unknown. 13 Throughout the years various PB protocols (according to number of cores) have been used, but only the sextant PB introduced by Hodge et al 14 in 1989 was considered a standard method of TRUS-guided PB.…”

Section: Discussionmentioning

confidence: 99%

Prostate cancer detection using an extended prostate biopsy schema in combination with additional targeted cores from suspicious images in conventional and functional endorectal magnetic resonance imaging of the prostate

Engelhard

Zugor

et al. 2009

Prostate Cancer Prostatic Dis

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The purpose of this study is to report our method in detecting prostate cancer (PCa) using an 18-core transrectal ultrasound (TRUS) prostate biopsy (PB) schema, in combination with additional targeted cores from suspicious images in conventional (e-cMRI) and functional (e-fMRI) endorectal magnetic resonance imaging (e-MRI) of the prostate. From 2004 to 2008, 260 consecutive patients with a clinical suspicion of PCa underwent PB and were prospectively studied. e-cMRI and e-fMRI was performed in all patients before PB. The patients were divided into two groups (A and B) according to the results of their radiological findings (group A ¼ suspicious findings, group B ¼ non-suspicious findings). After the images were processed, an 18-core TRUS-guided PB was performed. When a patient exhibited a suspicious site on e-cMRI and e-fMRI images, three additional targeted PBs were obtained from that site. In group A, 17.5% of PCa was detected by the 18-core PB and 56.5% of PCa was detected by the targeted cores. The overall PCa detection rate (18 þ targeted cores) was 73.9%. The overall specificity was 73.9%. In group B, overall false-positive detection rate reached 19.2%, with the overall sensitivity being 80.8%. The method described above is not only practical but also a promising modality in PCa detection. As seen, PCa was optimally detected when combining the 18-core and targeted-core PB schema together. Non-suspicious images do not rule out the probability of PCa, thus justifying a PB in these patients as well.

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Section: Discussionmentioning

confidence: 99%

Prostate cancer detection using an extended prostate biopsy schema in combination with additional targeted cores from suspicious images in conventional and functional endorectal magnetic resonance imaging of the prostate

Engelhard

Zugor

et al. 2009

Prostate Cancer Prostatic Dis

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“…Among men aged >50 years, for example, 21% of men in Japan had some element of prostate cancer at autopsy compared with 37% of black men in the U.S. 2 Prevalence was found to increase with age, with up to 67% of men aged >80 years having prostate cancer at the time of death. 8 When comparing rates of autopsydetected prostate cancers before and after the start of the PSA era, Konety et al 9 found a significant decrease in prevalence after the introduction and widespread use of PSA testing. These data suggest that a significant proportion of prostate tumors will never become clinically significant and that PSA screening likely identifies several of these cancers before death from other causes.…”

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confidence: 99%

Active surveillance for early‐stage prostate cancer

Dall′Era

Cooperberg²,

Chan

et al. 2008

Cancer

253

174

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The natural history of prostate cancer is remarkably heterogeneous and, at this time, not completely understood. The widespread adoption and application of prostate-specific antigen (PSA) screening has led to a dramatic shift toward the diagnosis of low-volume, nonpalpable, early-stage tumors. Autopsy and early observational studies have shown that approximately 1 in 3 men aged >50 years has histologic evidence of prostate cancer, with a significant portion of tumors being small and possibly clinically insignificant. Utilizing the power of improved contemporary risk stratification schema to better identify patients with a low risk of cancer progression, several centers are gaining considerable experience with active surveillance and delayed, selective, and curative therapy. A literature review was performed to evaluate the rationale behind active surveillance for prostate cancer and to describe the early experiences from surveillance protocols. It appears that a limited number of men on active surveillance have required treatment, with the majority of such men having good outcomes after delayed selective intervention for progressive disease. The best candidates for active surveillance are being defined, as are predictors of active treatment. The psychosocial ramifications of surveillance for prostate cancer can be profound and future needs and unmet goals will be discussed. Cancer 2008;112:1650-9.2008 American Cancer Society.KEYWORDS: prostate cancer, active surveillance, review, risk stratification. P rostate cancer is the most common form of noncutaneous malignancy among males in the U.S., and is the second leading cause of cancer mortality, accounting for more than 27,000 deaths in 2007.1 However, the natural history of this disease is remarkably heterogeneous and, at this time, not completely understood. Autopsy studies have shown that approximately 1 in 3 men aged >50 years has histologic evidence of prostate cancer, with up to 80% of these tumors measuring <0.5 cm in size and low in grade, suggesting that the majority are clinically insignificant.2 Approximately 3% of all men will die of prostate cancer, although the mortality from prostate cancer has declined by 31% over the past 13 years.1 The relative contributions of factors responsible for this decline including prostate-specific antigen (PSA) screening, improved detection strategies, and improved treatments are not known.

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“…This suggests that many men, especially those with low-grade disease, are more likely to die from attendant comorbidities than cancer. Several autopsy studies have described the unique prevalence of subclinical disease, with 30%-70% of men dying from other causes demonstrating evidence of prostate cancer at the time of death [3,4]. These observations have led clinicians to realize that not all men require immediate radical therapy for prostate cancer.…”

Section: Introductionmentioning

confidence: 97%