Prostate Testing for Cancer and Treatment (ProtecT) Feasibility Study

Donovan, Jenny

doi:10.1186/isrctn08435261

Cited by 55 publications

(78 citation statements)

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“…The model assumes that patients do not attend every GP visit to which they are invited. 92 Where applicable, the cost of TRUS-guided biopsy is added to the running total cost. A probability of experiencing infection due to TRUS is also sampled and the cost of treating the infection, if it occurs, is added to the running total.…”

Section: Workcentre 3: Transrectal Ultrasound-guided Prostate Needle mentioning

confidence: 99%

See 1 more Smart Citation

Economic modelling of diagnostic and treatment pathways in National Institute for Health and Care Excellence clinical guidelines: the Modelling Algorithm Pathways in Guidelines (MAPGuide) project

Lord

Willis²,

Eatock³

et al. 2013

Health Technology Assessment

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Section: Workcentre 3: Transrectal Ultrasound-guided Prostate Needle mentioning

confidence: 99%

“…91 Not all patients are willing to undergo biopsy; we assume 12% of men will opt-out. 92 Uncertainty surrounding these parameters was characterised using beta distributions.…”

Section: Diagnostic Test Accuracymentioning

confidence: 99%

Economic modelling of diagnostic and treatment pathways in National Institute for Health and Care Excellence clinical guidelines: the Modelling Algorithm Pathways in Guidelines (MAPGuide) project

Lord

Willis²,

Eatock³

et al. 2013

Health Technology Assessment

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“…Prostatic needle biopsy is currently considered the gold standard for the diagnosis of CaP and may be performed transrectally or transperineally, guided by ultrasound. The detection rates of these two techniques are comparable (5,6) and there is no final consensus regarding the optimal number of samples, although the British Prostate Testing for Cancer and Treatment Study has recommended 10 core biopsies (7), with antibiotic therapy, commonly quinolone, under local anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Upgrading and upstaging in prostate cancer: From prostate biopsy to radical prostatectomy

D’Elia¹,

Cerruto²,

Cioffi³

et al. 2014

Molecular and Clinical Oncology

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Abstract. Prostate cancer (CaP) is the most common malignancy in men and the second cause of cancer-related mortality after lung cancer. Several studies have evaluated the correlation between bioptic and pathological Gleason score (GS), documenting a correlation ranging between 30 and 60%. The aim of this study was the evaluation of the association between bioptic and pathological GS in a series of patients undergoing prostate needle biopsy and subsequent radical prostatectomy. We also aimed to evaluate the possible prognostic factors of upgrading and upstaging. We prospectively collected and retrospectively reviewed data from 300 consecutive patients who underwent radical retropubic or robot-assisted prostatectomy at our Institution. Patients who underwent prostate needle biopsy, transrectal or transperineal, with a minimum of 5 samples, were included in this study. Upgrading and downgrading were defined as increase or decrease, respectively, from one prognostic grade group to another, similar to up-or downstaging. The mean age of the patients was 62.97 years and the mean prostate-spesific antigen (PSA) level was 7.83 ng/ml. A total of 51.3% of the population underwent a transperineal prostate biopsy. The most frequently represented bioptic GS was 3+3 (64.0%) followed by 3+4=7 (15.6%); the most frequent pathological Gleason score was 3+4 (44.3%), followed by 3+3 (31.0%). With reagard to the bioptic GS 4-5-6 group, approximately half of the specimens (46.7%) were subsequently upgraded to GS 3+4, and 5.3% to 4+3. With regards to the bioptic GS 3+4 group, 57.4% was confirmed in the surgical specimen. In the 4+3 group, 23.5% of the cases was downgraded to 3+4 and 35.3% was confirmed. With regards to stage, ~39.7% of the patients received an upstaging on the pathological specimen. We evaluated the correlations between preoperative serum PSA level, prostate volume, digital rectal examination and biopsy type and none of the variables considered exhibited a correlation with any upgrading (P>0.05). Moreover, we evaluated the correlations between the aforementioned variables and upstaging and, at the multivariate analysis, only a serum PSA <4 ng/ml was found to be an independent variable predictive of upstaging (P=0.017). Therefore, new tools are required to predict upgrading and upstaging of our patients, in order to ensure better counseling for optimal treatment planning.

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“…90 An RCT comparing watchful waiting with radical prostatectomy is ongoing in the United Kingdom. 13,91 Taken together, therefore, these data show that benefits from improvements in prostate cancer risk prediction, screening, and prognostic stratification will depend to a large extent on clearer evidence that surveillance, diagnostic, and treatment strategies in themselves lead to reductions in morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

“…10 In a large proportion of men the disease is indolent, and it is difficult to predict which tumors will be aggressive. The value of aggressive management for localized prostate cancer is debated, [11][12][13][14] and only a small proportion of men with early-stage prostate cancer die from the disease within 10 to 15 years of diagnosis. Developing tools to differentiate aggressive and indolent disease is of key importance.…”

mentioning

confidence: 99%

Multigene panels in prostate cancer risk assessment: a systematic review

Little

Wilson

Carter

et al. 2016

Genetics in Medicine

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Prostate cancer is the fourth most common malignancy worldwide, and the second most common among men.1 In 2014, it was estimated that more than a quarter of a million new cases were diagnosed in North America and that the disease accounted for more than 33,000 deaths. 2,3 These numbers are likely to increase with the aging of the population. On the basis of data from the Surveillance, Epidemiology, and End Results program, more men were diagnosed with prostate cancer at a younger age and earlier stage in 2004-2005 than in the mid-late 1990s, and disparity between ethnic groups in cancer stage at diagnosis decreased. 4 Apart from age, 5 ethnic group, 5,6 and family history, 7-9 the risk factors associated with prostate cancer are unclear, 5 making primary prevention difficult. Prostate cancer is currently considered to be a complex, multifactorial disease, and the vast majority of familial clustering is attributed to the interaction of multiple shared susceptibility genes with moderate to low penetrance and shared environmental factors within these families.The natural history of prostate cancer is highly variable. 10 In a large proportion of men the disease is indolent, and it is difficult to predict which tumors will be aggressive. The value of aggressive management for localized prostate cancer is debated, [11][12][13][14] and only a small proportion of men with early-stage prostate cancer die from the disease within 10 to 15 years of diagnosis. Developing tools to differentiate aggressive and indolent disease is of key importance.Prostate-specific antigen (PSA) screening was introduced in the late 1980s.15 Meta-analyses of seven randomized controlled trials (RCTs) of screening using PSA testing alone or in combination with digital rectal examination suggested no evidence of benefit in reducing mortality 16,17 and some evidence of harm from overdiagnosis.17 Amid substantial debate, 18-20 the argument has been made for developing more accurate screening tests, including possible genetic markers. Purpose: Single-nucleotide polymorphism (SNP) panel tests have been proposed for use in the detection of, and prediction of risk for, prostate cancer and as prognostic indicator in affected men. A systematic review was undertaken to address three research questions to evaluate the analytic validity, clinical validity, clinical utility, and prognostic validity of SNP-based panels.Methods: Data sources comprised MEDLINE, Cochrane CEN-TRAL, Cochrane Database of Systematic Reviews, and EMBASE; these were searched from inception to April 2013. The gray-literature searches included contact with manufacturers. Eligible studies included English-language studies evaluating commercially available SNP panels. Study selection and risk of bias assessment were undertaken by two independent reviewers. Results:Twenty-one studies met eligibility criteria. All focused on clinical validity and evaluated 18 individual panels with 2 to 35 SNPs.All had poor discriminative ability (overall area under receiver-operator characteristic curves, 5...

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Prostate Testing for Cancer and Treatment (ProtecT) Feasibility Study

Cited by 55 publications

References 0 publications

Economic modelling of diagnostic and treatment pathways in National Institute for Health and Care Excellence clinical guidelines: the Modelling Algorithm Pathways in Guidelines (MAPGuide) project

Economic modelling of diagnostic and treatment pathways in National Institute for Health and Care Excellence clinical guidelines: the Modelling Algorithm Pathways in Guidelines (MAPGuide) project

Upgrading and upstaging in prostate cancer: From prostate biopsy to radical prostatectomy

Multigene panels in prostate cancer risk assessment: a systematic review

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