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To collect and analyze quality-of-life (QOL) data from PROvenge Treatment and Early Cancer Treatment trial (PROTECT, NCT00779402), a phase III, randomized controlled trial of sipuleucel-T in patients with asymptomatic androgen-dependent prostate cancer.Patients experiencing prostate-specific antigen relapse after radical prostatectomy entered a 3- to 4-month run-in phase of androgen-deprivation therapy...
To explore the prognostic and predictive value of baseline variables in 512 patients with metastatic castration-resistant prostate cancer from the phase III Immunotherapy for Prostate Adenocarcinoma Treatment (IMPACT) trial who were randomized to receive sipuleucel-T or control.The most powerful of these prognostic factors, baseline prostate-specific antigen (PSA), was subdivided into quartiles to...
To define current standards of care for patients with prostate-specific antigen (PSA) failure after initial definitive local treatment of prostate cancer using Comprehensive, Observational, Multicenter, Prostate Adenocarcinoma Registry (COMPARE). This article describes the design of the COMPARE Registry, together with patient characteristics and prostate cancer management at enrolment.The COMPARE...
To evaluate laparoscopic radical prostatectomy (LRP) specimens for pathologic stage and the malignant and benign surgical margin status to determine areas for improvement in surgical technique. LRP is gaining significant attention as a viable alternative to retropubic radical prostatectomy. A total of 110 consecutive LRP specimens were retrospectively reviewed. A single experienced genitourinary...
Conclusions. The results of our study show that TRUS-guided prostate biopsy leads to transient voiding impairment, and therefore, the alpha 1 -blocker tamsulosin before biopsy and for a brief interval afterward may decrease this morbidity.
When addressing the appropriateness of luteinizing hormone-releasing hormone (LHRH) analog monotherapy as a method of androgen deprivation, it is important to look at the alternative option of androgen deprivation by combined androgen blockade (CAB). The randomized control trials studying CAB have been thoroughly analyzed and subjected to meta-analyses that have shown a small but significant difference...
Objectives. Combined androgen blockade with medical or surgical castration plus a nonsteroidal antiandrogen for metastatic prostate cancer has been the subject of 20 randomized trials. The findings range from no expected increase in survival in 17 studies to an estimated 3.7 to 7 months' survival improvement noted in 3 studies. Most recently, a 1999 evidence report from the Agency for Healthcare Research...
We report the first detailed case of testicular lymphoma managed with chemotherapy and radiation without orchiectomy. A 60-year-old man with Stage II extralymphatic bilateral testicular lymphoma refused orchiectomy, but underwent cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy and radiation. He remained disease free for 52 months, when a solitary central nervous system relapse...
Objectives. To determine and compare quality-of-life (QOL) evaluations from patients who received external beam radiation therapy or radical prostatectomy for the treatment of localized prostate cancer, and to compare differences in QOL assessments for urinary and sexual function after radical prostatectomy as reported by patient and physician.Methods. Two hundred three patients treated by radical...
Objectives. Finasteride, a common agent used to treat benign prostatic hyperplasia (BPH), inhibits 5-alpha-reductase. Testosterone is converted by 5-alpha-reductase to the more potent dihydrotestosterone, which is the primary androgen in the prostate. Leuprolide is a stronger antiandrogen that is used to downstage prostate cancer before radical prostatectomy. Leuprolide induces marked atrophy of prostate...
Objectives. Invasive penile and urethral tumors are traditionally treated with aggressive excision that requires involved organ and adjacent organ sacrifice. An alternative approach seeks to completely excise the tumor with adequate margins while preserving form and function of the organ. We present 6 patients who underwent such organ-sparing surgery.Methods. Six selected cases (4 penile and 2 urethral)...
Primary bladder amyloidosis is a rare disease. Treatment recommendations are necessarily anecdotal. We report a case of a 52-year-old woman treated successfully with intravesical dimethyl sulfoxide instillation.
Objectives. Patients with prostate cancer may have more of the complexed form of prostate-specific antigen (PSA) in the serum, whereas patients with benign prostatic hyperplasia have less of this complexed form and thus a higher proportion of the free form. However, the molecular basis for the lower percent of free PSA in patients with prostate cancer remains unknown, and considerable overlap in values...
Objectives. To perform exploratory analyses of data from a controlled trial that assessed the efficacy and tolerability of two antiandrogens, bicalutamide and flutamide, each combined with monthly depot preparations of leuprolide or goserelin, in patients with Stage D2 prostate cancer. One analysis compared goserelin plus antiandrogen therapy with leuprolide plus antiandrogen therapy; a second analysis...
Objectives. To compare the efficacy and tolerability of bicalutamide and flutamide, each combined with luteinizing hormone-releasing hormone analogue (LHRH-A) therapy, in patients with metastatic (Stage D2) prostate cancer.Methods. This was a randomized, double-blind (for antiandrogen therapy), multicenter study with a two-by-two factorial design. Eight hundred thirteen patients were allocated...
Objectives. To report a technique for excision of bilateral ureteral transitional cell carcinoma which preserves renal function and provides ready access for endoscopic follow-up and therapy of the renal pelvis.Methods. The operative procedure of bilateral ureterectomy with construction of a separated pyelocolocutaneous diversion utilizing transverse colon is described and the clinical course of...
Objectives. To evaluate the BTA stat Test in the detection of recurrent bladder cancer.Methods. Sensitivity and specificity were determined using frozen voided urine samples from patients with recurrent bladder cancer, volunteers, patients with nonurologic conditions, and patients with a history of bladder cancer but free of disease. Results of cytology and the original BTA Test were compared with...
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