Prevalence of Prostate Cancer on Autopsy: Cross-Sectional Study on Unscreened Caucasian and Asian Men

Zlotta, Alexandre R.; Egawa, Shin; Pushkar, Dmitry; Govorov, Alexander; Kimura, Takahiro; Kido, Masahito; Takahashi, Hiroyuki; Kuk, Cynthia; Ковылина, М. В.; Aldaoud, Najla; Fleshner, Neil; Finelli, Antonio; Klotz, Laurence; Sykes, Jenna; Lockwood, Gina; Kwast, Theodorus H. van der

doi:10.1093/jnci/djt151

Cited by 217 publications

(168 citation statements)

References 39 publications

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“…This figure is likely to be an underestimation since many histological cases of malignant transformation do not advance to clinical disease. Autopsy evaluation of 320 men without apparent clinical history of prostate cancer, detected evidences of malignant transformations in 40% of cases older than 60 years (Zlotta et al, 2013). Our results are in accordance with previous reports that older patients who were diagnosed with prostate cancer have shorter survival probably due to comorbidities deteriorating health status (Holmberg et al, 2012).…”

Section: Discussionsupporting

confidence: 91%

Survival of Patients with Prostate Cancer in Yazd, Iran

Zahir

Nazemian²,

Zand³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: Prostate cancer is the second leading cause of cancer death in men worldwide. Several factors such as availability of screening tests, and dietary, other lifestyle, environmental and genetic influences contribute to worldwide disparities in prostate cancer incidence and mortality rates. Our aims were to investigate patient characteristics at the time of diagnosis, common treatment strategies employed and survival in an Iranian male population with prostate cancer. Materials and Methods: Archives of Pathology Departments of five referral centers affiliated with the School of Medicine of Shahid Sadoughi University in Yazd province were reviewed. Paraffin-embedded blocks were reviewed by two independent pathologists to confirm the diagnosis. The latest modification of the Gleason Scoring System was adopted to determine pathological grading. Following pathological evaluation, patients were contacted via telephone to acquire information regarding their current status. Results: Pathology blocks were available for 113 patients. However, upon phone contacts, we were unable to determine the survival status in 23 patients (response rate=83%). Therefore, 90 patients were enrolled in the final analysis. The median follow-up time was 6.0 years (ranging from 0.3 to 8.8 years). There were 30 death attributed to prostate cancer in the study group. Kaplan-Meier analysis revealed that patient age at the time of diagnosis was a significant predictor of survival. Another significant predictor of poorer survival was higher tumor grade. Conclusions: Our observations indicate that age and pathological grade can negatively affect survival of individuals with prostate cancer in Iran.

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Section: Discussionsupporting

confidence: 91%

Survival of Patients with Prostate Cancer in Yazd, Iran

Zahir

Nazemian²,

Zand³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…A number of epidemiological studies have also reported on the incidence of multiple primary tumors within the same or neighboring organs, with potentially important insights (10)(11)(12)(13)(14)(15)(16)(17). Notably, premalignant lesions are usually excluded from cancer statistics so that real frequencies of MP lesions are likely to be significantly underestimated, a conclusion supported by the staggering numbers of premalignant and malignant lesions that are discovered by autopsy studies of individuals with other causes of death (30%-40% of cases) (18)(19)(20)(21).…”

Section: The Clinical Problemmentioning

confidence: 99%

Multifocal epithelial tumors and field cancerization: stroma as a primary determinant

Dotto¹

2014

J. Clin. Invest.

130

112

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It is increasingly evident that cancer results from altered organ homeostasis rather than from deregulated control of single cells or groups of cells. This applies especially to epithelial cancer, the most common form of human solid tumors and a major cause of cancer lethality. In the vast majority of cases, in situ epithelial cancer lesions do not progress into malignancy, even if they harbor many of the genetic changes found in invasive and metastatic tumors. While changes in tumor stroma are frequently viewed as secondary to changes in the epithelium, recent evidence indicates that they can play a primary role in both cancer progression and initiation. These processes may explain the phenomenon of field cancerization, i.e., the occurrence of multifocal and recurrent epithelial tumors that are preceded by and associated with widespread changes of surrounding tissue or organ "fields."

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“…Use of the prostate-specific antigen (PSA) test in PCa screening is controversial, due to uncertainty surrounding its benefits and risks (2); the PSA test can identify asymptomatic, indolent tumors, leading to unnecessary treatments and significant side effects associated with these treatments (1,3). The prevalence of clinically indolent tumors has been estimated to range from 30 to 70% in men aged >60 years (4,5). Therefore, a reliable method for distinguishing between indolent and aggressive PCa is urgently required.…”

Section: Introductionmentioning

confidence: 99%

Low serum testosterone is associated with tumor aggressiveness and poor prognosis in prostate cancer

Meng

et al. 2017

Oncology Letters

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Abstract. Serum testosterone is a potential marker to distinguish between indolent and aggressive prostate cancer (PCa). The present study aimed to investigate whether low levels of total serum testosterone at diagnosis were associated with aggressive PCa and poor clinical outcomes. In total, 762 non-Hispanic Caucasian men with previously untreated PCa were recruited from The University of Texas MD Anderson Cancer Center (Houston, TX, USA). Patients were categorized into three groups based on their total serum testosterone levels according to clinical guidelines [low (<230 ng/dl), intermediate (230-350 ng/dl) and normal (>350 ng/dl)]. PCa aggressiveness (low-, intermediate-or high-risk, or metastatic) was compared using multinomial logistic regression. Rates of disease progression, mortality from any cause and PCa-specific mortality were compared using the multivariate Cox proportional hazards model. Testosterone levels significantly decreased as PCa aggressiveness increased (P<0.001). Compared with the normal testosterone group, the low testosterone group had 2.9-fold (OR, 2.92; 95% CI, 1.74-4.90; P<0.001), 5.6-fold (OR, 5.63; 95% CI, 3.14-10.12; P<0.001) and 72.4-fold (OR, 72.40; 95% CI,; P<0.001) increased risks of having intermediate-risk, high-risk and metastatic PCa, respectively. Furthermore, low levels of testosterone were significantly associated with a 10.7-fold (HR, 10.68; 95% CI, 1.35-84.44; P= 0.03) increased risk of PCa-specific mortality. The results of the present study indicate that low levels of total serum testosterone at diagnosis are associated with aggressive PCa and predict poor PCa-specific survival.

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Prevalence of Prostate Cancer on Autopsy: Cross-Sectional Study on Unscreened Caucasian and Asian Men

Abstract: PCa is found on autopsy in a similar proportion of Russian and Japanese men. More than 50% of cancers in ASI and nearly 25% of cancers in CAU men have a GS of 7 or greater. Our results suggest that the definition of clinically insignificant PCa might be worth re-examining.

Cited by 217 publications

References 39 publications

Survival of Patients with Prostate Cancer in Yazd, Iran

Survival of Patients with Prostate Cancer in Yazd, Iran

Multifocal epithelial tumors and field cancerization: stroma as a primary determinant

Low serum testosterone is associated with tumor aggressiveness and poor prognosis in prostate cancer

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