bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical implications of the rise and fall of prostate specific antigen after laser prostatectomy
Authors: Van Iersel M.P. , Thomas C.M.G. , Witjes W.P.J. , De Graaf R. , De La Rosette J.J.M.C.H. , Debruyne F.M.J. 
Published: November 2003

Objective To characterize the serum kinetics of prostate specific antigen (PSA) after visual laser ablation of the prostate (VLAP). Patients and methods The PSA values of 45 patients were measured at 24 h and at 1, 4, 12, 26 and 52 weeks after VLAP and the changes assessed in relation to symptom scores, urinary flow rates and prostate size. Results After an initial rise immmediately after VLAP, the serum PSA level declined. At 24 h, the PSA value reached a mean level 23 times higher than the PSA level before VLAP and then took a mean of 78 days to reach a new baseline. The mean decrease of the subsequent baseline value relative to that before treatment was 1.7 ng/mL. The prostatic size and energy applied correlated positively with the rise in PSA 24 h after VLAP. The rise in maximal urinary flow after VLAP, the decrease in the symptom score and residual urine volume did not correlate with the rise in PSA level 24 h after VLAP or with the time to reach a value halfway between the level at 24 h and the new baseline value. Conclusions The pattern of the increase in serum PSA level and decline after VLAP was not predictive of the clinical outcome of therapy.
Experience with low‐dose oestrogen in the treatment of advanced prostate cancer: a personal view
Authors: Bishop M.C. 
Published: November 2003

Objective To re‐evaluate the treatment of advanced prostatic carcinoma with diethylstilboestrol (DES) in low dosage in relation to the degree of suppression of plasma testosterone. Patients and methods The study comprised 106 patients with advanced carcinoma of the prostate (89 with T3/4 M1 and 17 with T3/4 N0/1 M0) who were treated with 1 mg/day of DES. The response was assessed clinically and by the change in plasma prostate specific antigen, prostatic acid phosphatase and alkaline phosphatase, and plasma testosterone was monitored regularly. In a few patients it was possible to reduce the dose to 0.5 mg/day DES; in others, the initial response was not sustained and they were treated with an increased dose of DES or bilateral orchidectomy. Results Seventy patients (Group 1) showed a sustained response to 1 mg/day of DES (0.5 mg/day in three) and 50 remained in remission at a mean of 21 months of treatment. Of the 36 patients offered secondary treatment, 12 (Group 2) responded with a second remission. Only 27% of patients had mean testosterone levels in the castrate range (0–2 nmol/L) but most in Group 1 had mean levels of<10 nmol/L, whilst in 10 of the 12 patients in Group 2, the level was>10 nmol/L. Overall times to progression and death were comparable with the results of conventional monotherapy or combination treatment and complication rates were acceptable. Conclusion Low‐dose oestrogen therapy (1 mg/day of DES) is cheap, effective and caused few side‐effects, none of which was life‐threatening. In many patients, only minimal suppression of the plasma testosterone was required and the response appeared to be qualitative, although there was considerable variation in the threshold of response. A randomized trial of oestrogen, in a minimal dose adjusted to the requirements of the individual patient, against conventional hormone treatment now seems justified.
Radioligand‐binding analysis of human prostatic alpha‐1 adrenoreceptor density following transurethral microwave therapy
Authors: Bdesha A.S. , Schachter M. , Sever P. , Witherow R.O'N. 
Published: November 2003

Objective To determine the effects of single‐session transurethral microwave treatment (TUMT) on human prostatic alpha‐1 adrenoreceptor density in patients with symptomatic bladder outlet obstruction caused by benign prostatic hyperplasia. Patients and methods Radioligand‐binding assays using 3H‐prazosin were performed on prostatic tissue obtained from 25 patients, 10 of whom had received a single TUMT whilst the remaining 15 patients had not, and acted as controls. Prostatic tissue was obtained by cold‐punch biopsy immediately before transurethral resection of the prostate from 20 patients (10 following microwave treatment and 10 controls) and from a further five patients at the time of retropubic prostatectomy; these five patients again had undergone TUMT. There were no statistically significant differences in several variables between the groups except for the weight of resected tissue, which was greater for the patients undergoing retropubic prostatectomy. Differences in the maximum receptor density (Bmax) and dissociation constant (Kd) were analysed statistically using the Mann–Whitney U‐test because the data were non‐parametric. Results Binding was saturable and a single class of high‐affinity binding sites was identified in all cases. In the control group, the mean and 95% confidence interval (CI) alpha‐1 adrenoreceptor density (Bmax) was 96.4 (82.7–110.1) fmol/mg and the mean (95% CI) dissociation constant (Kd) was 0.56 (0.37–0.74) nmol/L. In those patients who had undergone TUMT, the mean Bmax was significantly lower at 71.3 (58.6–84.7) fmol/mg (P < 0.02) but the Kd of 0.56 (0.20–1.14) mmol/L was identical to that in the control group. Conclusions Single‐session TUMT, using a non‐irrigated catheter, causes a significant reduction in prostatic alpha‐1 adrenoreceptor density in the region of the prostate subjected to maximum heating. This may represent one possible mechanism of action by which microwave treatment exerts its beneficial effects.
Anti‐androgenic effects of combination finasteride plus flutamide in patients with prostatic carcinoma
Authors: Fleshner N.E. , Fair W.R. 
Published: November 2003

Objectives To determine the anti‐androgenic effects and safety of the combination of finasteride and flutamide in men with prostate cancer. Patients and methods Seventeen men with various stages of prostate cancer, all of whom were candidates for androgen deprivation therapy, were treated with finasteride plus flutamide and were followed for a mean of 13.6 months using measurements of serum prostate specific anti gen (PSA), and an assessment of regression and side‐effects. Results The initial median PSA level was 19.8 ng/mL; at 3, 6 and 12 months the median PSA had fallen to 1.2, 0.85 and 0.8 ng/mL, respectively. In four patients followed for 2 years, the anti‐neoplastic effects were sustained. Patients with initially palpable disease had regression, as assessed by a digital rectal examination. Side‐effects included gynaecomastia (five patients), mildly elevated hepatic transaminases (two) and diarrhoea (one). Most (10) men maintained their previous sexual function. Conclusions Early results suggest that the combination of finasteride and flutamide provides significant anti‐androgenic therapy and maintains sexual function in most men. A further investigation with more patients and a longer follow‐up is warranted.
Significance of placental alkaline phosphatase (PLAP) in the monitoring of patients with seminoma
Authors: Koshida K. , Uchibayashi T. , Yamamoto H. , Hirano K. 
Published: November 2003

Objective To investigate the significance of placental alkaline phosphatase (PLAP) as a tumour marker for seminoma.Patients and methods A total of 673 serum samples from 116 patients with testicular germ cell tumours (78 seminomas and 38 non‐seminomas) were analysed for several markers including PLAP, total alkaline phosphatase (AL‐P), alpha fetoprotein (AFP), beta human chorionic gonadotrophin (HCG‐B), and lactic dehydrogenase (LDH).Results Serum PLAP was increased initially in about 50% of patients with seminoma, and the mean magnitude of elevation was about five times the normal value. There was no significant correlation between PLAP and LDH or between PLAP and HCG‐B. Therefore, a combination of these three markers was of value, and resulted in a positive identification rate of 82% of patients with seminoma. False‐positive results for PLAP appeared in 1.6% of 673 samples investigated.Conclusion The monitoring of serum PLAP might be of value, as fluctuations in this marker provide information about disease status and prognosis.
The role of cystoscopy before radical prostatectomy
Authors: Schwartz B.F. , Norbeck J.C. , Hansberry K.L. , Wettlaufer J.N. , Thrasher J.B. 
Published: November 2003

Objective To determine the role of pre‐operative cystoscopy in men undergoing radical prostatectomy for clinically localized adenocarcinoma of the prostate.Patients and methods One hundred men undergoing radical prostatectomy for clinically localized adenocarcinoma of the prostate were evaluated for coexisting bladder pathology from a retrospective review of their charts and records.Results Four of 100 men undergoing radical prostatectomy for clinically localized prostate cancer were found to have synchronous bladder tumours. Two of these had superficial low‐grade transitional cell carcinoma (TCC), one had a poorly differentiated invasive TCC and the last was found to have an inverted papilloma during radical retropubic prostatectomy. The patient with invasive disease died before the initiation of definitive therapy. The other three men are free of disease 2 years after diagnosis and treatment.Conclusion Because of the low cost and minimal morbidity of pre‐operative flexible cystoscopy, we recommend that this procedure be performed on the operating table before prostatectomy. In patients with gross or microscopic haematuria, a significant history of smoking, a prior history of urothelial malignancy or symptoms of bladder outlet obstruction, cystoscopy would be best performed before surgery in an out‐patient setting.
Critical temperature for in vivo cryoablation of human prostate cancer in a xenograft model
Authors: Cozzi P.J. , Lawson J.A. , Lynch W.J. , Morris D.L. 
Published: November 2003

Objectives To assess the in vivo sensitivity of human prostate cancer cells (PC3) to cryoablation and thus define the minimum temperature needed to prevent the recurrence of cancer after percutaneous transperineal radical prostatic cryoablation.Materials and methods Twenty‐five male nu/nu mice were inoculated by a subcutaneous injection with 5×105 PC3 cells. After 3 weeks the tumours (mean area 60.4 mm2 , sem 5.7) were frozen using a 3 mm cryotherapy probe (LCS 3000 Cryotech UK) to temperatures ranging from 0° to −40°C.Results No tumours recurred in seven mice which had tumours frozen to <−15°C. There were eight recurrences in 15 mice which had tumours frozen to between 0° and −15°C, and all were confirmed histologically.Conclusions The minimum temperature required to prevent recurrence of tumours from human prostate cancer cells was <−15°C in this in vivo mouse model.
Estramustine‐binding protein to dihydrotestosterone ratio in human prostatic carcinoma: a new marker for predicting disease progression
Authors: Shiina H. , Igawa M. , Ishibe T. 
Published: November 2003

Objective To elucidate the clinical significance of estramustine‐binding protein (EMBP) in human prostatic carcinoma (PC) as an indicator for predicting disease progression.Patients and methods EMBP concentrations in prostate tissue samples taken from 35 patients with benign prostatic hyperplasia (BPH), 33 patients with prostatic carcinoma (PC) taken before treatment, and from nine patients with hormone‐refractory PC (hr‐PC) were measured by radioimmunoassay using an antibody raised against rat EMBP. The dihydrotestosterone (DHT), prostatic acid phosphatase (PAP), prostate‐specific antigen (PSA) and zinc levels in the tissue were also measured.Results The EMBP concentration in well differentiated PC (W‐PC) samples was no higher than in samples of BPH tissue, whereas concentrations in moderately differentiated PC (M‐PC) and poorly differentiated PC (P‐PC) were significantly higher (P<0.01 and P<0.005, respectively); the highest levels were those in tissue from hr‐PC (P<0.001). Levels of PAP, PSA and zinc were significantly lower in tissue from PC than from BPH, while the differences in levels between W‐PC, M‐PC and P‐PC were not significant. The EMBP to DHT ratio in the tissue increased significantly from W‐PC through M‐PC to P‐PC and was greatest in hr‐PC tissue. Conversely, the PAP:DHT, PSA:DHT and zinc:DHT ratios did not correlate with the progress of histological grade. In addition, the pre‐treatment EMBP:DHT and zinc:DHT ratios in 14 patients who developed hr‐PC within 3 years after the administration of estramustine phosphate were significantly higher when compared with the remaining 19 patients (P<0.001 and P=0.0184, respectively), whereas the PAP:DHT and PSA:DHT ratios showed no significant difference between the groups. Moreover, patients with a high EMBP:DHT ratio (≥82) had a low progression‐free probability compared to those with a lower ratio.Conclusion The androgen‐dependent property of EMBP tends to decline with the transformation of prostatic tissue into biologically more malignant disease. The tissue EMBP:DHT ratio before treatment may be a good indicator of the individual malignant potential of PCs.
Changes in sexual function after radiotherapy treatment of prostate cancer
Authors: Beckendorf MD V. , Hay MD M. , Rozan MD R. , Lagrange MD J.L. , N'Guyen MD T. , Giraud MD B. 
Published: November 2003

Objective To assess sexual function before and after definitive irradiation for the treatment of cancer of the prostate.Patients and methods The study comprised 67 patients (mean age 68 years) treated in five radiotherapy departments and assessed with repeated questionnaires about their libido, arousal, frequency and quality of intercourse, and sexual satisfaction. Interviews were obtained before radiotherapy and at the end of the first year after treatment. Sixty‐three patients were married and 50 had a sexually effective partner. Forty‐six patients presented with another pathology or medical treatment capable of inducing sexual dysfunction. Before radiotherapy, 40 patients were sexually active, with good to acceptable intercourse.Results Between 10 and 24 months after the end of radiotherapy, no disease progression was observed and prostate‐specific antigen levels remained high in only two patients. Sexual function was preserved in 67% of patients but only 50% observed no change. The functional prognosis seemed to be related to the initial frequency and quality of intercourse; more than three times per month, the prognosis remained good, under three per month, it was poor. The patient's age was a predictive factor for the frequency of intercourse.Conclusion Several causes of impairment of sexual function may be associated and can change over a long time. A longer survey should be conducted to analyse the organic response to radiation.
Immunohistochemical evaluation of proliferating cell nuclear antigen, prostate‐specific antigen and α1‐antichymotrypsin in human prostate cancer
Authors: Igawa M. , Urakami S. , Shiina H. , Ishibe T. , Shirane T. , Usui T. , Chodak G.W. 
Published: November 2003

Objective To determine the relationship between growth fractions defined by proliferating cell nuclear antigen (PCNA), prostate‐specific antigen (PSA) and α1‐anti chymotrypsin (ACT) staining in prostate cancer.Materials and methods A total of 96 lesions, including 71 from prostate cancers and 25 from benign prostatic hyperplasia (BPH) were evaluated in microscopic sections of the prostatic tissues from 34 patients with prostate cancer. Immunohistochemical staining was performed with an avidin‐biotin system using monoclonal anti‐PCNA antibodies, polyclonal anti‐PSA and anti‐ACT antibodies.Results There was a significant difference in the mean PCNA labelling index between tissue from prostate cancer (4.2±7.1) and BPH (0.5±1.1) (P=0.002). The mean labelling index of PCNA tended to increase with increasing Gleason score. The proportion of cells positive for PSA was significantly higher in tissue from BPH than from prostate cancer (P=0.005). While the proportion of cells immunostaining for ACT was significantly higher in tissue from BPH compared to that from prostate cancer (P=0.02), there was no significant difference in the proportion of ACT‐positive cells among prostate cancers of differing Gleason score. The mean labelling index of PCNA decreased significantly with the increase in the proportion of PSA‐positive cells (P=0.013). There was a significant relationship between the proportion of ACT‐ and PSA‐positive cells (P=0.001).Conclusion These results indicate a reciprocal relationship between cell growth and tumour differentiation in prostate cancer. Although the significance of ACT deserves further study, there was evidence for the complexing of PSA with ACT from the immunohistochemical studies.
A 12‐month study of the placebo effect in transurethral microwave thermotherapy
Authors: de Wildt M.J.A.M. , Hubregtse M. , Ogden C. , Carter S.St C. , Debruyne F.M.J. , de la Rosette J.J.M.C.H. 
Published: November 2003

Objective To determine the placebo effect of transurethral microwave thermotherapy (TUMT) in the treatment of benign prostatic enlargement (BPE). Patients and methods A prospective, randomized sham‐controlled study in 93 patients (mean age 65, range 50–88) was conducted at two centres comparing TUMT or a sham treatment. Patients randomized to receive sham treatment underwent the same initial procedure as for TUMT, but the complete procedure was simulated on the visual display with no application of microwave energy. If the patient's condition had not improved after 3 months, a second genuine TUMT treatment was given at the patient's request. Results After 3 months there were significant clinical and statistical differences in efficacy between the groups; 62% and 18% of patients had a >50% improvement in symptom score in the treated and sham groups, respectively (P=0.001). The corresponding changes in flow rate were 36% and 11% (P=0.002), respectively. After 1 year, 63 patients were divided into those that had TUMT initally, those that had sham initially but subsequently had TUMT and those whose sham procedure had led to sufficient clinical improvement to require no further treatment. The two treated groups had a significant improvement over the sham group. Conclusion The benefit from TUMT cannot be due to a placebo effect alone.
Pyridinium cross‐links as urinary markers of bone metastases in patients with prostate cancer
Authors: Ikeda I. , Miura T. , Kondo I. 
Published: November 2003

Objectives To determine whether the urinary excretion of urinary pyridinoline (Py) and deoxypyridinoline (dPy) serve as markers to evaluate the activity of bone metastases and the response to endocrine therapy, by determining the relationship between the excretion of these compounds and the activity of bone metastases in patients with prostate cancer.Patients and methods Urine specimens were obtained from 15 patients with benign prostatic hypertrophy (BPH), 17 with carcinoma clinically confined to the prostate and 26 with prostate cancer and bone metastases. Among the patients with prostate cancer and bone metastases, 15 were new or reactivated cases and the 11 others were well controlled by hormonal therapy. Urinary Py and dPy were analysed using high‐pressure liquid chromatography.Results Patient with new or reactivated prostate cancer with bone metastases had a higher urinary excretion of Py and dPy than did the patients with BPH, patients with prostate cancer and no bone metastases and patients with prostate cancer and bone metastases well controlled with hormonal therapy. Urinary levels of these compounds correlated with the extent of bone metastases in new and reactivated cases. Initial high levels of these cross‐linked compounds in patients with multiple bone metastases fell as the prostate cancer was controlled by hormonal therapy.Conclusion Urinary excretion of Py and Dpy appears to be a useful marker for evaluating the activity of bone metastases and their response to hormonal treatment in prostate cancer.
The management of extensive penile fibrosis: a new technique of ‘minimal scar‐tissue excision’
Authors: George V.K. , Shah G.S. , Mills R. , Dhabuwala C.B. 
Published: November 2003

Objective To evaluate the results of excising minimal scar tissue in patients undergoing insertion of a penile prosthesis for extensive corporal fibrosis. Patients and methods Twelve patients (mean age 58 years, range 44–73) with extensive corporal fibrosis who underwent the insertion of a penile prosthesis were evaluated. Eleven patients had a defect of varying extent after the insertion of the penile prosthesis, and a polytetrafluoroethylene graft was used to cover the area. Results All 12 patients tolerated the procedure well and currently have a functioning penile implant. Conclusions Minimal excision of scar tissue provided better results and fewer complications when compared to other studies which used extensive excision.
Induction androgen deprivation therapy before radical prostatectomy for prostate cancer — initial results
Authors: Abbas F. , Kaplan M. , Soloway M.S. 
Published: November 2003

Objective To determine if androgen deprivation therapy (ADT) on induction decreases the incidence of positive surgical margins and the subsequent risk of disease progression. Patients and methods Between January 1992 and July 1994, 160 men with prostate cancer underwent radical retropubic prostatectomy (RP) and bilateral pelvic node dissection (PLND). Forty men (mean age 64.2 years) with either a higher clinical stage or a significant increase in serum prostate‐specific antigen (PSA) level (P<0.001) received induction ADT with a luteinizing hormone‐releasing hormone (LH‐RH) analogue alone (six patients), or with an anti‐androgen (34 patients), 3–20 months before undergoing RP. The remaining 120 men (mean age 64 years) underwent surgery alone and served as historical controls. Prostatectomy specimens were evaluated using step‐sections at 2–3 mm intervals and whole‐mount reconstruction. The clinical and pathological results were compared. Results There was a clinically significant decrease in the size of the prostate in almost all patients treated with ADT. After ADT the mean PSA level declined by >95% from the levels before RP (P<0.001). Of 40 men receiving ADT and the 120 controls patients, nine (22.5%) and 49 (40.8%) had positive margins (P<0.05), nine (22.5%) and 18 (15%) had seminal‐vesicle invasion (P=0.90) and one (2.5%) and two (1.6%) had lymph‐node metastases (P=0.73), respectively. At a mean 17.6 months (range 2–29), 20 of the control patients were lost to follow‐up. PSA levels were elevated (>0.4 ng/mL) in seven (17.5%) of the men who received ADT and 14 (14%) of the control patients (P=0.60). To date, all patients are alive. Conclusions The results of this study suggest that neoadjuvant ADT before RP is beneficial in men with a high likelihood of having a positive surgical margin. A prospective randomized trial is necessary to determine if there is a benefit in progression‐free and overall survival.