{"title":"Chemotherapy for androgen-independent prostate cancer.","authors":"D. Petrylak","doi":"10.1053/suro.2002.35052","DOIUrl":"https://doi.org/10.1053/suro.2002.35052","url":null,"abstract":"While men with metastatic prostate cancer frequently show a good initial response to androgen ablation, few options have been available for progressive hormone-refractory prostate cancer, and survival following chemotherapy has not exceeded 9 to 12 months. The combination of prednisone and mitoxantrone has significant palliative effects on bone pain but does not extend survival. The combination of estramustine phosphate (EMP) with the taxanes paclitaxel or docetaxel produces greater than additive cytotoxicity in vivo, and phase I and II studies of taxane-based therapy demonstrate improved survival in hormone-refractory prostate cancer compared to historical controls. Docetaxel appears to have relatively high activity as a single agent and in combination with EMP. Further studies are needed to clarify the optimum dose of EMP, taking into account potential cardiovascular toxicity. Phase III studies of its combination with docetaxel are in progress.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 3 Suppl 1 1","pages":"31-5"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58398849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Detection and characterization of renal masses and staging of renal cancers: new considerations in the era of helical computed tomography.","authors":"Richard H Cohan","doi":"10.1053/suro.2002.35332","DOIUrl":"https://doi.org/10.1053/suro.2002.35332","url":null,"abstract":"<p><p>With the introduction of helical CT and its ability to acquire images very rapidly, new problems are being encountered, which can profoundly affect the quality of CT examinations performed for evaluation of known or suspected renal masses. In this article, these problems are summarized and recommendations made for CT techniques that will maximize sensitivity and specificity in renal mass detection, accuracy in renal mass characterization, and accuracy in staging of renal cancer.</p>","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 3","pages":"166-73"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21976972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Imaging for nephron-sparing surgery.","authors":"Erick M Remer, Brian R Herts, Joseph C Veniero","doi":"10.1053/suro.2002.35330","DOIUrl":"https://doi.org/10.1053/suro.2002.35330","url":null,"abstract":"<p><p>Nephron-sparing surgery is more technically demanding than conventional nephrectomy. The urologist can benefit from modern radiological methods to plan and monitor surgery and to provide post-surgical surveillance. This article describes how 3D volume renderings of CT and MRI data can be useful in planning nephron-sparing surgery, how intraoperative imaging can guide surgery and tumor ablation, and how CT and MRI can be used to monitor for recurrent disease and postoperative complications.</p>","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 3","pages":"180-91"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21976975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Therapeutic considerations for patients with high-risk, nonmetastatic, prostate cancer.","authors":"M. Eisenberger","doi":"10.1053/SURO.2002.35049","DOIUrl":"https://doi.org/10.1053/SURO.2002.35049","url":null,"abstract":"The management of patients with high-risk, early-stage, prostate cancer represents a major challenge to all disciplines involved in the treatment of this common malignant neoplasm. Definition of the natural history of this disease, including the identification of key prognostic factors, in addition to the availability of active systemic therapeutic modalities for patients with advanced disease, are among the basic requirements that allow for early intervention in high-risk patients. Emerging new antiprogression approaches, targeted at various known stages of the metastatic cascade with the potential benefit of altering the natural history of early prostate cancer are attractive alternatives for early interventions with innovative programs. Studies on the natural history of patients with evidence of biochemical relapse following local treatment provide the basis for appropriate estimation of the risk ratio for development of clinical metastasis and selection of candidates for aggressive implementation of early treatment. The study of new candidate biomarkers of disease activity should be included in the context of clinical trials. Genotypic and phenotypic characterization of patients in clinical trials may enhance future therapeutic prospects in this disease.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 3 Suppl 1 1","pages":"19-23"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58399198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editorial: the coming revolution in the treatment of prostate cancer patients.","authors":"D. Petrylak, R. de Wit","doi":"10.1053/SURO.2002.35050","DOIUrl":"https://doi.org/10.1053/SURO.2002.35050","url":null,"abstract":"","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 3 Suppl 1 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58399236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Magnetic resonance imaging of prostate cancer.","authors":"Saroja Adusumilli, E Scott Pretorius","doi":"10.1053/suro.2002.35333","DOIUrl":"https://doi.org/10.1053/suro.2002.35333","url":null,"abstract":"<p><p>Management of carcinoma of the prostate has traditionally been guided by digital rectal examination, and by laboratory data such as serum prostate-specific antigen (PSA) level and histopathologic tumor grade. The introduction of the endorectal coil has improved the ability of magnetic resonance imaging (MRI) to contribute to staging and treatment planning of prostate cancer, especially in cases of confined or locally invasive disease. Exciting research in the fields of magnetic resonance spectroscopy (MRS) and MR-guided intervention of the prostate may soon expand the role of MRI in the diagnosis and treatment of prostate cancer. This article reviews current MRI techniques, the MRI features of prostate cancer, the role and efficacy of MRI in prostate carcinoma staging, and the current and future uses of MR spectroscopy and MR-guided prostate brachytherapy.</p>","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 3","pages":"192-210"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21976976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel Yao, Edouard J Trabulsi, Lale Kostakoglu, Shankar Vallabhajosula, Maureen A Joyce, David M Nanus, Matthew Milowsky, He Liu, Stanley J Goldsmith
{"title":"The utility of monoclonal antibodies in the imaging of prostate cancer.","authors":"Daniel Yao, Edouard J Trabulsi, Lale Kostakoglu, Shankar Vallabhajosula, Maureen A Joyce, David M Nanus, Matthew Milowsky, He Liu, Stanley J Goldsmith","doi":"10.1053/suro.2002.36250","DOIUrl":"https://doi.org/10.1053/suro.2002.36250","url":null,"abstract":"<p><p>Monoclonal antibodies (mAbs) to prostate-specific antigens, such as PSMA, have great potential as diagnostic and therapeutic tools in the management of advanced prostate cancer. PSMA is a very attractive target for mAb-based imaging. It is expressed by virtually all prostate cancers and its expression is further increased in poorly differentiated, metastatic, and hormone-refractory carcinomas. The ProstaScint scan (Cytogen, Princeton, NJ), based on the mAb 7E11-C5.3, is currently approved for the imaging of prostate cancer in soft tissue but is not approved for imaging bone metastases. It appears superior to conventional imaging studies for soft-tissue disease but has limitations attributed to its intracellular binding site on PSMA. Overcoming this limitation, new mAbs to the extracellular domain of PSMA have been developed. The radioisotopes, (111)Indium, (90)Yttrium, and (177)Lutetium have been conjugated to one such mAb, J591. Radioimmunoscintigraphy with this immunoconjugate has demonstrated excellent tumor targeting of prostate cancer sites not only in soft tissue but also in bone.</p>","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 3","pages":"211-8"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21976977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Vergouwe, E. Steyerberg, M. Eijkemans, J. Habbema
{"title":"Validity of prognostic models: when is a model clinically useful?","authors":"Y. Vergouwe, E. Steyerberg, M. Eijkemans, J. Habbema","doi":"10.1053/SURO.2002.32521","DOIUrl":"https://doi.org/10.1053/SURO.2002.32521","url":null,"abstract":"Prognostic models combine patient characteristics to predict medical outcomes. Unfortunately, such models do not always perform as well for other patients as those from whose data the models were derived. Therefore, validity of prognostic models needs to be assessed in new patients. Predicted probabilities can be calculated with the model and compared with the actually observed outcomes. We may distinguish several aspects of validity: (1) agreement between predicted probabilities and observed probabilities (calibration), (2) ability of the model to distinguish subjects with different outcomes (discrimination), and (3) ability of the model to improve the decision-making process (clinical usefulness). We discuss those aspects and show some measures by using models for testicular and prostate cancer. We conclude that good calibration and discriminative ability are not sufficient for a model to be clinically useful. Application of a prognostic model is sensible, if the model is able to provide useful additional information for clinical decision making.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 2 1","pages":"96-107"},"PeriodicalIF":0.0,"publicationDate":"2002-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58398763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The dilemma of patients with a rising PSA level after definitive local therapy for prostate cancer.","authors":"L. Lassiter, M. Eisenberger","doi":"10.1053/SURO.2002.32834","DOIUrl":"https://doi.org/10.1053/SURO.2002.32834","url":null,"abstract":"Patients with a rising prostate-specific antigen (PSA) levels after definitive local therapy now represent one of the largest and fastest growing groups of men with prostate cancer. The great majority of these men are asymptomatic with no other evidence of disease, and their clinical outcomes have been widely variable and poorly understood. Recently, several groups have analyzed their institutions' data and reported on certain pathologic and clinical variables that have increased our understanding of the natural history of these men, and to some extent allowed for the development of predictive models to aid in deciding who should be treated more aggressively and who should be watched. This article reviews and critically evaluates the most relevant available data for this group of men, and offers a summary of the most useful models and predictive variables after both radical prostatectomy and radiotherapy. This article also offers recommendations for strategies to improve our current knowledge of the natural history of these men, to facilitate the development and implementation of clinical trials in this population, and to ultimately be able to offer the most appropriate recommendations to our patients in the clinic.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 2 1","pages":"146-54"},"PeriodicalIF":0.0,"publicationDate":"2002-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58398535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Artificial neural networks for diagnosis and prognosis in prostate cancer.","authors":"G. Schwarzer, M. Schumacher","doi":"10.1053/SURO.2002.32492","DOIUrl":"https://doi.org/10.1053/SURO.2002.32492","url":null,"abstract":"The application of artificial neural networks (ANNs), especially feed-forward neural networks (FFNNs), has become very popular for diagnosis and prognosis in clinical medicine, often accompanied by exaggerated statements of their potential. The excitement stems mainly from the fact that ANNs were developed as attempts to model the decision process of the human brain. Traditionally, logistic regression models and proportional hazard regression models have been used in these applications. In this article, FFNNs are introduced as flexible, nonlinear regression models and necessary precautions for their use are discussed. Furthermore, the results of a literature survey of applications of ANNs in prostate cancer published between 1999 and 2001 are described; most applications suffer from methodologic deficiencies. It is concluded that there is so far no evidence that the application of ANNs provide real progress in the field of diagnosis and prognosis in prostate cancer.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"20 2 1","pages":"89-95"},"PeriodicalIF":0.0,"publicationDate":"2002-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58397886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}