Tertiary Gleason grades and consequent prognostic risk

We have known for a while that men with a tertiary Gleason grade of 4 or 5 (as  discussed below) are at heightened risk for progressive forms of prostate cancer.

Salvage cryoablation in men with recurrent prostate cancer after first-line radiotherapy

Two recent papers from a clinical research team at the University of Western Ontario in Canada have offered us insights into the appropriate usage of cryoablation as salvage therapy for men with progressive (recurrent) prostate cancer after first-line treatment for localized and locally advanced prostate cancer.

Does ProsVue accurately identify men at minimal risk for disease progression?

The NADiA® ProsVue™ test is a highly sensitive investigational PSA immunoassay.

What if we could sequence whole prostate cancer genomes?

There has been little doubt over the years that prostate cancer was a genetically complex disease. No one has ever seriously thought that prostate cancer was the result of a single change in the DNA of the individual patient. Now we finally have some proof!

Is CCP testing really the prognostic tool we need?

A new report just published on line in Lancet Oncology is suggesting that the cell cycle progression (CCP) score — a measure of the levels of expression of selected genes that are important to cell growth — may be an important indicator of risk for more aggressive types of prostate cancer.

The appropriate selection of patients for active surveillance

A recent French study nicely illustrates the very real problem associated with the selection of the best candidates for active surveillance and the exclusion from active surveillance of patients who probably would be better served by immediate treatment.

Researchers claim four-gene panel can identify high-risk prostate cancer

According to an article on the Wall Street Journal web site today, some Boston-based researchers associated with a company called Metamark Genetics are claiming to have isolated a combination of four genes that might be able to identify early stage prostate cancer that will evolve into an aggressive and potentially deadly form of the disease.

When ethics trump science — you need to find a “work around”

One of the problems with prostate cancer is that it can take many years for the disease to develop from a very small group of cells in a man’s prostate into a disorder that has actual clinical significance.

The prognostic significance of perineural invasion — redux

About 7 months ago we commented on an Italian study of the association between perineural invasion (PNI) on biopsy and outcomes after first-line surgical treatment for localized prostate cancer.

Third study confirms value of PSADT as a prognostic indicator post-surgery

Earlier studies based on data from Johns Hopkins and the Center for Prostate Disease Research have shown that PSA doubling times are strongly associated with risk for metastasis, prostate cancer-specific, and overall mortality.

High-grade PIN and risk for clinically significant prostate cancer: an update

Work by Bostwick and his colleagues (long before the development of Bostwick Laboratories) first showed a clear association between an initial diagnosis of high-grade prostatic intraepithelial neoplasia (HG-PIN) and subsequent risk for a diagnosis of prostate cancer.

Second study confirms data on PSADT and survival post-surgery

In 2009, at a presentation at the American Society for Clinical Oncology, Antonorakis et al. initially presented data, from the Johns Hopkins database, demonstrating the prognostic significance of PSA doubling time (PSADT) to long-term survival of men with progressive prostate cancer who were otherwise untreated after surgery.

Accuracy and relevance of clinical stage in diagnosis and prognosis of localized prostate cancer

According to a new report from the University of California, San Francisco (to be published in Cancer this week), clinical staging errors may — at least in part — underlie the fact that the researchers were unable to demonstrate a clear link between clinical stage and risk for prostate cancer recurrence in patients initially diagnosed [...]

Is PCA3 any more useful than a PSA test in the “real world”?

At major academic medical centers and in at least one large clinical trial, the prostate cancer gene 3 or PCA3 test has appeared to work better than the total serum PSA test as a means to  predict the presence of prostate cancer on biopsy.

Prolaris: prognostically accurate but of limited utility?

According to a media release from  Myriad Genetics, the company’s investigational genetic test (Prolaris™) can accurately predict prostate cancer-specific mortality at 10 years in men known to have clinically localized prostate cancer.

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