The Thursday news reports: March 26, 2009

This morning’s news report addresses items on:

  • p53 overexpression and prostate cancer outcomes
  • Diet and prostate cancer in newly diagnosed patients and prostate cancer survivors
  • Outcomes of surgical treatment of men with clinical T1a and T1b disease
  • Peripheral androgen ablation in men with biochemical recurrence after first-line treatment

Kudahetti et al. have published data supporting the hypothesis that p53 overexpression is an independent marker for prostate cancer outcome based on data from 705 patients with clinically localized prostate cancer who were treated conservatively. Their study suggests that p53 overexpression was a significant predictor of cause-specific and overall survival. The authors conclude that p53 may have a future role in the work-up of newly diagnosed prostate cancer patients.

Lewis et al. have compared the dietary habits of 382 control subjects and 478 men with prostate cancer (373 newly diagnosed or “incident” patients and 105 previously diagnosed or “prevalent” patients), with a particular focus on their consumption of plant food group products. They report that Caucasian controls had significantly higher daily servings of vegetables and fruits and/or fruit juices compared to African American controls. In Caucasians, incident cases reported lower intake of fiber, vitamin C, vitamin A, α-carotene, β-carotene, cryptoxanthin, folate, genistein, daidzein, and fruits and/or fruit juice than controls and/or prevalent cases. In African Americans, incident cases had lower intake of α-carotene compared to controls and prevalent cases. Reduced prostate cancer risk was associated with high intake of cryptoxanthin, fiber, vitamin C, and fruits and/or fruit juices. Increased risk of prostate cancer was associated with high consumption of protein and daily servings of grains. The authors state that the significantly higher consumption of protective dietary constituents among the patients with prevalent prostate cancer compared to incident cases suggests that prostate cancer survivors may be amenable to dietary change.

Helfand et al. have reported data on the surgical treatment of 29 men treated for clinical stage T1a and 83  men with T1b prostate cancer and comparing their outcomes to those of 1,774 patients with a diagnosis of T1c disease. They conclude that although T1a and T1b prostate cancer can be associated with aggressive pathological features and have a similar rate of progression as clinical stage T1c disease, most of the patients in this series had favourable long-term functional outcomes. There was no statistical difference in the rates of biochemical recurrence and the 10-year overall survival rates between patients with T1a,b disease and T1c disease.

Bañez et al. have reported data from a Phase II clinical trial of “peripheral androgen blockade” using low-dose flutamide + finasteride vs low-dose flutamide alone in the treatment of 56 men who had biochemical progression after first-line therapy between 1997 and 2001. Patients on the combination therapy (n = 36) and on flutamide alone (n = 20) had a median follow-up of 54 and 43.5 months, respectively. Men on the combination therapy had a greater decrease in their PSA level and significantly less risk of progression than men on monotherapy. There was no significant difference in the frequency of side effects between the groups. This study appears to validate the clinical application of peripheral androgen blockade, but the use of these two older agents may not offer the best option for care.

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