What’s being presented at the AUA in May: Part VII

A total of 44 presentations and posters address prostate cancer-specific topics under the general heading of “epidemiology and natural history” in three sessions at the annual meeting of the American Urological Association this year.

In the session entitled “Prostate Cancer: Epidemiology & Natural History I” (on Tuesday, May 20):

  • Preston et al. (abstract no. PD31-02) will present data extracted from large, Danish, population-based databases to demonstrate that men being treated with metformin (a drug commonly used to treat Type II diabetes) had a lower risk for diagnosis of prostate cancer than otherwise comparable controls who did not use metformin. As regular readers will be aware, there are ongoing studies exploring the potential uses of metformin in the prevention and management of prostate cancer.
  • Murtola et al. (abstract no. PD31-03) will present data from the Finnish Prostate Cancer Screening Trial (conducted between 1996 and 2009) suggesting that statin use may delay or prevent prostate cancer death among prostate cancer patients, especially in men with high-risk prostate cancer.
  • Ovadia et al. (abstract no. PD31-07) will present data from the SEARCH database indicating that, among prostate cancer patients exposed to Agent Orange who underwent a radical prostatectomy, such exposure was not associated with worse preoperative characteristics such as elevated PSA or biopsy Gleason score, nor was it associated with worse postoperative long-term outcomes of metastases or prostate cancer-specific mortality.
  • Zaid et al. (abstract no. PD-31-09) will present data showing that they were able to have a very large impact on risk for infectious complications in men undergoing TRUS-guided prostate biopsy at their institution through structured modification of the institutional antibiotic prophylaxis protocol.

In the session entitled “Prostate Cancer: Epidemiology & Natural History II” (also on Tuesday, May 20):

  • Sachdeva et al. (abstract no. PD34-01) will present a poster suggesting that, even after risk adjustment, prostate-cancer mortality in England is significantly higher than it is in the USA for men with intermediate- and high-risk disease. According to the authors, this difference appears to be explained by less frequent use of radical therapy in England.
  • Vacchio et al. (abstract no. PD34-09) will present a poster further establishing the concept that true Gleason 6 disease does not have metastatic capability (although we still cannot state that no patient with true Gleason 6 disease will ever have metastatic disease; it is really incredibly difficult to “prove a negative” like that).
  • Jang et al. (abstract no. PD34-03) used data from the SEER-Medicare database to show that, among men ≥ 65 years of age treated between 1992 and 2009 who had either locally advanced (lymph node-negative) or regionally advanced (lymph node positive) prostate cancer, those who were treated with radical prostatectomy + external beam radiation therapy had a lower risk of prostate cancer-specific death and improved overall survival as compared to those treated with external beam radiation therapy + androgen deprivation therapy — but the surgically treated patients experienced slightly higher rates of  post-surgical erectile dysfunction and urinary incontinence.

In the session entitled “Prostate Cancer: Epidemiology & Natural History III” (again on Tuesday, May 20):

  • Moreira et al. (abstract no. MP78-03) will present data showing that in a cohort of 259 patients with castration-resistant prostate cancer (CRPC), but no known evidence of metastasis, 80 percent were diagnosed with metastatic disease during the first 5 years after onset of CRPC, and that most metastasis occurred within the first 2 years. Higher Gleason score, higher PSA levels, and shorter time from ADT to CRPC were independently associated with shorter time to metastasis.
  • Barbarosa et al. (abstract no. MP78-20) note that patients using the U.S. Veterans Administration health care system (VAHCS) tend to be older and often have more co-morbid conditions associated with lower baseline health than otherwise comparable men of similar age in the general population. They go on to show that the overall survival for all patients diagnosed with low-risk prostate cancer in the VAHCS is less than that observed in the general population and in reports from single institutions.

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