Locally advanced prostate cancer (LAPC) is defined as histologically proven T3–4 prostatic adenocarcinoma. In this review, we define the individual roles of radiotherapy (RT), short-term (ST-) and long-term (LT-) androgen deprivation therapy (ADT), and their combination in multimodal therapy for LAPC. Despite limitations in comparing the clinical outcomes among published papers, in the present study, a trend of 10-year clinical outcomes was roughly estimated by calculating the average rates weighted by the cohort number. With RT alone, the following rates were estimated: 87% biochemical failure, 34% local failure (LF), 48% distant metastasis (DM), 38% overall survival (OS), and 27% disease-specific mortality (DSM). Those associated with ADT alone were 74% BCF, 54% OS, and 25% DSM, which appeared to be better than those of RT alone. The addition of ADT to RT produced a notable local and systemic effect, regardless of ST- or LT-ADT. The LF rate decreased from 34% with RT alone to 21% with ST-ADT and further to 15% with LT-ADT. The DM and DSM rates also showed a similar trend among RT alone, RT+ST-ADT, and RT+LT-ADT. The combination of RT+LT-ADT resulted in the best long-term clinical outcomes, indicating that both RT and ADT are important parts of multimodal therapy.
Adenocarcinoma ; Cohort Studies ; Mortality ; Neoplasm Metastasis ; Prostate* ; Prostatic Neoplasms* ; Radiotherapy*

Locally advanced prostate cancer (LAPC) is defined as histologically proven T3–4 prostatic adenocarcinoma. In this review, we define the individual roles of radiotherapy (RT), short-term (ST-) and long-term (LT-) androgen deprivation therapy (ADT), and their combination in multimodal therapy for LAPC. Despite limitations in comparing the clinical outcomes among published papers, in the present study, a trend of 10-year clinical outcomes was roughly estimated by calculating the average rates weighted by the cohort number. With RT alone, the following rates were estimated: 87% biochemical failure, 34% local failure (LF), 48% distant metastasis (DM), 38% overall survival (OS), and 27% disease-specific mortality (DSM). Those associated with ADT alone were 74% BCF, 54% OS, and 25% DSM, which appeared to be better than those of RT alone. The addition of ADT to RT produced a notable local and systemic effect, regardless of ST- or LT-ADT. The LF rate decreased from 34% with RT alone to 21% with ST-ADT and further to 15% with LT-ADT. The DM and DSM rates also showed a similar trend among RT alone, RT+ST-ADT, and RT+LT-ADT. The combination of RT+LT-ADT resulted in the best long-term clinical outcomes, indicating that both RT and ADT are important parts of multimodal therapy.
Adenocarcinoma ; Cohort Studies ; Mortality ; Neoplasm Metastasis ; Prostate* ; Prostatic Neoplasms* ; Radiotherapy*

Most prostate cancer cases ultimately relapse after a period of initial response to castration therapy and progress to intractable castration-resistant prostate cancer (CRPC). Hardly any therapeutic options currently used can improve the 2- to 3-year survival of the patient. Recently, some new drugs for the treatment of CRPC through various action mechanisms have been approved, and others are in the advanced stage of clinical trial. This review provides an overview of these new therapeutic agents.
Antineoplastic Agents ; therapeutic use ; Humans ; Male ; Neoplasm Recurrence, Local ; Orchiectomy ; Prostatic Neoplasms ; surgery ; Prostatic Neoplasms, Castration-Resistant ; drug therapy ; mortality

OBJECTIVE: To systematically evaluate the effect of statins on prognosis for patients with cancers.
 METHODS: Literature on PubMed, EMbase and Cochrane library was screened from the establishment of databases to March, 2015 to find relevant studies. Random-effects models were used to calculate the pooled hazard ratios (HR) and 95% confidence interval (CI) for the association between statin use and all-cause mortality and cancer-specific mortality.
 RESULTS: A total of 25 studies covered 523 193 patients were identified and included in this Meta-analysis. The pooled effect showed that statin application was associated with a reduction in all-cause mortality in cancer patients (HR, 0.82; 95% CI: 0.76 to 0.89). A significantly decreased mortality in prostate cancer was revealed in subgroup by cancer sites (HR, 0.66; 95% CI: 0.52 to 0.83). In addition, sensitivity analysis demonstrated a weakened association between statin application and all-cause mortality after excluding the studies with shorter follow-up duration (HR, 0.91; 95% CI: 0.75 to 1.10).
 CONCLUSION A beneficial effect of statin on all-cause mortality and cancer-specific mortality is presented in patients with cancer. However, further studies are needed to confirm the long term effect.
Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Male ; Neoplasms ; drug therapy ; mortality ; Prognosis ; Prostatic Neoplasms ; drug therapy ; mortality

To identify clinical significance of prostate specific antigen (PSA) in orchiectomized patients with metastatic prostate cancer, we longitudinally investigated significant factors in the progression of the advanced prostate cancer in 28 patients who were comparatively well followed after subcapsular orchiectomy. Following results were obtained. 1) The mean followup interval was 25.9 months (1 to 68 months). Mean patient age was 67.6 years (50 to 82 years). 2) Eleven of 28 patients were expired during follow-up. Death rate was 39.3 percent. 3) Patients whose post-treatment nadir PSA level decreased below 2.8 ng/ml had a significantly longer remission duration rate than those whose nadir PSA remained elevated (mean survival times 53.9 versus 25.4 months, survival rate 85.0 versus 0%, p <0.01). 4) Patients whose interval to nadir PSA was less than 6 months had a significantly longer remission and a larger survival rate than those whose interval to nadir PSA was more than 6 months (mean survival times 58.3 versus 36.4 months, survival rate 93.3 versus 33.3%, p <0.05). 5) After orchiectomy, patients whose duration from nadir PSA level decreased below 2.8 ng/ml to the above 2.8 ng/ml was more than 9 months had a significantly longer remission duration and a larger survival rate than those whose duration was less than 9 months (mean survival times 62.7 versus 24.9 months, survival rate 88.9 versus 27.3%, p <0.001). 6) Patients whose serum PSA was changed earlier than bone scan had a significantly shorter survival duration and a smaller survival rate than those whose bone scan was changed earlier than PSA (mean survival times 24.4 versus 50.3 months, survival rate 30.0 versus 75.0%, p <0.05). 7) Patients whose Gleason grade was below 3 had a better prognosis than those whose Gleason grade was above 4 (mean survival times 50.4 versus 29.9 months, survival rate 78.6 versus 42.9%, p<0.05). 8) Patients` age over 70 years at the time of diagnosis was a Significantly better prognostic factor (p<0.05). pre-treatment PSA levels and PSA half-times were not significant in advanced prostate cancer patients (p>0.05). As the result of the above, we conclude that serial serum PSA levels in advanced prostate cancer patients after endocrinal therapy can aid in distinguishing favorable from nonfavorable responders early in the course of therapy and greatly assist in monitoring for progression.
Diagnosis ; Follow-Up Studies ; Humans ; Mortality ; Orchiectomy ; Prognosis ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms* ; Survival Rate

Prognosis of prostatic carcinoma can be cheefly influenced not by method of treatment, but histological differentiation and tumor stage. We reviewed histologic grade and survival of prostatic carcinoma retrospectively using the Gleason grade system based on gland differentiation and relation between gland and stroma in 25 patients from Jan, 1980 to Jan, 1987, Whom we had follow-up data about. The following results were obtained. 1. The average age of patients was 69 years with a range of 56 to 84 years. 2. We identified 1 patients as grade 2, 4 patients as grade 3, 9 patients as grade 4, 11 patients as grade 5 of total 25 patients. In 2 year survival, there were 100% for low combined Gleason(2-4), 90% for intermediate group(5-7), 80% for high grade. 3. There was close relationship between tumor grade and stage such that high grade is high stage, low grade is in low stage. 4. There were high mortality index(0.102) in high grade group, low mortality index(0.039 %) in low grade group in prostatic index combined Gleason grade with clinical tumor staging.
Adenocarcinoma* ; Follow-Up Studies ; Humans ; Mortality ; Neoplasm Grading ; Neoplasm Staging ; Prognosis* ; Prostatic Neoplasms ; Retrospective Studies

Despite advance in detection and management of prostate cancer, this disease remains a major cause of morbidity and mortality in men. Increasing attention has focused on the role of chemoprevention for prostate cancer, ie the administration of agents that inhibit one or more steps in the natural history of prostate carcinogenesis. Chemoprevention of prostate cancer is currently being tested in a wide range of clinical trials, and have focused on the role of dietary factors, vitamins and trace elements in prostate cancer. These studies have the potential to fundamentally alter the current approach to prostate cancer management. The current status of clinical trials investigating the use of interventions designed to reduce the risk of prostate cancer is reviewed.
Carcinogenesis ; Chemoprevention* ; Humans ; Male ; Mortality ; Natural History ; Prostate ; Prostatic Neoplasms ; Trace Elements ; Vitamins

PURPOSE: We studied and reported on cancer incidence and mortality rates as projected for the year 2014 in order to estimate Korea's current cancer burden. MATERIALS AND METHODS: Cancer incidence data from 1999 to 2011 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2012 were acquired from Statistics Korea. Cancer incidence in 2014 was projected by fitting a linear regression model to observed age-specific cancer incidence rates against observed years, then multiplying the projected age-specific rates by the age-specific population. For cancer mortality, a similar procedure was employed, except that a Joinpoint regression model was used to determine at which year the linear trend changed significantly. RESULTS: A total of 265,813 new cancer cases and 74,981 cancer deaths are expected to occur in Korea in 2014. Further, the crude incidence rate per 100,000 of all sites combined will likely reach 524.7 and the age-standardized incidence rate, 338.5. Meanwhile, the crude mortality rate of all sites combined and age-standardized rate are projected to be 148.0 and 84.6, respectively. Given the rapid rise in prostate cancer cases, it is anticipated to be the fourth most frequently occurring cancer site in men for the first time. CONCLUSION: Cancer has become the most prominent public health concern in Korea, and as the population ages, the nation's cancer burden will continue to increase.
Forecasting ; Humans ; Incidence* ; Korea ; Linear Models ; Male ; Mortality* ; Prostatic Neoplasms ; Public Health

PURPOSE: The purpose of this study was to establish the contribution of four founder alleles of NBN to prostate cancer risk and cancer survival. MATERIALS AND METHODS: Five thousand one hundred eighty-nine men with prostate cancer and 6,152 controls were genotyped for four recurrent variants of NBN (657del5, R215W, I171V, and E185Q). RESULTS: The NBN 657del5 mutation was detected in 74 of 5,189 unselected cases and in 35 of 6,152 controls (odds ratio [OR], 2.5; p < 0.001). In carriers of 657del5 deletion, the cancer risk was restricted to men with the GG genotype of the E185Q variant of the same gene. Among men with the GG genotype, the OR associated with 657del5 was 4.4 (95% confidence interval [CI], 2.4 to 8.0). Among men with other E185Q genotypes, the OR associated with 657del5 was 1.4 (95% CI, 0.8 to 2.4) and the interaction was significant (homogeneity p=0.006). After a median follow-up of 109 months, mortality was worse for 657del5 mutation carriers than for non-carriers (hazard ratio [HR], 1.6; p=0.001). The adverse effect of 657del5 on survival was only seen on the background of the GG genotype of E185Q (HR, 1.9; p=0.0004). CONCLUSION: The NBN 657del5 mutation predisposes to poor prognosis prostate cancer. The pathogenicity of this mutation, with regards to both prostate cancer risk and survival, is modified by a missense variant of the same gene (E185Q).
Alleles ; Follow-Up Studies ; Genotype ; Humans ; Male ; Mortality ; Prognosis ; Prostate ; Prostatic Neoplasms ; Virulence

OBJECTIVETo explore the diagnosis, treatment, and prognosis of prostatic malignant mesenchymal tumors (PMMT).

METHODSWe retrospectively analyzed the clinical and follow-up data about 20 cases of PMMT and reviewed the literature relevant to the diagnosis, treatment, and prognosis of the disease.

RESULTSBased on the results of pathology and immunohistochemistry, the 20 PMMT cases included leiomyosarcoma (n = 7), rhabdomyosarcoma (n = 5), prostatic stromal sarcoma (n = 3), chondrosarcoma (n = 1), and undifferentiated PMMT (n = 4). Twelve of the patients were treated by radical prostatectomy (3 concurrently by sigmoid colostomy and 1 by cystostomy), 2 by pelvic tumor resection following arterial embolization, 1 by total pelvic exenteration, 1 by colostomy with pelvic lymph node biopsy, and 4 by conservative therapy because of metastasis to the lung, pelvis and bone. Of the 20 patients, 9 died of systemic metastasis within 3 months after treatment, 3 died at 6, 7, and 14 months, respectively, 3 survived with tumor for 5, 11, and 12 months, respectively, 2 survived without tumor for 12 and 24 months so far, all subjected to periodic chemotherapy postoperatively, and 3 lost to follow-up.

CONCLUSIONPMMT is a tumor of high malignancy and rapid progression, for which transrectal ultrasound-guided biopsy remains the main diagnostic method. The clinical stage of the tumor is an important factor influencing its prognosis and the survival rate of the patients can be improved by early diagnosis and combined therapy dominated by radical prostatectomy.

Combined Modality Therapy ; methods ; Humans ; Immunohistochemistry ; Male ; Mesenchymoma ; mortality ; pathology ; therapy ; Prognosis ; Prostatectomy ; Prostatic Neoplasms ; mortality ; pathology ; therapy ; Retrospective Studies