INTRODUCTIONThis paper examines the incidence, mortality and survival patterns among all Chinese residents with prostate cancer reported to the Singapore Cancer Registry in Singapore from 1968 to 2002 by metastatic staging.

MATERIALS AND METHODSThis is a retrospective population-based study including all prostate cancer cases aged over 20 reported to the Singapore Cancer Registry (SCR) from 1968 to 2002 who are Singapore Chinese residents. Follow-up was ascertained by matching with the National Death Register until 2002. Metastatic status was obtained from the SCR. Age-standardised incidence and mortality rates, as well as the 5-year relative survival ratios (RSRs), were obtained for each 5-year period and grouped by metastatic stage. A weighted linear regression was performed on the log-transformed age-standardised incidence and mortality rates over the study period.

RESULTSIn the most recent period of 1998 to 2002, the age-standardised incidence and mortality rates (per 100,000) for prostate cancer among the Chinese were 30.9 (95% CI, 29.1 to 32.8) and 9.6 (95% CI, 8.6 to 10.7), respectively. The percentage increase in the age-standardised incidence and age-standardised mortality rates per year were 5.6% and 6.0%, respectively, for all Chinese Singapore residents. There was an improvement in the 5-year RSRs for Chinese diagnosed with non-metastatic cases from 51.3% in 1973 to 1977, to 76.1% in 1998 to 2002. However, the RSR remains poor (range, 11.1% to 49.7%) for Chinese diagnosed with metastatic prostate cancer.

CONCLUSIONSBoth age-standardised incidence and mortality rates for prostate cancer among Chinese Singapore residents are still on the rise especially since the 1990s. Since the 1990s, the improvement in RSRs was substantial for the Chinese non-metastatic cases.

Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; ethnology ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; diagnosis ; Prostatic Neoplasms ; epidemiology ; ethnology ; mortality ; Registries ; Retrospective Studies ; Singapore ; epidemiology ; Survival Rate ; trends ; Young Adult

INTRODUCTIONThis study evaluated the data completeness in the registration of prostate cancer after robotic radical prostatectomy (RRP) in the Urological Cancer Registry at the Singapore General Hospital (SGH), and its compliance to the international standards of US Commission on Cancer (CoC).

MATERIALS AND METHODSA certified cancer registrar reviewed all RRP cases between June 2003 and July 2008 in the Urological Cancer Registry at SGH.

RESULTSA total of 365 cases were reviewed. The results showed that 351 (96.2%) of RRP patients' demographic data were captured and 321 (87.9%) of RRP patients were staged. According to the international standards of CoC for an academic institution, the requirement is to capture 100% of all cancer cases and stage at least 90% of them. As for data completeness, 317 (86.7%) of RRP details were captured as compared to the CoC standard requirement of 90%.

CONCLUSIONSThe existing manual cancer registry does not fully meet the CoC standards. Hence, the registry increased sources of case-finding and used active case-finding. With improvements made to the data collection methodology, the number of prostate cancer cases identified has been increased by 52.1% from 215 in 2007 to 327 in 2009. The registry is expected to be fully compliant with the CoC standard with the recruitment of more full time cancer registrars when a new web-based cancer registry is in full operation.

Algorithms ; Data Collection ; methods ; Demography ; Humans ; Male ; Prostatectomy ; instrumentation ; methods ; statistics & numerical data ; Prostatic Neoplasms ; surgery ; Registries ; Research Design ; standards ; Robotics ; Singapore

INTRODUCTIONWe evaluated the accuracy of endorectal magnetic resonance imaging (MRI) in the staging of prostate cancer.

MATERIALS AND METHODSWe retrospectively reviewed 32 patients who underwent endorectal MR prostate prior to radical prostatectomy. The tumour stage based on MR imaging was compared with the pathologic stage. The sensitivity and specificity of endorectal MR prostate in the evaluation of extracapsular extension (ECE) of the tumour were then determined.

RESULTSMR correctly diagnosed 17 cases of organ-confined prostate carcinoma and 2 cases of locally advanced disease. In the evaluation of ECE, endorectal MR achieved a high specificity of 94.4%, low sensitivity of 14.3% and moderate accuracy of 59.4%.

CONCLUSIONEndorectal MR prostate has high specificity for the detection of ECE. It is useful in the local staging of prostate cancer in patients with intermediate risk as this helps to ensure that few patients will be deprived of potentially curative surgery.

Adult ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Medical Audit ; Middle Aged ; Neoplasm Staging ; methods ; Prostatectomy ; Prostatic Neoplasms ; pathology ; surgery ; Rectum ; Retrospective Studies ; Sensitivity and Specificity

The prognostic features of T1N0M0 renal cell carcinoma (RCC) in Asian patients have not been well explored in large sample studies. In this study, we retrospectively analyzed the records of 713 patients undergoing nephrectomy for T1N0M0 RCC between 1991 and 2009 in three Asian hospitals. Univariate and multivariate analysis were performed to identify the independent predictive factors for T1N0M0 RCC prognosis among a series of clinicopathological parameters, including age, gender, tumor size, Fuhrman grade, and histological classification. Our results showed that 388 of 713 patients had tumors 4.0 cm or smaller (stage T1a) and 325 of 713 patients had tumors 4.0-7.0 cm in size (stage T1b). Five-year cancer-specific survival (CSS) and recurrence-free survival (RFS) rates for this group of patients were 96.0% and 93.5%, respectively. The patients with T1b RCC had a significantly lower 5-year CSS and RFS rates than did those with T1a RCC (CSS, 93.1% vs. 98.6%, P = 0.026; RFS, 90.0% vs. 96.5%, P < 0.001). Patients with low grade (grades I-II) tumors had a higher 5-year CSS (97.8% vs. 91.2%, P = 0.001) and RFS (95.5% vs. 85.5%, P < 0.001) rate than did those with high grade (grades I-II) tumors. More interestingly, when stratifying patients to T1a and T1b groups, the role of grade in distinguishing prognosis could be only observed in patients with T1b disease. Cox regression showed tumor size and Fuhrman grade were significant in predicting CSS and RFS. Our study suggests that the prognosis of patients with T1N0M0 RCC is excellent, and these results are comparable to previously reported studies in Western patients. Furthermore, our data indicates that patients with T1b disease and high Fuhrman grade have high risk of tumor recurrence and death, thus requiring more frequent follow-up.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asia ; epidemiology ; Carcinoma, Renal Cell ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Nephrectomy ; Proportional Hazards Models ; Retrospective Studies ; Risk Assessment ; Survival Rate ; Tumor Burden ; Young Adult