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  1. Article ; Online: The association of body mass index with tumor aggression among men undergoing radical prostatectomy.

    Gregg, Justin R / Magill, Resa / Fang, Andrew M / Chapin, Brian F / Davis, John W / Adibi, Mehrad / Chéry, Lisly / Papadopoulos, John / Pettaway, Curtis / Pisters, Louis / Ward, John F / Hahn, Andrew W / Daniel, Carrie R / Bhaskaran, Jerusha / Zhu, Keyi / Guerrero, Mireya / Zhang, Miao / Troncoso, Patricia

    Urologic oncology

    2024  Volume 42, Issue 4, Page(s) 116.e1–116.e7

    Abstract: Objectives: To evaluate the association of preoperative body mass index (BMI) on adverse pathology in peripheral (PZ) and transition zone (TZ) tumors at time of prostatectomy for localized prostate cancer.: Methods: Clinical and pathologic ... ...

    Abstract Objectives: To evaluate the association of preoperative body mass index (BMI) on adverse pathology in peripheral (PZ) and transition zone (TZ) tumors at time of prostatectomy for localized prostate cancer.
    Methods: Clinical and pathologic characteristics were obtained from up to 100 consecutive prostatectomy patients from 10 prostate surgeons. BMI groups included normal (18.5-24.9), overweight (25-29.9) and obese (> 29.9). "Aggressive" pathology was defined as the presence of Grade Group (GG) 3 or higher and/or pT3a or higher. Pathologic characteristics were evaluated for association with BMI using univariate analyses. Our primary outcome was the association of BMI with adverse pathology, which was assessed using logistic regression accounting for patient age. We hypothesized that obese BMI would be associated with aggressive TZ tumor.
    Results: Among 923 patients, 140 (15%) were classified as "normal" BMI, 413 (45%) were "overweight", and 370 (40%) were "obese." 474 patients (51%) had aggressive PZ tumors while 102 (11%) had aggressive TZ tumors. "Obese" BMI was not associated with aggressive TZ tumor compared to normal weight. Increasing BMI group was associated with overall increased risk of aggressive PZ tumor (HR 1.56 [95CI 1.04-2.34]; P = 0.03). Among patients with GG1 or GG2, increasing BMI was associated with presence of pT3a or higher TZ tumor (P = 0.03).
    Conclusions: Increased BMI is associated with adverse pathology in PZ tumors. TZ adverse pathology risk may be increased among obese men with GG1 or GG2 disease, which has implications for future studies assessing behavioral change among men whose tumors are actively monitored.
    MeSH term(s) Male ; Humans ; Prostate/pathology ; Body Mass Index ; Aggression ; Retrospective Studies ; Prostatic Neoplasms/complications ; Prostatic Neoplasms/surgery ; Prostatic Neoplasms/pathology ; Prostatectomy ; Obesity/complications ; Overweight
    Language English
    Publishing date 2024-01-22
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1336505-8
    ISSN 1873-2496 ; 1078-1439
    ISSN (online) 1873-2496
    ISSN 1078-1439
    DOI 10.1016/j.urolonc.2023.12.013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Performance of a Prostate Cancer Genomic Classifier in Predicting Metastasis in Men with Prostate-specific Antigen Persistence Postprostatectomy.

    Spratt, Daniel E / Dai, Darlene L Y / Den, Robert B / Troncoso, Patricia / Yousefi, Kasra / Ross, Ashley E / Schaeffer, Edward M / Haddad, Zaid / Davicioni, Elai / Mehra, Rohit / Morgan, Todd M / Rayford, Walter / Abdollah, Firas / Trabulsi, Edouard / Achim, Mary / Tapia, Elsa Li Ning / Guerrero, Mireya / Karnes, Robert Jeffrey / Dicker, Adam P /
    Hurwitz, Mark A / Nguyen, Paul L / Feng, Felix F Y / Freedland, Stephen J / Davis, John W

    European urology

    2017  Volume 74, Issue 1, Page(s) 107–114

    Abstract: Background: Prostate cancer patients who have a detectable prostate-specific antigen (PSA) postprostatectomy may harbor pre-existing metastatic disease. To our knowledge, none of the commercially available genomic biomarkers have been investigated in ... ...

    Abstract Background: Prostate cancer patients who have a detectable prostate-specific antigen (PSA) postprostatectomy may harbor pre-existing metastatic disease. To our knowledge, none of the commercially available genomic biomarkers have been investigated in such men.
    Objective: To evaluate if a 22-gene genomic classifier can independently predict development of metastasis in men with PSA persistence postoperatively.
    Design, setting, and participants: A multi-institutional study of 477 men who underwent radical prostatectomy (RP) between 1990 and 2015 from three academic centers. Patients were categorized as detectable PSA (n=150) or undetectable (n=327) based on post-RP PSA nadir ≥0.1 ng/ml.
    Outcome measurements and statisitical analysis: Cumulative incidence curves for metastasis were constructed using Fine-Gray competing risks analysis. Penalized Cox univariable and multivariable (MVA) proportional hazards models were performed to evaluate the association of the genomic classifier with metastasis.
    Results and limitations: The median follow-up for censored patients was 57 mo. The median time from RP to first postoperative PSA was 1.4 mo. Detectable PSA patients were more likely to have higher adverse pathologic features compared with undetectable PSA patients. On MVA, only genomic high-risk (hazard ratio [HR]: 5.95, 95% confidence interval [CI]: 2.02-19.41, p=0.001), detectable PSA (HR: 4.26, 95% CI: 1.16-21.8, p=0.03), and lymph node invasion (HR: 12.2, 95% CI: 2.46-70.7, p=0.003) remained prognostic factors for metastasis. Among detectable PSA patients, the 5-yr metastasis rate was 0.90% for genomic low/intermediate and 18% for genomic high risk (p<0.001). Genomic high risk remained independently prognostic on MVA (HR: 5.61, 95% CI: 1.48-22.7, p=0.01) among detectable PSA patients. C-index for Cancer of the Prostate Risk Assessment Postsurgical score, Gandaglia nomogram, and the genomic classifier plus either Cancer of the Prostate Risk Assessment Postsurgical score or Gandaglia were 0.69, 0.68, and 0.82 or 0.81, respectively. Sample size was a limitation.
    Conclusions: Despite patients with a detectable PSA harboring significantly higher rates of aggressive clinicopathologic features, Decipher independently predicts for metastasis. Prospective validation of these findings is warranted and will be collected as part of the ongoing randomized trial NRG GU-002.
    Patient summary: Decipher independently predicted metastasis for patients with detectable prostate-specific antigen after prostatectomy.
    MeSH term(s) Aged ; Biomarkers, Tumor/biosynthesis ; Biomarkers, Tumor/blood ; Genome ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis/genetics ; Predictive Value of Tests ; Prognosis ; Prostate-Specific Antigen/biosynthesis ; Prostate-Specific Antigen/blood ; Prostatectomy ; Prostatic Neoplasms/genetics ; Prostatic Neoplasms/metabolism ; Prostatic Neoplasms/secondary ; Risk Assessment
    Chemical Substances Biomarkers, Tumor ; Prostate-Specific Antigen (EC 3.4.21.77)
    Language English
    Publishing date 2017-12-10
    Publishing country Switzerland
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 193790-x
    ISSN 1873-7560 ; 1421-993X ; 0302-2838
    ISSN (online) 1873-7560 ; 1421-993X
    ISSN 0302-2838
    DOI 10.1016/j.eururo.2017.11.024
    Database MEDical Literature Analysis and Retrieval System OnLINE

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