Search

Your search keyword '"Frohneberg D"' showing total 5 results
Start Over Author "Frohneberg D" Topic prostate-specific antigen
5 results on '"Frohneberg D"'

1. Is there a prostate-specific antigen upper limit for radical prostatectomy?

Author

Gontero P, Spahn M, Tombal B, Bader P, Hsu CY, Marchioro G, Frea B, Van Der Eeckt K, Kneitz B, Frohneberg D, Tizzani A, Van Poppel H, and Joniau S

Subjects
Aged, Humans, Male, Prostatic Neoplasms mortality, Retrospective Studies, Survival Rate, Prostate-Specific Antigen blood, Prostatectomy, Prostatic Neoplasms blood, Prostatic Neoplasms surgery
Abstract

Objective: • To assess the feasibility of radical prostatectomy (RP) in a series of patients with prostate cancer with very high prostate-specific antigen (PSA) levels by comparing the clinical outcomes of different PSA thresholds (20.1-50 ng/mL, 50.1-100 ng/mL and >100 ng/mL, respectively)., Patients and Methods: • Within a multicentre European retrospective database of 712 RP in patients with a baseline PSA level >20 ng/mL, we identified 48 patients with prostate cancer with a preoperative PSA level >100 ng/mL, 137 with a PSA level between 50.1 and 100 ng/mL and 527 with PSA values between 20.1 and 50 ng/mL. • Comparisons between groups were performed using chi-square test, analysis of variance and Kaplan-Meier analysis with log-rank test., Results: • Ten-year projected cancer-specific survival (79.8% in the PSA >100 ng/mL group vs 85.4% in the PSA 50.1-99 ng/mL group vs 90.9% in the PSA 20.1-50 ng/mL interval; P = 0.037) but not overall survival (59.6% in the PSA >100 ng/mL group vs 71.8% in the PSA 50.1-99 ng/mL group vs 75.3% in the PSA 20.1-50 ng/mL interval; P = 0.087) appeared significantly affected by the different PSA thresholds. • At a median follow-up of 78.7 months, 25.8%, 6.6% and 8.3% of patients in the PSA level groups for 20.1-50 ng/mL, 50.1-100 ng/mL and >100 ng/mL respectively, were cured by surgery alone., Conclusions: • Ten-year cancer-specific survival, while showing significant reduction with increasing PSA values intervals, remain relatively high even for PSA levels >100 ng/mL. • As part of a multimodal treatment strategy, RP may therefore be an option, even in selected patients with prostate cancer whose PSA level is >100 ng/mL., (© 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.)

Published
2011
Full Text
View/download PDF

2. Outcome predictors of radical prostatectomy in patients with prostate-specific antigen greater than 20 ng/ml: a European multi-institutional study of 712 patients.

Author

Spahn M, Joniau S, Gontero P, Fieuws S, Marchioro G, Tombal B, Kneitz B, Hsu CY, Van Der Eeckt K, Bader P, Frohneberg D, Tizzani A, and Van Poppel H

Subjects
Aged, Carcinoma blood, Carcinoma surgery, Cohort Studies, Europe, Follow-Up Studies, Humans, Lymph Node Excision methods, Male, Middle Aged, Neoplasm Recurrence, Local mortality, Neoplasm Recurrence, Local pathology, Neoplasm Staging, Prognosis, Prostate pathology, Prostate surgery, Prostatic Neoplasms blood, Prostatic Neoplasms surgery, Retrospective Studies, Risk Factors, Treatment Outcome, Carcinoma mortality, Prostate-Specific Antigen blood, Prostatectomy methods, Prostatic Neoplasms mortality
Abstract

Background: Prostate cancer (PCa) patients with pretreatment prostate-specific antigen (PSA) >20 ng/ml have a high risk of biochemical and clinical failure and even cancer-related death after local therapy. Pretreatment predictors of outcome after radical prostatectomy (RP) in this patient group are necessary., Objective: Our aim was to assess how the use of additional high-risk factors (biopsy Gleason score [bGS] > or = 8 or clinical stage 3-4) can improve prediction of treatment failure and cancer-related death after RP in patients with PSA >20., Design, Setting, and Participants: In a retrospective multicentre cohort study from six European centres between 1987 and 2005, 712 patients with PSA >20 ng/ml underwent RP and bilateral pelvic lymphadenectomy., Measurements: Subgroups were analysed to determine the relationship between the number of high-risk factors and histopathology, biochemical progression-free survival, clinical evidence of progressive disease, prostate cancer-specific mortality (PCSM), and overall mortality. Kaplan-Meier analysis with log-rank test and Cox multivariable analysis were applied., Results and Limitations: Median follow-up was 77 mo. The number of high-risk factors was significantly associated with unfavourable histopathology. Among patients with only PSA >20 ng/ml, 33% had pT2 PCa, 57.9% had bGS <7, 54% had negative surgical margins, and 85% were lymph node negative (pN0), whereas among patients with all three high-risk factors, 4.5% had pT2 PCa, 2.3% had bGS <7, 20.5% had negative margins, and 49% were pN0 (p<0.001). The strongest predictor of progression and mortality was bGS. PSA >20 ng/ml associated with bGS < or =7 resulted in 10-yr PCSM of 5%; when associated with bGS > or =8, PCSM was 35%. The main limitations of the study were retrospective design and varying treatment modalities., Conclusions: PCa patients with PSA >20 ng/ml have varying risk levels of disease progression and PCSM. Considering additional risk factors further stratifies this group into four subgroups that can guide the clinician in preoperative patient counselling., (Copyright 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Published
2010
Full Text
View/download PDF

3. Pretreatment tables predicting pathologic stage of locally advanced prostate cancer

Author

Joniau, S, Spahn, M, Briganti, A, Gandaglia, G, Tombal, B, Tosco, L, Marchioro, G, Hsu, Cy, Walz, J, Kneitz, B, Bader, P, Frohneberg, D, Tizzani, A, Graefen, M, van Cangh, P, Karnes, Rj, Montorsi, F, van Poppel, H, Gontero, Paolo, European Multicenter Prostate Cancer Clinical, Translational Research Group, Joniau, S, Spahn, M, Briganti, A, Gandaglia, G, Tombal, B, Tosco, L, Marchioro, G, Hsu, Cy, Walz, J, Kneitz, B, Bader, P, Frohneberg, D, Tizzani, A, Graefen, M, van Cangh, P, Karnes, Rj, Montorsi, Francesco, van Poppel, H, and Gontero, P.

Subjects
Oncology, Male, Biopsy, Physics::Medical Physics, Predictive Value of Test, urologic and male genital diseases, Prostate cancer, Locally advanced prostate cancer, Decision Support Technique, Retrospective Studie, Risk Factors, Pretreatment table, 610 Medicine & health, Pathologic stage, Lymph Node, Kallikrein, Radical prostatectomy, Europe, Treatment Outcome, Lymphatic Metastasis, Kallikreins, Human, medicine.medical_specialty, Logistic Model, Quantitative Biology::Tissues and Organs, Urology, Locally advanced, Reproducibility of Result, Decision Support Techniques, Predictive Value of Tests, Internal medicine, medicine, Humans, Neoplasm Staging, Retrospective Studies, Prostatectomy, business.industry, Risk Factor, Patient Selection, Prostatic Neoplasms, Reproducibility of Results, Lymphatic Metastasi, Prostate-Specific Antigen, medicine.disease, Logistic Models, Computer Science::Computer Vision and Pattern Recognition, Prostatic Neoplasm, Lymph Node Excision, Lymph Nodes, Neoplasm Grading, business
Abstract

Background Pretreatment tables for the prediction of pathologic stage have been published and validated for localized prostate cancer (PCa). No such tables are available for locally advanced (cT3a) PCa. Objective To construct tables predicting pathologic outcome after radical prostatectomy (RP) for patients with cT3a PCa with the aim to help guide treatment decisions in clinical practice. Design, setting, and participants This was a multicenter retrospective cohort study including 759 consecutive patients with cT3a PCa treated with RP between 1987 and 2010. Intervention Retropubic RP and pelvic lymphadenectomy. Outcome measurements and statistical analysis Patients were divided into pretreatment prostate-specific antigen (PSA) and biopsy Gleason score (GS) subgroups. These parameters were used to construct tables predicting pathologic outcome and the presence of positive lymph nodes (LNs) after RP for cT3a PCa using ordinal logistic regression. Results and limitations In the model predicting pathologic outcome, the main effects of biopsy GS and pretreatment PSA were significant. A higher GS and/or higher PSA level was associated with a more unfavorable pathologic outcome. The validation procedure, using a repeated split-sample method, showed good predictive ability. Regression analysis also showed an increasing probability of positive LNs with increasing PSA levels and/or higher GS. Limitations of the study are the retrospective design and the long study period. Conclusions These novel tables predict pathologic stage after RP for patients with cT3a PCa based on pretreatment PSA level and biopsy GS. They can be used to guide decision making in men with locally advanced PCa. Patient summary Our study might provide physicians with a useful tool to predict pathologic stage in locally advanced prostate cancer that might help select patients who may need multimodal treatment.

Published
2015

4. Stratification of high-risk prostate cancer into prognostic categories: A european multi-institutional study

Author

Joniau, S, Briganti, A, Gontero, Paolo, Gandaglia, G, Tosco, L, Fieuws, S, Tombal, B, Marchioro, G, Walz, J, Kneitz, B, Bader, P, Frohneberg, D, Tizzani, A, Graefen, M, van Cangh, P, Karnes, Rj, Montorsi, F, Van Poppel, H, Spahn, M, European Multicenter Prostate Cancer Clinical, Translational Research Group, Joniau, Steven, Briganti, Alberto, Gontero, Paolo, Gandaglia, Giorgio, Tosco, Lorenzo, Fieuws, Steffen, Tombal, Bertrand, Marchioro, Giansilvio, Walz, Jochen, Kneitz, Burkhard, Bader, Pia, Frohneberg, Detlef, Tizzani, Alessandro, Graefen, Marku, van Cangh, Paul, Karnes R., Jeffrey, Montorsi, Francesco, Van Poppel, Hein, and Spahn, Martin

Subjects
Oncology, High-risk prostate cancer, Male, medicine.medical_specialty, Urology, Predictive Value of Test, Disease, Risk Assessment, Stratification (mathematics), Disease-Free Survival, Prostate cancer, Locally advanced prostate cancer, Risk groups, Predictive Value of Tests, Risk Factors, Retrospective Studie, Internal medicine, medicine, Humans, Risk stratification, Proportional Hazards Models, Retrospective Studies, Aged, Neoplasm Staging, business.industry, Risk Factor, Risk group, Prostatic Neoplasms, Middle Aged, Prostate-Specific Antigen, medicine.disease, Europe, Survival Rate, Area Under Curve, Prostatic Neoplasm, Proportional Hazards Model, Neoplasm Grading, business, Human
Abstract

Background High-risk prostate cancer (PCa) is an extremely heterogeneous disease. A clear definition of prognostic subgroups is mandatory. Objective To develop a pretreatment prognostic model for PCa-specific survival (PCSS) in high-risk PCa based on combinations of unfavorable risk factors. Design, setting, and participants We conducted a retrospective multicenter cohort study including 1360 consecutive patients with high-risk PCa treated at eight European high-volume centers. Intervention Retropubic radical prostatectomy with pelvic lymphadenectomy. Outcome measurements and statistical analysis Two Cox multivariable regression models were constructed to predict PCSS as a function of dichotomization of clinical stage ( 20 ng/ml). The first "extended" model includes all seven possible combinations; the second "simplified" model includes three subgroups: a good prognosis subgroup (one single high-risk factor); an intermediate prognosis subgroup (PSA > 20 ng/ml and stage cT3-4); and a poor prognosis subgroup (GS 8-10 in combination with at least one other high-risk factor). The predictive accuracy of the models was summarized and compared. Survival estimates and clinical and pathologic outcomes were compared between the three subgroups. Results and limitations The simplified model yielded an R of 33% with a 5-yr area under the curve (AUC) of 0.70 with no significant loss of predictive accuracy compared with the extended model (R: 34%; AUC: 0.71). The 5- and 10-yr PCSS rates were 98.7% and 95.4%, 96.5% and 88.3%, 88.8% and 79.7%, for the good, intermediate, and poor prognosis subgroups, respectively (p = 0.0003). Overall survival, clinical progression-free survival, and histopathologic outcomes significantly worsened in a stepwise fashion from the good to the poor prognosis subgroups. Limitations of the study are the retrospective design and the long study period. Conclusions This study presents an intuitive and easy-to-use stratification of high-risk PCa into three prognostic subgroups. The model is useful for counseling and decision making in the pretreatment setting.

Published
2015

5. Identifying the Best Candidate for Radical Prostatectomy Among Patients with High-Risk Prostate Cancer

Author

Hendrik Van Poppel, Bruno Frea, Burkhard Kneitz, Jochen Walz, Bertrand Tombal, R. Jeffrey Karnes, Giansilvio Marchioro, Niccolo Passoni, Paolo Gontero, Steven Joniau, Francesco Montorsi, Firas Abdollah, Alberto Briganti, Detlef Frohneberg, Markus Graefen, Chris H. Bangma, Martin Spahn, Alessandro Tizzani, Urology, Briganti, Alberto, Joniau, S, Gontero, P, Abdollah, F, Passoni, Nm, Tombal, B, Marchioro, G, Kneitz, B, Walz, J, Frohneberg, D, Bangma, Ch, Graefen, M, Tizzani, A, Frea, B, Karnes, Rj, Montorsi, Francesco, Van Poppel, H, and Spahn, M.

Subjects
Male, Oncology, medicine.medical_specialty, Urology, medicine.medical_treatment, Disease, urologic and male genital diseases, Androgen deprivation therapy, Prostate cancer, SDG 3 - Good Health and Well-being, Risk Factors, Internal medicine, Humans, Medicine, In patient, Aged, Retrospective Studies, Prostatectomy, business.industry, Patient Selection, Prostatic Neoplasms, Retrospective cohort study, Middle Aged, Prostate-Specific Antigen, Nomogram, medicine.disease, Nomograms, Prostate-specific antigen, Treatment Outcome, Lymph Node Excision, Neoplasm Grading, business
Abstract

Background: The current role of radical prostatectomy (RP) in patients with high-risk disease remains controversial. Objective: To identify which high-risk prostate cancer (PCa) patients might have favorable pathologic outcomes when surgically treated. Design, setting, and participants: We evaluated 1366 patients with high-risk PCa (ie, at least one of the following risk factors: prostate-specific antigen [PSA] > 20 ng/ml, cT3, biopsy Gleason 8-10) treated with RP and pelvic lymph node dissection (PLND) at eight European centers between 1987 and 2009. A favorable pathologic outcome was defined as specimen-confined (SC) disease-namely, pT2-pT3a, node negative PCa with negative surgical margins. Intervention: All patients underwent radical retropubic prostatectomy and PLND. Measurements: Univariable and multivariable logistic regression models tested the association between predictors and SC disease. A logistic regression coefficient-based nomogram was developed and internally validated using 200 bootstrap resamples. The Kaplan-Meier method was used to depict biochemical recurrence (BCR) and cancer-specific survival (CSS) rates. Results and limitations: Overall, 505 of 1366 patients (37%) had SC disease at RP. All preoperative variables (ie, age and PSA at surgery, clinical stage, and biopsy Gleason sum) were independent predictors of SC PCa at RP (all p

Published
2012

Catalog

Books, media, physical & digital resources
See catalog results