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1. Organised prostate cancer testing in Sweden – results from the first three years of inviting 50-year-old men

Author

Arnsrud Godtman, R., primary, Jiborn, T., additional, Wallström, J., additional, Akre, O., additional, Carlsson, S., additional, Nordström, T., additional, Thimansson, E., additional, Alterbeck, M., additional, Zackrisson, S., additional, Hugosson, J., additional, Bjartell, A., additional, Lantz, A., additional, and Bratt, O., additional

Published
2024
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7. Long-term predictive value of serum PSA values obtained in clinical practice – Results from the Norwegian Prostate Cancer Consortium (NPCC)

Author

Carlsson, S., primary, Bjerner, J., additional, Lilja, H., additional, Aas, K., additional, Fosså, S.D., additional, Müller, C., additional, Müller, S., additional, Stensvold, A., additional, Thomas, O., additional, Røe, O.D., additional, Walz, J., additional, Bratt, O., additional, and Oldenburg, J., additional

Published
2021
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8. Single institution followed by national implementation of systematic surgical quality control and feedback for radical prostatectomy : a 20-year journey

Author

Stranne, J, Axen, E, Franck-Lissbrant, I, Fransson, P, Frånlund, M, Hugosson, J, Khatami, A, Koss-Modig, K, Lodding, P, Nyberg, M, Stattin, Pär, Bratt, O, Stranne, J, Axen, E, Franck-Lissbrant, I, Fransson, P, Frånlund, M, Hugosson, J, Khatami, A, Koss-Modig, K, Lodding, P, Nyberg, M, Stattin, Pär, and Bratt, O

Abstract

PURPOSE: The demand for objective and outcome-based facts about surgical results after radical prostatectomy (RP) is increasing. Systematic feedback is also essential for each surgeon to improve his/her performance. METHODS: RP outcome data (e.g., pT-stage and margin status) have been registered at Sahlgrenska University Hospital (SUH) since 1988 and patient-related outcome measures (PROM) have been registered since 2001. The National Prostate Cancer Registry (NPCR) has covered all Regions in Sweden since 1998 and includes PROM-data from 2008. Initially PROM was on-paper questionnaires but due since 2018 all PROMs are collected electronically. In 2014 an on-line "dashboard" panel was introduced, showing the results for ten quality-control variables in real-time. Since 2017 all RP data on hospital, regional, and national levels are publicly accessible on-line on " www.npcr.se/RATTEN ". RESULTS: The early PROM-data from SUH have been used for internal quality control. As national clinical and PROM-data from the NPCR have been made accessible on-line and in real-time we have incorporated this into our pre-existing protocol. Our data are now internally available as real-time NPCR reports on the individual surgeons' results, as well as ePROM data. We can compare the results of each surgeon internally and to other departments' aggregated data. The public can access data and compare hospital level data on "RATTEN". CONCLUSIONS: The process of quality control of RP locally at SUH, and nationally through the NPCR, has been long but fruitful. The online design, with direct real-time feedback to the institutions that report the data, is essential.

Published
2020
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9. Short term health-related quality-of-life in men with metastatic castration-resistant prostate cancer treated with first-line enzalutamide or abiraterone plus prednisone: A systematic review and meta-analysis

Author

Ternov Kvorning, K., primary, Nolsøe, A.B., additional, Bratt, O., additional, Fode, M., additional, Lindberg, H., additional, Kistorp, C., additional, Palapattu, G., additional, Klausen, T.W., additional, Sønksen, J., additional, and Østergren, P.B., additional

Published
2020
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13. The Cambridge Prognostic Groups for improved prediction of disease mortality at diagnosis in primary non-metastatic prostate cancer: a validation study

Author

Gnanapragasam, Vincent, Bratt, O, Muir, K, Lee, LS, Huang, HH, Stattin, P, Lophatananon, A, Gnanapragasam, Vincent [0000-0003-4722-4207], and Apollo - University of Cambridge Repository

Subjects
Male, lcsh:Medicine, Cohort Studies, Urologi och njurmedicin, Urology and Nephrology, Humans, Mortality, Medicine(all), Cancer och onkologi, Cambridge Prognostic Groups, Prostate cancer, lcsh:R, Cancer-specific mortality, Prostatic Neoplasms, Treatment selection, All-cause mortality, Prognosis, Competing risks, Improved treatment section, Survival Rate, Prognostic prediction, Cancer and Oncology, Non-metastatic disease, Stratification, Research Article
Abstract

Background The purpose of this study is to validate a new five-tiered prognostic classification system to better discriminate cancer-specific mortality in men diagnosed with primary non-metastatic prostate cancer. Methods We applied a recently described five-strata model, the Cambridge Prognostic Groups (CPGs 1-5), in two international cohorts and tested prognostic performance against the current standard three-strata classification of low-, intermediate- or high-risk disease. Diagnostic clinico-pathological data for men obtained from the Prostate Cancer data Base Sweden (PCBaSe) and the Singapore Health Study were used. The main outcome measure was prostate cancer mortality (PCM) stratified by age group and treatment modality. Results The PCBaSe cohort included 72,337 men, of whom 7162 died of prostate cancer. The CPG model successfully classified men with different risks of PCM with competing risk regression confirming significant intergroup distinction (p < 0.0001). The CPGs were significantly better at stratified prediction of PCM compared to the current three-tiered system (concordance index (C-index) 0.81 vs. 0.77, p < 0.0001). This superiority was maintained for every age group division (p < 0.0001). Also in the ethnically different Singapore cohort of 2550 men with 142 prostate cancer deaths, the CPG model outperformed the three strata categories (C-index 0.79 vs. 0.76, p < 0.0001). The model also retained superior prognostic discrimination in the treatment sub-groups: radical prostatectomy (n = 20,586), C-index 0.77 vs. 074; radiotherapy (n = 11,872), C-index 0.73 vs. 0.69; and conservative management (n = 14,950), C-index 0.74 vs. 0.73. The CPG groups that sub-divided the old intermediate-risk (CPG2 vs. CPG3) and high-risk categories (CPG4 vs. CPG5) significantly discriminated PCM outcomes after radical therapy or conservative management (p < 0.0001). Conclusions This validation study of nearly 75,000 men confirms that the CPG five-tiered prognostic model has superior discrimination compared to the three-tiered model in predicting prostate cancer death across different age and treatment groups. Crucially, it identifies distinct sub-groups of men within the old intermediate-risk and high-risk criteria who have very different prognostic outcomes. We therefore propose adoption of the CPG model as a simple-to-use but more accurate prognostic stratification tool to help guide management for men with newly diagnosed prostate cancer. Electronic supplementary material The online version of this article (10.1186/s12916-018-1019-5) contains supplementary material, which is available to authorized users.

Published
2018

14. Single institution followed by national implementation of systematic surgical quality control and feedback for radical prostatectomy: a 20-year journey

Author

Stranne, J., primary, Axen, E., additional, Franck-Lissbrant, I., additional, Fransson, P., additional, Frånlund, M., additional, Hugosson, J., additional, Khatami, A., additional, Koss-Modig, K., additional, Lodding, P., additional, Nyberg, M., additional, Stattin, P., additional, and Bratt, O., additional

Published
2019
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22. “Saturation target biopsies” - can a reduction in biopsy cores maintain accuracy of mpMRI supported target and systematic trans-perineal prostate biopsies?

Author

Lloyd, T., primary, Patruno, G., additional, Macchi, A., additional, Czarniecki, M., additional, Gnanapragasam, V., additional, Koo, B., additional, Saeb-Parsy, K., additional, Nadeem, S., additional, Warren, A., additional, Bratt, O., additional, Shah, N., additional, barrett, T., additional, and Kastner, C., additional

Published
2018
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43. NATION-WIDE POPULATION-BASED STUDY ON 15-YEAR MORTALITY IN PROSTATE CANCER ACCORDING TO RISK CATEGORIES IN THE NATIONAL PROSTATE CANCER REGISTER (NPCR) OF SWEDEN in EUROPEAN UROLOGY SUPPLEMENTS, vol 10, issue 2, pp 324-325

Author

Stattin, P, Sandin, F, Ahlgren, G, Bratt, O, E Damber, J, Hugosson, J, Robinson, D, Tornblom, M, Karlsson, S, Andren, O, Widmark, A, Egevad, L, Ehrnstrom, R, Adolfsson, J, Lambe, M, E Johansson, J, Stattin, P, Sandin, F, Ahlgren, G, Bratt, O, E Damber, J, Hugosson, J, Robinson, D, Tornblom, M, Karlsson, S, Andren, O, Widmark, A, Egevad, L, Ehrnstrom, R, Adolfsson, J, Lambe, M, and E Johansson, J

Abstract

n/a

Published
2011

44. Open-label, clinical phase I studies of tasquinimod in patients with castration-resistant prostate cancer

Author

Bratt, O., Häggman, Michael, Ahlgren, G., Nordle, O., Björk, A., Damber, Jan-Erik, Bratt, O., Häggman, Michael, Ahlgren, G., Nordle, O., Björk, A., and Damber, Jan-Erik

Abstract

BACKGROUND: Tasquinimod is a quinoline-3-carboxamide derivative with anti-angiogenic activity. Two open-label phase I clinical trials in patients were conducted to evaluate the safety and tolerability of tasquinimod, with additional pharmacokinetic and efficacy assessments. METHODS: Patients with castration-resistant prostate cancer with no previous chemotherapy were enrolled in this study. The patients received tasquinimod up to 1 year either at fixed doses of 0.5 or 1.0 mg per day or at an initial dose of 0.25 mg per day that escalated to 1.0 mg per day. RESULTS: A total of 32 patients were enrolled; 21 patients were maintained for >or=4 months. The maximum tolerated dose was determined to be 0.5 mg per day; but when using stepwise intra-patient dose escalation, a dose of 1.0 mg per day was well tolerated. The dose-limiting toxicity was sinus tachycardia and asymptomatic elevation in amylase. Common treatment-emergent adverse events included transient laboratory abnormalities, anaemia, nausea, fatigue, myalgia and pain. A serum prostate-specific antigen (PSA) decline of >or=50% was noted in two patients. The median time to PSA progression (>25%) was 19 weeks. Only 3 out of 15 patients (median time on study: 34 weeks) developed new bone lesions. CONCLUSION: Long-term continuous oral administration of tasquinimod seems to be safe, and the overall efficacy results indicate that tasquinimod might delay disease progression.

Published
2009
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46. Geographical variation in incidence of prostate cancer in Sweden : Survey from the National Prostate Cancer Register

Author

Stattin, P., Johansson, R., Lodnert, R., Andren, O., Bill-Axelsson, A., Bratt, O., Damber, J.-E., Hellstrom, M., Hugosson, J., Lundgren, R., Tornblom, M., Varenhorst, Eberhard, Johansson, J.-E., Stattin, P., Johansson, R., Lodnert, R., Andren, O., Bill-Axelsson, A., Bratt, O., Damber, J.-E., Hellstrom, M., Hugosson, J., Lundgren, R., Tornblom, M., Varenhorst, Eberhard, and Johansson, J.-E.

Abstract

Objective. To investigate the geographical variation in prostate cancer incidence in Sweden, in particular the incidences of screening-detected tumours and curative treatment of prostate cancer. Material and methods. Data were retrieved from the National Prostate Cancer Register of Sweden for all cases of prostate cancer diagnosed in the year 2000-01. There were a total of 14376 cases of prostate cancer and the mean total annual age-adjusted incidence was 197/100000 men. There were 3318 cases in tumour category T1c, i.e. non-palpable tumours diagnosed during work-up for an elevated serum level of prostate-specific antigen, 1006 of which (30%) were asymptomatic and detected at a health check-up. Results. The difference between the counties with the lowest and highest age-adjusted incidences per 1OO 000 men of total prostate cancer was almost twofold (128 vs 217). The corresponding variation in incidence of category Tie tumours was more than fourfold (13 vs 60), the difference in incidence of Tie tumours detected in asymptomatic men was up to 10-fold (2 vs 20), and there was more than a fourfold variation in incidence of curative treatment between counties (13 vs 67). Measured incidences were mostly highest in urban regions and in counties with university hospitals. Conclusion. There are large geographical variations in prostate cancer incidence and in the frequency of curative treatment for prostate cancer in Sweden and there appear to be large geographical variations in the uptake of prostate cancer screening. © 2005 Taylor & Francis.

Published
2005
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49. 1050 NATION-WIDE POPULATION-BASED STUDY ON 15-YEAR MORTALITY IN PROSTATE CANCER ACCORDING TO RISK CATEGORIES IN THE NATIONAL PROSTATE CANCER REGISTER (NPCR) OF SWEDEN

Author

Stattin, P., primary, Sandin, F., additional, Ahlgren, G., additional, Bratt, O., additional, Damber, J.E., additional, Hugosson, J., additional, Pettersson, B., additional, Robinson, D., additional, Törnblom, M., additional, Karlsson, S., additional, Andrén, O., additional, Bill-Axelson, A., additional, Widmark, A., additional, Egevad, L., additional, Ehrnström, R., additional, Adolfsson, J., additional, Lambe, M., additional, and Johansson, J.E., additional

Published
2011
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