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Wang H.T.,Tianjin Medical University | Wang H.T.,Research Group of Evidence based Clinical Oncology | Wang H.T.,Tianjin Key Laboratory of Cancer Prevention and Therapy | Li B.G.,Tianjin Medical University | And 5 more authors.
Tumor Biology

Liver metastasis fromprostate cancer is uncommon and remains poorly understood. We computer searched the clinical records of all our patients registered into a database to identify patients that presented or developed liver metastases. A total of 27 prostate cancer patients with ultrasound or CT/MRimaging evidence of livermetastases were included in our analysis. The liver metastasis rate from metastatic prostate cancer was 4.29 %. Eight (29.63 %) patients had previously untreated, hormone-naive prostate cancer (synchronous liver metastases at diagnosis of prostate cancer), whereas 19 (70.37 %) patients had already been diagnosed as having hormone-refractory prostate cancer. In the hormone-naive group, the median overall survival after liver metastases diagnosis was 38 months and half of the patients were still alive at the latest follow-up, whereas only 6 months in the hormonerefractory group (p =0.003). High concentration of serum neuron-specific enolase and previous chemotherapy were associated with a significantly poor overall survival after liver metastases in the hormone-refractory group using Kaplan-Meier curves and logrank tests for univariate analysis. Source

Wang H.,Tianjin Medical University | Wang H.,Research Group of Evidence based Clinical Oncology | Wang H.,Tianjin Key Laboratory of Cancer Prevention and Therapy | Yao Y.,Tianjin Medical University | And 3 more authors.
Diagnostic Pathology

Background: Prostate cancer patients with rectal involvement are rare, and the factors associated with the survival of these patients are yet to be elucidated.Patients and methods: We collected data on patients who were admitted to our hospital for prostate cancer in the last thirteen years and of those in studies in the literature. The associations of clinical characteristics with survival were evaluated using Cox regression models.Results: This study included 94 patients (5 admitted to our hospital and 89 from studies in the literature) of prostate cancer with rectal involvement. 11 patients in the group of synchronous rectal involvement at first cancer diagnosis (n = 58) and 23 patients in the group of metachronous diagnosis of rectal involvement (n = 29) died at the latest follow up. The estimated overall survival rate (% ± SE) at 1, 3, and 5 years were 68.3 ± 5.3%, 54.4 ± 7.2%, and 38.1 ± 11.1%, respectively. In the Cox univariate analysis, Asian prostate cancer (p = 0.001) was associated with better survival, while rectal bleeding (p = 0.043), metachronous presentation of development of rectal involvement (p = 0.000), prior hormonal therapy (p = 0.000) and extrarectal metastases (p = 0.054) were associated with poor survival. In multivariate analysis, prior hormone therapy (HR = 14.540, p = 0.000) and rectal bleeding (HR = 2.195, p = 0.041) retained independent poor prognostic values. There were 13 patients survived for more than 3 years, the longest survival time was 96 months. Total pelvic extenteration (TPE) combined with hormonal therapy in 12 hormone-untreated prostate cancer give us six of thirteen long-term survivors for more than 3 years in this series.Conclusions: Our findings suggest that rectal involvement does not necessarily predict a worse outcome when presenting as a previously hormone-untreated disease and that the prognosis was worse when presenting as a hormone relapsed disease. Prior hormone therapy and rectal bleeding were associated independently with a significantly poor overall survival in prostate cancer patients with rectal involvement. TPE combined with hormonal therapy appears to confer better overall survival in hormonally untreated patients.Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1604504118106105. © 2014 Wang et al.; licensee BioMed Central Ltd. Source

Zhang J.,Tianjin Medical University | Zhang J.,Research Group of Evidence based Clinical Oncology | Zhang J.,Tianjin Key Laboratory of Cancer Prevention and Therapy | Yao Y.-H.,Tianjin Medical University | And 8 more authors.
Scientific Reports

Although most studies have reported that high serum lactate dehydrogenase (LDH) levels are associated with poor prognosis in several malignancies, the consistency and magnitude of the impact of LDH are unclear. We conducted the first comprehensive meta-analysis of the prognostic relevance of LDH in solid tumors. Overall survival (OS) was the primary outcome; progression-free survival (PFS) and disease-free survival (DFS) were secondary outcomes. We identified a total of 68 eligible studies that included 31,857 patients. High LDH was associated with a HR for OS of 1.48 (95% CI = 1.43 to 1.53; P < 0.00001; I 2 = 93%), an effect observed in all disease subgroups, sites, stages and cutoff of LDH. HRs for PFS and DFS were 1.70 (95% CI = 1.44 to 2.01; P < 0.00001; I 2 = 13%) and 1.86(95% CI = 1.15 to 3.01; P = 0.01; I 2 = 88%), respectively. Analysis of LDH as a continuous variable showed poorer OS with increasing LDH (HR 2.11; 95% CI = 1.35 to 3.28). Sensitivity analyses showed there was no association between LDH cutoff and reported HR for OS. High LDH is associated with an adverse prognosis in many solid tumors and its additional prognostic and predictive value for clinical decision-making warrants further investigation. Source

Wang H.T.,Tianjin Medical University | Wang H.T.,Research Group of Evidence based Clinical Oncology | Wang H.T.,Tianjin Key Laboratory of Cancer Prevention and Therapy | Yao Y.H.,Tianjin Medical University | And 10 more authors.
Journal of Clinical Oncology

Purpose An often under-recognized late manifestation of prostate adenocarcinoma (PCa) is the development of treatment-related neuroendocrine prostate cancer (NEPC). The aim of this study is to identify the risk factors related to survival after NEPC diagnosis (NEPCS) and time from initial diagnosis of PCa to development of NEPC (TTNEPC). Patients and Methods A literature search on NEPC was performed using databases such as MEDLINE and EMBASE. Studies were eligible if outcomes data (NEPCS and/or TTNEPC) were reported in patients with a prior history of PCa and histopathologically confirmed NEPC. NEPCS and TTNEPC were evaluated using the Cox regression model with the robust sandwich estimates of the covariance matrix. Results There were 54 eligible publications, contributing 123 patients. The median TTNEPC was 20 months. In multivariable analyses, the Gleason score was significantly associated with shorter TTNEPC (hazard ratio [HR], 1.66; P = .032). The median NEPCS was 7 months. In multivariable analyses, the number of organs with metastatic disease at NEPC was significantly associated with shorter NEPCS (HR, 3.31; P = .001). Type of treatment after NEPC was significantly associated with longer NEPCS, with HRs of 0.66 (radiotherapy v palliative therapy; P = .034), 0.38 (chemotherapy v palliative therapy; P = .018), and 0.29 (chemoradiotherapy v palliative therapy; P = .012), respectively. Conclusion Treatment-related NEPC is an often under-recognized late manifestation of PCa with poor prognosis. Our study found that Gleason score was the only independent factor contributing to TTNEPC. Once NEPC is diagnosed, type of treatment and the number of organs with metastatic disease were the most important factors related to survival. © 2014, American Society for Microbiology. All Rights Reserved. Source

Yao Y.,Tianjin Medical University | Yao Y.,Research Group of Evidence based Clinical Oncology | Yao Y.,Tianjin Key Laboratory of Cancer Prevention and Therapy | Wang H.,Tianjin Medical University | And 8 more authors.
Tumor Biology

The diagnostic value of TMPRSS2:ERG detection in patients with prostate cancer is controversial. We performed a meta-analysis to consolidate current evidence regarding the use of TMPRSS2:ERG detection assays to diagnose prostate cancers. PubMed, Web of knowledge and other databases were searched for relevant original articles published until July 30, 2013. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Studies that investigated the presence of TMPRSS2:ERG in the body fluid, needle biopsy and prostatectomy tissue of patients with prostate cancer were identified and reviewed. Sensitivities, specificities, and positive likelihood ratios (LR+) and negative likelihood ratios (LR-) of TMPRSS2:ERG detection in individual studies were calculated and meta-analyzed by random effects model. Thirty-two studies met the inclusion criteria for the meta-analysis. Overall sensitivity of TMPRSS2:ERG detection assays was 47.4 % (95 % CI, 45.5-49.3 %); specificity, LR+, and LR- was 92.6 % (95 % CI, 91.5-93.7 %), 8.94 (95 % CI, 5.65-14.13) and 0.49 (95 % CI, 0.43-0.55). The pooled sensitivity and specificity in the body fluid subgroup was 44.7 % (95 % CI, 41.5-47.9 %) and 85.8 % (95 % CI, 83.5-87.8 %), respectively. The pooled sensitivity and specificity based on the reverse transcripts PCR was 49.0 % (95 % CI, 45.9-52.1 %) and 90.2 % (95 % CI, 88.2-92.0 %), respectively. TMPRSS2:ERG may not be used as first-line screening test. However, due to the high specificity, TMPRSS2: ERG detection maybe can serve as a quick and noninvasive method for confirming prostate cancer diagnosis. © 2013 International Society of Oncology and BioMarkers (ISOBM). Source

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