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397 What impact on prognosis has time from diagnosis to treatment in patients with localized prostate cancer?
397 WHAT IMPACT ON PROGNOSIS TREATMENT IN PATIENTS WITH Graefen University
M., Walz J., Eggert Hospital
HAS TIME LOCALIZED
FROM DIAGNOSIS TO PROSTATE CANCER?
T., Haese A., Chun Y., Huland
Hamburg,
Department
of Urology,
MATERIAL & METHODS: Preoperative data of 795 men treated for localized prostate cancer by RP between l/l992 and 612000 were evaluated including pretreatment PSA, clinical stage and biopsy Gleason score. In addition, time from biopsy to the date of RP was obtained and investigated as a potential prognostic factor. The influence of the time gap between biopsy and surgery was statistically evaluated using a univariate Cox regression analysis; furthermore, a multivariate Cox Model was performed including all preoperative parameters. RESULTS: Mean Follow-up of the patients was 33 months (l-116 months). Sixty-one percent of the patients failed (defined as a PSA level ?O,l ngiml) during that time period. Mean time gap between diagnosis and treatment was 62 days (median 54 days) ranging from 5 to 5 18 days. Univariate Cox regression analysis showed no significant correlation (p=O.O62) of waiting time with recurrence rate. Multivariate Cox regression documented a highly significant association of PSA, clinical stage and biopsy Gleason grade but not for time to treatment (p=O.7). CONCLUSIONS: The time between diagnosis and treatment in the investigated time span seems not to adversely affect outcome in patients treated with RP for localized PCs. S~UALDYSFUNeTlON~DRUGTR~TMENTANDOUT~OMES Friday, 26 March, 12.15-13.45, Hall I/ Blue level
OF TOTAL CANCER
Oberaigner
PSA BEFORE
BIOPSY
W.3, Pelzer A.‘, Klocker
IN MEN
WITH
H.2, Bartsch G.2, Boyle P.‘,
IIstituto Europea di Oncologia, Divisione di Epidemiologia e Biostatistica, Milan, Italy, 2University of Innsbruck, Department of Urology, Innsbruck, Austria, 3University of Innsbruck, Tumour Registry, Innsbruck, Austria
Germany
INTRODUCTION & OBJECTIVES: In many centres patients with prostate cancer have to accept a waiting list for definitive treatment. This time gap between diagnosis and treatment is often a concern to the patients as well as to the therapist. We investigated if a certain time between diagnosis and treatment can influence outcome after radical prostatectomy (RP) for localized prostate cancer (PCs).
I'23
HISTORY PROSTATE
Severi G.l, BergerA.*, Hominger W.2
H.
Hamburg,
398 DIFFERENT BPH AND
INTRODUCTION & OBJECTIVES: To evaluate PSA changes over time in patients with biopsy proven benign prostatic hyperplasia (BPH) and prostate cancer in a population based early prostate cancer detection program. MATERIAL & METHODS: A total of 16321 PSA tests in 4868 men were evaluated. A linear mixed effect model was used to evaluate the PSA changes over time in the BPH- and prostate cancer group. We modelled the logarithm of PSA with time, age at biopsy (centered at 60 years) and group (BPH and prostate cancer) as covariates together with the interaction between time and group. Time was included as categorical variable. RESULTS: At the time of diagnosis PSA values were significantly higher in the prostate cancer compared to the BPH group. Although this difference was still significant in the period 5-9 years before the biopsy (p
The difference between p values < 0.01).
BPH and prostate cancer is statistically
in all time periods (all
CONCLUSIONS: Total PSA in patients subsequently diagnosed with prostate were already higher 5 years before diagnosis compared to BPH patients. The increase of total PSA was statistically higher in the prostate cancer group compared to the BPH group (6%, p
399
cancer annual (10%) of PSA
400 CHANGES THERAPY
IN PEAK SYSTOLIC WITH SILDENAFIL
Mofferdin A.‘, Sighinolfi MCI, A.F.G.*, Bianchi G.l
VELOCITY CITRATE
INDUCED
BY CHRONIC
De Stefani S.l, Micali C.‘, Celia A.‘, Silingardi V.‘, Cicero
‘Universitd di Modena, Department of Urology, Modena, Italy, 2Universit& Clinical Medicine and Applied Biotechnology, Bologna, Italy
di Bologna,
INTRODUCTION & OBJECTIVES: Many urologists adopted sildenafil for the treatment of patients affected by erectile failure of vascular origin. Results are satisfactory and easily reproducible. Real reason of this erectile improvement after long term therapy has not been completely understood although cavernous oxygenation has been supposed to be involved in that mechanism. The enhancement of systolic peak inside cavernous arteries as revealed by our research utilizing Colour Doppler Ultrasound is practically the only detectable change in penile vascular flow that we observed with time. This condition may lead to a better erection. The present study assesses the influence of chronic sildenafil citrate therapy on peak systolic velocity during dynamic phase. MATERIAL & METHODS: 30 patients aged by erectile failure of different aetiology tested (IIEF-5) were casually enrolled in the study Ultrasound during basic and dynamic phases
WITHDRAWN
administration
from 36-65 years (mean 56.1 years) affected with International Index of Erectile Failure and valuated with penile Colour Doppler (5 mg PGEl) before and after chronic self
of Sildenafil Citrate. The dosage suggested was up to 50 mg as required (min
1-max 3 /weekly) for a period of 5 to 20 months (mean 10.3); the treatment has been interrupted 7-15 days before the second ultrasound evaluation. Cut-off values to define sufficient arterial response were a peak flow velocity (PSV) >20 cm/s. Subjective improvement of erectile function has been assessed with International Index of Erectile Failure (IIEF-5).
RESULTS: 22130 patients showed a normal peak systolic and late-diastolic velocity before the treatment; in 8130 patients a border-line arterial flow was weighed up. After chronic therapy with Sildenafil Citrate a global improvement of 12.8% on peak systolic velocity has been proved but it was not any statistical difference between patients with normal pretreatment peak and those with a borderline
one. These results were valuated with a paired-
samples T-test (p=O.OOO). The percent rate of improvement in International Failure (IIEF-5) turned out to be the same as reported in literature.
Index of Erectile
CONCLUSIONS: The concept of “vasomotonal gym” in order to increase the erection in patient suffering from a moderate vascular deficit has been branded by a lot of Authors. Nevertheless the lack of a control group has not allowed the exact mechanism of this improvement to come out. Even if a great deal of features may cause an improvement in erectile function, the increase m peak systolic velocity after chronic therapy with Sildenafil Citrate is the only change that could be clearly demonstrated and has a statistically relevance. European
Urology
Supplements
3 (2004)
No. 2, pp.
102
M., Walz J., Eggert Hospital
HAS TIME LOCALIZED
FROM DIAGNOSIS TO PROSTATE CANCER?
T., Haese A., Chun Y., Huland
Hamburg,
Department
of Urology,
MATERIAL & METHODS: Preoperative data of 795 men treated for localized prostate cancer by RP between l/l992 and 612000 were evaluated including pretreatment PSA, clinical stage and biopsy Gleason score. In addition, time from biopsy to the date of RP was obtained and investigated as a potential prognostic factor. The influence of the time gap between biopsy and surgery was statistically evaluated using a univariate Cox regression analysis; furthermore, a multivariate Cox Model was performed including all preoperative parameters. RESULTS: Mean Follow-up of the patients was 33 months (l-116 months). Sixty-one percent of the patients failed (defined as a PSA level ?O,l ngiml) during that time period. Mean time gap between diagnosis and treatment was 62 days (median 54 days) ranging from 5 to 5 18 days. Univariate Cox regression analysis showed no significant correlation (p=O.O62) of waiting time with recurrence rate. Multivariate Cox regression documented a highly significant association of PSA, clinical stage and biopsy Gleason grade but not for time to treatment (p=O.7). CONCLUSIONS: The time between diagnosis and treatment in the investigated time span seems not to adversely affect outcome in patients treated with RP for localized PCs. S~UALDYSFUNeTlON~DRUGTR~TMENTANDOUT~OMES Friday, 26 March, 12.15-13.45, Hall I/ Blue level
OF TOTAL CANCER
Oberaigner
PSA BEFORE
BIOPSY
W.3, Pelzer A.‘, Klocker
IN MEN
WITH
H.2, Bartsch G.2, Boyle P.‘,
IIstituto Europea di Oncologia, Divisione di Epidemiologia e Biostatistica, Milan, Italy, 2University of Innsbruck, Department of Urology, Innsbruck, Austria, 3University of Innsbruck, Tumour Registry, Innsbruck, Austria
Germany
INTRODUCTION & OBJECTIVES: In many centres patients with prostate cancer have to accept a waiting list for definitive treatment. This time gap between diagnosis and treatment is often a concern to the patients as well as to the therapist. We investigated if a certain time between diagnosis and treatment can influence outcome after radical prostatectomy (RP) for localized prostate cancer (PCs).
I'23
HISTORY PROSTATE
Severi G.l, BergerA.*, Hominger W.2
H.
Hamburg,
398 DIFFERENT BPH AND
INTRODUCTION & OBJECTIVES: To evaluate PSA changes over time in patients with biopsy proven benign prostatic hyperplasia (BPH) and prostate cancer in a population based early prostate cancer detection program. MATERIAL & METHODS: A total of 16321 PSA tests in 4868 men were evaluated. A linear mixed effect model was used to evaluate the PSA changes over time in the BPH- and prostate cancer group. We modelled the logarithm of PSA with time, age at biopsy (centered at 60 years) and group (BPH and prostate cancer) as covariates together with the interaction between time and group. Time was included as categorical variable. RESULTS: At the time of diagnosis PSA values were significantly higher in the prostate cancer compared to the BPH group. Although this difference was still significant in the period 5-9 years before the biopsy (p
The difference between p values < 0.01).
BPH and prostate cancer is statistically
in all time periods (all
CONCLUSIONS: Total PSA in patients subsequently diagnosed with prostate were already higher 5 years before diagnosis compared to BPH patients. The increase of total PSA was statistically higher in the prostate cancer group compared to the BPH group (6%, p
399
cancer annual (10%) of PSA
400 CHANGES THERAPY
IN PEAK SYSTOLIC WITH SILDENAFIL
Mofferdin A.‘, Sighinolfi MCI, A.F.G.*, Bianchi G.l
VELOCITY CITRATE
INDUCED
BY CHRONIC
De Stefani S.l, Micali C.‘, Celia A.‘, Silingardi V.‘, Cicero
‘Universitd di Modena, Department of Urology, Modena, Italy, 2Universit& Clinical Medicine and Applied Biotechnology, Bologna, Italy
di Bologna,
INTRODUCTION & OBJECTIVES: Many urologists adopted sildenafil for the treatment of patients affected by erectile failure of vascular origin. Results are satisfactory and easily reproducible. Real reason of this erectile improvement after long term therapy has not been completely understood although cavernous oxygenation has been supposed to be involved in that mechanism. The enhancement of systolic peak inside cavernous arteries as revealed by our research utilizing Colour Doppler Ultrasound is practically the only detectable change in penile vascular flow that we observed with time. This condition may lead to a better erection. The present study assesses the influence of chronic sildenafil citrate therapy on peak systolic velocity during dynamic phase. MATERIAL & METHODS: 30 patients aged by erectile failure of different aetiology tested (IIEF-5) were casually enrolled in the study Ultrasound during basic and dynamic phases
WITHDRAWN
administration
from 36-65 years (mean 56.1 years) affected with International Index of Erectile Failure and valuated with penile Colour Doppler (5 mg PGEl) before and after chronic self
of Sildenafil Citrate. The dosage suggested was up to 50 mg as required (min
1-max 3 /weekly) for a period of 5 to 20 months (mean 10.3); the treatment has been interrupted 7-15 days before the second ultrasound evaluation. Cut-off values to define sufficient arterial response were a peak flow velocity (PSV) >20 cm/s. Subjective improvement of erectile function has been assessed with International Index of Erectile Failure (IIEF-5).
RESULTS: 22130 patients showed a normal peak systolic and late-diastolic velocity before the treatment; in 8130 patients a border-line arterial flow was weighed up. After chronic therapy with Sildenafil Citrate a global improvement of 12.8% on peak systolic velocity has been proved but it was not any statistical difference between patients with normal pretreatment peak and those with a borderline
one. These results were valuated with a paired-
samples T-test (p=O.OOO). The percent rate of improvement in International Failure (IIEF-5) turned out to be the same as reported in literature.
Index of Erectile
CONCLUSIONS: The concept of “vasomotonal gym” in order to increase the erection in patient suffering from a moderate vascular deficit has been branded by a lot of Authors. Nevertheless the lack of a control group has not allowed the exact mechanism of this improvement to come out. Even if a great deal of features may cause an improvement in erectile function, the increase m peak systolic velocity after chronic therapy with Sildenafil Citrate is the only change that could be clearly demonstrated and has a statistically relevance. European
Urology
Supplements
3 (2004)
No. 2, pp.
102