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POS-03.76: Bone mineral density in men undergoing prostate biopsy
UNMODERATED POSTER SESSIONS
Abstract Withdrawn POS-03.76 Bone mineral density in men undergoing prostate biopsy Leoca´dio DE, Mandalapu S, Stein BS Department of Urology, Rhode Island Hospital/Brown Medical School, Providence, RI, USA Introduction: This study was undertaken in order to determine whether bone mineral density (BMD) is lower in men at the time of diagnosis with prostate cancer (CAP) vs. age matched men without a biopsy revealing cancer, while controlling for testosterone level. Methods: Dual energy x-ray absorptiometry (DEXA) scans of the femoral neck and serum osteocalcin levels were used to quantify bone turnover in 58 patients at the time of initial prostate biopsy. Total serum testosterone levels were also obtained. BMD and serum assays of patients diagnosed with cancer (n ⫽ 31) were compared to those whose diagnosis was benign (n ⫽ 27). Results: No significant difference was found between the Cancer and No-Cancer groups in terms of mean BMD T-score (-1.04 ⫾ 1.08 and -1.07 ⫾ 1.08, respectively; p ⫽ 0.91); however, the mean of both groups was in the osteopenic range. No statistically significant differences were found between the Cancer and No-Cancer groups when comparing mean testosterone levels (396 ⫾ 139 and 407 ⫾ 166 ng/dl, respectively; p ⫽ 0.99) alone, nor when testosterone was compared across BMD diagnoses for the Cancer (p ⫽ 0.88) and No Cancer (p ⫽ 0.67) groups. Mean ages for the Cancer and No-Cancer groups were 64.0 ⫾ 1.6 and 62.4 ⫾ 1.4 years, respectively (p ⫽ 0.462). Conclusions: When controlling for age and testosterone levels, there was no difference in BMD in patients with or without CAP. Both groups, however, had average BMD levels in the osteopenic range (T-score ⫽ -1.04). POS-03.77 Correlation between the international prostate symptom score, prostate specific antigen, and quality of life findings in a screening population Leoca´dio DE, Stein BS, Schwartz M Department of Urology, Rhode Island Hospital/Brown Medical School, Providence, RI, USA Introduction: We studied the prevalence of lower urinary tract symptoms (LUTS) and the relationship between the Interna-
296
tional Prostate Symptom Score (IPSS), prostate specific antigen (PSA), and quality of life (QOL) issues in a prostate cancer screening population. Methods: Between 1994 and 2001, free prostate cancer screening was offered to the general population in conjunction with prostate cancer awareness week. Of the 2,677 patient visits, 1023 represented men at their initial presentation at our center. Sixty-two subjects were excluded due to having been previously screened elsewhere or who had incomplete data leaving a total of 961 patient presentations in our study group. The IPSS/QOL questionnaire was completed and the results analyzed along with obtained PSA levels. Results: Of the 961 men, 645 (67%) men had mild or no symptoms (IPSS ⫽ 0-7), 260 (27%) men had moderate symptoms (IPSS ⫽ 8-19), and 56 (6%) men had severe symptoms (IPSS ⫽ 20-35) at their initial presentation. PSA levels in the mild, moderate, and severe symptom groups were 1.6 ⫾ 1.8 ng/ml, 1.9 ⫾ 2.2 ng/ml, and 3.3 ⫾ 6.8 ng/ml, respectively. There was a statistically significant difference in PSA between the mild and severe symptom groups (p ⬍ 0.0001), and also between the moderate and severe symptom groups (p ⬍ 0.0001). The differences in QOL scores for the mild, moderate, and severe symptom categories were statistically significant (p ⬍ 0. 0001), and there was a linear correlation (r ⫽ 0.6978) between the QOL and the IPSS. Conclusions: A strong correlation between the IPSS, QOL, and PSA scores exists in the screening population. One third of men undergoing screening had moderate to severe LUTS at their initial presentation. QOL was significantly correlated with IPSS and PSA levels. POS-03.78 Usefulness of magnetic resonance imaging (MRI) screening for the patients with gray-zone prostatespecific antigen levels Ishizuka O, Ogawa T, Tanabe T, Kinebuchi Y, Kawakami M, Igawa Y, Nishizawa O Shinshu University School of Medicine, Matsumoto, Japan Introduction: In Japan, community-based PSA (Prostate Specific Antigen) screening has become popular and the recent trend is to sample a larger number of cores at systematic biopsy, which may result in an increase in the detection of small cancer foci, including insignificant or indolent tumours. Therefore, it is becoming more
important to select clinically meaningful candidates for prostate biopsies. Even though very small cancer foci are not detected by magnetic resonance imaging (MRI), such small foci might be clinically meaningless. So, we studied the change of PSA level, and the characters of prostate cancers which were found during the follow up, in the patients who were not suspected prostate cancers by first MRI screening (Signa Infinity Excite 1.5, GE Yokokawa Ltd.). Methods: Without prostate biopsies, prostate MRI screenings were performed in 132 patients (average 66.5 years old) with gray-zone PSA levels (av. 6.3 ng/ml). All MRI films were diagnosed by expert radiologists. The patients who were not suspected of having cancer by MRI, were followed without prostate biopsies, by PSA every 100 day and occasional MRI, if necessary. Results: Prostate cancer was suspected based on the results of MRI in 37 of 132 patients. Prostate cancers were detected in 15 of 35 biopsies (43%). Prostate cancers were not suspected in 95 of 132 patients. Eighty-eight patients followed without prostate biopsies. After about 100 days (n⫽75, 85%), 200 days (n⫽60, 68%) and 300 days (n⫽44, 50%), their PSA levels were changed from 6.1 to 5.3, 6.0, 6.2. There was not significant increase. During the follow up, the second MRI screening were performed in 24 patients, because of the slight increase of PSA, and the cancers were suspected in 5 patients. They received prostate biopsies, and the cancers were detected in 3 patients. Their clinical stages were early stages; T1cN0M0 (n⫽3), the Gleason sum 5 (n⫽1) and 6 (n⫽2). Conclusion: MRI screening might be one of the useful tools to select good candidates for prostate biopsy, and the patients might be followed-up safely by monitoring PSA level, and by following MRI examination. POS-03.79 Survey of relative frequency of incidental carcinoma of the prostate in patients undergone prostatectomy in Razi hospital in Rasht city, Iran Khosropanah I, Roshani A, Salehi M, Askari S, Mokhtari G, Falahatkar S, Hydari Bateni Z, Khosropanah S Urology Research Center, Razi Hospital, Rasht, Iran Introduction: BPH and prostatic cancer are two major diseases in old men. The incidence of these diseases has increased in recent years as the age of population
UROLOGY 70 (Supplment 3A), September 2007
Abstract Withdrawn POS-03.76 Bone mineral density in men undergoing prostate biopsy Leoca´dio DE, Mandalapu S, Stein BS Department of Urology, Rhode Island Hospital/Brown Medical School, Providence, RI, USA Introduction: This study was undertaken in order to determine whether bone mineral density (BMD) is lower in men at the time of diagnosis with prostate cancer (CAP) vs. age matched men without a biopsy revealing cancer, while controlling for testosterone level. Methods: Dual energy x-ray absorptiometry (DEXA) scans of the femoral neck and serum osteocalcin levels were used to quantify bone turnover in 58 patients at the time of initial prostate biopsy. Total serum testosterone levels were also obtained. BMD and serum assays of patients diagnosed with cancer (n ⫽ 31) were compared to those whose diagnosis was benign (n ⫽ 27). Results: No significant difference was found between the Cancer and No-Cancer groups in terms of mean BMD T-score (-1.04 ⫾ 1.08 and -1.07 ⫾ 1.08, respectively; p ⫽ 0.91); however, the mean of both groups was in the osteopenic range. No statistically significant differences were found between the Cancer and No-Cancer groups when comparing mean testosterone levels (396 ⫾ 139 and 407 ⫾ 166 ng/dl, respectively; p ⫽ 0.99) alone, nor when testosterone was compared across BMD diagnoses for the Cancer (p ⫽ 0.88) and No Cancer (p ⫽ 0.67) groups. Mean ages for the Cancer and No-Cancer groups were 64.0 ⫾ 1.6 and 62.4 ⫾ 1.4 years, respectively (p ⫽ 0.462). Conclusions: When controlling for age and testosterone levels, there was no difference in BMD in patients with or without CAP. Both groups, however, had average BMD levels in the osteopenic range (T-score ⫽ -1.04). POS-03.77 Correlation between the international prostate symptom score, prostate specific antigen, and quality of life findings in a screening population Leoca´dio DE, Stein BS, Schwartz M Department of Urology, Rhode Island Hospital/Brown Medical School, Providence, RI, USA Introduction: We studied the prevalence of lower urinary tract symptoms (LUTS) and the relationship between the Interna-
296
tional Prostate Symptom Score (IPSS), prostate specific antigen (PSA), and quality of life (QOL) issues in a prostate cancer screening population. Methods: Between 1994 and 2001, free prostate cancer screening was offered to the general population in conjunction with prostate cancer awareness week. Of the 2,677 patient visits, 1023 represented men at their initial presentation at our center. Sixty-two subjects were excluded due to having been previously screened elsewhere or who had incomplete data leaving a total of 961 patient presentations in our study group. The IPSS/QOL questionnaire was completed and the results analyzed along with obtained PSA levels. Results: Of the 961 men, 645 (67%) men had mild or no symptoms (IPSS ⫽ 0-7), 260 (27%) men had moderate symptoms (IPSS ⫽ 8-19), and 56 (6%) men had severe symptoms (IPSS ⫽ 20-35) at their initial presentation. PSA levels in the mild, moderate, and severe symptom groups were 1.6 ⫾ 1.8 ng/ml, 1.9 ⫾ 2.2 ng/ml, and 3.3 ⫾ 6.8 ng/ml, respectively. There was a statistically significant difference in PSA between the mild and severe symptom groups (p ⬍ 0.0001), and also between the moderate and severe symptom groups (p ⬍ 0.0001). The differences in QOL scores for the mild, moderate, and severe symptom categories were statistically significant (p ⬍ 0. 0001), and there was a linear correlation (r ⫽ 0.6978) between the QOL and the IPSS. Conclusions: A strong correlation between the IPSS, QOL, and PSA scores exists in the screening population. One third of men undergoing screening had moderate to severe LUTS at their initial presentation. QOL was significantly correlated with IPSS and PSA levels. POS-03.78 Usefulness of magnetic resonance imaging (MRI) screening for the patients with gray-zone prostatespecific antigen levels Ishizuka O, Ogawa T, Tanabe T, Kinebuchi Y, Kawakami M, Igawa Y, Nishizawa O Shinshu University School of Medicine, Matsumoto, Japan Introduction: In Japan, community-based PSA (Prostate Specific Antigen) screening has become popular and the recent trend is to sample a larger number of cores at systematic biopsy, which may result in an increase in the detection of small cancer foci, including insignificant or indolent tumours. Therefore, it is becoming more
important to select clinically meaningful candidates for prostate biopsies. Even though very small cancer foci are not detected by magnetic resonance imaging (MRI), such small foci might be clinically meaningless. So, we studied the change of PSA level, and the characters of prostate cancers which were found during the follow up, in the patients who were not suspected prostate cancers by first MRI screening (Signa Infinity Excite 1.5, GE Yokokawa Ltd.). Methods: Without prostate biopsies, prostate MRI screenings were performed in 132 patients (average 66.5 years old) with gray-zone PSA levels (av. 6.3 ng/ml). All MRI films were diagnosed by expert radiologists. The patients who were not suspected of having cancer by MRI, were followed without prostate biopsies, by PSA every 100 day and occasional MRI, if necessary. Results: Prostate cancer was suspected based on the results of MRI in 37 of 132 patients. Prostate cancers were detected in 15 of 35 biopsies (43%). Prostate cancers were not suspected in 95 of 132 patients. Eighty-eight patients followed without prostate biopsies. After about 100 days (n⫽75, 85%), 200 days (n⫽60, 68%) and 300 days (n⫽44, 50%), their PSA levels were changed from 6.1 to 5.3, 6.0, 6.2. There was not significant increase. During the follow up, the second MRI screening were performed in 24 patients, because of the slight increase of PSA, and the cancers were suspected in 5 patients. They received prostate biopsies, and the cancers were detected in 3 patients. Their clinical stages were early stages; T1cN0M0 (n⫽3), the Gleason sum 5 (n⫽1) and 6 (n⫽2). Conclusion: MRI screening might be one of the useful tools to select good candidates for prostate biopsy, and the patients might be followed-up safely by monitoring PSA level, and by following MRI examination. POS-03.79 Survey of relative frequency of incidental carcinoma of the prostate in patients undergone prostatectomy in Razi hospital in Rasht city, Iran Khosropanah I, Roshani A, Salehi M, Askari S, Mokhtari G, Falahatkar S, Hydari Bateni Z, Khosropanah S Urology Research Center, Razi Hospital, Rasht, Iran Introduction: BPH and prostatic cancer are two major diseases in old men. The incidence of these diseases has increased in recent years as the age of population
UROLOGY 70 (Supplment 3A), September 2007