A 10-year analysis of metastatic prostate cancer as an initial presentation in an underserved population
Objective To analyze patients from an underserved area who presented initially with metastatic prostate cancer in order to identify patients in our population who would suffer greatly if PSA screening was eliminated. Materials and Methods A prospectively maintained androgen deprivation therapy d...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Sociedade Brasileira de Urologia
2014-06-01
|
Series: | International Brazilian Journal of Urology |
Subjects: | |
Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382014000300316&lng=en&tlng=en |
id |
doaj-5f60db010a6943de910e6dfb74129ab8 |
---|---|
record_format |
Article |
spelling |
doaj-5f60db010a6943de910e6dfb74129ab82020-11-24T23:15:49ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192014-06-0140331632110.1590/S1677-5538.IBJU.2014.03.04S1677-55382014000300316A 10-year analysis of metastatic prostate cancer as an initial presentation in an underserved populationAndrew G. WinerJohn P. SfakianosLlewellyn M. HyacintheBrian K. McNeilObjective To analyze patients from an underserved area who presented initially with metastatic prostate cancer in order to identify patients in our population who would suffer greatly if PSA screening was eliminated. Materials and Methods A prospectively maintained androgen deprivation therapy database from an inner city municipal hospital was queried to identify patients who presented with metastatic prostate cancer. We identified 129 individuals from 1999 to 2009 eligible for study. Those who underwent previous treatment for prostate cancer were excluded. We examined metastatic distribution and analyzed survival using Kaplan Meier probability curves. Results The median age of presentation was 68 with a median Gleason sum of 8 per prostate biopsy. Thirty-two patients presented with hydronephrosis with a median creatinine of 1.79, two of whom required emergent dialysis. Of those patients who underwent radiographic imaging at presentation, 35.5% (33/93) had lymphadenopathy suspicious for metastasis, 16.1% (15/93) had masses suspicious for visceral metastases. Of the patients who underwent a bone scan 93% (118/127) had positive findings with 7.9% (10/127) exhibiting signs of cord compression. The 2 and 5- year cancer specific survival was 92.1% and 65.6%, respectively. Conclusions In this study we have highlighted a group of men in an underserved community who presented with aggressive and morbid PCa despite widespread acceptance of PSA screening.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382014000300316&lng=en&tlng=enProstatic NeoplasmsProstate-Specific AntigenMass ScreeningMedically Underserved Area |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Andrew G. Winer John P. Sfakianos Llewellyn M. Hyacinthe Brian K. McNeil |
spellingShingle |
Andrew G. Winer John P. Sfakianos Llewellyn M. Hyacinthe Brian K. McNeil A 10-year analysis of metastatic prostate cancer as an initial presentation in an underserved population International Brazilian Journal of Urology Prostatic Neoplasms Prostate-Specific Antigen Mass Screening Medically Underserved Area |
author_facet |
Andrew G. Winer John P. Sfakianos Llewellyn M. Hyacinthe Brian K. McNeil |
author_sort |
Andrew G. Winer |
title |
A 10-year analysis of metastatic prostate cancer as an initial presentation in an underserved population |
title_short |
A 10-year analysis of metastatic prostate cancer as an initial presentation in an underserved population |
title_full |
A 10-year analysis of metastatic prostate cancer as an initial presentation in an underserved population |
title_fullStr |
A 10-year analysis of metastatic prostate cancer as an initial presentation in an underserved population |
title_full_unstemmed |
A 10-year analysis of metastatic prostate cancer as an initial presentation in an underserved population |
title_sort |
10-year analysis of metastatic prostate cancer as an initial presentation in an underserved population |
publisher |
Sociedade Brasileira de Urologia |
series |
International Brazilian Journal of Urology |
issn |
1677-6119 |
publishDate |
2014-06-01 |
description |
Objective To analyze patients from an underserved area who presented initially with metastatic prostate cancer in order to identify patients in our population who would suffer greatly if PSA screening was eliminated. Materials and Methods A prospectively maintained androgen deprivation therapy database from an inner city municipal hospital was queried to identify patients who presented with metastatic prostate cancer. We identified 129 individuals from 1999 to 2009 eligible for study. Those who underwent previous treatment for prostate cancer were excluded. We examined metastatic distribution and analyzed survival using Kaplan Meier probability curves. Results The median age of presentation was 68 with a median Gleason sum of 8 per prostate biopsy. Thirty-two patients presented with hydronephrosis with a median creatinine of 1.79, two of whom required emergent dialysis. Of those patients who underwent radiographic imaging at presentation, 35.5% (33/93) had lymphadenopathy suspicious for metastasis, 16.1% (15/93) had masses suspicious for visceral metastases. Of the patients who underwent a bone scan 93% (118/127) had positive findings with 7.9% (10/127) exhibiting signs of cord compression. The 2 and 5- year cancer specific survival was 92.1% and 65.6%, respectively. Conclusions In this study we have highlighted a group of men in an underserved community who presented with aggressive and morbid PCa despite widespread acceptance of PSA screening. |
topic |
Prostatic Neoplasms Prostate-Specific Antigen Mass Screening Medically Underserved Area |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382014000300316&lng=en&tlng=en |
work_keys_str_mv |
AT andrewgwiner a10yearanalysisofmetastaticprostatecancerasaninitialpresentationinanunderservedpopulation AT johnpsfakianos a10yearanalysisofmetastaticprostatecancerasaninitialpresentationinanunderservedpopulation AT llewellynmhyacinthe a10yearanalysisofmetastaticprostatecancerasaninitialpresentationinanunderservedpopulation AT briankmcneil a10yearanalysisofmetastaticprostatecancerasaninitialpresentationinanunderservedpopulation AT andrewgwiner 10yearanalysisofmetastaticprostatecancerasaninitialpresentationinanunderservedpopulation AT johnpsfakianos 10yearanalysisofmetastaticprostatecancerasaninitialpresentationinanunderservedpopulation AT llewellynmhyacinthe 10yearanalysisofmetastaticprostatecancerasaninitialpresentationinanunderservedpopulation AT briankmcneil 10yearanalysisofmetastaticprostatecancerasaninitialpresentationinanunderservedpopulation |
_version_ |
1725589447398916096 |