Journals / Yeni Üroloji Dergisi / 2020 / Cilt: 15 - Sayı: 3

Palliative Care Decision in Aging Male With Prostate Cancer

Prostat Kanserli Yaşlanan Erkekte Palyatif Bakım Kararı

Pages
164–170
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In terms of the presence of prostate cancer in a patient, at a cut-off value of age 75, specificity was 77.17%, sensitivity 68.18%, positive predictive value (PPV) 48.28%, negative predictive value (NPV) 88.58%, and accuracy 70.68%; a PSA cut-off point of 20 exhibited sensitivity of 92.13%, specificity of 91.52%, PPV of 80.69%, NPV of 96.79%, and accuracy of 91.68%; and also sensitivity at a percentage of quadrant cut-off value of 0.41, specificity was 75.59%, PPV 52.17%, NPV 88.64%, and accuracy 73.96%.Conclusion: Decision in management should be made by evaluating age and PSA value whether to apply palliative care or curative treatments in the geriatric age group without performing a biopsy.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: The aim of our study is to demonstrate that differentiating patients receiving a palliative approach to prostate cancer from candidates for definitive treatment using age and PSA value at initial presentation.Material and Method: The records of patients diagnosed with prostate cancer in our clinic and external centers and presenting to our clinic for treatment between 2007 and 2012 were examined retrospectively.
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Key Findings & Data:Information was collected concerning patients’ ages at presentation, presentation PSA values, rectal examination findings at time of presentation, prostate volumes, transrectal ultrasonography (TRUS)-guided prostate biopsy results, imaging findings performed for staging purposes in patients with prostate cancer, and pathological specimens in operated patients..Results: Mean age of patients was 70.85±8.40.
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Conclusion & Impact:In terms of the presence of prostate cancer in a patient, at a cut-off value of age 75, specificity was 77.17%, sensitivity 68.18%, positive predictive value (PPV) 48.28%, negative predictive value (NPV) 88.58%, and accuracy 70.68%; a PSA cut-off point of 20 exhibited sensitivity of 92.13%, specificity of 91.52%, PPV of 80.69%, NPV of 96.79%, and accuracy of 91.68%; and also sensitivity at a percentage of quadrant cut-off value of 0.41, specificity was 75.59%, PPV 52.17%, NPV 88.64%, and accuracy 73.96%.Conclusion: Decision in management should be made by evaluating age and PSA value whether to apply palliative care or curative treatments in the geriatric age group without performing a biopsy.
🔬Design:Research Article
📍Scope:2007 Verileri
⚙️Variables:Prostat kanseri · palyatif bakım · metastaz

Abstract

Objective: The aim of our study is to demonstrate that differentiating patients receiving a palliative approach to prostate cancer from candidates for definitive treatment using age and PSA value at initial presentation.Material and Method: The records of patients diagnosed with prostate cancer in our clinic and external centers and presenting to our clinic for treatment between 2007 and 2012 were examined retrospectively. Information was collected concerning patients’ ages at presentation, presentation PSA values, rectal examination findings at time of presentation, prostate volumes, transrectal ultrasonography (TRUS)-guided prostate biopsy results, imaging findings performed for staging purposes in patients with prostate cancer, and pathological specimens in operated patients..Results: Mean age of patients was 70.85±8.40. Mean ages, PSA levels, percentage quadrant rates, and Gleason scores differed significantly depending on presence of metastasis (p<0.01). In terms of the presence of prostate cancer in a patient, at a cut-off value of age 75, specificity was 77.17%, sensitivity 68.18%, positive predictive value (PPV) 48.28%, negative predictive value (NPV) 88.58%, and accuracy 70.68%; a PSA cut-off point of 20 exhibited sensitivity of 92.13%, specificity of 91.52%, PPV of 80.69%, NPV of 96.79%, and accuracy of 91.68%; and also sensitivity at a percentage of quadrant cut-off value of 0.41, specificity was 75.59%, PPV 52.17%, NPV 88.64%, and accuracy 73.96%.Conclusion: Decision in management should be made by evaluating age and PSA value whether to apply palliative care or curative treatments in the geriatric age group without performing a biopsy.

Özet

Amaç: Çalışmamızın amacı, prostat kanserinde hastanın geliş hasta yaşı ve PSA değeri ilepalyatif yaklaşım veya küratif tedavi kararının verilebileceğini göstermektir.Gereç ve Yöntemler: 2007 ve 2012 kliniğimizde prostat kanseri tanısı almış hastalar retrospektif olarak tarandı. Hastaların yaşı, prostat hacimleri, transrektal ultrasonografi eşliğinde prostat biyopsi sonuçları, metastaz taraması için yapılan görüntülemeleri ve radikal prostatektomi yapılan hastaların patoloji sonuçları kaydedildi.Bulgular: Hastaların yaş ortalaması 70.85 ± 8.40 idi. Ortalama yaş, PSA seviyeleri, yüzde kadran oranları ve Gleason skorları metastaz varlığına bağlı olarak anlamlı farklılık gösterdi (p<0.01). Bir hastada prostat kanseri varlığı açısından, 75 yaş kesme değerinde özgüllük % 77,17, duyarlılık % 68,18, pozitif öngörü değeri (PPV) % 48,28, negatif öngörü değeri (NPV) % 88,58 ve doğruluk % 70,68 idi; 20 PSA kesme noktasında duyarlılık % 92,13, özgüllük % 91,52, PPV % 80,69, NPV % 96,79 ve doğruluk % 91,68 idi; 0,41 Çeyreksel kesme değerinde, özgüllük % 75,59, PPV % 52,17, NPV % 88,64 ve duyarlılık % 73,96 idi.Sonuç: Geriatrik yaş grubunda, palyatif bakım veya küratif tedavi kararında hastaların yaş ve PSA değeri değerlendirilerek hasta yönetiminde karar verilmelidir.

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Cite This Article

ÇELEBİ, E. E., SERTKAYA, Z., KUTLUHAN, M. A., KABA, S., ÖZTÜRK, M., KARAMAN, M. İ. (2020). Palliative Care Decision in Aging Male With Prostate Cancer. Yeni Üroloji Dergisi, Cilt: 15 - Sayı: 3, 164–170. https://ajindex.com/articles/337107

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References (2)

  1. Gronberg H. Prostate cancer epidemiology. Lancet. 8;361 (9360):859-64, 2003 2. Sakr WA, Grignon DJ, Crissman JD et al. High grade intraepithelial neoplasia and prostatic adeno carcinoma between the ages of 20-69: an autopsy study of 249 cases. In Vivo. 1994 May-Jun;8(3):439-43. 3. Özen H., Türkeri L. Üroonkoloji Kitabı 1. Baskı 1. Cilt s:594 4. Bill-Axelson A, Holmberg L, Ruutu M, et al. Radical prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med 2011 May;364(18):1708-17. 5. Pilepich MV, Winter K, Lawton CA, et al. Androgen suppression adjuvant to definitive radiotherapy in prostate carcinoma--long-term results of phase III RTOG 85-31. Int J Radiat Oncol Biol Phys 2005 Apr 1;61(5):1285-90. 6. Roach M, Bae K, Speight J, et al. Short-term neoadjuvant androgen deprivation therapy and externalbeam radiotherapy for locally advanced prostate cancer: long term results of RTOG 8610. J Clin Oncol 2008 Feb;26(4):585-91. 7. D’Amico A, Renshaw AA, Loffredo M, et al. Androgen suppression and radiation vs radiation alone for prostate cancer; a randomized controlled trial. JAMA 2008 Jan;299(3):289-95 8. Ceylan Y, Gunlusoy B, Koskderelioglu A et al. The depressive effects of androgen deprivation therapy in locally advanced or metastatic prostate cancer: a comparative study. Aging Male. 2019 Mar 29:1-7. doi: 10.1080/13685538.2019.1586869. 9. Wagenlehner FM et al Infective complications after prostate biopsy: Outcome of the Global Prevalence Study of Infections in Urology (GPIU) 2010 and 2011, a prospective multinational multicentre prostate biopsy study. Eur Urol. 2013 Mar; 63(3):521-7 10. Axel Heidenreich, Gunnar Aus, Michel Bolla, Steven Joniau, Vsevolod B. Matveev, Hans Peter Schmid, Filliberto Zattoni EAU Guidelines on Prostate Cancer 2010 p11. 11.Boccon-Gibod L, Berttaccini A, Bono AV, et al. Management of locally advanced prostate cancer: a European consensus. Int J Clin Pract. 2003; 57:187-94.12. Boyle P, Dresler C. Preventing the lung cancer epidemic. Ann Oncol. 2005 Oct; 16(10):1565-6. 13. Chan TY, Partin AW, Walsh PC, Epstein JI. Prognostic significance of Gleason score 3+4 versus Gleason score 4+3 tumor at radical prostatectomy. Urology. 2000 Nov 1;56(5):823-7 14. Dinçel C. Uroonkoloji, Prostat kanserinde biyopsi. 1.Baskı.
  2. İzmir, Meta Basım Matbaacılık, 2007, p 45. 15. Epstein JI, Allsbrook WC Jr, Amin MB, Egevad LL. ISUP Grading Committee. The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on