Materiały źródłowe

• #1 Prognostic Determinants in Prostate Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3240856/

  Clinical outcomes in prostate cancer are heterogeneous and given the high prevalence of the disease, there is a pressing need to identify clinically useful markers of prognosis. […] With a growing understanding of the molecular pathogenesis of prostate cancer, there is the potential that the next generation of makers will prove sufficiently robust to guide the optimal management of men with prostate cancer. […] The high incidence of prostate cancer in Western countries underscores the urgency to develop means to distinguish indolent from potentially lethal prostate cancer and accurately identify at the time of diagnosis men for whom treatment is indicated. […] The search for molecular prognostic determinants is particularly challenging in prostate cancer given the enormous intratumoral genomic and biological heterogeneity in most early stage prostate cancers.

• #2 Prognostic Factors in Prostate Cancer | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-540-40901-4_3

  In the nineteenth century the main goal of medicine was predictive: diagnose the disease and achieve a satisfying prognosis of the patients chances. […] Based on different prognostic factors it should be possible to tell patients how they are expected to do after prostate cancer has been diagnosed and how different treatments may change this outcome. […] Prognostic factors in (prostate) cancer are defined as variables that can account for some of the heterogeneity associated with the expected course and outcome of a disease. […] Prognostic factors are not only essential to understand the natural history and the course of the disease, but also to predict possible different outcomes of different treatments or perhaps no treatment at all. […] This is extremely important in a disease like prostate cancer where there is clear evidence that a substantial number of cases discovered by prostate-specific antigen (PSA) testing are unlikely ever to become clinically significant, not to mention mortal.

• #3 Survival statistics for prostate cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/prostate/prognosis-and-survival/survival-statistics

  Survival statistics for prostate cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular person’s chances of survival. […] In general, most men diagnosed with prostate cancer do not die from the disease itself and will die from other causes. […] In Canada, the 5-year net survival for prostate cancer is 91%. This means that, on average, about 91% of men diagnosed with prostate cancer will live for at least 5 years. […] Survival varies with each stage of prostate cancer. The grade of prostate cancer is also a strong predictor for survival. […] Generally, the earlier prostate cancer is diagnosed and treated, the better the outcome. […] Advanced and recurrent prostate cancers and castration-resistant prostate cancer (prostate cancer that doesn’t respond to hormone therapy or comes back after hormone therapy) can be hard to treat because they do not respond well to some treatments. […] In Canada, survival by stage for prostate cancer is reported as 5-year net survival. […] Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.

• #4 Prostate Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/prostate/hp/prostate-treatment-pdq

  The median age at diagnosis of prostate cancer is 67 years. Prostate cancer may be cured when localized, and it frequently responds to treatment when widespread. The rate of tumor growth varies from very slow to moderately rapid, and some patients may have prolonged survival even after the cancer has metastasized to distant sites, such as bone. The 5-year relative survival rate for men diagnosed in the United States from 2014 to 2020 with local or regional disease was greater than 99%, and the rate for distant disease was 37%; a 97% survival rate was observed for all stages combined. The approach to treatment is influenced by age and coexisting medical problems. Side effects of various forms of treatment should be considered in selecting appropriate management. […] Many patients especially those with localized tumors may die of other illnesses without ever having suffered disability from prostate cancer, even if managed conservatively without an attempt at curative therapy. In part, these favorable outcomes are likely the result of widespread screening with the prostate-specific antigen (PSA) test, which can identify patients with asymptomatic tumors that have little or no lethal potential. The prevalence of clinically indolent tumors is estimated at 30% to 70% in men older than 60 years, based on autopsy series of men dying of causes unrelated to prostate cancer.

• #5 Survival of prostate cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/prostate-cancer/survival

  Survival for prostate cancer is generally good, particularly if you are diagnosed early. […] Almost everyone (almost 100%) will survive their cancer for 5 years or more after they are diagnosed. […] Around 95 out of every 100 men (around 95%) will survive their cancer for 5 years or more after diagnosis. […] Around 50 out of every 100 men (around 50%) will survive their cancer for 5 years or more after they are diagnosed. […] Generally for men with prostate cancer in England: more than 95 out of 100 (more than 95%) will survive their cancer for 1 year or more; around 90 out of 100 (around 90%) will survive their cancer for 5 years or more; almost 80 out of 100 (almost 80%) will survive their cancer for 10 years or more. […] Your outlook depends on the stage of the cancer when it was diagnosed. This means how big it is and whether it has spread.

• #6 Prostate Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/prostate/hp/prostate-treatment-pdq

  The following factors influence the survival of patients with prostate cancer: Extent of tumor, Histological grade of tumor, Patient’s age and health, Prostate-specific antigen (PSA) level. […] When the cancer is confined to the prostate gland, long-term prognosis is excellent. Locally advanced cancer is not usually curable, but 5-year survival is still very good. If prostate cancer has spread to distant organs, current therapy will not cure it. Median survival is usually 1 to 3 years, and most of these patients will die of prostate cancer. Even in this group of patients, indolent clinical courses lasting for many years may be observed. […] Poorly differentiated tumors are more likely to have metastasized before diagnosis and are associated with a poorer prognosis. The most commonly used method to report tumor differentiation is the Gleason score.

• #7 Prognosis and survival for prostate cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/prostate/prognosis-and-survival

  If you have prostate cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis. […] Prostate cancer with a lower stage at diagnosis has a more favourable prognosis. Cancer that hasn’t spread outside of the prostate at the time of diagnosis has a better prognosis than cancer that has spread outside of the prostate. […] The lower the Gleason score the better the prognosis. Prostate cancer with a Gleason score lower than 7 has a more favourable prognosis than prostate cancer with a score of 7 or higher.

• #8 Prognostic Determinants in Prostate Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3240856/

  While clinical validation of markers remains limited, several recent additions to the field show great promise. […] Gleason score is the strongest clinical predictor of prostate cancer progression. […] Men diagnosed with Gleason grade 7 or higher tumors are at increased risk of extraprostatic extension, increased risk of recurrence after initial therapy, and more likely to die of their disease. […] In contrast, men diagnosed with well-differentiated Gleason 6 disease are at very low risk of cancer-specific death. […] The presence of cancer cells invading the space around nerves has been found to be of prognostic relevance in other malignancies and is thought to be a mechanism by which prostate cancer can extend beyond the capsule. […] Beyond individual factors, the combination of clinical and pathological factors represents a more powerful tool to aid in prostate cancer prognostication.

• #9 Prognosis and survival for prostate cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/prostate/prognosis-and-survival

  Some research shows that a higher than normal prostate-specific antigen (PSA) level may indicate a poor prognosis. This is because a high PSA level is linked to a greater risk that prostate cancer will spread. […] PSA doubling time can help doctors find out if a prostate cancer is aggressive, which means it is more likely to grow quickly and spread. Shorter doubling times are linked to a worse prognosis. […] Doctors may classify prostate cancer into groups based on the risk of the cancer coming back (recurring) after treatment. These risk groups are based on the tumour (T), Gleason score and PSA level. The lower the risk group, the lower the risk of prostate cancer recurring after a radical prostatectomy. […] There is some evidence that those who smoke at the time of diagnosis are more likely to have a biochemical recurrence (also called a biochemical failure) and die from prostate cancer than those who don’t smoke.

• #10 Survival of prostate cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/prostate-cancer/survival

  The type of prostate cancer and grade of the cancer also affects your survival. […] Your outlook also depends on your PSA level. A high PSA level may mean your cancer grows more quickly. […] Your general health and fitness also affect survival. The fitter you are, the better you are able to cope with your cancer and treatment. […] 5 year survival is the number of people who have not died from their cancer within 5 years after diagnosis.

• #11 Prostate Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/prostate/hp/prostate-treatment-pdq

  PSA, an organ-specific marker, is often used as a tumor marker. The higher the level of PSA at baseline, the higher the risk of metastatic disease or subsequent disease progression. However, it is an imprecise marker of risk. […] After radical prostatectomy, a detectable PSA level identifies patients at elevated risk of local treatment failure or metastatic disease; however, a substantial proportion of patients with an elevated or rising PSA level after surgery remain clinically free of symptoms for extended periods. […] After radiation therapy with curative intent, persistently elevated or rising PSA may be a prognostic factor for clinical disease recurrence. However, reported case series have used a variety of definitions of PSA failure. […] The optimal follow-up strategy for men treated for prostate cancer is uncertain.

• #12 Web tool gives individual prognosis for prostate cancer patients | CRUK CC

  https://crukcambridgecentre.org.uk/news/web-tool-gives-individual-prognosis-prostate-cancer-patients

  Evidence-based web tool aims to better inform and refine the need for treatment in early prostate cancer. A new web-based tool to predict an individuals prognosis following a prostate cancer diagnosis could help prevent unnecessary treatment and related side effects, say researchers at the University of Cambridge. The online calculator, PREDICT Prostate, launched to coincide with publication in the journal PLOS Medicine of the research that underpins it. It brings together the latest evidence and mathematical models to give a personalised prognosis, which the researchers say will empower patients as they discuss treatment options with their consultant. […] When a patient is diagnosed with prostate cancer, they are currently classified as low, intermediate or high risk. Depending on the patients risk group, clinicians will recommend either an active monitoring approach or treatment.

• #13 Web tool gives individual prognosis for prostate cancer patients | CRUK CC

  https://crukcambridgecentre.org.uk/news/web-tool-gives-individual-prognosis-prostate-cancer-patients

  However, evidence suggests that these classifications, which are in the current guidelines provided by the National Institute for Health and Care Excellence (NICE), are only 60-70% accurate. This means that many men may elect for treatment when it is not necessary. In fact, a recent study carried out in the UK showed that for early prostate cancer (low and intermediate risk), treatment is no more beneficial in terms of ten year survival compared to no treatment. […] PREDICT Prostate takes routinely available information including PSA test results, the cancer grade and stage, the proportion of biopsies with cancerous cells, and details about the patient including his age and other illnesses. It then gives a 10-15 year survival estimate. Importantly, the tool also estimates how his chance of survival differs depending on whether he opts for monitoring or treatment, providing context of the likelihood of success of treatment and risk of side effects.

• #14 Models predicting survival to guide treatment decision-making in newly diagnosed primary non-metastatic prostate cancer: a systematic review | BMJ Open

  https://bmjopen.bmj.com/content/9/6/e029149

  Men diagnosed with non-metastatic prostate cancer require standardised and robust long-term prognostic information to help them decide on management. […] Few long-term prognostic models exist to inform decision-making at diagnosis of non-metastatic prostate cancer. Improved models are required to inform management and avoid undertreatment and overtreatment of non-metastatic prostate cancer. […] Despite finding a number of published prognostic models, there remains a lack of well-validated, unbiased, generalisable models for use at diagnosis. In particular, there was a lack of external validation and dearth of models that compare outcomes between conservative management and radical treatment. […] The most robust tools we found are the three that have been externally validated namely the Cambridge Prognostic Groups, The SEER Cancer Survival Calculator and the UCSF CAPRA score. However, both have significant shortcomings and are limited in their applicability at diagnosis by failing to include treatment effect, and disregarding non-cancer mortality. Work should focus on developing prognostic models built on long-term survival outcomes which maximally utilise available clinico-pathological information and contextualise PCa within a patients context of competing risks. High quality models including treatment effect are overdue, and crucial if both undertreatment and overtreatment of prostate cancer is to be minimised.

• #15 Prognosis and survival for prostate cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/prostate/prognosis-and-survival

  The levels of certain chemicals in the blood can predict a worse prognosis in men with metastatic castrate-resistant prostate cancer. […] These genetic signatures can help doctors make a prognosis. Some genetic signatures are linked to a better prognosis and better response to treatment. Other genetic signatures are associated with a worse prognosis.

• #16 Prognostic Determinants in Prostate Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3240856/

  The predictive utility of these combined clinical sets to risk stratify prostate cancer patients have been evaluated primarily in cohorts of patients following curative therapy, either radiation or prostatectomy. […] The ideal marker would be measurable at diagnosis, would have both high sensitivity and specificity for distinguishing lethal and indolent prostate cancer, be cost-effective, and be reliably measured across observers and institutions. […] The prognostic value of these markers among potentially untreated men is an area with limited testing. […] The processes controlling this capacity to invade and ultimately metastasize are not fully understood but the tumor microenvironment is thought to play a crucial role. […] These four signatures hold promise to improve prognostication among men diagnosed with prostate cancer. […] Further, comparative oncogenomics with functional validation of the drivers of a biologic process have helped to overcome the significant heterogeneity seen in human prostate cancer to provide critical insights into the prognosis of a man following surgery or possibly at the time of diagnosis.

• #17 Prostate Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/prostate/hp/prostate-treatment-pdq

  Prophylactic radiation therapy to clinically or pathologically uninvolved pelvic lymph nodes does not appear to improve OS or prostate cancer-specific survival. […] The addition of chemotherapy has been shown in randomized trials to improve OS compared with ADT alone, with efficacy that appears to be comparable with hormonal therapy, which includes ADT plus abiraterone acetate. However, the two approaches have not been directly compared in a randomized study. […] In the randomized double-blind LATITUDE trial, 1,199 men with high-risk metastatic castration-sensitive prostate cancer were given ADT plus either abiraterone acetate and prednisone or ADT plus abiraterone-prednisone placebos. After a median follow-up of 30.4 months, the trial was stopped because of a clear overall survival benefit in the abiraterone study group: median survival not reached versus 34.7 months OS.

• #18 Prostate Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/prostate/hp/prostate-treatment-pdq

  The phase III EMBARK trial included 1,068 men. Patients had received prior definitive therapy with radical prostatectomy and/or radiation therapy with curative intent, had a rapidly rising PSA, and were not candidates for salvage pelvic-directed therapy. […] The combination of a PARP inhibitor, talazoparib, with enzalutamide was tested in the phase III, double-blind, randomized, multicohort TALAPRO-2 study as first-line therapy in men with mCRPC. […] The PARP inhibitor olaparib was tested in an open-label, phase III, randomized controlled trial in men with mCRPC and variants in one of 15 prespecified homologous recombination repair genes, including BRCA1 or BRCA2.

• #19 Articles | Journal of Translational Medicine

  https://translational-medicine.biomedcentral.com/articles

  An anti-androgen resistance-related gene signature acts as a prognostic marker and increases enzalutamide efficacy via PLK1 inhibition in prostate cancer. […] Anti-androgen resistance remains a major clinical challenge in the treatment of prostate cancer (PCa), leading to disease progression and treatment failure.

• #20 Castration-Resistant Prostate Cancer Outcome Prediction Using Phased Long Short-Term Memory with Irregularly Sampled Serial Data

  https://www.mdpi.com/2076-3417/10/6/2000

  Castration-resistant prostate cancer (CRPC) is a „prostate cancer that keeps growing even when the amount of testosterone in the body is reduced to very low levels.” […] It is important to administer appropriate treatments at the right time. […] A CRPC prediction model can support physicians’ decision-making and will help to identify appropriate treatments for PCa patients. […] In this study, we built a model to predict CPRC-treated patients. From this, we were able to draw the following conclusions. Serial medical data is an important factor in predicting the likely outcome of patients with PCa. […] We built a CRPC prediction model, which can support physicians’ decision making and allows them to review more patients in a short period of time. […] The phased-LSTM deep learning method builds a fast and accurate prediction model using serial medical data. The predictions show high precision recall scores, which means that they are highly accurate. […] Ultimately, this study shows how the state-of-the-art phased-LSTM deep learning method can be used to make meaningful prediction models based on serial medical data. This can help clinicians who want to know their patients’ likely outcomes from irregularly sampled follow up data.

• #21 Dr. Answer AI for prostate cancer: Clinical outcome prediction model and service

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7406030/

  The importance of clinical outcome prediction models using artificial intelligence (AI) is being emphasized owing to the increasing necessity of developing a clinical decision support system (CDSS) employing AI. Therefore, in this study, we proposed a Dr. Answer AI software based on the clinical outcome prediction model for prostate cancer treated with radical prostatectomy. […] The proposed clinical outcome prediction model could function as an effective CDSS, supporting the decisions of the physicians, while enabling the patients to understand their treatment outcomes. The Dr. Answer AI software for prostate cancer helps the doctors to explain the treatment outcomes to the patients, allowing the patients to be more confident about their treatment plans. […] The clinical outcome prediction model could also function as a CDSS, supporting the decisions of doctors and helping the patients in understanding their treatment outcome. Furthermore, the Dr. Answer AI SW for PCa also enabled the doctors to clearly explain the treatment outcomes to patients; thus, allowing patients to have confidence in their treatment plans.

• #22 What Are the Survival Rates for Prostate Cancer? | American Cancer Society

  https://www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/survival-rates.html

  Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. […] Survival rates cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful. […] Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. […] A relative survival rate compares people with the same type and stage of cancer to people in the overall population. […] If the 5-year relative survival rate for a specific stage of prostate cancer is 90%, it means that men who have that cancer are, on average, about 90% as likely as men who dont have that cancer to live for at least 5 years after being diagnosed.

• #23 Development and validation of a nomogram to predict cancer-specific survival in nonsurgically treated elderly patients with prostate cancer | Scientific Reports

  https://www.nature.com/articles/s41598-023-44911-z

  Our results showed that age, race, marriage, PSA, GS, RT mode, chemotherapy and TNM stage are independent risk factors for elderly prostate patients 3 and 8 years. […] Our nomogram shows that TNM stage is also an independent risk factor for CSS in elderly nonsurgical PC patients, and patients with distant as well as lymph node metastases have worse outcomes than nonmetastases and higher T stage, which is consistent with previous studies. […] Our prediction model shows that the level of PSA is also an independent risk factor affecting the CSS of PC. […] Our nomogram showed that chemotherapy is also an independent risk factor for prognosis, and our KM curve analysis revealed that survival was lower in high-risk and low-risk groups than in patients without chemotherapy. […] Our study developed a predictive model for nonsurgically treated elderly PC patients with all data from the SEER database, and we found that age, race, marriage, TNM stage, PSA, GS, RT modality, and chemotherapy were independent risk factors affecting patient CSS.

• #24 Development and validation of a nomogram to predict cancer-specific survival in nonsurgically treated elderly patients with prostate cancer | Scientific Reports

  https://www.nature.com/articles/s41598-023-44911-z

  Prostate Cancer (PC) is the most common male nonskin tumour in the world, and most diagnosed patients are over 65 years old. […] Currently, for nonsurgically treated elderly patients, few studies have evaluated their prognostic factors. […] Univariate and multivariate Cox regression model analyses showed that age, race, marital status, TNM stage, chemotherapy, radiotherapy modality, PSA and GS were independent risk factors for predicting CSS in nonsurgically treated elderly PC patients. […] The C-index of the training set and the validation set was 0.894 (95% CI 0.8880.900) and 0.897 (95% CI 0.8870.907), respectively, indicating the good discrimination ability of the nomogram. […] The nomogram combines various clinicopathological factors, including PSA and GS, to predict cancer-specific survival (CSS) in PC patients, and there are already some nomograms for the prognosis of PC.

• #25 Individual prognosis at diagnosis in nonmetastatic prostate cancer: Development and external validation of the PREDICT Prostate multivariable model | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002758

  Prognostic stratification is the cornerstone of management in nonmetastatic prostate cancer (PCa). […] To address this unmet need, we developed an individualised prognostic model that contextualises PCa-specific mortality (PCSM) against other cause mortality, and estimates the impact of treatment on survival. […] A multivariable model estimating individualised 10- and 15-year survival outcomes was constructed combining age, prostate-specific antigen (PSA), histological grade, biopsy core involvement, stage, and primary treatment, which were each independent prognostic factors for PCSM, and age and comorbidity, which were prognostic for NPCM. […] PREDICT Prostate is an individualised multivariable PCa prognostic model built from baseline diagnostic information and the first to our knowledge that models potential treatment benefits on overall survival.

• #26 Individual prognosis at diagnosis in nonmetastatic prostate cancer: Development and external validation of the PREDICT Prostate multivariable model | PLOS Medicine

  https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002758

  The model demonstrated good discrimination, with a C-index of 0.84 (95% CI: 0.82-0.86) and 0.84 (95% CI: 0.80-0.87) for 15-year PCSM in the UK and Singapore validation cohorts, respectively, comparing favourably to international risk-stratification criteria. […] The model has the potential to enable well-informed and standardised decision-making and reduce both over- and undertreatment.

• #27 What Are the Survival Rates for Prostate Cancer? | American Cancer Society

  https://www.cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/survival-rates.html

  The SEER database tracks 5-year relative survival rates for prostate cancer in the United States, based on how far the cancer has spread. […] These numbers apply only to the stage of the cancer when it is first diagnosed. They do not apply later on if the cancer grows, spreads, or comes back after treatment. […] These numbers dont take everything into account. Survival rates are grouped based on how far the cancer has spread, but your age and overall health; test results, such as the PSA level and Grade Group of the cancer; how well the cancer responds to treatment; and other factors can also affect your outlook. […] Men now being diagnosed with prostate cancer may have a better outlook than these numbers show. Treatments for prostate cancer have improved over time, and these numbers are based on men who were diagnosed and treated at least 5 years earlier.

Zobacz więcej