The Experts below are selected from a list of 315 Experts worldwide ranked by ideXlab platform
Stephen J. Freedland - One of the best experts on this subject based on the ideXlab platform.
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Obesity and Prostate enlargement in men with localized Prostate cancer.
BJU international, 2011Co-Authors: Ryan Kopp, Misop Han, Stephen J. Freedland, Alan W. Partin, Elizabeth B. Humphreys, J. Kellogg ParsonsAbstract:Study Type – Prevalence (retrospective cohort) Level of Evidence 2b What’s known on the subject? and What does the study add? Obesity is associated with Prostate enlargement in men without Prostate cancer. This study demonstrates an association between obesity and Prostate enlargement in men with Prostate cancer, and leads to possible implications for Prostate cancer screening and diagnosis. OBJECTIVE • To determine if obesity is associated with Prostate size in men with Prostate cancer. PATIENTS AND METHODS • We examined preoperative body mass index (BMI) and whole Prostate Weight in a cohort of 16 325 patients undergoing radical Prostatectomy for localized Prostate cancer from 1975 to 2008 at a single institution. • We used multivariable regression modelling adjusting for age, year of surgery, preoperative serum Prostate-specific antigen (PSA), pathological stage and Gleason grade. RESULTS • Of the entire cohort, 13 343 (82%) patients had a Prostate Weight of at least 40 g. These men were older (P < 0.001), had a higher preoperative BMI (P < 0.002), higher preoperative PSA (P < 0.001), and were more likely to have pT2 disease (P < 0.001). • In multivariable regression, preoperative BMI was associated with increased Prostate Weight: for each 1 kg/m2 increase in BMI, Prostate Weight increased by 0.45 g (95% CI 0.35–0.55, P-trend < 0.001). • Compared with men with BMI < 25 kg/m2, men with a BMI ≥35 kg/m2 had a 40% (odds ratio 1.40, 95% CI 1.01–1.95) increased risk of Prostate Weight of at least 40 g and a 70% (odds ratio 1.70, 95% CI 1.32–2.20) increased risk of Prostate Weight of at least 50 g. CONCLUSIONS • In men with localized Prostate cancer, obesity is associated with an increased risk of Prostate enlargement. • These data validate other observations linking obesity with Prostate enlargement and may have important ramifications for Prostate cancer diagnosis in obese men.
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Race and Prostate Weight as independent predictors for biochemical recurrence after radical Prostatectomy.
Prostate cancer and prostatic diseases, 2008Co-Authors: Florian R. Schroeck, Leon Sun, Stephen J. Freedland, Jayakrishnan Jayachandran, Cary N. Robertson, Judd W. MoulAbstract:We hypothesized that factors beyond pathological stage, grade, PSA and margin status would be important predictors of biochemical recurrence (BCR) after radical Prostatectomy (RP). A cohort of 3194 patients who underwent RP between 1988 and 2007 and who had neither neoadjuvant therapy nor postoperative adjuvant hormonal therapy was retrieved from the Duke Prostate Center database. Age, Prostate-specific antigen (PSA), pathological Gleason score (pG), lymph node status, seminal vesicle invasion (SVI), extracapsular extension (ECE), positive surgical margin (PSM) status, year of surgery, race, adjuvant radiation therapy (XRT), percent tumor involvement in the RP specimen and Prostate Weight were evaluated as possible predictors of BCR in multivariate Cox regression analysis. BCR was defined as a PSA of 0.2 ng ml(-1) or higher at least 30 days after surgery. A nomogram was developed from the Cox model. Predictive accuracy was obtained by calculating bias-corrected Harrell's c and by bootstrap calibration. In multivariate analysis, PSA (hazard ratio 1.39 (95% confidence interval 1.29-1.51)), ECE (1.22 (1.04-1.44)), pG score (1.38 (1.14-1.68), 2.23 (1.76-2.84), 2.69 (2.12-3.40) for pG 3+4, 4+3, >7, respectively), SVI (1.72 (1.40-2.12)), PSM (2.05 (1.73-2.42)), year of surgery (0.65 (0.54-0.77)), African-American race (1.37 (1.13-1.66)), adjuvant XRT (0.19 (0.11-0.34)) and Prostate Weight (0.83 (0.76-0.92)) were identified as independent predictors of BCR (P< or =0.018 for all factors). Predictive accuracy of the nomogram was 0.75. Race and Prostate Weight were independent predictors for BCR after RP. By incorporating these variables, we developed a nomogram, which provides a highly accurate means for estimating risk of BCR after RP.
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body mass index Prostate Weight and transrectal ultrasound Prostate volume accuracy
The Journal of Urology, 2007Co-Authors: Kamran P Sajadi, Joseph C. Presti, Martha K Terris, William J Aronson, Christopher L Amling, Christopher J Kane, Robert J Hamilton, Jennifer Cullen, Stephen J. FreedlandAbstract:Purpose: Transrectal ultrasound can be used to calculate Prostate volume, which has implications for benign and malignant Prostate disease. We hypothesized that obesity may represent a technical challenge when performing transrectal ultrasound that decreases the accuracy of estimating Prostate volume.Materials and Methods: We examined the records of men with previously untreated Prostate cancer who underwent radical Prostatectomy between 1995 and 2006 and who were in the Shared-Equal Access Regional Cancer Hospital database. Transrectal ultrasound volume calculations were correlated with radical Prostatectomy specimen Weight using the Spearman coefficient. We calculated the percent and absolute error, and evaluated the relationship between them and transrectal ultrasound volume, body mass index, age, Prostate specific antigen and race using multivariate linear regression.Results: A total of 497 patients with preoperative transrectal ultrasound volume, specimen Weight and body mass index data were identifi...
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obesity serum Prostate specific antigen and Prostate size implications for Prostate cancer detection
The Journal of Urology, 2006Co-Authors: Stephen J. Freedland, Joseph C. Presti, Elizabeth A Platz, William J Aronson, Christopher L Amling, Christopher J Kane, Martha K TerrisAbstract:Purpose: Obesity has been associated with lower serum testosterone, theoretically resulting in decreased PSA production. Obesity has also been associated with prostatic enlargement, making the detection of existent cancer more difficult. Together these findings would result in an apparent protective effect of obesity on Prostate cancer risk due to technical detection issues unrelated to cancer biology. We examined the association between BMI, and PSA and Prostate Weight in a cohort of men undergoing RP.Materials and Methods: We evaluated the association of BMI with Prostate Weight and PSA using linear regression, adjusting for patient age at RP, year of RP, race, and pathological stage and grade in 1,414 men treated with RP between 1988 and 2004 at the 5 equal access medical centers that comprise the Shared Equal Access Regional Cancer Hospital Database.Results: On multivariate analysis increasing BMI was associated with increasing Prostate Weight but only in men younger than 63 years and not in men 63 ye...
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Prostate size and risk of high grade advanced Prostate cancer and biochemical progression after radical Prostatectomy a search database study
Journal of Clinical Oncology, 2005Co-Authors: Stephen J. Freedland, Joseph C. Presti, William B Isaacs, Elizabeth A Platz, Martha K Terris, William J Aronson, Christopher L Amling, Christopher J KaneAbstract:Purpose Prostate growth and differentiation are under androgenic control, and prior studies suggested that tumors that develop in hypogonadal men are more aggressive. We examined whether Prostate Weight was associated with tumor grade, advanced disease, or risk of biochemical progression after radical Prostatectomy (RP). Patients and Methods We evaluated the association of Prostate Weight with pathologic tumor grade, positive surgical margins, extracapsular disease, and seminal vesicle invasion using logistic regression and with biochemical progression using Cox proportional hazards regression among 1,602 men treated with RP between 1988 and 2003 at five equal-access medical centers, which composed the Shared Equal Access Regional Cancer Hospital (SEARCH) Database. Results In outcome prediction models including multiple predictor variables, it was found that the predictor variable of Prostate Weight was significantly inversely associated with the outcomes of high-grade disease, positive surgical margins, ...
Joseph C. Presti - One of the best experts on this subject based on the ideXlab platform.
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small Prostate size and high grade disease biology or artifact
The Journal of Urology, 2011Co-Authors: Jen Jane Liu, Michelle Ferrari, James D. Brooks, Rosie Nolley, Joseph C. PrestiAbstract:Purpose: Prior radical Prostatectomy series have shown an inverse association between Prostate size and high grade cancer. It has been suggested that smaller size Prostates arise in a low androgen environment, enabling development of more aggressive cancer. We propose that this observation is the result of ascertainment bias driven by Prostate specific antigen performance.Materials and Methods: We identified 1,404 patients from the Stanford Radical Prostatectomy Database with clinical stage T1c (723) and T2 (681) disease who underwent surgery between 1988 and 2002, and underwent detailed morphometric mapping by a single pathologist. Multivariate linear regression was performed to assess for the effects of age, Prostate Weight and Prostate specific antigen on total and high grade (Gleason grade 4/5) cancer volume and percentage of high grade disease.Results: In patients who underwent biopsy due to abnormal Prostate specific antigen (stage T1c), Prostate Weight was negatively associated (p = 0.0002) with to...
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Small Prostate Size and High Grade Disease—Biology or Artifact?
The Journal of urology, 2011Co-Authors: Jen Jane Liu, Michelle Ferrari, James D. Brooks, Rosie Nolley, Joseph C. PrestiAbstract:Purpose: Prior radical Prostatectomy series have shown an inverse association between Prostate size and high grade cancer. It has been suggested that smaller size Prostates arise in a low androgen environment, enabling development of more aggressive cancer. We propose that this observation is the result of ascertainment bias driven by Prostate specific antigen performance.Materials and Methods: We identified 1,404 patients from the Stanford Radical Prostatectomy Database with clinical stage T1c (723) and T2 (681) disease who underwent surgery between 1988 and 2002, and underwent detailed morphometric mapping by a single pathologist. Multivariate linear regression was performed to assess for the effects of age, Prostate Weight and Prostate specific antigen on total and high grade (Gleason grade 4/5) cancer volume and percentage of high grade disease.Results: In patients who underwent biopsy due to abnormal Prostate specific antigen (stage T1c), Prostate Weight was negatively associated (p = 0.0002) with to...
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body mass index Prostate Weight and transrectal ultrasound Prostate volume accuracy
The Journal of Urology, 2007Co-Authors: Kamran P Sajadi, Joseph C. Presti, Martha K Terris, William J Aronson, Christopher L Amling, Christopher J Kane, Robert J Hamilton, Jennifer Cullen, Stephen J. FreedlandAbstract:Purpose: Transrectal ultrasound can be used to calculate Prostate volume, which has implications for benign and malignant Prostate disease. We hypothesized that obesity may represent a technical challenge when performing transrectal ultrasound that decreases the accuracy of estimating Prostate volume.Materials and Methods: We examined the records of men with previously untreated Prostate cancer who underwent radical Prostatectomy between 1995 and 2006 and who were in the Shared-Equal Access Regional Cancer Hospital database. Transrectal ultrasound volume calculations were correlated with radical Prostatectomy specimen Weight using the Spearman coefficient. We calculated the percent and absolute error, and evaluated the relationship between them and transrectal ultrasound volume, body mass index, age, Prostate specific antigen and race using multivariate linear regression.Results: A total of 497 patients with preoperative transrectal ultrasound volume, specimen Weight and body mass index data were identifi...
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obesity serum Prostate specific antigen and Prostate size implications for Prostate cancer detection
The Journal of Urology, 2006Co-Authors: Stephen J. Freedland, Joseph C. Presti, Elizabeth A Platz, William J Aronson, Christopher L Amling, Christopher J Kane, Martha K TerrisAbstract:Purpose: Obesity has been associated with lower serum testosterone, theoretically resulting in decreased PSA production. Obesity has also been associated with prostatic enlargement, making the detection of existent cancer more difficult. Together these findings would result in an apparent protective effect of obesity on Prostate cancer risk due to technical detection issues unrelated to cancer biology. We examined the association between BMI, and PSA and Prostate Weight in a cohort of men undergoing RP.Materials and Methods: We evaluated the association of BMI with Prostate Weight and PSA using linear regression, adjusting for patient age at RP, year of RP, race, and pathological stage and grade in 1,414 men treated with RP between 1988 and 2004 at the 5 equal access medical centers that comprise the Shared Equal Access Regional Cancer Hospital Database.Results: On multivariate analysis increasing BMI was associated with increasing Prostate Weight but only in men younger than 63 years and not in men 63 ye...
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Prostate size and risk of high grade advanced Prostate cancer and biochemical progression after radical Prostatectomy a search database study
Journal of Clinical Oncology, 2005Co-Authors: Stephen J. Freedland, Joseph C. Presti, William B Isaacs, Elizabeth A Platz, Martha K Terris, William J Aronson, Christopher L Amling, Christopher J KaneAbstract:Purpose Prostate growth and differentiation are under androgenic control, and prior studies suggested that tumors that develop in hypogonadal men are more aggressive. We examined whether Prostate Weight was associated with tumor grade, advanced disease, or risk of biochemical progression after radical Prostatectomy (RP). Patients and Methods We evaluated the association of Prostate Weight with pathologic tumor grade, positive surgical margins, extracapsular disease, and seminal vesicle invasion using logistic regression and with biochemical progression using Cox proportional hazards regression among 1,602 men treated with RP between 1988 and 2003 at five equal-access medical centers, which composed the Shared Equal Access Regional Cancer Hospital (SEARCH) Database. Results In outcome prediction models including multiple predictor variables, it was found that the predictor variable of Prostate Weight was significantly inversely associated with the outcomes of high-grade disease, positive surgical margins, ...
Martha K Terris - One of the best experts on this subject based on the ideXlab platform.
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body mass index Prostate Weight and transrectal ultrasound Prostate volume accuracy
The Journal of Urology, 2007Co-Authors: Kamran P Sajadi, Joseph C. Presti, Martha K Terris, William J Aronson, Christopher L Amling, Christopher J Kane, Robert J Hamilton, Jennifer Cullen, Stephen J. FreedlandAbstract:Purpose: Transrectal ultrasound can be used to calculate Prostate volume, which has implications for benign and malignant Prostate disease. We hypothesized that obesity may represent a technical challenge when performing transrectal ultrasound that decreases the accuracy of estimating Prostate volume.Materials and Methods: We examined the records of men with previously untreated Prostate cancer who underwent radical Prostatectomy between 1995 and 2006 and who were in the Shared-Equal Access Regional Cancer Hospital database. Transrectal ultrasound volume calculations were correlated with radical Prostatectomy specimen Weight using the Spearman coefficient. We calculated the percent and absolute error, and evaluated the relationship between them and transrectal ultrasound volume, body mass index, age, Prostate specific antigen and race using multivariate linear regression.Results: A total of 497 patients with preoperative transrectal ultrasound volume, specimen Weight and body mass index data were identifi...
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obesity serum Prostate specific antigen and Prostate size implications for Prostate cancer detection
The Journal of Urology, 2006Co-Authors: Stephen J. Freedland, Joseph C. Presti, Elizabeth A Platz, William J Aronson, Christopher L Amling, Christopher J Kane, Martha K TerrisAbstract:Purpose: Obesity has been associated with lower serum testosterone, theoretically resulting in decreased PSA production. Obesity has also been associated with prostatic enlargement, making the detection of existent cancer more difficult. Together these findings would result in an apparent protective effect of obesity on Prostate cancer risk due to technical detection issues unrelated to cancer biology. We examined the association between BMI, and PSA and Prostate Weight in a cohort of men undergoing RP.Materials and Methods: We evaluated the association of BMI with Prostate Weight and PSA using linear regression, adjusting for patient age at RP, year of RP, race, and pathological stage and grade in 1,414 men treated with RP between 1988 and 2004 at the 5 equal access medical centers that comprise the Shared Equal Access Regional Cancer Hospital Database.Results: On multivariate analysis increasing BMI was associated with increasing Prostate Weight but only in men younger than 63 years and not in men 63 ye...
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Prostate size and risk of high grade advanced Prostate cancer and biochemical progression after radical Prostatectomy a search database study
Journal of Clinical Oncology, 2005Co-Authors: Stephen J. Freedland, Joseph C. Presti, William B Isaacs, Elizabeth A Platz, Martha K Terris, William J Aronson, Christopher L Amling, Christopher J KaneAbstract:Purpose Prostate growth and differentiation are under androgenic control, and prior studies suggested that tumors that develop in hypogonadal men are more aggressive. We examined whether Prostate Weight was associated with tumor grade, advanced disease, or risk of biochemical progression after radical Prostatectomy (RP). Patients and Methods We evaluated the association of Prostate Weight with pathologic tumor grade, positive surgical margins, extracapsular disease, and seminal vesicle invasion using logistic regression and with biochemical progression using Cox proportional hazards regression among 1,602 men treated with RP between 1988 and 2003 at five equal-access medical centers, which composed the Shared Equal Access Regional Cancer Hospital (SEARCH) Database. Results In outcome prediction models including multiple predictor variables, it was found that the predictor variable of Prostate Weight was significantly inversely associated with the outcomes of high-grade disease, positive surgical margins, ...
Christopher L Amling - One of the best experts on this subject based on the ideXlab platform.
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body mass index Prostate Weight and transrectal ultrasound Prostate volume accuracy
The Journal of Urology, 2007Co-Authors: Kamran P Sajadi, Joseph C. Presti, Martha K Terris, William J Aronson, Christopher L Amling, Christopher J Kane, Robert J Hamilton, Jennifer Cullen, Stephen J. FreedlandAbstract:Purpose: Transrectal ultrasound can be used to calculate Prostate volume, which has implications for benign and malignant Prostate disease. We hypothesized that obesity may represent a technical challenge when performing transrectal ultrasound that decreases the accuracy of estimating Prostate volume.Materials and Methods: We examined the records of men with previously untreated Prostate cancer who underwent radical Prostatectomy between 1995 and 2006 and who were in the Shared-Equal Access Regional Cancer Hospital database. Transrectal ultrasound volume calculations were correlated with radical Prostatectomy specimen Weight using the Spearman coefficient. We calculated the percent and absolute error, and evaluated the relationship between them and transrectal ultrasound volume, body mass index, age, Prostate specific antigen and race using multivariate linear regression.Results: A total of 497 patients with preoperative transrectal ultrasound volume, specimen Weight and body mass index data were identifi...
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obesity serum Prostate specific antigen and Prostate size implications for Prostate cancer detection
The Journal of Urology, 2006Co-Authors: Stephen J. Freedland, Joseph C. Presti, Elizabeth A Platz, William J Aronson, Christopher L Amling, Christopher J Kane, Martha K TerrisAbstract:Purpose: Obesity has been associated with lower serum testosterone, theoretically resulting in decreased PSA production. Obesity has also been associated with prostatic enlargement, making the detection of existent cancer more difficult. Together these findings would result in an apparent protective effect of obesity on Prostate cancer risk due to technical detection issues unrelated to cancer biology. We examined the association between BMI, and PSA and Prostate Weight in a cohort of men undergoing RP.Materials and Methods: We evaluated the association of BMI with Prostate Weight and PSA using linear regression, adjusting for patient age at RP, year of RP, race, and pathological stage and grade in 1,414 men treated with RP between 1988 and 2004 at the 5 equal access medical centers that comprise the Shared Equal Access Regional Cancer Hospital Database.Results: On multivariate analysis increasing BMI was associated with increasing Prostate Weight but only in men younger than 63 years and not in men 63 ye...
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Prostate size and risk of high grade advanced Prostate cancer and biochemical progression after radical Prostatectomy a search database study
Journal of Clinical Oncology, 2005Co-Authors: Stephen J. Freedland, Joseph C. Presti, William B Isaacs, Elizabeth A Platz, Martha K Terris, William J Aronson, Christopher L Amling, Christopher J KaneAbstract:Purpose Prostate growth and differentiation are under androgenic control, and prior studies suggested that tumors that develop in hypogonadal men are more aggressive. We examined whether Prostate Weight was associated with tumor grade, advanced disease, or risk of biochemical progression after radical Prostatectomy (RP). Patients and Methods We evaluated the association of Prostate Weight with pathologic tumor grade, positive surgical margins, extracapsular disease, and seminal vesicle invasion using logistic regression and with biochemical progression using Cox proportional hazards regression among 1,602 men treated with RP between 1988 and 2003 at five equal-access medical centers, which composed the Shared Equal Access Regional Cancer Hospital (SEARCH) Database. Results In outcome prediction models including multiple predictor variables, it was found that the predictor variable of Prostate Weight was significantly inversely associated with the outcomes of high-grade disease, positive surgical margins, ...
William J Aronson - One of the best experts on this subject based on the ideXlab platform.
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body mass index Prostate Weight and transrectal ultrasound Prostate volume accuracy
The Journal of Urology, 2007Co-Authors: Kamran P Sajadi, Joseph C. Presti, Martha K Terris, William J Aronson, Christopher L Amling, Christopher J Kane, Robert J Hamilton, Jennifer Cullen, Stephen J. FreedlandAbstract:Purpose: Transrectal ultrasound can be used to calculate Prostate volume, which has implications for benign and malignant Prostate disease. We hypothesized that obesity may represent a technical challenge when performing transrectal ultrasound that decreases the accuracy of estimating Prostate volume.Materials and Methods: We examined the records of men with previously untreated Prostate cancer who underwent radical Prostatectomy between 1995 and 2006 and who were in the Shared-Equal Access Regional Cancer Hospital database. Transrectal ultrasound volume calculations were correlated with radical Prostatectomy specimen Weight using the Spearman coefficient. We calculated the percent and absolute error, and evaluated the relationship between them and transrectal ultrasound volume, body mass index, age, Prostate specific antigen and race using multivariate linear regression.Results: A total of 497 patients with preoperative transrectal ultrasound volume, specimen Weight and body mass index data were identifi...
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obesity serum Prostate specific antigen and Prostate size implications for Prostate cancer detection
The Journal of Urology, 2006Co-Authors: Stephen J. Freedland, Joseph C. Presti, Elizabeth A Platz, William J Aronson, Christopher L Amling, Christopher J Kane, Martha K TerrisAbstract:Purpose: Obesity has been associated with lower serum testosterone, theoretically resulting in decreased PSA production. Obesity has also been associated with prostatic enlargement, making the detection of existent cancer more difficult. Together these findings would result in an apparent protective effect of obesity on Prostate cancer risk due to technical detection issues unrelated to cancer biology. We examined the association between BMI, and PSA and Prostate Weight in a cohort of men undergoing RP.Materials and Methods: We evaluated the association of BMI with Prostate Weight and PSA using linear regression, adjusting for patient age at RP, year of RP, race, and pathological stage and grade in 1,414 men treated with RP between 1988 and 2004 at the 5 equal access medical centers that comprise the Shared Equal Access Regional Cancer Hospital Database.Results: On multivariate analysis increasing BMI was associated with increasing Prostate Weight but only in men younger than 63 years and not in men 63 ye...
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Prostate size and risk of high grade advanced Prostate cancer and biochemical progression after radical Prostatectomy a search database study
Journal of Clinical Oncology, 2005Co-Authors: Stephen J. Freedland, Joseph C. Presti, William B Isaacs, Elizabeth A Platz, Martha K Terris, William J Aronson, Christopher L Amling, Christopher J KaneAbstract:Purpose Prostate growth and differentiation are under androgenic control, and prior studies suggested that tumors that develop in hypogonadal men are more aggressive. We examined whether Prostate Weight was associated with tumor grade, advanced disease, or risk of biochemical progression after radical Prostatectomy (RP). Patients and Methods We evaluated the association of Prostate Weight with pathologic tumor grade, positive surgical margins, extracapsular disease, and seminal vesicle invasion using logistic regression and with biochemical progression using Cox proportional hazards regression among 1,602 men treated with RP between 1988 and 2003 at five equal-access medical centers, which composed the Shared Equal Access Regional Cancer Hospital (SEARCH) Database. Results In outcome prediction models including multiple predictor variables, it was found that the predictor variable of Prostate Weight was significantly inversely associated with the outcomes of high-grade disease, positive surgical margins, ...
