<i  >Objective</i>. To assess the impact of low-to-moderate risk prostate cancer on patients&#x2019; quality of life (QoL) at diagnosis and within the first year of treatment. <i  >Subjects and Methods</i>. Men (<svg  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.2063894pt" id="M1" height="8.54217pt" version="1.1" viewBox="-0.0498162 -8.33578 41.1683 8.54217" width="41.1683pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g50-111" d="M504 89L488 119C453 85 428 69 416 69C408 69 405 75 412 102L462 304C492 438 460 451 436 451S388 441 356 423C311 397 229 336 170 256H168L189 340C208 418 200 451 177 451C144 451 82 413 24 352L40 322C65 345 98 369 108 369C114 369 119 363 112 335L28 -3L36 -12C54 -3 83 4 112 10C125 73 138 122 153 174C205 258 328 382 376 382C395 382 399 369 384 305L330 93C312 25 323 -12 351 -12C378 -12 439 21 504 89Z"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="512" vert-adv-y="512"/></g><g transform="matrix(.013,0,0,-0.013,10.332,0)"><path id="g54-34" d="M556 331V384H55V331H556ZM556 140V193H55V140H556Z"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="611" vert-adv-y="611"/></g><g transform="matrix(.013,0,0,-0.013,21.95,0)"><path id="g50-55" d="M141 347C171 480 264 541 327 570C364 587 403 599 436 605L429 641C389 634 339 622 300 609C191 570 37 458 37 239C37 86 126 -12 245 -12C367 -12 454 89 454 210C454 314 380 397 272 397C252 397 230 390 208 380L141 347ZM231 338C323 338 366 257 366 174C366 108 340 27 263 27C180 27 129 123 129 244C129 268 130 292 135 310C158 323 193 338 231 338Z"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g><g transform="matrix(.013,0,0,-0.013,28.281,0)"><path id="g50-56" d="M453 623H65C60 580 56 530 46 472H80C103 538 110 548 175 548H389C310 380 195 168 90 0L98 -12L175 -2C273 206 366 408 462 610L453 623Z"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g><g transform="matrix(.013,0,0,-0.013,34.614,0)"><path id="g50-51" d="M414 144C384 79 371 75 317 75H135L276 221C367 316 408 376 408 465C408 570 327 635 237 635C179 635 131 609 100 575L42 494L67 471C94 510 138 565 205 565C277 565 321 517 321 435C321 348 258 270 195 195C146 137 88 81 33 26V0H411C423 44 433 88 446 135L414 144Z"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g></svg>) aged 50&#x2013;75 years with prostate cancer (Gleason score <svg  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-1.15895pt" id="M2" height="9.2729pt" version="1.1" viewBox="-0.0498162 -8.11395 18.1025 9.2729" width="18.1025pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g54-93" d="M552 72V131L122 319L552 507V566L59 344V293L552 72ZM552 -41V12H59V-41H552Z"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="611" vert-adv-y="611"/></g><g transform="matrix(.013,0,0,-0.013,11.618,0)"><use xlink:href="#g50-56"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g></svg>, PSA <svg  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-1.15895pt" id="M3" height="9.49473pt" version="1.1" viewBox="-0.0498162 -8.33578 24.4573 9.49473" width="24.4573pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g54-93"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="611" vert-adv-y="611"/></g><g transform="matrix(.013,0,0,-0.013,11.618,0)"><use xlink:href="#g50-51"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g><g transform="matrix(.013,0,0,-0.013,17.949,0)"><path id="g50-49" d="M245 635C92 635 37 457 37 312C37 149 91 -12 244 -12C395 -12 449 166 449 312C449 469 395 635 245 635ZM243 598C332 598 358 454 358 312C358 173 334 26 245 26C158 26 128 174 128 313S152 598 243 598Z"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g></svg>&#x2009;ng/mL and clinical staging T1c&#x2013;T2b) were enrolled in five European countries. Patients completed five questionnaires, including EORTC Quality of Life Questionnaire&#x2014;Prostate Cancer 25 (QLQ-PR25) and EORTC Quality of Life Questionnaire&#x2014;Cancer 30 (QLQ-C30). Questionnaires were completed at baseline, at 3 months and 12 months after starting treatment. The primary endpoint was the change in QLQ-PR25 urinary symptoms subscale score from baseline to the assessment at 3 months. <i  >Results</i>. Mean (SD) age was 65.0 (5.7) years and 400 (66&#x25;) men had Gleason score &#x2264;6 prostate cancer. The most frequently used initial treatment was radical prostatectomy (71&#x25; of patients). QLQ-PR25 urinary symptoms subscale score was significantly increased at 3 months (<svg  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.7022505pt" id="M4" height="9.29899pt" version="1.1" viewBox="-0.0498162 -8.59674 52.051 9.29899" width="52.051pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><path id="g50-81" d="M622 479C622 589 545 650 400 650H146L140 618C229 609 230 602 215 527L135 132C117 43 112 41 27 32L18 0H305L313 32C213 40 205 44 222 132L251 284L324 262H365C484 269 622 333 622 479ZM528 477C528 356 420 305 344 305C300 305 276 314 259 321L303 554C311 597 313 600 331 606C345 611 361 614 379 614C463 614 528 580 528 477Z"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="640" vert-adv-y="640"/></g><g transform="matrix(.013,0,0,-0.013,11.766,0)"><path id="g54-91" d="M530 -6V57L144 261V263L530 468V530L81 290V234L530 -6Z"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="611" vert-adv-y="611"/></g><g transform="matrix(.013,0,0,-0.013,23.385,0)"><use xlink:href="#g50-49"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g><g transform="matrix(.013,0,0,-0.013,29.716,0)"><path id="g50-47" d="M117 -12C153 -12 178 12 178 50C178 84 153 110 118 110C84 110 59 84 59 50C59 12 84 -12 117 -12Z"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="237" vert-adv-y="237"/></g><g transform="matrix(.013,0,0,-0.013,32.797,0)"><use xlink:href="#g50-49"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g><g transform="matrix(.013,0,0,-0.013,39.128,0)"><use xlink:href="#g50-49"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g><g transform="matrix(.013,0,0,-0.013,45.459,0)"><path id="g50-50" d="M389 0V32C297 38 291 46 291 118V635C234 613 175 595 109 583V556L161 554C203 552 207 547 207 497V118C207 46 201 38 110 32V0H389Z"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g></svg>), indicating that urinary symptoms worsened after treatment. The score was lower at 12 months than at 3 months, but it was still significantly higher than at baseline (<svg  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.7022505pt" id="M5" height="9.29899pt" version="1.1" viewBox="-0.0498162 -8.59674 52.051 9.29899" width="52.051pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g50-81"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="640" vert-adv-y="640"/></g><g transform="matrix(.013,0,0,-0.013,11.766,0)"><use xlink:href="#g54-91"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="611" vert-adv-y="611"/></g><g transform="matrix(.013,0,0,-0.013,23.385,0)"><use xlink:href="#g50-49"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g><g transform="matrix(.013,0,0,-0.013,29.716,0)"><use xlink:href="#g50-47"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="237" vert-adv-y="237"/></g><g transform="matrix(.013,0,0,-0.013,32.797,0)"><use xlink:href="#g50-49"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g><g transform="matrix(.013,0,0,-0.013,39.128,0)"><use xlink:href="#g50-49"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g><g transform="matrix(.013,0,0,-0.013,45.459,0)"><use xlink:href="#g50-50"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g></svg>). Hormonal treatment-related symptoms, sexual functioning, and sexual activity scores significantly worsened at 3 and 12 months (all <svg  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.7022505pt" id="M6" height="9.29899pt" version="1.1" viewBox="-0.0498162 -8.59674 52.051 9.29899" width="52.051pt"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g50-81"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="640" vert-adv-y="640"/></g><g transform="matrix(.013,0,0,-0.013,11.766,0)"><use xlink:href="#g54-91"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="611" vert-adv-y="611"/></g><g transform="matrix(.013,0,0,-0.013,23.385,0)"><use xlink:href="#g50-49"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g><g transform="matrix(.013,0,0,-0.013,29.716,0)"><use xlink:href="#g50-47"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="237" vert-adv-y="237"/></g><g transform="matrix(.013,0,0,-0.013,32.797,0)"><use xlink:href="#g50-49"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g><g transform="matrix(.013,0,0,-0.013,39.128,0)"><use xlink:href="#g50-49"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g><g transform="matrix(.013,0,0,-0.013,45.459,0)"><use xlink:href="#g50-50"/><glyph.data ascent="3443" descent="-2856" horiz-adv-x="487" vert-adv-y="487"/></g></svg>). For the QLQ-C30 questionnaire, global health status/QoL score significantly decreased at month 3 but was not different from baseline by month 12. Scales for physical, role, and social functioning, and fatigue, showed significant deterioration at 3 and 12 months. <i  >Conclusions</i>. Low-to-moderate risk prostate cancer may have a substantial effect on patients&#x2019; QoL within one year following treatment.

Cesare Selli

Anders Bjartell

Javier Burgos

Matthew Somerville

Juan-Manuel Palacios

Laure Benjamin

Libby Black

Ramiro Castro

Burden of Illness in Prostate Cancer Patients with a Low-to-Moderate Risk of Progression: A One-Year, Pan-European Observational Study

<i>Background</i>. Prior studies evaluating the effect of statins or acetylsalicylic acid (ASA) on the survival of men receiving prostate cancer were treatment have reported conflicting results, and have not adjusted for comorbidity. Our aim is to investigate the influence of statins and ASA on prostate cancer survival, when comorbidity is adjusted for, in men treated with external beam radiation therapy (EBRT) for prostate cancer. <i>Methods</i>. A cohort of 3851 patients with prostate cancer treated with curative EBRT &#xb1; androgen deprivation therapy (ADT) between 2000 and 2007. Stage, treatment, medication use, and Charlson comorbidity index (CCI) scores were analyzed. <i>Results</i>. Median followup was 8.4 years. Mean age was 70.3 years. Neoadjuvant ADT was used in 67&#x25;. Statins were used in 23&#x25;, ASA in 24&#x25;, and both in 11&#x25;. Comorbidity scores were 0 in 65&#x25;, 1 in 25&#x25;, and &#x2265;2 in 10&#x25; of patients. Statin and ASA use were associated with increased age and comorbidity. Although statin and ASA use were significantly associated with improved prostate cancer specific survival (PCSS) on univariate analysis, neither were on multivariate analysis. <i>Conclusion</i>. Neither statin nor ASA use impacted PCSS on multivariate competing risks analysis. Survival was impacted by increased comorbidity as well as statin and ASA use.

J. Caon

M. Paquette

J. Hamm

T. Pickles

Does Statin or ASA Affect Survival When Prostate Cancer Is Treated with External Beam Radiation Therapy?

<i  >Background and Purpose</i>. Life expectancy data could identify men with favorable post-radiation prostate-specific antigen (PSA) failure kinetics unlikely to require androgen deprivation therapy (ADT). <i  >Materials and Methods</i>. Of 206 men with unfavorable-risk prostate cancer in a randomized trial of radiation versus radiation and ADT, 53 experienced a PSA failure and were followed without salvage ADT. Comorbidity, age and established prognostic factors were assessed for relationship to death using Cox regression analyses. <i  >Results</i>. The median age at failure, interval to PSA failure, and PSA doubling time were 76.6 years (interquartile range [IQR]: 71.8&#x2013;79.3), 49.1 months (IQR: 37.7&#x2013;87.4), and 25 months (IQR: 13.1&#x2013;42.8), respectively. After a median follow up of 4.0 years following PSA failure, 45&#x25; of men had died, none from prostate cancer and no one had developed metastases. Both increasing age at PSA failure (HR: 1.14; 95&#x25; CI: 1.03&#x2013;1.25; <svg     style="vertical-align:-0.1638pt;width:66.875px;" id="M1" height="11.375" version="1.1" viewBox="0 0 66.875 11.375" width="66.875"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><path id="x1D443" d="M619 482q0 -69 -40.5 -119t-96 -72.5t-118.5 -26.5h-44l-70 20l-31 -151q-14 -67 0.5 -83t89.5 -22l-5 -28h-287l8 28q65 7 81.5 22t29.5 83l79 398q12 56 0.5 70.5t-78.5 20.5l7 28h255q108 0 164 -43t56 -125zM524 478q0 141 -146 141q-25 0 -47 -8q-16 -6 -20.5 -13.5&#xA;t-10.5 -39.5l-43 -241q37 -13 83 -13q67 0 125.5 45t58.5 129z" /></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><path id="x3D" d="M535 323h-483v50h483v-50zM535 138h-483v50h483v-50z" /></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><path id="x30" d="M241 635q53 0 94 -28.5t63.5 -76t33.5 -102.5t11 -116q0 -58 -11 -112.5t-34 -103.5t-63.5 -78.5t-94.5 -29.5t-95 28t-64.5 75t-34.5 102.5t-11 118.5q0 58 11.5 112.5t34.5 103t64.5 78t95.5 29.5zM238 602q-32 0 -55.5 -25t-35.5 -68t-17.5 -91t-5.5 -105&#xA;q0 -76 10 -138.5t37 -107.5t69 -45q32 0 55.5 25t35.5 68.5t17.5 91.5t5.5 105t-5.5 105.5t-18 92t-36 68t-56.5 24.5z" /></g><g transform="matrix(.017,-0,0,-.017,38.446,11.112)"><path id="x2E" d="M113 -12q-24 0 -39.5 16t-15.5 42q0 24 16 40.5t40 16.5t40 -16.5t16 -40.5q0 -26 -16 -42t-41 -16z" /></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,50.481,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,58.64,11.112)"><path id="x38" d="M249 635q70 0 116 -43t46 -105q0 -46 -28 -80q-22 -25 -80 -64q62 -35 97 -75t35 -99q0 -81 -63 -131t-135 -50q-83 0 -137.5 45.5t-54.5 123.5q0 52 45 95q29 28 89 64q-109 62 -109 155q0 66 50.5 115t128.5 49zM238 603q-42 0 -67.5 -31t-25.5 -72q0 -50 32.5 -79.5&#xA;t98.5 -62.5q61 48 61 124q0 59 -29.5 90t-69.5 31zM248 20q46 0 76.5 33.5t30.5 89.5q0 50 -39 85.5t-110 71.5q-81 -54 -81 -137q0 -67 35.5 -105t87.5 -38z" /></g>

		
	
</svg>) and the presence of moderate to severe comorbidity (HR: 12.5; 95&#x25; CI: 3.81&#x2013;41.0; <svg     style="vertical-align:-0.1638pt;width:66.875px;" id="M2" height="11.375" version="1.1" viewBox="0 0 66.875 11.375" width="66.875"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><use xlink:href="#x1D443"/></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><path id="x3C" d="M512 -3l-437 233v51l437 233v-58l-378 -200v-2l378 -199v-58z" /></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,38.446,11.112)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,50.481,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,58.64,11.112)"><path id="x31" d="M384 0h-275v27q67 5 81.5 18.5t14.5 68.5v385q0 38 -7.5 47.5t-40.5 10.5l-48 2v24q85 15 178 52v-521q0 -55 14.5 -68.5t82.5 -18.5v-27z" /></g>

		
	
</svg>) were significantly associated with an increased risk of death. <i  >Conclusions</i>. Men over the age of 76 with significant comorbidity and a PSA doubling time &#x3e;2 years following post-radiation PSA failure appear to be good candidates for observation without ADT intervention.

Neil E. Martin

Ming-Hui Chen

Clair J. Beard

Paul L. Nguyen

Marian J. Loffredo

Andrew A. Renshaw

Philip W. Kantoff

Anthony V. D&#x2019;Amico

Natural History of Untreated Prostate Specific Antigen Radiorecurrent Prostate Cancer in Men with Favorable Prognostic Indicators

<i> Purpose.</i> Published data about cryotherapy for prostate cancer (PC) treatment are based on case series with a lack of clinical trials and the inexistence of a validated definition of biochemical failure. A prospective study with standardized followup protocol was conducted in our institution. <i>Material and Methods.</i> Prospective study of a series of cases including 108 patients diagnosed with localized PC at clinical stage T1c-T2c treated by primary cryoablation and median followup of 61 months. Criteria of biochemical recurrence were unified according to the American Society for Therapeutic Radiology and Oncology (ASTRO). End points were biochemical progression-free survival (BPFS), cancer-specific survival, and overall survival. Rate of complications was reported. <i>Results.</i> The BPFS for low-, medium-, and high-risk patients was 96.4&#x25;, 91.2&#x25;, and 62.2&#x25;, respectively. Cancer-specific survival was 98.1&#x25;. Overall survival reached 94.4&#x25;. Complications included incontinence in 5.6&#x25;, urinary tract obstruction in 1.9&#x25;, urethral sloughing in 5.6&#x25;, haematuria in 1.9&#x25;, perineal pain in 11.1&#x25;, and prostatorectal fistula in 0.9&#x25;. Erectile disfunction was found in 98.1&#x25;. <i>Conclusions.</i> Cryotherapy is an effective and minimally invasive treatment for primary PC in well-selected cases, with low surgical risk and good results in terms of BPFS, cancer-specific survival, and overall survival.

S. Alvarez Rodr&#xed;guez

F. Arias F&#xfa;nez

C. Bueno Bravo

R. Rodr&#xed;guez-Patr&#xf3;n Rodr&#xed;guez

E. Sanz Mayayo

V. Hevia Palacios

F. J. Burgos Revilla

Cryotherapy for Primary Treatment of Prostate Cancer: Intermediate Term Results of a Prospective Study from a Single Institution

<i>Aim</i>. To compare the diagnostic performance of diffusion weighted imaging (DWI) using <svg     style="vertical-align:-0.1638pt;width:8.1000004px;" id="M2" height="12.4375" version="1.1" viewBox="0 0 8.1000004 12.4375" width="8.1000004"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,12.162)"><use xlink:href="#x1D44F"/></g>

		
	
</svg>-values of 1000&#x2009;s/mm<sup  >2</sup> and 2000&#x2009;s/mm<sup  >2</sup> at 3 Tesla (T) for the evaluation of clinically significant prostate cancer. <i  >Matherials and Methods</i>. Seventy-eight prostate cancer patients underwent a 3T MRI scan followed by radical prostatectomy. DWI was performed using <svg     style="vertical-align:-0.1638pt;width:8.1000004px;" id="M3" height="12.4375" version="1.1" viewBox="0 0 8.1000004 12.4375" width="8.1000004"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,12.162)"><use xlink:href="#x1D44F"/></g>

		
	
</svg>-values of 0, 1000, and 2000&#x2009;s/mm<sup  >2</sup> and qualitatively analysed by two radiologists. ADC maps were obtained at <svg     style="vertical-align:-0.1638pt;width:8.1000004px;" id="M4" height="12.4375" version="1.1" viewBox="0 0 8.1000004 12.4375" width="8.1000004"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,12.162)"><use xlink:href="#x1D44F"/></g>

		
	
</svg>-values of 1000 and 2000&#x2009;s/mm<sup  >2</sup> and quantitatively analyzed in consensus. <i  >Results</i>. For diagnosis of 78 prostate cancers the accuracy of DWI for the young reader was significantly greater at <svg     style="vertical-align:-0.1638pt;width:8.1000004px;" id="M5" height="12.4375" version="1.1" viewBox="0 0 8.1000004 12.4375" width="8.1000004"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,12.162)"><use xlink:href="#x1D44F"/></g>

		
	
</svg> = 2000&#x2009;s/mm<sup  >2</sup> for the peripheral zone (PZ) but not for the transitional zone (TZ). For the experienced reader, DWI did not show significant differences in accuracy between <svg     style="vertical-align:-0.1638pt;width:8.1000004px;" id="M6" height="12.4375" version="1.1" viewBox="0 0 8.1000004 12.4375" width="8.1000004"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,12.162)"><use xlink:href="#x1D44F"/></g>

		
	
</svg>-values of 1000 and 2000&#x2009;s/mm<sup  >2</sup>. The quantitative analysis in the PZ and TZ was substantially superimposable between the two <svg     style="vertical-align:-0.1638pt;width:8.1000004px;" id="M7" height="12.4375" version="1.1" viewBox="0 0 8.1000004 12.4375" width="8.1000004"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,12.162)"><use xlink:href="#x1D44F"/></g>

		
	
</svg>-values, albeit with a higher accuracy with a <svg     style="vertical-align:-0.1638pt;width:8.1000004px;" id="M8" height="12.4375" version="1.1" viewBox="0 0 8.1000004 12.4375" width="8.1000004"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,12.162)"><use xlink:href="#x1D44F"/></g>

		
	
</svg>-value of 2000&#x2009;s/mm<sup  >2</sup>. <i  >Conclusions</i>. With a <svg     style="vertical-align:-0.1638pt;width:8.1000004px;" id="M9" height="12.4375" version="1.1" viewBox="0 0 8.1000004 12.4375" width="8.1000004"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,12.162)"><use xlink:href="#x1D44F"/></g>

		
	
</svg>-value of 2000&#x2009;s/mm<sup  >2</sup> at 3T both readers differentiated clinical significant cancer from benign tissue; higher <svg     style="vertical-align:-0.1638pt;width:8.1000004px;" id="M10" height="12.4375" version="1.1" viewBox="0 0 8.1000004 12.4375" width="8.1000004"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,12.162)"><use xlink:href="#x1D44F"/></g>

		
	
</svg>-values can be helpful for the less experienced readers.

Guglielmo Manenti

Marco Nezzo

Fabrizio Chegai

Erald Vasili

Elena Bonanno

Giovanni Simonetti

DWI of Prostate Cancer: Optimal <svg style="vertical-align:-0.1638pt" height="12.4375" version="1.1" viewBox="0 0 8.1000004 12.4375" width="8.1000004" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg"><g transform="matrix(.017,-0,0,-.017,.062,12.162)"><path id="x1D44F" d="M452 333q0 -82 -46 -164t-116 -128q-81 -53 -158 -53q-26 0 -51 13t-37 32q-26 41 -6 134l91 431q7 40 2.5 47t-34.5 7h-33l2 25q36 4 72.5 13t58.5 15.5t28 6.5q10 0 4 -29l-91 -391h2q65 77 130 116.5t105 39.5q36 0 56.5 -32t20.5 -83zM365 316q0 76 -35 76&#xA;q-31 0 -93.5 -49t-107.5 -110q-12 -37 -17 -70q-9 -65 12 -96.5t59 -31.5q31 0 56 14q53 29 89.5 105t36.5 162z" /></g></svg>-Value in Clinical Practice

<i  >Purpose</i>. Increasing body mass index (BMI) is associated with higher risk prostate cancer (PC) at presentation. Whether increasing BMI also prompts earlier salvage androgen suppression therapy (sAST) is unknown. <i  >Materials and Methods</i>. Between 1995 and 2001, 206 men with unfavorable risk PC were treated with radiation therapy (RT) or RT and six months of androgen suppression therapy in a randomized controlled trial (RCT). 108 sustained PSA failure; 51 received sAST for PSA approaching 10&#x2009;ng/mL; 49 with BMI data comprised the study cohort. A multivariable Cox regression analysis identified pretreatment factors associated with earlier sAST receipt. <i  >Results</i>. Increasing BMI prompted earlier sAST (median years: 3.7 for overweight/obese, 6.9 for normal weight; adjusted hazard ratio (AHR): 1.11; 95&#x25; CI: 1.04, 1.18; <svg     style="vertical-align:-0.1638pt;width:66.875px;" id="M1" height="11.375" version="1.1" viewBox="0 0 66.875 11.375" width="66.875"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><path id="x1D443" d="M619 482q0 -69 -40.5 -119t-96 -72.5t-118.5 -26.5h-44l-70 20l-31 -151q-14 -67 0.5 -83t89.5 -22l-5 -28h-287l8 28q65 7 81.5 22t29.5 83l79 398q12 56 0.5 70.5t-78.5 20.5l7 28h255q108 0 164 -43t56 -125zM524 478q0 141 -146 141q-25 0 -47 -8q-16 -6 -20.5 -13.5&#xA;t-10.5 -39.5l-43 -241q37 -13 83 -13q67 0 125.5 45t58.5 129z" /></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><path id="x3D" d="M535 323h-483v50h483v-50zM535 138h-483v50h483v-50z" /></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><path id="x30" d="M241 635q53 0 94 -28.5t63.5 -76t33.5 -102.5t11 -116q0 -58 -11 -112.5t-34 -103.5t-63.5 -78.5t-94.5 -29.5t-95 28t-64.5 75t-34.5 102.5t-11 118.5q0 58 11.5 112.5t34.5 103t64.5 78t95.5 29.5zM238 602q-32 0 -55.5 -25t-35.5 -68t-17.5 -91t-5.5 -105&#xA;q0 -76 10 -138.5t37 -107.5t69 -45q32 0 55.5 25t35.5 68.5t17.5 91.5t5.5 105t-5.5 105.5t-18 92t-36 68t-56.5 24.5z" /></g><g transform="matrix(.017,-0,0,-.017,38.446,11.112)"><path id="x2E" d="M113 -12q-24 0 -39.5 16t-15.5 42q0 24 16 40.5t40 16.5t40 -16.5t16 -40.5q0 -26 -16 -42t-41 -16z" /></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,50.481,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,58.64,11.112)"><path id="x32" d="M412 140l28 -9q0 -2 -35 -131h-373v23q112 112 161 170q59 70 92 127t33 115q0 63 -31 98t-86 35q-75 0 -137 -93l-22 20l57 81q55 59 135 59q69 0 118.5 -46.5t49.5 -122.5q0 -62 -29.5 -114t-102.5 -130l-141 -149h186q42 0 58.5 10.5t38.5 56.5z" /></g>

		
	
</svg>) as did high versus other risk PC (median: 3.2 versus 5.2 years; AHR: 2.01; 95&#x25; CI: 1.05, 3.83; <svg     style="vertical-align:-0.1638pt;width:58.712502px;" id="M2" height="11.375" version="1.1" viewBox="0 0 58.712502 11.375" width="58.712502"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><use xlink:href="#x1D443"/></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,38.446,11.112)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,50.481,11.112)"><path id="x33" d="M285 378v-2q65 -13 102 -54.5t37 -97.5q0 -57 -30.5 -104.5t-74 -75t-85.5 -42t-72 -14.5q-31 0 -59.5 11t-40.5 23q-19 18 -16 36q1 16 23 33q13 10 24 0q58 -51 124 -51q55 0 88 40t33 112q0 64 -39 96.5t-88 32.5q-29 0 -64 -11l-6 29q77 25 118 57.5t41 84.5&#xA;q0 45 -26.5 69.5t-68.5 24.5q-67 0 -120 -79l-20 20l43 63q51 56 127 56h1q66 0 107 -37t41 -95q0 -42 -31 -71q-22 -23 -68 -54z" /></g>

		
	
</svg>). Increasing median time to sAST was observed for overweight/obese men with high versus other risk PC and for normal-weight men with any risk PC being 2.3, 4.6, and 6.9 years, respectively (<svg     style="vertical-align:-0.1638pt;width:66.875px;" id="M3" height="11.375" version="1.1" viewBox="0 0 66.875 11.375" width="66.875"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><use xlink:href="#x1D443"/></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><path id="x3C" d="M512 -3l-437 233v51l437 233v-58l-378 -200v-2l378 -199v-58z" /></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,38.446,11.112)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,50.481,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,58.64,11.112)"><path id="x31" d="M384 0h-275v27q67 5 81.5 18.5t14.5 68.5v385q0 38 -7.5 47.5t-40.5 10.5l-48 2v24q85 15 178 52v-521q0 -55 14.5 -68.5t82.5 -18.5v-27z" /></g>

		
	
</svg> for trend). <i  >Conclusion</i>. Increasing BMI was associated with earlier sAST. A RCT evaluating whether BMI reduction delays or eliminates need for sAST is warranted.

Ravi A. Chandra

Danjie Zhang

Marian Loffredo

Evidence Suggesting That Obesity Prevention Measures May Improve Prostate Cancer Outcomes Using Data from a Prospective Randomized Trial

<i>Aims.</i> In this study we report our results with storage of cryopreserved semen intended for preservation and subsequent infertility treatment in men with testicular cancer during the last 18 years. <i>Methods.</i> Cryopreserved semen of 523 men with testicular cancer was collected between October 1995 and the end of December 2012. Semen of 34 men (6.5&#x25;) was used for fertilization of their partners. They underwent 57 treatment cycles with cryopreserved, fresh, and/or donor sperm. <i>Results.</i> A total of 557 men have decided to freeze their semen before cancer treatment. Seminoma was diagnosed in 283 men (54.1&#x25;) and nonseminomatous germ cell tumors in 240 men (45.9&#x25;). 34 patients who returned for infertility treatment underwent 46 treatment cycles with cryopreserved sperm. Totally 16 pregnancies were achieved, that is, 34.8&#x25; pregnancy rate. <i>Conclusion.</i> The testicular cancer survivors have a good chance of fathering a child by using sperm cryopreserved prior to the oncology treatment, even when it contains only limited number of spermatozoa.

Roland Van Velthoven

Fouad Aoun

Ksenija Limani

Krishna Narahari

Marc Lemort

Alexandre Peltier

Primary Zonal High Intensity Focused Ultrasound for Prostate Cancer: Results of a Prospective Phase IIa Feasibility Study

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<p><em>Prostate Cancer</em> provides a multidisciplinary platform for scientists, surgeons, oncologists and clinicians working on prostate cancer. Research includes diagnosis, surgery, radiotherapy, drug discovery and medical management of the disease.</p>


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Prostate Cancer provides a multidisciplinary platform for scientists, surgeons, oncologists and clinicians working on prostate cancer. Research includes diagnosis, surgery, radiotherapy, drug discovery and medical management of the disease.

Prostate Cancer