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| 13. |
- Henningsohn, L, et al.
(author)
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Time after surgery, symptoms and well-being in survivors of urinary bladder cancer
- 2003
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In: BJU International. - 1464-4096 .- 1464-410X. ; 91:4, s. 325-330
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To evaluate how an increasing burden of symptoms influences well-being, anxiety and depression at different intervals after a radical cystectomy with urostomy for bladder cancer, as this therapy can induce long-term distressful symptoms. PATIENTS AND METHODS: Patients with bladder cancer undergoing radical cystectomy in Stockholm between 1969 and 1995 were matched with 434 controls from the normal population, all 404 patients operated on between 1985 and 1995 at three other hospitals in Sweden were invited to enter the study. The final analysis included 306 patients and 310 controls, all assessed for symptoms and well-being. RESULTS: A low or moderate level of well-being was reported by 35% of the patients having none or one of the symptoms studied, by 39% with two symptoms, by 45% with three symptoms and by 66% of those with four or more symptoms. The values, irrespective of symptom burden, were 45% after 2-5 years of follow-up, 58% after 6-10 years and 38% at > 10 years after surgery. The total symptom burden also influenced the risk of anxiety and depression. Symptom prevalence remained largely unaffected by the duration of follow-up, except for defecation urgency. CONCLUSIONS: The number of long-term symptoms after radical surgery with a urostomy for urinary bladder cancer affects the risk of anxiety, depression and low or moderate well-being.
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| 19. |
- Blijenberg, BG, et al.
(author)
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Quality assessment for prostate-specific antigen (PSA) in relation to ERSPC: report of the PSA Committee
- 2003
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In: BJU International. - : Wiley. - 1464-4096 .- 1464-410X. ; 92:Suppl. 2, s. 66-70
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Journal article (peer-reviewed)abstract
- Objective To assess the application of a quality control scheme for total prostate-specific antigen (PSA) as used for participants of the European Randomized Study for Screening of Prostate Cancer (ERSPC) during 1996-2002. Methods From 1996, the first complete year being 1997, an external scheme was organized by the Dutch Quality Assessment Foundation especially for the ERSPC. This scheme consists of one control round every 2 months with two different human serum samples and is only meant to compare the recovery of methods. From 1998 an internal scheme was also applied by adding two distinct samples to every round. Results Initially there was a wide variation (coefficient of variation of +/-15% at threshold PSA of 4.0 ng/mL) among all ERSPC participants who were all using the Tandem assay (Hybritech Inc, USA). After introducing the internal scheme the performance of some intra-ERSPC group comparisons for PSA and the introduction of the completely automated Beckman-Access analyser in 2001 there was state-of-the-art precision for PSA of 5% in the 2002 surveys. Conclusion The ERSPC group measurements of PSA have considerably improved since 1996 because of the application of a quality-assessment scheme and with the introduction of complete automation of the PSA assay. Both findings are in line with earlier developments in clinical chemistry.
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| 20. |
- Hugosson, J, et al.
(author)
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Population-based screening for prostate cancer by measuring free and total serum prostate-specific antigen in Sweden
- 2003
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In: BJU International. - : Wiley. - 1464-4096 .- 1464-410X. ; 92, s. 39-43
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Journal article (peer-reviewed)abstract
- Objectives To report the initial results from Sweden of a large population-based randomized study of screening using prostate-specific antigen (PSA) to detect prostate cancer, as the efficacy of such screening to decrease prostate cancer mortality has not yet been proven. Methods From the population registry men aged 50-66 years were randomized to screening (9973) and to future controls (9973). Men randomized to screening were invited to have their serum measured for free PSA (fPSA) and total PSA (tPSA) in serum using the Prostatus(R) f/tPSA assay (Perkin-Elmer, Turku, Finland). Men with a tPSA of <3.0 ng/mL were not further investigated, while those with a tPSA of &GE;3.0 ng/mL were investigated with a digital rectal examination (DRE), transrectal ultrasonography (TRUS) and sextant biopsies. Results Of those invited, 60% accepted PSA testing and 11.3% had a tPSA of &GE;3.0 ng/mL. Altogether 145 cancers were detected (positive predictive value, PPV, 24%); none were stage M1, two were stage N+ and 10 stage T3-4. Most (59%) cancers were impalpable and 39% were both impalpable and invisible on TRUS. At biopsy, 7% were Gleason score 2-4, 71% 5-6, 19% 7 and 2% Gleason score 8-10. A threshold tPSA of &GE;4.0 ng/mL would have detected 109 cancers in 366 biopsied men (PPV 30%) while cancer detection would have been 14% higher with a PPV of 36% using a threshold tPSA of &GE;3.0 ng/mL combined with a f/tPSA threshold of &LE;18%. Conclusion PSA screening detects early-stage low-grade prostate cancer. Both the sensitivity and specificity can be increased by incorporating f/tPSA with a tPSA threshold of <4 ng/mL.
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