AMERICAN UROLOGICAL ASSOCIATION
1998 NATIONAL SCIENTIFIC MEETING
SAN DIEGO CONVENTION CENTER
SAN DIEGO, CALIFORNIA
MAY 30 - JUNE 4, 1998
TITLES/DESCRIPTIONS OF SELECTED NEWSWORTHY SCIENTIFIC ABSTRACTS
Contact: Bill Glitz (703) 532-3797 or by e-mail at [email protected]
From May 30 through 12 noon on June 4, please call the Press Room
at (619) 525-6246.
Embargoed until Monday, June 1
Mortality from Prostate Cancer after Non-Curative Treatment--
Past, Present, Future--Abstract # 483
(Gunnar Aus; 10:30 a.m. - 12 noon on Monday, June 1; poster
presentation; Room 11B, San Diego Convention Center)
In Sweden, prostate cancer patients are treated traditionally without curative intent, through hormone treatment. Consequently, mortality from prostate cancer mirrors the ultimate outcome of this non-curative approach. The objective of this study by Swedish investigators was to correlate the increase in prostate cancer mortality over the 30-year period from 1966 to 1995 with a change in the male age profile. Utilizing the Swedish cause of death register (in use since 1750), researchers noted that of the 42,303 men who died in 1966, 2.7% or 1,128 died from prostate cancer. In 1995, 47,428 died, with 4.8% or 2,280 men expiring from prostate cancer. According to the researchers, there was a 102% increase in prostate cancer mortality over the 30-year period as contrasted with a 12% increase in total mortality. They explain that the main reason for the increase is a rise in the average life span from 71.7 years to 75.8 years over the 30 years. Although death rates from prostate cancer were fairly stable over the 30-year period, they increased by age group: from 0.014% in men 55 - 59 years; to 0.35% in men aged 75 - 79; to 0.96 in men over 90 years. By projecting to the year 2025, prostate cancer deaths would increase 42% to 3,248 men. Since more men are living longer, an increase in prostate cancer mortality is to be expected, according to the investigators.
Grade, Stage, and Age Migration in the PSA Era: Lead Time and
Length Time Effects - Population Based Data from the SEER
Prostate Cancer Working Group--Abstract # 475
(Robert A. Stephenson; 10:30 - 12 noon on Monday, June 1; poster
session; Room 11B, San Diego Convention Center)
By examining data on 250,109 cases of prostate cancer from the National Cancer Institute SEER Program from the years 1973 - 1994, these investigators were able to detect grade, stage, and age differences between the pre-prostate specific antigen (PSA) test period (1973 - 1983) and the post-PSA era (1989 - 1994). They found that during pre-PSA period, the higher and lower graded cancers (known Gleason scores) had roughly the same incidence at 17 to 23 cases per 100,000 men. Yet, after the start of the PSA era, there was a major increase in incidence to 97.4 cases per 100,000 men. About 75% of the increase was accounted for by moderately differentiated tumors. Only 8% of the increase was the result of newly diagnosed well- differentiated prostate cancers. Also, distant stage rates for the disease declined by 50% from the pre-PSA era (from 14.6 to 7.1 cases per 100,000 men). After examining age data, they found the average age at diagnosis declined slightly from 72 (pre-PSA), to just under 69-1/2 during the PSA era. The investigators suggest that declining age at diagnosis and decreasing distant stage rates suggest earlier diagnosis takes place during the PSA era. However, the definitive impact of these effects on patient outcome must await future mortality data.
Occupational Risk Factors for Prostate Cancer - A Case Control
Study from a Area of Coal, Iron, and Steel Industry--Abstract #
481
(Thomas Reckwith; 10:30 a.m. to 12 noon on Monday, June 1; poster
presentation; Room 11B, San Diego Convention Center)
The aim of this German study was to identify occupations associated with elevated risk of prostate cancer. The researchers interviewed 238 patients with histologically confirmed prostate cancer, and talked to 414 patients with benign prostatic hyperplasia (BPH). The investigators wanted to find out from each individual their smoking habits and information about occupations in which they had been employed for a year or more. According to the investigators, there was no relationship between "pack years" smoked and prostate cancer. However, underground coal miners and painters/varnishers had elevated risks for the disease. Businessmen showed a remarkably low rate of prostate cancer. Among those 70 and over, underground coal miners were the group in which risk was higher; also, horticultural, forestry, and chemical workers were at greater risk for prostate cancer.
Recent Declines in Prostate Cancer Incidence and Mortality in
Olmsted County, MN, 1980-1995--Abstract # 474
(Rosebud W. Roberts; 10:30 a.m. - 12 noon on Monday, June 1;
poster presentation; Room 11B, San Diego Convention Center)
This study reviewed the 1983 to 1995 incidence of prostate cancer in Olmsted County, Minnesota. After checking all community medical records during those years, the researchers discovered that of the 687 men with biopsy-proven prostate cancer, 163 had died from the disease. They found that incidence rates per 100,000 person years had increased from 64 in 1983 to 209 in 1992, before declining to 132 in 1995. Although the incidence of organ-confined cancer increased from 1987 to 1992 before declining to level seen before the prostate specific antigen (PSA) test became available, regional or distant disease showed a consistent downward trend from 1988 through 1995. Community mortality rates per 100,000 men increased initially from 38.5 in 1980 to 48.7 in 1991, then showed a consistent downward trend to 14.5 in 1995. (That figure represented a 62% reduction from the 1980 rate.) According to the investigators, since mortality rates have shown a regular decline in the last 5 years to below pre-PSA rates, increased screening for prostate cancer may have had a significant beneficial effect on community mortality rates from this disease.
Duration of Pre-Clinical Prostate Cancer Based on Serial PSA Data
from the VA Normative Aging Study--Abstract # 479
(Steven Skates; 10:30 a.m. - 12 noon on Monday, June 1; poster
presentation; Room 11B, San Diego Convention Center)
The Veteran Affairs Normative Aging Study (NAS) is a 30-year study of 2,200 men as they age. These researchers obtained serum samples to run PSA tests from 97 NAS participants who had prostate cancer, and from 281 participants with benign prostatic hyperplasia (BPH) or enlarged prostate. The investigators found that the average age at tumor inception was almost 61 years, with an age range of approximately 49 to 73. There was a duration of pre-clinical prostate cancer of almost 10 years. At 50 years of age, the average PSA level was 2.4 ng/ml if the patient did not already have prostate cancer. After tumor inception, the average annual rate of increase in PSA level was 25.5% According to this study, these researchers believe a substantial portion of prostate cancer develops in the early 50's for patients, with the disease being diagnosed some 6.6 to 10 years later. They feel this information is important to developing optimal approaches to PSA screening for prostate cancer as men age.
Testicular Transposition for Treatment of Chronic Lymphedema
Following Inguinal Node Dissection--Abstract # 615
(Owen Prowse; 3:30 p.m. - 5:30 p.m. on Monday, June 1; podium
presentation; Room 1A and 1B, San Diego Convention Center)
Lymph node dissection after cancer surgery can lead to swelling of an extremity due to the accumulation of fluid from obstruction of the lymph vessels. Sometimes, this problem cannot be treated medically, and can be very disabling. In penile cancer, nodes in the groin are dissected as part of the surgery. These investigators have assisted 4 patients who had serious leg swelling from lymphatic obstruction associated with lymph node surgery in penile cancer. The surgeons adapted a technique to use the testicular lymphatics or gonadal system to reduce the edema successfully. They have decreased patient discomfort and reduced leg circumference by more than 30% following their operation. They have concluded that this technique should be considered a surgical treatment option for this type of edema if it is unresponsive to treatment.
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