Background: Despite rapid advances in the treatment of prostate cancer (PCa), the optimal treatment for elderly patients with PCa remains unclear due to a lack of high-quality evidence. This study aimed to evaluate whether surgical procedures are beneficial for PCa patients aged 75 years and older and compare the effects of focal ablation and prostatectomy.
Methods: Male patients aged 75 years and older who were diagnosed with Tis-T2/N0/M0 PCa between 2000 and 2017 were retrospectively identified from the Surveillance, Epidemiology, and End Results program database. Cox regression models were used to test for statistical differences between the overall survival (OS) and disease-specific survival (DSS).
Results: A total of 114,506 patients aged 75 years and older with PCa were included in this study, among which 60,131 died during the study period. The most prevalent surgical procedure for these patients was focal ablation. The local excision rate increased with advancing age, while the prostatectomy rate decreased sharply with age. The proportion of the elderly patients who underwent a focal ablation also increased with the age at diagnosis. The survival rate of patients aged 75 years and older who underwent a focal ablation was significantly worse than that for those who did not undergo any surgical procedures (OS: HR, 1.32, <0.001; DSS: HR, 1.58, <0.001). Although only a few of the patients underwent prostatectomy, the procedure was still related to improved OS and DSS (OS: HR, 0.60, < 0.001; DSS: HR, 0.37, <0.001) rates.
Conclusions: Focal ablation has gradually replaced prostatectomy as the most common surgical procedure for elderly patients with PCa in the United States. However, our results revealed that the procedure might not provide benefits for elderly patients with PCa; instead, we found that focal ablation resulted in increased negative effects on patient prognoses. Elderly patients should have the same opportunity to be treated with standard surgical interventions as younger patients.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11256698 | PMC |
http://dx.doi.org/10.1016/j.jncc.2021.11.005 | DOI Listing |
Open Life Sci
December 2024
School infirmary, Fudan University, Shanghai, 200433, China.
Both irreversible electroporation (IRE) and radiofrequency ablation (RFA) are viable ablation methods for localized treatment of liver tumors. We conducted a meta-analysis to access the efficacy and safety of IRE and RFA in liver cancer treatment. Clinical studies on IRE and RFA for the treatment of liver cancer were collected from PubMed and CNKI until June 2023.
View Article and Find Full Text PDFRev Bras Ortop (Sao Paulo)
December 2024
Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, Paquistão.
Surgical procedures of curettage and surgical resection are used to treat giant cell tumor (GCT) of the distal radius, but it is still controversial whether one provides better functional outcomes than the other. The present study aims to determine and compare both procedures regarding complications, local recurrence, and mobility. A complete search of the applicable literature was done and independently assessed by three authors.
View Article and Find Full Text PDFJACC Clin Electrophysiol
November 2024
Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA. Electronic address:
Background: Arrhythmias originating from papillary muscles (PAPs) can be challenging when targeted with catheter ablation. The prevalence and impact of structural abnormalities on PAPs in patients with focal PAP arrhythmias is unknown.
Objectives: The purpose of this study was to analyze, in a consecutive patient series with focal PAP arrhythmias, the impact of structural abnormalities detected by multimodality imaging.
JACC Clin Electrophysiol
November 2024
Electrophysiology Section, Division of Cardiology, Hunter Holmes McGuire VA Medical Center, Richmond, Virginia, USA; Pauley Heart Center, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA. Electronic address:
Background: The mechanisms underlying postoperative atrial fibrillation (POAF) remain unclear.
Objectives: The aim of this study was to test the hypothesis that targeted chemical ganglionated plexi (GP) modulation of all major left atrial-pulmonary vein GP using novel nanoformulated calcium chloride (nCaCl) can reverse postoperative neuroelectrical remodeling by suppressing vagosympathetic nerve activity and the localized inflammatory process, both critical substrates of POAF.
Methods: In a novel canine model of POAF with serial thoracopericardiotomies, sympathetic nerve activity (SNA), vagal nerve activity (VNA) and GP nerve activity (GPNA) were recorded; spontaneous and in vivo AF vulnerability were assessed; and atrial and circulating inflammatory markers and norepinephrine (NE) were measured to determine the neuroelectrical remodeling that promotes POAF and its subsequent modulation with nCaCl GP treatment (n = 6) vs saline sham controls (n = 6).
World J Surg Oncol
December 2024
Hepatobiliary and Pancreatic Intervention Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Background: At present, the main clinical application of local ablation therapy, such as radiofrequency ablation (RFA), is to heat the tissue to a certain temperature. However, high temperature will cause thermal damage. Irreversible electroporation (IRE) is a novel minimally invasive local ablation technology for tumors.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!