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Outcomes of combination MRI-targeted and transperineal template biopsy in restaging low-risk prostate cancer for active surveillance

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Asian Journal of Urology 2018年第3期5卷 184-193页

作者： Kenneth Chen kae jack tay Yan Mee Law Hakan Aydin Henry Ho Christopher Cheng John Shyi Peng Yuen Department of Urology Singapore General HospitalSingapore Department of Diagnostic Radiology Singapore General HospitalSingapore Department of Pathology Singapore General HospitalSingapore

Objective:Active surveillance(AS)offers a strategy to reduce overtreatment and now is a widely accepted treatment option for low-risk prostate *** ideal tool for risk-stratification would detect aggressive cancers and exclude such men from taking up AS in the first *** evaluate if a combination of transperineal template biopsy with magnetic resonance imaging(MRI)-targeted biopsy identifies significant prostate cancer amongst men initially diagnosed with low-risk prostate ***:This prospective,single-blinded study included men with low-risk prostate cancer(D’Amico’s Criteria)diagnosed on conventional transrectal ultrasound-guided *** first underwent multiparametric MRI of the prostate6 weeks after initial *** suspicious lesion is mapped and assigned a Prostate Imaging Reporting and Data System(PIRADS)*** biopsy is first performed with the surgeon blinded to MRI findings followed by MRI-targeted biopsy using a robotic transperineal biopsy ***:The age of the 19 men included is 65.4±4.9 years(mean±SD).Prostate specific antigen(PSA)at diagnosis and at the time of transperineal biopsy were comparable(7.3±1.7 ng/mL and 7.0±1.8 ng/mL,p Z 0.67),so were prostate volumes(34.2±8.9 mL and 32.1±13.4 mL,p Z 0.28).MRI-targeted biopsy had a higher percentage of cancer detection per core compared to template biopsy(11.7%vs.6.5%,p Z 0.02),this was more than 3 times superior for Gleason 7 disease(5.9%vs.1.6%,p<0.01).Four of 18(22.2%)patients with MRI lesions had significant disease with MRI-targeted biopsy *** of 19 patients(15.8%)had significant disease with template biopsy *** combination,both techniques upclassified five patients(26.3%),all of whom underwent radical *** mount histology confirmed tumour location and *** six patients with PIRADS 5 lesions had cancer detected(66.6%significant disease).Conclusion:A combination of MRI-targeted and template biopsy may optimally risk-classi

关键词： Active surveillance Magnetic resonance imaging Targeted biopsy Transperineal prostate biopsy Robotic biopsy Low-risk prostate cancer

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^(68)Gallium-labelled PSMA-PET/CT as a diagnostic and clinical decision-making tool in Asian prostate cancer patients following prostatectomy

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Cancer Biology & Medicine 2019年第1期16卷 157-165页

作者： Janice S.H.Tan Charles X.Y.Goh Yen Sin Koh Youquan Li Jeffrey K.L.Tuan Eu Tiong Chua Terence W.K.Tan Michael L.C.Wang Lui Shiong Lee kae jack tay Ravindran Kanesvaran Chee Keong Toh Aaron K.T.Tong Winnie W.C.Lam Melvin L.K.Chua Division of Radiation Oncology National Cancer Centre Singapore Department of Nuclear Medicine and Molecular Imaging Singapore General Hospital Radiological Sciences Academic Clinical Programme Duke-NUS Medical School Oncology Academic Clinical Programme Duke-NUS Medical School Department of Urology Singapore General Hospital Department of Surgery Sengkang General Hospital Division of Medical Oncology National Cancer Centre Singapore Division of Medical Sciences National Cancer Centre Singapore

Objective: Prostate cancers(PCa) in Asian individuals are molecularly distinct from those found in their Caucasian *** is no risk stratification tool for Asian men with rapid biochemical recurrence(BCR) following radical prostatectomy(Rad P). This study aims to assess the detection rate of ^(68)Ga-prostate-specific membrane antigen-positron emission tomography/computed tomography(PSMA-PET/CT) for diagnosis of clinical recurrence and as a treatment decision making tool in Asian patients with BCR post-Rad ***: ^(68)Ga PSMA-PET and CT body with/without bone scan [conventional workup(CWU)] were performed in 55 Asian patients with BCR within 36 months post-Rad P. Two blinded reviewers assessed the images. Detection rates of ^(68)Ga PSMAPET/CT were evaluated, and impact on management was reviewed by comparison with ***: Median time to BCR post-Rad P was 8.1 months. Detection rate for ^(68)Ga PSMA-PET/CT was 80%(44/55). A positive scan was significantly associated with increasing prostate-specific antigen(PSA) level [odds ratio(OR) = 1.13(95% CI 1.05–1.30), P =0.017], but not with higher Gleason grade or shorter PSA doubling time. Compared to CWU, ^(68)Ga PSMA-PET/CT detected an additional 106 lesions in 33/44 patients with a positive scan, resulting in a change in management in 25/44(56.8%) patients: 10 to hormonal therapy(HT) and whole pelvis radiotherapy(RT) in addition to bed RT, and 15 to palliative HT ***: In the present report, we demonstrated the diagnostic and treatment decision utility of ^(68)Ga PSMA-PET/CT in Asian men with rapid BCR. Detection of small volume nodal and systemic recurrences at low PSA levels(< 1.0 ng/mL) highlights the role of the tool in assigning patients to treatment intensification with HT-RT or palliative HT in polymetastatic disease.

关键词： ^68Ga PSMA PET/CT prostate cancer Asian diagnostic recurrence prostatectomy salvage radiotherapy

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Transcriptomic analyses of localized prostate cancers of East Asian and North American men reveal race-specific luminal-basal and microenvironmental differences

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Cancer Communications 2023年第10期43卷 1164-1168页

作者： Melvin L.K.Chua Alexander K.Hakansson Enya H.W.Ong Boon Hao Hong Jing Jing Miao Adelene Y.L.Sim Janice S.H.Tan Kah Min Tan Gabrielle C.J.Lee Kar Perng Low Jeffrey K.L.Tuan Terence W.K.Tan Michael L.C.Wang Joe P.S.Yeong Michael C.S.Tan Lui Shiong Lee Ravindran Kanesvaran Xin Zhao Julian Ho Daniel E.Spratt Edward M.Schaeffer kae-jack tay Yang Liu Elai Davicioni Li Yan Khor Division of Radiation Oncology National Cancer Centre SingaporeSingaporeSingapore Duke-NUS Medical School SingaporeSingapore Division of Medical Sciences National Cancer Centre SingaporeSingaporeSingapore Veracyte IncSan DiegoCAUSA Department of Nasopharyngeal Carcinoma State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat-sen University Cancer CenterGuangzhouGuangdongP.R.China Faculty of Medicine Nursing and Health SciencesMonash UniversityVictoriaAustralia Department of Anatomical Pathology Singapore General HospitalSingaporeSingapore Department of Pathology Changi General HospitalSingaporeSingapore Department of Urology Sengkang General HospitalSingaporeSingapore Division of Medical Oncology National Cancer Centre SingaporeSingaporeSingapore Department of Radiation Oncology University Hospitals Seidman Cancer CenterCase Comprehensive Cancer CenterClevelandOHUSA Department of Urology Northwestern University Feinberg School of MedicineChicagoILUSA Department of Urology Singapore General HospitalSingaporeSingapore

Dear editor,Prostate cancer(PCa)remains a major healthcare burden in men globally[1].Most patients present with localized disease,and treatment is recommended based on risk classification systems like the National Comprehensive Cancer Network(NCCN)[2].However,these methods are imprecise for estimating metastasis-free survival and prostate cancer-specific mortality and thus biomarkers that can predict tumor aggression are needed[3–5].Several studies have since characterized the molecular landscape of localized PCa in White[4,5]and Black/African-American men[6],but data is lacking in Asian *** Chinese Prostate Cancer Genome and Epigenome Atlas(CPGEA)reported on the genomic and epigenomic landscape of 208 PCa of men from China[7].Comparative analyses between the CPGEA cohort and data from The Cancer Genome Atlas(TCGA)revealed higher frequencies of Forkhead box A1(FOXA1)and chromodomain-helicase DNA-binding 1(CHD1)mutations,and lower frequencies of phosphatase and tensin homolog(PTEN)mutations and transmembrane protease serine 2-E26 transformationspecific related gene(TMPRSS2-ERG)fusion in Chinese compared with White men[7].These preliminary findings highlight the presence of race-specific differences in molecular phenotypes of PCa.

关键词： landscape Atlas editor

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Quantifying the impact of inhalational burns:a prospective study

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Burns & Trauma 2018年第3期6卷 209-218页

作者： Si jack Chong Yee Onn Kok Rosanna Xiang Ying tay Desai Suneel Ramesh Kok Chai Tan Bien Keem Tan Department of Plastic Reconstructive and Aesthetic SurgerySingapore General HospitalLevel 5AcademiaSingapore 169865Singapore Department of Anaesthesiology Singapore General HospitalLevel 5AcademiaSingapore 169865Singapore

Background:Inhalational injury is a major cause of morbidity and mortality in burns patients. This study aims to analyse the clinical outcomes, complications and bacteriology of inhalational burn patients. Methods:A prospective study was done on consecutive admissions to Burn Department, Singapore General Hospital over 15 months from January 2015 to March 2016. Presence of inhalational injury, demographics, complications and outcomes was recorded. Diagnosis of inhalational injury was based on history, symptoms and nasoendoscopy. Diagnosis of acute respiratory distress syndrome (ARDS), acute kidney injury (AKI) and infective complications were according to the Berlin criteria, acute kidney injury network (AKIN) classification stage 2 and above and the American Burns Association guidelines. Results:Thirty-five patients (17.3%) had inhalational burns out of 202 patients (63.4%male, 57.4%Chinese population). The average age was 43 ± 16.7 years (range 16–86), and percentage of total body surface area (%TBSA) was 12.1 ± 18.0 (range 0–88). In patients with inhalational injury, age was 38.9 ± 17.2 years and%TBSA was 30.3 ± 32.3. In patients without inhalational injury, age was 44.1 ± 12.8 years and%TBSA was 8.3 ± 9.59. Compared to patients with cutaneous injury alone, patients with inhalational burns had more surgeries (3 ± 7.07 vs 1 ± 1.54, p=0.003), increased length of stay (21 days vs 8 days, p=0.004) and higher in-hospital mortality rate (17.1%vs 0.6%, p<0.001). Incidence of ARDS and AKI was 48.6%and 37.1%, respectively, compared to 0.6%and 1.2%in the patients without inhalational injury (p<0.001). Patients with inhalational injury had increased incidence of bacteraemia (31.4%vs 2.4%, p<0.001), pneumonia (37.1% vs 1.2%, p<0.001) and burn wound infection (51.4% vs 25.1%, p=0.004). Inhalational injury predicted AKI with an adjusted odds ratio (OR) of 17.43 (95%confidence interval (CI) 3.07–98.87, p<0.001);ARDS, OR=106.71 (95%CI 12.73–894.53, p<0.001) and pneumonia, OR=13.

关键词： Inhalational Burns Injury Acute kidney injury Acute respiratory distress syndrome Pneumonia

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New interchange English for international communication 2

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2005年

作者： jack C. Richards tay Lesley

本教材主要使用美国英语，但涉及许多国家、地区和文化，它强调在实际交流活动中培养语言，主要活动有主题讨论、语法结构、语言功能、词汇扩展和语言训练。

ISBN: (纸本)7560022154

关键词：英语

来源：畅想之星图书光盘版（南... 评论

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英国赫尔肢体畸形矫正培训班见闻

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中华骨与关节外科杂志 2023年第9期16卷 840-842页

作者：臧建成郑楷贤北京中医药大学第三附属医院手足外科北京100029 “中医骨伤治疗与运动康复智能化”教育部工程研究中心北京100029 秦泗河矫形医学研究院北京101199 新加坡中央医院足踝外科新加坡市699010新加坡

2023年6月18-23日,第12届赫尔肢体畸形矫正培训班(Hull Deformity Planning Couse)在英国赫尔(Hull)成功召开。本届培训班由英国肢体重建学会(British Limb Reconstruction Society)主席、赫尔大学肢体重建中心Hemant Sharma教授和桑德兰(Sunderland)皇家医院Gavin de Kiewiet教授担任课程主席。来自英国、加拿大、印度、埃及、尼日利亚、沙特阿拉伯、比利时、波兰及中国香港等国家和地区的60位学员参加了培训。作为国际矫形与创伤外科学会(Societe Intemationale de Chirurgie Orthopedique et de Traumatologie,SICOT)肢体重建委员会国际委员,我受邀作为讲师团成员出席了培训班,深度参与和认真体会了其独具特色的教学模式和培训精髓,现简要总结如下,希望对今后国内及亚洲的肢体重建培训事业有所借鉴。

关键词：创伤外科学畸形矫正培训事业赫尔大学中国香港尼日利亚深度参与沙特阿拉伯

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