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Practice patterns and outcomes of equivocal bone scans for patients with castration-resistant prostate cancer: results from SEArCH

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Asian Journal of Urology 2019年第3期6卷 242-248页

作者： Brian T.Hanyok Mary M.Everist Lauren E.Howard Amanda M.De Hoedt William J.Aronson matthew r.cooperberg Christopher J.Kane Christopher L.Amling Martha K.Terris Stephen J.Freedland Urology Section Department of SurgeryVeterans Affairs Medical CenterDurhamNCUSA New York Medical College ValhallaNYUSA Department of Biostatistics and Bioinformatics Duke University School of MedicineDurhamNCUSA Urology Section Department of SurgeryVeterans Affairs Medical CenterGreater Los AngelesLos AngelesCAUSA Department of Urology University of California at Los Angeles Medical CenterLos AngelesCAUSA Departments ofUrology and Epidemiology&Biostatistics University of CaliforniaSan FranciscoCAUSA Urology Section Department of SurgeryVeterans Affairs Medical CenterSan FranciscoCAUSA Division of Urology Department of SurgeryUniversity of California at San Diego Medical CenterSan DiegoCAUSA Division of Urology Department of SurgeryOregon Health&Science UniversityPortlandORUSA Urology Section Division of SurgeryVeterans Affairs Medical CenterAugustaGAUSA Division of Urologic Surgery Department of SurgeryMedical College of GeorgiaAugustaGAUSA Division of Urology Department of SurgerySamuel Oschin Comprehensive Cancer InstituteCedars-Sinai Medical CenterLos AngelesCAUSA Center for Integrated research in Cancer and Lifestyle Samuel Oschin Comprehensive Cancer InstituteCedars-Sinai Medical CenterLos AngelesCAUSA

Objective:To review follow-up imaging after equivocal bone scans in men with castration resistant prostate cancer(CrPC)and examine the characteristics of equivocal bone scans that are associated with positive follow-up ***:We identified 639 men from five Veterans Affairs Hospitals with a technetium-99m bone scan after CrPC diagnosis,of whom 99(15%)had equivocal *** with equivocal scans were segregated into“high-risk”and“low-risk”subcategories based upon wording in the bone scan *** follow-up imaging(bone scans,computed tomography[CT],magnetic resonance imaging[MrI],and X-rays)in the 3 months after the equivocal scan were *** were compared between patients with a positive *** follow-up imaging after an equivocal bone ***:Of 99 men with an equivocal bone scan,43(43%)received at least one follow-up imaging test,including 32/82(39%)with low-risk scans and 11/17(65%)with high-risk scans(p=0.052).Of follow-up tests,67%were negative,14%were equivocal,and 19%were *** those who underwent follow-up imaging,3/32(9%)low-risk men had metastases vs.5/11(45%)high-risk men(p=0.015).Conclusion:While 19%of all men who received follow-up imaging had positive follow-up imaging,only 9%of those with a low-risk equivocal bone scan had metastases versus 45%of those with *** preliminary findings,if confirmed in larger studies,suggest follow-up imaging tests for low-risk equivocal scans can be delayed while high-risk equivocal scans should receive follow-up imaging.

关键词： Castration-resistant prostate cancer Equivocal test result Bone scan radiology report Follow-up imaging Neoplasm metastasis

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External-beam radiation therapy should be given with androgen deprivation treatment for intermediate-risk prostate cancer： new confirmatory evidence

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Asian Journal of Andrology 2012年第1期14卷 132-133页

作者： matthew r.cooperberg Department of Urology University of California San Francisco CA 94143-1695 USA

Anewly published study, radiation Therapy Oncology Group （rTOG） trial 94-08, has demonstrated that a short-course ofneoadjuvant androgen deprivation therapy （ADT） given together with external-beam radiation therapy （EBrT） improves outcomes for men with intermediate-risk prostate cancer compared with EBrT alone） The benefits of neoadjuvant ADT for men receiving EBrT have been recognized for years, but in light of growing concerns regarding potential long-term skeletal, metabolic and cardiovascular toxicities of ADT, the demonstration of benefits with only shortterm treatment is timely.

关键词： External-beam radiation therapy intermediate-risk prostate cancer neoadjuvant ADT rTOG 94-08 brachytherapy

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睾丸活检组织学结果的变异与卵母细胞单精子显微注射治疗男性不孕症的相关性

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世界核心医学期刊文摘（妇产科学分册） 2006年第1期2卷 37-38页

作者： cooperberg M.r. ChiT. Jad A. P.J. Turek 张剑萍 Department of Urology 1600 Divisadero Street A633 San Francisco CA 94143- 1695 United StatesDr.

To determine whether center to center discrepancies in the ability to locate sperm in infertile testes with abnormal histology stems in part from inconsistencies in pathologists’ readings of testis biopsies. Design: Prospective cohort study. Setting: Academic male infertility practice. Patient(s): Consecutive series of azoospermic men referred with testis biopsy slides between 1998 and 2003. Intervention(s): Testis biopsy histologies on azoospermic patients referred for infertility care were re-reviewed by a single pathologist blinded to the original reading. Subsequent infertility care was guided by the findings from the second histologic reading. Main Outcome Measure(s): Agreement between the outside and in-house review of testis biopsy readings was assessed with the kappa statistic. Pregnancy outcomes that resulted from clinical decisions informed by the second histologic readings were also assessed. result(s): Among 113 histologic specimens, re-review was complicated by fixation artifacts in 18 cases (16% ) and insufficient biopsy sample size in 13 cases (12% ). The kappa score for interobserver agreement in readings was 0.43 (95% CI 0.32- 0.54). Mixed histology patterns in particular were underappreciated by outside pathologists (13% of cases on original reading, 36% of cases on review). In 27% of all cases, the differences in biopsy readings had a significant impact on clinical management. Conclusion(s): A correlation between independent testis histology readings in azoospermic men demonstrates frequent inconsistencies. These differences contribute to inaccurate phenotyping of male infertility and can significantly impact the direction of infertility care. These findings highlight the need for a standardized approach to testis histologic review.

关键词：男性不孕症组织学标本睾丸活检显微注射治疗卵母细胞 kappa检验单精子结果一致性前瞻性队列研究变异

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