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Cancer
Mayo Clinic Urologists Present Findings at 2014 Annual Meeting of the American Urological Association
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*See specific embargo dates and times for each study
ROCHESTER, Minn. – Mayo Clinic urologists will present studies on a new non-mesh outpatient procedure for treating female stress incontinence stress incontinence, lymph node surgery guided by 11c-Choline imaging for patients with nodal recurrent prostate cancer, a Prostate Specific Antigen (PSA) cut point correlated with systemic progression of prostate cancer, an increased mortality risk for diabetes patients undergoing surgery for kidney cancer and other research at the 2014 Annual meeting of the American Urological Association, May 16–21, in Orlando, Fla. Mayo Clinic experts will also be available to provide comment for reporters covering the conference. Studies to be presented at the meeting and their embargo dates include:
New non-mesh outpatient sling procedure for treating female stress urinary incontinence shows promise
Embargoed until Sunday, May 18, 2014 10:00 AM ET
http://www.aua2014.org/abstracts/files/presenter_LinderBrian.cfm
https://www.youtube.com/watch?v=pB0ptOP7Stw
A feasibility study of a novel non-mesh-based outpatient surgical procedure to treat female stress incontinence has promising results. Early results show that all patients have experienced decreased leakage volumes after surgery, while 80 percent reported no leakage and no longer required absorbent pads. Female stress incontinence is characterized by the unintentional loss of urine during physical activity such as exercise, coughing, sneezing or laughing. The minimally invasive outpatient procedure developed by Daniel Elliott, M.D., and Brian Linder, M.D., of Mayo Clinic, was designed to avoid the controversies and complications of mesh procedures. During the procedure the surgeon inserts a sling, made from a small amount of the patient’s own tissue, to support the urethra.“Unlike other outpatient sling procedures to treat female stress incontinence, ours uses the patient’s native tissue rather than any synthetic mesh,” says Dr. Linder. “The patients in our study have shown significant improvement in their incontinence and quality of life. None have suffered vaginal extrusions, urethral erosions or other complications that may be encountered in mesh procedures.”
Surgery guided by 11c-Choline imaging shows promise for patients with nodal recurrent prostate cancer
Embargoed until Wednesday, May 21, 2014 8 AM ET (Best Abstract)
http://www.aua2014.org/abstracts/files/presenter_KarnesRJeffrey.cfm
A study of 52 men with prostate cancer who had their prostates removed at Mayo Clinic from 2008 to 2013 has found that subsequent lymph node removal for prostate cancer recurrence, guided by 11 c-Choline imaging, may represent a useful treatment option. “This, to our knowledge, represents the largest U.S. study of salvage lymph node dissection in the setting of metastatic prostate cancer with rising PSA following radical prostatectomy,” says author R. Jeffrey Karnes, M.D. “While a longer follow-up of these patients is needed, salvage lymph node dissection, guided by 11 c-Choline imaging, may represent a valid treatment option as part of a multimodal approach involving hormonal therapy or may even be potentially curative in select men.”
PSA cut point of 0.4 shows strong correlation with systemic progression of prostate cancer after surgery
Embargoed until Tuesday, May 20, 2014 5:30 PM ET
http://www.aua2014.org/abstracts/files/presenter_StewartSuzanne.cfm
A study looking at medical records of more than 13,000 prostate cancer patients who received care at Mayo Clinic between 1987 and 2010 has found that a PSA cut point of 0.4 nanograms/milliliter reflects the threshold at which a rise in PSA levels becomes durable and shows the strongest correlation with biochemical recurrence of prostate cancer.
“There have been multiple definitions of biochemical recurrence for prostate cancer,” says Suzanne Stewart, M.D., author of the study. “Our study is important because it identifies a cut point which is critical for counseling patients, risk stratification and developing a standard definition of biochemical recurrence.”
Diabetes associated with increased mortality from cancer in kidney cancer patients undergoing surgery
Embargoed until Monday, May 19, 2014 12:30 PM ET
http://www.aua2014.org/abstracts/files/presenter_PsutkaSarah.cfm
A study looking at medical records of more than 2,500 patients treated for clear cell renal cell carcinoma (kidney cancer) at Mayo Clinic between 1990 and 2008 found that diabetes was independently associated with decreased cancer-specific survival among patients being surgically treated for the cancer. The review also found that diabetes was associated with decreased overall survival in patients with all forms of renal cell carcinoma. “Conflicting data exist regarding the interaction of diabetes with outcomes for patients with kidney cancer,” says lead author Sarah Psutka, M.D. “Our review points out the need for further studies to determine the potential biologic mechanism of this interaction.”
Study looks at the impact of prostate avidity on fluorodeoxyglucose positron emission tomography
Embargoed until Monday, May 19, 2014 12:30 PM ET
http://www.aua2014.org/abstracts/files/presenter_CockerillPatrick.cfm
A study looking at medical records of 65 prostate cancer patients treated at Mayo Clinic from 2000 to 2013 found that 38 percent of patients with incidental fluorodeoxyglucose (FDG) avidity in the prostate were diagnosed with prostate cancer. The review also found that 18 percent of those patients had intermediate or high-risk malignancy.
“While positron emission tomography (PET) utilizing FDG is increasingly used for staging of multiple cancers, its use for staging in prostate cancer is unclear as it does not appear to improve existing clinical staging because prostate cancer has a lower avidity for glucose-based tracers,” says Patrick Cockerill, M.D. of Mayo Clinic. “There is clearly a need for further study to determine the need for prostate biopsy, in concert with other factors, such as age, family history, comorbidity, PSA and clinical examination.”
Physicians may be able to predict how well a patient will recover from radical cystectomy
Embargoed until Monday, May 19, 2014 10:00 AM ET
http://www.aua2014.org/abstracts/files/presenter_PsutkaSarah.cfm
A study looking at medical records of more than 1,300 patients with bladder cancer who underwent radical cystectomy — complete removal of the bladder, lymph nodes, part of the urethra, and nearby organs that may contain cancer cells — at Mayo Clinic between 1995 and 2006 found that an individual patient’s presurgical performance status, as measured by the Eastern Cooperative Oncology Group performance criteria, was strongly associated with the patient’s risk for a prolonged length of stay. A lengthy hospital stay is associated with postoperative complications and mortality. “We compared the preoperative characteristics of the patients in this study between patients who experienced a prolonged length of stay, which we defined as 10 days or longer, and those who did not,” says lead author Sarah Psutka, M.D. “Our findings underscore the need for a patient’s performance status to influence patient counseling and preoperative decision-making.”
Muscle loss associated with increased mortality in patients undergoing radical cystectomy for cancer
Embargoed until Monday, May 19, 2014 12:30 PM ET
http://www.aua2014.org/abstracts/files/presenter_PsutkaSarah.cfm
A study looking at medical records of 205 patients with sarcopenia and muscle-invasive bladder cancer who underwent radical cystectomy — complete removal of the bladder, lymph nodes, part of the urethra, and nearby organs that may contain cancer cells — at Mayo Clinic between 2000 and 2007 found that the presence of sarcopenia, age-related muscle loss, significantly increases the risk of death from cancer and all causes.
“Our findings warrant further study of sarcopenia as an objective measure of preoperative frailty,” says lead author Sarah Psutka, M.D. “This measure may also incorporated into risk stratification to assist physicians in patient counseling and treatment planning.”
Combination of muscle loss and obesity significantly influences survival among patients undergoing radical cystectomy for bladder cancer
Embargoed until Monday, May 19, 2014 10:30 AM-12:30 PM ET
http://www.aua2014.org/abstracts/files/presenter_PsutkaSarah.cfm
A study looking at medical records of 207 patients with sarcopenic obesity and muscle-invasive bladder cancer who underwent radical cystectomy — complete removal of the bladder, lymph nodes, part of the urethra, and nearby organs that may contain cancer cells — at Mayo Clinic between 2000 and 2007 found that sarcopenic obesity appears to significantly influence the risk of death from cancer and all causes. Sarcopenic obesity is characterized by extreme muscle wasting and excessive fat accumulation. “Our study would indicate the need for further research to better delineate the biological relationship between skeletal muscle wasting and obesity in patients with urologic malignancy,” says lead author Sarah Psutka, M.D. “Sarcopenic obesity may represent a potential objective measure of frailty and comorbidity burden that could assist physicians in their evaluation of patients before surgery.”
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