Prostatic Neoplasms: Matveev VB

Heidenreich A, Aus G, Bolla M, Joniau S, Matveev VB, Schmid HP, Zattoni F, Anonymous00089. · Servicio de Urología, Hospital Universitario de Colonia, Colonia, Alemania. · Actas Urol Esp. · Pubmed #19418833 links to  free full text

Abstract: OBJECTIVES: To present a summary of the 2007 version of the European Association of Urology (EAU) guidelines on prostate cancer (PCa). METHODS: A literature review of the new data emerging from 2004 to 2007 was performed by the working panel. The guidelines have been updated, and the level of evidence/grade of recommendation was added to the text based on a systematic review of the literature, which included a search of online databases and bibliographic reviews. RESULTS: A full version is available at the EAU Office or at www.uroweb.org. Systemic prostate biopsy under ultrasound guidance is the preferred diagnostic method. Active treatment is mostly recommended for patients with localized disease and a long life expectancy, with radical prostatectomy being shown to be superior to watchful waiting in a prospective randomized trial. Nerve-sparing radical prostatectomy represents the approach of choice in organ-confined disease; neoadjuvant androgen deprivation demonstrates no improvement of outcome variables. Radiation therapy should be performed with at least 72 and 78 Gy in low-risk and intermediate- to high-risk PCa, respectively. Monotherapeutic androgen deprivation is the standard of care in metastatic PCa; intermittent androgen deprivation might be an alternative treatment option for selected patients. Follow-up is largely based on prostate-specific antigen and a disease-specific history with imaging only indicated when symptoms occur. Cytotoxic therapy with docetaxel has emerged as the reference treatment for metastatic hormone-refractory PCa. CONCLUSIONS: The knowledge in the field of PCa is rapidly changing. These EAU guidelines on PCa summarize the most recent findings and put them into clinical practice.

Heidenreich A, Aus G, Bolla M, Joniau S, Matveev VB, Schmid HP, Zattoni F, Anonymous00006. · Department of Urology, University Hospital Cologne, Cologne, Germany. · Eur Urol. · Pubmed #17920184 No free full text.

Abstract: OBJECTIVES: To present a summary of the 2007 version of the European Association of Urology (EAU) guidelines on prostate cancer (PCa). METHODS: A literature review of the new data emerging from 2004 to 2007 was performed by the working panel. The guidelines have been updated, and the level of evidence/grade of recommendation was added to the text based on a systematic review of the literature, which included a search of online databases and bibliographic reviews. RESULTS: A full version is available at the EAU Office or at www.uroweb.org. Systemic prostate biopsy under ultrasound guidance is the preferred diagnostic method. Active treatment is mostly recommended for patients with localized disease and a long life expectancy, with radical prostatectomy being shown to be superior to watchful waiting in a prospective randomized trial. Nerve-sparing radical prostatectomy represents the approach of choice in organ-confined disease; neoadjuvant androgen deprivation demonstrates no improvement of outcome variables. Radiation therapy should be performed with at least 72 and 78 Gy in low-risk and intermediate- to high-risk PCa, respectively. Monotherapeutic androgen deprivation is the standard of care in metastatic PCa; intermittent androgen deprivation might be an alternative treatment option for selected patients. Follow-up is largely based on prostate-specific antigen and a disease-specific history with imaging only indicated when symptoms occur. Cytotoxic therapy with docetaxel has emerged as the reference treatment for metastatic hormone-refractory PCa. CONCLUSIONS: The knowledge in the field of PCa is rapidly changing. These EAU guidelines on PCa summarize the most recent findings and put them into clinical practice.

Matveev VB, Volkova MI, Mitin AA, Kalinin SA, Ermilova VD. · No affiliation provided · Urologiia. · Pubmed #19526872 No free full text.

Abstract: The data of preoperative diagnosis and morphological examination were compared for 144 patients with prostatic carcinoma T1-4N0-XM0 subjected to radical prostatectomy in 1997-2007. In assessment of prostatic capsule invasion, sensitivity of the rectal examination was 21.7%, specificity--89.8%, diagnostic efficacy--68.1%, PPV--50.0%, NPV--70.9%, AUC under ROC curve--0.558 +/- 0.053 (p = 0.348); sensitivity of transrectal ultrasonic investigation--21.7%, specificity--89.8%, diagnostic efficacy--68.8%, PPV--52.6%, NPV--71.2%, AUC under ROC curve--0.563 +/- 0.053 (p = 0.211). Factors of a poor prognosis of prostatic capsule invasion were PSA > 10 ng/ml (p = 0.028) and Gleason score > 7 (p = 0.052). Combined use of these two parameters raises quality of preoperative assessment of category T [sensitivity--80.0%, specificity--55.1%, diagnostic efficacy--56.3%, PPV--80.4%, NPV--44.9%, AUC under ROC curve--0.624 +/- 0.049 (p = 0.017)]. Sensitivity of clinical assessment of N category was 11.1% in 100% specificity, 94.4% diagnostic efficacy, 100% PPV, 94.4% NPV, 0.556 +/- 0.107 (p = 0.577) AUC under ROC curve. A single significant prognostic factor of pN+ category was PSA > 10 ng/ml (p = 0.014). Sensitivity of histological examination of biopsy material in relation to true Gleason's parameter (< 7 or > 7) was 59.4%, specificity 89.3%, diagnostic efficacy 82.6%, PPV 61.3%, NPV 88.5%, AUC under ROC curve 0.743 +/- 0.056 (p < 0.0001). Thus, combined use of a baseline PSA concentration with a borderline value > 10 ng/ml and biopsy Gleason score > 7 raises quality of preoperative evaluation of extraprostatic tumor extension and condition of regional lymph nodes.

Davydov MI, Matveev VB, Volkova MI. · No affiliation provided · Vestn Ross Akad Med Nauk. · Pubmed #19140397 No free full text.

Abstract: Based on the personal experience, the authors emphasize the leading role of surgery in the treatment of patients with various malignant neoplasms of the urinary tract and masculine sexual organs. Current standard indications for surgical intervention and its scope are discussed with reference to the methods for the achievement of optimal immediate and delayed postoperative outcomes. Special emphasis is laid on the necessity of combined surgical techniques for the management of local and disseminated tumours of the urinary tract and male sexual organs. The rationale is proposed for extensive and combined operations on such neoplasms. The main avenues of further development of surgical oncosurgery are postulated with a view to improving quality of life of the treated patients.

Matveev VB. · Cancer Research Center, Moscow, Russia. · Arch Ital Urol Androl. · Pubmed #17269620 No free full text.

Abstract: INTRODUCTION: The incidence rate of prostate cancer (PC) in Russia has increased from 9.3 to 16.5 per 100000 person-years making it the 4th commonest form of cancer in men. In spite of lack of evidence to justify the wide spread incorporation of PSA screening it continues to gain popularity. We present the results of the screening study, which was initiated at Blokhin Cancer Center in 1996. MATERIALS AND METHODS: 1129 healthy volunteers, 40-80 years old were recruited into the screening arm. Participants underwent 3 screening tests including total PSA measurement, digital rectal examination (DRE) and transrectal ultrasound (TRUS). 6-10 core biopsies were performed in patients with suspicious findings on DRE or TRUS and patients with PSA greater than 4 ng/ml. The control arm included 943 patients who were referred to our center between 1996 and 2001. RESULTS: Five yearly rounds of screening were performed with an overall cancer detection rate of 5.7% (64). 54 cancers were detected in the first round, 6 in the second, 3 in the third, 1 in the fourth and none in the fifth round. In patients with PSA between 4 and 10 ng/ml the sensitivity of total PSA was 92% with specificity 63%. The majority of patients with high grade PC (21 of 22) had PSA above 4 ng/ml. The sensitivity of DRE reached 54%, with a specificity 94% and PPV 24.7%. The sensitivity of TRUS was 65% with a specificity 92%, and PPV 22.4%. In the control arm prostate cancer was diagnosed in 489 (52%) of 943 patients with 79% having either locally advanced or metastatic disease. On the contrary, 80% of men in screening arm had clinically localized disease. 41% (22) of screened patients had high grade disease compared to 57% (538) in the control arm. Over 50% of screen detected patients were treated with radical prostatectomy or radiotherapy compared to only 25% in clinically diagnosed group. The overall 8-year survival of patients in the screening arm treated with definite therapy (radiotherapy or radical prostatectomy) was better than in patients treated conservatively, 66% versus 43% (p = 0.047). However, when adjusted to the stage the difference in survival was lost, 74% versus 56% (p = 0.2). CONCLUSION: Screening of PC enables detection of the disease at an earlier, localized stage. The increased detection of cases with organ-confined PC is hoped to result in a decreased number of cancer-specific deaths.

Karseladze AI, Rytin IE, Matveev VB. · No affiliation provided · Arkh Patol. · Pubmed #15822791 No free full text.

Abstract: 10 normal prostates and 100 prostates with tumour were studied immunohistochemically. ACT was found mainly in the cells lining the ducts. Synthesis of ACT is significantly increased in carcinoma due to mainly two parallel processes: ACT production by carcinoma cells and intensification of its production by normal cells mainly at the tumour periphery. Hyperplastic structures showed not very high ACT content, adenomatous structures revealed a higher response. On the whole, there is a parallelism between the content of ACT and prostatic specific antigen (PSA) in both normal and carcinomatous prostate, however PSA is being found in a much more wider spectrum of cells. Content of ACT in seminal fluid may be used as a parameter for diagnosis and monitoring of prostate cancer.