The presence of glycosylated isoforms of prostate-specific antigen (PSA) in prostate cancer (PC) cells is a potential marker of their aggressiveness. We characterized the origin of α2,3-sialylated prostate-specific antigen (S23PSA) by tissue-based sialylation-related gene expression and studied the performance of S23PSA density (S23PSAD) alone and in combination with multiparametric magnetic resonance imaging (MRI) for the detection of clinically significant prostate cancer in men with elevated PSA.Tissue-based quantification of S23PSA and sialyltransferase and sialidase gene expression was evaluated in 71 radical prostatectomy specimens. The diagnostic performance of S23PSAD was studied in 1099 men retrospectively enrolled in a multicenter systematic biopsy (SBx) cohort. We correlated the S23PSAD with Prostate Imaging Reporting and Data System (PI-RADS) scores in 98 men prospectively enrolled in a single-center MRI-targeted biopsy (MRI-TBx) cohort. The primary outcome was the PC-diagnostic performance of the S23PSAD, the secondary outcome was the avoidable biopsy rate of S23PSAD combined with DRE and total PSA (tPSA), and with or without PI-RADS.S23PSA was significantly higher in Gleason pattern 4 and 5 compared with benign prostate tissue. In the retrospective cohort, the performance of S23PSAD for detecting PC was superior to tPSA or PSA density (PSAD) (AUC: 0.7758 vs. 0.6360 and 0.7509, respectively). In the prospective cohort, S23PSAD was superior to tPSA, PSAD, and PI-RADS (AUC: 0.7725 vs. 0.5901, 0.7439 and 0.7305, respectively), and S23PSAD + PI-RADS + DRE + tPSA was superior to DRE + tPSA+PI-RADS with avoidance rate of MRI-TBx (13% vs. 1%) at 30% risk threshold.The diagnostic performance of S23PSAD was superior to conventional strategies but comparable to mpMRI.
Objective This study aimed to assess survival outcomes in older patients with de novo metastatic prostate cancer who initially received androgen deprivation therapy. Methods The retrospective multicenter study included 2784 men with metastatic prostate cancer who were treated with androgen deprivation therapy between 2008 and 2017. Patients were classified into <75, 75–79, and ≥80 age groups. Propensity score matching was conducted to assess the cancer‐specific survival of the groups. The 5‐year net overall survival of each group was derived to evaluate relative survival compared with the general population using the Pohar–Perme estimator and the 2019 Japan Life Table. Results During the follow‐up (median, 34 months), 1014 patients died, of which 807 died from metastatic prostate cancer progression. Compared with the <75 group, the cancer‐specific survival of the 75–79 group was similar (hazard ratio 1.07; 95% confidence interval 0.84–1.37; P = 0.580), whereas that of the ≥80 group was significantly worse (hazard ratio 1.41; 95% confidence interval 1.10–1.80; P = 0.006). The 5‐year net overall survival of the <75, 75–79, and ≥80 age groups were 0.678, 0761, and 0.718, respectively. The 5‐year net overall survival of patients aged ≥80 years with low‐ and high‐volume disease were 0.893 and 0.586, respectively, which was comparable with those in patients aged <75 years (0.872 and 0.586, respectively). Conclusions Older metastatic prostate cancer patients aged ≥80 years had poorer cancer‐specific survival compared with younger patients. Conversely, 5‐year net overall survival in older patients aged ≥80 years was comparable with that in younger patients aged <75 years.
A new and efficient control scheme is proposed for the real-time control of system voltage and reactive power control and the conventional computational algorithms are reviewed from the point of view of on-line centralized control on a real-time basis. A simplified linear model describing the voltage and reactive power control characteristics is given which is conveniently constructed for the purpose of minimizing the transmission losses under the constraint of the voltage settling condition.
This paper presents a simplified yet practical method to be used for quick evaluation of the reliabilities of hierarchical power control systems consisting of control computers, a variety of regulating devices and human operators interconnected by communication networks. The quantity "percent loss of information" is defined and used as a measure to evaluate the overall reliabilities of hierarchical computer control complexes. The proposed method is tested for a simple control system and the result checked against the Monte Carlo approach. It is then applied to 2- and 3-level hierarchical power control system models. Further applications of the method such as the design of component redundancies are also discussed.
Abstract Background This study assessed the incidence and impact of acute kidney injury (AKI) on renal prognosis in patients who underwent robot‐assisted laparoscopic radical prostatectomy (RARP). Methods Medical records of 305 patients treated with RARP were retrospectively reviewed. The patients with postoperative AKIs were dichotomized into early AKI (immediately after surgery) and late AKI (1‐7 days after surgery). The impact of AKIs and their risk factors were statistically assessed. Results Early and late AKI were observed in 143 (46.9%) and 12 (3.9%) patients, respectively. Hypertension and console time were independent risk factors for early AKI. Among the patients with preoperative eGFR ≥60 mL/min, the eGFR decline 12 months after surgery was significantly greater in patients with early AKI than that without early AKI (−6.8 vs −3.2 mL/min, P = .02). Conclusions Approximately half of patients developed early AKI after RARP. The patients with early AKI had reduced renal function 12 months after surgery.
