Biomedical subjects

P J M Kil

Publications and source records attributed to P J M Kil.

3 recordsLinked to original sources

PubMed2006

Greater influence of age than co-morbidity on primary treatment and complications of prostate cancer patients: an in-depth population-based study.

We investigated the influence of age and co-morbidity on treatment, the occurrence of serious non-urological complications of treatment and prognosis for prostate cancer patients diagnosed and treated in community hospitals. Additional information from a random sample of 505 prostate cancer patients (aged 40 years or older) from the Eindhoven Cancer Registry diagnosed between 1995 and 1999 was collected. In all, 43% of the prostate cancer patients aged 40-69 years and 64% of those aged 70 or older suffered from one or more serious concomitant disease that barely affected primary treatment choice. However, compared to patients without co-morbidity, patients with cardiovascular diseases underwent radical prostatectomy less often (P=0.01). In all, 38% of the patients undergoing radical prostatectomy suffered from complications during the first year after diagnosis versus about 20% of those receiving radiotherapy. The number of complications did not seem to be affected by co-morbidity. After adjustment for age, stage, grade, prostate-specific antigen level and treatment, the cumulative risk of death was almost two times higher for patients with two or more concomitant diseases than for patients without co-morbidity. After adjustment for age, prostate cancer patients with co-morbidity were not treated differently, did not suffer from more complications but had a worse prognosis, compared to those without co-morbidity.

Adult↗

PubMed2003

Tissue polypeptide-specific antigen (TPS) determinations before and during intermittent maximal androgen blockade in patients with metastatic prostatic carcinoma.

OBJECTIVE: To evaluate the prognostic significance of serially measured tissue polypeptide-specific antigen (TPS) levels in patients with metastatic prostatic carcinoma treated with intermittent maximal androgen blockade (MAB). To determine its value with respect to predicting response to treatment and time to clinical progression. Finally to compare TPS with prostate-specific antigen (PSA) measurements in terms of prognostic impact in patients with metastatic prostatic carcinoma. METHODS AND PATIENTS: TPS and PSA measurements were performed before start of and monthly during intermittent MAB in 68 patients participating in EORTC protocol 30954. Both TPS and PSA were measured in serum. Fifty-six patients from eight centers were included in the final analysis because at least three TPS values were available. TPS and PSA values were correlated with clinical course of the disease. Median follow-up was 21.3 months. Three patient groups were defined on clinical grounds: (a) clinically progressive disease (n=18); (b) clinically stable disease (n=33); and (c) patients who did not reach a predefined nadir PSA value following 9 months of treatment (n=5). RESULTS: Pretreatment TPS was significantly higher in the clinically progressive patients than in the other patient groups (p=0.0041). When grouping patients according to their pretreatment TPS values (cut-off value of 100 U/l) the pretreatment TPS value (>100 U/l) proved to be a statistically significant prognostic factor with respect to time to progression: elevated TPS was associated with a 3.8 increased risk for progressive disease (p=0.0055). Pretreatment PSA (>100 ng/ml) was of no prognostic value for time to progression. In five patients increase of TPS coincided with or preceded clinical progression during treatment, whereas PSA remained normal. CONCLUSION: Additional value of pretreatment TPS measurements in metastatic prostate cancer patients is found in defining the patients with rapid clinical progression. Following MAB an increase in TPS signifies clinical progression even if PSA is found to remain normal.

Androgen Antagonists↗

PubMed2002

[Characterisation of families with hereditary prostate cancer in the Netherlands].

OBJECTIVE: To inventory the characteristics of Dutch families with hereditary prostate carcinoma (HPC). DESIGN: Descriptive. METHOD: From a national registry of families that meet the criteria of HPC, information was collected about patients with HPC and their first-degree relatives from 1995 through to 30 June 2001. The ages of the HPC patients at diagnosis were compared with those of all patients with prostate cancer in the Dutch population during the period 1990 to 1996. The cumulative risk of prostate cancer for HPC families was calculated on the basis of the ages of the patients with prostate cancer and their first-degree male relatives. RESULTS: A total of 70 families fulfilled the criteria. The families included 273 patients with prostate cancer. The diagnosis had been confirmed in 208 (76%) of these patients. Two cases of prostate cancer were observed in 3 families, 3 cases were found in 31 families, and in the remaining families 4-8 cases of prostate cancer were observed. The mean age at diagnosis of prostate cancer was 65.5 years (range: 46-89). Of the 273 HPC patients, 128 (47%) were younger than 65 years at the time of diagnosis, whereas in unselected cases of prostate cancer this figure was 16%. The risk of developing prostate cancer before the age of 70 years for members of HPC families was 39%. The mean age of death due to prostate cancer was 71 years (54-84). The mean value of prostate specific antigen (PSA), known for 47 (17%) of the HPC patients, was 36.8 ng/ml (2.1-280).

Adult↗