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S Haukaas

Publications and source records attributed to S Haukaas.

At least 19 recordsLinked to original sources
PubMed2001

Magnetic resonance imaging of the prostate.

Magnetic resonance imaging has been shown to be more accurate than other imaging modalities in the evaluation of both malignancies and various benign lesions of the prostate. Despite its superiority, because of its cost and low availability, magnetic resonance imaging should play a role as a problem-solver secondary to computed tomography or ultrasonography. The routine use of magnetic resonance imaging in the staging of prostate cancer before surgery cannot be justified on the basis of published data. Magnetic resonance imaging has been proved to be of value in the planning and delivery of different types of radiotherapy to patients with prostate cancer. Through the use of combined magnetic resonance imaging and the new modality, magnetic resonance spectroscopy, the accuracy and specificity of tumour detection and the delineation of tumour extent can be improved. Magnetic resonance technology is rapidly evolving, and in the near future, new possibilities such as biological imaging will have a great impact on magnetic resonance imaging of the prostate.

Adenocarcinoma↗
PubMed2000

Prognostic significance of p16 and CDK4 proteins in localized prostate carcinoma.

BACKGROUND: In prostate carcinoma, a very low frequency of point mutations of the tumor suppressor gene CDKN2/MTS1 (p16(INK4) ) has been reported, but deletions of 9p21 and inactivation by promoter methylation are observed more frequently. In the current study the authors evaluated the expression of p16 and CDK4 proteins and their prognostic significance in patients with clinically localized prostate carcinoma. METHODS: The levels of p16 and CDK4 proteins were quantitated by immunofluorescence flow cytometry, using paraffin embedded material, in 104 adenocarcinomas of the prostate after radical prostatectomy. These levels then were compared with 25 cases of benign prostate hyperplasia (BPH). RESULTS: In prostatic carcinoma specimens, p16 protein was elevated significantly compared with BPH, with a median fluorescence index (FI) of 15.4 versus 10.7, respectively (P = 0.010). This was not the case for CDK4 protein, although p16 protein expression correlated significantly with CDK4 protein expression in BPH (Spearman rank correlation [R(S)] = 0.63) and carcinoma (R(S) = 0.78). In univariate survival analysis of the first 5 years, high levels of p16 protein expression (FI > 11.7) (P = 0.005), tumor greatest dimension, World Health Organization (WHO) histologic grade, capsular penetration, seminal vesicle invasion, positive surgical margins, lymph node involvement, and preoperative serum prostate specific antigen > 20 ng/mL all were significant predictors of biochemical failure. In multivariate survival analysis, high p16 protein expression (P = 0.015), age, WHO histologic grade, capsular penetration, and seminal vesicle involvement remained as independent predictors of biochemical failure. CONCLUSIONS: These data suggest that increased expression of p16 protein, but not CDK4 protein, may be involved in the development of prostate carcinoma and may represent an independent predictor of biochemical failure after radical prostatectomy.

Adenocarcinoma↗
PubMed1999

MRI with an endorectal coil for staging of clinically localised prostate cancer prior to radical prostatectomy.

The purpose of this study was to evaluate the ability of MR imaging with an endorectal coil (erMRI) to predict the local pathological stage of prostatic carcinoma prior to radical prostatectomy. Thirty-one consecutive patients (median age 61 years, range 40-71 years) with clinically localised prostate cancer were assessed preoperatively by endorectal MRI (at 1.0 T). The pulse sequences consisted of fast spin-echo axial and coronal T2-weighted images and inversion recovery with two echoes for axial fat-suppressed images. The assessment of tumour stage and measurement of tumour dimension by erMRI were compared with the corresponding findings on whole-mount step sections of the surgical specimens. Postoperatively, 14 of the 31 patients (45 %) were found to have extracapsular extension, 7 with capsular penetration (CP) only, and 7 had a combination of CP and seminal vesicle invasion (SVI). Capsular penetration was detected by erMRI with a sensitivity of 0.71 and specificity of 0.47, whereas the sensitivity for SVI detection was 0.71 and the specificity 0.83. Endorectal MRI for staging clinically localised prostatic carcinoma gives a good prediction of invasion of the seminal vesicles but is unreliable in predicting capsular penetration.

Adult↗
PubMed1999

Use of pelvic surface coil MR imaging for assessment of clinically localized prostate cancer with histopathological correlation.

We evaluated the ability of magnetic resonance imaging (MRI) operating at 1.0 Tesla with a Helmholz pelvic surface coil to predict the pathological stage of prostate carcinoma. Radiological diagnosis was based on fast spin-echo axial T2-weighted images with and without frequency selective fat-suppression and fast spin-echo coronal T2-weighted images. Thirty-one consecutive patients (mean age 61 years, range 49 to 71 years) underwent pelvic MRI before radical prostatectomy. Correlation with whole-mount step-sections of the surgical specimens showed that the tumours were correctly localized in all but one prostate gland in which the tumour could not be seen on pelvic MRI. The transverse diameter of the visible tumour at pelvic MRI appeared to represent an approximate estimate of the true tumour dimension. Based on histopathologic whole-mount step-sections of the surgical specimens, 22 of 31 patients (71%) had tumours extending beyond the confines of the prostatic capsule. The specificity for MRI to predict capsular penetration and seminal vesicle invasion was relatively high (0.80 and 0.86, respectively). The sensitivity was acceptable for capsular penetration (0.62) but poor for seminal vesicle invasion (0.30).

Aged↗
PubMed1999

The long-term outcome in patients with superficial transitional cell carcinoma of the bladder: a single-institutional experience.

OBJECTIVE: To determine the natural history of transitional cell carcinoma (TCC) of the bladder, and to identify factors which place patients at lifelong risk of developing progression and dying from bladder carcinoma. PATIENTS AND METHODS: The long-term outcome was evaluated retrospectively in 231 patients with superficial bladder TCC, assessed for the first time within a 6-year period from 1981 to 1986, with a median follow-up of 108 months. Of 231 patients, 217 (94%) were initially treated by transurethral or segmental resection. RESULTS: Recurrence developed in 141 of 217 (65%) patients; the duration of the interval free of recurrence was significantly less for patients with initial G3 tumours than that for those with G1 (P<0.01) and for pT1 compared with pTa disease (P<0.01). The disease progressed in 42 of 231 (18%) patients. Differences in the progression-free interval between patients with G1 and G3 tumours, and with pTa and pT1 disease, were statistically significant (P<0. 005 and P<0.001, respectively). In 27 of 231 patients (12%), TCC of the bladder was the cause of death, whilst 118 (51%) died from unrelated causes. There were no deaths among patients with initial pTaG1 tumours, compared with 10 of 26 (38%) deaths in those with pT1G3 disease at presentation. CONCLUSION: The long-term prognosis is good for patients with pTaG1 tumours, whilst pT1G3 is a potentially aggressive disease. Lifelong endoscopic surveillance is mandatory in patients in whom new tumours are very active, at least in those of younger age. Routine cystoscopy can possibly be discontinued in patients with low-grade, low-stage disease in whom a low liability of recurrence has been shown during follow-up.

Adult↗
PubMed1999

Survival after radical treatment for transitional cell carcinoma of the bladder.

AIMS: To investigate survival after radical treatment for transitional cell carcinomas of the bladder. METHODS: This retrospective study included 135 patients with transitional cell carcinoma of the bladder undergoing radical cystectomy or radiotherapy at Haukeland Hospital, Bergen, Norway, during the period 1981-1986. Forty-five patients had cystectomy and 90 underwent external high-dose radiotherapy. RESULTS: The overall 5- and 10-year survival rates were 39 and 23%, respectively. After cystectomy 10-year overall survival rates for superficial and muscle-infiltrating tumours were 67 and 26%; after radiotherapy, the corresponding survival rates for superficial and muscle-infiltrating tumours were 26 and 5%, respectively. CONCLUSIONS: Long-term survival and cure can be achieved after cystectomy in many patients with aggressive superficial or muscle-infiltrating bladder carcinoma. The introduction of orthotopic neobladder reconstruction should encourage the use of cystectomy in patients with aggressive superficial tumour.

Aged↗
PubMed1998

Lymphangiography combined with biopsy and computer tomography to detect lymph node metastases in localized prostate cancer.

To evaluate the efficacy of lymphangiography combined with fine needle aspiration biopsy and computer tomography (CT) for lymph node staging in clinically localized prostate cancer. Prospective evaluation of nodal involvement was carried out using standard bipedal lymphangiography combined with fine needle aspiration biopsy (FNAB) in 70 patients (aged 47 to 75 years, mean age 63 years) with apparently locally confined prostate cancer before intended radical prostatectomy. Sixty-four patients also underwent computer tomography. Seventeen withdrew the decision to undergo a radical prostatectomy, leaving 53 patients with pathologic examination of the lymph nodes eligible for analysis. Lymph node metastases were diagnosed in 8 patients (8/53 = 15.1%). Three were diagnosed preoperatively by FNAB, 3 peroperatively by lymph node dissection and frozen section biopsy and an additional 2 at the final pathologic assessment. The sensitivity, specificity, positive and negative predictive values for lymphangiography and lymphangiography combined with FNAB in predicting nodal disease, based on the analysis of the 53 patients with known pathologic results, were 0.63, 0.76, 0.31, 0.92 and 0.38, 1.00, 1.00, 0.90, respectively. The corresponding values for CT staging were 0.25, 0.98, 0.67 and 0.87, respectively. The efficacy of bipedal lymphangiography alone or combined with FNAB or CT alone for assessment of nodal metastases is too low to be worthwhile for lymph node staging in localized prostate cancer patients with expected low or intermediate probability of nodal disease.

Aged↗
PubMed1997

When is bone scintigraphy necessary in the assessment of newly diagnosed, untreated prostate cancer?

OBJECTIVE: To evaluate the utility of bone scintigraphy in the assessment of newly diagnosed, untreated prostate cancer. PATIENTS AND METHODS: The probability of a positive bone scan for metastases was analysed for different threshold values of pre-treatment concentrations of prostate specific antigen (PSA), clinical stage, tumour grade based on biopsy, and age in 128 men (mean age 69 years, range 50-90) with newly diagnosed, untreated prostate cancer. The overall survival probabilities estimated from PSA level, extent of bone metastases, tumour grade, clinical stage, and age were calculated using the product-limit method. RESULTS: The positive predictive values of PSA level for bone metastases at thresholds of 10 and 20 ng/mL were poor (27.5 and 47.5%, respectively) whereas similar threshold levels of PSA gave negative predictive values of 100 and 94%, respectively, for a positive bone scan. In a univariate analysis, the overall survival was significantly affected by the extent of bone scan pathology (P < 0.001), the pre-treatment level of PSA (P < 0.001) and tumour grade (P = 0.01), whereas a multivariate analysis identified, in order of significance, tumour grade (P = 0.003), bone scan findings (P = 0.007) and PSA levels (P = 0.03) as independent prognostic factors. CONCLUSIONS: Bone scintigraphy seems to be unnecessary in the evaluation of newly diagnosed, untreated prostate cancer in patients with no clinical signs of bone pathology and serum PSA levels of < or = 10 ng/mL. However, the bone scan accurately assesses bone metastases and the prognostic significance of bone scan findings is superior to that of serum PSA level.

Adenocarcinoma↗
PubMed1997

Tumour size measured by transrectal ultrasonography in the staging of prostate cancer before radical prostatectomy.

OBJECTIVE: To assess the diagnostic accuracy of transrectal ultrasonography (TRUS) in predicting the local extent of prostate cancer before radical prostatectomy. PATIENTS AND METHODS: From April 1990 to April 1993, 59 consecutive patients (mean age 63 years, range 49-71) with clinically localized prostate cancer were examined using TRUS before radical prostatectomy. Primary tumours were clinically categorized according to the TNM classification and biopsies graded histologically. Tumour size was measured as length on a longitudinal and height and width on a transverse ultrasonogram. The results from TRUS were compared with those from the histopathological examination of whole-mount step sections of the surgical specimens. RESULTS: In 50 patients, TRUS using standard criteria achieved sensitivity, specificity, positive- and negative predictive values (PPV, NPV) of 0.47, 0.63, 0.73 and 0.36, respectively, in predicting pathological stage. Dimensions were obtained from 45 patients with hypoechoic tumours; in a multivariate linear discriminant analysis the TRUS estimate of width was the best predictor of pathological stage. The sensitivity, specificity, PPV and NPV for tumour width from TRUS, using a threshold of 19 mm, were 0.42, 0.93, 0.93 and 0.43, respectively. CONCLUSION: Tumour width measured by TRUS may improve the assessment of the local extent of prostate cancer.

Aged↗
PubMed1995

[Prostate-specific membrane antigen. A new sensitive molecular indicator in metastasizing prostatic cancer].

Prostate cancer is the most common malignant disease in men in western societies. Extracapsular spread of carcinoma is found in approximately half of the patients that are treated by radical prostatectomy. Recently, a new prostate-specific membrane glycoprotein was cloned and sequenced. A highly sensitive and specific nested reverse transcriptase polymerase chain reaction has been developed to detect early occult haematogeneous micrometastatic prostate cells. We analysed venous samples from 17 patients with metastatic prostate cancer using a modified reaction assay. This showed presence of micrometastatic prostate cells in 14 patients. Molecular detection of circulating prostatic epithelial cells could improve clinical staging and treatment of early prostate cancer.

Aged↗
PubMed1995

[Ascent of the testis].

Testes ascending from the normal scrotal position to an undescended position is common, but not well known. The case notes of 37 boys who underwent orchidopexy between 1980 and 1994 at Nordfjordeid Hospital, Norway, were collected. None of the boys had previously undergone inguinal surgery. All patients underwent testicular examination at the time of birth. 23 boys (62%) had normally descended testes at birth but subsequently developed maldescens. According to these figures, testicular ascent is far more common than previously recorded. It is of major importance that the testicular position be examined repeatedly until the age of seven years.

Adolescent↗
PubMed1994

Transrectal ultrasonography to assess local extent of prostatic cancer before radical prostatectomy.

OBJECTIVE: To evaluate transrectal ultrasonography (TRUS) with a 7 mHz rotating probe as a staging procedure in 33 patients with localized prostatic carcinoma. PATIENTS AND METHODS: The ultrasound scans were compared to histopathological whole-mount step sections of the surgical specimens. Twenty-five of the patients had tumours with pathological stage T3 (pT3) and eight had tumours with stage pT2 giving a prevalence of extracapsular growth of 0.76. RESULTS: The overall sensitivity, specificity, positive and negative predictive values for detection of extracapsular tumour growth by TRUS of prostatic cancer were found to be 0.68, 0.63, 0.85 and 0.38, respectively. Six tumours showed solely microscopic foci of extracapsular tumour growth. CONCLUSION: This technique gives a high percentage of both understaging (32%) and overstaging (37%) and therefore TRUS is an unreliable tool in the staging protocol prior to radical prostatectomy.

Humans↗
PubMed1993

Inability of refined CT to assess local extent of prostatic cancer.

A refined procedure for CT was evaluated as a staging procedure in 19 patients with localized prostatic carcinoma. The CT images were compared to histopathologic whole-mount step sections of the surgical specimens. Fourteen of the patients had pathologic stage T3 (pT3) and 5 had stage pT2 giving a prevalence of extracapsular growth of 0.74. The CT images were read by 2 radiologists independently with a diagnostic accuracy of 0.37 for both observers. This is no better than in previous studies using a routine CT procedure. We conclude that CT is of little value in the staging protocol for the local extent of prostatic carcinoma before radical prostatectomy.

Humans↗
PubMed1992

Radical retropubic prostatectomy: our experience with the first 54 patients.

Complications were analysed in a contemporary series of the first 54 retropubic radical prostatectomies performed for carcinoma of the prostate at our Institution. The postoperative morbidity was notable; three life threatening and ten minor complications occurred within the first 30 postoperative days. Thus, more than 1 year after the operations 7 patients had severe stress incontinence and 17 noticed minor degree of incontinence. Twenty-six per cent of the patients who claimed to be potent before surgery maintained potency. The operative time averaged 195 min and the demand for transfusions averaged 2.98 units per patient. Our experience in this early series of radical prostatectomy is that the operation cannot be done without notable postoperative morbidity.

Aged↗
PubMed1991

Squamous cell carcinoma of the urinary bladder.

Thirteen patients with squamous cell carcinoma of the bladder were reviewed. All tumours were muscle invasive at the time of diagnosis. One third of the patients were irradiated, either before cystectomy or as a full course radiotherapy. The 1-year and 5-year survivals were 25 and 17%, respectively. Only cystectomized patients were alive after 5 years.

Aged↗
PubMed1990

[Prostate-specific antigen. A new biological serum marker for prostatic adenocarcinoma].

Prostate-specific antigen (PSA) was measured by polyclonal radioimmunoassay in 45 untreated patients with prostatic cancer and 14 patients with benign prostatic hyperplasia. Prostatic acid phosphatase (PAP) was determined in 35 patients with prostatic cancer and 14 patients with benign hyperplasia. Serum PSA was raised in 42 patients with cancer of the prostate, but only 14 of 35 patients showed increased serum levels of PAP. Half the patients with benign prostate hyperplasia had PSA greater than 4 micrograms/l and one third had PSA greater than 10 micrograms/l. PAP was slightly elevated in two patients with benign prostatic hyperplasia. Serum PSA increased with the clinical stage of prostatic cancer. However, preoperative levels of PSA were not sufficiently reliable to predict the final pathological stage for each individual patient. After radical prostatectomy for cancer confined to the prostate, serum PSA fell to an undetectable level.

Acid Phosphatase↗
PubMed1986

Microsphere method in measurement of blood flow to wall layers of small intestine.

Microspheres of 10.90 +/- 0.65 micron (SD) were injected in the superior mesenteric artery of cats and their intramural distribution and diameter in the small intestine were studied microscopically under basal conditions and after vasodilation by isoproterenol. Approximately 2% of the spheres were shunted through the small intestinal vasculature and could be recovered in the liver. Analysis of the tissue distribution suggested that all spheres arrested in villi represented villous blood flow, spheres arrested in the crypt layer represented flow to the crypts, and the majority of microspheres trapped in the submucosa also represented crypt flow. Nutritive blood flow to the submucosa constituted only 1.5% of total intestinal flow. Log-linear analyses identified factors responsible for sphere distribution, including effects of sphere size, isoproterenol treatment, and local blood flow or vascular resistance. Spheres with diameters greater than 11.08 micron had 1.35 times larger odds than smaller spheres to embolize in the muscularis rather than in the mucosa, but no consistent difference between diameter profiles in the crypts and villi was found. With this reservation, 11-micron spheres seem to be appropriate for measuring blood flow to the muscle, crypt, and villous layers of the small intestine.

Animals↗