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Mayo Clinic urologists present findings at American Urological Association Annual Meeting

Studies on kidney stones, prostate cancer among highlights

2012-05-23
(Press-News.org) ROCHESTER, Minn. -- Mayo Clinic researchers will present findings on prostate cancer risk, screening, treatment and other urological research at the annual meeting of the American Urological Association May 19-23 in Atlanta. Mayo Clinic urologists will also be available to provide expert comment for reporters covering the conference.

Mayo Clinic studies that will be presented and their embargo dates include:

No negative impact on overall survival from post-prostate surgery hormone therapy
Embargoed until 10:30 a.m. ET Monday, May 21

In a first-of-its-kind study of adjuvant hormonal therapy (AHT) following radical prostatectomy, Mayo Clinic researchers found no adverse impact in overall survival of patients even when other health factors, specifically cardiovascular disease, were taken into account. AHT treatment controls testosterone production in patients who have undergone radical prostatectomy in order to prevent or slow the return of cancer cells. For the study, "Adjuvant Hormonal Therapy Does Not Adversely Impact Overall Survival Following Radical Prostatectomy for Men with High Risk Prostate Cancer When Stratified by Charlson Comorbidity Index or Cardiovascular Risk Factors," researchers reviewed the history of 1,247 patients who had prostate surgery at Mayo Clinic from 1988 to 2004. The review included the outcomes of patients who received AHT after prostate surgery and their cardiovascular disease history.

"Knowing the cardiovascular disease history allowed us to distinguish which factor negatively impacted the overall survival -- the cancer or the cardiovascular disease," says lead author Jeffrey Karnes, M.D., a Mayo urologist. The study found the 10-year overall survival rate among patients with cardiovascular disease who received AHT was 72 percent; it was 76 percent for those with cardiovascular disease who did not receive AHT. Similarly, for patients without cardiovascular disease the 10-year overall survival among patients who received ATH was 74 percent, compared to a 79 percent 10-year survival rate for those who did not receive AHT.

Young men with low PSA level at very low risk of prostate cancer
Embargoed until 1 p.m. ET, Monday, May 21
MULTIMEDIA ALERT: Video of interview excerpts is available on the Mayo Clinic News Network.

Three-fourths of young men ages 40󈞝 could safely avoid annual prostate-specific antigen (PSA) screening for an additional 10 years if their baseline PSA falls in the lowest 75th percentile, according to a study led by Mayo Clinic urologist Christopher Weight, M.D. The study, "Men with a Single Baseline PSA below 1.0 ng/ml Between the Ages of 40-49, Can Safely Avoid Additional PSA Screening for at Least 10 Years: Results from a Prospectively Followed Population Cohort," looked at prostate outcomes in a random sample of 268 men, ages 40󈞝, in Olmsted County, Minn., since 1990. Each patient was evaluated by a urologist every two years, including PSA screening, an ultrasound examination and questionnaire. Among study participants, no one between 40 and 49 with a baseline PSA below 1 nanogram per milliliter developed an intermediate- or high-risk cancer during nearly 20 years of follow-up. The study also found that participants with low PSAs, below 1.0 ng/ml, were also very unlikely to develop even low-risk prostate cancer.

One-third of kidney stone sufferers likely to have recurrence
Embargoed until 8 a.m. ET, Tuesday, May 22
MULTIMEDIA ALERT: Video of interview excerpts is available on the Mayo Clinic News Network.

Roughly one-third of people who suffer from kidney stones will experience symptomatic stone recurrence, a Mayo Clinic study finds. The 10-year study, "Symptomatic Stone Recurrence Following Ureteroscopy, Percutaneous Nephrolithotomy, and Shockwave Lithotripsy," monitored 333 patients for the reappearance of stones after their surgery in 1999�.

Regardless of treatment method, "approximately one-third of patients undergoing a surgical procedure for stones will experience a recurrence. Patients with a previous history of stones, prior stone surgery, and positive family history are at increased risk," says lead author Amy Krambeck M.D., a Mayo Clinic urologist.

Patients having shock wave lithotripsy were at highest risk of recurrence, while stones were least likely to return in those receiving percutaneous nephrolithotomy. Dr. Krambeck says patients and doctors should focus on treatment options most likely to leave the patient stone free with the least invasive and fewest surgical interventions.

Three studies support C-11 choline PET/CT scans as prostate cancer evaluation tool
Embargoed until 8 a.m. ET, Wednesday, May 23

Recent European studies have suggested that C-11 choline positron emission tomography/ computerized tomography scans may be used as an evaluation and therapeutic tool in prostate cancer. The results of three Mayo Clinic studies validate findings in Europe and expand the potential use of C-11 choline PET scans.

One study found that C-11 choline PET/CT scans can be used as an evaluation tool rather than multiple X-rays, but are not necessarily better. The two additional Mayo studies support the favorable claims made in recent medical literature about the use of PET scans to evaluate patients with recurrent prostate cancer. These findings are important because distinguishing localized disease recurrence from systemic recurrence is a vital step in optimizing treatment following primary treatment failure.

"Taken together, the three studies represent an important validation of the C-11 choline PET/CT scan as an evaluation tool for patients with prostate cancer," says Jeffrey Karnes, M.D., senior author of all three papers. "We believe the use of these scans can improve the evaluation and treatment of this common form of cancer, while potentially reducing the cost of delivering the best possible care."

Positron emission tomography is an imaging test that uses a small amount of radioactive material to reveal how tissues and organs are functioning. A C-11 choline PET scan involves the injection into a vein of a small amount of C-11 choline, a radioactive form of the vitamin choline. Clinicians then use a scanner and computer to make detailed pictures of areas where the C-11 choline collects. Since cancer cells take up more C-11 choline than normal cells, the pictures can be used to find cancer in the body.

### About Mayo Clinic Cancer Center As a leading institution funded by the National Cancer Institute, Mayo Clinic Cancer Center conducts basic, clinical and population science research, translating discoveries into improved methods for prevention, diagnosis, prognosis and therapy. For information on cancer clinical trials, call 507-538-7623.

About Mayo Clinic Mayo Clinic is a nonprofit worldwide leader in medical care, research and education for people from all walks of life. For more information, visit www.mayoclinic.org/about/ and www.mayoclinic.org/news.


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[Press-News.org] Mayo Clinic urologists present findings at American Urological Association Annual Meeting
Studies on kidney stones, prostate cancer among highlights