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The variation in mortality-to-incidence ratios (MIRs) among countries reflects the clinical outcomes and the available interventions for colorectal cancer treatments. The association between MIR of prostate cancer and cancer care disparities among countries is an interesting issue that is rarely investigated. For the present study, cancer incidence and mortality rates were obtained from the GLOBOCAN 2012 database. The rankings and total expenditures on health of various countries were obtained from the World Health Organization (WHO). The association between variables was analyzed by linear regression analyses. In this study, we estimated the role of MIRs from 35 countries that had a prostate cancer incidence greater than 5,000 cases per year. As expected, high prostate cancer incidence and mortality rates were observed in more developed regions, such as Europe and the Americas. However, the MIRs were 2.5 times higher in the less developed regions. Regarding the association between MIR and cancer care disparities, countries with good WHO ranking and high total expenditures on health/gross domestic product (GDP) were significant correlated with low MIR. The MIR variation for prostate cancer correlates with cancer care disparities among countries further support the role of cancer care disparities in clinical outcome.

A 67-year-old man with a biopsy proving prostate diffuse large B-cell lymphoma was referred for an F-FDG PET/CT scan for postchemotherapy treatment monitoring. The FDG PET/CT scan revealed a significant reduction of prostate lymphoma and a prostatorectal fistula formation. The patient developed Klebsiella pneumoniae sepsis, and a follow-up FDG PET/CT 3 months later revealed multifocal lung, bone, and muscle infection. The FDG PET/CT scans of this patient not only demonstrated the effectiveness of chemotherapy for prostate lymphoma but also the complications of a prostatorectal fistula and multiple infectious foci.

The two cancers after renal transplantation (RTx) are transitional cell carcinoma (TCC) and hepatoma reported in Taiwan most frequently, versus lymphproliferative diseases and skin cancers in the Western literature. Herein, we present a 49-year-old man with spinal cord injury and end-stage renal disease who developed multifocal TCC in the urologic tract and incidental detection of prostatic adenocarcinoma 15 months after a cadaveric RTx. En bloc complete native urinary tract excision and ileal conduit urinary diversion were performed smoothly. After 2-year follow up, there was no evidence of tumor recurrence, and graft function remained stable, with minimal hydronephrosis. Transplant physicians should carefully monitor any signs of urinary cancers, especially in renal transplant recipients with history of analgesics. Also, aggressive surgical treatment is recommended for these patients to prolong survival.

Background: The prognosis and proper treatment of stage T1a prostate cancer remain unsettled. The aim of the study was to identify retrospectively some predictors of disease progression in stage T1a prostate cancer., Methods: We reported on 52 patients with stage T1a prostate cancer diagnosed between 1983 and 1996 at Taichung Veterans General Hospital. The recorded clinical follow-up, pathological staging and treatment of these patients were reviewed. Disease progression is defined as progressive elevation of the serum PSA value and proved by transrectal needle biopsy of the prostate or the appearance of metastatic disease. All original surgical pathology material from each patient was reviewed by a single pathologist and graded by the Gleason system., Results: The mean age of patients with T1a prostate cancer at diagnosis was 71.5 +/- 7 years old. During the median follow-up of 7.3 years (range, 0.5 to 15 years), four patients (7.7%) developed disease progression. Twenty-one patients died due to other causes and no patient died due to prostate cancer. It was statistically significant that the patient with pathological Gleason score > or = 5 had positive correlation with disease progression., Conclusions: The clinical course of stage T1a prostate cancer is variable. The presence of Gleason score > or = 5 in pathological report is usually associated with cancer progression. More aggressive treatment including radical prostatectomy or local radiotherapy is advised in those selected high risk patients with a long life expectancy. Patients with tumor Gleason score < 5 have a low risk of disease progression and can be managed conservatively; but they should remain under observation indefinitely.

Background: To find a predictor for extracapsular tumor extension at radical retropubic prostatectomy (RRP) in Taiwanese patients with stage T1c prostate cancer (PC), preoperative transrectal sonoguiding prostate biopsy outcomes and clinicopathological data obtained from these patients were reviewed., Methods: Fifty-five consecutive men who underwent radical retropubic prostatectomy for stage T1c PC were included. Preoperative sextant needle biopsies of the prostate were performed and whole-mount prostatectomy specimens were processed. The pathological end point was tumor capsular perforation extending entirely through the prostate capsule. Preoperative prostate-specific antigen (PSA), free-to-total PSA ratio, prostate volume, PSA density, Gleason score, number of positive biopsy cores, percentage cancer of sextant biopsies, percentage cancer of one lobe and percentage cancer of one core were analyzed for their ability to predict extracapsular tumor extension at RRP., Results: Eighteen of the 55 specimens showed evidence of tumor capsular perforation. Those with extracapsular tumor extension (ECE) had higher PSA than organ-confined disease (OCD) (18.4 vs 8.3 ng/ml, P < 0.01). The ECE had a higher PSA density than OCD (0.556 vs 0.226, P < 0.01). The percentage of cancer in biopsies, percentage cancer of one lobe and percentage cancer of one core were all higher in ECE than OCD (P < 0.05). The ECE had a higher biopsy Gleason score than OCD (5.6 vs 4.5, P < 0.01)., Conclusions: The four strongest predictors for extracapsular tumor extension of patients with T1c PC were PSA density >or=0.35, biopsy Gleason score >or=6, >or=20% cancer in biopsies and PSA >or=10 ng/ml.