Grant Number:	1R01CA116399-01A1 Interpret this number
Primary Investigator:	Lu-Yao, Grace
Organization:	Univ Of Med/Dent Nj-R W Johnson Med Sch
Project Title:	Evaluation of Palliative Prostate Cancer Among Elderly Men
Fiscal Year:	2006

DESCRIPTION (provided by applicant): The long-term objective of this application is to improve prostate cancer care for elderly patients. Although prostate cancer is common, outcomes data specific for elderly patients (aged 75 years or older) are sparse. In the past decade, the use of primary androgen deprivation therapy (PADT) for localized prostate cancer has increased by more than 25% among elderly men, perhaps because it is often perceived as safer than the alternatives of surgery or radiation. Disturbingly, among elderly patients the risk of being hospitalized for fractures within five year of cancer diagnosis (20%) increased by more than 50% after 5 years of PADT use compared with patients without any androgen deprivation. Disease-specific mortality and serious cancer- related complications; however, are similar between long-term and short-term PADT users. Because of the concerns about the potential side effects of PADT, the Prostate Cancer Progress Review Groups has identified assessment of PADT as a top priority in the current prostate cancer research plan. The primary objectives of the study will be to define the prognosis of elderly patients with localized prostate cancer, in term of fractures, overall and disease-specific survival, and serious-cancer related complications, following PADT and conservative management. Furthermore, this proposed study will assess these outcomes as a function of the duration of PADT exposure and quantify the excess risk associated with PADT use. This population-based study will use the SEER-Medicare linked data to identify eligible patients diagnosed in 1992-2002. Because of its large sample size (about 38,000 men with up to 12 years of follow-up), this study will have ample statistical power. The data will be analyzed utilizing modern methods designed to minimize biases (e.g., propensity scores, prospective eligibility criteria, multivariate analysis). The findings of this study will be important for informed decision making, planning for future trials, and developing strategies to improve the quality of care. Lay Description-About 69,000 new prostate cancer cases are diagnosed among men over age 75 each year. This study is to provide the probabilities of various clinical outcomes following two commonly used treatment options: deferred treatment and hormonal therapy. The findings of this study will provide benchmark references to help elderly patients weigh the potential risks and benefits of alternative approaches and to facilitate treatment decision-making.




Comparative Effectiveness of Radical Prostatectomy With Adjuvant Radiotherapy Versus Radiotherapy Plus Androgen Deprivation Therapy for Men With Advanced Prostate Cancer.
Authors: Jang T.L. , Patel N. , Faiena I. , Radadia K.D. , Moore D.F. , Elsamra S.E. , Singer E.A. , Stein M.N. , Eastham J.A. , Scardino P.T. , et al. .
Source: Cancer, 2018-09-25 00:00:00.0; , .
EPub date: 2018-09-25 00:00:00.0.
PMID: 30252932
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Reply to Michael Froehner, Rainer Koch, Manfred P. Wirth's Letter to the Editor re: Grace L. Lu-Yao, Peter C. Albertsen, Dirk F. Moore, Yong Lin, Robert S. DiPaola, Siu-Long Yao. Fifteen-year Outcomes Following Conservative Management Among Men Aged 65 Years or Older with Localized Prostate Cancer. Eur Urol 2015;68:805-11.
Authors: Albertsen P.C. , Lu-Yao G.L. .
Source: European Urology, 2016 Jun; 69(6), p. e131-2.
EPub date: 2015-12-22 00:00:00.0.
PMID: 26706104
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Fifteen-year Outcomes Following Conservative Management Among Men Aged 65 Years or Older with Localized Prostate Cancer.
Authors: Lu-Yao G.L. , Albertsen P.C. , Moore D.F. , Lin Y. , DiPaola R.S. , Yao S.L. .
Source: European Urology, 2015 Nov; 68(5), p. 805-11.
PMID: 25800944
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Fifteen-year survival outcomes following primary androgen-deprivation therapy for localized prostate cancer.
Authors: Lu-Yao G.L. , Albertsen P.C. , Moore D.F. , Shih W. , Lin Y. , DiPaola R.S. , Yao S.L. .
Source: Jama Internal Medicine, 2014 Sep; 174(9), p. 1460-7.
PMID: 25023796
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Fracture after androgen deprivation therapy among men with a high baseline risk of skeletal complications.
Authors: Shao Y.H. , Moore D.F. , Shih W. , Lin Y. , Jang T.L. , Lu-Yao G.L. .
Source: Bju International, 2013 May; 111(5), p. 745-52.
PMID: 23331464
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Words of wisdom: re: radical prostatectomy versus observation for localized prostate cancer.
Authors: Lu-Yao G. .
Source: European Urology, 2013 Apr; 63(4), p. 767.
PMID: 23438392
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Does primary androgen-deprivation therapy delay the receipt of secondary cancer therapy for localized prostate cancer?
Authors: Lu-Yao G.L. , Albertsen P.C. , Li H. , Moore D.F. , Shih W. , Lin Y. , DiPaola R.S. , Yao S.L. .
Source: European Urology, 2012 Dec; 62(6), p. 966-72.
PMID: 22608160
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Treatment profile and complications associated with cryotherapy for localized prostate cancer: a population-based study.
Authors: Roberts C.B. , Jang T.L. , Shao Y.H. , Kabadi S. , Moore D.F. , Lu-Yao G.L. .
Source: Prostate Cancer And Prostatic Diseases, 2011 Dec; 14(4), p. 313-9.
PMID: 21519347
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The impact of PSA testing frequency on prostate cancer incidence and treatment in older men.
Authors: Shao Y.H. , Albertsen P.C. , Shih W. , Roberts C.B. , Lu-Yao G.L. .
Source: Prostate Cancer And Prostatic Diseases, 2011 Dec; 14(4), p. 332-9.
PMID: 21709691
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Words Of Wisdom: Re: Active Surveillance Compared With Initial Treatment For Men With Low-risk Prostate Cancer: A Decision Analysis
Authors: Lu-Yao,G.L. .
Source: European Urology, 2011 Aug; 60(2), p. 393.
PMID: 21703967
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Impact of comorbidity on survival among men with localized prostate cancer.
Authors: Albertsen P.C. , Moore D.F. , Shih W. , Lin Y. , Li H. , Lu-Yao G.L. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2011-04-01 00:00:00.0; 29(10), p. 1335-41.
EPub date: 2011-04-01 00:00:00.0.
PMID: 21357791
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The Science And Art Of Prostate Cancer Screening
Authors: Yao,S.L. , Lu-Yao,G.L. .
Source: Journal Of The National Cancer Institute, 2011-03-16 00:00:00.0; 103(6), p. 450-1.
PMID: 21350220
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Patterns and correlates of prostate cancer treatment in older men.
Authors: Roberts C.B. , Albertsen P.C. , Shao Y.H. , Moore D.F. , Mehta A.R. , Stein M.N. , Lu-Yao G.L. .
Source: The American Journal Of Medicine, 2011 Mar; 124(3), p. 235-43.
PMID: 21396507
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Risk profiles and treatment patterns among men diagnosed as having prostate cancer and a prostate-specific antigen level below 4.0 ng/ml.
Authors: Shao Y.H. , Albertsen P.C. , Roberts C.B. , Lin Y. , Mehta A.R. , Stein M.N. , DiPaola R.S. , Lu-Yao G.L. .
Source: Archives Of Internal Medicine, 2010-07-26 00:00:00.0; 170(14), p. 1256-61.
PMID: 20660846
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Diagnosis of localized, screen-detected, prostate cancer--crisis or opportunity?
Authors: Yao S.L. , Lu-Yao G.L. .
Source: Journal Of The National Cancer Institute, 2010-07-07 00:00:00.0; 102(13), p. 919-20.
EPub date: 2010-07-07 00:00:00.0.
PMID: 20562372
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Contemporary risk profile of prostate cancer in the United States.
Authors: Shao Y.H. , Demissie K. , Shih W. , Mehta A.R. , Stein M.N. , Roberts C.B. , Dipaola R.S. , Lu-Yao G.L. .
Source: Journal Of The National Cancer Institute, 2009-09-16 00:00:00.0; 101(18), p. 1280-3.
EPub date: 2009-09-16 00:00:00.0.
PMID: 19713548
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Outcomes of localized prostate cancer following conservative management.
Authors: Lu-Yao G.L. , Albertsen P.C. , Moore D.F. , Shih W. , Lin Y. , DiPaola R.S. , Barry M.J. , Zietman A. , O'Leary M. , Walker-Corkery E. , et al. .
Source: Jama, 2009-09-16 00:00:00.0; 302(11), p. 1202-9.
PMID: 19755699
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Composite likelihood modeling of neighboring site correlations of DNA sequence substitution rates.
Authors: Deng L. , Moore D.F. .
Source: Statistical Applications In Genetics And Molecular Biology, 2009; 8, p. Article 6.
PMID: 19222389
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Associations of lifestyle and physiologic factors with prostate-specific antigen concentrations: evidence from the National Health and Nutrition Examination Survey (2001-2004).
Authors: Parekh N. , Lin Y. , Marcella S. , Kant A.K. , Lu-Yao G. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2008 Sep; 17(9), p. 2467-72.
PMID: 18768517
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Survival following primary androgen deprivation therapy among men with localized prostate cancer.
Authors: Lu-Yao G.L. , Albertsen P.C. , Moore D.F. , Shih W. , Lin Y. , DiPaola R.S. , Yao S.L. .
Source: Jama, 2008-07-09 00:00:00.0; 300(2), p. 173-81.
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