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Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
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Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
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A Novel Nomogram Based on Initial Features to Predict BPH Progression.

Lorenzo G Luciani1, Daniele Mattevi2, Daniele Ravanelli3

  • 1Robotic Surgery Unit, S. Chiara Hospital, 38122 Trento, Italy.

International Journal of Environmental Research and Public Health
|August 12, 2022
PubMed
Summary
This summary is machine-generated.

This study developed a nomogram to predict the 10-year risk of interventions for benign prostatic hyperplasia (BPH)-related lower urinary tract symptoms (LUTS). The tool identifies patients needing pharmaceutical or surgical treatments, aiding clinical decision-making for BPH management.

Keywords:
5-ARI5-alphareductase inhibitorsBPHLUTSSerenoa repensalpha-blockersbenign prostatic hyperplasialower urinary tract symptomsphytotherapyprogressionsupplements

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Area of Science:

  • Urology
  • Andrology
  • Pharmacology

Background:

  • Benign prostatic hyperplasia (BPH) significantly impacts men's lower urinary tract symptoms (LUTS).
  • Predicting the long-term need for pharmaceutical or surgical interventions in BPH patients is crucial for effective management.
  • Current tools for risk stratification of BPH progression are limited.

Purpose of the Study:

  • To develop and validate a predictive tool (nomogram) for identifying patients at risk of requiring pharmaceutical or surgical interventions for BPH-related LUTS.
  • To establish a 10-year follow-up risk assessment for BPH progression.

Main Methods:

  • Retrospective review of 107 male patients with mild to moderate LUTS undergoing phytotherapy.
  • 10-year follow-up including medical visits and telephone consultations.
  • Multivariate analysis to identify predictors for treatment switch or clinical progression, constructing two nomograms.

Main Results:

  • 53% of patients switched from phytotherapy to alpha-blockers or 5-alpha-reductase inhibitors (5-ARI) within a median of 24 months.
  • One-third of those switching therapy experienced clinical progression (acute urinary retention or surgery) after a median of 54 months.
  • Age, symptom score, peak flow rate (Qmax), prostate-specific antigen (PSA), and post-void residual volume were significant predictors.

Conclusions:

  • A validated nomogram can predict the 10-year risk of pharmaceutical or surgical interventions for BPH-related LUTS.
  • Proposed thresholds suggest >75% risk for pharmaceutical and >40% for surgical intervention, and <25% and <5% for low risk, respectively.
  • This tool aids in personalized risk assessment and management strategies for BPH patients.