Centocor Ortho Biotech Inc. announced today that a federal jury has returned a verdict of $1.67 billion against Abbott Laboratories in a patent infringement suit.

“We are pleased that the jury has ruled in our favor in the patent litigation case against Abbott,” said Kim Taylor, President, Centocor Ortho Biotech Inc. The patent in question relates to the companys antiTNF class of arthritis treatments, and is coowned by New York University and Centocor, for which Centocor is the exclusive licensee.

“We are particularly gratified that the jury recognized our valuable intellectual property, finding our patent both valid and infringed. We will continue to assert intellectual property rights for our immunology therapies, as they offer significant advances in treatment for patients with a number of immune mediated inflammatory diseases,” Taylor added.

Source
Centocor Ortho Biotech Inc.

A discovery by scientists at deCODE genetics (Nasdaq DCGN) and academic colleagues from Iceland, the Netherlands and Denmark has pointed to a common biological mechanism contributing to both kidney stones and decreased bone mineral density (BMD). About 60% of the population carry two copies of a singleletter variation in the human genome (SNP) on chromosome 21, putting them at roughly 65% greater likelihood of developing kidney stones than those who carry no copies. This single variant may thus account for more than a quarter of the incidence of kidney stones, and in women carriers it is also associated with decreased BMD at the hip and spine.

The SNP is in the gene encoding claudin 14 (CLDN14), a protein expressed in the kidney and one of a family of membrane proteins that regulate the passage of ions and small solutes between cells. As calcium is a key component both of most kidney stones and of bone, the deCODE team examined the relationship between CLDN14 and the metabolism of calcium. The results suggest that the SNP may be contributing to increased calcium excretion in urine, a major risk factor for kidney stones and also a sign of bone loss.

“This is an exciting finding because it uncovers a highly plausible common biological mechanism leading to two diseases. This offers a potentially attractive new pathway for drug discovery, and the next task is to build on our understanding of how this SNP increases risk of these diseases and how this pathway could be targeted therapeutically to address this risk. As ever, deCODEme subscribers will see this new variant in their profiles, and we look forward building on this discovery,” said Kari Stefansson, CEO of deCODE.

About kidney stones

Kidney stones are small crystals formed of dissolved minerals, mainly calcium, that form in the kidneys. Smaller stones can simply be passed through urination, though larger ones can block the urinary tract, causing considerable pain and bleeding. Kidney stones affect some 5% of women and 10% of men in the industrialized world. Larger stones can be detected with ultrasound screening and broken up to facilitate passage, though the recurrence rate is high.

deCODE would like to thank all those who participated in this study, as well as the collaborating clinicians and scientists from the Landspitali University Hospital in Reykjavik, Iceland; Radboud University Nijmegen Medical Centre in Nijmegen, Netherlands; Nordic Bioscience A/S in Herlev, Denmark; and the Center for Clinical and Basic Research A/S in Ballerup, Denmark.

About deCODE

deCODE is a biopharmaceutical company developing drugs and DNAbased tests to improve the treatment, diagnosis and prevention of common diseases. Its lead therapeutic programs, which leverage the companys expertise in chemistry and structural biology, include DG041, an antiplatelet compound being developed for the prevention of arterial thrombosis; DG051 and DG031, compounds targeting the leukotriene pathway for the prevention of heart attack; and DG071 and a platform for other PDE4 modulators with therapeutic applications in Alzheimers disease and other conditions. deCODE is a global leader in human genetics, and has identified key variations in the genome (SNPs) conferring increased risk of major public health challenges from cardiovascular disease to cancer. Based upon these discoveries deCODE has brought to market a growing range of DNAbased tests for gauging risk and empowering prevention of common diseases. Through its CLIAregistered laboratory, deCODE offers deCODE T2(TM) for type 2 diabetes; deCODE AF(TM) for atrial fibrillation and stroke; deCODE MI(TM) for heart attack; deCODE ProstateCancer(TM) for prostate cancer; deCODE Glaucoma(TM) for a major type of glaucoma; and deCODE BreastCancer, for the common forms of breast cancer

Any statements contained in this presentation that relate to future plans, events or performance are forwardlooking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These forwardlooking statements are subject to a number of risks and uncertainties that could cause actual results, and the timing of events, to differ materially from those described in the forwardlooking statements. These risks and uncertainties include, among others, those relating to our ability to obtain sufficient financing to continue as a going concern, our ability to develop and market diagnostic products, the level of third party reimbursement for our products, risks related to preclinical and clinical development of pharmaceutical products, including the identification of compounds and the completion of clinical trials, our ability to form collaborative relationships, the effect of government regulation and the regulatory approval processes, market acceptance, our ability to obtain and protect intellectual property rights for our products, dependence on collaborative relationships, the effect of competitive products, industry trends and other risks identified in deCODEs filings with the Securities and Exchange Commission, including, without limitation, the risk factors identified in our most recent Annual Report on Form 10K and any updates to those risk factors filed from time to time in our Quarterly Reports on Form 10Q or Current Reports on Form 8K. deCODE undertakes no obligation to update or alter these forwardlooking statements as a result of new information, future events or otherwise.

Source deCODE genetics

USAID announced on Thursday a $1 million commitment to a Red Cross project aimed at helping those “living along southern Africas Zambezi River cope with worsening natural disasters because of climate change,” the AP/Washington Post reports.

“For the 32 million people who live in the Zambezis basin some of the worlds poorest the river is a source of transportation, jobs and fertile soil for agriculture,” the AP/Washington Post writes. “But it also brings misery with a cycle of flood and drought that displaces hundreds of thousands of people annually. Extreme flooding and dry spells destroy crops and cause food shortages, while receding waters leave cholera, dysentery and malaria,” according to AP/Washington Post.

The Red Cross chose to launch the Zambezi River Basin Initiative after this years devastating flood season claimed the lives of 90 people and displaced over 276,000 in Namibia alone, according to the AP/Washington Post.

Through the threeyear $8.6 million initiative, the Red Cross will work with “the seven nations that the river winds through Angola, Botswana, Malawi, Mozambique, Namibia, Zambia and Zimbabwe” to “boost early warning systems and local training for disaster management, as well provide funds for malaria, cholera, and HIV/AIDS awareness and prevention projects,” the AP/Washington Post writes (Theriault, AP/Washington Post, 6/25).

This information was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

According to a new study from researchers at Duke University, total knee arthroplasty (TKA) procedures performed in older patients with osteoarthritis of the knee result in longterm, significant improvement of physical functioning and motor skills when compared to patients who do not receive TKA.

Published in the July 2009 issue of Medical Care, the study examined physical functioning and gauged outcomes in a national sample of Americans aged 65 and older for up to four yearsa longer period than previous TKA studies. Relative to the untreated comparison group, recipients of total knee replacements experienced significant improvement in function, including a 17.5% increase in mobility, a 39.3% improvement in motor skills; and a 46.9% decrease in limitations in activities of daily living such as bathing and dressing oneself.

The number of total knee replacements performed in the United States has increased dramatically since 1990; currently 581,000 such procedures are performed every year. This number is expected to increase markedly as Baby Boomers age.

“In this era of costcutting, policymakers have underscored the importance of evaluating treatments in terms of effectiveness and benefits to patients,” says lead author Frank Sloan, Ph.D., McMahon professor of health policy and management and professor of economics at Duke University. “Our findings show that knee replacements are effective in treating patients with advanced osteoarthritis, contributing to reduced disability and improved quality of life for these individuals. Such findings are extremely important for the broader context of discussions about healthcare reform, costcontainment, device quality, and patient safety.”

For the study, Duke researchers identified 2272 patients diagnosed with osteoarthritis of the lower leg using data from the Health and Retirement Study (HRS) linked to Medicare claims from 1994 through 2006. Of that group, 516 underwent TKA procedures and 1756 did not. Researchers used propensity score matching to generate 515 pairs of treated and untreated individuals who were matched on relevant, measurable factors such as baseline functional status, other health conditions, socioeconomic characteristics, and time before TKA or diagnosis.

Among the patients who underwent TKA, baseline physical functioning measures were taken at an interview before and closest to surgery. For the comparison group, these measures were taken from an interview preceding and closest in time to the year of their first diagnosis with osteoarthritis of the lower leg. Each pair was followed for up to four years, and their resulting physical abilities were compared.

The studys mobility, gross motor skills, large muscle activities, and limitations in activities of daily living indices accounted for a wide breadth of physical activities, including getting in and out of bed; the ability to bathe and dress oneself; sitting for two hours; getting up from a chair; stooping, kneeling, and crouching; walking across the room, one block, and several blocks; climbing one flight and several flights of stairs; and pushing and pulling a large object.

The study comes at a time when Congress and the nations healthcare agencies are looking for ways to identify diagnostics and therapies that offer the greatest value to patients and the healthcare system. Representatives Bill Pascrell Jr. (DNJ) and Lloyd Doggett (DTX) have introduced legislation to establish a federallyfunded registry of patients who have received artificial hips or knees, providing researchers and policymakers with an ongoing source of data about patient outcomes with such devices and related surgical procedures.

According to Sloan, total knee replacement has repeatedly been shown to offer clinical benefits for patients with osteoarthritis, a major risk factor for disability in the United States. Recently, a team at Brigham and Womens Hospital and the Boston University School of Public Health confirmed that, for older adults with advanced osteoarthritis, total knee replacement also appears to be a costeffective procedure across all patient risk groups.

“We know that the inability to perform activities of daily living is highly predictive of nursing home admittance, as patients can no longer care for themselves,” says Sloan. “TKA offers the potential for extending independence and therefore delays the need for assisted living.”

The Duke University research was supported by a grant from the Institute for Health Technology Studies (InHealth). The coauthors of this study are David Ruiz Jr., MA, and Alyssa Platt, MA.

Source
Robyn Stein

A new study from Bradley Hospital and The Warren Alpert Medical School of Brown University, as well as two other institutions, adds to mounting evidence that clinicians consider irritability as a symptom when diagnosing pediatric bipolar disorder.

Reporting in the July issue of the Journal of the American Academy of Child and Adolescent Psychiatry, researchers say a small percentage of children with bipolar disorder experience manic episodes without extreme elation one of the hallmarks of the disorder and are diagnosed based on irritable mood alone.

“Diagnosing children with bipolar disorder is challenging. One of the chief controversies is whether irritability should be included among the criteria for this diagnosis because it can also overlap with a number of other psychiatric disorders, such as attention deficit hyperactivity disorder,” says lead author Jeffrey Hunt, MD, a child psychiatrist and training director at Bradley Hospital. “Our findings confirm that while irritableonly mania is uncommon, it does exist particularly in younger children and should be considered in a bipolar diagnosis.”

Bipolar disorder is characterized by dramatic mood swings from euphoria, elation and irritability the manic phase of the disorder to severe depression. Bipolar disorder often begins in late adolescence or early adulthood, although it can develop as early as the preschool years. Recent studies have shown that the number of children and teens being treated for bipolar disorder has grown dramatically in the last decade. Although it is unclear what has caused this increase, experts believe it may be due in part to more aggressive diagnoses by physicians and a greater awareness of pediatric bipolar disorder in the medical community.

Hunt and colleagues studied 361 children between the ages of 7 and 17 with bipolar disorder participating in the multisite Course and Outcome of Bipolar Illness in Youth (COBY) study at Bradley Hospital and Alpert Medical School, the University of Pittsburgh and the University of CaliforniaLos Angeles. COBY is the largest and most comprehensive study of children and adolescents with bipolar disorder to date.

Researchers quantified the frequency and severity of manic symptoms of each participant, including whether irritability and elation were present. Based on this data, the group was then reclassified into three subgroups elationonly, irritableonly and both elated and irritable.

Approximately 10 percent of children fell into the irritableonly category, while elatedonly constituted about 15 percent. Nearly threequarters experienced both elation and irritability. The irritableonly participants were significantly younger in age than the other two groups; however, there were no other sociodemographic differences between the groups. There were also no significant differences in terms of bipolar subtype, rate of psychiatric comorbidities, severity and duration of illness, and family history of mania and other psychiatric disorders. However, depression and alcohol abuse in seconddegree relatives occurred more frequently in the irritableonly subgroup.

“The fact that the irritableonly and elationonly subgroup had similar clinical characteristics and family histories of bipolar disorder provides support for continuing to consider episodic irritability in the diagnosis of pediatric bipolar disorder,” says Hunt, who is an assistant professor of psychiatry and human behavior at Alpert Medical School. Hunt is also training director of the child and adolescent fellowship and triple board residency programs.

The authors say continual, longterm followup of this study sample will help clarify whether the presence or predominance of elation or irritability at baseline will predict future clinical outcomes.

The research was funded by a grant from the National Institute of Mental Health. Study coauthors include Jennifer Dyl and the late Henrietta Leonard from Bradley Hospital and Alpert Medical School; Christianne EspositoSmythers, Martin Keller, Lance Swenson and Robert Stout from Alpert Medical School; Boris Birmaher, David Axelson, Neal Ryan, Benjamin Goldstein, Tina Goldstein, MaryKay Gill and Mei Yang from the University of Pittsburgh Medical Center; and Michael Strober from the David Geffen School of Medicine, University of California at Los Angeles.

Source
Jessica Collins Grimes

Nearly 90 percent of morbidly obese patients with Type 2 diabetes experienced diabetes resolution within the first year of gastric bypass surgery and about 60 percent remained diabetesfree five to 16 years later, according to a new study presented today at the 26th Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS).

Those most likely to experience a recurrence of diabetes regained the most weight or had a more severe insulindependent form of diabetes prior to surgery. More than 75 percent of patients who were controlling their diabetes with dietary and lifestyle management and more than 65 percent who were using oral medications before surgery continue to be diabetesfree after gastric bypass surgery. About 70 percent of insulindependent patients had a recurrence of diabetes independent of weight loss or gain, and 40 percent of those who regained about 20 percent of the weight also experienced a return of the disease.

“The severity of the diabetes at the time of surgery and the regain of excess weight loss longterm seem to be the primary determinants of longterm diabetes resolution after gastric bypass surgery,” said James W. Maher, MD, professor of Surgery at Virginia Commonwealth University and coauthor of the study. “This study suggests that people with Type 2 diabetes and morbid obesity who get surgery before becoming insulindependent have the greatest chance for complete resolution and avoiding the progression of diabetes.”

In a retrospective analysis, researchers at Virginia Commonwealth University studied 177 people with morbid obesity and Type 2 diabetes who had gastric bypass surgery between 1993 and 2003. Researchers divided patients into three categories based on their diabetes treatment prior to surgery insulin dependent (59); oral medications (83); diet and lifestyle changes only (35). Patients were followed from five to 16 years.

Patients who had a recurrence of diabetes regained about 10 percent more of their excess weight than those with no recurrence. On average, patients who remain free of diabetes had excess weight loss of about 73 percent while diabetes returned in those that had 66 percent excess weight loss.

“Our study suggests that the shortterm resolution of diabetes that is independent of weight loss may be different than the mechanism that is responsible for longterm resolution,” added Dr. Maher. “In any case, bariatric surgery remains one of the most effective treatments for diabetes and morbid obesity.”

Nearly 24 million Americans are affected by diabetes1 and the total estimated cost of diabetes in 2007 was $174 billion, including $116 billion in excess medical expenditures and $58 billion in reduced national productivity.2 About 50 percent of men and 70 percent of women who have the disease are obese.3

People who are morbidly obese are generally 100 or more pounds overweight, have a BMI of 40 or more, or a BMI of 35 or more with an obesityrelated disease, such as Type 2 diabetes, heart disease or sleep apnea. According to the ASMBS, more than 15 million Americans are considered morbidly obese and in 2008 an estimated 220,000 people had some form of bariatric surgery. The most common methods of bariatric surgery are laparoscopic gastric bypass and laparoscopic adjustable gastric banding (LAGB).
vThe American Diabetes Association (ADA) recently recommended bariatric surgery be considered for adults with BMI > 35 and Type 2 diabetes, especially if diabetes is difficult to control under current therapy.5

Two landmark studies, published in the New England Journal of Medicine in August 2007, showed patients with morbid obesity who have bariatric surgery (including gastric banding, gastric bypass, and vertical banded gastroplasty) lost significant weight over the longterm and are significantly less likely to die from heart disease, diabetes and cancer seven to 10 years following the procedure than those who did not have surgery.6, 7

A 2004 study in the Journal of the American Medical Association showed that bariatric surgery resolved or improved Type 2 diabetes in 86 percent of patients and resolved sleep apnea in more than 85 percent of patients.8

References

1. Centers for Disease Control and Prevention. National diabetes fact sheet general information and national estimates of diabetes in the United States, 2007. Atlanta, GA U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2008.

2. American Diabetes Association. “Economic Costs of Diabetes in the U.S. in 2007.” Diabetes Care. Volume 31. Number 3. March 2008.

3. American Heart Association. Type 2 Diabetes. Updated 18 February 2009. [Cited 27 April 2009] Available from americanheart.org/presenter.jhtml?identifier=3044759

4. Dixon JB. Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes. JAMA. 2008; 299(3)316323

5. American Diabetes Association. Standards of Medical Care in Diabetes 2009. Diabetes Care, Volume 32, Supplement 1. January 2009. [Cited 2009 April 27].

6. Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007; 35774152.

7. Adams TD, Gress RE, Smith SC, et al. Longterm mortality after gastric bypass surgery. N Engl J Med 200735775361.

8. Buchwald H. Bariatric Surgery A Systematic Review and Metaanalysis. JAMA. 2004; 29217241737.

Source

The Network of African Science Academies (NASAC) issued a statement (pdf) asking developed countries to establish training programs that would allow African students to stay in Africa or other developing countries in effort to curb the “tide of African talent leaving the continents universities,” CNN reports (Wong, CNN, 6/22).

Ahead of next months meeting in Italy which includes G8 leaders plus Brazil, China, India, Mexico and South Africa NASAC has asked the group for greater investment in Africas research infrastructure, EurActiv.com reports. According to NASAC, onethird of all African scientists live and work in developed countries, which has crippled development efforts in Africa. Only about 1.4 percent of articles published in international peerreviewed journals come from Africa, NASAC said (EurActiv.com, 6/18).

CNN Examines London Schools Program To Educate Students In Developing Countries

CNN examines the London School of Hygiene and Tropical Medicines distance learning program, which could be the “key to curbing the flight of the skilled health professionals from the developing world.” The school started the program “to allow health professionals to enhance their skills and knowledge at their own pace and in their own country,” CNN writes. Currently, 2,500 students are enrolled in the program, which offers Masters degrees and graduate diplomas in infectious diseases, public health and clinical trials.

Andrew Haines, the director of the London School, said, “We dont train people for the brain drain. We train people very much to make a contribution to their own countries.”

According to Sharon Huttly, the dean of studies, approximately 40 percent of students in the program are based in Africa. Theres also a significant portion from Southeast Asia.

Although Internet access has improved since the program launched in 1998, one of the “biggest challenges is trying to deliver something that is still accessible and suitable to a student who is sitting somewhere thats got very poor Internet access but also is suitable for a student sitting somewhere whos got every gadget and highspeed bandwidth available to them,” Huttly said (CNN, 6/22).

Program Helps Developing Country Researchers Publish Work

In related news, SciDev.Net examines SciEdit, which is a “free editing service for developing country researchers who are trying to publish their work.” A group of undergraduate and graduate students in Canada, Europe and the U.S. run SciEdit, which aims to “provide detailed editorial feedback in accordance with the standards of journals,” including Nature and Science.

SciEdit cofounder Justin Chakma, who is a researcher at the McLaughlinRotman Centre for Global Health in Canada, said, although there is a lot of “innovative” research happening in developing countries, “its not being represented well in international literature, unfortunately.” Chakma said English and editorial conventions can be challenging for students who are unfamiliar with the language and procedures.

As a result, Chakma said the group mostly offers help with “grammar, the conventions, the style that you need.” He added, “But we also offer, if [the researchers] want, feedback on the science because we have graduate students across a variety of disciplines” (Antony, SciDev.net, 6/22).

Select Rite Aid stores nationwide will host Diabetes Solutions Days on June 23 and 25 offering patients living with diabetes valuable health screenings and selfmanagement solutions. Caregivers and patients alike can benefit from this free chance to get professional advice on the symptoms and treatments for diabetes as well as watching handson demonstrations.

The free events and store locations are listed online based on zip code at riteaid.com; events run from 2 to 6 p.m., do not require an appointment and are part of Rite Aids yearround focus helping diabetes patients take the best care of themselves. The events include blood pressure screenings, personal pharmacist consultations and glucose meter selection and training. There also will be product coupons and samples of the latest in athome diabetes care, and visitors can enter a raffle at each location for a $50 Rite Aid gift card.

“The key to effective diabetes management is to understand the conditions symptoms and treatments. On Diabetes Solutions Day, patients can consult with trained Rite Aid pharmacists on their diabetes symptoms and treatment regimen as well as sample the latest techniques in athome monitoring,” said Robert Thompson, Rite Aid senior vice president of pharmacy.

A free 16page Diabetes Guide, developed with the American Diabetes Association, is available in all Rite Aid stores and identifies the risk factors for prediabetes and diabetes. It includes important information on weight management and eating smart, featuring diabetesfriendly recipes. The guide also provides advice and safe treatment options on health conditions like gum disease, dry eyes, and wound and foot care, all of which can be especially harmful to people with diabetes if left untreated.

In addition to printed materials available at the event, Rite Aid offers diabetes information online at riteaiddiabetes.com including tips on managing and living with diabetes, a section devoted to family and caregivers, a frequently asked questions section and educational articles on topics including nutrition, foot care and blood glucose monitoring.

South Dakota State University research shows that a child with leaner body mass, or muscle, builds bigger bones than a child who weighs the same but has a greater percentage of fat.

“We were interested in the relative influence of lean mass, which is muscle, versus fat mass on how bone grows as kids grow,” said Howard Wey, an associate professor in SDSUs College of Nursing.

Wey and professor Bonny Specker, director and chair of the Ethel Austin Martin Program in Human Nutrition at SDSU, are continuing to study the issue. They have analyzed data Specker and her team have assembled by taking bone and body composition measurements of rural Hutterite children in South Dakota.

“Theres a little bit of controversy because weight itself has a positive influence on bone,” said Wey. “Heavier individuals tend to have more bone just to support their weight.”

The SDSU study was designed to look deeper at that issue to see whether there are differences in how lean mass and fat mass correlate with bone development. Wey presented the findings at the annual meeting of the Pediatric Academic Societies in Baltimore in early May.

“A larger child is going to have larger bones just because hes heavier,” Wey said. “But if you have two kids at the same weight, the one whose weight is dominated by fat mass is more likely to have smaller bones than the one whose weight is dominated by lean mass. Smaller bones are weaker than larger bones.”

The study is an offshoot of SDSUs ongoing South Dakota Rural Bone Health Study, directed by Specker. To date the project has tracked more than 1,700 individuals over a threeyear period to evaluate how lifestyle affects bone density in three groups of people Hutterites, rural nonHutterites and nonrural nonHutterites.

The National Institutes of Health funds that research. The Ethel Austin Martin Endowed Program in Human Nutrition also supports SDSUs ongoing bone research.

To study fat mass versus lean mass as a factor in bone development, the SDSU researchers gathered two to three measurements over a 36month period on about 150 male and about 200 female Hutterite children ages 8 to 18.

Because they are growing children, all the children in the study showed increases in bone mass, area and density, Wey noted. But there were clear differences in rates of change.

“We looked at multiple measurements over time. We found that lean mass had a positive effect on rates of change,” Wey said. “Kids with higher lean mass, or muscle, tended to have greater rates of change, and kids with higher fat mass tended to have lower rates of change.”

Wey said the results are preliminary but are fairly consistent. They also confirm what Speckers research team has learned in a crosssectional study of Hutterite children. That study essentially a look at an entire group of children at one point in time suggests that lean mass has a positive effect on bone.

The ongoing SDSU research will add to what scientists know about bone development. The new knowledge is one factor that can help the medical community in forming guidelines about diet and exercise to deal with health issues such as childhood obesity and the subsequent influence on adult disorders such as osteoporosis.

UroToday.com In the online issue of the World Journal of Urology, a group headed by Professor Markus Hohenfellner compared the outcomes of radical prostatectomy (RP) in men younger and older than age 70 years. They suggest that in wellselected men over age 70 years, the outcomes are comparable.

The study cohort consisted of 626 men who underwent RP at their institution between 1990 and 2006. A total of 526 were younger than 70 years old, and 100 were older than 70 years. The majority underwent radical retropubic RP and 46 underwent a perineal approach. The majority had a pelvic lymphadenectomy performed. Median patient age was 64.4 years, median PSA was 8.9ng/ml, and median followup was 5.3 years. For the analysis preop PSA, pathologic tumor stage, WHO tumor grading, margin status, time of PSA recurrence, time of distant metastatic recurrence, CaP specific and overall survival were considered.

ECOG status was >1 in 7% of the older cohort compared to 2.3% of the younger men. While median age was almost 10 years older, percentage of organconfined cancer, grade, positive lymph node and positive margin status did not differ. Median PSAfree survival was 10.2 years for the young men and not yet reached for the older men. The 10year PSAfree survival was 51.8% for the young and 57.4% for the older men. The 10year metastasisfree survival was 86.9% and 89.7% for the 70 year old patients, respectively. The 10year prostate cancer specific survival was 92.3% and 97.6% for the young and old men, respectively. Median overall survival was 14 and 12.4 years and 10year overall survival was 78.1% and 71.2% for the 70 year old patients, respectively. In multivariable analysis, there was no difference in any of the categories for clinical outcome where the age was a risk factor for adverse outcome.

Pfitzenmaier J, Pahernik S, Buse S, Haferkamp A, Djakovic N, Hohenfellner M
World J Urol. 2009 Apr 26. Epub ahead of print.
doi10.1007/s0034500904140

Written by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

UroToday the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go tourotoday.com