Neil Fleshner
MD, MPH, FRCSC
Phone
(416) 946-4501 ext. 2899
Assistant(s)
Biography
Dr. Neil Fleshner is Chair and Professor at the Division of Urology, University of Toronto. Dr. Fleshner is certified in both urology and epidemiology. He earned his MPH degree from the School of Public Health at Columbia University and completed his oncology training at Memorial Sloan Kettering Cancer Center.
Dr. Fleshner is an avid music lover and father of three.
Areas of Specialty and Research Interests
Aside from surgical practice, Dr. Fleshner conducts research on urologic cancer prevention with an emphasis on prostate cancer. He has authored over 400 scientific papers. Dr. Fleshner's current research projects include 2 randomized trials of nutritional intervention in prostate cancer as well as laboratory work assessing oxidative biomarkers and cell cycle regulation in prostate cancer cells exposed to micronutrients.
Affiliated Hospital(s)
Mount Sinai Hospital, Princess Margaret Cancer Centre (UHN), Toronto General Hospital (UHN)
Latest Publications
Population-based outcomes of men with a single negative prostate biopsy: Importance of continued follow-up among older patients.
Related Articles
Population-based outcomes of men with a single negative prostate biopsy: Importance of continued follow-up among older patients.
Urol Oncol. 2019 Feb 13;:
Authors: Sayyid RK, Alibhai SMH, Sutradhar R, Eberg M, Fung K, Klaassen Z, Goldberg H, Perlis N, Madi R, Terris MK, Urbach DR, Fleshner NE
Abstract
PURPOSE: To determine in Ontario-based men with a single negative transrectal ultrasound-guided prostate biopsy the long-term rates of prostate cancer-specific mortality, diagnosis, and treatment; number of repeat biopsies; and predictors of prostate cancer diagnosis and mortality.
MATERIALS AND METHODS: This was a population-based cohort study, using data from linked, validated health administrative databases, of all Ontario-based men with a negative first biopsy between January 1994 and October 2014. Patients were followed from time of first biopsy till death, administrative censoring, or end of study period. Cumulative incidence functions were used to calculate the study outcomes' cumulative incidences. Univariable and multivariable regression analyses using Fine and Gray's semiparametric proportional hazards model were used to assess predictors of prostate cancer diagnosis and mortality.
RESULTS: The study cohort included 95,675 men with a median age of 63.0 years. Median follow-up was 8.1 years. The 20-year cumulative rates of prostate cancer-specific mortality and diagnosis were 1.8% and 23.7%, respectively. Men ages 70 to 79 and 80 to 84 at initial biopsy had 20-year prostate cancer-specific mortality cumulative rates of 3.2% and 6.4% respectively. The 20-year cumulative rate of receiving radical prostatectomy was 7.6%. Higher socioeconomic status and urban residence were associated with higher diagnosis risks yet lower prostate cancer-specific mortality risks.
CONCLUSIONS: This is the first population-based study assessing long-term cancer outcomes in North American men with a single negative transrectal ultrasound-guided prostate biopsy. Following a negative initial biopsy, 23.7% of men are still diagnosed with and 1.8% die of prostate cancer within 20 years. Cancer-specific mortality outcomes are significantly worse in older men, with prostate cancer mortality rates several times higher than the rest of the population.
PMID: 30770299 [PubMed - as supplied by publisher]
( Dr. Neil Fleshner, Oncologist, Toronto, ON) is in good standing with the College of Physicians and Surgeons.
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