This page is part of the Evidence Based Medicine on FHIR Implementation Guide (v1.0.0-ballot2: STU1 Ballot 2) based on FHIR (HL7® FHIR® Standard) v6.0.0. No current official version has been published yet. For a full list of available versions, see the Directory of published versions
Page standards status: Informative |
<Citation xmlns="http://hl7.org/fhir">
<id value="179628"/>
<meta>
<versionId value="9"/>
<lastUpdated value="2025-03-27T12:20:19.370Z"/>
<profile
value="http://hl7.org/fhir/uv/ebm/StructureDefinition/journal-article-citation"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Citation 179628</b></p><a name="179628"> </a><a name="hc179628"> </a><a name="179628-en-US"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">version: 9; Last updated: 2025-03-27 12:20:19+0000</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-journal-article-citation.html">JournalArticleCitation</a></p></div><p><b>url</b>: <a href="Citation-179628.html">Citation 14706014 Chemohormonal therapy as primary treatment for metastatic prostate cancer: a randomized study of estramustine phosphate plus luteinizing hormone-releasing hormone agonist versus flutamide plus luteinizing hormone-releasing hormone agonist.</a></p><p><b>identifier</b>: FEvIR Object Identifier/https://fevir.net/FOI/179628, <code>https://pubmed.ncbi.nlm.nih.gov</code>/14706014, <a href="http://terminology.hl7.org/6.2.0/NamingSystem-uri.html" title="As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.txt
This oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid:
Note that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR.
This OID may also be used in CD.codeSystem.">Uniform Resource Identifier (URI)</a>/urn:oid:2.16.840.1.113883.4.642.40.44.15.16</p><p><b>version</b>: 1.0.0-ballot2</p><p><b>title</b>: 14706014 Chemohormonal therapy as primary treatment for metastatic prostate cancer: a randomized study of estramustine phosphate plus luteinizing hormone-releasing hormone agonist versus flutamide plus luteinizing hormone-releasing hormone agonist.</p><p><b>status</b>: Active</p><p><b>date</b>: 2025-03-28 17:11:38+0000</p><p><b>publisher</b>: HL7 International / Clinical Decision Support</p><p><b>contact</b>: HL7 International / Clinical Decision Support: <a href="http://www.hl7.org/Special/committees/dss">http://www.hl7.org/Special/committees/dss</a></p><p><b>description</b>: </p><div><p>This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide.</p>
</div><h3>UseContexts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td><a href="http://hl7.org/fhir/R5/codesystem-citation-classification-type.html#citation-classification-type-fevir-platform-use">Citation Classification Type fevir-platform-use</a>: FEvIR Platform Use</td><td><span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier medline-base}">Medline Base</span></td></tr></table><p><b>jurisdiction</b>: <span title="Codes:{http://unstats.un.org/unsd/methods/m49/m49.htm 001}">World</span></p><p><b>copyright</b>: </p><div><p>https://creativecommons.org/licenses/by-nc-sa/4.0/</p>
</div><p><b>approvalDate</b>: 2004-06-15</p><p><b>lastReviewDate</b>: 2019-09-22</p><p><b>author</b>: Computable Publishing®: MEDLINE-to-FEvIR Converter: </p><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/citation-classification-type citation-source}">Citation Source</span></p><p><b>classifier</b>: <span title="Codes:">MEDLINE</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/citation-classification-type medline-owner}">MEDLINE Citation Owner</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/bsd/licensee/elements_descriptions.html#owner_value NLM}">National Library of Medicine, Index Section</span></p></blockquote><p><b>currentState</b>: <span title="Codes:{http://hl7.org/fhir/citation-status-type medline-medline}">Medline Citation Status of Medline</span>, <span title="Codes:{http://hl7.org/fhir/citation-status-type pubmed-publication-status-ppublish}">PubMed PublicationStatus of ppublish</span></p><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title="Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-pubmed}">PubMed Pubstatus of Pubmed</span></p><p><b>period</b>: ?? --> 2004-01-07 05:00:00+0000</p></blockquote><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title="Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-medline}">PubMed Pubstatus of Medline</span></p><p><b>period</b>: ?? --> 2004-06-16 05:00:00+0000</p></blockquote><blockquote><p><b>statusDate</b></p><p><b>activity</b>: <span title="Codes:{http://hl7.org/fhir/citation-status-type pubmed-pubstatus-entrez}">PubMed Pubstatus of Entrez</span></p><p><b>period</b>: ?? --> 2004-01-07 05:00:00+0000</p></blockquote><blockquote><p><b>citedArtifact</b></p><p><b>identifier</b>: <code>https://pubmed.ncbi.nlm.nih.gov</code>/14706014, <code>https://doi.org</code>/10.1111/j.1442-2042.2004.t01-1-00748.x, pii/748</p><h3>Titles</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Language</b></td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://hl7.org/fhir/title-type primary}">Primary title</span></td><td><span title="Codes:{urn:ietf:bcp:47 en}">English</span></td><td><div><p>Chemohormonal therapy as primary treatment for metastatic prostate cancer: a randomized study of estramustine phosphate plus luteinizing hormone-releasing hormone agonist versus flutamide plus luteinizing hormone-releasing hormone agonist.</p>
</div></td></tr></table><h3>Abstracts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://hl7.org/fhir/cited-artifact-abstract-type primary-human-use}">Primary human use</span></td><td><div><p><strong>BACKGROUND:</strong> The present study was undertaken mainly to investigate whether chemohormonal therapy with estramustine phosphate plus luteinizing hormone-releasing hormone (LHRH) agonist has a more beneficial effect than the hormonal therapy with flutamide plus LHRH agonist for newly diagnosed patients with metastatic prostate cancer.
<strong>METHODS:</strong> A total of 57 patients with metastatic prostate cancer aged 59-80 years (median 74 years) were entered in the study and were randomized to the treatment of estramustine phosphate (560 mg/day) plus LHRH agonist (estramustine group) or flutamide (375 mg/day) plus LHRH agonist (flutamide group) with stratification for the degree of performance status, histological differentiation and bone metastasis.
<strong>RESULTS:</strong> Both of the treatment regimens were well tolerated with similar incidences of adverse drug reactions. The overall response rates (complete response plus partial response) at 12 weeks after treatment in the estramustine and flutamide groups were 76 and 55%, respectively. The median time to objective progression for the estramustine group (25.4 months) was longer than that of the flutamide group (14.6 months). The serum levels of follicle stimulating hormone and testosterone were significantly lower in the estramustine group.
<strong>CONCLUSIONS:</strong> Chemohormonal therapy with estramustine phosphate plus LHRH agonist showed longer clinical progression-free survival than the hormonal therapy with flutamide plus LHRH agonist (P = 0.03), although there was no significant difference in the overall survival. A larger-scaled trial with more statistical power is required to clarify that the former regimen is more beneficial than the latter for newly diagnosed patients with advanced prostate cancer.</p>
</div></td></tr></table><blockquote><p><b>publicationForm</b></p><blockquote><p><b>publishedIn</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/published-in-type D020492}">Periodical</span></p><p><b>identifier</b>: Print ISSN Type/0919-8172, ISOAbbreviation/Int J Urol, ISSN Linking/0919-8172, Medline Title Abbreviation/Int J Urol, NLM Unique ID/9440237</p><p><b>title</b>: International journal of urology : official journal of the Japanese Urological Association</p><p><b>publisherLocation</b>: Australia</p></blockquote><p><b>citedMedium</b>: <span title="Codes:{http://hl7.org/fhir/cited-medium print}">Print</span></p><p><b>volume</b>: 11</p><p><b>issue</b>: 2</p><p><b>articleDate</b>: 2004-02</p><p><b>publicationDateText</b>: 2004-Feb</p><p><b>pageString</b>: 103-9</p></blockquote><h3>WebLocations</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Classifier</b></td><td><b>Url</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://hl7.org/fhir/artifact-url-classifier abstract}">Abstract</span></td><td><a href="https://pubmed.ncbi.nlm.nih.gov/14706014/">https://pubmed.ncbi.nlm.nih.gov/14706014/</a></td></tr></table><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type publishing-model}">Publishing Model</span></p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier Print}">Print</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type chemical}">Chemical</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D000726}">Androgen Antagonists</span>, <span title="Codes:{https://www.nlm.nih.gov/mesh D018931}">Antineoplastic Agents, Hormonal</span>, <span title="Codes:{https://www.cas.org/support/documentation/chemical-substances 33515-09-2}, {https://www.nlm.nih.gov/mesh D007987}">Gonadotropin-Releasing Hormone</span>, <span title="Codes:{https://www.cas.org/support/documentation/chemical-substances 35LT29625A}, {https://www.nlm.nih.gov/mesh D004961}">Estramustine</span>, <span title="Codes:{https://www.cas.org/support/documentation/chemical-substances 76W6J0943E}, {https://www.nlm.nih.gov/mesh D005485}">Flutamide</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">MeSH heading</span></p><p><b>artifactAssessment</b>: <a href="#hc179628/meshHeading0">ArtifactAssessment: artifact[x] = this resource</a></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type publication-type}">Publication type</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D016430}">Clinical Trial</span>, <span title="Codes:{https://www.nlm.nih.gov/mesh D016428}">Journal Article</span>, <span title="Codes:{https://www.nlm.nih.gov/mesh D016449}">Randomized Controlled Trial</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type knowledge-artifact-type}">Knowledge Artifact Type</span></p><p><b>classifier</b>: <span title="Codes:{http://hl7.org/fhir/citation-artifact-classifier D016428}">Journal Article</span></p><p><b>artifactAssessment</b>: Classifier added by Computable Publishing LLC</p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type citation-subset}">Citation subset</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/bsd/licensee/elements_descriptions.html#citationsubset IM}">IM</span></p></blockquote><blockquote><p><b>contributorship</b></p><p><b>complete</b>: true</p><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc179628/contributor0">Noguchi M</a></p><p><b>forenameInitials</b>: M</p><p><b>affiliation</b>: Department of Urology, Kurume University School of Medicine, Kurume, Japan. noguchi@med.kurume-u.ac.jp</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc179628/contributor1">Noda S</a></p><p><b>forenameInitials</b>: S</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc179628/contributor2">Yoshida M</a></p><p><b>forenameInitials</b>: M</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc179628/contributor3">Ueda S</a></p><p><b>forenameInitials</b>: S</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc179628/contributor4">Shiraishi T</a></p><p><b>forenameInitials</b>: T</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc179628/contributor5">Itoh K</a></p><p><b>forenameInitials</b>: K</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a href="#hc179628/contributor6">Kurume-Kumamoto Estracyt Study Group</a></p></blockquote></blockquote></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Practitioner #contributor0</b></p><a name="179628/contributor0"> </a><a name="hc179628/contributor0"> </a><a name="179628/contributor0-en-US"> </a><p><b>name</b>: Masanori Noguchi </p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Practitioner #contributor1</b></p><a name="179628/contributor1"> </a><a name="hc179628/contributor1"> </a><a name="179628/contributor1-en-US"> </a><p><b>name</b>: Shinshi Noda </p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Practitioner #contributor2</b></p><a name="179628/contributor2"> </a><a name="hc179628/contributor2"> </a><a name="179628/contributor2-en-US"> </a><p><b>name</b>: Masaki Yoshida </p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Practitioner #contributor3</b></p><a name="179628/contributor3"> </a><a name="hc179628/contributor3"> </a><a name="179628/contributor3-en-US"> </a><p><b>name</b>: Shoichi Ueda </p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Practitioner #contributor4</b></p><a name="179628/contributor4"> </a><a name="hc179628/contributor4"> </a><a name="179628/contributor4-en-US"> </a><p><b>name</b>: Taizo Shiraishi </p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Practitioner #contributor5</b></p><a name="179628/contributor5"> </a><a name="hc179628/contributor5"> </a><a name="179628/contributor5-en-US"> </a><p><b>name</b>: Kyogo Itoh </p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Organization #contributor6</b></p><a name="179628/contributor6"> </a><a name="hc179628/contributor6"> </a><a name="179628/contributor6-en-US"> </a><p><b>name</b>: Kurume-Kumamoto Estracyt Study Group</p></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: ArtifactAssessment #meshHeading0</b></p><a name="179628/meshHeading0"> </a><a name="hc179628/meshHeading0"> </a><a name="179628/meshHeading0-en-US"> </a><p><b>artifact</b>: <a href="#hc179628">Citation 14706014 Chemohormonal therapy as primary treatment for metastatic prostate cancer: a randomized study of estramustine phosphate plus luteinizing hormone-releasing hormone agonist versus flutamide plus luteinizing hormone-releasing hormone agonist.</a></p><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D000368}">Aged</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D000369}">Aged, 80 and over</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D000726}">Androgen Antagonists</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000008}">administration & dosage</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49488}">Yes</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D018931}">Antineoplastic Agents, Hormonal</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000008}">administration & dosage</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49487}">No</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D018572}">Disease-Free Survival</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D004305}">Dose-Response Relationship, Drug</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D004334}">Drug Administration Schedule</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D004359}">Drug Therapy, Combination</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D004961}">Estramustine</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000008}">administration & dosage</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49488}">Yes</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D005485}">Flutamide</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000008}">administration & dosage</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49488}">Yes</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D007987}">Gonadotropin-Releasing Hormone</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000037}">antagonists & inhibitors</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49487}">No</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D006801}">Humans</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D008297}">Male</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D008875}">Middle Aged</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D009361}">Neoplasm Invasiveness</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000473}">pathology</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49488}">Yes</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D009367}">Neoplasm Staging</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D011336}">Probability</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D011379}">Prognosis</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D011471}">Prostatic Neoplasms</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:">is not a major topic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000188}">drug therapy</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49488}">Yes</span></td></tr></table></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000401}">mortality</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49487}">No</span></td></tr></table></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: <span title="Codes:">qualifier</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh Q000473}">pathology</span></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">is Major topic</span></td><td><span title="Codes:{http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl C49488}">Yes</span></td></tr></table></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D016019}">Survival Analysis</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/cited-artifact-classification-type mesh-heading}">components (if present) include qualifier codings</span></p><p><b>classifier</b>: <span title="Codes:{https://www.nlm.nih.gov/mesh D016896}">Treatment Outcome</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">qualifier</span></td><td><span title="Codes:">is not a major topic</span></td></tr></table></blockquote></blockquote></div>
</text>
<contained>
<Practitioner>
<id value="contributor0"/>
<name>
<family value="Noguchi"/>
<given value="Masanori"/>
</name>
</Practitioner>
</contained>
<contained>
<Practitioner>
<id value="contributor1"/>
<name>
<family value="Noda"/>
<given value="Shinshi"/>
</name>
</Practitioner>
</contained>
<contained>
<Practitioner>
<id value="contributor2"/>
<name>
<family value="Yoshida"/>
<given value="Masaki"/>
</name>
</Practitioner>
</contained>
<contained>
<Practitioner>
<id value="contributor3"/>
<name>
<family value="Ueda"/>
<given value="Shoichi"/>
</name>
</Practitioner>
</contained>
<contained>
<Practitioner>
<id value="contributor4"/>
<name>
<family value="Shiraishi"/>
<given value="Taizo"/>
</name>
</Practitioner>
</contained>
<contained>
<Practitioner>
<id value="contributor5"/>
<name>
<family value="Itoh"/>
<given value="Kyogo"/>
</name>
</Practitioner>
</contained>
<contained>
<Organization>
<id value="contributor6"/>
<name value="Kurume-Kumamoto Estracyt Study Group"/>
</Organization>
</contained>
<contained>
<ArtifactAssessment>
<id value="meshHeading0"/>
<artifactReference>
<reference value="#"/>
<type value="Citation"/>
</artifactReference>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D000368"/>
<display value="Aged"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D000369"/>
<display value="Aged, 80 and over"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D000726"/>
<display value="Androgen Antagonists"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="Q000008"/>
<display value="administration & dosage"/>
</coding>
</classifier>
<component>
<type>
<text value="is Major topic"/>
</type>
<classifier>
<coding>
<system
value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C49488"/>
<display value="Yes"/>
</coding>
</classifier>
</component>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D018931"/>
<display value="Antineoplastic Agents, Hormonal"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="Q000008"/>
<display value="administration & dosage"/>
</coding>
</classifier>
<component>
<type>
<text value="is Major topic"/>
</type>
<classifier>
<coding>
<system
value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C49487"/>
<display value="No"/>
</coding>
</classifier>
</component>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D018572"/>
<display value="Disease-Free Survival"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D004305"/>
<display value="Dose-Response Relationship, Drug"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D004334"/>
<display value="Drug Administration Schedule"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D004359"/>
<display value="Drug Therapy, Combination"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D004961"/>
<display value="Estramustine"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="Q000008"/>
<display value="administration & dosage"/>
</coding>
</classifier>
<component>
<type>
<text value="is Major topic"/>
</type>
<classifier>
<coding>
<system
value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C49488"/>
<display value="Yes"/>
</coding>
</classifier>
</component>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D005485"/>
<display value="Flutamide"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="Q000008"/>
<display value="administration & dosage"/>
</coding>
</classifier>
<component>
<type>
<text value="is Major topic"/>
</type>
<classifier>
<coding>
<system
value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C49488"/>
<display value="Yes"/>
</coding>
</classifier>
</component>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D007987"/>
<display value="Gonadotropin-Releasing Hormone"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="Q000037"/>
<display value="antagonists & inhibitors"/>
</coding>
</classifier>
<component>
<type>
<text value="is Major topic"/>
</type>
<classifier>
<coding>
<system
value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C49487"/>
<display value="No"/>
</coding>
</classifier>
</component>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D006801"/>
<display value="Humans"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D008297"/>
<display value="Male"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D008875"/>
<display value="Middle Aged"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D009361"/>
<display value="Neoplasm Invasiveness"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="Q000473"/>
<display value="pathology"/>
</coding>
</classifier>
<component>
<type>
<text value="is Major topic"/>
</type>
<classifier>
<coding>
<system
value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C49488"/>
<display value="Yes"/>
</coding>
</classifier>
</component>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D009367"/>
<display value="Neoplasm Staging"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D011336"/>
<display value="Probability"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D011379"/>
<display value="Prognosis"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D011471"/>
<display value="Prostatic Neoplasms"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="Q000188"/>
<display value="drug therapy"/>
</coding>
</classifier>
<component>
<type>
<text value="is Major topic"/>
</type>
<classifier>
<coding>
<system
value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C49488"/>
<display value="Yes"/>
</coding>
</classifier>
</component>
</component>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="Q000401"/>
<display value="mortality"/>
</coding>
</classifier>
<component>
<type>
<text value="is Major topic"/>
</type>
<classifier>
<coding>
<system
value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C49487"/>
<display value="No"/>
</coding>
</classifier>
</component>
</component>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="Q000473"/>
<display value="pathology"/>
</coding>
</classifier>
<component>
<type>
<text value="is Major topic"/>
</type>
<classifier>
<coding>
<system
value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C49488"/>
<display value="Yes"/>
</coding>
</classifier>
</component>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D016019"/>
<display value="Survival Analysis"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
</content>
<content>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
<text value="components (if present) include qualifier codings"/>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D016896"/>
<display value="Treatment Outcome"/>
<userSelected value="false"/>
</coding>
</classifier>
<freeToShare value="true"/>
<component>
<type>
<text value="qualifier"/>
</type>
<classifier>
<text value="is not a major topic"/>
</classifier>
</component>
</content>
</ArtifactAssessment>
</contained>
<url value="https://fevir.net/resources/Citation/179628"/>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="ACSN"/>
<display value="Accession ID"/>
</coding>
<text value="FEvIR Object Identifier"/>
</type>
<system value="urn:ietf:rfc:3986"/>
<value value="https://fevir.net/FOI/179628"/>
<assigner>
<display value="Computable Publishing LLC"/>
</assigner>
</identifier>
<identifier>
<system value="https://pubmed.ncbi.nlm.nih.gov"/>
<value value="14706014"/>
</identifier>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:oid:2.16.840.1.113883.4.642.40.44.15.16"/>
</identifier>
<version value="1.0.0-ballot2"/>
<title
value="14706014 Chemohormonal therapy as primary treatment for metastatic prostate cancer: a randomized study of estramustine phosphate plus luteinizing hormone-releasing hormone agonist versus flutamide plus luteinizing hormone-releasing hormone agonist."/>
<status value="active"/>
<date value="2025-03-28T17:11:38+00:00"/>
<publisher value="HL7 International / Clinical Decision Support"/>
<contact>
<name value="HL7 International / Clinical Decision Support"/>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/dss"/>
</telecom>
</contact>
<description
value="This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide."/>
<useContext>
<code>
<system value="http://hl7.org/fhir/citation-classification-type"/>
<code value="fevir-platform-use"/>
<display value="FEvIR Platform Use"/>
</code>
<valueCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/citation-artifact-classifier"/>
<code value="medline-base"/>
<display value="Medline Base"/>
<userSelected value="false"/>
</coding>
</valueCodeableConcept>
</useContext>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
<display value="World"/>
</coding>
</jurisdiction>
<copyright value="https://creativecommons.org/licenses/by-nc-sa/4.0/"/>
<approvalDate value="2004-06-15"/>
<lastReviewDate value="2019-09-22"/>
<author>
<name value="Computable Publishing®: MEDLINE-to-FEvIR Converter"/>
</author>
<classification>
<type>
<coding>
<system value="http://hl7.org/fhir/citation-classification-type"/>
<code value="citation-source"/>
<display value="Citation Source"/>
</coding>
</type>
<classifier>
<text value="MEDLINE"/>
</classifier>
</classification>
<classification>
<type>
<coding>
<system value="http://hl7.org/fhir/citation-classification-type"/>
<code value="medline-owner"/>
<display value="MEDLINE Citation Owner"/>
</coding>
</type>
<classifier>
<coding>
<system
value="https://www.nlm.nih.gov/bsd/licensee/elements_descriptions.html#owner_value"/>
<code value="NLM"/>
<display value="National Library of Medicine, Index Section"/>
<userSelected value="false"/>
</coding>
</classifier>
</classification>
<currentState>
<coding>
<system value="http://hl7.org/fhir/citation-status-type"/>
<code value="medline-medline"/>
<display value="Medline Citation Status of Medline"/>
</coding>
</currentState>
<currentState>
<coding>
<system value="http://hl7.org/fhir/citation-status-type"/>
<code value="pubmed-publication-status-ppublish"/>
<display value="PubMed PublicationStatus of ppublish"/>
</coding>
</currentState>
<statusDate>
<activity>
<coding>
<system value="http://hl7.org/fhir/citation-status-type"/>
<code value="pubmed-pubstatus-pubmed"/>
<display value="PubMed Pubstatus of Pubmed"/>
</coding>
</activity>
<period>
<end value="2004-01-07T05:00:00.000Z"/>
</period>
</statusDate>
<statusDate>
<activity>
<coding>
<system value="http://hl7.org/fhir/citation-status-type"/>
<code value="pubmed-pubstatus-medline"/>
<display value="PubMed Pubstatus of Medline"/>
</coding>
</activity>
<period>
<end value="2004-06-16T05:00:00.000Z"/>
</period>
</statusDate>
<statusDate>
<activity>
<coding>
<system value="http://hl7.org/fhir/citation-status-type"/>
<code value="pubmed-pubstatus-entrez"/>
<display value="PubMed Pubstatus of Entrez"/>
</coding>
</activity>
<period>
<end value="2004-01-07T05:00:00.000Z"/>
</period>
</statusDate>
<citedArtifact>
<identifier>
<system value="https://pubmed.ncbi.nlm.nih.gov"/>
<value value="14706014"/>
</identifier>
<identifier>
<system value="https://doi.org"/>
<value value="10.1111/j.1442-2042.2004.t01-1-00748.x"/>
</identifier>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="ACSN"/>
<display value="Accession ID"/>
</coding>
<text value="pii"/>
</type>
<value value="748"/>
</identifier>
<title>
<type>
<coding>
<system value="http://hl7.org/fhir/title-type"/>
<code value="primary"/>
<display value="Primary title"/>
</coding>
</type>
<language>
<coding>
<system value="urn:ietf:bcp:47"/>
<code value="en"/>
<display value="English"/>
</coding>
</language>
<text
value="Chemohormonal therapy as primary treatment for metastatic prostate cancer: a randomized study of estramustine phosphate plus luteinizing hormone-releasing hormone agonist versus flutamide plus luteinizing hormone-releasing hormone agonist."/>
</title>
<abstract>
<type>
<coding>
<system value="http://hl7.org/fhir/cited-artifact-abstract-type"/>
<code value="primary-human-use"/>
<display value="Primary human use"/>
</coding>
</type>
<text
value="**BACKGROUND:** The present study was undertaken mainly to investigate whether chemohormonal therapy with estramustine phosphate plus luteinizing hormone-releasing hormone (LHRH) agonist has a more beneficial effect than the hormonal therapy with flutamide plus LHRH agonist for newly diagnosed patients with metastatic prostate cancer.
**METHODS:** A total of 57 patients with metastatic prostate cancer aged 59-80 years (median 74 years) were entered in the study and were randomized to the treatment of estramustine phosphate (560 mg/day) plus LHRH agonist (estramustine group) or flutamide (375 mg/day) plus LHRH agonist (flutamide group) with stratification for the degree of performance status, histological differentiation and bone metastasis.
**RESULTS:** Both of the treatment regimens were well tolerated with similar incidences of adverse drug reactions. The overall response rates (complete response plus partial response) at 12 weeks after treatment in the estramustine and flutamide groups were 76 and 55%, respectively. The median time to objective progression for the estramustine group (25.4 months) was longer than that of the flutamide group (14.6 months). The serum levels of follicle stimulating hormone and testosterone were significantly lower in the estramustine group.
**CONCLUSIONS:** Chemohormonal therapy with estramustine phosphate plus LHRH agonist showed longer clinical progression-free survival than the hormonal therapy with flutamide plus LHRH agonist (P = 0.03), although there was no significant difference in the overall survival. A larger-scaled trial with more statistical power is required to clarify that the former regimen is more beneficial than the latter for newly diagnosed patients with advanced prostate cancer."/>
</abstract>
<publicationForm>
<publishedIn>
<type>
<coding>
<system value="http://hl7.org/fhir/published-in-type"/>
<code value="D020492"/>
<display value="Periodical"/>
</coding>
</type>
<identifier>
<type>
<coding>
<system
value="https://www.nlm.nih.gov/bsd/licensee/elements_descriptions.html#issn"/>
<code value="Print"/>
<display value="Print"/>
</coding>
<text value="Print ISSN Type"/>
</type>
<system value="https://portal.issn.org"/>
<value value="0919-8172"/>
</identifier>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="XX"/>
<display value="Organization identifier"/>
</coding>
<text value="ISOAbbreviation"/>
</type>
<system
value="https://www.issn.org/services/online-services/access-to-the-ltwa/"/>
<value value="Int J Urol"/>
</identifier>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="XX"/>
<display value="Organization identifier"/>
</coding>
<text value="ISSN Linking"/>
</type>
<system
value="https://www.issn.org/understanding-the-issn/assignment-rules/the-issn-l-for-publications-on-multiple-media/"/>
<value value="0919-8172"/>
</identifier>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="XX"/>
<display value="Organization identifier"/>
</coding>
<text value="Medline Title Abbreviation"/>
</type>
<system
value="https://www.nlm.nih.gov/tsd/cataloging/contructitleabbre.html"/>
<value value="Int J Urol"/>
</identifier>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="XX"/>
<display value="Organization identifier"/>
</coding>
<text value="NLM Unique ID"/>
</type>
<system
value="https://locatorplus.gov/cgi-bin/Pwebrecon.cgi?DB=local"/>
<value value="9440237"/>
</identifier>
<title
value="International journal of urology : official journal of the Japanese Urological Association"/>
<publisherLocation value="Australia"/>
</publishedIn>
<citedMedium>
<coding>
<system value="http://hl7.org/fhir/cited-medium"/>
<code value="print"/>
<display value="Print"/>
</coding>
</citedMedium>
<volume value="11"/>
<issue value="2"/>
<articleDate value="2004-02"/>
<publicationDateText value="2004-Feb"/>
<pageString value="103-9"/>
</publicationForm>
<webLocation>
<classifier>
<coding>
<system value="http://hl7.org/fhir/artifact-url-classifier"/>
<code value="abstract"/>
<display value="Abstract"/>
</coding>
</classifier>
<url value="https://pubmed.ncbi.nlm.nih.gov/14706014/"/>
</webLocation>
<classification>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="publishing-model"/>
<display value="Publishing Model"/>
<userSelected value="false"/>
</coding>
</type>
<classifier>
<coding>
<system value="http://hl7.org/fhir/citation-artifact-classifier"/>
<code value="Print"/>
<display value="Print"/>
<userSelected value="false"/>
</coding>
</classifier>
</classification>
<classification>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="chemical"/>
<display value="Chemical"/>
<userSelected value="false"/>
</coding>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D000726"/>
<display value="Androgen Antagonists"/>
<userSelected value="false"/>
</coding>
</classifier>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D018931"/>
<display value="Antineoplastic Agents, Hormonal"/>
<userSelected value="false"/>
</coding>
</classifier>
<classifier>
<coding>
<system
value="https://www.cas.org/support/documentation/chemical-substances"/>
<code value="33515-09-2"/>
<userSelected value="false"/>
</coding>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D007987"/>
<display value="Gonadotropin-Releasing Hormone"/>
<userSelected value="false"/>
</coding>
</classifier>
<classifier>
<coding>
<system
value="https://www.cas.org/support/documentation/chemical-substances"/>
<code value="35LT29625A"/>
<userSelected value="false"/>
</coding>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D004961"/>
<display value="Estramustine"/>
<userSelected value="false"/>
</coding>
</classifier>
<classifier>
<coding>
<system
value="https://www.cas.org/support/documentation/chemical-substances"/>
<code value="76W6J0943E"/>
<userSelected value="false"/>
</coding>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D005485"/>
<display value="Flutamide"/>
<userSelected value="false"/>
</coding>
</classifier>
</classification>
<classification>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="mesh-heading"/>
<display value="MeSH heading"/>
</coding>
</type>
<artifactAssessment>
<reference value="#meshHeading0"/>
<type value="ArtifactAssessment"/>
</artifactAssessment>
</classification>
<classification>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="publication-type"/>
<display value="Publication type"/>
</coding>
</type>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D016430"/>
<display value="Clinical Trial"/>
<userSelected value="false"/>
</coding>
</classifier>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D016428"/>
<display value="Journal Article"/>
<userSelected value="false"/>
</coding>
</classifier>
<classifier>
<coding>
<system value="https://www.nlm.nih.gov/mesh"/>
<code value="D016449"/>
<display value="Randomized Controlled Trial"/>
<userSelected value="false"/>
</coding>
</classifier>
</classification>
<classification>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="knowledge-artifact-type"/>
<display value="Knowledge Artifact Type"/>
<userSelected value="false"/>
</coding>
</type>
<classifier>
<coding>
<system value="http://hl7.org/fhir/citation-artifact-classifier"/>
<code value="D016428"/>
<display value="Journal Article"/>
<userSelected value="false"/>
</coding>
</classifier>
<artifactAssessment>
<display value="Classifier added by Computable Publishing LLC"/>
</artifactAssessment>
</classification>
<classification>
<type>
<coding>
<system
value="http://hl7.org/fhir/cited-artifact-classification-type"/>
<code value="citation-subset"/>
<display value="Citation subset"/>
<userSelected value="false"/>
</coding>
</type>
<classifier>
<coding>
<system
value="https://www.nlm.nih.gov/bsd/licensee/elements_descriptions.html#citationsubset"/>
<code value="IM"/>
<display value="IM"/>
<userSelected value="false"/>
</coding>
</classifier>
</classification>
<contributorship>
<complete value="true"/>
<entry>
<contributor>
<reference value="#contributor0"/>
<type value="Practitioner"/>
<display value="Noguchi M"/>
</contributor>
<forenameInitials value="M"/>
<affiliation>
<display
value="Department of Urology, Kurume University School of Medicine, Kurume, Japan. noguchi@med.kurume-u.ac.jp"/>
</affiliation>
</entry>
<entry>
<contributor>
<reference value="#contributor1"/>
<type value="Practitioner"/>
<display value="Noda S"/>
</contributor>
<forenameInitials value="S"/>
</entry>
<entry>
<contributor>
<reference value="#contributor2"/>
<type value="Practitioner"/>
<display value="Yoshida M"/>
</contributor>
<forenameInitials value="M"/>
</entry>
<entry>
<contributor>
<reference value="#contributor3"/>
<type value="Practitioner"/>
<display value="Ueda S"/>
</contributor>
<forenameInitials value="S"/>
</entry>
<entry>
<contributor>
<reference value="#contributor4"/>
<type value="Practitioner"/>
<display value="Shiraishi T"/>
</contributor>
<forenameInitials value="T"/>
</entry>
<entry>
<contributor>
<reference value="#contributor5"/>
<type value="Practitioner"/>
<display value="Itoh K"/>
</contributor>
<forenameInitials value="K"/>
</entry>
<entry>
<contributor>
<reference value="#contributor6"/>
<type value="Organization"/>
<display value="Kurume-Kumamoto Estracyt Study Group"/>
</contributor>
</entry>
</contributorship>
</citedArtifact>
</Citation>