Prostate Cancer[JOURNAL]
Sun
200 papers
Optimal PSA Threshold for Obtaining MRI-Fusion Biopsy in Biopsy-Naïve Patients.
Wang LL, Henslee BL, Sam PB … +2 more , LaGrange CA, Boyle SL
Prostate Cancer · 2021 · PMID 34306761 · Full text
OBJECTIVE: The study investigates the prostate-specific antigen threshold for adding targeted, software-based, magnetic resonance imaging-ultrasound fusion biopsy during a standard 12-core biopsy in biopsy-naïve patients...
OBJECTIVE: The study investigates the prostate-specific antigen threshold for adding targeted, software-based, magnetic resonance imaging-ultrasound fusion biopsy during a standard 12-core biopsy in biopsy-naïve patients. It secondarily explores whether the targeted biopsy is necessary in setting of abnormal digital rectal examination. METHODS: 260 patients with suspected localized prostate cancer with no prior biopsy underwent prostate magnetic resonance imaging and were found to have Prostate Imaging Reporting and Data System score ≥ 3 lesion(s). All 260 patients underwent standard 12-core biopsy and targeted biopsy during the same session. Clinically significant cancer was Gleason ≥3 + 4. RESULTS: Percentages of patients with prostate-specific antigen 0-1.99, 2-3.99, 4-4.99, 5-5.99, 6-9.99, and ≥10 were 3.0%, 4.7%, 20.8%, 16.9%, 37.7%, and 16.9%, respectively. Cumulative frequency of clinically significant prostate cancer increased with the addition of targeted biopsy compared with standard biopsy alone across all prostate-specific antigen ranges. The difference in clinically significant cancer detection between targeted plus standard biopsy compared to standard biopsy alone becomes statistically significant at prostate-specific antigen >4.3 (=0.031). At this threshold, combination biopsy detected 20 clinically significant prostate cancers, while standard detected 14 with 88% sensitivity and 20% specificity. Excluding targeted biopsy in setting of a positive digital rectal exam would save 12.3% magnetic resonance imaging and miss 1.8% clinically significant cancers in our cohort. CONCLUSIONS: In biopsy-naïve patients, at prostate-specific antigen >4.3, there is a significant increase in clinically significant prostate cancer detection when targeted biopsy is added to standard biopsy. Obtaining standard biopsy alone in patients with abnormal digital rectal examinations would miss 1.8% clinically significant cancers in our cohort.
Implications of Regionalizing Care in the Developing World: Impact of Distance to Referral Center on Compliance to Biopsy Recommendations in a Brazilian Prostate Cancer Screening Cohort.
Freedland AR, Muller RL, Hoyo C … +8 more , Turner EL, Moorman PG, Faria EF, Carvalhal GF, Reis RB, Mauad EC, Carvalho AL, Freedland SJ
Prostate Cancer · 2021 · PMID 34239732 · Full text
Given growing specialization in medical care, optimal care may require regionalization, which may create access barriers. We tested this within a large prostate cancer (PC) screening program in Brazil. In 2004-2007, Barr...
Given growing specialization in medical care, optimal care may require regionalization, which may create access barriers. We tested this within a large prostate cancer (PC) screening program in Brazil. In 2004-2007, Barretos Cancer Hospital prospectively screened men for PC throughout rural Brazil. Men with abnormal screen were referred for follow-up and possible biopsy. We tested the link between distance from screening site to Barretos Cancer Hospital and risk of noncompliance with showing up for biopsy, PC on biopsy and, among those with PC, PC grade using crude and multivariable logistic regression analysis. Among 10,467 men undergoing initial screen, median distance was 257 km (IQR: 135-718 km). On crude and multivariable analyses, farther distance was significantly linked with biopsy noncompliance (OR/100 km: 0.83, < 0.001). Among men who lived within 150 km of Barretos Cancer Hospital, distance was unrelated to compliance (OR/100 km: 1.09, =0.87). There was no association between distance and PC risk or PC grade (all > 0.25). In Brazil, where distances to referral centers can be large, greater distance was related to reduced biopsy compliance in a PC screening cohort. Among men who lived within 150 km, distance was unrelated to compliance. Care regionalization may reduce access when distances are large.
The Weight of HLA-DPA1 rs3077 Single Nucleotide Polymorphism in Prostate Cancer, a Multicenter Study.
Alenzi MJ, Ghazy AA, Taha DE
Prostate Cancer · 2021 · PMID 33976942 · Full text
Prostate cancer (PCa) has almost the highest genetic transmission that mimics an autosomal dominance hereditary pattern of cancers in some families. Its incidence in Arab countries was reported to be steadily increasing....
Prostate cancer (PCa) has almost the highest genetic transmission that mimics an autosomal dominance hereditary pattern of cancers in some families. Its incidence in Arab countries was reported to be steadily increasing. . To determine the relevance of HLA-DPA1 rs3077 (A/G) SNP with prostate cancer's risk and/or severity. . Forty PCa patients and forty age matched patients with benign prostatic hyperplasia (BPH), as a control group, were enrolled in the study. Serum levels of urea, creatinine, total prostate-specific antigen (PSA), and free PSA were measured. PSA ratio was determined as well. Genotyping of HLA-DPA1 rs3077 (A/G) SNP was done using real-time PCR. . The measured lab parameters, except free PSA, were significantly higher among PCa patients in comparison to controls ( < 0.001 ). Moreover, PSA ratio was significantly high among PCa patients ( < 0.001 ). HLA-DPA1 rs3077 GG genotype was more frequent in PCa patients and the associated OR was 2.546 (=0.059), while AA genotype was more frequent in the control group and the associated OR was 0.145 (=0.081). Frequency of G allele was higher among PCa patients than the control group while A allele frequency was significantly decreased (=0.034 ) (protective allele). On multivariate analysis, there is no significant correlation found between HLA-DPA1 rs3077 SNP and PSA ratio (OR = 4.5, 95% CI = 1.2-17.4, =0.856). . HLA-DPA1 rs3077 G allele could be a risk factor for prostate cancer. However, HLA-DPA1 rs3077 SNP has no relation to PCa severity.
High Serum Alkaline Phosphatase Flare after First-Line Androgen Deprivation Therapy Predicts Poor Prognosis in Metastatic Prostate Cancer Patients Treated with Second-Generation Androgen Receptor Targeted Therapy.
Kojima S, Masuda H, Suyama T … +4 more , Hou K, Mikami K, Araki K, Naya Y
Prostate Cancer · 2021 · PMID 33898066 · Full text
OBJECTIVES: To determine whether an alkaline phosphatase (ALP) flare after androgen deprivation therapy (ADT) is associated with the treatment response in castration-resistant prostate cancer (CRPC) and predicts the prog...
OBJECTIVES: To determine whether an alkaline phosphatase (ALP) flare after androgen deprivation therapy (ADT) is associated with the treatment response in castration-resistant prostate cancer (CRPC) and predicts the prognosis of metastatic prostate cancer (PCa) patients. METHODS: One hundred and nineteen patients diagnosed with metastatic PCa between 2008 and 2017 were retrospectively studied. The ALP flare ratio was calculated as the ratio of ALP levels 1 month after beginning ADT to ALP levels at diagnosis. The association of the ALP flare ratio with the prostate-specific antigen (PSA) response to CRPC treatment (second-generation androgen receptor targeted therapy (ART) or docetaxel), time to CRPC, and overall survival (OS) were investigated. RESULTS: The time to CRPC and OS was significantly longer in patients with an ALP flare ratio less than 1.33 compared to a ratio more than 1.33. No difference in PSA response was seen regarding the ALP flare ratio in both ART and docetaxel treatment. Second-generation ART-treated patients with a low ALP flare ratio showed longer OS than those with a higher ALP flare ratio (=0.0367). However, no difference was seen between a high and low ALP flare ratio (=0.8054) in docetaxel-treated patients. The ALP flare ratio was the most significant prognostic factor for OS ( < 0.0001). CONCLUSIONS: A higher ALP flare ratio after first-line ADT was a significant prognostic factor in metastatic PCa, especially in patients treated with second-generation ART for CRPC. Chemotherapy for patients with a higher ALP flare ratio 1 month after induction of ADT may be a clinically relevant decision.
Predictive and Prognostic Role of Lipocalin-2 Expression in Prostate Cancer and Its Association with Gleason Score.
Ulusoy MH, Cirak Y, Adali Y
Prostate Cancer · 2021 · PMID 33542838 · Full text
Lipocalin-2 has an important role in tumor progression, invasion, and metastasis. However, its role in prostate cancer remains unclear. The objective of this study is to determine the expression level of lipocalin-2 in h...
Lipocalin-2 has an important role in tumor progression, invasion, and metastasis. However, its role in prostate cancer remains unclear. The objective of this study is to determine the expression level of lipocalin-2 in human prostate cancer tissues and to evaluate the relationship between its expression level and clinicopathologic parameters including response to docetaxel treatment, Gleason score, progression-free survival (PFS), and overall survival (OS). We retrospectively analyzed paraffin-embedded tissue sections from 33 metastatic castrate-resistant prostate cancer (mCRPC) patients whose clinical outcomes had been tracked after docetaxel treatment. The expression status of lipocalin-2 was defined by immunohistochemistry (IHC) using the anti-lipocalin-2 antibody. Lipocalin-2 was highly expressed in 36% of the examined specimens. There was no significant correlation between high lipocalin-2 expression and docetaxel response ( : 0.09). High lipocalin-2 expression was significantly associated with a higher Gleason score (=0.027). Kaplan-Meier survival analysis failed to show a significant correlation between expression levels of lipocalin-2 and both OS and PFS although patients with high lipocalin-2 levels had a numerically shorter PFS and OS time compared to patients with low levels. Consequently, it is clear that further studies are needed to evaluate the predictive and prognostic role of lipocalin-2 in prostate cancer patients.
A Multicentric, Retrospective Efficacy and Safety Study of Nanosomal Docetaxel Lipid Suspension in Metastatic Castration-Resistant Prostate Cancer.
Samar A, Tiwari S, Subramanian S … +4 more , Joshi N, Sejpal J, Khan MA, Ahmad I
Prostate Cancer · 2020 · PMID 33381320 · Full text
PURPOSE: To evaluate the efficacy and safety of nanosomal docetaxel lipid suspension (NDLS, DoceAqualip) in patients with metastatic castration-resistant prostate cancer (mCRPC). MATERIALS AND METHODS: In this multicente...
PURPOSE: To evaluate the efficacy and safety of nanosomal docetaxel lipid suspension (NDLS, DoceAqualip) in patients with metastatic castration-resistant prostate cancer (mCRPC). MATERIALS AND METHODS: In this multicenter, retrospective study, we analyzed the medical charts of mCRPC patients, who were treated with NDLS administered as 2-weekly (50 mg/m) or 3-weekly regimens (75 mg/m). The study endpoints were prostate-specific antigen (PSA) response (>50% PSA decline from baseline), PSA progression (PSA increase from baseline beyond 12 weeks: ≥25% and ≥2 ng/mL), median PSA decline, and time-to-treatment failure (TTF). Overall survival (OS) and safety were also evaluated. RESULTS: Data of 24 patients with mCRPC were analyzed in this study. NDLS was administered as a 2-weekly regimen in 37.5% (9/24; all first-line) patients and as a 3-weekly regimen in 62.5% patients (15/24; first-line: 20% (3/15), second-line: 80% (12/15)). Overall, PSA response was reported in 66.7% (16/24) patients. The PSA response was 77.8% (7/9 patients) in the 2-weekly group and 60% (9/15 patients) in the 3-weekly group. The median decline in PSA was 96.31% in the 2-weekly group and 83.29% in the 3-weekly group; the median TTF was 6.7 and 6.5 months in the 2 weekly group and 3-weekly group, respectively. The median OS was 14.6 months (follow-up: 5.5-25.8 months) in the 2-weekly group whereas it was not reached in the 3-weekly group (follow-up: 7.9-15.6 months). The most common hematological AEs were anemia, lymphopenia, thrombocytopenia, and neutropenia whereas nausea, weakness, constipation, vomiting, and diarrhea were the most common (≥10%) nonhematological AEs. Overall, NDLS treatment was well tolerated without any new safety concerns. CONCLUSIONS: Nanosomal docetaxel lipid suspension (2-weekly or 3-weekly) was effective and well tolerated in patients with metastatic castration-resistant prostate cancer.
Clinical, Histopathological, and Prognostic Characteristics of Patients with Prostate Cancer in Lubumbashi, Democratic Republic of Congo.
Mbey PM, Mukuku O, Arung WK … +5 more , Tengu GK, Amisi NL, Kyabu VK, Odimba EFK, Tshilombo FK
Prostate Cancer · 2020 · PMID 33376609 · Full text
INTRODUCTION: Prostate cancer is currently a public health problem with a frequency that varies from country to country. This study aims to describe the epidemiological, clinical, and histopathological and outcome featur...
INTRODUCTION: Prostate cancer is currently a public health problem with a frequency that varies from country to country. This study aims to describe the epidemiological, clinical, and histopathological and outcome features of prostate cancer in Lubumbashi in the Democratic Republic of Congo. MATERIALS AND METHODS: This was a descriptive longitudinal study of patients diagnosed with prostate cancer at the University Clinics of Lubumbashi. The study period was 3 years (2017 to 2019). Parameters studied were age and clinical, biological (PSA level, prostatic specific antigen), histopathological, and outcome features. RESULTS: The mean age of patients was 68.7 years (range: 47 and 90 years). The 60 to 69 age group was the most affected (43.18%). Elderly subjects (≥60 years old) represented 89.77% of the cases ( = 79). Voiding disorders were the main reason for consultation in 55.68% of the cases. The mean PSA level was 133.7 ng/ml (range: 4 and 1564.5 ng/ml) at diagnosis and 125.4 ng/ml after 3 months of follow-up (range: 0.16 and 1782.1 ng/ml). Adenocarcinoma was the predominant histological type (100%). In prognosis, 31.82% of patients had a Gleason score greater than 7 and 59.10% had a high risk at the D'Amico risk classification for Prostate Cancer. Hormone therapy was administered alone in 75% of the cases and in combination with pulpectomy in 13.64% of the cases. The 3-year overall survival was 56.82%. CONCLUSION: Prostate cancer is frequent and has a poor outcome in our country. The establishment of an individual screening policy would be an undeniable advantage in improving the prognosis.
Somatic Mitochondrial DNA Point Mutations Used as Biomarkers to Demonstrate Genomic Heterogeneity in Primary Prostate Cancer.
Arstad C, Taskén K, Refinetti P … +3 more , Axcrona U, Giercksky KE, Ekstrøm PO
Prostate Cancer · 2020 · PMID 32908706 · Full text
Primary prostate tumor heterogeneity is poorly understood, leaving research efforts with challenges regarding the initiation and advancement of the disease. The growth of tumor cells is accompanied by mutations in nuclea...
Primary prostate tumor heterogeneity is poorly understood, leaving research efforts with challenges regarding the initiation and advancement of the disease. The growth of tumor cells is accompanied by mutations in nuclear and in mitochondrial genomes. Thus, mitochondrial DNA mutations may be used as tumor cell markers. By the use of laser capture microdissection coupled with assays for mitochondrial point mutation detection, mtDNA mutations were used to trace mutated cells at a histological level. Point mutations in mtDNA were determined in 12 primary prostate cancers. The tumors represent different pathology-prognostic grade groups. Known mutational hotspots of the mtDNA were scanned for heteroplasmy. All specimens with mtDNA heteroplasmy were subsequently subsampled by laser capture microdissection. From a total number of 1728 microsamples, mitochondrial DNA target sequences were amplified and base substitutions detected by cycling temperature capillary electrophoresis. Real-time PCR was used as a quantitative assay to determine the relative mtDNA copy number of 12 tumors studied, represented by two samples from each ( = 24); a high degree (75%) demonstrated tumor specimen heterogeneity. A grid of 96 spots isolated by laser capture microdissection demonstrated interfocal sample heterogeneity and increased the limit of detection. The spots demonstrated a wide range of mutant fractions from 0 to 100% mutant copies. The mitochondrial DNA copy number in the samples was determined by real-time PCR. No correlation between copy number and pathology-prognostic grade groups was observed. Somatic mitochondrial DNA point mutations represent traceable biomarkers demonstrating heterogeneity in primary prostate cancer. Mutations can be detected in areas before changes in tissue histopathology are evident to the pathologist.
Interleukin-10 Induces Expression of Neuroendocrine Markers and PDL1 in Prostate Cancer Cells.
Samiea A, Yoon JSJ, Ong CJ … +3 more , Zoubeidi A, Chamberlain TC, Mui AL
Prostate Cancer · 2020 · PMID 32802517 · Full text
Interleukin-10 (IL10) is best studied for its inhibitory action on immune cells and ability to suppress an antitumour immune response. But IL10 also exerts direct effects on nonimmune cells such as prostate cancer epithe...
Interleukin-10 (IL10) is best studied for its inhibitory action on immune cells and ability to suppress an antitumour immune response. But IL10 also exerts direct effects on nonimmune cells such as prostate cancer epithelial cells. Elevated serum levels of IL10 observed in prostate and other cancer patients are associated with poor prognosis. After first-line androgen-deprivation therapy, prostate cancer patients are treated with androgen receptor antagonists such as enzalutamide to inhibit androgen-dependent prostate cancer cell growth. However, development of resistance inevitably occurs and this is associated with tumour differentiation to more aggressive forms such as a neuroendocrine phenotype characterized by expression of neuron specific enolase and synaptophysin. We found that treatment of prostate cancer cell lines with IL10 or enzalutamide induced markers of neuroendocrine differentiation and inhibited androgen receptor reporter activity. Both also upregulated the levels of PDL1, which could promote tumour survival through its interaction with the immune cell inhibitory receptor PD1 to suppress antitumour immunity. These findings suggest that IL10's direct action on prostate cancer cells could contribute to prostate cancer progression independent of IL10's suppression of host immune cells.
Prognostic Factors for Overall Survival of Patients with Prostate Cancer in Kyadondo County, Uganda.
Yahaya JJ, Okecha T, Odida M … +1 more , Wabinga H
Prostate Cancer · 2020 · PMID 32411479 · Full text
BACKGROUND: Prostate cancer is the second most common cancer among men globally. A few studies that have been done in Uganda on survival of patients with prostate cancer indicate that, the overall survival of patients wi...
BACKGROUND: Prostate cancer is the second most common cancer among men globally. A few studies that have been done in Uganda on survival of patients with prostate cancer indicate that, the overall survival of patients with prostate cancer in Uganda is poor. The aim of this study was to determine the 3-year overall survival rate of a cohort of patients with prostate cancer residing in Kyadondo County who were diagnosed from 2012 to 2014. The secondary objective was to correlate the overall survival with the clinicopathological prognostic factors. MATERIALS AND METHODS: This was a retrospective cohort study which involved 136 patients who were diagnosed histologically with prostate cancer at the department of pathology between 2012 and 2014. The cases were registered at the Kampala cancer registry and followed up to 31 December 2017. Data analysis was done using STATA version 12.0. The Kaplan-Meir curves were used for analysis of the 3-year overall survival rate. Hazard ratio (HR) and Log-rank test at 95% confidence interval under Cox-regression model were used to evaluate the effect of the covariates on the 3-year overall survival rate. < 0.05 was considered statistically significant. RESULTS: More than half of the cases, 55.9% ( = 76) had Gleason score >8. Most of the patients, 67.7% ( = 92) had advanced disease at diagnosis. The 3-year overall survival rate was 67.6% with median survival of 36.5 months and range of 0-65 months. Clinical stage of the patients (HR = 1.65, = 0.039), Gleason score (HR = 1.88, = 0.008), and lymphovascular invasion (HR = 0.37, = 0.002) were the independent predictors of the 3-year overall survival rate in this study. The 3-year overall survival of prostate cancer patients in Uganda is poor. Most of the patients with are diagnosed with advanced clinical stages (stage III and IV). The Gleason score, clinical stage and lymphovascular invasion can powerfully predict independently the overall survival of patients with prostate cancer. This implies that the Gleason score, clinical stage and lymphovascular invasion may be used to predict the overall survival of patients with prostate cancer even prior prostatectomy.
Epidemiological and Economic Evaluation of a Pilot Prostate Cancer Screening Program.
Smailova DS, Fabbro E, Ibrayev SE … +7 more , Brusati L, Semenova YM, Samarova US, Rakhimzhanova FS, Zhussupov SM, Khismetova ZA, Hosseini H
Prostate Cancer · 2020 · PMID 32411478 · Full text
Prostate cancer (PCa) is the second most commonly diagnosed cancer, and the sixth most common killer among men worldwide (Aubry et al., 2013). This research was motivated by the fact that PCa screening continues to be a...
Prostate cancer (PCa) is the second most commonly diagnosed cancer, and the sixth most common killer among men worldwide (Aubry et al., 2013). This research was motivated by the fact that PCa screening continues to be a controversial topic in the Kazakh medical community. This study aimed at description of how newly diagnosed PCa patients are managed in Pavlodar region of the Kazakhstan Republic and at presentation of a budget impact analysis (BIA) for PCa screening program. Also, we aimed to provide a comparative analysis of pricing system on medical services applied in both private and public healthcare sectors of the Kazakhstan Republic. . New cases of PCa have been retrospectively analyzed for the period from January 2013 to December 2017 based on the information obtained from information system "Policlinic" maintained by the Pavlodar regional branch of the Republican Center for Electronic Health and from Cancer Registry of Pavlodar Regional Oncology Center. All data were analyzed with the help of SPSS 20.0 software. The mean age of PCa patients was 68.34 years (SD = 8.559). The government of Kazakhstan invested 20,437,000 KZT (Kazakhstani tenge) in 2017 equivalently 61,188 USD-to fund a pilot study for examination of 9638 men. From 2013 to 2017, out of 49,334 men residing in Pavlodar region of Kazakhstan 1,248 men were diagnosed with prostate diseases, including 130 PCa cases. The PCa detection rate was equal to two cases per month. Only 22.8% of all PCa cases identified in the region within specified time period were revealed as a result of the government-funded PCa screening program. The average prostate cancer detection rate among the target group of Pavlodar region within the period of 5 years was equal to 0.23%. Based on the fact that the PCa screening program failed to enable adequate detection of new PCa cases, we would not recommend to continue this type of screening unless it is undergone careful revision and replanning.
Impact and Outcomes of Pretreatment Total Serum Testosterone on Localized Prostate Cancer Patients.
Usera BM, Creveling P, Tward JD
Prostate Cancer · 2020 · PMID 32395350 · Full text
PURPOSE: To investigate how pretreatment testosterone levels correlate with progression-free survival, metastasis-free survival, and overall survival in a propensity-adjusted localized prostate cancer population. METHODS...
PURPOSE: To investigate how pretreatment testosterone levels correlate with progression-free survival, metastasis-free survival, and overall survival in a propensity-adjusted localized prostate cancer population. METHODS: Men diagnosed with clinical NCCN-risk stratified very-low, low, intermediate, high, and/or very-high risk prostate cancer who had a baseline total serum testosterone level≥100 ng/dl measured within the 100 days preceding the first definitive therapy were identified from our prospectively gathered institutional database. Cohorts below (100-239 ng/dl), within (240-593 ng/dl), or above (594 + ng/dl) one standard deviation from the mean testosterone level (416 ng/dl) were used for comparison. Progression-free, metastasis-free, and overall survival were evaluated. A separate cohort of men not receiving ADT was used to evaluate testosterone recovery after various treatment modalities (surgery, external beam radiation, brachytherapy, or combined EBRT + Brachy). RESULTS: There was no statistically significant difference between the low, average, and high testosterone cohorts for PFS, MFS, or OS. In men not using ADT, there were no statistically significant changes in testosterone levels 1 year after therapy, regardless of therapy type. CONCLUSION: In men with serum testosterone levels >=100 ng/dl at diagnosis, baseline testosterone does not impact PFS, MFS, or OS. Recovery of testosterone back to baseline is expected for men undergoing either surgery, external beam or brachytherapy, or combined modality radiation when not using ADT.
Understanding and Improving F-Fluciclovine PET/CT Reports: A Guide for Physicians Treating Patients with Biochemical Recurrence of Prostate Cancer.
Lowentritt BH, Kipper MS
Prostate Cancer · 2020 · PMID 32395349 · Full text
The positron emission tomography (PET) tracer F-fluciclovine has seen increasing use to localize disease in men with biochemical recurrence of prostate cancer, i.e., elevated prostate-specific antigen (PSA) levels post-t...
The positron emission tomography (PET) tracer F-fluciclovine has seen increasing use to localize disease in men with biochemical recurrence of prostate cancer, i.e., elevated prostate-specific antigen (PSA) levels post-treatment. F-Fluciclovine PET/computed tomography (CT) imaging reports now play central roles in many physician-patient discussions. However, because no standardized grading system or templates yet exist for F-fluciclovine image assessment, reports vary in format, comprehensiveness, and terminology and may be challenging to fully understand. To better utilize these documents, referring physicians should be aware of six key features of F-fluciclovine PET/CT. First, F-fluciclovine is a radiolabeled synthetic amino acid targeting the amino acid transporters ASCT2 and LAT1, which are ubiquitous throughout the body, but overexpressed in prostate cancer. Second, F-fluciclovine image interpretation is predominantly visual/qualitative: radiotracer uptake in suspicious lesions is compared with uptake in bone marrow or blood pool. Location of F-fluciclovine-avid lesions relative to typical recurrence sites and findings elsewhere in the patient are considered when evaluating lesions' probability of malignancy, as is visibility on maximum intensity projection images when assessing bone lesions. Third, F-fluciclovine PET/CT detection rates increase as PSA levels rise. Fourth, detection rates may differ among centers, possibly due to equipment and reader experience. Fifth, since no diagnostic test is 100% accurate, scan data should not be used in isolation. Lastly, F-fluciclovine PET/CT findings frequently induce changes in disease management plans. In the prospective multicenter LOCATE and FALCON studies, scans altered management plans in 59% (126/213) and 64% (66/104) of patients, respectively; 78% (98/126) and 65% (43/66) of changes, respectively, involved modality switches. Referring physicians and imagers should collaborate to improve scan reports. Referrers should clearly convey critical information, including prescan PSA levels, and open clinical questions. Imagers should produce reports that read like consultations, avoid leaving open questions, and if needed, provide thoughts on next diagnostic steps.
Cancer Detection Rates of Systematic and Targeted Prostate Biopsies after Biparametric MRI.
Gayet MCW, van der Aa AAMA, Beerlage HP … +6 more , Schrier BP, Gielens M, Heesakkers R, Jager GJ, Mulders PFA, Wijkstra H
Prostate Cancer · 2020 · PMID 32308996 · Full text
OBJECTIVE: To compare prostate cancer detection rates (CDRs) and pathology results with targeted prostate biopsy (TB) and systematic prostate biopsy (SB) in biopsy-naive men. METHODS: An in-patient control study of 82 me...
OBJECTIVE: To compare prostate cancer detection rates (CDRs) and pathology results with targeted prostate biopsy (TB) and systematic prostate biopsy (SB) in biopsy-naive men. METHODS: An in-patient control study of 82 men undergoing SB and subsequent TB in case of positive prostate MRI between 2015 and 2017 in the Jeroen Bosch Hospital, the Netherlands. RESULTS: Prostate cancer (PCa) was detected in 54.9% with 70.7% agreement between TB and SB. Significant PCa (Gleason score ≥7) was detected in 24.4%. The CDR with TB and SB was 35.4% and 48.8%, respectively (=0.052). The CDR of significant prostate cancer with TB and SB was both 20.7%. Clinically significant pathology upgrading occurred in 7.3% by adding TB to SB and 22.0% by adding SB to TB. CONCLUSIONS: There is no statistically significant difference between CDRs of SB and TB. Both SB and TB miss significant PCas. Moreover, pathology upgrading occurred more often by adding SB to TB than vice versa. This indicates that the omission of SB in this study population might not be justified.
The Prospect of Identifying Resistance Mechanisms for Castrate-Resistant Prostate Cancer Using Circulating Tumor Cells: Is Epithelial-to-Mesenchymal Transition a Key Player?
Khan T, Scott KF, Becker TM … +4 more , Lock J, Nimir M, Ma Y, de Souza P
Prostate Cancer · 2020 · PMID 32292603 · Full text
Prostate cancer (PCa) is initially driven by excessive androgen receptor (AR) signaling with androgen deprivation therapy (ADT) being a major therapeutic approach to its treatment. However, the development of drug resist...
Prostate cancer (PCa) is initially driven by excessive androgen receptor (AR) signaling with androgen deprivation therapy (ADT) being a major therapeutic approach to its treatment. However, the development of drug resistance is a significant limitation on the effectiveness of both first-line and more recently developed second-line ADTs. There is a need then to study AR signaling within the context of other oncogenic signaling pathways that likely mediate this resistance. This review focuses on interactions between AR signaling, the well-known phosphatidylinositol-3-kinase/AKT pathway, and an emerging mediator of these pathways, the Hippo/YAP1 axis in metastatic castrate-resistant PCa, and their involvement in the regulation of epithelial-mesenchymal transition (EMT), a feature of disease progression and ADT resistance. Analysis of these pathways in circulating tumor cells (CTCs) may provide an opportunity to evaluate their utility as biomarkers and address their importance in the development of resistance to current ADT with potential to guide future therapies.
Long-Term Follow-Up after Prostatectomy for Prostate Cancer and the Need for Active Monitoring.
Swanson GP, Chen W, Trevathan S … +1 more , Hermans M
Prostate Cancer · 2020 · PMID 32231799 · Full text
BACKGROUND: Only truly long-term follow-up can determine the ultimate outcome in prostate cancer. Most studies have a median follow-up of less than 10 years and then project outcomes out to 15 and 20 years. We sought to...
BACKGROUND: Only truly long-term follow-up can determine the ultimate outcome in prostate cancer. Most studies have a median follow-up of less than 10 years and then project outcomes out to 15 and 20 years. We sought to follow patients for at least 20 years. . We followed 754 prostate cancer patients treated with radical prostatectomy from 1988 to 1995 for a median follow-up (in survivors) of 23.9 years. We excluded lymph node and seminal vesicle positive patients and an additional 47 patients that did not have baseline prostate-specific antigen (PSA). This left 581 patients for analysis. RESULTS: With the factors of PSA, Gleason score, and extraprostatic extension/margin positivity, we could partition patients into three risk groups for biochemical failure (low, intermediate, and high). In further analysis, we found that the risk of metastatic disease in the first two groups was almost identical (4% and 5%, respectively), while it was 19% in the high-risk group. High-risk patients were those with PSA >20 ng/ml and/or Gleason >7, or Gleason 7 + PSA 10-20 + epe (and or margin) positive. They had a 22% prostate cancer mortality. CONCLUSION: In patients with truly long-term follow-up after prostatectomy for prostate cancer, the risk of metastatic disease and cancer death is very low. Patients with the lower risk findings do not appear to benefit from routine follow-up after 10 years free of biochemical recurrence. With a higher risk of later failure, we recommend that the higher risk patients be followed at least intermittently for another 5 years (out to 15 years).
Prevalence of Anxiety and Depression in Prostate Cancer Patients and Their Spouses: An Unaddressed Reality.
Sánchez Sánchez E, González Baena AC, González Cáliz C … +3 more , Caballero Paredes F, Moyano Calvo JL, Castiñeiras Fernández J
Prostate Cancer · 2020 · PMID 32231798 · Full text
OBJECTIVES: To estimate the prevalence of unsuspected anxiety or depression in prostate cancer patients and their spouses, as well as factors involved in its onset. . A prospective study of 184 patients and 137 spouses e...
OBJECTIVES: To estimate the prevalence of unsuspected anxiety or depression in prostate cancer patients and their spouses, as well as factors involved in its onset. . A prospective study of 184 patients and 137 spouses evaluated in our hospital during 2019 using the Memorial Anxiety Scale for Prostate Cancer (MAX-PC), Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire depression module (PHQ-9). This study provides an internal validity assessment of the scales and their correlation (alpha and rho coefficients; index ). The contributions of age, education level, months after diagnosis, pain, prostate-specific antigen (PSA) level, stage of the disease and treatment performed to the positivity of the questionnaires were studied using the Wilcoxon-Mann-Whitney and chi-square tests. RESULTS: The prevalence of anxiety was 10.9% (MAX-PC) and 28.3% (MAX-PC-PSA). The HADS-A questionnaire indicated pathology in 14.1% of the patients and 16.05% of the spouses. Depression was detected in 7% (HADS-D) and 9.2% (PHQ-9) of patients as well as in 8.8% (HADS-D) and 16.05% (PHQ-9) of their spouses. The greatest concordance between men and women was with the PHQ-9 (Spearman's rho: 0.78; = 0.01). Education level is significantly related to the presence of anxiety and depression, regardless of the questionnaire applied. The probability of detecting pathology in the MAX-PC varied from 6% in patients with elementary education to 23.5% in university students ( = 0.04). The greatest differences were detected when applying the PHQ-9 to patients (4% pathological, elementary education vs. 35.3% pathological, university education). Our study confirms the lack of a relationship between rates of anxiety and depression and factors such as PSA level, age of the patient and number of comorbidities. CONCLUSION: There is a high prevalence of unsuspected anxiety and depression in patients with prostate cancer and their wives. Education level correlates with such prevalence.
Detection of Prostate Cancer Antigen 3 and Prostate Cancer Susceptibility Candidate in Non-DRE Urine Improves Diagnosis of Prostate Cancer in Chinese Population.
Ye LF, He S, Wu X … +7 more , Jiang S, Zhang RC, Yang ZS, Chen FW, Pan DL, Li D, Li G
Prostate Cancer · 2020 · PMID 32099679 · Full text
Although prostate biopsy is the gold standard for the diagnosis of prostate cancer, it also leads to high incidence of negative biopsies and the diagnosis of clinically low-risk prostate cancer and the subsequent overtre...
Although prostate biopsy is the gold standard for the diagnosis of prostate cancer, it also leads to high incidence of negative biopsies and the diagnosis of clinically low-risk prostate cancer and the subsequent overtreatment. It remains an unmet need to discover new biomarkers in order to defer the unnecessary biopsies in clinical practice. In this study, we described a new method, LBXexo score, to measure the urine exosomal PCA3/PRAC expression from non-DRE urine as a noninvasive diagnosis to improve the detection rate in Chinese population with a low serum PSA level. First-voided urine samples were collected to isolate exosomes, and exosomal RNAs of PCA3 and PRAC were measured by quantitative reverse transcription PCR. A significant increase in exoPCA3/PRAC was observed in both any-grade and high-grade prostate cancer groups when compared with the biopsy-negative group. Receiver-operating characteristic curve analyses showed that the LBXexo score significantly improved diagnostic performance in predicting biopsy results, with AUCs of 0.723 (=0.017) and 0.736 (=0.038) for any-grade and high-grade (GS ≥ 7) prostate cancer, respectively. For high-grade cancer, LBXexo had the negative and positive predictive values of 100% and 27.59%, respectively, and could potentially avoid unnecessary biopsy. This is the first report in Chinese population that demonstrates the predictive value of the exosomal expression of PCA3 and PRAC derived from non-DRE urine in predicting prostate biopsy outcomes. It could be used in clinical practice to make a better informed biopsy decision and avoid unnecessary biopsies in Chinese population.
Synthetic Apparent Diffusion Coefficient for High -Value Diffusion-Weighted MRI in Prostate.
Sahoo P, Rockne RC, Jung A … +3 more , Gupta PK, Rathore RKS, Gupta RK
Prostate Cancer · 2020 · PMID 32095289 · Full text
PURPOSE: It has been reported that diffusion-weighted imaging (DWI) with ultrahigh -value increases the diagnostic power of prostate cancer. DWI with higher -value increases the diagnostic power of prostate cancer. DWI w...
PURPOSE: It has been reported that diffusion-weighted imaging (DWI) with ultrahigh -value increases the diagnostic power of prostate cancer. DWI with higher -value increases the diagnostic power of prostate cancer. DWI with higher -value increases the diagnostic power of prostate cancer. DWI with higher -value increases the diagnostic power of prostate cancer. DWI with higher . Fifteen patients (7 malignant and 8 benign) were included in this study retrospectively with the institutional ethical committee approval. All images were acquired at a 3T MR scanner. The ADC values were calculated using a monoexponential model. Synthetic ADC (sADC) for higher -value increases the diagnostic power of prostate cancer. DWI with higher. RESULTS: No significant difference was observed between actual ADC and sADC for -value increases the diagnostic power of prostate cancer. DWI with higher =0.002, paired -test) in sDWI as compared to DWI. Malignant lesions showed significantly lower sADC as compared to benign lesions (=0.002, paired -test) in sDWI as compared to DWI. Malignant lesions showed significantly lower sADC as compared to benign lesions (/. CONCLUSION: Our initial investigation suggests that the ADC values corresponding to higher -value can be computed using log-linear relationship derived from lower -values ( ≤ 1000). Our method might help clinicians to decide the optimal -value for prostate lesion identification.-value increases the diagnostic power of prostate cancer. DWI with higher -value increases the diagnostic power of prostate cancer. DWI with higher -value increases the diagnostic power of prostate cancer. DWI with higher -value increases the diagnostic power of prostate cancer. DWI with higher.
Association of Angiotensin I Converting Enzyme Insertion/287 bp Deletion Polymorphisms and Proliferative Prostatic Diseases among Lebanese Men.
El Ezzi AA, Clawson JM, El-Saidi MA … +5 more , Zaidan WR, Kovash A, Orellana J, Thornock A, Kuddus RH
Prostate Cancer · 2020 · PMID 32089890 · Full text
BACKGROUND: Angiotensin I converting enzyme (ACE) insertion (I) and 287 bp Alu repeat DNA fragment deletion (D) polymorphisms have been indicated in various cancers. Here, we investigated I/D polymorphisms in prostate ca...
BACKGROUND: Angiotensin I converting enzyme (ACE) insertion (I) and 287 bp Alu repeat DNA fragment deletion (D) polymorphisms have been indicated in various cancers. Here, we investigated I/D polymorphisms in prostate cancer (PCa) and benign prostate hyperplasia (BPH) among Lebanese men. METHODS: Blood DNA extracted from 69 control subjects, 69 subjects with clinically confirmed PCa, and 69 subjects with clinical BPH, all the subjects were aged 50 years or older, was subjected to the polymerase chain reaction. The PCR products were resolved in polyacrylamide gels to determine II, ID, and DD genotypes. The odds ratios (OR), 95% confidence intervals (CI), and values of the allele frequencies and genotype ratios were calculated for establishing possible association of the alleles and/or genotypes and PCa and/or BPH. RESULTS: The proportions of II, ID, and DD genotypes were significantly different from Hardy-Weinberg equilibrium for BPH and PCa groups (but not the control group), mostly due to overabundance of the ID genotypes. There was no significant difference in the I and D allele frequencies between the control groups and the affected groups. The ratio of (DD + ID)/II is significantly lower among the control group compared to the BPH group (RR = 8.92, values of the allele frequencies and genotype ratios were calculated for establishing possible association of the alleles and/or genotypes and PCa and/or BPH. values of the allele frequencies and genotype ratios were calculated for establishing possible association of the alleles and/or genotypes and PCa and/or BPH. CONCLUSIONS: Our data indicate that the D allele of the I/D polymorphisms of the ACE gene is associated with increased risk of BPH, and the ID genotype is a risk factor for both BPH and PCa among Lebanese males.
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