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Wei HC. A mathematical model of tumour growth with Beddington-DeAngelis functional response: a case of cancer without disease. JOURNAL OF BIOLOGICAL DYNAMICS 2018; 12:194-210. [PMID: 29322865 DOI: 10.1080/17513758.2017.1418028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 12/11/2017] [Indexed: 06/07/2023]
Abstract
A previously published mathematical model, governing tumour growth with mixed immunotherapy and chemotherapy treatments, is modified and studied. The search time, which is assumed to be neglectable in the previously published model, is incorporated into the functional response for tumour-cell lysis by effector cells. The model exhibits bistability where a tumour-cell population threshold exists. A tumour with an initial cell population below the threshold can be controlled by the immune system and remains microscopic and asymptomatic called cancer without disease while that above the threshold grows to lethal size. Bifurcation analysis shows that (a) the chemotherapy-induced damage may cause a microscopic tumour, which would never grow to become lethal if untreated, to grow to lethal size, (b) applying chemotherapy alone requires a large dosage to be successful,
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Affiliation(s)
- Hsiu-Chuan Wei
- a Department of Applied Mathematics , Feng Chia University , TaiChung , Taiwan
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2
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Co-existence of mucin-producing urothelial-type adenocarcinoma of the prostate and inverted papilloma of the bladder. Contemp Oncol (Pozn) 2017; 21:184-187. [PMID: 28947891 PMCID: PMC5611510 DOI: 10.5114/wo.2017.68629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Accepted: 11/24/2013] [Indexed: 01/24/2023] Open
Abstract
Adenocarcinoma of prostate with mucinous differentiation arising in the male urethra is extremely rare, with only 21 cases reported in the previous literature. A diagnosis of mucin-producing urothelial carcinoma of the prostate is based on the pathology, immunohistochemistry, and clinical examination by excluding the secondary adenocarcinoma of the prostate. We present a case of unexpected mucinous urothelial carcinoma of prostate with co-existing inverted papilloma of bladder in a 57-year-old man. The patient underwent transurethral resection of the prostate (TURP) and transurethral resection of a bladder tumour (TUR-Bt), and the pathologic result showed mucinous prostate carcinoma and bladder inverted papilloma. Immunohistological stain was negative for prostate-specific antigen (PSA), prostate-specific acid phosphatase (PSAP), and P63, but positive for cytokeratin 7 (CK 7), CK 20, clone 34βE12 and P504S. A complete endoscopic examination was performed to exclude the secondary adenocarcinoma of prostate. This case illustrates the clinical and pathological features of a rare and unexpected mucin-producing urothelial carcinoma of prostate in a bladder neoplasm patient.
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Mokhtar A, Al MM, Al WM, Othman KA, Kattan SA, Al MF. Is survival after radical cystectomy for bladder cancer in Saudi patients different from that of Western patients? Ann Saudi Med 2017; 37:194-200. [PMID: 28578357 PMCID: PMC6150585 DOI: 10.5144/0256-4947.2017.194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Although radical cystectomy (RC) is considered the gold standard treatment of muscle invasive bladder cancer, nearly half of patients develop metastases and ultimately die within 2 years. OBJECTIVE To assess survival, evaluate different prognostic factors that may affect disease-free survival (DFS) in Saudi patients after RC for carcinoma of the bladder and to compare our results with those of Western countries. DESIGN Retrospective chart review. SETTING A tertiary care center in Saudi Arabia. PATIENTS AND METHODS We collected data on patients who underwent RC for bladder cancer in the period between 1979 and 2014. Demographic, clinical and pathological variables and the application of perioperative chemotherapy were reviewed. Univariate and multivariate analyses were done with DFS as the end point. MAIN OUTCOME MEASURE Disease-specific survival. RESULTS On 328 patients for whom data was available, the median follow up was 23 months (range, 2 month-28 years) and median age was 58 years (range, 21-90). Of these patients, 268 were males (81.7%), 235 (71.7%) had urothelial carcinoma (UC), 79 (24.1%) had squamous cell carcinoma (SCC), and 208 (63.4%) had pathological tumor stage 3 or more. The 5-year overall survival (OS) and DFS were 52% and 48%, respectively. There was no statistically significant difference in DFS of patients with UC and pure SCC. On univariate analysis, lymph node status and pathological tumor stage were significant predictors of DFS. Both variables sustained statistical significance in a multivariate analysis. CONCLUSION Survival following RC is almost the same as others. Moreover, pathological tumor stage and lymph node metastasis were the only independent predictors for survival following RC. Future cooperative prospective studies are required to gain data on our region. LIMITATIONS Relatively small sample size and retrospective.
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Affiliation(s)
| | - Mohamed Matar Al
- Dr. Mohammed Faihan Al Otaibi, Consultant Urology,, Department of Urology,, King Faisal Specialist Hospital & Research Centre, PO Box 3354, Riyadh 11211, Saudi Arabia T: +966555787885 F: +966114424301
| | - Waleed Mohamad Al
- Dr. Mohammed Faihan Al Otaibi, Consultant Urology,, Department of Urology,, King Faisal Specialist Hospital & Research Centre, PO Box 3354, Riyadh 11211, Saudi Arabia T: +966555787885 F: +966114424301
| | | | | | - Mohammed Faihan Al
- Dr. Mohammed Faihan Al Otaibi, Consultant Urology,, Department of Urology,, King Faisal Specialist Hospital & Research Centre, PO Box 3354, Riyadh 11211, Saudi Arabia T: +966555787885 F: +966114424301
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Ahn HS. Overdiagnosis in health care: impact of cancer screening. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2017. [DOI: 10.5124/jkma.2017.60.4.323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Hyeong Sik Ahn
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
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Kareva I. Escape from tumor dormancy and time to angiogenic switch as mitigated by tumor-induced stimulation of stroma. J Theor Biol 2016; 395:11-22. [PMID: 26826487 DOI: 10.1016/j.jtbi.2016.01.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 01/12/2016] [Accepted: 01/13/2016] [Indexed: 11/28/2022]
Abstract
A variety of mechanisms have been proposed to explain "cancer without disease", the state of tumor dormancy, characterized by balance in cell proliferation and cell death within a tumor. Here we have investigated a theoretical construct, whereby one of such mechanisms, the time to induction of angiogenesis, or "angiogenic switch", is mitigated by the degree of stromal stimulation by the tumor. We tested this hypothesis and its implications by introducing a mathematical model that captures how angiogenesis regulators, released from the platelet clot, contribute to formation of normal vasculature. We then modified the model to introduce tumor-induced increase in production of angiogenesis regulators and were able to simulate pathological angiogenesis. Through varying parameters governing the degree of tumor-induced stromal stimulation, we were able to qualitatively replicate experimentally observed growth curves for both dormant and actively growing tumors of breast cancer and liposarcoma. In fact, variation of very few parameters was sufficient to replicate any experimentally observed time to angiogenic switch in the available data. Finally, we investigated the effects of tighter binding isoforms of angiogenesis stimulators on neovasculature formation and tumor growth, which may provide an explanation for variations in angiogenesis -dependence in tumors of different tissue origin.
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Affiliation(s)
- Irina Kareva
- Floating Hospital for Children at Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA; Mathematical, Computational and Modeling Sciences Center, Arizona State University, Tempe, AZ 85287, USA.
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6
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Cancer Ecology: Niche Construction, Keystone Species, Ecological Succession, and Ergodic Theory. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s13752-015-0226-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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7
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Pignot G, Salomon L, Lebacle C, Neuzillet Y, Lunardi P, Rischmann P, Zerbib M, Champy C, Roupret M, Peyronnet B, Verhoest G, Murez T, Quintens H, Larré S, Houédé N, Compérat E, Soulié M, Pfister C. Prostate cancer incidence on cystoprostatectomy specimens is directly linked to age: results from a multicentre study. BJU Int 2014; 115:87-93. [PMID: 24825727 DOI: 10.1111/bju.12803] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the incidence and age-related histopathological characteristics of incidentally diagnosed prostate cancer from specimens obtained via radical cystoprostatectomy (RCP) for muscle-invasive bladder cancer. PATIENTS AND METHODS A retrospective review of the histopathological features of 2424 male patients who underwent a RCP for bladder cancer was done at eight centres between January 1996 and June 2012. No patient had preoperative suspicion of prostate cancer. Statistical analyses were performed in different age-related groups. RESULTS Overall, prostate cancer was diagnosed in 518 men (21.4%). Incidences varied significantly according to age (5.2% in those aged <50 years to 30.5% in those aged >75 years, P < 0.001). Most of the prostate cancers were considered as 'non-aggressive', that is to say organ-confined (≤pT2) and well-differentiated (Gleason score <7). Tumour-Node-Metastasis (TNM) stage and proportion with a Gleason score of ≥7 were significantly greater in older patients (P < 0.001). Apart from age, there were no preoperative predictive factors for 'non-aggressive' prostate-cancer status. At the end of the follow-up, only nine patients (1.7%) had biochemical recurrence of prostate cancer, and no preoperative predictive factors were identified. CONCLUSION The rate of incidentally diagnosed prostate cancer from RCP specimens is ≈20%, most of them being organ-confined and well-differentiated. The probability of having a 'non-aggressive' prostate cancer decreases in older men.
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Affiliation(s)
- Géraldine Pignot
- Department of Urology, Bicetre Academic Hospital, Assistance Publique Hôpitaux de Paris, Paris XI University, Paris, France; Oncologic Committee of the French Association of Urology (CCAFU), Paris, France
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Qarro A, Ammani A, Bazine K, Najoui M, Samir J, Alami M. Synchronous primary malignancies of the male urogenital tract. Can Urol Assoc J 2014; 8:E353-5. [PMID: 24940463 DOI: 10.5489/cuaj.1532] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The finding of prostate cancer after a cystoprostatectomy for a bladder tumour can occur in up to 70% of cases. The incidence of prostate cancer in patients with a bladder tumour is 18 times higher than in the general population; moreover, the incidence of bladder cancer in patients with prostate cancer is 19 times higher than in the general population. This association can be explained by the common embryological origin of these organs, with molecular similarities. Other similarities between these two cancers are noted. They are multifocal and may be secondary to urinary stasis. However, this association does not seem responsible for an increased risk of progression of both diseases. The prognosis is related to the extension of each cancer. The stage and grade of bladder cancer are, in terms of prognosis, greater than those of prostate cancer. Most often, this is insignificant prostate cancer. Despite this, the prostate-specific antigen test should be administered to monitor patients after cystoprostatectomy.
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Affiliation(s)
| | - Abdelghani Ammani
- Department of Urology, Military Hospital Moulay Ismail, Meknes, Morocco
| | - Khalil Bazine
- Department of Urology, Military Hospital Moulay Ismail, Meknes, Morocco
| | - Mohammed Najoui
- Department of Urology, Military Hospital Moulay Ismail, Meknes, Morocco
| | - Jamaleddine Samir
- Department of Urology, Military Hospital Moulay Ismail, Meknes, Morocco
| | - Mohammed Alami
- Department of Urology, Military Hospital Moulay Ismail, Meknes, Morocco
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9
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Pan J, Xue W, Sha J, Yang H, Xu F, Xuan H, Li D, Huang Y. Incidental prostate cancer at the time of cystectomy: the incidence and clinicopathological features in Chinese patients. PLoS One 2014; 9:e94490. [PMID: 24722643 PMCID: PMC3983210 DOI: 10.1371/journal.pone.0094490] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Accepted: 03/17/2014] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES To evaluate the incidence and the clinicopathological features of incidental prostate cancer detected in radical cystoprostatectomy (RCP) specimens in Chinese men and to estimate the oncological risk of prostate apex-sparing surgery for such patients. METHODS The clinical data and pathological feature of 504 patients who underwent RCP for bladder cancer from January 1999 to March 2013 were retrospectively reviewed. Whole mount serial section of the RCP specimens were cut transversely at 3-4 mm intervals and examined in same pathological institution. RESULTS Thirty-four out of 504 patients (6.8%) had incidental prostate cancer with a mean age of 70.3 years. 12 cases (35.2%) were diagnosed as significant disease. 4 cases were found to have apex involvement of adenocarcinoma of the prostate while in 5 cases the prostate stroma invasion by urothelial carcinoma were identified (one involved prostate apex). The mean follow-up time was 46.4±33.8 months. Biochemical recurrence occurred in 3 patients but no prostate cancer-related death during the follow-up. There was no statistical significance in cancer specific survival between the clinically significant and insignificant cancer group. CONCLUSIONS The prevalence of incidental prostate cancer in RCP specimens in Chinese patients was remarkably lower than in western people. Most of the incidental prostate cancer was clinically insignificant and patient's prognosis was mainly related to the bladder cancer. Sparing the prostate apex was potentially associated with a 1.0% risk of leaving significant cancer of the prostate or urothelial carcinoma.
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Affiliation(s)
- Jiahua Pan
- Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Wei Xue
- Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Jianjun Sha
- Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Hu Yang
- Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Fan Xu
- Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Hanqing Xuan
- Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Dong Li
- Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Yiran Huang
- Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China
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10
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Pignot G, Salomon L, Neuzillet Y, Masson-Lecomte A, Lebacle C, Patard JJ, Lunardi P, Rischmann P, Pasticier G, Bernhard JC, Cohen J, Timsit MO, Verkarre V, Peyronnet B, Verhoest G, Le Goux C, Zerbib M, Brecheteau F, Bigot P, Larre S, Murez T, Thuret R, Lacarriere E, Champy C, Roupret M, Comperat E, Berger J, Descazeaud A, Toledano H, Bastide C, Lavilledieu S, Avances C, Delage F, Valeri A, Molimard B, Houlgatte A, Gres P, Donnaint A, Kleinclauss F, Legal S, Doerfler A, Koutlidis N, Cormier L, Hetet JF, Colls P, Arvin-Berod A, Rambeaud JJ, Quintens H, Soulie M, Pfister C. Clinicopathological Characteristics of Incidental Prostate Cancer Discovered from Radical Cystoprostatectomy Specimen: A Multicenter French Study. Ann Surg Oncol 2014; 21:684-690. [DOI: 10.1245/s10434-013-3340-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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11
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Kefer JC, Cherullo EE, Jones JS, Gong MC, Campbell SC. Prostate-sparing cystectomy: has Pandora’s box been opened? Expert Rev Anticancer Ther 2014; 7:1003-14. [PMID: 17627460 DOI: 10.1586/14737140.7.7.1003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
En bloc removal of the prostate has traditionally been an integral component of radical cystectomy for men with bladder cancer owing to a high incidence of occult prostatic malignancy. However, the risk of functional morbidity following this procedure is considerable and can delay patient acceptance of cystectomy, which can adversely affect the long-term prognosis. Recently, some investigators have advocated prostate-sparing cystectomy (PSCx) to improve postoperative continence and potency rates, and this may also improve timely patient acceptance of cystectomy. Several of these PSCx series describe excellent functional results postoperatively and PSCx may also facilitate a laparoscopic approach, offering further dividends. However, valid concerns regarding the oncologic efficacy of this procedure still predominate and protocols for patient selection, technique and postoperative surveillance are not well defined. The concept of PSCx is arguably one of the most controversial topics in the field of bladder cancer today.
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Affiliation(s)
- John C Kefer
- Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
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12
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Zappalà G, McDonald PG, Cole SW. Tumor dormancy and the neuroendocrine system: an undisclosed connection? Cancer Metastasis Rev 2013; 32:189-200. [PMID: 23090259 DOI: 10.1007/s10555-012-9400-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Tumor dormancy is a poorly understood phenomenon conceptualized as a protracted quiescent state during which cancer cells are present but clinical disease is not apparent, a condition referred to as "cancer without disease" by Folkman. Examples include the incidental detection of occult in situ tumors in post-mortem organ analysis and cancer recurrence after long disease-free periods. Lack of angiogenic competency has been proposed as a major determinant of the fate of dormant tumors. Other proposed processes include establishment of homeostatic equilibrium between tumor cells and the host's immune system response and a non-permissive microenvironment for tumor growth. Recent cellular and molecular studies suggest that neuroendocrine mediators regulate the biology of tumor progression and act as endogenous modulators of angiogenesis, inflammation, and other molecular processes involved in tumor reactivation from dormancy. We review experimental and clinical evidence and propose that neuroendocrine dynamics of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis might contribute to the loss of tumor dormancy.
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Affiliation(s)
- Giovanna Zappalà
- Basic Biobehavioral and Psychological Sciences Branch, Clinical Research Directorate/CMRP, SAIC-Frederick, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD 21702, USA.
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Pathogenic intestinal bacteria enhance prostate cancer development via systemic activation of immune cells in mice. PLoS One 2013; 8:e73933. [PMID: 23991210 PMCID: PMC3753256 DOI: 10.1371/journal.pone.0073933] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 07/24/2013] [Indexed: 01/10/2023] Open
Abstract
A role for microbes has been suspected in prostate cancer but difficult to confirm in human patients. We show here that a gastrointestinal (GI) tract bacterial infection is sufficient to enhance prostate intraepithelial neoplasia (PIN) and microinvasive carcinoma in a mouse model. We found that animals with a genetic predilection for dysregulation of wnt signaling, ApcMin/+ mutant mice, were significantly susceptible to prostate cancer in an inflammation-dependent manner following infection with Helicobacter hepaticus. Further, early neoplasia observed in infected ApcMin/+ mice was transmissible to uninfected mice by intraperitoneal injection of mesenteric lymph node (MLN) cells alone from H. hepaticus-infected mutant mice. Transmissibility of neoplasia was preventable by prior neutralization of inflammation using anti-TNF-α antibody in infected MLN donor mice. Taken together, these data confirm that systemic inflammation triggered by GI tract bacteria plays a pivotal role in tumorigenesis of the prostate gland.
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Powell S, Tarchand G, Rector T, Klein M. Synchronous and metachronous malignancies: analysis of the Minneapolis Veterans Affairs (VA) tumor registry. Cancer Causes Control 2013; 24:1565-73. [PMID: 23737025 DOI: 10.1007/s10552-013-0233-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 05/14/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE Multiple primary malignancies (MPMs) are increasing as cancer survivorship improves. A large analysis of the SEER database estimates that approximately 16 % of new cancers reported to their registry represent a second or higher order malignancy. The purpose of this study is to estimate the number of MPM diagnoses and to define differences in synchronous and metachronous cancers in the Veterans Affairs (VA) population. METHODS The primary objective of this study was to determine the proportion of second or higher order cancers diagnosed at the Minneapolis VA Medical Center from 1 January 2005 to 31 December 2009. The secondary objectives were to analyze and compare correlative demographic, exposure, clinical, and tumor data among those with synchronous and metachronous malignancies. We included any patient with a diagnosis of a malignant cancer during the study period. RESULT A total of 4,449 patients were diagnosed with malignancies during the study period. Of these, 506 patients (11.4 % of cancer diagnoses) had a diagnosis of a second or higher order malignancy. Of the 506 patients, 124 (24.3 %) had synchronous malignancies and 383 (75.5 %) had metachronous malignancies. The most common malignancy pairing was prostate cancer with bladder/ureter cancer (12 %) of MPM diagnoses. Differences between patients with synchronous and metachronous second occurrences were identified. CONCLUSION Multiple primary malignancies are a growing area of interest in cancer survivorship. At our institution, approximately 1 in 9 new cancer diagnoses during the 5-year study period represented second-order malignancies. Our data suggest that the VA population is at risk of developing second primary cancers. Further analysis of this population to identify unique risk factors is warranted.
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Affiliation(s)
- Steven Powell
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
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15
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Ahmadi N, Delprado WJ, Brooks AJ, Brenner PC, Coombes GM, Grant A, Patel MI. Cancer identified incidentally in the prostate following radical cystoprostatectomy: an Australian study. ANZ J Surg 2012; 84:473-6. [DOI: 10.1111/ans.12015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2012] [Indexed: 01/20/2023]
Affiliation(s)
- Nariman Ahmadi
- Urological Cancer Outcomes Centre; Discipline of Surgery; The University of Sydney; Sydney New South Wales Australia
| | | | - Andrew J. Brooks
- Westmead Hospital; The University of Sydney; Sydney New South Wales Australia
| | | | - Graham M. Coombes
- Concord Repatriation General Hospital; Sydney New South Wales Australia
| | | | - Manish I. Patel
- Urological Cancer Outcomes Centre; Discipline of Surgery; The University of Sydney; Sydney New South Wales Australia
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Potentially clinically relevant prostate cancer is found more frequently after complete than after partial histopathological processing of radical cystoprostatectomy specimens. Virchows Arch 2012; 461:655-61. [DOI: 10.1007/s00428-012-1328-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Revised: 09/03/2012] [Accepted: 09/29/2012] [Indexed: 11/25/2022]
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17
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Makis W, Ciarallo A, Rakheja R, Probst S, Hickeson M, Rush C, Novales-Diaz JA, Derbekyan V, Stern J, Lisbona R. Spectrum of malignant renal and urinary bladder tumors on 18F-FDG PET/CT: a pictorial essay. Clin Imaging 2012; 36:660-73. [PMID: 23153993 DOI: 10.1016/j.clinimag.2012.01.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2011] [Revised: 12/30/2011] [Accepted: 01/03/2012] [Indexed: 11/18/2022]
Abstract
A wide variety of malignant renal and urinary bladder diseases can be detected on (18)F-FDG PET/CT. Although the PET/CT findings are often nonspecific, the aim of this atlas was to demonstrate that the spectrum of renal and urinary bladder malignancy that can be evaluated with PET/CT is much broader than current medical literature would suggest. PET/CT readers and oncologists should be aware of the variety of urological tumor types that can be detected on PET/CT and some of the patterns of (18)F-FDG uptake that can be observed in these cases.
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Affiliation(s)
- William Makis
- Department of Nuclear Medicine, Brandon Regional Health Centre, 150 McTavish Ave E, Brandon, MB, Canada R7A 2B3.
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18
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Klotz L. Prostate capsule sparing radical cystectomy: oncologic safety and clinical outcome. Ther Adv Urol 2011; 1:43-50. [PMID: 21789053 DOI: 10.1177/1756287209103921] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Prostate capsule sparing radical cystectomy (PSRC) is a modification of the traditional surgical approach to radical cystectomy and neobladder, which offers the prospect of improved preservation of erectile function and continence. METHODS This is a review of the literature regarding the oncologic and quality of life outcomes of this approach for transitional cell carcinoma of the bladder, and a comparison of these results to conventional cystoprostatectomy and neobladder. RESULTS There are a limited number of studies addressing prostate capsule or prostate sparing cystectomy. All are retrospective, non-comparative and not uniform in terms of patient selection and technique. Long-term follow-up is lacking. The incidence of synchronous and or metachronous prostate cancer and TCC of the prostatic urethra is lower than that found in conventional cystoprostatectomy. This is likely due to pre-operative patient selection, restricting the procedure to those with no evidence of prostatic involvement by either disease. The local recurrence rate is 5%, comparable to standard cystoprostatectomy. Recurrence free and overall survival rates are comparable.
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Affiliation(s)
- Laurence Klotz
- Professor of Surgery, University of Toronto, Sunnybrook Health Sciences Centre, 2075 Bayview Ave. #MG408, Toronto, Ontario M4N 3M5, Canada
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Marcinkiewicz K, Scotland KB, Boorjian SA, Nilsson EM, Persson JL, Abrahamsson PA, Allegrucci C, Hughes IA, Gudas LJ, Mongan NP. The androgen receptor and stem cell pathways in prostate and bladder cancers (review). Int J Oncol 2011; 40:5-12. [PMID: 21956088 DOI: 10.3892/ijo.2011.1212] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 08/12/2011] [Indexed: 12/30/2022] Open
Abstract
Bladder cancer is three times more common in men than in women. However, the physiological basis of the male predominance of bladder cancer remains poorly understood. A higher than expected association of prostate and bladder cancers has also been reported which may indicate a common mechanism of carcinogenesis. Consistent with this, androgens and the androgen receptor (AR) play essential roles in prostate carcinogenesis and are believed to play a role in bladder carcinogenesis. There is also evidence implicating cancer stem cells in prostate and bladder cancers. Indeed putative prostate and bladder cancer stem cells share some common molecular features. We highlight key proteins (CD49f, CD133, PTEN, CD44) which are implicated in both prostate and bladder cancers and are enriched in putative prostate and bladder cancer stem cells. We examine published chromatin immuno-precipitation studies analyzing the genome-wide distribution of the AR to identify AR association with, and by inference potential AR-regulation of, these loci. We discuss recent evidence indicating a role for the AR in the splicing of the key urological stem cell protein CD44. We propose a model whereby aberrant AR regulation of these putative stem cell proteins contributes to malignant transformation of prostate and bladder cells. For these reasons we propose that the relationship between androgens and cancer stem cell associated proteins warrants further investigation.
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Houghton J, Li H, Fan X, Liu Y, Liu JH, Rao VP, Poutahidis T, Taylor CL, Jackson EA, Hewes C, Lyle S, Cerny A, Bowen G, Cerny J, Moore N, Kurt-Jones EA, Erdman SE. Mutations in bone marrow-derived stromal stem cells unmask latent malignancy. Stem Cells Dev 2011; 19:1153-66. [PMID: 20199238 DOI: 10.1089/scd.2009.0439] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Neoplastic epithelia may remain dormant and clinically unapparent in human patients for decades. Multiple risk factors including mutations in tumor cells or the stromal cells may affect the switch from dormancy to malignancy. Gene mutations, including p53 mutations, within the stroma of tumors are associated with a worse clinical prognosis; however, it is not known if these stromal mutations can promote tumors in genetically at-risk tissue. To address this question, Apc(Min/+) and Apc(Min/+) Rag2(-/-) mice, which have a predilection to mammary carcinoma (as well as wild-type (wt) mice), received mesenchymal stem cells (MSC) with mutant p53 (p53MSC) transferred via tail vein injection. In the wt mouse, p53MSC circulated in the periphery and homed to the marrow cavity where they could be recovered up to a year later without apparent effect on the health of the mouse. No mammary tumors were found. However, in mice carrying the Apc(Min/+) mutation, p53MSC homed to mammary tissue and significantly increased the incidence of mammary carcinoma. Tumor necrosis factor (TNF)-alpha-dependent factors elaborated from mesenchymal cells converted quiescent epithelia into clinically apparent disease. The increased cancer phenotype was completely preventable with neutralization of TNF-alpha or by transfer of CD4(+) regulatory T cells from immune competent donors, demonstrating that immune competency to regulate inflammation was sufficient to maintain neoplastic dormancy even in the presence of oncogenic epithelial and stromal mutations. The significant synergy between host immunity and mesenchymal cells identified here may restructure treatments to restore an anticancer microenvironment.
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Affiliation(s)
- JeanMarie Houghton
- Department of Medicine, Division of Gastroenterology, University of Massachusetts Medical School, Worcester, Massachusetts 01635, USA.
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Madu CO, Lu Y. Novel diagnostic biomarkers for prostate cancer. J Cancer 2010; 1:150-77. [PMID: 20975847 PMCID: PMC2962426 DOI: 10.7150/jca.1.150] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Accepted: 10/04/2010] [Indexed: 01/08/2023] Open
Abstract
Prostate cancer is the most frequently diagnosed malignancy in American men, and a more aggressive form of the disease is particularly prevalent among African Americans. The therapeutic success rate for prostate cancer can be tremendously improved if the disease is diagnosed early. Thus, a successful therapy for this disease depends heavily on the clinical indicators (biomarkers) for early detection of the presence and progression of the disease, as well as the prediction after the clinical intervention. However, the current clinical biomarkers for prostate cancer are not ideal as there remains a lack of reliable biomarkers that can specifically distinguish between those patients who should be treated adequately to stop the aggressive form of the disease and those who should avoid overtreatment of the indolent form. A biomarker is a characteristic that is objectively measured and evaluated as an indicator of normal biologic processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention. A biomarker reveals further information to presently existing clinical and pathological analysis. It facilitates screening and detecting the cancer, monitoring the progression of the disease, and predicting the prognosis and survival after clinical intervention. A biomarker can also be used to evaluate the process of drug development, and, optimally, to improve the efficacy and safety of cancer treatment by enabling physicians to tailor treatment for individual patients. The form of the prostate cancer biomarkers can vary from metabolites and chemical products present in body fluid to genes and proteins in the prostate tissues. Current advances in molecular techniques have provided new tools facilitating the discovery of new biomarkers for prostate cancer. These emerging biomarkers will be beneficial and critical in developing new and clinically reliable indicators that will have a high specificity for the diagnosis and prognosis of prostate cancer. The purpose of this review is to examine the current status of prostate cancer biomarkers, with special emphasis on emerging markers, by evaluating their diagnostic and prognostic potentials. Both genes and proteins that reveal loss, mutation, or variation in expression between normal prostate and cancerous prostate tissues will be covered in this article. Along with the discovery of prostate cancer biomarkers, we will describe the criteria used when selecting potential biomarkers for further development towards clinical use. In addition, we will address how to appraise and validate candidate markers for prostate cancer and some relevant issues involved in these processes. We will also discuss the new concept of the biomarkers, existing challenges, and perspectives of biomarker development.
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Affiliation(s)
- Chikezie O Madu
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
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Bryniarski P, Fryczkowski M, Pawlaczek P, Pliszek K, Prokopowicz G, Kaletka Z, Paradysz A. Prognostic value of radical cystoprostatectomy in men with bladder cancer infiltrating prostate versus co-existing prostate cancer: a research study. BMC Urol 2010; 10:16. [PMID: 20860834 PMCID: PMC2954913 DOI: 10.1186/1471-2490-10-16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2010] [Accepted: 09/22/2010] [Indexed: 12/02/2022] Open
Abstract
Background The aim of the following study is to evaluate the advancement of incidentally diagnosed prostate cancer in specimen after cystoprostatectomies caused by muscle-invasive bladder cancer. Secondly we assessed the survival in patients after radical cystoprostatectomy whose postoperative specimen was characterized by the presence of co-existing prostate cancer or prostate infiltration by urothelial bladder cancer. Methods Between 1993 and 2009 a total of 320 patients with muscle-invasive bladder cancer underwent cystoprostatectomy. The first analyzed group consisted of 52 patients with bladder cancer infiltrating prostate, while the second group consisted of 21 patients with co-existing prostate cancer. In all patients cancer specific survival and progression were analyzed. Average follow up was 75.2 months (range: 0 - 181). Results Cancer-specific survival was significantly shorter in group I (p = 0.03). Neoplastic progression in patients from group I was observed in 42.2% of patients, while in patients from group II in 23.6% of patients (p = 0.04). No statistical difference was observed in the percentage of positive lymph nodes between the groups (p = 0.22). The median Gleason score in patients with co-existing prostate cancer was equal to 5. The stage of prostate cancer pT2/pT3 was equal to 20 (96%)/1 (4%) patients. 12 (57%) prostate cancers were clinically insignificant. Biochemical recurrence occurred in 2 (9%) patients. Conclusions 1. Incidentally diagnosed prostate cancer in specimen after cystoprostatectomies is frequently clinically insignificant and characterized by low progression. 2. Patients with bladder cancer infiltrating prostate are characterized by higher percentage of progression and death in comparison with patients with co-existing prostate cancer.
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Affiliation(s)
- Piotr Bryniarski
- Medical University of Silesia, Department of Urology, Zabrze, Poland.
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23
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Bryniarski P, Fryczkowski M, Pawlaczek P, Pliszek K, Prokopowicz G, Kaletka Z, Paradysz A. Prognostic value of radical cystoprostatectomy in men with bladder cancer infiltrating prostate versus co-existing prostate cancer: a research study. BMC Urol 2010. [PMID: 20860834 DOI: 10.1186/1471-2490-10-16.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the following study is to evaluate the advancement of incidentally diagnosed prostate cancer in specimen after cystoprostatectomies caused by muscle-invasive bladder cancer. Secondly we assessed the survival in patients after radical cystoprostatectomy whose postoperative specimen was characterized by the presence of co-existing prostate cancer or prostate infiltration by urothelial bladder cancer. METHODS Between 1993 and 2009 a total of 320 patients with muscle-invasive bladder cancer underwent cystoprostatectomy. The first analyzed group consisted of 52 patients with bladder cancer infiltrating prostate, while the second group consisted of 21 patients with co-existing prostate cancer. In all patients cancer specific survival and progression were analyzed. Average follow up was 75.2 months (range: 0 - 181). RESULTS Cancer-specific survival was significantly shorter in group I (p = 0.03). Neoplastic progression in patients from group I was observed in 42.2% of patients, while in patients from group II in 23.6% of patients (p = 0.04). No statistical difference was observed in the percentage of positive lymph nodes between the groups (p = 0.22). The median Gleason score in patients with co-existing prostate cancer was equal to 5. The stage of prostate cancer pT₂/pT₃ was equal to 20 (96%)/1 (4%) patients. 12 (57%) prostate cancers were clinically insignificant. Biochemical recurrence occurred in 2 (9%) patients. CONCLUSIONS 1. Incidentally diagnosed prostate cancer in specimen after cystoprostatectomies is frequently clinically insignificant and characterized by low progression.2. Patients with bladder cancer infiltrating prostate are characterized by higher percentage of progression and death in comparison with patients with co-existing prostate cancer.
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Affiliation(s)
- Piotr Bryniarski
- Medical University of Silesia, Department of Urology, Zabrze, Poland.
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Trpkov K, Yilmaz A, Bismar TA, Montironi R. ‘Insignificant’ prostate cancer on prostatectomy and cystoprostatectomy: variation on a theme ‘low-volume/ low-grade’ prostate cancer? BJU Int 2010; 106:304-15. [DOI: 10.1111/j.1464-410x.2010.09499.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Stein JP, Hautmann RE, Penson D, Skinner DG. Prostate-sparing cystectomy: A review of the oncologic and functional outcomes. Contraindicated in patients with bladder cancer. Urol Oncol 2009; 27:466-72. [DOI: 10.1016/j.urolonc.2007.12.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2007] [Revised: 12/18/2007] [Accepted: 12/31/2007] [Indexed: 10/21/2022]
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26
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Georgios Moutzouris, Calypso Barbatis, Dimitrios Plastiras,. Incidence and Histological Findings of Unsuspected Prostatic Adenocarcinoma in Radical Cystoprostatectomy for Transitional Cell Carcinoma of the Bladder. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/003655999750016230] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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27
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Thorstenson A, O'connor RC, Ahonen R, Jonsson MN, Wijkström H, Akre O, Hosseini A, Wiklund NP, Henningsohn L. Clinical outcome following prostatic capsule- and seminal-sparing cystectomy for bladder cancer in 25 men. ACTA ACUST UNITED AC 2009; 43:127-32. [DOI: 10.1080/00365590802571751] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - R. Corey O'connor
- Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Riitta Ahonen
- Department of Molecular Medicine and Surgery, Section of Urology
| | | | | | - Olof Akre
- Division of Urology, CLINTEC
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - N. Peter Wiklund
- Department of Molecular Medicine and Surgery, Section of Urology
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Kurahashi T, Miyake H, Furukawa J, Kumano M, Takenaka A, Fujisawa M. Characterization of prostate cancer incidentally detected in radical cystoprostatectomy specimens from Japanese men with bladder cancer. Int Urol Nephrol 2009; 42:73-9. [DOI: 10.1007/s11255-009-9578-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2008] [Accepted: 04/21/2009] [Indexed: 10/20/2022]
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Barbisan F, Mazzucchelli R, Scarpelli M, Lopez-Beltran A, Cheng L, Kirkali Z, Montironi R. Urothelial and incidental prostate carcinoma in prostates from cystoprostatectomies for bladder cancer: is there a relationship between urothelial and prostate cancer? BJU Int 2009; 103:1058-63. [DOI: 10.1111/j.1464-410x.2008.08207.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Autorino R, Di Lorenzo G, Damiano R, Giannarini G, De Sio M, Cheng L, Montironi R. Pathology of the prostate in radical cystectomy specimens: A critical review. Surg Oncol 2009; 18:73-84. [DOI: 10.1016/j.suronc.2008.07.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2008] [Revised: 06/20/2008] [Accepted: 07/14/2008] [Indexed: 11/27/2022]
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31
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Mazzucchelli R, Barbisan F, Scarpelli M, Lopez-Beltran A, van der Kwast TH, Cheng L, Montironi R. Is incidentally detected prostate cancer in patients undergoing radical cystoprostatectomy clinically significant? Am J Clin Pathol 2009; 131:279-83. [PMID: 19141388 DOI: 10.1309/ajcp4ocyzban9tju] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Cystoprostatectomy specimens obtained from patients with bladder cancer provide a unique opportunity to assess the features of silent prostate adenocarcinoma (PCa). The whole-mount prostate sections of 248 totally embedded and consecutively examined radical cystoprostatectomy (RCP) specimens were reviewed to determine the incidence and features of incidentally detected PCa. PCa was considered clinically significant if any of the following criteria were present: total tumor volume, 0.5 cc or more; Gleason grade, 4 or more; extraprostatic extension; seminal vesicle invasion; lymph node metastasis (of PCa); or positive surgical margins. PCa was present in 123 (49.6%) of 248 specimens. Features were as follows: acinar adenocarcinoma, 123 (100.0%); peripheral zone location, 98 (79.7%); pT2a, 96 (78.0%); pT2b, 11 (8.9%); pT2c, 9 (7.3%); pT3a, 5 (4.1%); pT3b, 2 (1.6%); pT4, 0 (0.0%); Gleason score 6 or less, 107 (87.0%); negative margins, 119 (96.7%); pN0 for PCa, 123 (100.0%); and tumor volume less than 0.5 cc, 116 (94.3%). Of the 123 incidentally detected cases of PCa, 100 (81.3%) were considered clinically insignificant. Incidentally detected PCa is frequently observed in RCP. The majority are clinically insignificant.
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Affiliation(s)
- Roberta Mazzucchelli
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
| | - Francesca Barbisan
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
| | - Marina Scarpelli
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
| | - Antonio Lopez-Beltran
- Department of Pathology, Reina Sofia University Hospital and Faculty of Medicine, Cordoba, Spain
| | - Theodorus H. van der Kwast
- Department of Pathology and Laboratory Medicine, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis
| | - Rodolfo Montironi
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
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Saad M, Abdel-Rahim M, Abol-Enein H, Ghoneim MA. Concomitant pathology in the prostate in cystoprostatectomy specimens: a prospective study and review. BJU Int 2008; 102:1544-50. [DOI: 10.1111/j.1464-410x.2008.07831.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Tumor dormancy is a phenomenon whereby cancer cells persist below the threshold of diagnostic detection for months to decades. This condition may arise due to either cell cycle arrest or a dynamic equilibrium state in which cell proliferation is in balance with cells undergoing apoptosis. Tumor dormancy is usually a reference to occult cancer cells that persist for an extended period of time after treatment, but primary cancers can also exhibit extended growth plateaus below the limits of detection. For example, autopsies of individuals who died of trauma reveal that most individuals harbor microscopic primary cancers. Mechanisms that operate independently or successively may restrict tumor expansion throughout tumor progression from incipiency to late-stage cancer. Proposed mechanisms include cell cycle withdrawal, immune surveillance, and blocked angiogenesis. The precise mechanisms underlying dormancy remain to be established, and relevant models will have an important impact on diagnostic and therapeutic strategies for treating cancer. This review summarizes the phenomenon of tumor dormancy, experimental models, and potential mechanisms.
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Affiliation(s)
- Taturo Udagawa
- Vascular Biology Program and Department of Surgery, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
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Abstract
Tumor progression is dependent on a number of sequential steps, including initial tumor-vascular interactions and recruitment of blood vessels (i.e., the angiogenic switch), as well as tumor cells interacting with the surrounding microenvironment and its different components. Failure of a microscopic tumor to complete one or more of these early stages may lead to delayed clinical manifestation of the cancer and a state of stable non-progressing disease (i.e., tumor dormancy). In this review, some of the clinical and experimental evidence is summarized, suggesting that microscopic human cancers, either primary, recurrent or metastatic, can remain in an asymptomatic, non-detectable, and occult state for a long period of time. We also review current experimental human tumor dormancy models which closely recapitulate clinically observed delay in tumor progress.
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Affiliation(s)
- George N Naumov
- Department of Surgery, Harvard Medical School; and Vascular Biology Program, Children's Hospital Boston, Boston, MA, USA.
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Thomas C, Wiesner C, Melchior S, Gillitzer R, Schmidt F, Thüroff JW. Indications for Preoperative Prostate Biopsy in Patients Undergoing Radical Cystoprostatectomy for Bladder Cancer. J Urol 2008; 180:1938-41; discussion 1941. [DOI: 10.1016/j.juro.2008.07.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2008] [Indexed: 11/26/2022]
Affiliation(s)
- Christian Thomas
- Department of Urology, Johannes Gutenberg University, Mainz, Germany
| | - Christoph Wiesner
- Department of Urology, Johannes Gutenberg University, Mainz, Germany
| | | | - Rolf Gillitzer
- Department of Urology, Johannes Gutenberg University, Mainz, Germany
| | - Folke Schmidt
- Department of Urology, Johannes Gutenberg University, Mainz, Germany
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Kefer JC, Campbell SC. Current status of prostate-sparing cystectomy. Urol Oncol 2008; 26:486-93. [DOI: 10.1016/j.urolonc.2008.03.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2008] [Revised: 03/10/2008] [Accepted: 03/10/2008] [Indexed: 10/21/2022]
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Jin XD, Chen ZD, Wang B, Cai SL, Yao XL, Jin BY. Incidental prostate cancer in radical cystoprostatectomy specimens. Asian J Androl 2008; 10:809-14. [DOI: 10.1111/j.1745-7262.2008.00420.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Oncological Evaluation of Prostate Sparing Cystectomy: The Montsouris Long-Term Results. J Urol 2008; 179:2170-4; discussion 2174-5. [DOI: 10.1016/j.juro.2008.01.112] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2007] [Indexed: 11/20/2022]
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Revelo MP, Cookson MS, Chang SS, Shook MF, Smith JA, Shappell SB. Incidence and location of prostate and urothelial carcinoma in prostates from cystoprostatectomies: implications for possible apical sparing surgery. J Urol 2008; 179:S27-32. [PMID: 18405745 DOI: 10.1016/j.juro.2008.03.134] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2003] [Indexed: 10/22/2022]
Abstract
PURPOSE Prostatic carcinoma (Pca) at cystoprostatectomy is usually an incidental finding with the majority thought to be clinically insignificant. Most studies have not specifically addressed the location of Pca or the incidence and location of in situ or invasive urothelial carcinoma (Uca) in prostates of cystoprostatectomy specimens. The frequency of involvement of the apex with these processes has clinical implications. Specifically urinary continence following orthotopic diversion may be enhanced by prostate apical sparing. In this study the pathological features of Pca and Uca, and the frequency of apical involvement were investigated in prostates from cystoprostatectomy specimens. MATERIALS AND METHODS Whole mounted prostates from 121 consecutive cystoprostatectomy specimens were analyzed. Pca location, tumor volume, grade, stage, surgical margin and pelvic lymph node status of Pcas were assessed. Clinically insignificant Pcas had a volume of less than 0.5 cc without Gleason pattern 4, extracapsular extension, seminal vesicle invasion, lymph node involvement or positive surgical margins. Prostate involvement by Uca or urothelial carcinoma in situ (CIS)/severe dysplasia and its location were assessed. RESULTS Of 121 prostates 50 (41%) had unsuspected Pca, of which 24 (48%) were clinically significant. Of Pcas 30 of 50 (60%) involved the apex, including 19 of 24 (79%) that were significant and 11 of 26 (42%) that were insignificant. Of 121 prostates 58 (48%) had Uca involving the prostatic stroma, noninvasive Uca or urothelial CIS/severe dysplasia in the prostatic urethra or periurethral ducts, of which 19 (33%) had apical involvement. Overall only 32 of 121 patients (26%) had no Pca or prostate Uca/CIS and only 45 (37%) had no clinically significant Pca or Uca/CIS in the prostate. However, 74 of the 121 patients (61%) had no prostatic apical involvement by Pca or Uca/CIS and 85 (70%) had no apical involvement by clinically significant Pca or Uca/CIS. Patients with prostatic apical involvement by invasive or in situ Uca uniformly had involvement of more proximal (toward the base) portions of the prostate. CONCLUSIONS The majority of prostates from cystoprostatectomies had no involvement of the prostatic apex by Uca or clinically significant Pca. Hence, most patients may be candidates for prostate apical sparing. However, involvement of the apex by Uca in any patient raises concern about procedures that leave portions of the prostate urethra after cystectomy in an effort to improve continence. In candidates for orthotopic neobladder reconstruction removing all of the prostatic urethra and sparing the remainder of the prostatic apex may allow improved preservation of urinary continence with an acceptable low risk of clinical Pca progression. Whether future strategies for preoperative exclusion of apical Pca and intraoperative assessment of more proximal prostate to help exclude apical urothelial disease may identify patients suitable for prostatic apical sparing remains to be determined. The impact on functional outcomes and cancer control also require additional study.
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Affiliation(s)
- Monica P Revelo
- Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2561, USA
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Singh A, Kinoshita Y, Rovito PM, Landas S, Silberstein J, Nsouli I, Wang CY, Haas GP. Higher than expected association of clinical prostate and bladder cancers. J Urol 2008; 179:S2-5. [PMID: 18405742 DOI: 10.1016/j.juro.2008.03.130] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2004] [Indexed: 11/26/2022]
Abstract
PURPOSE In this study we evaluated the risk of a second malignancy of the bladder or prostate in patients with a previous diagnosis of prostate cancer (PCa) or urothelial cancer (TCC). MATERIALS AND METHODS We retrospectively analyzed all cases of PCa and TCC diagnosed between January 1996 and June 2003. Only PCa diagnosed due to abnormal digital rectal examination or increased prostate specific antigen were included. All patients with TCC presented with hematuria or irritative voiding symptoms and the diagnoses were confirmed with a tissue diagnosis. The incidence of lung, colon and renal cancers was also analyzed. RESULTS A total of 816 men were diagnosed with PCa and/or TCC. Of 673 men initially diagnosed with PCa 21 had TCC. Of 149 men initially diagnosed with TCC 18 had PCa. Average age at PCa and TCC diagnosis +/- SD was 68.2 +/- 7.9 and 68.2 +/- 10.4 years, respectively. The standardized incidence ratio (SIR) of TCC in patients with PCa (SIR 4.31, 95% CI 2.411 to 7.110) and of PCa in patients with TCC (SIR 3.83, 95% CI 1.911 to 6.858) was significantly increased. There was no statistical significant difference in SIR for TCC in men with or without radiotherapy. SIR for lung, renal or colon cancer was not significantly different from what was expected. CONCLUSIONS Patients with PCa have higher incidence of bladder cancer and those with bladder cancer have a higher incidence of PCa. This study has clinical implications in the care of these patients and it may stimulate research interest that may identify common pathways of carcinogenesis.
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Affiliation(s)
- Amar Singh
- Department of Urology, Upstate Medical University and Veterans Affairs Medical Center Syracuse, Syracuse, New York 13210, USA
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Hiros M, Spahović H, Selimović M, Sadović S. Incidental prostate cancer in patients undergoing radical cystoprostatectomy for bladder cancer. Bosn J Basic Med Sci 2008; 8:147-51. [PMID: 18498265 PMCID: PMC5698345 DOI: 10.17305/bjbms.2008.2970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objective of this work is to verify the incidence of incidental prostate adenocarcinoma in patients who underwent radical cystoprostatectomy for invasive bladder carcinoma. We have retrospectively reviewed patients who underwent radical cystoprostatectomy for infiltrative bladder tumors in period between 2003 and 2007 year, 94 men with bladder cancer underwent radical cystoprostatectomy at Urology Clinic-University of Sarajevo Clinics Centre. Mean age of patients was 67 years, with age limits ranging between 48 and 79 years. Pathohistological evaluation was used for all specimens from RCP. We found that 9,57% of cystoprostatectomy specimens in patients with bladder cancer also contained incidental prostate cancer. This result was much lower than overall mean frequency of incidentally detected prostate cancer in other series of cystoprostatectomy cases (range, 23%-68%). In conclusion we recommended digital rectal examination (DRE) and prostate-specific antigen (PSA) test as part of the bladder cancer work up and complete removal of the prostate at cystoprostatectomy to prevent residual prostate cancer.
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Affiliation(s)
- Mustafa Hiros
- Urology Clinic, University of Sarajevo Clinics Centre, Sarajevo, Bosnia and Herzegovina
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Nieuwenhuijzen J, Meinhardt W, Horenblas S. Clinical Outcomes After Sexuality Preserving Cystectomy and Neobladder (Prostate Sparing Cystectomy) in 44 Patients. J Urol 2008; 179:S35-8. [DOI: 10.1016/j.juro.2008.03.135] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2004] [Indexed: 11/30/2022]
Affiliation(s)
- J.A. Nieuwenhuijzen
- Department of Urology, The Netherlands Cancer Institute / Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - W. Meinhardt
- Department of Urology, The Netherlands Cancer Institute / Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - S. Horenblas
- Department of Urology, The Netherlands Cancer Institute / Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
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Haas GP, Delongchamps N, Brawley OW, Wang CY, de la Roza G. The worldwide epidemiology of prostate cancer: perspectives from autopsy studies. BJU Int 2008; 101:508-12. [PMID: 18304396 DOI: 10.1111/j.1464-410x.2007.07285.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Prostate cancer is the most frequently diagnosed non-skin cancer in the United States and the third leading cause of cancer deaths. International trends in the incidence, mortality and prevalence of prostate cancer are assessed. METHODS Databases from the Surveillance, Epidemiology and End Results (SEER) program of the National Cancer Institute and the International Agency for Research on Cancer (IARC), and the literature on autopsy studies on prostate cancer were reviewed and summarized in the article. RESULTS Prostate cancer remains an important public health concern in Western countries and an emerging malignancy in developing nations. Prostate cancer incidence is dependent on efforts to detect the disease. Autopsy studies provide accurate and useful information regarding comparative prevalence rates of the disease among regions of interest. CONCLUSIONS Improved cancer registration is needed in developing nations. The prevalence of prostate cancer must be established to predict the expected incidence of the disease and in order to plan rational detection and treatment strategies. Clinically significant disease should be distinguished from insignificant disease which may pose little or no biological danger to the patient.
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Affiliation(s)
- Gabriel P Haas
- Department of Urology, SUNY Upstate Medical University, Syracuse, New York 13210, USA
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Incidental prostate cancer detected by cystoprostatectomy in Korean men. Urology 2008; 73:153-7. [PMID: 18407328 DOI: 10.1016/j.urology.2008.02.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2007] [Revised: 02/11/2008] [Accepted: 02/19/2008] [Indexed: 01/29/2023]
Abstract
OBJECTIVES To determine the incidence and characteristics of incidental prostate cancer diagnosed by cystoprostatectomy (CPT) in Korean men. METHODS Thirty-six consecutive male patients scheduled to undergo CPT were prospectively enrolled. The CPT specimens were examined and the clinicopathologic characteristics of incidental cancers compared with those of T1c prostate cancers that had undergone radical prostatectomy. Complete transverse sections of the prostate were taken from the apex to the base at 4-mm intervals. RESULTS Of the 36 CPT patients, 18 (50%) had incidental prostate cancer. Most of the incidental tumors were confined to the prostate gland, except in 1 patient. Tumor involvement at the prostate apex was found in 3 patients (16.7%), and Gleason scores in 3 cases were 7 to 10. Median tumor volume was 0.08 cm(3) (range, 0.01 to 20.51 cm(3)), and a tumor volume of more than 0.5 cm(3) was identified in 5 patients. Of these incidental prostate cancers, 38.9% (19.4% of all CPT patients) were clinically significant. As compared with the 38 T1c prostate cancer patients, incidental prostate cancer patients were older, had a lower prostate-specific antigen level, a lower grade, smaller tumor volume, and were less likely to have multiple tumors. However, no significant differences were observed between these two groups with respect to apical tumor involvement or tumor confinement to the prostate (P >0.05 for each). CONCLUSIONS Incidental prostate cancers were diagnosed in 50% of CPT specimens, and 19.4% of these were clinically significant.
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Lu T, Hano H. Deletion at chromosome arms 6q16-22 and 10q22.3-23.1 associated with initiation of prostate cancer. Prostate Cancer Prostatic Dis 2008; 11:357-61. [PMID: 18227855 DOI: 10.1038/pcan.2008.4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Loss of heterozygosity (LOH) at 6q16-22 and 10q22.3-23.1 is common chromosomal alteration in advanced prostate cancer and suggests that one or more tumor suppressor genes may lie within these chromosome arms. However, the genetic changes in early stage prostate cancer and premalignant lesions remain to be investigated. We used 11 informative microsatellite markers at 6q16-22 and 10q22.3-23.1 in Japanese patients to compare the frequency of LOH in 53 lesions of high-grade prostatic intraepithelial neoplasia (HGPIN), 38 cases (38 lesions) of incidental prostate cancer (IPC) and 107 cases (168 lesions) of clinical prostate cancer (CPC). The frequency of LOH at 6q16-22 with at least one marker was 38 and 49% in IPC and CPC cases, respectively. Similarly, allelic loss at 10q22.3-23.1 was present in 35 and 39% of IPC and CPC, respectively. High-frequency LOH was detected in both the clinically insignificant and significant prostate cancers at 6q16-22 and 10q22.3-23.1 (P>0.05). However, no allelic loss was detected in any markers at the same regions in HGPIN (0%), which is usually considered a premalignant lesion to prostate cancer. Deletions of both the chromosome regions, 6q16-22 and 10q22.3-23.1, are more likely important events in the initiation and/or promotion of prostate cancer.
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Affiliation(s)
- T Lu
- Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan.
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Shen SS, Lerner SP. Prostatic transitional cell carcinoma: pathologic features and clinical management. Expert Rev Anticancer Ther 2007; 7:1155-62. [PMID: 18028024 DOI: 10.1586/14737140.7.8.1155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Prostatic involvement by transitional cell carcinoma (pTCC) in patients with bladder cancer is a frequent finding, particularly in patients with high-grade invasive tumor and urothelial carcinoma in situ. Various patterns and levels of prostatic involvement have been described, and their impact in patients' management and their prognosis recognized. The role of prostatic urethral biopsy and intraoperative frozen section in the management of bladder cancer, tailoring to the bladder tumor stage is still not well defined and universally accepted. This review discusses the current understanding of the biology and histological patterns of pTCC and their clinical significance and management options. A rational approach for management of pTCC in patients with bladder cancer will be proposed on the basis of our experience and our review of literature.
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Affiliation(s)
- Steven S Shen
- Department of Pathology, The Methodist Hospital and Weill Medical College of Cornell University, 6565 Fannin Street, Houston, TX 77030, USA.
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Weizer AZ, Shah RB, Lee CT, Gilbert SM, Daignault S, Montie JE, Wood DP. Evaluation of the prostate peripheral zone/capsule in patients undergoing radical cystoprostatectomy: Defining risk with prostate capsule sparing cystectomy. Urol Oncol 2007; 25:460-4. [DOI: 10.1016/j.urolonc.2006.09.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2006] [Revised: 09/26/2006] [Accepted: 09/28/2006] [Indexed: 10/22/2022]
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Damiano R, Di Lorenzo G, Cantiello F, De Sio M, Perdonà S, D'Armiento M, Autorino R. Clinicopathologic Features of Prostate Adenocarcinoma Incidentally Discovered at the Time of Radical Cystectomy: An Evidence-Based Analysis. Eur Urol 2007; 52:648-57. [PMID: 17600614 DOI: 10.1016/j.eururo.2007.06.016] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2007] [Accepted: 06/11/2007] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To review all relevant features of incidentally discovered prostate cancer (PCa) in patients undergoing radical cystectomy for bladder cancer: incidence, pathologic characteristics, clinical significance, and implications for its management. METHODS A structured literature review through a MEDLINE search was performed. RESULTS The frequency of incidentally discovered PCa in cystoprostatectomy specimens is extremely variable because of several factors, particularly the pathology sampling. The relationship among clinically, incidentally, and autopsy-detected cancer is uncertain. The definition of clinically significant cancer varies among published reports and remains inadequate for clinical application. High-grade prostatic intraepithelial neoplasia is a marker for concurrent PCa and the risk depends more on the volume than on its absolute presence. Outcome of patients with unsuspected PCa after cystoprostatectomy relies mostly on the bladder tumor. CONCLUSIONS Incidental PCa in patients with bladder cancer is highly variable and with an unclear clinical significance. For those who are candidates for prostate-sparing surgery, it seems reasonable to include a routine prostate biopsy in the standard preoperative work-up irrespective of prostate-specific antigen values. In the absence of sufficient data to make firm recommendations, when PCa is incidentally discovered, PCa surveillance should be part of the follow-up scheme after radical cystectomy.
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Affiliation(s)
- Rocco Damiano
- Clinica Urologica, Università Magna Graecia, Catanzaro, Italy
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Delongchamps NB, Singh A, Haas GP. Epidemiology of prostate cancer in Africa: another step in the understanding of the disease? Curr Probl Cancer 2007; 31:226-36. [PMID: 17543950 DOI: 10.1016/j.currproblcancer.2007.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Nicolas B Delongchamps
- Department of Urology, State University of New York Health Sciences center, Syracuse, New York, USA
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Cassetti T, Scheibel M, Stracci F, Minelli L, La Rosa F. Incidence of Multiple Primary Bladder and Prostate Cancer in a Central Region of Italy. Umbria, 1994-2004. TUMORI JOURNAL 2007; 93:242-3. [PMID: 17679457 DOI: 10.1177/030089160709300302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to determine the incidence of multiple bladder-prostate cancers in the population of the Italian region of Umbria and to clarify some diagnostic aspects. Prostate and bladder cancer incidence data in Umbria were obtained from cancer registry records. In the period from 1994 to 2004, 3,470 new patients with bladder cancer and 5,430 new patients with prostate cancer were registered. Among these patients there were 238 who presented multiple bladder and prostate cancers. Synchronous cancers were detected in 74 of these patients. Fifty-four of them had simultaneous tumors (diagnosed during the same hospitalization), while in 16 patients bladder cancer was detected earlier than prostate cancer and in 4 patients the opposite occurred. This study confirmed an increase in prostate cancer diagnoses in patients with bladder cancer. The increase was mainly accounted for by the detection of prostate cancers during cystectomies performed for bladder carcinoma.
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Affiliation(s)
- Tiziana Cassetti
- Umbrian Population Cancer Registry, Department of Medical-Surgical Specialities and Public Health, Public Health Section, University of Perugia, Perugia, Italy.
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