1
|
Lavi Arab F, Hoseinzadeh A, Hafezi F, Sadat Mohammadi F, Zeynali F, Hadad Tehran M, Rostami A. Mesenchymal stem cell-derived exosomes for management of prostate cancer: An updated view. Int Immunopharmacol 2024; 134:112171. [PMID: 38701539 DOI: 10.1016/j.intimp.2024.112171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 04/16/2024] [Accepted: 04/27/2024] [Indexed: 05/05/2024]
Abstract
Prostate cancer represents the second most prevalent form of cancer found in males, and stands as the fifth primary contributor to cancer-induced mortality on a global scale. Research has shown that transplanted mesenchymal stem cells (MSCs) can migrate by homing to tumor sites in the body. In prostate cancer, researchers have explored the fact that MSC-based therapies (including genetically modified delivery vehicles or vectors) and MSC-derived exosomes are emerging as attractive options to improve the efficacy and safety of traditional cancer therapies. In addition, researchers have reported new insights into the application of extracellular vesicle (EV)-MSC therapy as a novel treatment option that could provide a more effective and targeted approach to prostate cancer treatment. Moreover, the new generation of exosomes, which contain biologically functional molecules as signal transducers between cells, can simultaneously deliver different therapeutic agents and induce an anti-tumor phenotype in immune cells and their recruitment to the tumor site. The results of the current research on the use of MSCs in the treatment of prostate cancer may be helpful to researchers and clinicians working in this field. Nevertheless, it is crucial to emphasize that although dual-role MSCs show promise as a therapeutic modality for managing prostate cancer, further investigation is imperative to comprehensively grasp their safety and effectiveness. Ongoing clinical trials are being conducted to assess the viability of MSCs in the management of prostate cancer. The results of these trials will help determine the viability of this approach. Based on the current literature, engineered MSCs-EV offer great potential for application in targeted tumor therapy.
Collapse
Affiliation(s)
- Fahimeh Lavi Arab
- Department of Immunology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Akram Hoseinzadeh
- Department of Immunology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran.; Cancer Research Center, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Fatemeh Hafezi
- Immunology Research Center, Inflammation and Inflammatory Diseases Division, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Sadat Mohammadi
- Immunology Research Center, Inflammation and Inflammatory Diseases Division, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farid Zeynali
- Department of Urology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Melika Hadad Tehran
- Department of Biology, Faculty of Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | - Amirreza Rostami
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
2
|
Bzoma B, Dębska-Ślizień A, Rościńska P, Piątkowski K, Kostro J, Łukiański M, Bigda J, Chamienia A. The Prevalence of Prostate Cancer in Organ Donors With Increased Prostate-Specific Antigen. Transplant Proc 2024; 56:763-766. [PMID: 38724405 DOI: 10.1016/j.transproceed.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 03/18/2024] [Indexed: 06/18/2024]
Abstract
Elevated prostate-specific antigen (PSA) levels were found in 139 of 472 kidney donors from our transplant center tested between 2009 and 2022, representing 29%. The mean age of these donors was 47.3 years. PSA values ranged from 2.8 to 160.4 ng/mL (mean 13.9 ng/mL). The recommended range is <2.5 ng/mL. Prostate histopathologic examination was performed in 38 of the 139 (27%). We found 14 cases of prostate cancer (PCa), with Gleason 3+3 in 8 cases, 3+4 in 4 cases (one donor disqualification), 1 case Gleason 4+3 (donor disqualification), and 1 case Gleason 4+5 (donor disqualification). Thirty-three patients met the criteria, were aged ≥50 years, and had a PSA level >10 mg/mL. Of these, prostate histopathologic examination was performed in 24 cases. PCa was found in 10 cases (42%). There was no difference between donors ≥50 years of age, with PSA>10 ng/mL with and without pathomorphologic diagnosis of PCa regarding age (mean 60.4 vs 60.6 years), creatinine clearance according to the Cockroft-Gaulta formula (mean 101.6 vs 94.8 mL/min) and PSA levels (mean 34.1 vs 29.3 ng/mL). Among other donors with PCa, 3 were <50 years with PSA >10 ng/mL, and 1 was ≥50 years with PSA<8 ng/mL. Kidneys from donors with PCa were transplanted into 10 men and 9 women. Follow-up time was 1 to 10 years. No cases of PCa transmission were reported. One of the recipients died of neoplasm-breast cancer. Donors ≥50 years of age with PSA>10 ng/mL have a higher risk for Pca. Accepting donors with Pca (Gleason 3+3 and 3+4) possesses minimal risk for transmission. All donors ≥50 years with increased PSA require further diagnostic procedures (eg, digital rectal examination, ultrasound, and eventually histologic examination).
Collapse
Affiliation(s)
- Beata Bzoma
- Department of Nephrology, Transplantology and Internal Diseases, Gdańsk, Poland.
| | | | - Paulina Rościńska
- Division of General, Endocrine and Transplant Surgery, Gdańsk, Poland
| | - Konrad Piątkowski
- Division of General, Endocrine and Transplant Surgery, Gdańsk, Poland
| | - Justyna Kostro
- Division of General, Endocrine and Transplant Surgery, Gdańsk, Poland
| | - Marian Łukiański
- Division of General, Endocrine and Transplant Surgery, Gdańsk, Poland
| | - Justyna Bigda
- Division of General, Endocrine and Transplant Surgery, Gdańsk, Poland
| | | |
Collapse
|
3
|
de Visser KE, Joyce JA. The evolving tumor microenvironment: From cancer initiation to metastatic outgrowth. Cancer Cell 2023; 41:374-403. [PMID: 36917948 DOI: 10.1016/j.ccell.2023.02.016] [Citation(s) in RCA: 559] [Impact Index Per Article: 559.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/28/2023] [Accepted: 02/14/2023] [Indexed: 03/14/2023]
Abstract
Cancers represent complex ecosystems comprising tumor cells and a multitude of non-cancerous cells, embedded in an altered extracellular matrix. The tumor microenvironment (TME) includes diverse immune cell types, cancer-associated fibroblasts, endothelial cells, pericytes, and various additional tissue-resident cell types. These host cells were once considered bystanders of tumorigenesis but are now known to play critical roles in the pathogenesis of cancer. The cellular composition and functional state of the TME can differ extensively depending on the organ in which the tumor arises, the intrinsic features of cancer cells, the tumor stage, and patient characteristics. Here, we review the importance of the TME in each stage of cancer progression, from tumor initiation, progression, invasion, and intravasation to metastatic dissemination and outgrowth. Understanding the complex interplay between tumor cell-intrinsic, cell-extrinsic, and systemic mediators of disease progression is critical for the rational development of effective anti-cancer treatments.
Collapse
Affiliation(s)
- Karin E de Visser
- Division of Tumor Biology and Immunology, Oncode Institute, The Netherlands Cancer Institute, 1066 CX Amsterdam, the Netherlands; Department of Immunology, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands.
| | - Johanna A Joyce
- Department of Oncology, University of Lausanne, 1011 Lausanne, Switzerland; Ludwig Institute for Cancer Research, 1011 Lausanne, Switzerland; Agora Cancer Center Lausanne, and Swiss Cancer Center Léman, 1011 Lausanne, Switzerland.
| |
Collapse
|
4
|
Circulating Chromosome Conformation Signatures Significantly Enhance PSA Positive Predicting Value and Overall Accuracy for Prostate Cancer Detection. Cancers (Basel) 2023; 15:cancers15030821. [PMID: 36765779 PMCID: PMC9913359 DOI: 10.3390/cancers15030821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Prostate cancer (PCa) has a high lifetime prevalence (one out of six men), but currently there is no widely accepted screening programme. Widely used prostate specific antigen (PSA) test at cut-off of 3.0 ng/mL does not have sufficient accuracy for detection of any prostate cancer, resulting in numerous unnecessary prostate biopsies in men with benign disease and false reassurance in some men with PCa. We have recently identified circulating chromosome conformation signatures (CCSs, Episwitch® PCa test) allowing PCa detection and risk stratification in line with standards of clinical PCa staging. The purpose of this study was to determine whether combining the Episwitch PCa test with the PSA test will increase its diagnostic accuracy. METHODS n = 109 whole blood samples of men enrolled in the PROSTAGRAM screening pilot study and n = 38 samples of patients with established PCa diagnosis and cancer-negative controls from Imperial College NHS Trust were used. Samples were tested for PSA, and the presence of CCSs in the loci encoding for of DAPK1, HSD3B2, SRD5A3, MMP1, and miRNA98 associated with high-risk PCa identified in our previous work. RESULTS PSA > 3 ng/mL alone showed a low positive predicted value (PPV) of 0.14 and a high negative predicted value (NPV) of 0.93. EpiSwitch alone showed a PPV of 0.91 and a NPV of 0.32. Combining PSA and Episwitch tests has significantly increased the PPV to 0.81 although reducing the NPV to 0.78. Furthermore, integrating PSA, as a continuous variable (rather than a dichotomised 3 ng/mL cut-off), with EpiSwitch in a new multivariant stratification model, Prostate Screening EpiSwitch (PSE) test, has yielded a remarkable combined PPV of 0.92 and NPV of 0.94 when tested on the independent prospective cohort. CONCLUSIONS Our results demonstrate that combining the standard PSA readout with circulating chromosome conformations (PSE test) allows for significantly enhanced PSA PPV and overall accuracy for PCa detection. The PSE test is accurate, rapid, minimally invasive, and inexpensive, suggesting significant screening diagnostic potential to minimise unnecessary referrals for expensive and invasive MRI and/or biopsy testing. Further extended prospective blinded validation of the new combined signature in a screening cohort with low cancer prevalence would be the recommended step for PSE adoption in PCa screening.
Collapse
|
5
|
Zhen L, Zhien Z, Hanzi H, Xingcheng W, Yu X, Wenze W, Yuzhi Z, Yuliang C, Yi Z, Weigang Y. Comparison of malignancy and spatial distribution between latent and clinical prostate cancer: an 8-year biopsy study. Eur J Med Res 2022; 27:175. [PMID: 36088348 PMCID: PMC9464402 DOI: 10.1186/s40001-022-00801-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Current prostate cancer (PCa) screening may detect nonprogressive lesion, leading to overdiagnosis and overtreatment. The purpose of the present study is to investigate whether the tumor pathological origin of latent prostate cancer (lPCa) and clinical prostate cancer (cPCa) are consistent, and to verify the current clinically significant prostate cancer criteria.
Methods
Prostate specimens were obtained from postmortem autopsy between 2014 and 2021 and patients who went through radical prostatectomy from 2013 to 2021. The pathological characteristics and spatial distribution of the lPCa group and cPCa group were compared and analyzed through SPSS software with P < 0.05 representing statistical significant.
Results
In lPCa group, a total of 45 tumor lesions from 24 lPCa cases were included, 54.2% of lPCa patients were ISUP ≥ 2, 12.5% had tumor volume ≥ 0.5 ml, and 16.7% had extraprostatic extension (EPE). In cPCa group, there were a total of 429 tumor lesions in 126 cases, 92.1% of cPCa patients were ISUP ≥ 2, and 82.5% had tumor volume of ≥ 0.5 ml. 36.3% had EPE. LPCa and cPCa have the same spatial distribution characteristics, and no significant difference was detected between the anterior and posterior zone. Peripheral zone tumors were significantly more common than transitional zone tumors. Tumors in apical 1/3 and middle 1/3 were significantly more common than basal 1/3.
Conclusion
The malignancy of cPCa is significantly higher than that of lPCa, and the spatial distribution of cPCa and lPCa is consistent. ISUP grade 2 is not sufficient to determine clinical significance of tumor.
Collapse
|
6
|
Soltani MH, Khabazian R, Dadpour M, Borumandnia N, Simforoosh N. Comparison of histopathological features, survival, and oncological outcome between patients under and above 55-year-old with prostate cancer who underwent radical prostatectomy. Urologia 2022; 90:83-88. [PMID: 35191332 DOI: 10.1177/03915603221078266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: To compare the disease course, histopathological features and survival rates of prostate cancer (PCa) between patients aged ⩽ 55 and > 55 year old. Materials and methods: In this retrospective study, we enrolled 644 patients with organ-confide prostate cancer who had undergone radical prostatectomy from 2005 to 2018. Seventy-six (11.8%) patients were under 55 years of age (group 1) and 568 (88.2%) patients were >55 years old (group 2). Results: Pre-operative hypertension was detected in 4 (5.3%) patients of group 1 and 80 (14.1%) patients of groups 2 ( p = 0.029). The mean (±SD) prostate volume was higher in group 2 compared with group 1 (34.1(±8.4) ml vs 54.1(±9.9) ml, p < 0.001). Positive surgery margin was observed in 15 (19.7%) and 58 (10.2%) patients in group 1 and 2, respectively ( p = 0.020). Co-existence of diabetes mellitus, mean pre-operative PSA, Gleason’s score, and permanent pathology and pathologic stage were similar between the two groups. Log-rank test failed to show any statistical difference in terms of biochemical-relapse free survival, local recurrence-free survival, and metastasis-free survival between the two groups ( p = 0.316, 0.441, 0.654, respectively). After performing multivariate analysis, positive surgical margin was the only factor that was independently predictive of biochemical relapse ( p < 0.001) and local recurrence/metastasis ( p < 0.001). Conclusion: No difference was observed in terms of histopathologic features, biochemical relapse, and local recurrence/metastasis-free survival rates between patients younger and older than 55 years of age.
Collapse
Affiliation(s)
- Mohammad Hossein Soltani
- Shahid Beheshti University of Medical Sciences, Labbafinejad Hospital, Urology and Nephrology Research Center, Tehran, Iran
| | - Reza Khabazian
- Shahid Beheshti University of Medical Sciences, Urology and Nephrology Research Center, Tehran, Iran
| | - Mehdi Dadpour
- Shahid Beheshti University of Medical Sciences, Urology and Nephrology Research Center, Tehran, Iran
| | - Nasrin Borumandnia
- Shahid Beheshti University of Medical Sciences, Urology and Nephrology Research Center, Tehran, Iran
| | - Nasser Simforoosh
- Shahid Beheshti University of Medical Sciences, Labbafinejad Hospital, Urology and Nephrology Research Center, Tehran, Iran
| |
Collapse
|
7
|
Khadir RM, Sayyid RK, Matthews B, King SA, Terris MK. Impact of early hypothalamic-pituitary-gonadal axis maturation on prostate cancer: cross-sectional analysis of a Veterans affairs cohort. Transl Androl Urol 2021; 10:3368-3374. [PMID: 34532261 PMCID: PMC8421831 DOI: 10.21037/tau-21-433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/30/2021] [Indexed: 12/02/2022] Open
Abstract
Background It has been hypothesized that earlier onset of puberty, and thus a more prolonged exposure to high androgen levels, increases risk of prostate cancer development. Our objective was to determine whether earlier age of first shave and height, as surrogates of pubertal onset, were associated with risk of prostate cancer diagnosis. Methods A prospectively collected outcomes registry of patients presenting for a prostate biopsy at the Charlie Norwood Veterans Affair Medical Center in Augusta, GA between July 1995 and June 2016 was utilized. The associations between age of first shave and height, each, and risks of a positive prostate biopsy, high grade cancer, and high volume disease were evaluated using univariable and multivariable logistic regression analysis, controlling for baseline patient demographic and oncologic characteristics. Results Our cohort included 2,456 patients. Biopsies were positive in 1,257 (51.2%) patients, of whom 293 (23.3%) and 407 (32.4%) had high grade and volume disease, respectively. Median age of first shave was 17.0 years (interquartile range 16.0–19.0) and height was 177.7 cm (172.8–182.9). On multivariable analysis, later of age of first shave was significantly associated with increased odds of a positive prostate biopsy (odds ratio for >18 versus <16 years: 5.34, P=0.02) and taller patients had significantly increased odds of high grade cancer (odds ratio for 175–180 versus <175 cm: 7.46, P=0.037). Conclusions Amongst patients presenting for a prostate biopsy, those with a later age of first shave and taller height have an increased risk of a positive prostate biopsy and high grade prostate cancer, respectively.
Collapse
Affiliation(s)
| | - Rashid K Sayyid
- Charlie Norwood VA Medical Center, Augusta, GA, USA.,Department of Surgery, Section of Urology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | | | - Sherita A King
- Charlie Norwood VA Medical Center, Augusta, GA, USA.,Department of Surgery, Section of Urology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Martha K Terris
- Charlie Norwood VA Medical Center, Augusta, GA, USA.,Department of Surgery, Section of Urology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| |
Collapse
|
8
|
Namakshenas P, Mojra A. Optimization of polyethylene glycol-based hydrogel rectal spacer for focal laser ablation of prostate peripheral zone tumor. Phys Med 2021; 89:104-113. [PMID: 34364254 DOI: 10.1016/j.ejmp.2021.07.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/23/2021] [Accepted: 07/28/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Focal Laser ablation therapy is a technique that exposes the prostate tumor to hyperthermia ablation and eradicates cancerous cells. However, due to the excessive heating generated by laser irradiation, there is a possibility of damage to the adjacent healthy tissues. This paper through in silico study presents a novel approach to reduce collateral effects due to heating by the placement of polyethylene glycol (PEG) spacer between the rectum and tumor during laser irradiation. The PEG spacer thickness is optimized to reduce the undesired damage at common laser power used in the clinical trials. Our study also encompasses novelty by conducting the thermal analysis based on the porous structure of prostate tumor. METHODS The thermal parameters and two thermal phase lags between the temperature gradient and the heat flux, are determined by considering the vascular network of prostate tumor. The Nelder-Mead algorithm is applied to find the minimum thickness of the PEG spacer. RESULTS In the absence of the spacer, the predicted results for the laser power of 4 W, 8 W, and 12 W show that the temperature of the rectum rises up to 58.6 °C, 80.4 °C, and 101.1 °C, while through the insertion of 2.59 mm, 4 mm, and 4.9 mm of the PEG spacer, it dramatically reduces below 42 °C. CONCLUSIONS The results can be used as a guideline to ablate the prostate tumors while avoiding undesired damage to the rectal wall during laser irradiation, especially for the peripheral zone tumors.
Collapse
Affiliation(s)
- Pouya Namakshenas
- Department of Mechanical Engineering, K. N. Toosi University of Technology, Tehran, Iran
| | - Afsaneh Mojra
- Department of Mechanical Engineering, K. N. Toosi University of Technology, Tehran, Iran.
| |
Collapse
|
9
|
Huang D, Wu YS, Ye DW, Qi J, Liu F, Helfand BT, Zheng SL, Ding Q, Xu DF, Na R, Xu JF, Sun YH. Prostate volume does not provide additional predictive value to prostate health index for prostate cancer or clinically significant prostate cancer: results from a multicenter study in China. Asian J Androl 2021; 22:539-543. [PMID: 31929198 PMCID: PMC7523603 DOI: 10.4103/aja.aja_136_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
To evaluate whether prostate volume (PV) would provide additional predictive utility to the prostate health index (phi) for predicting prostate cancer (PCa) or clinically significant prostate cancer, we designed a prospective, observational multicenter study in two prostate biopsy cohorts. Cohort 1 included 595 patients from three medical centers from 2012 to 2013, and Cohort 2 included 1025 patients from four medical centers from 2013 to 2014. Area under the receiver operating characteristic curves (AUC) and logistic regression models were used to evaluate the predictive performance of PV-based derivatives and models. Linear regression analysis showed that both total prostate-specific antigen (tPSA) and free PSA (fPSA) were significantly correlated with PV (all P < 0.05). [-2]proPSA (p2PSA) was significantly correlated with PV in Cohort 2 (P < 0.001) but not in Cohort 1 (P = 0.309), while no significant association was observed between phi and PV. When combining phi with PV, phi density (PHID) and another phi derivative (PHIV, calculated as phi/PV0.5) did not outperform phi for predicting PCa or clinically significant PCa in either Cohort 1 or Cohort 2. Logistic regression analysis also showed that phi and PV were independent predictors for both PCa and clinically significant PCa (all P < 0.05); however, PV did not provide additional predictive value to phi when combining these derivatives in a regression model (all models vs phi were not statistically significant, all P > 0.05). In conclusion, PV-based derivatives (both PHIV and PHID) and models incorporating PV did not improve the predictive abilities of phi for either PCa or clinically significant PCa.
Collapse
Affiliation(s)
- Da Huang
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yi-Shuo Wu
- Department of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China.,Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Ding-Wei Ye
- Department of Urology, Shanghai Cancer Center, Fudan University, Shanghai 200032, China
| | - Jun Qi
- Department of Urology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Fang Liu
- Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Brian T Helfand
- Division of Urology, NorthShore University Health System, Evanston, IL 60201, USA
| | - Siqun L Zheng
- Program for Personalized Cancer Care, NorthShore University Health System, Evanston, IL 60201, USA
| | - Qiang Ding
- Department of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China.,Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Dan-Feng Xu
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Rong Na
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.,Program for Personalized Cancer Care, NorthShore University Health System, Evanston, IL 60201, USA
| | - Jian-Feng Xu
- Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai 200040, China.,Program for Personalized Cancer Care, NorthShore University Health System, Evanston, IL 60201, USA
| | - Ying-Hao Sun
- Department of Urology, Shanghai Changhai Hospital, The Second Military Medical University, Shanghai 200433, China
| |
Collapse
|
10
|
Lan T, Park Y, Colditz GA, Liu J, Sinha R, Wang M, Wu K, Giovannucci E, Sutcliffe S. Adolescent animal product intake in relation to later prostate cancer risk and mortality in the NIH-AARP Diet and Health Study. Br J Cancer 2021; 125:1158-1167. [PMID: 34135472 DOI: 10.1038/s41416-021-01463-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 05/13/2021] [Accepted: 06/07/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Adolescent intake of animal products has been proposed to contribute to prostate cancer (PCa) development because of its potentially carcinogenic constituents and influence on hormone levels during adolescence. METHODS We used data from 159,482 participants in the NIH-AARP Diet and Health Study to investigate associations for recalled adolescent intake of red meat (unprocessed beef and processed red meat), poultry, egg, canned tuna, animal fat and animal protein at ages 12-13 years with subsequent PCa risk and mortality over 14 years of follow-up. Cox proportional hazard regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of total (n = 17,349), advanced (n = 2,297) and fatal (n = 804) PCa. RESULTS Suggestive inverse trends were observed for adolescent unprocessed beef intake with risks of total, advanced and fatal PCa (multivariable-adjusted P-trends = 0.01, 0.02 and 0.04, respectively). No consistent patterns of association were observed for other animal products by PCa outcome. CONCLUSION We found evidence to suggest that adolescent unprocessed beef intake, or possibly a correlate of beef intake, such as early-life socioeconomic status, may be associated with reduced risk and mortality from PCa. Additional studies with further early-life exposure information are warranted to better understand this association.
Collapse
Affiliation(s)
- Tuo Lan
- Department of Occupational and Environmental Health, College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery; and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery; and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Jingxia Liu
- Division of Public Health Sciences, Department of Surgery; and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Rashmi Sinha
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Department of Health and Human Services, Bethesda, MD, USA
| | - Molin Wang
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Kana Wu
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Edward Giovannucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA.,Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery; and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA.
| |
Collapse
|
11
|
|
12
|
Balázs K, Antal L, Sáfrány G, Lumniczky K. Blood-Derived Biomarkers of Diagnosis, Prognosis and Therapy Response in Prostate Cancer Patients. J Pers Med 2021; 11:296. [PMID: 33924671 PMCID: PMC8070149 DOI: 10.3390/jpm11040296] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 03/31/2021] [Accepted: 04/03/2021] [Indexed: 12/11/2022] Open
Abstract
Prostate cancer is among the most frequent cancers in men worldwide. Despite the fact that multiple therapeutic alternatives are available for its treatment, it is often discovered in an advanced stage as a metastatic disease. Prostate cancer screening is based on physical examination of prostate size and prostate-specific antigen (PSA) level in the blood as well as biopsy in suspect cases. However, these markers often fail to correctly identify the presence of cancer, or their positivity might lead to overdiagnosis and consequent overtreatment of an otherwise silent non-progressing disease. Moreover, these markers have very limited if any predictive value regarding therapy response or individual risk for therapy-related toxicities. Therefore, novel, optimally liquid biopsy-based (blood-derived) markers or marker panels are needed, which have better prognostic and predictive value than the ones currently used in the everyday routine. In this review the role of circulating tumour cells, extracellular vesicles and their microRNA content, as well as cellular and soluble immunological and inflammation- related blood markers for prostate cancer diagnosis, prognosis and prediction of therapy response is discussed. A special emphasis is placed on markers predicting response to radiotherapy and radiotherapy-related late side effects.
Collapse
Affiliation(s)
| | | | | | - Katalin Lumniczky
- Unit of Radiation Medicine, Department of Radiobiology and Radiohygiene, National Public Health Centre, 1221 Budapest, Hungary; (K.B.); (L.A.); (G.S.)
| |
Collapse
|
13
|
Zhou Y, Mai Z, Yan W, Chen Y, Zhou Z, Xiao Y, Wang W, Shang Z, Yuan R, Ji Z, Li H. The characteristics and spatial distributions of prostate cancer in autopsy specimens. Prostate 2021; 81:135-141. [PMID: 33306857 DOI: 10.1002/pros.24091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The characteristics of prostate cancer on autopsy and early-stage prostate cancer are identical. Using autopsy specimens, we analysed prostate cancer characteristics and clarified the spatial distributions of lesions. METHOD We obtained prostate specimens from Chinese donors without a prostate cancer diagnosis and analyzed prostate cancer pathological characteristics on autopsy by whole-mount sampling. We determined the distributions of lesions in horizontal and vertical dimensions. The horizontal dimension included four horizontal quadrants (left-anterior, left-posterior, right-anterior, and right-posterior quadrants), the peripheral zone, and the transition zone. RESULT The overall positive rate of prostate cancer among 113 specimens was 35.4%. There were 73 lesions in 40 prostates with prostate cancer. The positive rates of lesions in the left-anterior, left-posterior, right-anterior, and right-posterior quadrants were 24.7% (18/73), 27.4% (20/73), 26.0% (19/73), and 21.9% (16/73), respectively. The positive rate of prostate cancer was 74% in the areas between the apex above 0.5-0.8 cm and the middle slice. There were 22 (30.1%) and 51 (69.9%) lesions in the superior and inferior half of the prostate. There were no significant differences in the median volume and Gleason grade group between the superior and inferior half (p = .876 and p = .228). CONCLUSION In the horizontal dimension, the positive rate of prostate cancer was consistent in the four quadrants. Prostate cancer mainly originated from the areas between the apex above 0.5-0.8 cm and the middle slice. Compared with the superior half, the inferior half of the prostate had a higher positive rate but the same lesion characteristics.
Collapse
Affiliation(s)
- Yi Zhou
- Department of Urology, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Zhipeng Mai
- Department of Urology, Zhongshan City People's Hospital, Zhongshan, Guangdong, China
| | - Weigang Yan
- Department of Urology, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Yuliang Chen
- Department of Urology, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Zhien Zhou
- Department of Urology, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Yu Xiao
- Department of Pathology, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Wenze Wang
- Department of Pathology, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Zhiyuan Shang
- Department of Urology, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Runqiang Yuan
- Department of Urology, Zhongshan City People's Hospital, Zhongshan, Guangdong, China
| | - Zhigang Ji
- Department of Urology, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| | - Hanzhong Li
- Department of Urology, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
| |
Collapse
|
14
|
Alshaker H, Mills R, Hunter E, Salter M, Ramadass A, Skinner BM, Westra W, Green J, Akoulitchev A, Winkler M, Pchejetski D. Chromatin conformation changes in peripheral blood can detect prostate cancer and stratify disease risk groups. J Transl Med 2021; 19:46. [PMID: 33509203 PMCID: PMC7845038 DOI: 10.1186/s12967-021-02710-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Current diagnostic blood tests for prostate cancer (PCa) are unreliable for the early stage disease, resulting in numerous unnecessary prostate biopsies in men with benign disease and false reassurance of negative biopsies in men with PCa. Predicting the risk of PCa is pivotal for making an informed decision on treatment options as the 5-year survival rate in the low-risk group is more than 95% and most men would benefit from surveillance rather than active treatment. Three-dimensional genome architecture and chromosome structures undergo early changes during tumourigenesis both in tumour and in circulating cells and can serve as a disease biomarker. METHODS In this prospective study we screened whole blood of newly diagnosed, treatment naïve PCa patients (n = 140) and cancer-free controls (n = 96) for the presence of 14,241 chromosomal loops in the loci of 425 genes. RESULTS We have detected specific chromosome conformation changes in the loci of ETS1, MAP3K14, SLC22A3 and CASP2 genes in peripheral blood from PCa patients yielding PCa detection with 80% sensitivity and 80% specificity. Further analysis between PCa risk groups yielded prognostic validation sets consisting of HSD3B2, VEGFC, APAF1, BMP6, ERG, MSR1, MUC1, ACAT1 and DAPK1 genes that achieved 80% sensitivity and 93% specificity stratifying high-risk category 3 vs low risk category 1 and 84% sensitivity and 89% specificity stratifying high risk category 3 vs intermediate risk category 2 disease. CONCLUSIONS Our results demonstrate specific chromosome conformations in the blood of PCa patients that allow PCa diagnosis and risk stratification with high sensitivity and specificity.
Collapse
Affiliation(s)
- Heba Alshaker
- School of Medicine, University of East Anglia, Norwich, UK
| | - Robert Mills
- Department of Urology, Norfolk and Norwich NHS Trust, Norwich, UK
| | | | | | | | | | | | | | | | - Mathias Winkler
- Department of Surgery and Cancer, Imperial College London, London, UK
| | | |
Collapse
|
15
|
Global Trends of Latent Prostate Cancer in Autopsy Studies. Cancers (Basel) 2021; 13:cancers13020359. [PMID: 33478075 PMCID: PMC7835858 DOI: 10.3390/cancers13020359] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/15/2021] [Accepted: 01/17/2021] [Indexed: 12/09/2022] Open
Abstract
Simple Summary The incidence of prostate cancer (PC) is statistically biased due to the increase in prostate-specific antigen (PSA) screening and the accuracy of national cancer registration systems. However, studies on latent PC provide less biased information. This comprehensive review included studies evaluating latent PC in several countries. The prevalence of latent PC has been stable since 1950 in Western countries, but it has increased over time in Asian countries. Latent PC in Asian men has increased in prevalence and is higher in grade. This increase occurred not only due to the increase in PSA screening, but also due to increasing adoption of a Westernized lifestyle. Racial differences between Caucasian and Asian men may also explain the tumor location of latent PC. The autopsy findings in patients with latent PC included a significant proportion of high grade and stage cancers, suggesting a need to reconsider the definition of clinically insignificant PC. Abstract The incidence of prostate cancer (PC) has been increasing in Asian countries, where it was previously low. Although the adoption of a Westernized lifestyle is a possible explanation, the incidence is statistically biased due to the increase in prostate-specific antigen (PSA) screening and the accuracy of national cancer registration systems. Studies on latent PC provide less biased information. This review included studies evaluating latent PC in several countries after excluding studies using random or single-section evaluations and those that did not mention section thickness. The findings showed that latent PC prevalence has been stable since 1950 in Western countries, but has increased over time in Asian countries. Latent PC in Asian men has increased in both prevalence and number of high-grade cases. Racial differences between Caucasian and Asian men may explain the tumor location of latent PC. In conclusion, the recent increase in latent PC in Asian men is consistent with an increase in clinical PC. Evidence suggests that this increase is caused not only by the increase in PSA screening, but also by the adoption of a more Westernized lifestyle. Autopsy findings suggest the need to reconsider the definition of clinically insignificant PC.
Collapse
|
16
|
C J, Y P, Sf B, Rj B. "More men die with prostate cancer than because of it" - an old adage that still holds true in the 21st century. Cancer Treat Res Commun 2020; 26:100225. [PMID: 33360667 DOI: 10.1016/j.ctarc.2020.100225] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/26/2020] [Accepted: 09/30/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Prostate cancer (PCa) incidence has risen due to PSA testing, making it the commonest male malignancy. Most PSA-detected cases are organ-confined. Whilst radical treatment has increased, there has been little change in PCa-specific mortality. Over-detection of clinically insignificant PCa and active surveillance are increasing. We compared studies from the 21st century versus earlier reports demonstrating how commonly PCa is incidentally detected at autopsy. We describe the ongoing increasing prevalence of PCa with age, along with features of autopsy-detected disease. METHODS A literature review of PubMed and Scopus was conducted using the search terms "prostate cancer or carcinoma", "latent" or "autopsy", to January 2019. Citations and references from all publications found in this search were manually reviewed to identify additional articles. RESULTS 63 publications were identified between 1898 and 2017, reporting over 29,000 autopsies on subjects aged between 20 and ≥90 years. PCa prevalence was 21% across all ages, and we found no significant difference in 21st century studies versus earlier studies. Autopsy-detected incidental PCa cases were typically small (~0.5cubic cm), predominantly low grade, and only occasionally (10%) extra-prostatic. PCa prevalence increased with age, being detected in >50% in men aged ≥90 years. The frequency of high-grade PCa almost doubled with each increasing age category. CONCLUSION Most autopsy-detected PCa cases continue to be clinically insignificant. The prevalence of autopsy-detected PCa was 30-fold greater than PCa-specific mortality in each ten-year age category. This should be considered when counselling elderly men regarding PSA-testing, particularly in the context of competing co-morbidity.
Collapse
Affiliation(s)
- Jacklin C
- Medical Sciences Divisional Office, University of Oxford, Level 3, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
| | - Philippou Y
- Department of Urology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, United Kingdom
| | - Brewster Sf
- Department of Urology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, United Kingdom
| | - Bryant Rj
- Department of Urology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 7LE, United Kingdom; Nuffield Department of Surgical Sciences, University of Oxford, Oxford OX3 7DQ, United Kingdom.
| |
Collapse
|
17
|
de Nie I, de Blok CJM, van der Sluis TM, Barbé E, Pigot GLS, Wiepjes CM, Nota NM, van Mello NM, Valkenburg NE, Huirne J, Gooren LJG, van Moorselaar RJA, Dreijerink KMA, den Heijer M. Prostate Cancer Incidence under Androgen Deprivation: Nationwide Cohort Study in Trans Women Receiving Hormone Treatment. J Clin Endocrinol Metab 2020; 105:dgaa412. [PMID: 32594155 PMCID: PMC7379905 DOI: 10.1210/clinem/dgaa412] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/23/2020] [Indexed: 12/28/2022]
Abstract
CONTEXT Trans women (male sex assigned at birth, female gender identity) mostly use antiandrogens combined with estrogens and can subsequently undergo vaginoplasty including orchiectomy. Because the prostate remains in situ after this procedure, trans women are still at risk for prostate cancer. OBJECTIVE To assess the incidence of prostate cancer in trans women using hormone treatment. The incidence of prostate cancer in trans women using hormone treatment. DESIGN In this nationwide retrospective cohort study, data of participants were linked to the Dutch national pathology database and to Statistics Netherlands to obtain data on prostate cancer diagnosis and mortality. SETTING Gender identity clinic. PARTICIPANTS Trans women who visited our clinic between 1972 and 2016 and received hormone treatment were included. MAIN OUTCOME MEASURES Standardized incidence ratios (SIRs) were calculated using the number of observed prostate cancer cases in our cohort and the number of expected cases based on age-specific incidence numbers from the Netherlands Comprehensive Cancer Organization. RESULTS The study population consisted of 2281 trans women with a median follow-up time of 14 years (interquartile range 7-24), and a total follow-up time of 37 117 years. Six prostate cancer cases were identified after a median 17 years of hormone treatment. This resulted in a lower prostate cancer risk in trans women than in Dutch reference males (SIR 0.20, 95% confidence interval 0.08-0.42). CONCLUSIONS Trans women receiving androgen deprivation therapy and estrogens have a substantially lower risk for prostate cancer than the general male population. Our results support the hypothesis that androgen deprivation has a preventive effect on the initiation and development of prostate cancer.
Collapse
Affiliation(s)
- Iris de Nie
- Department of Endocrinology, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
- Centre of Expertise on Gender Dysphoria, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
| | - Christel J M de Blok
- Department of Endocrinology, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
- Centre of Expertise on Gender Dysphoria, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
| | - Tim M van der Sluis
- Department of Urology, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
| | - Ellis Barbé
- Department of Pathology, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
| | - Garry L S Pigot
- Centre of Expertise on Gender Dysphoria, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
- Department of Urology, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
| | - Chantal M Wiepjes
- Department of Endocrinology, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
- Centre of Expertise on Gender Dysphoria, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
| | - Nienke M Nota
- Department of Endocrinology, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
- Centre of Expertise on Gender Dysphoria, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
| | - Norah M van Mello
- Centre of Expertise on Gender Dysphoria, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
- Department of Obstetrics and Gynecology, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
| | - Noelle E Valkenburg
- Department of Endocrinology, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
| | - Judith Huirne
- Department of Obstetrics and Gynecology, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
| | - Louis J G Gooren
- Department of Endocrinology, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
- Centre of Expertise on Gender Dysphoria, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
| | | | - Koen M A Dreijerink
- Department of Endocrinology, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
- Centre of Expertise on Gender Dysphoria, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
| | - Martin den Heijer
- Department of Endocrinology, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
- Centre of Expertise on Gender Dysphoria, Amsterdam UMC, VU University Medical Centre, Amsterdam, the Netherlands
| |
Collapse
|
18
|
Lan T, Park Y, Colditz GA, Liu J, Wang M, Wu K, Giovannucci E, Sutcliffe S. Adolescent dairy product and calcium intake in relation to later prostate cancer risk and mortality in the NIH-AARP Diet and Health Study. Cancer Causes Control 2020; 31:891-904. [PMID: 32743740 DOI: 10.1007/s10552-020-01330-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 07/24/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Although a growing body of evidence supports an early-life contribution to prostate cancer (PCa) development, few studies have investigated early-life diet, and only three have examined early-life dairy product intake, a promising candidate risk factor because of its known/suspected influence on insulin-like growth factor levels and height. METHODS We used recalled dietary data from 162,816 participants in the NIH-AARP Diet and Health Study to investigate associations for milk, cheese, ice cream, total dairy, and calcium intake at ages 12-13 years with incident total (n = 17,729), advanced (n = 2,348), and fatal PCa (n = 827) over 14 years of follow-up. We calculated relative risks (RRs) and 95% confidence intervals (CIs) by Cox proportional hazards regression. RESULTS We observed suggestive positive trends for milk, dairy, and calcium intake with total and/or advanced PCa (p-trends = 0.016-0.148). These trends attenuated after adjustment for additional components of adolescent diet, particularly red meat and vegetables/potatoes. In contrast, suggestive inverse trends were observed for cheese and ice cream intake with total and/or advanced PCa (p-trends = 0.043-0.153), and for milk, dairy, and calcium intake with fatal PCa (p-trend = 0.045-0.117). CONCLUSION Although these findings provide some support for a role of adolescent diet in increasing PCa risk, particularly for correlates of milk intake or overall dietary patterns, our protective findings for cheese and ice cream intake with PCa risk and mortality, and for all dairy products with PCa mortality, suggest alternative explanations, such as the influence of early-life socioeconomic status, and increased PCa screening, earlier detection, and better PCa care.
Collapse
Affiliation(s)
- Tuo Lan
- Department of Occupational and Environmental Health, College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.,Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Graham A Colditz
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.,Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Jingxia Liu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.,Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Molin Wang
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Kana Wu
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Edward Giovannucci
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA.,Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA. .,Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA.
| |
Collapse
|
19
|
Zheng Y, Lin SX, Wu S, Dahl DM, Blute ML, Zhong WD, Zhou X, Wu CL. Clinicopathological characteristics of localized prostate cancer in younger men aged ≤ 50 years treated with radical prostatectomy in the PSA era: A systematic review and meta-analysis. Cancer Med 2020; 9:6473-6484. [PMID: 32697048 PMCID: PMC7520296 DOI: 10.1002/cam4.3320] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/16/2022] Open
Abstract
Objectives With the rapid increase in younger age prostate cancer (PCa) patients, the impact of younger age on decision‐making for PCa treatment needs to be revaluated in the new era. Materials and Methods A systematic literature search was performed using PubMed, EMBASE, and Web of Science up to October 2019 to identify the eligible radical prostatectomy (RP) studies focusing on understanding the impact of age on clinicopathological features and oncological prognosis in patients with localized PCa in PSA era. Meta‐analyses were conducted using available hazard ratios (HRs) from both univariate and multivariate analyses. Results Twenty‐six studies including 391 068 patients with RP treatments from the PSA era were included. Of these studies, age of 50 years old (age50) is the most commonly used cut‐off age to separate the younger patient group (including either age < 50 or age ≤ 50) from the older patient group. In these studies, the incidence of younger patients varied between 2.6% and 16.6% with a median of 8.3%. Younger patients consistently showed more favorable clinicopathological features correlated with better BCR prognosis. Meta‐analyses showed a 1.38‐fold improved BCR survival of younger patients in multivariate analysis. Among the high‐risk PCa patients, younger age was independently associated with worse oncological outcomes in multivariate analyses. Conclusion In this study, we found younger age correlated with favorable clinicopathological characteristics and better BCR prognosis in low‐ to intermediate‐risk patients. In high‐risk group patients, younger patients often showed significantly worse oncological outcomes. Our study results suggest that age 50 could be used as a practical cut‐off age to separate younger age patients from older age PCa patients.
Collapse
Affiliation(s)
- Yu Zheng
- Department of Urology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.,Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sharron X Lin
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Shulin Wu
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Douglas M Dahl
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael L Blute
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Wei-De Zhong
- Department of Urology, Guangdong Key Laboratory of Clinical Molecular Medicine and Diagnostics, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xing Zhou
- Department of Urology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Chin-Lee Wu
- Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
20
|
Takaso M, Hitosugi M, Nakagawa R, Mukaisho K, Moriguchi S, Koh M, Sugihara H. Forensic Autopsies can Determine Latent Prostate Cancer Prevalence. J Forensic Sci 2020; 65:1557-1562. [PMID: 32501618 DOI: 10.1111/1556-4029.14472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 10/24/2022]
Abstract
To evaluate the usefulness of forensic autopsies in determining latent prostate cancer (PC) prevalence, we examined latent PC prevalence from autopsies and compared our findings between decedents with and without cancer. Data from forensic autopsies performed in Japan from 2004 to 2014 were obtained. For each prostate, histopathological examinations were performed in both the base and the apex sections. Three hundred and seventeen Japanese decedents were selected for analysis. The mean age of decedents was 56.4 ± 17.8 years (range, 14-94 years). Among this population, 39.4% died suddenly of disease and 60.6% died of external causes. Latent PC was identified in 45 (14.2%) decedents, who ranged from 27 to 93 years old (mean, 71.1 ± 12.9 years). The prevalence of clinically significant PC with a Gleason score of 7 or more was 8.8%, and the rate increased with age. Fifteen males had cancers other than PC. The prevalence of overall latent PC was significantly higher for those with cancer compared with those without (40.0% vs. 12.9%; P = 0.003). In this study, the use of forensic autopsy materials provided the opportunity to obtain a more accurate natural history of PC, as the decedents in this situation would have been more likely to have died suddenly while behaving as normal prior to death, and less likely to have been impacted by long-term medical interventions.
Collapse
Affiliation(s)
- Marin Takaso
- Department of Legal Medicine, Shiga University of Medical Science, Otsu, 520-2192, Japan
| | - Masahito Hitosugi
- Department of Legal Medicine, Shiga University of Medical Science, Otsu, 520-2192, Japan
| | - Risako Nakagawa
- Department of Legal Medicine, Shiga University of Medical Science, Otsu, 520-2192, Japan
| | - Kenichi Mukaisho
- Department of Pathology, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, 520-2192, Japan
| | - Shingo Moriguchi
- Department of Legal Medicine, Shiga University of Medical Science, Otsu, 520-2192, Japan
| | - Mirae Koh
- Department of Legal Medicine, Shiga University of Medical Science, Otsu, 520-2192, Japan
| | - Hiroyuki Sugihara
- Department of Pathology, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, 520-2192, Japan
| |
Collapse
|
21
|
Kohestani K, Wallström J, Dehlfors N, Sponga OM, Månsson M, Josefsson A, Carlsson S, Hellström M, Hugosson J. Performance and inter-observer variability of prostate MRI (PI-RADS version 2) outside high-volume centres. Scand J Urol 2019; 53:304-311. [PMID: 31661357 DOI: 10.1080/21681805.2019.1675757] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Despite the growing trend to embrace pre-biopsy MRI in the diagnostic pathway for prostate cancer (PC), its performance and inter-observer variability outside high-volume centres remains unknown. This study aims to evaluate sensitivity of and variability between readers of prostate MRI outside specialized units with radical prostatectomy (RP) specimen as the reference standard.Materials and methods: Retrospective study comprising a consecutive cohort of all 97 men who underwent MRI and subsequent RP between January 2012 and December 2014 at a private hospital in Sweden. Three readers, blinded to clinical data, reviewed all images (including 11 extra prostate MRI to reduce bias). A tumour was considered detected if the overall PI-RADS v2 score was 3-5 and there was an approximate match (same or neighbouring sector) of tumour sector according to a 24 sector system used for both MRI and whole mount sections.Results: Detection rate for the index tumour ranged from 67 to 76%, if PI-RADS 3-5 lesions were considered positive and 54-66% if only PI-RADS score 4-5 tumours were included. Detection rate for aggressive tumours (GS ≥ 4 + 3) was higher; 83.1% for PI-RADS 3-5 and 79.2% for PI-RADS 4-5. The agreement between readers showed average [Formula: see text] values of 0.41 for PI-RADS score 3-5 and 0.51 for PI-RADS score 4-5.Conclusions: Prostate MRI evidenced a moderate detection rate for clinically significant PC with a rather large variability between readers. Clinics outside specialized units must have knowledge of their performance of prostate MRI before considering omitting biopsies in men with negative MRI.
Collapse
Affiliation(s)
- Kimia Kohestani
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Urology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jonas Wallström
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Niclas Dehlfors
- Department of Radiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Marianne Månsson
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Andreas Josefsson
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Urology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.,Wallenberg Center for Molecular Medicine, Umeå University, Umeå, Umeå, Sweden
| | - Sigrid Carlsson
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Surgery (Urology Service) and Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mikael Hellström
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jonas Hugosson
- Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Urology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
22
|
Fine ND, LaPolla F, Epstein M, Loeb S, Dani H. Genomic classifiers for treatment selection in newly diagnosed prostate cancer. BJU Int 2019; 124:578-586. [PMID: 31055874 DOI: 10.1111/bju.14799] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To review systematically the literature on genomic tests for prostate cancer (PCa) and to evaluate the current state of the evidence on their use in patients with newly diagnosed PCa. METHODS We conducted a systematic review by searching PubMed, Embase, Cochrane Central and conference abstracts from the American Urological Association, published between 2010 and 2018. Studies evaluating Prolaris, Oncotype Dx and Decipher assays were assessed for inclusion by two authors. Studies were excluded if the results were derived from surgical specimens rather than biopsy specimens. A meta-analysis was not performed owing to significant variations in methodologies, definitions and outcome measures. RESULTS A total of 729 articles were retrieved in our initial search. After removing duplicates (270) and excluding articles deemed not relevant (432), 21 full-text articles were deemed suitable for inclusion in the present analysis. The full-text articles comprised eight studies on Prolaris, eight studies on Oncotype Dx and five studies on Decipher. For each genomic test we extracted data regarding the risks of adverse pathology, biochemical recurrence, metastasis and PCa-specific mortality. CONCLUSION The results of genomic tests that use biomarkers derived from prostate biopsy can be used in conjunction with clinicopathological variables to improve our ability to risk-stratify patients with newly diagnosed PCa. Additional data are needed on the impact of using these tests on long-term patient outcomes and their cost-effectiveness.
Collapse
Affiliation(s)
| | - Fred LaPolla
- NYU Health Sciences Library, New York University, New York, NY, USA
| | | | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan VA, New York, NY, USA
| | - Hasan Dani
- James Buchanan Brady Urological Institute, Johns Hopkins, University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
23
|
Palsdottir T, Nordström T, Aly M, Lindberg J, Clements M, Egevad L, Grönberg H, Eklund M. Are Prostate Specific-Antigen (PSA) and age associated with the risk of ISUP Grade 1 prostate cancer? Results from 72 996 individual biopsy cores in 6 083 men from the Stockholm3 study. PLoS One 2019; 14:e0218280. [PMID: 31194822 PMCID: PMC6564040 DOI: 10.1371/journal.pone.0218280] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 05/29/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Knowledge about the relationship between PSA, age and ISUP grade group (ISUP) 1 prostate cancer can improve clinical and biological understanding of prostate cancer. We aimed to investigate the associations between PSA and age and the risk of ISUP 1 and ISUP ≥ 2 prostate cancer, respectively. METHODS We included 6 083 men aged 50-69 biopsied with a total of 72 996 individual biopsy cores from the prospective and population based Stockholm3 diagnostic study. We computed the risk of ISUP 1 and ISUP ≥ 2 prostate cancer and their respective associations with PSA and age. Since lower Gleason grades often are masked by higher grades in the overall Gleason score, we compared associations both for overall Gleason score and for Gleason on individual biopsy cores. RESULTS ISUP 1 prostate cancer was not significantly associated with PSA at diagnosis: odds ratios ranged from 0.82 (95%CI: 0.68-1.00) for PSA 3-4 ng/mL, 0.96 (95%CI: 0.79-1.16) for PSA 4-6 ng/mL, 0.95 (95%CI: 0.75-1.21) for PSA 6-10 ng/mL, and 0.92 (95%CI: 0.58-1.45) for PSA 10-15 ng/mL compared with PSA 2-3 ng/mL. Age was not significantly associated with risk of ISUP 1 cancer. This contrasts to the strong relationship between ISUP ≥ 2 prostate cancer and its respective associations with PSA and age. CONCLUSIONS We find no significant association between the risk of ISUP 1 prostate cancer and PSA and age at diagnosis indicating that PSA contribution from ISUP 1 prostate cancer is closer to that of benign prostate tissue than to that of ISUP ≥ 2 prostate cancer.
Collapse
Affiliation(s)
- Thorgerdur Palsdottir
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Tobias Nordström
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden
| | - Markus Aly
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Urology, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Johan Lindberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mark Clements
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Lars Egevad
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Grönberg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Capio St Görans Sjukhus, Stockholm, Sweden
| | - Martin Eklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
24
|
Trabzonlu L, Kulac I, Zheng Q, Hicks JL, Haffner MC, Nelson WG, Sfanos KS, Ertunc O, Lotan TL, Heaphy CM, Meeker AK, Yegnasubramanian S, De Marzo AM. Molecular Pathology of High-Grade Prostatic Intraepithelial Neoplasia: Challenges and Opportunities. Cold Spring Harb Perspect Med 2019; 9:a030403. [PMID: 30082453 PMCID: PMC6444695 DOI: 10.1101/cshperspect.a030403] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A better understanding of the early stages of prostate cancer initiation, potentially arising from precursor lesions, may fuel development of powerful approaches for prostate cancer prevention or interception. The best-known candidate for such a precursor lesion has been referred to as high-grade prostatic intraepithelial neoplasia (HGPIN). Although there is significant evidence supporting the notion that such HGPIN lesions can give rise to invasive adenocarcinomas of the prostate, there are also numerous complicating considerations and evidence that cloud the picture in many instances. Notably, recent evidence has suggested that some fraction of such lesions that are morphologically consistent with HGPIN may actually be invasive carcinomas masquerading as HGPIN-a state that we term "postinvasive intraepithelial carcinoma" (PIC). Although the prevalence of such PIC lesions is not fully understood, this and other factors can confound the potential of identifying prostate precursors that can be targeted for disease prevention, interception, or treatment. Here, we review our current understanding of the morphological and molecular pathological features of prostate cancer precursor lesions.
Collapse
Affiliation(s)
- Levent Trabzonlu
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
| | - Ibrahim Kulac
- Department of Pathology, Koc University School of Medicine, Istanbul 34010, Turkey
| | - Qizhi Zheng
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
| | - Jessica L Hicks
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
| | - Michael C Haffner
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287
| | - William G Nelson
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287
- The Brady Urological Research Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
| | - Karen S Sfanos
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287
- The Brady Urological Research Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
| | - Onur Ertunc
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
| | - Tamara L Lotan
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287
| | - Christopher M Heaphy
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287
- The Brady Urological Research Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
| | - Alan K Meeker
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287
- The Brady Urological Research Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
| | - Srinivasan Yegnasubramanian
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287
- The Brady Urological Research Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
| | - Angelo M De Marzo
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287
- The Brady Urological Research Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231
| |
Collapse
|
25
|
Freitas DMO, Andriole GL, Castro-Santamaria R, Freedland SJ, Moreira DM. The association of atrophy in baseline prostate biopsy and lower prostate cancer grade in radical prostatectomy specimens. Scand J Urol 2019; 52:328-332. [PMID: 30762450 DOI: 10.1080/21681805.2018.1551244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION To evaluate whether the presence of prostate atrophy (P.A.) in negative prostate biopsy is associated with prostate cancer (P.C.a) grade at surgical pathology among men who are ultimately diagnosed with P.C.a and undergo radical prostatectomy (R.P.). METHODS A retrospective analysis was performed of 136 men from the placebo arm of the Reduction by Dutasteride of P.C.a Events (R.E.D.U.C.E.) trial who had a baseline prostate biopsy negative for P.C.a, and were later diagnosed with P.C.a on biopsy and underwent radical prostatectomy over the 4-year study period. The association of baseline P.A. (present/absent) with P.C.a grade (W.H.O./I.S.U.P. grade group 1 or ≥2) at surgical pathology was evaluated with logistic regression in uni- and multivariable analyses, controlling for baseline patient characteristics. RESULTS P.A. was observed in 74 prostate biopsies (54%). P.A. was not associated with baseline characteristics (age, body mass index, prostate-specific antigen level, prostate volume, race, family history of P.C.a, and digital rectal exam), except for chronic inflammation (p = 0.001). The presence of P.A. in baseline prostate biopsies was associated with lower risk of W.H.O./I.S.U.P. grade group ≥2 P.C.a in R.P. specimens on both univariable (O.R. = 0.39, 95% C.I. = 0.19-0.78, p = 0.008) and multivariable (O.R. = 0.43, 95% C.I. = 0.20-0.92, p = 0.029) analyses. CONCLUSIONS Among men with a baseline prostate biopsy negative for P.C.a who were later found to have P.C.a and underwent R.P., baseline P.A. is independently associated with lower risk of W.H.O./I.S.U.P. grade group ≥2 P.C.a on surgical pathology. P.A. may be used to identify subjects at lower risk for W.H.O./I.S.U.P. ≥ 2 P.C.a and select optimal candidates for active surveillance.
Collapse
Affiliation(s)
- D M O Freitas
- a Department of Urology , Nossa Senhora da Conceição Hospital , Porto Alegre , Brazil
| | - G L Andriole
- b Division of Urologic Surgery , Washington University School of Medicine , St. Louis , M.O. , U.S.A
| | - R Castro-Santamaria
- c GlaxoSmithKline Inc., Global R&D , King of Prussia , Pennsylvania , P.A. , U.S.A
| | - S J Freedland
- d Center for Integrated Research on Cancer and Lifestyle, Samuel Oschin Comprehensive Cancer Institute and the Division of Urology, Department of Surgery , Cedars-Sinai Medical Center , Los Angeles , C.A. , U.S.A.,e Durham V.A. Medical Center , Durham , N.C. , U.S.A
| | - D M Moreira
- f Department of Urology , University of Illinois at Chicago , Chicago , I.L., U.S.A
| |
Collapse
|
26
|
Lis-Święty A, Arasiewicz H, Ranosz-Janicka I, Brzezińska-Wcisło L. Serum androgens and prostate-specific antigen levels in androgenetic alopecia: is there a difference between frontal and vertex baldness? J Eur Acad Dermatol Venereol 2018; 32:1815-1818. [DOI: 10.1111/jdv.14758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 12/04/2017] [Indexed: 11/29/2022]
Affiliation(s)
- A. Lis-Święty
- Department of Dermatology; School of Medicine in Katowice; Medical University of Silesia; Katowice Poland
| | - H. Arasiewicz
- Department of Dermatology; School of Medicine in Katowice; Medical University of Silesia; Katowice Poland
| | - I. Ranosz-Janicka
- Department of Dermatology; School of Medicine in Katowice; Medical University of Silesia; Katowice Poland
| | - L. Brzezińska-Wcisło
- Department of Dermatology; School of Medicine in Katowice; Medical University of Silesia; Katowice Poland
| |
Collapse
|
27
|
Eure G, Fanney D, Lin J, Wodlinger B, Ghai S. Comparison of conventional transrectal ultrasound, magnetic resonance imaging, and micro-ultrasound for visualizing prostate cancer in an active surveillance population: A feasibility study. Can Urol Assoc J 2018; 13:E70-E77. [PMID: 30169149 DOI: 10.5489/cuaj.5361] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Active surveillance monitoring of prostate cancer is unique in that most patients have low-grade disease that is not well-visualized by any common imaging technique. High-resolution (29 MHz) micro-ultrasound is a new, real-time modality that has been demonstrated to be sensitive to significant prostate cancer and effective for biopsy targeting. This study compares micro-ultrasound imaging with magnetic resonance imaging (MRI) and conventional ultrasound for visualizing prostate cancer in active surveillance. METHODS Nine patients on active surveillance were imaged with multiparametric (mp) MRI prior to biopsy. During the biopsy procedure, imaging and target identification was first performed using conventional ultrasound, then using micro-ultrasound. The mpMRI report was then unblinded and used to determine cognitive fusion targets. Using micro-ultrasound, biopsy samples were taken from targets in each modality, plus 12 systematic samples. RESULTS mpMRI and micro-ultrasound both demonstrated superior sensitivity to Gleason sum 7 or higher cancer compared to conventional ultrasound (p=0.02 McNemar's test). Micro-ultrasound detected 89% of clinically significant cancer, compared to 56% for mpMRI. CONCLUSIONS Micro-ultrasound may provide similar sensitivity to clinically significant prostate cancer as mpMRI and visualize all significant mpMRI targets. Unlike mpMRI, micro-ultrasound is performed in the office, in real-time during the biopsy procedure, and so is expected to maintain the cost-effectiveness of conventional ultrasound. Larger studies are needed before these results may be applied in a clinical setting.
Collapse
Affiliation(s)
- Gregg Eure
- Urology of Virginia, Virginia Beach, VA, United States
| | - Daryl Fanney
- MRI & CT Diagnostics, Virginia Beach, VA, United States
| | - Jefferson Lin
- Urology of Virginia, Virginia Beach, VA, United States
| | | | - Sangeet Ghai
- Joint Department of Medical Imaging, University of Toronto, University Health Network-Mount Sinai Hospital-Women's College Hospital, Toronto General Hospital, Toronto, ON, Canada
| |
Collapse
|
28
|
Alimujiang A, Colditz GA, Gardner JD, Park Y, Berkey CS, Sutcliffe S. Childhood diet and growth in boys in relation to timing of puberty and adult height: the Longitudinal Studies of Child Health and Development. Cancer Causes Control 2018; 29:915-926. [PMID: 30109531 DOI: 10.1007/s10552-018-1068-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 08/03/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE To begin to explore the possible roles of childhood diet and growth in prostate cancer (PCa) development, we investigated these exposures in relation to two known/suspected PCa risk factors, earlier pubertal timing and greater attained height, in the Longitudinal Studies of Child Health and Development. METHODS We used biannual/annual height, weight, and dietary history data to investigate childhood diet, body mass index (BMI), birth length, and childhood height in relation to PCa risk factors (age at peak height velocity (APHV), height at age 13, and adult height) for 64 Caucasian American boys. RESULTS In adjusted models, childhood fat and animal protein intake was positively associated with height at age 13 and adult height (P < 0.05). A childhood diet high in fat and animal protein and low in vegetable protein was also associated with earlier APHV (P < 0.05), whereas no associations were observed for childhood energy intake or BMI. Birth length and childhood height were positively associated with height at age 13 and adult height, and childhood height was inversely associated with APHV (P < 0.05). CONCLUSION Our findings suggest that both childhood diet and growth potential/growth contribute to earlier pubertal timing and taller attained height in males, supporting roles of these factors in PCa development.
Collapse
Affiliation(s)
- Aliya Alimujiang
- Division of Public Health Sciences and the Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Graham A Colditz
- Division of Public Health Sciences and the Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
| | | | - Yikyung Park
- Division of Public Health Sciences and the Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
| | - Catherine S Berkey
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Siobhan Sutcliffe
- Division of Public Health Sciences and the Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA.
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 600 S. Taylor Avenue, 2nd floor, Rm. 208S, Box 8100, St Louis, MO, 63110, USA.
| |
Collapse
|
29
|
Srirangam V, Rai BP, Abroaf A, Agarwal S, Tadtayev S, Foley C, Lane T, Adshead J, Vasdev N. Atypical Small Acinar Proliferation and High Grade Prostatic Intraepithelial Neoplasia: Should We Be Concerned? An Observational Cohort Study with a Minimum Follow-Up of 3 Years. Curr Urol 2017; 10:199-205. [PMID: 29234263 DOI: 10.1159/000447181] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 01/24/2017] [Indexed: 12/18/2022] Open
Abstract
Introduction Atypical small acinar proliferation (ASAP) and high grade prostatic intraepithelial neoplasia (HGPIN) are considered precancerous. We aimed to measure the rate of repeat biopsy and adenocarcinoma in patients with ASAP and HGPIN and identify any clinico-pathologic parameters at diagnosis of ASAP/HGPIN that are predictive of adenocarcinoma. Materials and Methods Patients with a diagnosis of ASAP/HGPIN with no previous or concomitant cancer were identified. Prostate specific antigen (PSA) and magnetic resonance imaging (MRI) changes were monitored. Re-biopsy was at clinician discretion. Results Nineteen were diagnosed with ASAP and 17 with HGPIN. Seven with ASAP (37%) and 6 with HGPIN (35%) underwent re-biopsy. Three (16%) with ASAP and 5 with HGPIN (29%) were diagnosed with adenocarcinoma. The difference in cancer detection rates between ASAP and HGPIN was not significant (p = 0.35). Five (14%) in total required definitive therapy for adenocarcinoma. Twenty-three (64%) did not undergo repeat biopsy. Parameters at diagnosis of HGPIN and ASAP, including PSA, prostate volume and PSA density, were compared between the cancer and non-cancer cohorts with none found to be predictive of adenocarcinoma. Conclusion By monitoring PSA and MRI changes, we managed to spare re-biopsy in two-thirds of patients. Further evaluation is necessary to characterize a surveillance protocol in these populations.
Collapse
Affiliation(s)
| | - Bhavan Prasad Rai
- Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK
| | - Ahmed Abroaf
- Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK
| | | | - Sergey Tadtayev
- Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK
| | - Charlotte Foley
- Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK
| | - Tim Lane
- Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK
| | - Jim Adshead
- Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK
| | - Nikhil Vasdev
- Hertfordshire and South Bedfordshire Urological Cancer Centre, Department of Urology, Lister Hospital, Stevenage, UK
| |
Collapse
|
30
|
Pabisiak K, Ostrowski M, Kram A, Safranow K, Słojewski M, Ciechanowski K. Prostate Specific Antigen–Positive Deceased Organ Donor: A Pathologist Is Indispensable. Transplant Proc 2016; 48:2450-2453. [DOI: 10.1016/j.transproceed.2015.12.142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 12/30/2015] [Indexed: 10/20/2022]
|
31
|
Pabisiak K, Ostrowski M, Kram A, Safranow K, Myślak M, Sieńko J, Sulikowski T, Ciechanowski K. Prostate-Specific Antigen. Transplant Proc 2016; 48:1374-7. [DOI: 10.1016/j.transproceed.2016.01.092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 01/21/2016] [Indexed: 11/26/2022]
|
32
|
De Marzo AM, Haffner MC, Lotan TL, Yegnasubramanian S, Nelson WG. Premalignancy in Prostate Cancer: Rethinking What we Know. Cancer Prev Res (Phila) 2016; 9:648-56. [PMID: 26813971 DOI: 10.1158/1940-6207.capr-15-0431] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 01/18/2016] [Indexed: 11/16/2022]
Abstract
High-grade prostatic intraepithelial neoplasia (PIN) has been accepted as the main precursor lesion to invasive adenocarcinoma of the prostate, and this is likely to be the case. However, in an unknown number of cases, lesions fulfilling the diagnostic criteria for high-grade PIN may actually represent intra-acinar or intraductal spread of invasive carcinoma. Intriguingly, this possibility would not contradict many of the findings of previous epidemiologic studies linking high-grade PIN to carcinoma or molecular pathologic studies showing similar genomic (e.g., TMPRSS2-ERG gene fusion) as well as epigenomic and molecular phenotypic alterations between high-grade PIN and carcinoma. Also, this possibility would be consistent with previous anatomic studies in prostate specimens linking high-grade PIN and carcinoma in autopsy and other whole prostate specimens. In addition, if some cases meeting morphologic criteria for PIN actually represent intra-acinar spread of invasive carcinoma, this could be an important potential confounder of the interpretation of past clinical trials enrolling patients presumed to be without carcinoma, who are at high risk of invasive carcinoma. Thus, in order to reduce possible bias in future study/trial designs, novel molecular pathology approaches are needed to decipher when an apparent PIN lesion may be intra-acinar/intra-ductal spread of an invasive cancer and when it truly represents a precursor state. Similar approaches are needed for lesions known as intraductal carcinoma to facilitate better classification of them as true intra-ductal/acinar spread on one hand or as precursor high-grade PIN (cribriform type) on the other hand; a number of such molecular approaches (e.g., coevaluating TMPRSS-ERG fusion and PTEN loss) are already showing excellent promise. Cancer Prev Res; 9(8); 648-56. ©2016 AACR.
Collapse
Affiliation(s)
- Angelo M De Marzo
- Departments of Pathology Oncology Urology The Johns Hopkins University School of Medicine, The Sidney Kimmel Comprehensive Cancer Center The Brady Urological Research Institute at Johns Hopkins, Johns Hopkins University, Baltimore, MD.
| | - Michael C Haffner
- Departments of Pathology Oncology The Johns Hopkins University School of Medicine, The Sidney Kimmel Comprehensive Cancer Center
| | - Tamara L Lotan
- Departments of Pathology Oncology Urology The Johns Hopkins University School of Medicine, The Sidney Kimmel Comprehensive Cancer Center The Brady Urological Research Institute at Johns Hopkins, Johns Hopkins University, Baltimore, MD
| | - Srinivasan Yegnasubramanian
- Departments of Pathology Oncology Urology The Johns Hopkins University School of Medicine, The Sidney Kimmel Comprehensive Cancer Center The Brady Urological Research Institute at Johns Hopkins, Johns Hopkins University, Baltimore, MD
| | - William G Nelson
- Departments of Pathology Oncology Urology The Johns Hopkins University School of Medicine, The Sidney Kimmel Comprehensive Cancer Center The Brady Urological Research Institute at Johns Hopkins, Johns Hopkins University, Baltimore, MD
| |
Collapse
|
33
|
Jahn JL, Giovannucci EL, Stampfer MJ. The high prevalence of undiagnosed prostate cancer at autopsy: implications for epidemiology and treatment of prostate cancer in the Prostate-specific Antigen-era. Int J Cancer 2015; 137:2795-802. [PMID: 25557753 PMCID: PMC4485977 DOI: 10.1002/ijc.29408] [Citation(s) in RCA: 128] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 11/19/2014] [Indexed: 11/06/2022]
Abstract
Widespread prostate-specific antigen (PSA) screening detects many cancers that would have otherwise gone undiagnosed. To estimate the prevalence of unsuspected prostate cancer, we reviewed 19 studies of prostate cancer discovered at autopsy among 6,024 men. Among men aged 70-79, tumor was found in 36% of Caucasians and 51% of African-Americans. This enormous prevalence, coupled with the high sensitivity of PSA screening, has led to the marked increase in the apparent incidence of prostate cancer. The impact of PSA screening on clinical practice is well-recognized, but its effect on epidemiologic research is less appreciated. Before screening, a larger proportion of incident prostate cancers had lethal potential and were diagnosed at advanced stage. However, in the PSA era, overall incident prostate cancer mainly is indolent disease, and often reflects the propensity to be screened and biopsied. Studies must therefore focus on cancers with lethal potential, and include long follow-up to accommodate the lead time induced by screening. Moreover, risk factor patterns differ markedly for potentially lethal and indolent disease, suggesting separate etiologies and distinct disease entities. Studies of total incident or indolent prostate cancer are of limited clinical utility, and the main focus of research should be on prostate cancers of lethal potential.
Collapse
Affiliation(s)
- Jaquelyn L Jahn
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA
| | - Edward L Giovannucci
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
- Department of Nutrition, Harvard School of Public Health, Boston, MA
| | - Meir J Stampfer
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Department of Epidemiology, Harvard School of Public Health, Boston, MA
- Department of Nutrition, Harvard School of Public Health, Boston, MA
| |
Collapse
|
34
|
Angulo J, Viñas M, Gimbernat H, Fata FRD, Granados R, Luján M. Baseline PSA in a Spanish male population aged 40-49 years anticipates detection of prostate cancer. Actas Urol Esp 2015; 39:605-11. [PMID: 26099906 DOI: 10.1016/j.acuro.2015.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 05/04/2015] [Accepted: 05/05/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION We researched the usefulness of optimizing prostate cancer (PC) screening in our community using baseline PSA readings in men between 40-49 years of age. MATERIAL AND METHOD A retrospective study was performed that analyzed baseline PSA in the fifth decade of life and its ability to predict the development of PC in a population of Madrid (Spain). An ROC curve was created and a cutoff was proposed. We compared the evolution of PSA from baseline in patients with consecutive readings using the Friedman test. We established baseline PSA ranges with different risks of developing cancer and assessed the diagnostic utility of the annual PSA velocity (PSAV) in this population. RESULTS Some 4,304 men aged 40-49 years underwent opportunistic screening over the course of 17 years, with at least one serum PSA reading (6,001 readings) and a mean follow-up of 57.1±36.8 months. Of these, 768 underwent biopsy of some organ, and 104 underwent prostate biopsy. Fourteen patients (.33%) were diagnosed with prostate cancer. The median baseline PSA was .74 (.01-58.5) ng/mL for patients without PC and 4.21 (.76-47.4) ng/mL for those with PC. The median time from the reading to diagnosis was 26.8 (1.5-143.8) months. The optimal cutoff for detecting PC was 1.9ng/mL (sensitivity, 92.86%; specificity, 92.54%; PPV, 3.9%; NPV, 99.97%), and the area under the curve was 92.8%. In terms of the repeated reading, the evolution of the PSA showed no statistically significant differences between the patients without cancer (p=.56) and those with cancer (P=.64). However, a PSAV value >.3ng/mL/year revealed high specificity for detecting cancer in this population. CONCLUSIONS A baseline PSA level ≥1.9ng/mL in Spanish men aged 40-49 years predicted the development of PC. This value could therefore be of use for opportunistic screening at an early age. An appropriate follow-up adapted to the risk of this population needs to be defined, but an annual PSAV ≥.3ng/mL/year appears of use for reaching an early diagnosis.
Collapse
|
35
|
Monn MF, Tatem AJ, Cheng L. Prevalence and management of prostate cancer among East Asian men: Current trends and future perspectives. Urol Oncol 2015; 34:58.e1-9. [PMID: 26493449 DOI: 10.1016/j.urolonc.2015.09.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/08/2015] [Accepted: 09/11/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Previously East Asian men had been considered less likely to develop or die of prostate cancer. Emerging research and the onset of prostate-specific antigen screening in East Asian countries suggests that this may not be the case. We sought to analyze epidemiology and molecular genetic data and recent trends in the management of prostate cancer among East Asian men. METHODS AND MATERIALS We performed literature searches using PubMed, Embase, and Google Scholar to examine current literature on prostate cancer in East Asian men. Additionally, articles were searched for further references related to the topic. RESULTS Recent studies have reported increasing incidence of prostate cancer identified in East Asian men. Prostate cancer mortality has increased and is currently the fourth leading cause of death among men in Shanghai, China. Although prostate cancer was considered less aggressive among East Asian men, studies suggest that it is similarly aggressive to prostate cancer in Western populations. Molecular markers such as the TEMPRESS:ERG fusion gene and PTEN loss may provide novel methods of screening East Asian men for prostate cancer. National-level guidelines for prostate cancer screening and management are only available in Japan. CONCLUSIONS The prevalence of prostate cancer in East Asian men is likely similar to that in Western male populations. East Asian men present at higher stages of prostate cancer, likely because of a lack of standardized screening protocols. Urologists in Western countries should screen East Asian men for prostate cancer using the same standards as used for Western men.
Collapse
Affiliation(s)
- M Francesca Monn
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN
| | - Alexander J Tatem
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN
| | - Liang Cheng
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN; Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN.
| |
Collapse
|
36
|
Albini A, Cavuto S, Apolone G, Noonan DM. Strategies to Prevent "Bad Luck" in Cancer. J Natl Cancer Inst 2015; 107:djv213. [PMID: 26242894 PMCID: PMC4605730 DOI: 10.1093/jnci/djv213] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 07/10/2015] [Indexed: 12/16/2022] Open
Abstract
It is impossible to predict exactly who will develop a cancer and who will not. We know that several “risk factors” may increase the chance of getting cancer and that risk increases with age. However, even with that in mind we seem to be able to explain only a certain number of cancers. Recently, Tomasetti and Vogelstein published a provocative article in Science stating that a large percentage of cancers may be due to “bad luck” (stochastic mutation events during DNA replication) and only a few to carcinogens, pathogens, or inherited genes and that this should impact public health policies. However, their intriguing analysis has numerous limitations, some of which have already been commented upon, including the likely biased subset of cancers and that finding a correlation does not signify a cause-effect mechanism. Here, we point out that there may also be an alternative explanation for the data, the cancer stem cell hypothesis, which postulates that cancers are derived from tissue stem cells and not from somatic differentiated cells. We also highlight the importance of the tissue microenvironment in the growth of transformed cells and outline a table of concurrent factors for several cancers. The message communicated to the public should not be one of helplessness in avoiding cancers, particularly given the now extensive knowledge of known risk factors and several agents/behaviors that can lower risk for specific cancers. While some tumors will still be due to chance, prevention should still be a primary goal for public health policies.
Collapse
Affiliation(s)
- Adriana Albini
- IRCCS-Arcispedale Santa Maria Nuova in Reggio Emilia, Italy (AA, SC, GA); Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy (DMN); Science and Technology Center, IRCCS MultiMedica, Milano, Italy (DMN).
| | - Silvio Cavuto
- IRCCS-Arcispedale Santa Maria Nuova in Reggio Emilia, Italy (AA, SC, GA); Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy (DMN); Science and Technology Center, IRCCS MultiMedica, Milano, Italy (DMN)
| | - Giovanni Apolone
- IRCCS-Arcispedale Santa Maria Nuova in Reggio Emilia, Italy (AA, SC, GA); Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy (DMN); Science and Technology Center, IRCCS MultiMedica, Milano, Italy (DMN)
| | - Douglas M Noonan
- IRCCS-Arcispedale Santa Maria Nuova in Reggio Emilia, Italy (AA, SC, GA); Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy (DMN); Science and Technology Center, IRCCS MultiMedica, Milano, Italy (DMN)
| |
Collapse
|
37
|
Location of Prostate Cancers Determined by Multiparametric and MRI-Guided Biopsy in Patients With Elevated Prostate-Specific Antigen Level and at Least One Negative Transrectal Ultrasound–Guided Biopsy. AJR Am J Roentgenol 2015; 205:57-63. [DOI: 10.2214/ajr.14.12960] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
38
|
Renal donors with prostate cancer, no longer a reason to decline. Transplant Rev (Orlando) 2015; 30:48-50. [PMID: 26275676 DOI: 10.1016/j.trre.2015.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 06/14/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To fully assess the true risk of prostate cancer transmission in during renal transplantation. METHODS A full review of all existing literature relevant to the topic. RESULTS There has not been a single documented case of transmission of prostate cancer during renal transplant. Prostate cancer in deceased organ donors has an incidence estimated between 3% and 18.5% and over 100 transplants have been performed using organs from donor with proven prostate cancer without issue. CONCLUSION Transmission of prostate cancer through kidney transplantation seems very unlikely. The risks of remaining on the waiting list are outweighed by a transmission risk and the potential benefit makes the case to have clear guidelines about donor prostate malignancy when accepting potential organs.
Collapse
|
39
|
Kido M, Hitosugi M, Ishii K, Kamimura S, Joh K. Latent prostate cancer in Japanese men who die unnatural deaths: A forensic autopsy study. Prostate 2015; 75:917-22. [PMID: 25728717 DOI: 10.1002/pros.22975] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 01/09/2015] [Indexed: 11/11/2022]
Abstract
BACKGROUND An accurate natural history of prostate cancer (PC) can be obtained from forensic autopsies of individuals who had performed their normal daily activities immediately before death and had not undergone long-term medical interventions. A retrospective analysis of such individuals was performed to understand the features of latent PC in Japan. METHODS The findings of forensic autopsies performed at Dokkyo Medical University from August 2002 to July 2005 on men without severely destroyed or severely decomposed tissues were collected. Two cross sections, at the base and apex of the prostate, were examined histopathologically. Data collected included basic history, cause of death, location of PC, and Gleason score. RESULTS Of 196 forensically autopsied males aged 0-90 years, 24 (12.7%) had latent PC. When analyzed by age group, PC was most prevalent among individuals in their eighties (33.3%). The prevalence of PC was similar in males who died of disease and of external causes. Most PCs were located at the base of the prostate, but were present on both the anterior and posterior sides. Nine of the 24 autopsied individuals also had other diseases, with three having cancers other than PC. CONCLUSIONS This is the first report of the features of latent PC in Asian men who died of unnatural causes. Forensic autopsies can clarify the natural history of PC and may help fill knowledge gaps regarding latent PC.
Collapse
Affiliation(s)
- Masahito Kido
- Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | | | | | | | | |
Collapse
|
40
|
Mühlberger N, Kurzthaler C, Iskandar R, Krahn MD, Bremner KE, Oberaigner W, Klocker H, Horninger W, Conrads-Frank A, Sroczynski G, Siebert U. The ONCOTYROL Prostate Cancer Outcome and Policy Model: Effect of Prevalence Assumptions on the Benefit-Harm Balance of Screening. Med Decis Making 2015; 35:758-72. [PMID: 25977360 DOI: 10.1177/0272989x15585114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 04/06/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND The ONCOTYROL Prostate Cancer Outcome and Policy (PCOP) model is a state-transition microsimulation model evaluating the benefits and harms of prostate cancer (PCa) screening. The natural history and detection component of the original model was based on the 2003 version of the Erasmus MIcrosimulation SCreening ANalysis (MISCAN) model, which was not calibrated to prevalence data. Compared with data from autopsy studies, prevalence of latent PCa assumed by the original model is low, which may bias the model toward screening. Our objective was to recalibrate the original model to match prevalence data from autopsy studies as well and compare benefit-harm predictions of the 2 model versions differing in prevalence. METHODS For recalibration, we reprogrammed the natural history and detection component of the PCOP model as a deterministic Markov state-transition cohort model in the statistical software package R. All parameters were implemented as variables or time-dependent functions and calibrated simultaneously in a single run. Observed data used as calibration targets included data from autopsy studies, cancer registries, and the European Randomized Study of Screening for Prostate Cancer. Compared models were identical except for calibrated parameters. RESULTS We calibrated 46 parameters. Prevalence from autopsy studies could not be fitted using the original parameter set. Additional parameters, allowing for interruption of disease progression and age-dependent screening sensitivities, were needed. Recalibration to higher prevalence demonstrated a considerable increase of overdiagnosis and decline of screening sensitivity, which significantly worsened the benefit-harm balance of screening. CONCLUSIONS Our calibration suggests that not all cancers are at risk of progression, and screening sensitivity may be lower at older ages. PCa screening models that use calibration to simulate disease progression in the unobservable latent phase are highly sensitive to prevalence assumptions.
Collapse
Affiliation(s)
- Nikolai Mühlberger
- Department of Public Health and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Tyrol, Austria (NM, CK, RI, ACF, GS, US),Division of Health Technology Assessment and Bioinformatics, ONCOTYROL-Center for Personalized Cancer Medicine, Innsbruck, Austria (NM, CK, RI, ACF, GS, US)
| | - Christina Kurzthaler
- Department of Public Health and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Tyrol, Austria (NM, CK, RI, ACF, GS, US),Division of Health Technology Assessment and Bioinformatics, ONCOTYROL-Center for Personalized Cancer Medicine, Innsbruck, Austria (NM, CK, RI, ACF, GS, US)
| | - Rowan Iskandar
- Department of Public Health and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Tyrol, Austria (NM, CK, RI, ACF, GS, US),Division of Health Technology Assessment and Bioinformatics, ONCOTYROL-Center for Personalized Cancer Medicine, Innsbruck, Austria (NM, CK, RI, ACF, GS, US),Department of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA (RI)
| | - Murray D Krahn
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University of Toronto, Toronto, Ontario, Canada (MDK),Toronto General Research Institute, Toronto General Hospital, Toronto, Ontario, Canada (MDK, KEB)
| | - Karen E Bremner
- Toronto General Research Institute, Toronto General Hospital, Toronto, Ontario, Canada (MDK, KEB)
| | | | - Helmut Klocker
- Department of Urology, Innsbruck Medical University, Innsbruck, Austria (HK, WH)
| | - Wolfgang Horninger
- Department of Urology, Innsbruck Medical University, Innsbruck, Austria (HK, WH)
| | - Annette Conrads-Frank
- Department of Public Health and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Tyrol, Austria (NM, CK, RI, ACF, GS, US),Division of Health Technology Assessment and Bioinformatics, ONCOTYROL-Center for Personalized Cancer Medicine, Innsbruck, Austria (NM, CK, RI, ACF, GS, US)
| | - Gaby Sroczynski
- Department of Public Health and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Tyrol, Austria (NM, CK, RI, ACF, GS, US),Division of Health Technology Assessment and Bioinformatics, ONCOTYROL-Center for Personalized Cancer Medicine, Innsbruck, Austria (NM, CK, RI, ACF, GS, US)
| | - Uwe Siebert
- Department of Public Health and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Tyrol, Austria (NM, CK, RI, ACF, GS, US),Division of Health Technology Assessment and Bioinformatics, ONCOTYROL-Center for Personalized Cancer Medicine, Innsbruck, Austria (NM, CK, RI, ACF, GS, US),Center for Health Decision Science, Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA (US),Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA (US)
| |
Collapse
|
41
|
Bowen C, Zheng T, Gelmann EP. NKX3.1 Suppresses TMPRSS2-ERG Gene Rearrangement and Mediates Repair of Androgen Receptor-Induced DNA Damage. Cancer Res 2015; 75:2686-98. [PMID: 25977336 DOI: 10.1158/0008-5472.can-14-3387] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 04/17/2015] [Indexed: 02/02/2023]
Abstract
TMPRSS2 gene rearrangements occur at DNA breaks formed during androgen receptor-mediated transcription and activate expression of ETS transcription factors at the early stages of more than half of prostate cancers. NKX3.1, a prostate tumor suppressor that accelerates the DNA repair response, binds to androgen receptor at the ERG gene breakpoint and inhibits both the juxtaposition of the TMPRSS2 and ERG gene loci and also their recombination. NKX3.1 acts by accelerating DNA repair after androgen-induced transcriptional activation. NKX3.1 influences the recruitment of proteins that promote homology-directed DNA repair. Loss of NKX3.1 favors recruitment to the ERG gene breakpoint of proteins that promote error-prone nonhomologous end-joining. Analysis of prostate cancer tissues showed that the presence of a TMPRSS2-ERG rearrangement was highly correlated with lower levels of NKX3.1 expression consistent with the role of NKX3.1 as a suppressor of the pathogenic gene rearrangement.
Collapse
Affiliation(s)
- Cai Bowen
- Department of Medicine, Columbia University, Herbert Irving Comprehensive Cancer Center, New York, New York
| | - Tian Zheng
- Department of Statistics, Columbia University, Herbert Irving Comprehensive Cancer Center, New York, New York
| | - Edward P Gelmann
- Department of Medicine, Columbia University, Herbert Irving Comprehensive Cancer Center, New York, New York. Department of Pathology, Columbia University, Herbert Irving Comprehensive Cancer Center, New York, New York.
| |
Collapse
|
42
|
Seal LJ. A review of the physical and metabolic effects of cross-sex hormonal therapy in the treatment of gender dysphoria. Ann Clin Biochem 2015; 53:10-20. [PMID: 25933804 DOI: 10.1177/0004563215587763] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2015] [Indexed: 11/17/2022]
Abstract
This review focuses on the effect that cross-gender sex steroid therapy has on metabolic and hormonal parameters. There is an emphasis on those changes that result in significant clinical effects such as the positive effects of the development of secondary sexual characteristics and negative effects such as haemostatic effects and thromboembolism in transwomen or dyslipidaemia in transmen. There is also a description of the current hormonal regimens used at the largest UK gender identity clinic. The overall safety of these treatments in the context of long-term outcome data is reviewed.
Collapse
Affiliation(s)
- Leighton J Seal
- St George's Hospital Medical School, London, UK St George's Healthcare NHS Trust, London, UK West London Mental Health NHS Trust Gender Identity Clinic West London Mental Health NHS Trust, London, UK
| |
Collapse
|
43
|
Bell KJL, Del Mar C, Wright G, Dickinson J, Glasziou P. Prevalence of incidental prostate cancer: A systematic review of autopsy studies. Int J Cancer 2015; 137:1749-57. [PMID: 25821151 PMCID: PMC4682465 DOI: 10.1002/ijc.29538] [Citation(s) in RCA: 215] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 02/17/2015] [Indexed: 12/13/2022]
Abstract
Prostate cancer screening may detect nonprogressive cancers, leading to overdiagnosis and overtreatment. The potential for overdiagnosis can be assessed from the reservoir of prostate cancer in autopsy studies that report incidental prostate cancer rates in men who died of other causes. We aimed to estimate the age-specific incidental cancer prevalence from all published autopsy studies. We identified eligible studies by searches of Medline and Embase, forward and backward citation searches and contacting authors. We screened the titles and abstracts of all articles; checked the full-text articles for eligibility and extracted clinical and pathology data using standardized forms. We extracted mean cancer prevalence, age-specific cancer prevalence and validity measures and then pooled data from all studies using logistic regression models with random effects. The 29 studies included in the review dated from 1948 to 2013. Incidental cancer was detected in all populations, with no obvious time trends in prevalence. Prostate cancer prevalence increased with each decade of age, OR = 1.7 (1.6–1.8), and was higher in studies that used the Gleason score, OR = 2.0 (1.1–3.7). No other factors were significantly predictive. The estimated mean cancer prevalence increased in a nonlinear fashion from 5% (95% CI: 3–8%) at age <30 years to 59% (95% CI: 48–71%) by age >79 years. There was substantial variation between populations in estimated cancer prevalence. There is a substantial reservoir of incidental prostate cancer which increases with age. The high risk of overdiagnosis limits the usefulness of prostate cancer screening.
Collapse
Affiliation(s)
- Katy J L Bell
- Centre for Research in Evidence Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia.,Screening and Diagnostic Test Evaluation Program (STEP), School of Public Health, University of Sydney
| | - Chris Del Mar
- Centre for Research in Evidence Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia
| | - Gordon Wright
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia
| | - James Dickinson
- Department of Family Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
| | - Paul Glasziou
- Centre for Research in Evidence Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia
| |
Collapse
|
44
|
Hussein S, Satturwar S, Van der Kwast T. Young-age prostate cancer. J Clin Pathol 2015; 68:511-5. [DOI: 10.1136/jclinpath-2015-202993] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 03/05/2015] [Indexed: 12/14/2022]
|
45
|
Saffarini CM, McDonnell-Clark EV, Amin A, Huse SM, Boekelheide K. Developmental exposure to estrogen alters differentiation and epigenetic programming in a human fetal prostate xenograft model. PLoS One 2015; 10:e0122290. [PMID: 25799167 PMCID: PMC4370592 DOI: 10.1371/journal.pone.0122290] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 02/10/2015] [Indexed: 11/29/2022] Open
Abstract
Prostate cancer is the most frequent non-cutaneous malignancy in men. There is strong evidence in rodents that neonatal estrogen exposure plays a role in the development of this disease. However, there is little information regarding the effects of estrogen in human fetal prostate tissue. This study explored early life estrogen exposure, with and without a secondary estrogen and testosterone treatment in a human fetal prostate xenograft model. Histopathological lesions, proliferation, and serum hormone levels were evaluated at 7, 30, 90, and 200-day time-points after xenografting. The expression of 40 key genes involved in prostatic glandular and stromal growth, cell-cycle progression, apoptosis, hormone receptors and tumor suppressors was evaluated using a custom PCR array. Epigenome-wide analysis of DNA methylation was performed on whole tissue, and laser capture-microdissection (LCM) isolated epithelial and stromal compartments of 200-day prostate xenografts. Combined initial plus secondary estrogenic exposures had the most severe tissue changes as revealed by the presence of hyperplastic glands at day 200. Gene expression changes corresponded with the cellular events in the KEGG prostate cancer pathway, indicating that initial plus secondary exposure to estrogen altered the PI3K-Akt signaling pathway, ultimately resulting in apoptosis inhibition and an increase in cell cycle progression. DNA methylation revealed that differentially methylated CpG sites significantly predominate in the stromal compartment as a result of estrogen-treatment, thereby providing new targets for future investigation. By using human fetal prostate tissue and eliminating the need for species extrapolation, this study provides novel insights into the gene expression and epigenetic effects related to prostate carcinogenesis following early life estrogen exposure.
Collapse
Affiliation(s)
- Camelia M. Saffarini
- Department of Pathology and Laboratory Medicine, Brown University, Providence, Rhode Island, United States of America
| | - Elizabeth V. McDonnell-Clark
- Department of Pathology and Laboratory Medicine, Brown University, Providence, Rhode Island, United States of America
| | - Ali Amin
- Department of Pathology and Laboratory Medicine, Brown University, Providence, Rhode Island, United States of America
- Department of Pathology and Laboratory Medicine, Rhode Island Hospital, Providence, Rhode Island, United States of America
| | - Susan M. Huse
- Department of Pathology and Laboratory Medicine, Brown University, Providence, Rhode Island, United States of America
| | - Kim Boekelheide
- Department of Pathology and Laboratory Medicine, Brown University, Providence, Rhode Island, United States of America
- * E-mail:
| |
Collapse
|
46
|
Singh A, Cheedella NKS, Shakil SA, Gulmi F, Kim DS, Wang JC. Liver Metastases in Prostate Carcinoma Represent a Relatively Aggressive Subtype Refractory to Hormonal Therapy and Short-Duration Response to Docetaxel Monotherapy. World J Oncol 2015; 6:265-269. [PMID: 29147414 PMCID: PMC5649944 DOI: 10.14740/wjon903w] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND We report a single institution's experience from a small series of patients suggesting that liver metastasis in metastatic castration-refractory prostate cancer (mCRPC) represents a relatively aggressive subtype that is refractory to hormonal manipulation treatment, including luteinizing hormone-releasing hormone agonist (LA) and abiraterone (Ab) therapy, although docetaxel is briefly effective. METHODS Between 2007 and 2013, six patients with prostate cancer with liver metastases were analyzed. Biochemical response was defined as > 50% decrease in prostate-specific antigen (PSA) value. RESULTS Two patients who presented with liver metastases died in less than 3 months after LA therapy. Two out of three patients (one died while receiving chemotherapy) received Ab after chemotherapy did not show any response and died while on therapy. One patient who presented with lung metastases initially received LA therapy and progressed on it with liver metastases in < 6 months. Thus, five of six patients did not respond to hormone therapy including LA and Ab. Three patients who received docetaxel after LA therapy had more than 50% objective PSA response with a mean survival of 4 months. CONCLUSIONS No literature addresses the response to hormone treatment in hepatic metastasis in prostate carcinoma. This small series suggests that liver metastases in prostate carcinoma represent a relatively aggressive subset against which hormonal therapy, including the LA and Ab, appears to be ineffective. Although our patients responded to docetaxel chemotherapy, their responses were of short duration. A further clinical trial involving more patients will be necessary to substantiate our findings.
Collapse
Affiliation(s)
- Arsh Singh
- Division of Hematology/Oncology, Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Naga K. S. Cheedella
- Division of Hematology/Oncology, Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Shams A. Shakil
- Division of Hematology/Oncology, Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Frederick Gulmi
- Department of Urology, Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Dong-Sung Kim
- Department of Pathology, Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Jen C. Wang
- Division of Hematology/Oncology, Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| |
Collapse
|
47
|
Zhou CK, Pfeiffer RM, Cleary SD, Hoffman HJ, Levine PH, Chu LW, Hsing AW, Cook MB. Relationship between male pattern baldness and the risk of aggressive prostate cancer: an analysis of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. J Clin Oncol 2014; 33:419-25. [PMID: 25225425 DOI: 10.1200/jco.2014.55.4279] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Male pattern baldness and prostate cancer appear to share common pathophysiologic mechanisms. However, results from previous studies that assess their relationship have been inconsistent. Therefore, we investigated the association of male pattern baldness at age 45 years with risks of overall and subtypes of prostate cancer in a large, prospective cohort—the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. METHODS We included 39,070 men from the usual care and screening arms of the trial cohort who had no cancer diagnosis (excluding nonmelanoma skin cancer) at the start of follow-up and recalled their hair-loss patterns at age 45 years. Hazard ratios (HRs) and 95% CIs were estimated by using Cox proportional hazards regression models with age as the time metric. RESULTS During follow-up (median, 2.78 years), 1,138 incident prostate cancer cases were diagnosed, 571 of which were aggressive (biopsy Gleason score ≥ 7, and/or clinical stage III or greater, and/or fatal). Compared with no baldness, frontal plus moderate vertex baldness at age 45 years was not significantly associated with overall (HR, 1.19; 95% CI, 0.98 to 1.45) or nonaggressive (HR, 0.97; 95% CI, 0.72 to 1.30) prostate cancer risk but was significantly associated with increased risk of aggressive prostate cancer (HR, 1.39; 95% CI, 1.07 to 1.80). Adjustment for covariates did not substantially alter these estimates. Other classes of baldness were not significantly associated with overall or subtypes of prostate cancer. CONCLUSION Our analysis indicates that frontal plus moderate vertex baldness at age 45 years is associated with an increased risk of aggressive prostate cancer and supports the possibility of common pathophysiologic mechanisms.
Collapse
Affiliation(s)
- Cindy Ke Zhou
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA
| | - Ruth M Pfeiffer
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA
| | - Sean D Cleary
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA
| | - Heather J Hoffman
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA
| | - Paul H Levine
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA
| | - Lisa W Chu
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA
| | - Ann W Hsing
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA
| | - Michael B Cook
- Cindy Ke Zhou, Ruth M. Pfeiffer, and Michael B. Cook, National Cancer Institute, Bethesda, MD; Cindy Ke Zhou, Sean D. Cleary, Heather J. Hoffman, and Paul H. Levine, George Washington University, Washington, DC; and Lisa W. Chu and Ann W. Hsing, Cancer Prevention Institute of California, Fremont, CA.
| |
Collapse
|
48
|
Controversies associated with the evaluation of elderly men with localized prostate cancer when considering radical prostatectomy. Int J Clin Oncol 2014; 19:793-9. [DOI: 10.1007/s10147-014-0738-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 08/03/2014] [Indexed: 12/27/2022]
|
49
|
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.
Collapse
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
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Benzekry S, Gandolfi A, Hahnfeldt P. Global dormancy of metastases due to systemic inhibition of angiogenesis. PLoS One 2014; 9:e84249. [PMID: 24465399 PMCID: PMC3897365 DOI: 10.1371/journal.pone.0084249] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 11/13/2013] [Indexed: 12/12/2022] Open
Abstract
Autopsy studies of adults dying of non-cancer causes have shown that virtually all of us possess occult, cancerous lesions. This suggests that, for most individuals, cancer will become dormant and not progress, while only in some will it become symptomatic disease. Meanwhile, it was recently shown in animal models that a tumor can produce both stimulators and inhibitors of its own blood supply. To explain the autopsy findings in light of the preclinical research data, we propose a mathematical model of cancer development at the organism scale describing a growing population of metastases, which, together with the primary tumor, can exert a progressively greater level of systemic angiogenesis-inhibitory influence that eventually overcomes local angiogenesis stimulation to suppress the growth of all lesions. As a departure from modeling efforts to date, we look not just at signaling from and effects on the primary tumor, but integrate over this increasingly negative global signaling from all sources to track the development of total tumor burden. This in silico study of the dynamics of the tumor/metastasis system identifies ranges of parameter values where mutual angio-inhibitory interactions within a population of tumor lesions could yield global dormancy, i.e., an organism-level homeostatic steady state in total tumor burden. Given that mortality arises most often from metastatic disease rather than growth of the primary per se, this finding may have important therapeutic implications.
Collapse
Affiliation(s)
- Sébastien Benzekry
- Center of Cancer Systems Biology, GRI, Tufts University School of Medicine, Boston, Massachusetts, United States of America
- Inria team MC2, Institut de Mathématiques de Bordeaux, Bordeaux, France
| | - Alberto Gandolfi
- Istituto di Analisi dei Sistemi ed Informatica “Antonio Ruberti”, Roma, Italy
| | - Philip Hahnfeldt
- Center of Cancer Systems Biology, GRI, Tufts University School of Medicine, Boston, Massachusetts, United States of America
| |
Collapse
|