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Piccinelli ML, Luzzago S, Marvaso G, Laukhtina E, Miura N, Schuettfort VM, Mori K, Colombo A, Ferro M, Mistretta FA, Fusco N, Petralia G, Jereczek-Fossa BA, Shariat SF, Karakiewicz PI, de Cobelli O, Musi G. Association between previous negative biopsies and lower rates of progression during active surveillance for prostate cancer. World J Urol 2022; 40:1447-1454. [PMID: 35347414 PMCID: PMC9166841 DOI: 10.1007/s00345-022-03983-8] [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: 01/23/2022] [Accepted: 02/27/2022] [Indexed: 11/04/2022] Open
Abstract
Purpose To test any-cause discontinuation and ISUP GG upgrading rates during Active Surveillance (AS) in patients that underwent previous negative biopsies (PNBs) before prostate cancer (PCa) diagnosis vs. biopsy naive patients. Methods Retrospective analysis of 961 AS patients (2008–2020). Three definitions of PNBs were used: (1) PNBs status (biopsy naïve vs. PNBs); (2) number of PNBs (0 vs. 1 vs. ≥ 2); (3) histology at last PNB (no vs. negative vs. HGPIN/ASAP). Kaplan–Meier plots and multivariable Cox models tested any-cause and ISUP GG upgrading discontinuation rates. Results Overall, 760 (79.1%) vs. 201 (20.9%) patients were biopsy naïve vs. PNBs. Specifically, 760 (79.1%) vs. 138 (14.4%) vs. 63 (6.5%) patients had 0 vs. 1 vs. ≥ 2 PNBs. Last, 760 (79.1%) vs. 134 (13.9%) vs. 67 (7%) patients had no vs. negative PNB vs. HGPIN/ASAP. PNBs were not associated with any-cause discontinuation rates. Conversely, PNBs were associated with lower rates of ISUP GG upgrading: (1) PNBs vs. biopsy naïve (HR:0.6, p = 0.04); (2) 1 vs. 0 PNBs (HR:0.6, p = 0.1) and 2 vs. 0 PNBs, (HR:0.5, p = 0.1); (3) negative PNB vs. biopsy naïve (HR:0.7, p = 0.3) and HGPIN/ASAP vs. biopsy naïve (HR:0.4, p = 0.04). However, last PNB ≤ 18 months (HR:0.4, p = 0.02), but not last PNB > 18 months (HR:0.8, p = 0.5) were associated with lower rates of ISUP GG upgrading. Conclusion PNBs status is associated with lower rates of ISUP GG upgrading during AS for PCa. The number of PNBs and time from last PNB to PCa diagnosis (≤ 18 months) appear also to be critical for patient selection. Supplementary Information The online version contains supplementary material available at 10.1007/s00345-022-03983-8.
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Affiliation(s)
- Mattia Luca Piccinelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, Milan, Italy. .,Università degli Studi di Milano, Milan, Italy.
| | - Stefano Luzzago
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
| | - Giulia Marvaso
- Department of Radiotherapy, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
| | - Ekaterina Laukhtina
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.,Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Noriyoshi Miura
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Department of Urology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Victor M Schuettfort
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Department of Urology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Keiichiro Mori
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Alberto Colombo
- Division of Radiology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy
| | - Matteo Ferro
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, Milan, Italy
| | - Francesco A Mistretta
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
| | - Nicola Fusco
- Department of Pathology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
| | - Giuseppe Petralia
- Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences, IEO European Institute of Oncology IRCCS, 20141, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
| | - Barbara A Jereczek-Fossa
- Department of Radiotherapy, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
| | - Shahrokh F Shariat
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.,Department of Urology, Medical University of Vienna, Vienna, Austria.,Research Division of Urology, Department of Special Surgery, The University of Jordan, Amman, Jordan.,Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.,Department of Urology, Weill Cornell Medical College, New York, NY, USA.,Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.,European Association of Urology Research Foundation, Arnhem, Netherlands
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
| | - Ottavio de Cobelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
| | - Gennaro Musi
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
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Tonry C, Finn S, Armstrong J, Pennington SR. Clinical proteomics for prostate cancer: understanding prostate cancer pathology and protein biomarkers for improved disease management. Clin Proteomics 2020; 17:41. [PMID: 33292167 PMCID: PMC7678104 DOI: 10.1186/s12014-020-09305-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/11/2020] [Indexed: 12/12/2022] Open
Abstract
Following the introduction of routine Prostate Specific Antigen (PSA) screening in the early 1990's, Prostate Cancer (PCa) is often detected at an early stage. There are also a growing number of treatment options available and so the associated mortality rate is generally low. However, PCa is an extremely complex and heterogenous disease and many patients suffer disease recurrence following initial therapy. Disease recurrence commonly results in metastasis and metastatic PCa has an average survival rate of just 3-5 years. A significant problem in the clinical management of PCa is being able to differentiate between patients who will respond to standard therapies and those who may benefit from more aggressive intervention at an earlier stage. It is also acknowledged that for many men the disease is not life threatenting. Hence, there is a growing desire to identify patients who can be spared the significant side effects associated with PCa treatment until such time (if ever) their disease progresses to the point where treatment is required. To these important clinical needs, current biomarkers and clinical methods for patient stratification and personlised treatment are insufficient. This review provides a comprehensive overview of the complexities of PCa pathology and disease management. In this context it is possible to review current biomarkers and proteomic technologies that will support development of biomarker-driven decision tools to meet current important clinical needs. With such an in-depth understanding of disease pathology, the development of novel clinical biomarkers can proceed in an efficient and effective manner, such that they have a better chance of improving patient outcomes.
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Affiliation(s)
- Claire Tonry
- UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Stephen Finn
- Department of Histopathology and Morbid Anatomy, Trinity Translational Medicine Institute, Trinity College Dublin, Dublin 8, Ireland
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