1
|
Weiner AB, Siebert AL, Fenton SE, Abida W, Agarwal N, Davis ID, Dorff TB, Gleave M, James ND, Poon DM, Suzuki H, Sweeney CJ. First-line Systemic Treatment of Recurrent Prostate Cancer After Primary or Salvage Local Therapy: A Systematic Review of the Literature. Eur Urol Oncol 2022; 5:377-387. [DOI: 10.1016/j.euo.2022.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/02/2022] [Accepted: 04/29/2022] [Indexed: 12/01/2022]
|
2
|
Pak S, You D, Jeong IG, Kim YS, Hong JH, Kim CS, Ahn H. Time to biochemical relapse after radical prostatectomy and efficacy of salvage radiotherapy in patients with prostate cancer. Int J Clin Oncol 2019; 24:1238-1246. [PMID: 31087170 DOI: 10.1007/s10147-019-01463-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 05/02/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND To investigate the prognostic and therapeutic implications of time to biochemical relapse (BCR) in patients with prostate cancer after radical prostatectomy. METHODS The records of 3210 consecutive men with prostate cancer who underwent radical prostatectomy between January 1998 and June 2013 were retrospectively reviewed. Patients with BCR were divided into three groups based on quartiles of time to BCR, namely an early group (first quartile), an intermediate group (second and third quartiles) and late group (fourth quartile). RESULTS 817 (25.5%) patients experienced BCR at a median of 24.9 months after surgery. The 8-year rate of distant metastasis-free survival (64.3% vs. 41.3%, p = 0.002) and cancer-specific survival (86.6% vs. 63.4%, p < 0.001) was higher in the salvage radiotherapy (SRT) group than the androgen deprivation therapy (ADT) group in patients with early BCR, whereas those rates (91.3% vs. 87.9%, p = 0.607 and 100.0% vs. 93.1%, p = 0.144, respectively) were similar in patients with late BCR. In the intermediate BCR group, the impact of SRT over ADT on 8-year cancer-specific survival was modest (91.9% vs. 82.3%, p = 0.057) and was limited to patients with pT2 or pT3a disease. CONCLUSIONS SRT may decrease the risk of distant metastasis and cancer-specific mortality in patients with early BCR. However, a survival benefit for those with late BCR was not apparent. For patients with intermediate BCR, SRT was associated with a cancer-specific survival benefit in patients with pT2 or pT3a disease. Novel genomic tests and imaging modalities may support clinical decision-making in these patients.
Collapse
Affiliation(s)
- Sahyun Pak
- Department of Urology, Center for Urologic Cancer, National Cancer Center, Goyang, South Korea
| | - Dalsan You
- Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - In Gab Jeong
- Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Young Seok Kim
- Department of Radiation Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Jun Hyuk Hong
- Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Choung-Soo Kim
- Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - Hanjong Ahn
- Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
| |
Collapse
|
3
|
Bruni A, Ingrosso G, Trippa F, Di Staso M, Lanfranchi B, Rubino L, Parente S, Frassinelli L, Maranzano E, Santoni R, Sighinolfi MC, Lohr F, Mazzeo E. Macroscopic locoregional relapse from prostate cancer: which role for salvage radiotherapy? Clin Transl Oncol 2019; 21:1532-1537. [PMID: 30868389 DOI: 10.1007/s12094-019-02084-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 03/07/2019] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Salvage radiotherapy (SRT) after radical prostatectomy for prostate cancer (PCa) is recommended as soon as PSA rises above 0.20 ng/ml, but many patients (pts) still experience local macroscopic relapse. The aim of this multicentric retrospective analysis was to evaluate the role of SRT in pts with macroscopic relapse. MATERIALS AND METHODS From 2001 to 2016, 105 consecutive pts with macroscopic PCa relapse underwent SRT ± androgen deprivation therapy (ADT). Mean age was 72 years. At time of relapse, 29 pts had a PSA value < 1.0 ng/mL, 50 from 1.1 to 5, and 25 pts > 5. Before SRT, 23 pts had undergone 18F-choline PET and 15 pts pelvic MRI. Ninety-four pts had prostatic bed relapse only, and four nodal involvement. Fifty-one pts were previously submitted to first-line ADT, while 6 pts received ≥ 2 lines. RESULTS At a median follow-up of 52 months, 89 pts were alive, while 16 were dead. Total RT dose to macroscopic lesions was > 70 Gy in 58 pts, 66-70 Gy in 43, and < 66 Gy in 4 pts. In 72 pts, target volume encompassed only the prostatic bed with sequential boost to macroscopic site; 33 pts received prophylactic pelvic RT. Ten-year overall survival was 76.1%, while distant metastasis-free survival was 73.3%. No grade 4-5 toxicities were found. CONCLUSIONS SRT ± ADT for macroscopic relapse showed a favorable oncological outcome supporting its important role in this scenario. Data from this series suggest that SRT may either postpone ADT or improve results over ADT alone in appropriately selected pts.
Collapse
Affiliation(s)
- A Bruni
- Radiotherapy Unit, University Hospital of Modena, Via del Pozzo 71, 41100, Modena, Italy.
| | - G Ingrosso
- Radiotherapy Unit, "Tor Vergata" University General Hospital, Rome, Italy
| | - F Trippa
- Radiotherapy Unit, "Santa Maria" University Hospital, Terni, Italy
| | - M Di Staso
- Radiotherapy Unit, "Nuovo San Salvatore" Hospital, L'Aquila, Italy
| | - B Lanfranchi
- Radiotherapy Unit, University Hospital of Modena, Via del Pozzo 71, 41100, Modena, Italy
| | - L Rubino
- Radiotherapy Unit, University Hospital of Modena, Via del Pozzo 71, 41100, Modena, Italy
| | - S Parente
- Radiotherapy Unit, "Nuovo San Salvatore" Hospital, L'Aquila, Italy
| | - L Frassinelli
- Radiotherapy Unit, University Hospital of Modena, Via del Pozzo 71, 41100, Modena, Italy
| | - E Maranzano
- Radiotherapy Unit, "Santa Maria" University Hospital, Terni, Italy
| | - R Santoni
- Radiotherapy Unit, "Tor Vergata" University General Hospital, Rome, Italy
| | - M C Sighinolfi
- Urology Unit, University Hospital of Modena, Modena, Italy
| | - F Lohr
- Radiotherapy Unit, University Hospital of Modena, Via del Pozzo 71, 41100, Modena, Italy
| | - E Mazzeo
- Radiotherapy Unit, University Hospital of Modena, Via del Pozzo 71, 41100, Modena, Italy
| |
Collapse
|
4
|
Bjerre MT, Strand SH, Nørgaard M, Kristensen H, Rasmussen AK, Mortensen MM, Fredsøe J, Mouritzen P, Ulhøi B, Ørntoft T, Borre M, Sørensen KD. Aberrant DOCK2, GRASP, HIF3A and PKFP Hypermethylation has Potential as a Prognostic Biomarker for Prostate Cancer. Int J Mol Sci 2019; 20:ijms20051173. [PMID: 30866497 PMCID: PMC6429171 DOI: 10.3390/ijms20051173] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 02/12/2019] [Accepted: 02/28/2019] [Indexed: 12/18/2022] Open
Abstract
Prostate cancer (PCa) is a clinically heterogeneous disease and currently, accurate diagnostic and prognostic molecular biomarkers are lacking. This study aimed to identify novel DNA hypermethylation markers for PCa with future potential for blood-based testing. Accordingly, to search for genes specifically hypermethylated in PCa tissue samples and not in blood cells or other cancer tissue types, we performed a systematic analysis of genome-wide DNA methylation data (Infinium 450K array) available in the Marmal-aid database for 4072 malignant/normal tissue samples of various types. We identified eight top candidate markers (cg12799885, DOCK2, FBXO30, GRASP, HIF3A, MOB3B, PFKP, and TPM4) that were specifically hypermethylated in PCa tissue samples and hypomethylated in other benign and malignant tissue types, including in peripheral blood cells. Potential as diagnostic and prognostic biomarkers was further assessed by the quantitative methylation specific PCR (qMSP) analysis of 37 nonmalignant and 197 PCa tissue samples from an independent population. Here, all eight hypermethylated candidates showed high sensitivity (75–94%) and specificity (84–100%) for PCa. Furthermore, DOCK2, GRASP, HIF3A and PKFP hypermethylation was significantly associated with biochemical recurrence (BCR) after radical prostatectomy (RP; 197 patients), independent of the routine clinicopathological variables. DOCK2 is the most promising single candidate marker (hazard ratio (HR) (95% confidence interval (CI)): 1.96 (1.24–3.10), adjusted p = 0.016; multivariate cox regression). Further validation studies are warranted and should investigate the potential value of these hypermethylation candidate markers for blood-based testing also.
Collapse
Affiliation(s)
- Marianne T Bjerre
- Department of Molecular Medicine (MOMA), Aarhus University Hospital (AUH), Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
- Department of Urology, Aarhus University Hospital (AUH), Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | - Siri H Strand
- Department of Molecular Medicine (MOMA), Aarhus University Hospital (AUH), Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | - Maibritt Nørgaard
- Department of Molecular Medicine (MOMA), Aarhus University Hospital (AUH), Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | | | | | - Martin Mørck Mortensen
- Department of Urology, Aarhus University Hospital (AUH), Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | - Jacob Fredsøe
- Department of Molecular Medicine (MOMA), Aarhus University Hospital (AUH), Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | - Peter Mouritzen
- Exiqon ⁻ a Qiagen company, Skelstedet 16, 2950 Vedbæk, Denmark.
| | - Benedicte Ulhøi
- Department of Pathology, Aarhus University Hospital (AUH), Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | - Torben Ørntoft
- Department of Molecular Medicine (MOMA), Aarhus University Hospital (AUH), Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | - Michael Borre
- Department of Urology, Aarhus University Hospital (AUH), Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| | - Karina D Sørensen
- Department of Molecular Medicine (MOMA), Aarhus University Hospital (AUH), Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
| |
Collapse
|
5
|
This Month in Adult Urology. J Urol 2018. [DOI: 10.1016/j.juro.2018.07.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|