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Siebinga H, Heuvel JO, Rijkhorst EJ, Hendrikx JJMA, de Wit-van der Veen BJ. The Impact of Peptide Amount on Tumor Uptake to Assess PSMA Receptor Saturation on 68Ga-PSMA-11 PET/CT in Patients with Primary Prostate Cancer. J Nucl Med 2023; 64:63-68. [PMID: 35680416 DOI: 10.2967/jnumed.122.264101] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/02/2022] [Accepted: 06/02/2022] [Indexed: 01/07/2023] Open
Abstract
68Ga-labeled prostate-specific membrane antigen (PSMA) is often produced on-site, where usually a fixed amount of peptide is conjugated to the generator eluate. However, fluctuations in specific activity might influence tracer distribution and tumor accumulation. Therefore, our aim was to investigate the potential effect of varying the administered peptide amount on 68Ga-PSMA-11 uptake in tumors using PET/CT in patients with primary prostate cancer (PCa). Additionally, the impact of tumor volume on this potential effect and on accumulation in reference organs was assessed. Methods: The imaging data of 362 men with primary PCa who underwent 68Ga-PSMA-11 PET/CT were retrospectively included. Scans were quantified for normal tissue and primary tumors. Patients were divided into 3 groups based on their tumor volume. Correlation and multivariable linear regression analyses were performed. Results: The median index lesion volume was 9.50 cm3 (range, 0.064-174 cm3). Groups were based on quartiles of prostatic lesion volume: ≤4.11 cm3 (group 1), 4.11-20.6 cm3 (group 2), and ≥20.6 cm3 (group 3). No correlation was found between administered peptide amount and tumor uptake (SUVmean or SUVpeak) for any group, except for a significant correlation for SUVmean in the first group (P = 0.008). Linear regression analysis supported these findings. Conclusion: The amount of administered peptide had no evident effect on 68Ga-PSMA-11 uptake in tumors, except for a significant positive correlation between administered peptide amount and tumor SUVmean for group 1. The findings imply that no receptor saturation occurs in men with primary PCa at peptide levels of about 2.5 μg.
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Affiliation(s)
- Hinke Siebinga
- Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Pharmacy and Pharmacology, Netherlands Cancer Institute, Amsterdam, The Netherlands; and
| | - Judith Olde Heuvel
- Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Erik-Jan Rijkhorst
- Department of Medical Physics and Technology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jeroen J M A Hendrikx
- Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Pharmacy and Pharmacology, Netherlands Cancer Institute, Amsterdam, The Netherlands; and
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A novel nomogram provides improved accuracy for predicting biochemical recurrence after radical prostatectomy. Chin Med J (Engl) 2021; 134:1576-1583. [PMID: 34133352 PMCID: PMC8280057 DOI: 10.1097/cm9.0000000000001607] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: Various prediction tools have been developed to predict biochemical recurrence (BCR) after radical prostatectomy (RP); however, few of the previous prediction tools used serum prostate-specific antigen (PSA) nadir after RP and maximum tumor diameter (MTD) at the same time. In this study, a nomogram incorporating MTD and PSA nadir was developed to predict BCR-free survival (BCRFS). Methods: A total of 337 patients who underwent RP between January 2010 and March 2017 were retrospectively enrolled in this study. The maximum diameter of the index lesion was measured on magnetic resonance imaging (MRI). Cox regression analysis was performed to evaluate independent predictors of BCR. A nomogram was subsequently developed for the prediction of BCRFS at 3 and 5 years after RP. Time-dependent receiver operating characteristic (ROC) curve and decision curve analyses were performed to identify the advantage of the new nomogram in comparison with the cancer of the prostate risk assessment post-surgical (CAPRA-S) score. Results: A novel nomogram was developed to predict BCR by including PSA nadir, MTD, Gleason score, surgical margin (SM), and seminal vesicle invasion (SVI), considering these variables were significantly associated with BCR in both univariate and multivariate analyses (P < 0.05). In addition, a basic model including Gleason score, SM, and SVI was developed and used as a control to assess the incremental predictive power of the new model. The concordance index of our model was slightly higher than CAPRA-S model (0.76 vs. 0.70, P = 0.02) and it was significantly higher than that of the basic model (0.76 vs. 0.66, P = 0.001). Time-dependent ROC curve and decision curve analyses also demonstrated the advantages of the new nomogram. Conclusions: PSA nadir after RP and MTD based on MRI before surgery are independent predictors of BCR. By incorporating PSA nadir and MTD into the conventional predictive model, our newly developed nomogram significantly improved the accuracy in predicting BCRFS after RP.
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Kahl U, Callsen S, Beck S, Pinnschmidt H, von Breunig F, Haese A, Graefen M, Zöllner C, Fischer M. Health-related quality of life and self-reported cognitive function in patients with delayed neurocognitive recovery after radical prostatectomy: a prospective follow-up study. Health Qual Life Outcomes 2021; 19:64. [PMID: 33632235 PMCID: PMC7908756 DOI: 10.1186/s12955-021-01705-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 02/15/2021] [Indexed: 12/12/2022] Open
Abstract
Background Delayed neurocognitive recovery (DNCR) is a common and serious complication after radical prostatectomy. We hypothesized that patients with DNCR in the early postoperative period would report reduced health-related quality of life (HRQoL) and more cognitive failures 12 months after surgery, compared with patients without DNCR.
Methods We performed a 12-month follow-up on 367 patients who had been enrolled in a prospective observational trial to study the incidence of DNCR after radical prostatectomy. Patients were screened for preoperative cognitive impairment and depression. We defined DNCR as a decline in cognitive function between days 3 and 5 after surgery, compared with baseline assessments. We evaluated HRQoL and cognitive failures 12 months after surgery with the 36-item Short Form Health Survey and the Cognitive Failures Questionnaire. General linear models were used to analyze associations of DNCR with HRQoL and cognitive failures. Results Delayed neurocognitive recovery in the early postoperative period was significantly associated with self-reported cognitive failures (B for no DNCR = − 0.411 [95% CI: − 0.798;0.024], p = 0.038), but not with physical (B = 0.082 [95% CI: − 0.021;0.186], p = 0.118) or mental HRQoL (B = − 0.044 [95% CI: − 0.149;0.062], p = 0.417) 12 months after surgery. Preoperative depression screening scores were significantly associated with self-reported cognitive failures and both physical and mental HRQoL 12 months after surgery. Conclusions Delayed neurocognitive recovery in the early period after radical prostatectomy has a long-term impact on patients’ daily lives by impairing memory, attention, action, and perception. Therefore, prevention of DNCR must be a priority for physicians and researchers. Consequent preoperative screening for depressive symptoms may facilitate early psycho-oncological intervention to improve postoperative HRQoL.
Trials registrationDRKS00010014, date of registration: 21.03.2016, retrospectively registered.
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Affiliation(s)
- Ursula Kahl
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Sarah Callsen
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Stefanie Beck
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Hans Pinnschmidt
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska von Breunig
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Alexander Haese
- Martini-Klinik, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Markus Graefen
- Martini-Klinik, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Zöllner
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Marlene Fischer
- Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. .,Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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4
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Goujon A, Schoentgen N, Betari R, Thoulouzan M, Vanalderwerelt V, Oumakhlouf S, Brichart N, Pradere B, Roumiguie M, Rammal A, Soulie M, Fournier G, Bensalah K, Bruyere F, Grise P, Joulin V, Manunta A, Saint F, Huyghe E, Nouhaud FX, Peyronnet B. Prognostic factors after adrenalectomy for adrenal metastasis. Int Urol Nephrol 2020; 52:1869-1876. [PMID: 32419066 DOI: 10.1007/s11255-020-02496-w] [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: 01/28/2020] [Accepted: 05/04/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Very few studies have sought prognostic factors after adrenalectomy for metastasis. The aim of this study was to assess prognostic factors for oncological outcomes after adrenalectomy for adrenal metastasis. METHODS All adrenalectomies for metastases performed in seven centers between 2006 and 2016 were included in a retrospective study. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were estimated using the Kaplan-Meier method. Prognostic factors for CSS and RFS were sought by Cox regression analyses. RESULTS 106 patients were included. The primary tumors were mostly renal (47.7%) and pulmonary (32.3%). RFS and CSS estimated rates at 5 years were 20.7% and 63.7%, respectively. In univariate analysis, tumor size (HR 3.83; p = 0.04) and the metastasis timing (synchronous vs. metachronous; HR 0.47; p = 0.02) were associated with RFS. In multivariate analysis, tumor size (HR 8.28; p = 0.01) and metastasis timing (HR 18.60; p = 0.002) were significant factors for RFS. In univariate analysis, the renal origin of the primary tumor (HR 0.1; p < 0.001) and the disease-free interval (DFI; HR 0.12; p = 0.02) were associated with better CSS, positive surgical margins with poorer CSS (HR 3.4; p = 0.01). In multivariate analysis, the renal origin of the primary tumor vs. pulmonary (HR 0.13; p = 0.03) and vs. other origins (HR 0.10; p = 00.4) and the DFI (HR 0.01; p = 0.009) were prognostic factors for CSS. CONCLUSION In this study, tumor size and synchronous occurrence of the adrenal metastasis were associated with poorer RFS. Renal origin of the primary tumor and longer DFI were associated with better CSS. These prognostic factors might help for treatment decision in the management of adrenal metastasis.
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Affiliation(s)
- A Goujon
- Department of Urology, CHU Rennes, Rennes, France.
| | | | - R Betari
- Department of Urology, CHU Amiens, Amiens, France
| | - M Thoulouzan
- Department of Urology, CHU Toulouse, Toulouse, France
| | | | | | - N Brichart
- Department of Urology, CH Orleans, Orléans, France
| | - B Pradere
- Department of Urology, CHU Tours, Tours, France
| | - M Roumiguie
- Department of Urology, CHU Toulouse, Toulouse, France
| | - A Rammal
- Department of Urology, CH Orleans, Orléans, France
| | - M Soulie
- Department of Urology, CHU Toulouse, Toulouse, France
| | - G Fournier
- Department of Urology, CHU Brest, Brest, France
| | - K Bensalah
- Department of Urology, CHU Rennes, Rennes, France
| | - F Bruyere
- Department of Urology, CHU Tours, Tours, France
| | - P Grise
- Department of Urology, CHU Rouen, Rouen, France
| | - V Joulin
- Department of Urology, CHU Brest, Brest, France
| | - A Manunta
- Department of Urology, CHU Rennes, Rennes, France
| | - F Saint
- Department of Urology, CHU Amiens, Amiens, France
| | - E Huyghe
- Department of Urology, CHU Toulouse, Toulouse, France
| | - F-X Nouhaud
- Department of Urology, CHU Rouen, Rouen, France
| | - B Peyronnet
- Department of Urology, CHU Rennes, Rennes, France
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5
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Erdem S, Verep S, Bagbudar S, Ozluk Y, Sanli O, Ozcan F. The clinical predictive factors and postoperative histopathological parameters associated with upgrading after radical prostatectomy: A contemporary analysis with grade groups. Prostate 2020; 80:225-234. [PMID: 31794085 DOI: 10.1002/pros.23936] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 11/22/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND AIM Upgrading after radical prostatectomy (RP) is an ongoing problem since first description of Gleason score. In this retrospective study, our aim is to investigate upgrading after RP in grade groups (GG) and clinical predictive, and postoperative histopathological factors associated with GG upgrading (GGU). PATIENTS AND METHODS A total of 753 patients undergoing RP between January 2006 and June 2019 at our institution were investigated. Overall cohort were divided into two groups according to GGU status after RP as nonupgrading and upgrading. Retrospectively documented preoperative clinical and postoperative histopathological parameters were compared between two groups. Furthermore, we investigated a subgroup of institutional cohort (n = 398) whose prostate biopsy (Pbx) and RP were performed in our institution and we also divided this cohort into two groups according to GGU status. χ2 and Mann-Whitney U tests were used for comparative analyses. The independent preoperative predictive and postoperative histopathological factors associated with GGU were investigated using multivariate logistic regression analysis. RESULTS The total GGU was 55.8% in overall cohort and 45.2% in institutional cohort. The GGU was found as the most common in bioptic GG1 group in both overall (64.0%), and institutional (54.5%) cohorts. In multivariate analyses, the noninstitutional Pbx (odds ratio [OR] = 2.56; 95% confidence interval [CI]: 1.86-3.51; P < .001), tumor positive core numbers in Pbx (OR = 1.11; 95%CI: 1.04-1.19; P = .003), increased prostate specific antigen (PSA) density (OR = 3.59; 95%CI: 1.03-12.52, P = .045) and age (OR = 1.03; 95%CI: 1.00-1.05, P = .046) were independent clinical predictors of GGU in overall cohort whereas only increased PSA density (OR = 5.94; 95%CI: 1.28-27.50; P = .023) was independent predictor in institutional cohort. Among postoperative histopathological factors, perineural invasion (OR = 1.57; 95%CI: 1.70-3.87; P < .001 and OR = 2.53; 95%CI: 1.46-4.40; P = .001, respectively), increased maximum tumor diameter (OR = 1.46; 95%CI: 1.23-1.73; P < .001 and OR = 1.33; 95%CI: 1.07-1.66; P = .010, respectively), and high-grade prostatic intraepithelial neoplasia (HGPIN) existence at tumor surrounding tissue (OR = 1.96; 95%CI: 1.32-2.90; P = .001 and OR = 1.87; 95%CI: 1.10-3.21; P = .022, respectively) were independently associated with GGU after RP, in both of overall and institutional cohorts. CONCLUSIONS Noninstitutional prostate biopsy, increased PSA density, higher tumor positive cores in Pbx and older age are the clinical predictors of upgrading after RP in contemporary GG. Perineural invasion, increased maximum tumor diameter, and HGPIN existence at tumor surrounding tissue are postoperative histopathological factors associated with GGU.
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Affiliation(s)
- Selcuk Erdem
- Department of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Samed Verep
- Department of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Sidar Bagbudar
- Department of Pathology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Yasemin Ozluk
- Department of Pathology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Oner Sanli
- Department of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Faruk Ozcan
- Department of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
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6
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Kir G, Arikan EA, Seneldir H, Ankarali H, Oznergiz S, Olgun ZC, Yildirim A. Determining the cut-off values of tumor diameter, degree of extraprostatic extension, and extent of surgical margin positivity with regard to biochemical recurrence of prostate cancer after radical prostatectomy. Ann Diagn Pathol 2019; 44:151431. [PMID: 31837592 DOI: 10.1016/j.anndiagpath.2019.151431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/02/2019] [Accepted: 09/17/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND The pre-biopsy (bx) prostate-specific antigen (PSA) level, tumor volume/diameter, degree of extraprostatic extension (EPE), and extent of surgical margin positivity have been shown to be significant prognostic parameters of biochemical recurrence (BCR) after radical prostatectomy. The present study assessed the cut-off values of the pre-bx PSA level, maximum tumor diameter, radial and circumferential distances of EPE, and circumferential length of surgical margin (SM) positivity with regard to BCR. MATERIAL AND METHODS The study included 445 radical prostatectomy specimens, and the cut-off values of all parameters were determined using receiver operating characteristic curve analysis. RESULTS An ISUP grade group ≥ 3, radial distance of EPE >1 mm, and circumferential length of SM positivity ≥2 mm were identified as independent predictors of BCR after radical prostatectomy. The parameters that showed statistical significance in univariate analysis, such as pre-bx PSA level ≥ 7.20 ng/mL, tumor diameter ≥ 19.5 mm, presence of seminal vesicle invasion, and circumferential distance of EPE >3 mm, did not have independent prognostic values for BCR. CONCLUSIONS An ISUP grade group ≥ 3, radial distance of EPE >1 mm, and circumferential length of SM positivity ≥2 mm are predictors of BCR. Our findings might have significance in risk classification and adjuvant therapy consideration among patients with localized prostate cancer.
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Affiliation(s)
- Gozde Kir
- Department of Pathology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey.
| | - Evsen Apaydin Arikan
- Department of Pathology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Hatice Seneldir
- Department of Pathology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Handan Ankarali
- Department of Biostatistics, Istanbul Medeniyet University, Istanbul, Turkey
| | - Seca Oznergiz
- Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| | - Zeynep Cagla Olgun
- Department of Pathology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Asif Yildirim
- Department of Urology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
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7
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Frost JM, Smith LA, Sharma P, de Riese WT. Possible clinical implications of peripheral zone changes depending on prostate size. Int Urol Nephrol 2019; 51:1721-1726. [DOI: 10.1007/s11255-019-02221-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/22/2019] [Indexed: 10/26/2022]
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8
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Guzman JA, Sharma P, Smith LA, Buie JD, de Riese WT. Histological changes of the peripheral zone in small and large prostates and possible clinical implications. Res Rep Urol 2019; 11:77-81. [PMID: 30963056 PMCID: PMC6432882 DOI: 10.2147/rru.s182781] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Introduction It is well documented in literature that most prostate carcinomas (PCa) arise in the peripheral zone (PZ). Additionally, an inverse relationship between prostate size and the incidence of PCa has been demonstrated in recent studies. However, little is known about gland distribution in the peripheral zone of larger prostates compared to smaller prostates. In this study, we examined the histo-anatomical gland distribution within the peripheral zone in small and large prostates and discuss possible clinical implications. Methods A semi-quantitative analysis of gland density and capsule thickness was performed using light microscopy on 10 large (≥80 g) prostate specimens and 10 small (<30 g) prostate specimens from patients who underwent radical prostatectomy at Texas Tech University Health Sciences Center between the years 2010 and 2016. Samples from radical prostatectomies were used to ensure a whole, preserved prostate with an intact surgical capsule. Gland counts were performed on five random fields under 100 × magnification, while capsule thickness was measured on three random fields per case; thus, a total 50 fields and 30 fields were analyzed for each of the two groups for gland counts and capsule thickness measurements, respectively. Microscopy was standardized to the posterior aspect of the prostate, between 4 o'clock and 6 o'clock along the equatorial region between the apex and base. Results Large prostates possessed a significantly lower mean gland count per field compared to small prostates (10.34±4.15, n=50 vs 18.00±5.41, n=50; t=8.16, df=49, P<0.001). Additionally, large prostates showed a significantly higher average capsule thickness in millimeters compared to small prostates (1.80 mm, ±1.12 mm, n=30 vs 0.90 mm, ±0.56, n=30; t=8.16, df=49, P<0.001). Conclusion The results demonstrate that prostate hypertrophy leads to both decreased gland density in the peripheral zone and increased capsule thickness, suggesting that growth-induced expansion of the prostate against its capsule leads to compression-induced atrophy and fibrosis of glandular tissue within the peripheral zone (PZ). A decrease in gland density within the PZ may have clinical implications shedding light, for instance, on the reduction in PCa incidence in patients with large prostates as compared to smaller prostates, a phenomenon well documented in the literature.
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Affiliation(s)
- Jonathan A Guzman
- Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX, USA,
| | - Pranav Sharma
- Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX, USA,
| | - Lisa A Smith
- Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX, USA,
| | - John D Buie
- Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Werner T de Riese
- Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX, USA,
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9
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ADC Metrics From Multiparametric MRI: Histologic Downgrading of Gleason Score 9 or 10 Prostate Cancers Diagnosed at Nontargeted Transrectal Ultrasound–Guided Biopsy. AJR Am J Roentgenol 2018; 211:W158-W165. [DOI: 10.2214/ajr.17.18958] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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10
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Ouzzane A, Betrouni N, Valerio M, Rastinehad A, Colin P, Ploussard G. Focal therapy as primary treatment for localized prostate cancer: definition, needs and future. Future Oncol 2016; 13:727-741. [PMID: 27882770 DOI: 10.2217/fon-2016-0229] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Focal therapy (FT) may offer a promising treatment option in the field of low to intermediate risk localized prostate cancer. The aim of this concept is to combine minimal morbidity with cancer control as well as maintain the possibility of retreatment. Recent advances in MRI and targeted biopsy has improved the diagnostic pathway of prostate cancer and increased the interest in FT. However, before implementation of FT in routine clinical practice, several challenges are still to overcome including patient selection, treatment planning, post-therapy monitoring and definition of oncologic outcome surrogates. In this article, relevant questions regarding the key steps of FT are critically discussed and the main available energy modalities are analyzed taking into account their advantages and unmet needs.
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Affiliation(s)
- Adil Ouzzane
- Department of Urology, CHRU de Lille, Hôpital Claude Huriez, F-59037 Lille, France.,NSERM, U1189, ONCO-THAI, F-59037 Lille, France
| | | | - Massimo Valerio
- Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | | | - Pierre Colin
- Department of Urology, Hôpital Privé de la Louvière, Ramsay Générale de Santé, 59000 Lille, France
| | - Guillaume Ploussard
- Institut universitaire du Cancer de Toulouse - Oncopole, Toulouse, France.,Department of Urology, Saint-Jean Languedoc Hospital, Toulouse, France
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11
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Lim CS, McInnes MD, Lim RS, Breau RH, Flood TA, Krishna S, Morash C, Shabana WM, Schieda N. Prognostic value of Prostate Imaging and Data Reporting System (PI-RADS) v. 2 assessment categories 4 and 5 compared to histopathological outcomes after radical prostatectomy. J Magn Reson Imaging 2016; 46:257-266. [DOI: 10.1002/jmri.25539] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 10/19/2016] [Indexed: 01/05/2023] Open
Affiliation(s)
- Christopher S. Lim
- Ottawa Hospital, University of Ottawa, Department of Radiology, Civic Campus C1; Ottawa Ontario Canada
| | - Matthew D.F. McInnes
- Ottawa Hospital, University of Ottawa, Department of Radiology, Civic Campus C1; Ottawa Ontario Canada
| | - Robert S. Lim
- Ottawa Hospital, University of Ottawa, Department of Radiology, Civic Campus C1; Ottawa Ontario Canada
| | - Rodney H. Breau
- Ottawa Hospital, University of Ottawa, Division of Urology, Department of Surgery, General Campus; Ottawa Ontario Canada
| | - Trevor A. Flood
- Ottawa Hospital, University of Ottawa, Department of Anatomical Pathology, General Campus; Ottawa Ontario Canada
| | - Satheesh Krishna
- Ottawa Hospital, University of Ottawa, Department of Radiology, Civic Campus C1; Ottawa Ontario Canada
| | - Christopher Morash
- Ottawa Hospital, University of Ottawa, Division of Urology, Department of Surgery, General Campus; Ottawa Ontario Canada
| | - Wael M. Shabana
- Ottawa Hospital, University of Ottawa, Department of Radiology, Civic Campus C1; Ottawa Ontario Canada
| | - Nicola Schieda
- Ottawa Hospital, University of Ottawa, Department of Radiology, Civic Campus C1; Ottawa Ontario Canada
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12
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Al-Khalil S, Ibilibor C, Cammack JT, de Riese W. Association of prostate volume with incidence and aggressiveness of prostate cancer. Res Rep Urol 2016; 8:201-205. [PMID: 27822463 PMCID: PMC5087757 DOI: 10.2147/rru.s117963] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective The aim of this study was to investigate the possible correlation between prostate volume and aggressiveness and incidence of prostate cancer (PCa). Patients and methods A chart review of a cohort of 448 consecutive prostate biopsy-naive men was performed. These men underwent at least a 12-core biopsy at our institution due to increased prostate-specific antigen serum levels (>4 ng/mL) and/or suspicious findings on digital rectal examination during the period between 2008 and 2013. Transrectal ultrasound was used to determine the prostate volume. Results The positive biopsy rate was 66% for patients with a prostate volume of ≤35 cc and 40% for patients with a prostate volume of ≥65 cc (P<0.001). Of the 110 patients testing positive on biopsy with a volume of ≤35 cc, 10 patients (9.1%) had a Gleason score of ≥8. Of the 27 patients testing positive on biopsy with a volume of ≥65 cc, only 1 patient (3.7%) had a Gleason score of ≥8. Conclusion These results suggest that there may be an association between prostate volume and the incidence and aggressiveness of PCa. The larger the prostate, the lower the positive biopsy rate for PCa and the lower the Gleason score.
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Affiliation(s)
- Shadi Al-Khalil
- Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Christine Ibilibor
- Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - James Thomas Cammack
- Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Werner de Riese
- Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Yilmaz Ö, Kurul Ö, Ates F, Soydan H, Aktas Z. Does an asymmetric lobe in digital rectal examination include any risk for prostate cancer? results of 1495 biopsies. Int Braz J Urol 2016; 42:704-9. [PMID: 27564280 PMCID: PMC5006765 DOI: 10.1590/s1677-5538.ibju.2014.0598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 04/05/2016] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Despite the well-known findings related to malignity in DRE such as nodule and induration, asymmetry of prostatic lobes, seen relatively, were investigated in a few studies as a predictor of prostate cancer so that there is no universally expected conclusion about asymmetry. We aimed to compare cancer detection rate of normal, asymmetric or suspicious findings in DRE by using biopsy results. MATERIALS AND METHODS Data of 1495 patients underwent prostate biopsy between 2006-2014 were searched retrospectively. Biopsy indications were abnormal DRE and or elevated PSA level( >4ng/mL). DRE findings were recorded as Group 1: Benign DRE, Group 2: Asymmetry and Group 3: Nodule/induration. Age, prostatic volume , biopsy results and PSA levels were recorded. RESULTS Mean age, prostate volume and PSA level were 66.72, 55.98 cc and 18.61ng/ mL respectively. Overall cancer detection rate was 38.66 % (575 of 1495). PSA levels were similar in group 1 and 2 but significantly higher in group 3. Prostatic volume was similar in group 1 and 2 and significantly lower in Group 3. Malignity detection rate of group 1,2 and 3 were 28.93%, 34.89% and 55.99% respectively. Group 1 and 2 were similar (p=0.105) but 3 had more chance for cancer detection. CONCLUSION Nodule is the most important finding in DRE for cancer detection. Only na asymmetric prostate itself does not mean malignity.
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Affiliation(s)
- Ömer Yilmaz
- GATA Haydarpasa Teaching Hospital, Department of Urology, Istanbul, Turkey
| | - Özgür Kurul
- GATA Haydarpasa Teaching Hospital, Department of Urology, Istanbul, Turkey
| | - Ferhat Ates
- GATA Haydarpasa Teaching Hospital, Department of Urology, Istanbul, Turkey
| | - Hasan Soydan
- GATA Haydarpasa Teaching Hospital, Department of Urology, Istanbul, Turkey
| | - Zeki Aktas
- GATA Haydarpasa Teaching Hospital, Department of Urology, Istanbul, Turkey
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Moschini M, Gandaglia G, Suardi N, Fossati N, Cucchiara V, Damiano R, Cantiello F, Shariat SF, Montorsi F, Briganti A. Importance of prostate volume in the stratification of patients with intermediate-risk prostate cancer. Int J Urol 2015; 22:555-61. [PMID: 25783998 DOI: 10.1111/iju.12748] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/27/2015] [Accepted: 01/29/2015] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To evaluate the role of prostate volume assessed at final pathology in the risk of biochemical recurrence in patients with clinically localized prostate cancer treated with radical prostatectomy. METHODS Overall, 5637 patients treated with radical prostatectomy between January 1993 and August 2013 were identified. Multivariable Cox regression analyses tested the association between prostate volume and biochemical recurrence in the overall population and after stratifying patients according to the D'Amico risk groups. RESULTS Mean (median) prostate volume was 50.61 mL (46 mL). When patients were stratified according to D'Amico risk groups, mean (median) prostate volume was 51.7 mL (48 mL), 49.8 mL (45 mL) and 50.6 mL (46 mL) in low-, intermediate-, and high-risk prostate cancer, respectively (P = 0.04). Overall, the 5-year biochemical recurrence-free survival rate was 87.9%. In multivariable Cox regression analyses, prostate volume was associated with a lower risk of biochemical recurrence (hazard ratio 0.99, 95% confidence interval 0.99-1.00), after accounting for disease characteristics. However, when patients were stratified according to D'Amico risk groups, prostate volume represented an independent predictor of biochemical recurrence only in individuals with intermediate-risk disease (hazard ratio 0.99, 95% confidence interval 0.99-1.00). Conversely, prostate volume was not associated with the risk of experiencing biochemical recurrence in patients with low- and high-risk disease. CONCLUSIONS Smaller prostates are associated with increased risk of biochemical recurrence after surgery only in men with intermediate-risk disease. In this category, the preoperative assessment of prostate volume might be helpful in order to identify patients at higher risk of biochemical recurrence after surgery. Additionally, prostate volume might be used to individualize follow-up schedules after radical prostatectomy.
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Affiliation(s)
- Marco Moschini
- Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, Urological Research Institute, Milan, Italy.,Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy
| | - Giorgio Gandaglia
- Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, Urological Research Institute, Milan, Italy
| | - Nazareno Suardi
- Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, Urological Research Institute, Milan, Italy
| | - Nicola Fossati
- Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, Urological Research Institute, Milan, Italy
| | - Vito Cucchiara
- Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, Urological Research Institute, Milan, Italy
| | - Rocco Damiano
- Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy
| | - Francesco Cantiello
- Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna and General Hospital, Vienna, Austria
| | - Francesco Montorsi
- Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, Urological Research Institute, Milan, Italy
| | - Alberto Briganti
- Unit of Urology/Division of Oncology, IRCCS Ospedale San Raffaele, Urological Research Institute, Milan, Italy
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