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1
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Brière R, Martin AG, Letarte F, Fournier FR, Bouchard P, Drolet S. Surgical management of rectal cancer with synchronous treatment of prostate cancer. Langenbecks Arch Surg 2024; 409:133. [PMID: 38642125 DOI: 10.1007/s00423-024-03327-7] [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: 10/30/2023] [Accepted: 04/18/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE To assess the safety and efficacy of synchronous treatments for rectal (RC) and prostate (PC) cancers. METHODS Single-center retrospective study (2007-2021) of patients treated with neoadjuvant radiotherapy (RT) and total mesorectal excision (TME) for RC with synchronous PC treatment. The endpoints were 30-day postoperative severe complications, R0 resection rates, 3-year disease-free survival (DFS) and 3-year overall survival (OS). RESULTS Among the 16 patients, 15 (93.7%) received neoadjuvant pelvic RT (40-50.4 Gray) followed by either transperineal high dose rate prostate brachytherapy (62.5%), prostate external RT boost (25.0%), or androgen deprivation therapy (ADT) alone (6.3%). One (6.3%) patient received neoadjuvant rectal brachytherapy and ADT. Pelvic RT was combined with chemotherapy in 87.5% of cases. TME was performed in all patients with low anterior resection (87.5%) or abdominoperineal resection (12.5%), primarily using minimally invasive surgery (87.5%). The R0 resection rate was 93.8%. Six (37.5%) patients experienced 30-day Clavien-Dindo grade IIIb complications, including one (7.1%) anastomotic leak. After a median follow-up of 39.0 months, 63.6% of diverting ileostomies were reversed. Three-year DFS from RC was 71.4% (CI 40.2-88.3) and 3-year OS was 84.4% (CI 95% 50.4-95.9). No PC recurrence or death occurred. CONCLUSIONS Synchronous management of RC and PC with pelvic RT followed by curative prostate RT doses and TME showed acceptable morbidity and oncologic results. Prostate brachytherapy, the most commonly used treatment modality, allowed avoidance of prostatectomy and additional external RT to the rectum. PC should not limit the curative intent of RC, as all recurrences were from rectal origin.
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Affiliation(s)
- Raphaëlle Brière
- Department of Surgery, CHU de Québec - Université Laval, 1050, Avenue de La Médecine, Quebec City, QC, Canada.
| | - André-Guy Martin
- Radiation Oncology Department, CHU de Québec - Université Laval, Quebec City, QC, Canada
| | - François Letarte
- Department of Surgery, CHU de Québec - Université Laval, 1050, Avenue de La Médecine, Quebec City, QC, Canada
| | - François Rouleau Fournier
- Department of Surgery, CHU de Québec - Université Laval, 1050, Avenue de La Médecine, Quebec City, QC, Canada
| | - Philippe Bouchard
- Department of Surgery, CHU de Québec - Université Laval, 1050, Avenue de La Médecine, Quebec City, QC, Canada
| | - Sébastien Drolet
- Department of Surgery, CHU de Québec - Université Laval, 1050, Avenue de La Médecine, Quebec City, QC, Canada
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2
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Ma B, Chen B, Cai C, Zhang J. Establishment of survival models for primary prostate cancer and colorectal cancer based on the random survival forest. Asian J Surg 2023; 46:5787-5788. [PMID: 37666701 DOI: 10.1016/j.asjsur.2023.08.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/24/2023] [Indexed: 09/06/2023] Open
Affiliation(s)
- Bingqing Ma
- Department of Emergency General Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Biao Chen
- Department of Emergency General Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chengjun Cai
- Department of Emergency General Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jinxiang Zhang
- Department of Emergency General Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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3
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Celentano G, Creta M, Napolitano L, Abate M, La Rocca R, Capece M, Mirone C, Morra S, Di Bello F, Cirillo L, Mangiapia F, Califano G, Collà Ruvolo C, Sagnelli C, Sica A, Calogero A, Iacono F, Fusco F, Mirone V, Longo N. Prostate Cancer Diagnosis, Treatment and Outcomes in Patients with Previous or Synchronous Colorectal Cancer: A Systematic Review of Published Evidence. Diagnostics (Basel) 2022; 12:diagnostics12061475. [PMID: 35741285 PMCID: PMC9221875 DOI: 10.3390/diagnostics12061475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 11/18/2022] Open
Abstract
The management of patients with prostate cancer (PCa) and previous or synchronous colorectal cancer (CRC) represents a challenging issue. A systematic review was performed in May 2022 to summarize available evidence about the diagnosis, management, and outcomes of these patients. Twenty-seven studies involving 252 patients were identified. Overall, 163 (64.7%) and 89 (35.3%) patients had synchronous and metachronous PCa and CRC, respectively. In patients with synchronous diseases, PCa treatment involved active surveillance in 1 patient, radical prostatectomy (RP) in 36 patients, radiotherapy (RT) in 60 patients, RP plus RT in 1 patient, proton beam therapy in 1 patient, and cryoablation in 1 patient. In patients with previous CRC treatment, prostate biopsy was mostly performed by transrectal approach (n = 24). The trans-perineal and suprapubic approaches were adopted in 12 and 6 cases, respectively. Surgical PCa treatment in these cases involved endoscopic extraperitoneal RP, robot-assisted RP, and not otherwise specified RP in 30, 15, and 2 cases, respectively. Biochemical recurrence rates ranged from 20% to 28%. Non-surgical PCa treatment options included brachytherapy, RT plus androgen deprivation therapy, and RT alone in 23, 2 and 4 patients, respectively. PCa specific survival was reported by one study and was 100%.
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Affiliation(s)
- Giuseppe Celentano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
- Correspondence: ; Tel./Fax: +39-081-7462-611
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Marco Abate
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Roberto La Rocca
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Marco Capece
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Claudia Mirone
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy;
| | - Simone Morra
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Francesco Di Bello
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Luigi Cirillo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Francesco Mangiapia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Gianluigi Califano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Claudia Collà Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Antonello Sica
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80123 Naples, Italy;
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80130 Naples, Italy;
| | - Fabrizio Iacono
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Ferdinando Fusco
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80130 Naples, Italy; (G.C.); (L.N.); (M.A.); (R.L.R.); (M.C.); (S.M.); (F.D.B.); (L.C.); (F.M.); (G.C.); (C.C.R.); (F.I.); (V.M.); (N.L.)
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Norouzi G, Rezaei A, Adinehpour Z, Amini H, Vali R. 68Ga-PSMA PET/CT Scan Leading to Diagnosis of PSMA-Positive Rectal Adenocarcinoma in a Patient With Prostate Cancer. Clin Nucl Med 2022; 47:e323-e324. [PMID: 35067545 DOI: 10.1097/rlu.0000000000004066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT A 59-year-old prostate cancer patient, status post radical prostatectomy, was referred to our department for restaging with 68Ga-prostate-specific membrane antigen (PSMA) PET/CT scan. Aside multiple metastatic lesions involving pelvic lymph nodes as well as the right femoral trochanter, a PSMA-positive rectal wall thickening was detected. Colonoscopy correlation and tissue diagnosis, recommended to rule out accompanying primary malignancy, confirmed the presence of rectal adenocarcinoma. This case signifies the importance of requesting pathological correlation for unexplained PSMA-positive lesions, emphasizing the potential role PSMA ligands may play in detecting occult second primary malignancies, especially synchronous/metachronous colorectal cancers.
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Affiliation(s)
- Ghazal Norouzi
- From the Nuclear Medicine Department, Shohada-e Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, School of Medicine
| | - Alireza Rezaei
- Khatam PET/CT Center, Khatam Al-Anbia Hospital, Tehran, Iran
| | | | - Hamidreza Amini
- Khatam PET/CT Center, Khatam Al-Anbia Hospital, Tehran, Iran
| | - Reza Vali
- Nuclear Medicine Department, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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5
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Dema S, Bota A, Tăban SM, Gheju A, Dema ALC, Croitor A, Barna RA, Popa O, Bardan R, Cumpănaș AA. Multiple Primary Tumors Originating From the Prostate and Colorectum A Clinical-Pathological and Therapeutic Challenge. Am J Mens Health 2021; 15:15579883211044881. [PMID: 34493123 PMCID: PMC8436322 DOI: 10.1177/15579883211044881] [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] [Indexed: 01/22/2023] Open
Abstract
Considering that the incidence of colorectal (CRC) and prostatic cancer (PC) increases with age, metachronous and synchronous tumors can often affect the same patient. Despite the importance of this subject for the diagnosis and management of oncologic patients, in medical literature the data are scarce. The aim of the study was to evaluate the incidence and the characteristics of double/multiple primary malignant tumors (D/MPMTs) with colorectal and prostatic origin, in patients admitted to a reference hospital in West Romania. A 4-year retrospective observational study (2016–2019) was conducted by analyzing the medical records of all patients admitted in the hospital. Demographic and clinical data, as well as tumor-related parameters, were extracted. We identified 413 consecutive hospitalized patients with PC, and 21 (5%) of them also had a primary CRC. At the time of diagnosis, the mean age of the patients with PC was 71.2 ± 6 years, and 71.8 ± 10 years for patients with CRC. Synchronous PC and CRC tumors were identified in 3/21 cases and metachronous tumors in 18/21 cases. Prostate cancer was the first tumor to be diagnosed in 13/18 cases and CRC in 5/18 cases. The most frequent subtype of PC was acinar adenocarcinoma (90%) and for CRC cases, conventional adenocarcinoma (90%). Prostate and colorectal cancers tend to co-occur in a single patient. The diagnosis of one of these two types of tumors should imply the screening for the other one, because these patients require a multidisciplinary and personalized approach.
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Affiliation(s)
- Sorin Dema
- Radiotherapy Service, Emergency City Hospital Timisoara, Timisoara, Romania
| | - Andreea Bota
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Sorina Maria Tăban
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Adelina Gheju
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Alis Liliana Carmen Dema
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Alexei Croitor
- Urology Department, Emergency County Hospital Timisoara, Timisoara, Romania
| | - Robert Alexandru Barna
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.,Department of Internal Medicine II-Discipline of Gastroenterology and Hepatology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Oana Popa
- Department II Microscopic Morphology-Discipline of Morphopathology, "Anapatmol" Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Răzvan Bardan
- Department of Orthopedic Surgery-Traumatology-Urology-Medical Imaging-Urology Department, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Alin-Adrian Cumpănaș
- Department of Orthopedic Surgery-Traumatology-Urology-Medical Imaging-Urology Department, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
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Kobayashi N, Oike T, Kubo N, Miyasaka Y, Mizukami T, Sato H, Adachi A, Katoh H, Kawamura H, Ohno T. Colorectal Cancer Screening Outcomes of 2412 Prostate Cancer Patients Considered for Carbon Ion Radiotherapy. Cancers (Basel) 2021; 13:cancers13174481. [PMID: 34503291 PMCID: PMC8431542 DOI: 10.3390/cancers13174481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/03/2021] [Accepted: 09/03/2021] [Indexed: 02/06/2023] Open
Abstract
Colorectal cancer (CRC) screening is effective for detecting cancer in average-risk adults. For prostate cancer (PCa) patients considered for carbon ion radiotherapy (CIRT), pre-treatment CRC screening is performed empirically to avoid post-treatment colonoscopic manipulation. However, the outcomes of screening this population remain unclear. Here, we compared the outcomes of routine pre-CIRT CRC screening of 2412 PCa patients at average risk for CRC with data from two published datasets: the Japan National Cancer Registry (JNCR) and a series of 17 large-scale screening studies analyzing average-risk adults. The estimated prevalence rate was calculated using the pooled sensitivity elucidated by a previous meta-analysis. Consequently, 28 patients (1.16%) were diagnosed with CRC. CRC morbidity was significantly associated with high pre-treatment levels of prostate-specific antigen (p = 0.023). The screening positivity rate in this study cohort exceeded the annual incidence reported in the JNCR for most age brackets. Furthermore, the estimated prevalence rate in this study cohort (1.46%) exceeded that reported in all 17 large-scale studies, making the result an outlier (p = 0.005). These data indicate the possibility that the prevalence of CRC in PCa patients is greater than that in general average-risk adults, warranting further research in a prospective setting.
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Affiliation(s)
- Nao Kobayashi
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22 Showamachi, Maebashi 371-8511, Japan; (N.K.); (N.K.); (A.A.); (T.O.)
| | - Takahiro Oike
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22 Showamachi, Maebashi 371-8511, Japan; (N.K.); (N.K.); (A.A.); (T.O.)
- Gunma University Heavy Ion Medical Center, 3-39-22 Showa-machi, Maebashi 371-8511, Japan; (Y.M.); (H.S.); (H.K.)
- Correspondence: ; Tel.: +81-27-220-8383
| | - Nobuteru Kubo
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22 Showamachi, Maebashi 371-8511, Japan; (N.K.); (N.K.); (A.A.); (T.O.)
| | - Yuhei Miyasaka
- Gunma University Heavy Ion Medical Center, 3-39-22 Showa-machi, Maebashi 371-8511, Japan; (Y.M.); (H.S.); (H.K.)
| | - Tatsuji Mizukami
- Department of Radiology, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan;
| | - Hiro Sato
- Gunma University Heavy Ion Medical Center, 3-39-22 Showa-machi, Maebashi 371-8511, Japan; (Y.M.); (H.S.); (H.K.)
| | - Akiko Adachi
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22 Showamachi, Maebashi 371-8511, Japan; (N.K.); (N.K.); (A.A.); (T.O.)
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama 241-8515, Japan;
| | - Hidemasa Kawamura
- Gunma University Heavy Ion Medical Center, 3-39-22 Showa-machi, Maebashi 371-8511, Japan; (Y.M.); (H.S.); (H.K.)
| | - Tatsuya Ohno
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22 Showamachi, Maebashi 371-8511, Japan; (N.K.); (N.K.); (A.A.); (T.O.)
- Gunma University Heavy Ion Medical Center, 3-39-22 Showa-machi, Maebashi 371-8511, Japan; (Y.M.); (H.S.); (H.K.)
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