Bioptic intraprostatic chronic inflammation predicts adverse pathology at radical prostatectomy in patients with low-grade prostate cancer

2020 ◽  
Vol 38 (10) ◽  
pp. 793.e19-793.e25 ◽  
Author(s):  
Francesca Sanguedolce ◽  
Ugo Giovanni Falagario ◽  
Pietro Castellan ◽  
Michele Di Nauta ◽  
Giovanni Silecchia ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Chronic Inflammation ◽  
Low Grade

Among men with low-grade prostate cancer on prostate biopsy, the 4Kscore to predict prostate cancer aggressiveness at prostatectomy.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 65-65
Author(s):  
Bruno Nahar ◽  
Sanoj Punnen ◽  
Stephen M Zappala ◽  
Daniel Sjoberg ◽  
Dipen Parekh
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Radical Prostatectomy ◽  
Prostate Biopsy ◽  
The United States ◽  
Low Grade ◽  
Surgical Specimen ◽  
Aggressive Prostate Cancer ◽  
Free Psa ◽  
Cancer Aggressiveness

65 Background: Most men diagnosed with prostate cancer in the United States have low-grade tumors. While many of these men are good candidates for active surveillance, a proportion will have a bad outcome due to the presence of a more aggressive prostate cancer that was missed on initial biopsy. A recent study confirmed the 4Kscore accurately predicts the likelihood of aggressive cancer on prostate biopsy. We analyzed if the 4Kscore could predict the presence of more significant cancer in men with low-grade tumors on the diagnostic biopsy. Methods: A recent prospective validation of the 4Kscore was conducted at 26 sites throughout the United States. We selected men who were found to have low-grade (Gleason 6) cancer on biopsy for this analysis. The 4Kscore calculates the risk of aggressive prostate cancer on prostate biopsy by a blood test that measures levels of four kallikrein biomarkers (total PSA, free PSA, intact PSA, and human kallikrein-2) plus age, DRE findings, and prior biopsy status. We investigated whether the 4Kscore was associated with more significant cancer among men found to have Gleason 6 cancer on prostate biopsy. We also looked at a subset of these men who underwent radical prostatectomy to see if the 4Kscore was associated with prostate cancer being upgraded in the surgical specimen. Results: Among the 1,312 men enrolled in this trial, 306 men were found to have Gleason 6 cancer on prostate biopsy. The 4Kscore was significantly associated with the number of positive cores (p=0.001) and the millimeters of cancer seen (p=0.0002), with higher 4Kscores relating to more extensive cancer present on biopsy. In the subpopulation of 51 men who underwent radical prostatectomy, the median 4Kscore was significantly higher among men who had an upgrade to Gleason 7 or higher [15% (8,25)] compared to men who did not experience an upgrade [7% (4,14)] (p=0.032) in their final pathology. Conclusions: Among men with Gleason 6 prostate cancer on biopsy, the 4Kscore was associated with the prostate cancer being upgraded in the surgical specimen at radical prostatectomy. The 4Kscore test may facilitate the selection of men who can be observed versus those who should undergo immediate treatment.

scholarly journals Emphasizing the role of Wnt5a protein expression to predict favorable outcome after radical prostatectomy in patients with low‐grade prostate cancer

2012 ◽  
Vol 1 (1) ◽  
pp. 96-104 ◽  
Author(s):  
Azharuddin Sajid Syed Khaja ◽  
Lars Egevad ◽  
Leszek Helczynski ◽  
Peter Wiklund ◽  
Tommy Andersson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Protein Expression ◽  
Favorable Outcome ◽  
Low Grade

Association of chronic baseline prostate inflammation with lower tumor grade in men with prostate cancer on repeat biopsy.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 75-75
Author(s):  
Daniel M. Moreira ◽  
J. Curtis Nickel ◽  
Gerald L. Andriole ◽  
Ramiro Castro ◽  
Stephen J. Freedland
Keyword(s):  
Prostate Cancer ◽  
Chronic Inflammation ◽  
Prostate Biopsy ◽  
Acute Inflammation ◽  
Tumor Grade ◽  
Repeat Biopsy ◽  
Low Grade ◽  
High Grade ◽  
Prostate Biopsies ◽  
Prostate Inflammation

75 Background: We have previously shown that chronic baseline prostate inflammation in an otherwise benign biopsy was associated with lower risk of prostate cancer in repeat prostate biopsies and lower tumor volumes for those who are diagnosed with cancer. In the present study, we evaluated whether baseline acute or chronic prostate inflammation among men with initial negative biopsies for prostate cancer was associated with cancer grade at the 2-year repeat prostate biopsy. Methods: Retrospective analysis of 889 men 50-75 years-old with negative baseline prostate biopsy and positive 2-year repeat biopsy for prostate cancer in the REDUCE study. Acute and chronic prostate inflammation (coded as present or absent) and cancer grade were determined by central pathology. The association of inflammation in baseline biopsies with 2-year repeat biopsy cancer grade (low-grade: Gleason scores 2-6 vs. high-grade: Gleason scores 7-10) was evaluated with t test, chi-squared test and logistic regression controlling for age, race, body-mass index (BMI), digital rectal exam (DRE), prostate volume, baseline pre-study PSA and treatment (dutasteride or placebo). Results: Chronic, acute inflammation and both were detected in 533 (60%), 12 (1%) and 85 (10%) baseline biopsies, respectively. Presence of acute and chronic inflammations were significantly associated with each other (P < 0.001). Patients with chronic inflammation had significantly larger prostates (P < 0.001). Both types of inflammation were unrelated to race, BMI, PSA or DRE. At 2-year biopsy, a total of 621 (70%) tumors were low-grade and 268 (30%) tumors were high-grade. In both uni- and multivariable analyses, men with baseline chronic inflammation had significantly less high-grade tumors (univariable OR = 0.64, 95% CI = 0.47-0.87, P = 0.004; multivariable OR = 0.68, 95% CI = 0.50-0.93, P = 0.016) than those without baseline chronic inflammation. Baseline acute inflammation was not associated with tumor grade. Conclusions: Among men undergoing repeat prostate biopsy 2 years after a negative baseline biopsy who all had cancer on the follow-up biopsy, the presence baseline chronic inflammation was associated with lower prostate cancer grade.

Personalized risk stratification for patients with early prostate cancer (PRONTO): A Canadian team biomarker project.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 109-109
Author(s):  
David Monty Berman ◽  
Robert Lesurf ◽  
Anna YW Lee ◽  
Palak Patel ◽  
Tamara Jamaspishvili ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Risk Stratification ◽  
Sampling Error ◽  
Supervised Machine Learning ◽  
Low Grade ◽  
Gleason Grade ◽  
Intermediate Grade ◽  
Early Prostate Cancer ◽  
Molecular Classifier

109 Background: Current practice stratifies men with prostate cancer into risk groups based primarily on Gleason grade. When applied to biopsy samples, the Gleason grading is inaccurate due to sampling error and inter-observer variation. The result is that men either receive unnecessary surgical treatment, or they don’t receive adequate treatment, leading to worse outcomes. Previously published genomic tests have not successfully distinguished indolent low grade (G6 or GG1) cancers from their more aggressive intermediate grade (G7 or GG2 and 3) counterparts. PRONTO is specifically aimed at creating a multi-modal risk stratification tool to improve treatment stratification following a core biopsy diagnosis. Methods: PRONTO links 7 projects, each with novel diagnostic assays for risk stratification that focus on analysis of copy number variations (CNV), DNA hypermethylation, trans-differentiation, cancer metabolism, or the tumor microenvironment. We merged the best transcripts from each project into a single NanoString gene expression assay, measuring 393 transcripts, in a cohort of 365 cases of radical prostatectomy from low-to-intermediaterisk patients. To minimize sampling error, we took multiple samples, and obtained high grade, low grade and benign areas for each radical prostatectomy case. Results: Our primary goal was to develop a multivariate molecular classifier of grade that distinguished G6 from G7 (3+4 or 4+3). Cases were randomly partitioned into five equally sized groups. A supervised machine learning algorithm (random forests) was trained on samples from four of the groups, and then evaluated by testing on the fifth group. This process was repeated for each of the five groups, yielding a combined clinical and molecular classifier. DNA methylation profiles and CNV profiles are currently being integrated into our classifier Conclusions: We have developed a multivariate classifier that distinguishes low grade from intermediate grade prostate cancer. It will be clinically validated in biopsy samples from large cohorts of early prostate cancer patients.

A Selective Androgen Receptor Modulator (OPK-88004) in Prostate Cancer Survivors: A Randomized Trial

2021 ◽  
Author(s):  
Karol M Pencina ◽  
Arthur L Burnett ◽  
Thomas W Storer ◽  
Wen Guo ◽  
Zhuoying Li ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Androgen Receptor ◽  
Radical Prostatectomy ◽  
Sexual Desire ◽  
Erectile Function ◽  
Bone Markers ◽  
Low Grade ◽  
Prostate Cancer Survivors ◽  
Receptor Modulator ◽  
Psa Recurrence

Abstract Background Androgen deficiency is common among prostate cancer survivors, but many guidelines consider history of prostate cancer a contraindication for testosterone replacement. We determined the safety and efficacy of a selective androgen receptor modulator (OPK-88004) in symptomatic, testosterone-deficient men who had undergone radical prostatectomy for low grade, organ-confined prostate cancer. Methods In this placebo-controlled, randomized, double-blind trial, 114 men, &gt;19 years, who had undergone radical prostatectomy for low grade, organ-localized prostate cancer, undetectable PSA (&lt;0.1 ng/mL) for &gt;2 years after radical prostatectomy and testosterone deficiency were randomized in stages to placebo or 1, 5 or 15 mg OPK-88004 daily for 12-weeks. Outcomes included PSA recurrence, sexual activity, sexual desire, erectile function, body composition, muscle strength and physical function measures, mood, fatigue and bone markers. Results Participants were on average 67.5-years and had severe sexual dysfunction (mean erectile function and sexual desire domain scores 7.3, and 14.6, respectively). No participant experienced PSA recurrence or erythrocytosis. OPK-88004 was associated with a dose-related increase in whole body (P&lt;0.001) and appendicular (P&lt;0.001) lean mass and a significantly greater decrease in percent body fat (p&lt;0.001) and serum alkaline phosphatase (p&lt;0.001) than placebo. Changes in sexual activity, sexual desire, erectile function, mood, fatigue, physical performance, and bone markers did not differ among groups (p=0.73). Conclusions Administration of OPK-8804 was safe and not associated with PSA recurrence in androgen-deficient men who had undergone radical prostatectomy for organ-confined prostate cancer. OPK-88004 increased lean body mass and decreased fat mass, but did not improve sexual symptoms or physical performance.

PCA3 SCORE BASED NOMOGRAM TO PREDICT LOW-VOLUME/LOW-GRADE PROSTATE CANCER IN RADICAL PROSTATECTOMY SPECIMENS

2009 ◽  
Vol 181 (4S) ◽  
pp. 56-56
Author(s):  
John F Ward ◽  
Markus Graefen ◽  
Hartwig Huland ◽  
Jens Köllermann ◽  
Guido Sauter ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Low Grade ◽  
Low Volume

scholarly journals The presence of chronic inflammation in positive prostate biopsy is associated with upgrading in radical prostatectomy

2021 ◽  
Vol 93 (3) ◽  
pp. 280-284
Author(s):  
Ekrem Guner ◽  
Yavuz Onur Danacioglu ◽  
Yusuf Arikan ◽  
Kamil Gokhan Seker ◽  
Salih Polat ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Radical Prostatectomy ◽  
Chronic Inflammation ◽  
Logistic Regression Analysis ◽  
Prostate Biopsy ◽  
Chronic Prostatitis ◽  
Significant Difference ◽  
The Impact

Objective: This study aimed to determine the predictive effect of the presence of chronic prostatitis associated with prostate cancer (PCa) in prostate biopsy on Gleason score upgrade (GSU) in radical prostatectomy (RP) specimens. Materials and methods: The data of 295 patients who underwent open or robotic RP with a diagnosis of localized PCa following biopsy were retrospectively analyzed. Patients were divided into two groups with and without GSU following RP. Predictive factors affecting GSU on biopsy were determined. The impact of chronic prostatitis associated with prostate cancer on GSU was examined via logistic regression analysis. Results: Out of 224 patients with Gleason 3+3 scores on biopsy, 145 (64.7%) had Gleason upgrade, and 79 (35.2%) had no upgrade. Whilst comparing the two groups with and without Gleason upgrade in terms of patient age, prostate-specific antigen (PSA) value, PSA density (PSAD), prostate volume (PV), neutrophil/lymphocyte (N/L) ratio, number of positive cores, percentage of positive cores, and Prostate Imaging Reporting and Data System version 2 score, no statistically significant difference was detected. The presence of chronic prostatitis associated with PCa was higher in the patient cohort with GSU in contrast to the other group (p < 0.001). According to the univariate logistic regression analysis, the presence of chronic prostatitis was identified to be an independent marker for GSU. Conclusions: Pathologists and urologists should be careful regarding the possibility of a more aggressive tumor in the presence of chronic inflammation associated with PCa because inflammation within PCa was revealed to be linked with GSU after RP.

scholarly journals Modification of biochemical recurrence risk in patients with localized prostate cancer after radical prostatectomy with combined histomorphological changes in the peritumoral zone

2018 ◽  
Vol 99 (3) ◽  
pp. 408-415
Author(s):  
F S Bova ◽  
O I Kit ◽  
A Yu Maksimov ◽  
N S Karnaukhov
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Chronic Inflammation ◽  
Biochemical Recurrence ◽  
Intraepithelial Neoplasia ◽  
Prostatic Intraepithelial Neoplasia ◽  
Localized Prostate Cancer ◽  
Risk Of Recurrence ◽  
Number Of Patients ◽  
Risk Of Cancer

Aim. To assess the prognostic significance of histopathological processes in the peritumoral zone with respect to the risk of biochemical recurrence in patients with localized prostate cancer after radical prostatectomy. Methods. Histomorphological studies were conducted in the perifocal area of surgical tissue samples from 309 patients with localized prostate cancer (T1c-2cN0M0) after a radical surgery using light microscopy. Four groups of patients were identified depending on the risk of recurrence. Enzyme immunoassay was used to determine the concentration of prostate-specific antigen in the serum at baseline and every 3 months for two years after the surgery to detect biochemical recurrence. Results. Histomorphological examination of the peritumoral zone made it possible to identify histopathological processes associated with adenocarcinoma in 257 out of 309 (83.2%) patients with localized prostate cancer. The risk of biochemical recurrence of a combination of prostatic adenocarcinoma and prostatic intraepithelial neoplasia-2 increased by 3.3 (p=0.02), and of a combination of adenocarcinoma, neoplasia and chronic inflammation in the perifocal zone increased by 4.5 times (p=0.005) compared to patients without histopathological changes of the peritumoral zone. In combination of prostate adenocarcinoma with neoplasia and chronic inflammation in the peritumoral zone, the number of patients with an intermediate risk of cancer recurrence after surgical treatment increased due to decrease of the proportion of patients with very low and low risk of recurrence of the oncologic disease. Conclusion. The combination of prostate cancer with high-grade prostatic intraepithelial neoplasia and chronic inflammation in the peritumoral zone modifies the risk of biochemical recurrence of cancer after radical prostatectomy.

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