scholarly journals Persistent, Biologically Meaningful Prostate Cancer After 1 Year of Androgen Ablation and Docetaxel Treatment

2011 ◽  
Vol 29 (18) ◽  
pp. 2574-2581 ◽  
Author(s):  
Vassiliki Tzelepi ◽  
Eleni Efstathiou ◽  
Sijin Wen ◽  
Patricia Troncoso ◽  
Maria Karlou ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Cancer Progression ◽  
Intracellular Signaling ◽  
Regional Lymph Node ◽  
Locally Advanced ◽  
Immunohistochemical Analysis ◽  
Therapy Resistance ◽  
Primary Site ◽  
Androgen Ablation

Purpose Clinicians are increasingly willing to treat prostate cancer within the primary site in the presence of regional lymph node or even limited distant metastases. However, no formal study on the merits of this approach has been reported. We used a preoperative clinical discovery platform to prioritize pathways for assessment as therapeutic targets and to test the hypothesis that the primary site harbors potentially lethal tumors after aggressive treatment. Patients and Methods Patients with locally advanced or lymph node–metastatic prostate cancer underwent 1 year of androgen ablation and three cycles of docetaxel therapy, followed by prostatectomy. All specimens were characterized for stage by accepted criteria. Expression of select molecular markers implicated in disease progression and therapy resistance was determined immunohistochemically and compared with that in 30 archived specimens from untreated patients with high-grade prostate cancer. Marker expression was divided into three groups: intracellular signaling pathways, stromal-epithelial interaction pathways, and angiogenesis. Results Forty patients were enrolled, 30 (75%) of whom underwent prostatectomy and two (5%) who underwent cystoprostatectomy. Twenty-nine specimens contained sufficient residual tumor for inclusion in a tissue microarray. Immunohistochemical analysis showed increased epithelial and stromal expression of CYP17, SRD5A1, and Hedgehog pathway components, and modulations of the insulin-like growth factor I pathway. Conclusion A network of molecular pathways reportedly linked to prostate cancer progression is activated after 1 year of therapy; biomarker expression suggests that potentially lethal cancers persist in the primary tumor and may contribute to progression.

scholarly journals Treating the patient and not just the cancer: therapeutic burden in prostate cancer

2021 ◽  
Author(s):  
Daniel E. Spratt ◽  
Neal Shore ◽  
Oliver Sartor ◽  
Dana Rathkopf ◽  
Kara Olivier
Keyword(s):  
Prostate Cancer ◽  
Second Generation ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Patient Treatment ◽  
Free Survival ◽  
Androgen Ablation ◽  
Therapeutic Benefits ◽  
Age Related ◽  
Concomitant Medications

Abstract Background Prostate cancer (PC) is a leading cause of death in older men. Androgen deprivation therapy (ADT) is considered the standard-of-care for men with locally advanced disease. However, continuous androgen ablation is associated with acute and long-term adverse effects and most patients will eventually develop castration-resistant PC (CRPC). The recent approval of three, second-generation androgen receptor inhibitors (ARIs), apalutamide, enzalutamide, and darolutamide, has transformed the treatment landscape of PC. Treatment with these second-generation ARIs have produced positive trends in metastasis-free survival, progression-free survival, and overall survival. For patients with non-metastatic CRPC, who are mainly asymptomatic from their disease, maintaining quality of life is a major objective when prescribing therapy. Polypharmacy for age-related comorbidities also is common in this population and may increase the potential for drug–drug interactions (DDIs). Method This review summarizes the multiple factors that may contribute to the therapeutic burden of patients with CRPC, including the interplay between age, comorbidities, concomitant medications, the use of ARIs, and financial distress. Conclusions As the treatment landscape in PC continues to rapidly evolve, consideration must be given to the balance between therapeutic benefits and potential treatment-emergent adverse events that may be further complicated by DDIs with concomitant medications. Patient-centered communication is a crucial aspect of alleviating this burden, and healthcare professionals (HCPs) may benefit from training in effective patient communication. HCPs should closely and frequently monitor patient treatment responses, in order to better understand symptom onset and exacerbation. Patients also should be encouraged to participate in exercise programs, and health information and support groups, which may assist them in preventing or mitigating certain determinants of the therapeutic burden associated with PC and its management.

scholarly journals Invasion of the pterygoid plates: an indicator for regional lymph node failure in maxillary sinus cancer

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yasuo Kosugi ◽  
Terufumi Kawamoto ◽  
Masaki Oshima ◽  
Mitsuhisa Fujimaki ◽  
Shinichi Ohba ◽  
...  
Keyword(s):  
Lymph Node ◽  
Oral Cavity ◽  
Maxillary Sinus ◽  
Regional Lymph Node ◽  
Locally Advanced ◽  
Intraarterial Chemotherapy ◽  
Node Failure ◽  
Long Term Treatment ◽  
Maxillary Sinus Cancer ◽  
Sinus Cancer

Abstract Background The aim of this study was to evaluate the long-term treatment results of combined superselective intraarterial chemotherapy and radiation therapy for advanced maxillary sinus cancer (MSC) and the incidence of regional lymph node failure, and to reveal the clinical and anatomical predictive factors for metastasis. Methods We retrospectively evaluated 55 consecutive patients with locally advanced squamous cell carcinoma of the maxillary sinus who were treated with external radiotherapy and superselective intraarterial chemotherapy. Elective nodal irradiation (ENI) was performed only in the clinical node-positive (cN+) cases and not in the clinical node-negative (cN0) cases. Results: Thirty-eight patients were cN0, and 17 were cN+ at diagnosis. Regional lymph node metastases occurred in 7 of 38 patients with cN0, and 2 of 17 with cN+ during the median follow-up period of 36 months. There were more cases of high-grade (3 or 4) late adverse events in the ENI group than in the non-ENI group (13% vs. 41%, respectively; p = 0.03). In cN0 cases without ENI, invasion of the pterygoid plates (57% vs. 90%; p < 0.01) and oral cavity (35% vs. 92%, with invasion vs without invasion, respectively; p = 0.02) was significantly correlated with a low 5-year regional recurrence-free rate. Conclusions Patients with MCS and invasion of the pterygoid plates and oral cavity can be considered appropriate candidates for ENI.

Treatment of prostate cancer with regional lymph node (N1) metastasis

2003 ◽  
Vol 13 (2) ◽  
pp. 121-129 ◽  
Author(s):  
A POLLACK ◽  
E HORWITZ ◽  
B MOVSAS
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Regional Lymph Node

Lactate Dehydrogenase Is a Serum Prognostic Factor in Clinically Regional Lymph Node-positive Prostate Cancer

2021 ◽  
Vol 41 (8) ◽  
pp. 3885-3889
Author(s):  
LEANDRO BLAS ◽  
MASAKI SHIOTA ◽  
SHIGETOMO YAMADA ◽  
KOSUKE IEIRI ◽  
SHOHEI NAGAKAWA ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Lactate Dehydrogenase ◽  
Prognostic Factor ◽  
Regional Lymph Node ◽  
Node Positive ◽  
Lymph Node Positive

Disease Progression in Bladder Cancer: Which Developments since 1994

2009 ◽  
Vol 76 (2) ◽  
pp. 115-117
Author(s):  
V. Varca ◽  
A. Simonato ◽  
P. Traverso ◽  
A. Romagnoli ◽  
F. Venzano ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bladder Cancer ◽  
Lymph Node ◽  
Radical Prostatectomy ◽  
Lymph Nodes ◽  
Radical Cystectomy ◽  
Public Awareness ◽  
Locally Advanced ◽  
Node Dissection ◽  
Group 2

Objectives The introduction of PSA in clinical practice has resulted in decreasing the death rate form prostate cancer and in a downward shift of the pathological stage in radical prostatectomy specimens. This seems not to be the case for bladder cancer. In order to verify this assumption, we have reviewed the charts of the patients operated on of radical prostatectomy and radical cystectomy between 1994 and 2006. Methods 456 and 491 consecutive patients, respectively, underwent radical cystectomy and radical prostatectomy with bilateral lymph nodes dissection. We excluded all the patients who had received neoadjuvant treatment or did not undergo node dissection. The patients were divided into two consecutive groups according to the year of treatment: group 1 included pts treated from 1994 to 2000, and group 2 pts from 2001 to 2006. The histopathological findings of the two groups of pts were compared. The difference among TNM systems has been balanced evaluating histopathological reports critically and converting them to the 2002 edition. Results For patients with prostate cancer, those in group 2 had a decrease in the incidence of extracapsular extension and lymph nodes invasion. The bladder cancer patients belonging to group 2 had a greater number of T2, but there was an increased number of pN+ in this group. Conclusions Even if there is a decline in locally advanced disease in patients with bladder cancer, our retrospective analysis did not show a comparable success in early diagnosis as it did for prostate cancer. There is undoubtedly an increase in the lymph node dissemination, whether this is due to a more extended lymph node dissection or to a premature dissemination remains questionable. Public awareness regarding bladder cancer and its risk factors is limited, but several studies have reported that a delay in diagnosis of invasive bladder cancer is an adverse prognostic factor. A higher care in the development of new diagnostic markers for bladder tumors and especially in the screening protocols together with an earlier radical therapy could hopefully improve the management of such a pathology, as it happened for prostate cancer.

scholarly journals Distinguishing between HPV-Associated Metastatic Anal Squamous Cell Cancer and HPV-Associated Oropharyngeal Cancer

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Steven Sorscher
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Regional Lymph Node ◽  
Cell Cancer ◽  
Locally Advanced ◽  
Squamous Carcinoma ◽  
Therapeutic Implications ◽  
A Site

The histology and immunohistochemistry (IHC) of primary and metastatic diseases from a human papilloma virus- (HPV-) related anal squamous carcinoma (ASCC) would typically demonstrate the same histology as an HPV-related oropharyngeal squamous carcinoma (OPSCC). However, determining whether a site of squamous cell carcinoma represents distant metastatic ASCC versus a metastatic HPV-related metastasis from an OPSCC to a regional lymph node carries profound prognostic and therapeutic implications. A patient with a history of locally advanced ASCC treated with standard concurrent radiation therapy and chemotherapy in 2015 is described. In 2018, an enlarged supraclavicular lymph node was excised demonstrating squamous cell carcinoma and radiographic staging revealed no other areas suspicious for malignancy. Direct laryngoscopy with operating telescope and biopsies demonstrated squamous cell carcinoma at the tongue base. Described here are assays that might be considered in distinguishing between whether a focus distant from a previously identified ASCC represents metastatic disease or instead a separate primary HPV-related cancer.

scholarly journals Differing Roles of Hyaluronan Molecular Weight on Cancer Cell Behavior and Chemotherapy Resistance

Cancers ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 482 ◽  
Author(s):  
Zoe Price ◽  
Noor Lokman ◽  
Carmela Ricciardelli
Keyword(s):  
Molecular Weight ◽  
Tyrosine Kinase ◽  
Cancer Cell ◽  
Cancer Progression ◽  
Receptor Tyrosine Kinase ◽  
Intracellular Signaling ◽  
Therapy Resistance ◽  
Cell Behavior ◽  
Mesenchymal Transition

Hyaluronan (HA), a glycosaminoglycan located in the extracellular matrix, is important in embryo development, inflammation, wound healing and cancer. There is an extensive body of research demonstrating the role of HA in all stages of cancer, from initiation to relapse and therapy resistance. HA interacts with multiple cell surface receptors, including CD44, receptor for hyaluronan mediated motility (RHAMM) and intracellular signaling pathways, including receptor tyrosine kinase pathways, to promote the survival and proliferation of cancer cells. Additionally, HA promotes the formation of cancer stem cell (CSC) populations, which are hypothesized to be responsible for the initiation of tumors and therapy resistance. Recent studies have identified that the molecular weight of HA plays differing roles on both normal and cancer cell behavior. This review explores the role of HA in cancer progression and therapy resistance and how its molecular weight is important in regulating CSC populations, epithelial to mesenchymal transition (EMT), ATP binding cassette (ABC) transporter expression and receptor tyrosine kinase pathways.

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