scholarly journals Immunophenotype Rearrangement in Response to Tumor Excision May Be Related to the Risk of Biochemical Recurrence in Prostate Cancer Patients

2021 ◽  
Vol 10 (16) ◽  
pp. 3709
Author(s):  
Paulius Bosas ◽  
Gintaras Zaleskis ◽  
Daiva Dabkevičiene ◽  
Neringa Dobrovolskiene ◽  
Agata Mlynska ◽  
...  

Background: Prostate cancer (PCa) is known to exhibit a wide spectrum of aggressiveness and relatively high immunogenicity. The aim of this study was to examine the effect of tumor excision on immunophenotype rearrangements in peripheral blood and to elucidate if it is associated with biochemical recurrence (BCR) in high risk (HR) and low risk (LR) patients. Methods: Radical prostatectomy (RP) was performed on 108 PCa stage pT2–pT3 patients. Preoperative vs. postoperative (one and three months) immunophenotype profile (T- and B-cell subsets, MDSC, NK, and T reg populations) was compared in peripheral blood of LR and HR groups. Results: The BCR-free survival difference was significant between the HR and LR groups. Postoperative PSA decay rate, defined as ePSA, was significantly slower in the HR group and predicted BCR at cut-off level ePSA = −2.0% d−1 (AUC = 0.85 (95% CI, 0.78–0.90). Three months following tumor excision, the LR group exhibited a recovery of natural killer CD3 − CD16+ CD56+ cells, from 232 cells/µL to 317 cells/µL (p < 0.05), which was not detectable in the HR group. Prostatectomy also resulted in an increased CD8+ population in the LR group, mostly due to CD8+ CD69+ compartment (from 186 cells/µL before surgery to 196 cells/µL three months after, p < 001). The CD8+ CD69+ subset increase without total T cell increase was present in the HR group (p < 0.001). Tumor excision resulted in a myeloid-derived suppressor cell (MDSC) number increase from 12.4 cells/µL to 16.2 cells/µL in the HR group, and no change was detectable in LR patients (p = 0.12). An immune signature of postoperative recovery was more likely to occur in patients undergoing laparoscopic radical prostatectomy (LRP). Open RP (ORP) was associated with increased MDSC numbers (p = 0.002), whereas LRP was characterized by an immunity sparing profile, with no change in MDSC subset (p = 0.16). Conclusion: Tumor excision in prostate cancer patients results in two distinct patterns of immunophenotype rearrangement. The low-risk group is highly responsive, revealing postoperative restoration of T cells, NK cells, and CD8+ CD69+ numbers and the absence of suppressor MDSC increase. The high-risk group presented a limited response, accompanied by a suppressor MDSC increase and CD8+ CD69+ increase. The laparoscopic approach, unlike ORP, did not result in an MDSC increase in the postoperative period.

2015 ◽  
Vol 22 (3) ◽  
pp. 161-168
Author(s):  
Albertas Ulys ◽  
Agnė Ulytė ◽  
Pavel Dziameshka ◽  
Oleg Sukonko ◽  
Sergei Krasny ◽  
...  

Background/objective. Predictive criteria are needed to evaluate the risk of disease progression after radical prostatectomy. Such criteria would help to select patients most likely to benefit from adjuvant or multimodality treatment. Our aim was to identify predictive factors for biochemical recurrence among the  pre- and post-operative parameters in high-risk prostate cancer patients after radical prostatectomy. Methods. Data on high-risk prostate cancer patients between 2005 and 2009 were retrospectively reviewed in two cancer centers: National Cancer Institute, Vilnius, Lithuania, and N.  N.  Alexandrov National Cancer Centre of Belarus, Minsk, Belarus. 199 patients were selected for the  study. The  pre-operative independent variables were T stage, pretreatment PSA level and Gleason score. Surgical margins and perineural invasion were additionally known for 122 patients. The outcomes measured were biochemical recurrence free and overall survival. The mean follow-up time was 5.8 years. Results. Lower T stage (p = 0.001) and pretreatment PSA (p = 0.0001) were associated with better survival. In the multivariate analysis of pre-operative factors, high T stage (p = 0.008) and pretreatment PSA (p = 0.009) were predictive of biochemical recurrence. When postoperative parameters were included in the multivariate analysis, only pretreatment PSA (p = 0.01), positive surgical margins (p = 0.003) and perineural invasion (p = 0.03) remained relevant independent predictors of biochemical recurrence. Conclusions. Pretreatment PSA, positive surgical margins and perineural invasion were independent predictors of biochemical recurrence after radical prostatectomy in high-risk prostate cancer patients, while the  T stage became insignificant after adjusting for postoperative parameters.


Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2732
Author(s):  
Seo Hee Choi ◽  
Young Seok Kim ◽  
Jesang Yu ◽  
Taek-Keun Nam ◽  
Jae-Sung Kim ◽  
...  

Purpose: This nationwide multi-institutional study analyzed the patterns of care and outcomes of external beam radiotherapy (EBRT) in localized prostate cancer patients. We compared various risk classification tools and assessed the need for refinements in current radiotherapy (RT) schemes. Methods and Materials: We included non-metastatic prostate cancer patients treated with primary EBRT from 2001 to 2015 in this study. Data of 1573 patients from 17 institutions were analyzed and re-grouped using a risk stratification tool with the highest predictive power for biochemical failure-free survival (BCFFS). We evaluated BCFFS, overall survival (OS), and toxicity rates. Results: With a median follow-up of 75 months, 5- and 10-year BCFFS rates were 82% and 60%, and 5- and 10-year OS rates were 95% and 83%, respectively. NCCN risk classification revealed the highest predictive power (AUC = 0.556, 95% CI 0.524–0.588; p < 0.001). Gleason score, iPSA < 12 ng/mL, intensity-modulated RT (IMRT), and ≥179 Gy1.5 (EQD2, 77 Gy) were independently significant for BCFFS (all p < 0.05). IMRT and ≥179 Gy1.5 were significant factors in the high-risk group, whereas ≥170 Gy1.5 (EQD2, 72 Gy) was significant in the intermediate-risk group and no significant impact of dose was observed in the low-risk group. Both BCFFS and OS improved significantly when ≥179 Gy1.5 was delivered using IMRT and hypofractionation in the high-risk group without increasing toxicities. Conclusions: With NCCN risk classification, dose escalation with modern high-precision techniques might increase survivals in the high-risk group, but not in the low-risk group, although mature results of prospective studies are awaited.


2007 ◽  
Vol 177 (4S) ◽  
pp. 130-130
Author(s):  
Markus Graefen ◽  
Jochen Walz ◽  
Andrea Gallina ◽  
Felix K.-H. Chun ◽  
Alwyn M. Reuther ◽  
...  

2005 ◽  
Vol 173 (4S) ◽  
pp. 222-222 ◽  
Author(s):  
Adam S. Kibel ◽  
Joel Picus ◽  
Michael S. Cookson ◽  
Bruce Roth ◽  
David F. Jarrard ◽  
...  

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