Comparison of outcomes between medical and surgical treatment in dogs with prostatic adenocarcinoma: a retrospective study

Background Prostatic cancer is uncommon in dogs. Dogs with prostatic carcinoma have been reported to have a poor prognosis. Information regarding prognosis with various surgery options as well as prognosis with surgical vs. medical treatment is lacking. This retrospective study compares the outcomes of medical management to surgical treatment in dogs with prostatic adenocarcinoma and assesses the surgical outcomes of patients who underwent total prostatectomy (TP) and prostatocystectomy (TPC). The medical records of 41 dogs with prostatic adenocarcinoma, between February 2008 and June 2019, were reviewed for information on signalment, clinical signs in the initial evaluation, preoperative diagnostic imaging findings, treatment type (non-surgical or surgical), surgery type, postoperative complications, adjunctive medical therapy, and survival time. The dogs were divided into non-surgical (n = 12) or surgical (n = 29) groups. The surgical group was subdivided into the TP (n = 20) and TPC (n = 9) subgroups. Results Age was not significantly different between the surgical (median 13.1 years [8.4–15.4] years) and the non-surgical groups (median 10.8 [7.7–15.3] years). Body weight (BW) was also not significantly different between the surgical (median 6.8 kg [2.4–34.5 kg]) and non-surgical groups (median 6.4 kg [3.7–9.12 kg]). The overall median survival time (MST) from the initial evaluation was significantly longer in the surgical than in the non-surgical group (337 vs. 90.5 days). The postoperative MST was significantly longer in the TP group than in the TPC subgroup (510 vs. 83 days). As TPC was performed in cases of tumor progression, its postoperative complications were severe, resulting in a shorter MST. Ten (50%) and 6 patients (30%) in the TP subgroup postoperatively showed mild and severe urinary incontinence, respectively, whereas all patients in TPC subgroup did show severe incontinence. Conclusion Results of the study suggest that surgical treatment of prostatic carcinoma results in longer survival times over medical management alone. In particular, TP might be recommended for improving survival time and quality of life in canine prostatic adenocarcinoma that does not infiltrate the bladder. Early detection is key for a survival advantage with surgical treatment.

Assessment of Utility of Immunohistochemical Marker Prostein for Evaluation of Primary and Metastatic Prostatic Carcinomas

Background: To assess utility of immunohistochemical marker prostein for evaluation of primary and metastatic prostatic carcinomas.Methods:Fifty- six samples of clinically suspected carcinoma prostate was included. Immunohistochemistry (IHC) was performed for assessment of Prostein (P501S). The intensity of positivity was scored from 0 to 3 as follows: score 0 = non-stained; score 1 = weak; score 2 = moderate; and score 3 = strong. The percentage of positively stained cells for each staining intensity was estimated in the respective lesions.Results:Age group 18-28 years comprised of 6 patients, 28-38 years had 12, 38- 48 years had 16 and >48 years had 22 cases. Type of cases were normal prostatic epithelium in 11, benign prostate hyperplasia in 23, HGPIN in 10, primary prostatic adenocarcinoma in 7 and metastatic prostatic adenocarcinoma in 5 cases. Prostein expression was seen in 100% in normal prostatic epithelium with intensity score of 1.8-2.1, benign prostate hyperplasia having 2-2.7, HGPIN with 2-2.3, primary prostatic adenocarcinoma having 1-1.6 and metastatic prostatic adenocarcinoma with 0.8-1.4 intensity score. Conclusion:Prostein is a new prostate specific marker which showed 100% sensitivity and specificity to identify normal and prostatic lesions.

The Incidental prostatic adenocarcinoma and transitional cell carcinoma involvement of the prostate gland in patients undergoing radical cystoprostatectomy for bladder cancer treatment in Rajavithi Hospital

Objective: To determine the incidence of incidental prostatic adenocarcinoma and transitional cell carcinoma (TCC) involvement of the prostate gland in patients undergoing radical cystoprostatectomy in Rajavithi Hospital, Secondly, to assess the possible influence of the patient factors and bladder cancer on the pathological findings of the prostate gland. Materials and Methods: We retrospectively reviewed 169 male patients who had undergone radical cystoprostatectomy for bladder cancer between April 2013 and August 2019. Pathologic findings of the prostate gland and urothelial cancer in the prostate gland were catalogued. Information including age, body mass index (BMI), underlying disease, glomerular filtration rate (GFR), pathologic stage, and grade was collected and analyzed to determine any correlations. Results: Incidental prostatic adenocarcinoma and TCC involvement of the prostate gland were found in 15 patients (8.9%) and 29 patients (17.2%), respectively. There were no correlations between patient demographics and pathological findings of the prostate gland. Conclusion: Although the incidence of incidental prostatic adenocarcinoma and TCC involvement of the prostate gland in our research is low, the screening of every candidate for prostate sparing cystectomy with a digital rectal examination, prostate-specific antigen, and transurethral biopsy of the prostatic urethra and bladder neck prior to surgery are recommended.

Advanced Therapeutic Options for Treatment of Metastatic Castration Resistant Prostatic Adenocarcinoma

The initial stage of prostatic adenocarcinoma (PaC) has been treated with surgery and radiation therapy, but the advanced stages need systemic novel treatment. Since 2010, several advanced therapeutic innovations have been introduced in various randomized clinical trials to improve survival and reduce morbidity and mortality. Several of these therapeutics have shown substantial survival assistance globally, even in the advanced stages of metastatic castration-resistant prostatic adenocarcinoma (mCRPC). This article describes advanced PaC therapy regimens including chemotherapeutic options, hormonal therapies (abiraterone, enzalutamide), immunotherapeutic agents, and bone-modifying agents. We discussed various pros and cons of gene therapy approaches including Crispr/Cas9 mediation, oncolytic viruses, suicidal genes, and micro-RNA based antitumor therapy. The mCRPC microenvironment is characterized by elevated prostate-specific antigen (PSA) levels, which ultimately trigger the androgen receptor (AR) and its dependent signaling pathways. The advanced therapeutics target these receptors and inhibit the steroidogenic enzymes that play an important role in increasing testosterone (T) and dihydrotestosterone (DHT) levels in the body. These advanced therapeutic novelties also target AR-independent oncogenic signaling pathways by focusing on DNA damage repair (DDR) pathways and their mechanisms. Some of these options appear to be very attractive strategies for acute and chronic stages of PaC and mCRPC treatment by overcoming the mechanisms of resistance.

Large-scale human tissue analysis identifies Uroplakin 1b as a putative diagnostic marker in surgical pathology

Introduction/Objective Uroplakin 1B (Upk1b) protein is relevant for stabilizing and strengthening epithelial cells that line the bladder. It helps to prevent urothelial cells from rupturing during bladder distension. Based on RNA expression studies Upk1b is expressed in a limited number of normal tissues. Methods/Case Report To comprehensively evaluate the potential diagnostic and prognostic utility of Upk1b expression analysis, a tissue microarray containing 15,182 samples from 127 different tumor types and subtypes and 608 samples of 76 different normal tissue types was analyzed by immunohistochemistry. Results (if a Case Study enter NA) Upk1b positivity was found in 61 (48%) different tumor types including 50 (39%) with at least one moderately positive and 39 tumor types (31%) with at least one strongly positive tumor. The highest positivity rate and the highest levels of expression was found in urothelial neoplasms (58-95%), Brenner tumors of the ovary (92%), epitheloid mesothelioma (87%), serous carcinomas of the ovary (58%) and the endometrium (53%) as well as squamous cell carcinomas of various sites of origin. Immunostaining was infrequent in lung adenocarcinoma (0%) and largely absent in colorectal (0.7%) or prostatic adenocarcinoma (1.3%). In urothelial tumors cancer, low Upk1b expression was linked to high grade and invasive tumor growth (p<0.0001 each) as well as nodal metastasis (p=0.0006) but an unequivocal link to unfavorable tumor features was lacking in various other tumor entities. Conclusion In conclusion, the differential Upk1b expression in different tumor entities suggests potential diagnostic applications of Upk1b immunohistochemistry in panels for the distinction of malignant mesothelioma from adenocarcinoma of the lung, urothelial carcinoma from prostatic adenocarcinoma in the bladder, or pancreatico-biliary and gastro-esophageal from colorectal adenocarcinomas.