Biochemical Recurrence in Prostate Cancer: The European Association of Urology Prostate Cancer Guidelines Panel Recommendations

Broeck, Thomas Van den; Bergh, Roderick C.N. van den; Briers, Erik; Cornford, Philip; Cumberbatch, Marcus; Tilki, Derya; Santis, Maria De; Fanti, Stefano; Fossati, Nicola; Gillessen, Silke; Grummet, Jeremy; Henry, Ann; Lardas, Michael; Liew, Matthew; Mason, Malcolm David; Moris, Lisa; Schoots, Ivo G.; Kwast, Theodorus van der; Poel, Henk van der; Wiegel, Thomas; Willemse, Peter Paul M.; Rouvière, Olivier; Lam, Thomas; Mottet, Nicolas

doi:10.1016/j.euf.2019.06.004

Cited by 163 publications

(102 citation statements)

References 23 publications

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“…Future studies should focus on validating the predictive power of the five-miRNA panel in a prospective and multi-institutional setting. It would be worthwhile to include a head-to-head comparison with other multiple-miRNA-based tools, using a currently published novel EAU BCR risk stratification system as outcome endpoint [110].…”

Section: Discussionmentioning

confidence: 99%

A Novel Predictor Tool of Biochemical Recurrence after Radical Prostatectomy Based on a Five-MicroRNA Tissue Signature

Zhi

Weickmann

Jung

et al. 2019

Cancers

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Within five to ten years after radical prostatectomy (RP), approximately 15–34% of prostate cancer (PCa) patients experience biochemical recurrence (BCR), which is defined as recurrence of serum levels of prostate-specific antigen >0.2 µg/L, indicating probable cancer recurrence. Models using clinicopathological variables for predicting this risk for patients lack accuracy. There is hope that new molecular biomarkers, like microRNAs (miRNAs), could be potential candidates to improve risk prediction. Therefore, we evaluated the BCR prognostic capability of 20 miRNAs, which were selected by a systematic literature review. MiRNA expressions were measured in formalin-fixed, paraffin-embedded (FFPE) tissue RP samples of 206 PCa patients by RT-qPCR. Univariate and multivariate Cox regression analyses were performed, to assess the independent prognostic potential of miRNAs. Internal validation was performed, using bootstrapping and the split-sample method. Five miRNAs (miR-30c-5p/31-5p/141-3p/148a-3p/miR-221-3p) were finally validated as independent prognostic biomarkers. Their prognostic ability and accuracy were evaluated using C-statistics of the obtained prognostic indices in the Cox regression, time-dependent receiver-operating characteristics, and decision curve analyses. Models of miRNAs, combined with relevant clinicopathological factors, were built. The five-miRNA-panel outperformed clinically established BCR scoring systems, while their combination significantly improved predictive power, based on clinicopathological factors alone. We conclude that this miRNA-based-predictor panel will be worth to be including in future studies.

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Section: Discussionmentioning

confidence: 99%

A Novel Predictor Tool of Biochemical Recurrence after Radical Prostatectomy Based on a Five-MicroRNA Tissue Signature

Zhi

Weickmann

Jung

et al. 2019

Cancers

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“…Treatment selection for patients with BCR depends on the site of recurrence and the extent of progression; this information will be derived using imaging and other assessment including biomarker-based (such as GS) risk evaluation and PSA changes (236). Life expectancy, quality of life (QOL) and the time span of approximately 8 years for metastatic progression from BCR (7,13) are among the factors that affect treatment decision making (237,254).…”

Section: Management Of Patients With Biochemical Recurrencementioning

confidence: 99%

“…For patients with BCR following RT, salvage RP is an option with confirmed local recurrence according to EAU-ESTRO-SIOG guidelines (7). Similarly, the prostate cancer guidelines from the European Association of Nuclear Medicine (EAU-EANM)-European Society of Urogenital Radiology (ESTRO-ESUR)-SIOG classify males with BCR into a low-risk [PSA-DT >1 year and pathological GS (pGS) <8 or International Society of Urological Pathology (ISUP) grade <4] and high-risk group (PSA-DT ≤1 year, pGS 8-10 or ISUP grade 4-5) for biological recurrence following RP or a low-risk [IBF (interval from primary therapy to biochemical failure) >18 months and biopsy GC (bGS) <8 or ISUP grade <4] and high-risk (IBF ≤18 months and) groups (pGS 8-10 or ISUP grade 4-5) (254). The stratification was recently validated based on the 5-year risk of developing metastasis and PCSM in a large cohort of patients with BCR (n=1,040) (257).…”

Section: Management Of Patients With Biochemical Recurrencementioning

confidence: 99%

Assessment of biochemical recurrence of prostate cancer (Review)

Lin

Kapoor

et al. 2019

Int J Oncol

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The assessment of the risk of biochemical recurrence (BCR) is critical in the management of males with prostate cancer (PC). Over the past decades, a comprehensive effort has been focusing on improving risk stratification; a variety of models have been constructed using PC-associated pathological features and molecular alterations occurring at the genome, protein and RNA level. Alterations in RNA expression (lncRNA, miRNA and mRNA) constitute the largest proportion of the biomarkers of BCR. In this article, we systemically review RNA-based BCR biomarkers reported in PubMed according to the PRISMA guidelines. Individual miRNAs, mRNAs, lncRNAs and multigene panels, including the commercially available signatures, Oncotype DX and Prolaris, will be discussed; details related to cohort size, hazard ratio and 95% confidence intervals will be provided. Mechanistically, these individual biomarkers affect multiple pathways critical to tumorigenesis and progression, including epithelial-mesenchymal transition (EMT), phosphatase and tensin homolog (PTEN), Wnt, growth factor receptor, cell proliferation, immune checkpoints and others. This variety in the mechanisms involved not only validates their associations with BCR, but also highlights the need for the coverage of multiple pathways in order to effectively stratify the risk of BCR. Updates of novel biomarkers and their mechanistic insights are considered, which suggests new avenues to pursue in the prediction of BCR. Additionally, the management of patients with BCR and the potential utility of the stratification of the risk of BCR in salvage treatment decision making for these patients are briefly covered. Limitations will also be discussed. Contents 1. Introduction 2. Stratification of BCR risk: An update 3. Searching methods for RNA-based BCR biomarkers 4. Gene expression-based biomarkers 5. Management of patients with biochemical recurrence 6. Perspectives

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“…(2016) безрецидивная выживаемость после РАРП через 24 месяца после операции была статистически значимо лучше, чем у открытой операции [45]. Однако с учетом факторов риска, таких как стадия pT, значение ПСА сыворотки крови в предоперационном периоде и балл по шкале Глисона, статистически значимых различий в онкологических результатах пока не выявлено [46].…”

Section: сравнение медико-онкологических аспектов открытой и роботизиunclassified

Radical Prostatectomy: from Open Surgery towards Robotic Laparoscopy

Виланд

Burger

Denzinger

et al. 2020

Kreativnaâ hirurgiâ i onkologiâ

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Radical prostatectomy was first performed more than 100 years ago and has since become the gold standard in treatment of localized prostate cancer. Open surgery has been almost entirely replaced by robotic operations referred to as robot-assisted radical prostatectomy (RARP). Th e article introduces the basics of this innovative standard of operative access and tackles medical and historical aspects, oncological, medical and economic management pros and contras of robotic aid over open radical prostatectomy. Surgical trauma in RARP is clearly less pronounced compared to open surgery due to a much earlier postoperative mobilisation and a faster rehabilitation of patients leading to a statistically significant reduction in the length of hospital stay after RARP. Along with advances in intracorporeal imaging with 16-fold optical magnification coupled with shorter urethral catheterisation, RARP facilitates an earlier start of pelvic floor exercises, which reduces postoperative incontinence and need for pain relievers. Th e already mentioned technical advantages of the robotic method hold value to both patient and surgeon by securing instant access for an experienced colleague without interrupting the surgery. Noteworthy, the increasing advancement of robotic systems across the globe is leading urologist surgeons to abandon open operations. A drawback of the robotic method is much higher economic costs. However, greater expenditures may pay off in the long run by shorter hospital stays, faster rehabilitation and fewer complications demanding extra management and care.

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Biochemical Recurrence in Prostate Cancer: The European Association of Urology Prostate Cancer Guidelines Panel Recommendations

Cited by 163 publications

References 23 publications

A Novel Predictor Tool of Biochemical Recurrence after Radical Prostatectomy Based on a Five-MicroRNA Tissue Signature

A Novel Predictor Tool of Biochemical Recurrence after Radical Prostatectomy Based on a Five-MicroRNA Tissue Signature

Assessment of biochemical recurrence of prostate cancer (Review)

Radical Prostatectomy: from Open Surgery towards Robotic Laparoscopy

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