Control oncológico en cáncer de próstata de alto riesgo tras prostatectomía radical y radioterapia de rescate en comparación con radioterapia más hormonoterapia primaria

Caño-Velasco, J.; Herranz-Amo, F.; Bernardos, G. Barbas; Polanco-Pujol, L.; Verdú-Tartajo, F.; Lledó-García, E.; Hernández-Fernández, C.

doi:10.1016/j.acuro.2018.07.007

Cited by 3 publications

(6 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1,2 Almost all the studies published to date are case reports or case series. [2][3][4][5][6][8][9][10][11][12][13] The first report of mucin-producing urothelial-type adenocarcinoma of the prostate was made by Tran and Epstein in 1996. 2 In their study, they reported two patients that showed hematuria, urinary obstruction symptoms, and normal PSA levels.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Mucin-producing urothelial-type adenocarcinoma of the prostate is an extremely rare neoplasm, and its coexistence with a prostatic acinar adenocarcinoma is exceptional. To date, there are only 26 cases of mucin-producing urothelial-type adenocarcinoma of the prostate described in the literature, [2][3][4][5][6][7][8][9][10][11][12][13] and only two of them had minute foci of acinar adenocarcinoma of the prostate. 7…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Rare Case of Co-Existing Mucin-Producing Urothelial-Type Adenocarcinoma of the Prostate and Acinar Adenocarcinoma

Nova-Camacho

Mateos

2022

Int J Surg Pathol

View full text Add to dashboard Cite

Mucin-producing urothelial-type adenocarcinoma of the prostate is an extremely rare neoplasm, and its coexistence with acinar adenocarcinoma is exceptional. A 70-year-old man presented with treatment resistant symptoms of urinary obstruction. The serum prostate specific antigen (PSA) level was normal. Cystoscopy revealed a kind of “cottony fluff” in the prostatic urethra. A computed tomography (CT) scan and magnetic resonance imaging (MRI) showed a polylobulated, hyperintense lesion with mucinous content. It was located in the right lobe of the prostate and measured 35 × 27 × 35 mm. The bladder cavity did not show lesions and the gastrointestinal endoscopy was normal. Thus, the patient underwent a radical cystoprostatectomy. The histological sections showed the characteristics of a mucin-producing adenocarcinoma with extensive areas of mucin pools formation. No areas of necrosis, glandular urethritis, or carcinoma in situ were identified. Neither lymphovascular and perineural invasion nor lymph node metastases were identified. The immunohistochemical study showed diffuse positivity for keratin (KRT) 7, KRT20, and membranous beta-catenin and focal positivity for KRT34betaE12 and caudal-related homeobox gene 2 (CDX2). In addition, we identified a 10-mm focus of prostatic acinar adenocarcinoma that was positive for racemase and NKX3.1. There is no treatment algorithm for this condition; however, surgery (radical prostatectomy) with or without adjuvant chemotherapeutic treatment represents a therapeutic alternative.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Rare Case of Co-Existing Mucin-Producing Urothelial-Type Adenocarcinoma of the Prostate and Acinar Adenocarcinoma

Nova-Camacho

Mateos

2022

Int J Surg Pathol

View full text Add to dashboard Cite

show abstract

“…Therefore, data quality in all of these reports is low. RT was delivered as monotherapy (or the use of ADT was not documented) in 11/30 studies, and doses were <70Gy in 4/30 studies [38,41,[43][44][45]49,53,54,59,61,63]. Less than 50% of the studies included adjuvant/salvage treatment after RP.…”

Section: Radical Prostatectomy Versus Radiotherapymentioning

confidence: 99%

“…However, even this cannot completely correct for the inherent selection bias due to unmeasured confounding variables [108]. It is noteworthy that in several studies RP was compared with EBRT alone [38,41,[43][44][45]49,53,54,59,61,64] or EBRT <70 Gy [37,41,55,57] which should be regarded as sub-optimal treatment in a contemporary high-risk setting. The same applies to RP monotherapy, which fails to be a definitive cure in many patients.…”

Section: Rp Vs Ebrt and Rp Intergroup Comparisonmentioning

confidence: 99%

Benefits and Risks of Primary Treatments for High-risk Localized and Locally Advanced Prostate Cancer: An International Multidisciplinary Systematic Review

et al. 2020

View full text Add to dashboard Cite

Context. The optimal treatment for men with high-risk localized or locally advanced prostate cancer (PCa) remains unknown. Objective. To perform a systematic review of the existing literature on the effectiveness of the different primary treatment modalities for high-risk localized and locally advanced PCa. The primary oncological outcome is the development of distant metastases at ≥5 years of follow-up. Secondary oncological outcomes are prostate cancer specific mortality (PCSM), overall mortality (OM), biochemical recurrence and need for salvage treatment with ≥5 years of follow-up. Non-oncological outcomes are quality of life (QoL), functional outcomes and treatment-related side effects reported. Evidence acquisition. Medline, Medline In-Process, Embase, and the Cochrane Central Register of Randomized Controlled Trials were searched. All comparative (randomized and non-randomized) studies published between January 2000 and May 2019 with at least 50 participants in each arm were included. Studies reporting on high-risk localized PCa (ISUP grade 4-5 [GS 8-10] or PSA >20 ng/mL or ≥cT2c) and/or locally advanced PCa (any PSA, cT3-4 or cN+, any ISUP grade/ GS score) or where subanalyses were performed on either group were included. The following primary local treatments were mandated: radical prostatectomy (RP), external beam radiotherapy (EBRT) (≥64 Gy), brachytherapy (BT) or multimodality treatment combining any of the local treatments above (+/-any systemic treatment). Risk of Bias (RoB) and confounding factors were assessed for each study. A narrative synthesis was performed. Evidence synthesis. Overall, 90 studies met the inclusion criteria. RoB and confounding factors revealed high RoB for selection, performance and detection bias and low RoB for correction of initial PSA and biopsy GS. When comparing RP to EBRT, retrospective series suggested an advantage for RP, although with a low level of evidence. Both RT and RP should be seen as part of a multimodal treatment plan with possible addition of (post-operative) RT and/or ADT respectively. High levels of evidence exist for EBRT treatment with several RCTs showing superior outcome for adding long-term ADT or BT to EBRT. No clear cutoff can be proposed for RT dose but higher RT doses by means of dose escalation schemes result in an improved biochemical control. Twenty studies reported data on QoL, with RP resulting mainly in GU toxicity and sexual dysfunction, and EBRT in bowel problems. Conclusion. Based on the results of this systematic review, both RP as part of multimodal treatment and EBRT + long-term ADT can be recommended as primary treatment in high-risk and locally advanced PCa. For high-risk PCa, also EBRT + BT can be offered, despite more grade 3 toxicity. Interesting, for selected patients, e.g. with higher comorbidity, a shorter duration of ADT might be an option. For locally advanced PCa, EBRT + BT shows promising result but still needs further validation. In this setting, it is important that patients are aware that the offered therapy will be mos...

show abstract

“…Interestingly, four studies used in both analyses indicated perfect comparability between RT and RP groups by Wallis et al, yet some of these studies did not control for study center [37][38][39], year of diagnosis [35,37,38], or demographic characteristics [38]. Since patients undergoing RT are more likely to be older, have poorer prognostic characteristics, and have sociodemographic characteristics that are associated with poorer CSM and ACM [11,20,29], we anticipate the influence of these unaccounted-for biases to overestimate CSM and ACM in the RT group relative to the RP group. However, the discrepancy in such baseline characteristics appears more prominent among those undergoing EBRT ± ADT rather than EBRT + BT ± ADT wherein patients are more similar to those undergoing RP [11,20].…”

Section: Discussionmentioning

confidence: 99%

Characterizing Surgical and Radiotherapy Outcomes in Non-metastatic High-Risk Prostate Cancer: A Systematic Review and Meta-Analysis

Guy¹,

Chen²,

Boldt³

et al. 2021

Cureus

View full text Add to dashboard Cite

Background Identifying the optimal management of high-risk non-metastatic prostate cancer (PCa) is an important public health concern, given the large burden of this disease. We performed a meta-analysis of studies comparing PCa-specific mortality (CSM) among men diagnosed with high-risk non-metastatic PCa who were treated with primary radiotherapy (RT) and radical prostatectomy (RP). Methods Medline and Embase were searched for articles between January 1, 2005, and February 11, 2020. After title and abstract screening, two authors independently reviewed full-text articles for inclusion. Data were abstracted, and a modified version of the Newcastle-Ottawa Scale, involving a comprehensive list of confounding variables, was used to assess the risk of bias. Results Fifteen studies involving 131,392 patients were included. No difference in adjusted CSM in RT relative to RP was shown (hazard ratio, 1.02 [95% confidence interval: 0.84, 1.25]). Increased CSM was found in a subgroup analysis comparing external beam radiation therapy (EBRT) with RP (1.35 [1.10, 1.68]), whereas EBRT combined with brachytherapy (BT) versus RP showed lower CSM (0.68 [0.48, 0.95]). All studies demonstrated a high risk of bias as none fully adjusted for all confounding variables. Conclusion We found no difference in CSM between men diagnosed with non-metastatic high-risk PCa and treated with RP or RT; however, this is likely explained by increased CSM in men treated with EBRT and decreased CSM in men treated with EBRT + BT studies relative to RP. High risk of bias in all studies identifies the need for better data collection and confounding control in the PCa research.

show abstract

Control oncológico en cáncer de próstata de alto riesgo tras prostatectomía radical y radioterapia de rescate en comparación con radioterapia más hormonoterapia primaria

Cited by 3 publications

References 29 publications

A Rare Case of Co-Existing Mucin-Producing Urothelial-Type Adenocarcinoma of the Prostate and Acinar Adenocarcinoma

A Rare Case of Co-Existing Mucin-Producing Urothelial-Type Adenocarcinoma of the Prostate and Acinar Adenocarcinoma

Benefits and Risks of Primary Treatments for High-risk Localized and Locally Advanced Prostate Cancer: An International Multidisciplinary Systematic Review

Characterizing Surgical and Radiotherapy Outcomes in Non-metastatic High-Risk Prostate Cancer: A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About