Current guidelines for prostate cancer screening: A systematic review and minimal core proposal

Araújo, Fernando Antônio Glasner da Rocha; Oliveira, Ubirajara

doi:10.1590/1806-9282.64.03.290

Cited by 7 publications

(3 citation statements)

References 26 publications

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“…It is important to note that, in some cases, it is possible to use the same antibodies to detect target molecules both in vivo by immuno-PET analysis and ex vivo by immunohistochemistry [24]. The treatment of breast and prostate cancers is based on immunohistochemical analysis of well-known prognostic markers such as ER, PR, Ki67, cerb2 (Figure 1), or PSA [25, 26]. Nevertheless, cancer cells frequently undergo selection during pharmacological treatment, hence possibly changing their dominant molecular phenotype and leading to drug resistance.…”

Section: Diagnostic Imaging and Anatomic Pathology: An Alliance Fomentioning

confidence: 99%

Combining Diagnostic Imaging and Pathology for Improving Diagnosis and Prognosis of Cancer

Schillaci

Scimeca

Toschi

et al. 2019

Contrast Media & Molecular Imaging

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In the era of personalized medicine, the management of oncological patients requires a translational and multidisciplinary approach. During early phases of cancer development, biochemical alterations of cell metabolism occur much before the formation of detectable tumour masses. Current molecular imaging techniques, targeted to the study of molecular kinetics, employ molecular tracers capable of detecting cancer lesions with both high sensitivity and specificity while also providing essential information for both prognosis and therapy. On the contrary, complementary and crucial information is provided by histopathological examination and ancillary techniques such as immunohistochemistry. Thus, the successful collaboration between diagnostic imaging and anatomic pathology can represent a fundamental step in the “tortuous” but decisive path towards personalized medicine.

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Section: Diagnostic Imaging and Anatomic Pathology: An Alliance Fomentioning

confidence: 99%

Combining Diagnostic Imaging and Pathology for Improving Diagnosis and Prognosis of Cancer

Schillaci

Scimeca

Toschi

et al. 2019

Contrast Media & Molecular Imaging

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“…While generally accepted as a suitable management option for low risk PCa, AS monitoring regime vary among clinical practices and guidelines, leading to it being questioned by some clinicians and patients [ 10 ]. In effort to minimise this, the Movember Foundation launched the Global Action Plan Prostate Cancer Active Surveillance initiative (GAP3) which has combined data from AS cohorts worldwide to create a global consensus for selection, monitoring and treatment intervention thresholds [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Guy’s and St Thomas NHS Foundation active surveillance prostate cancer cohort: a characterisation of a prostate cancer active surveillance database

et al. 2021

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Background The routine clinical use of serum prostatic specific antigen (PSA) testing has allowed earlier detection of low-grade prostate cancer (PCa) with more favourable characteristics, leading to increased acceptance of management by active surveillance (AS). AS aims to avoid over treatment in men with low and intermediate-risk PCa and multiple governing bodies have described several AS protocols. This study provides a descriptive profile of the Guy’s and St Thomas NHS Foundation Trust (GSTT) AS cohort as a platform for future research in AS pathways in PCa. Methods Demographic and baseline characteristics were retrospectively collected in a database for patients at the GSTT AS clinic with prospective collection of follow-up data from 2012. Seven hundred eighty-eight men being monitored at GSTT with histologically confirmed intermediate-risk PCa, at least 1 follow-up appointment and diagnostic characteristics consistent with AS criteria were included in the profile. Descriptive statistics, Kaplan-Meier survival curves and multivariable Cox proportion hazards regression models were used to characterize the cohort. Discussion A relatively large proportion of the cohort includes men of African/Afro-Caribbean descent (22%). More frequent use of magnetic resonance imaging and trans-perineal biopsies at diagnosis was observed among patients diagnosed after 2012. Those who underwent trans-rectal ultrasound diagnostic biopsy received their first surveillance biopsy 20 months earlier than those who underwent trans-perineal diagnostic biopsy. At 3 years, 76.1% men remained treatment free. Predictors of treatment progression included Gleason score 3 + 4 (Hazard ratio (HR): 2.41, 95% Confidence interval (CI): 1.79–3.26) and more than 2 positive cores taken at biopsy (HR: 2.65, CI: 1.94–3.62). A decreased risk of progressing to treatment was seen among men diagnosed after 2012 (HR: 0.72, CI: 0.53–0.98). Conclusion An organised biopsy surveillance approach, via two different AS pathways according to the patient’s diagnostic method, can be seen within the GSTT cohort. Risk of patients progressing to treatment has decreased in the period since 2012 compared with the prior period with more than half of the cohort remaining treatment free at 5 years, highlighting that the fundamental aims of AS at GSTT are being met. Thus, this cohort is a good resource to investigate the AS treatment pathway.

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“…The value of 5.8 ng/mL of serum PSA is still surprising for a PC with LN metastases, the direct relationship between serum PSA value and PC extension being well known, only a small proportion of patients (about 5%) with PSA levels of 4.0–10.0 ng/mL having either seminal vesicle or LN involvement [ 18 ]. However, if the rectal resection had not been performed, PC would have remained undiagnosed in a relatively young patient, because Romania offers no implemented screening for PC detection, screening that address men above 50–55 years, according to most of the guidelines developed by the entities recommending the screening for PC [ 19 ]. The involvement of the rectum through PC can produce digestive symptoms such as constipation, alternating constipation and diarrhea, rectal bleeding [ 20 ], narrow stool, abdominal or rectal pain, the urgency of defecation, incontinence [ 21 ], all of can be wrongly attributed to a colonic tumor.…”

Section: ⧉ Discussionmentioning

confidence: 99%

Prostate carcinomas mimicking a digestive malignancy

Dema

Alc²,

Tăban³

et al. 2021

Rom J Morphol Embryol

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Aim : To report our experience with specific cases of prostate cancer (PC) in which patients presented digestive symptoms, cases that represent a challenge and a source of error regarding the clinical and morphological diagnosis. Methods : The most important clinical and pathological data were collected from three patients with PC which presented symptoms and/or investigations that initially suggested a digestive malignant tumor. Results : We identified three patients with PC where the prostate tumor was not suspected based on the clinical-imagistic data, the correct diagnosis being the prerogative of the morphological investigation: in the first case, PC was detected during the microscopic examination of the lymph nodes (LN) in the intestinal resection specimen performed for suspected rectal cancer (RC), in the second case, in which the PC was synchronous with a RC, the dominant symptomatology was gastrointestinal, and in the third case, initially, the patient presented a widely disseminated PC, with pleural and bone metastases, as well as LN metastases, and apparent peritoneal involvement. Conclusions : Unusual forms of PC presentation are not as rare as expected and should be acknowledged by all those involved in diagnosing this neoplasm. PC should always be considered in the differential diagnosis of a rectal tumor. The immunohistochemical (IHC) investigation is essential for establishing the diagnosis in difficult cases. An integrated approach of the interpretation of clinical manifestations, imagistic and serological changes would shorten the diagnostic time and help reduce diagnostic errors.

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Current guidelines for prostate cancer screening: A systematic review and minimal core proposal

Abstract: Although there are differences between them, it was possible to establish a minimum core of conducts that may be useful in the daily practice of the physician.

Cited by 7 publications

References 26 publications

Combining Diagnostic Imaging and Pathology for Improving Diagnosis and Prognosis of Cancer

Combining Diagnostic Imaging and Pathology for Improving Diagnosis and Prognosis of Cancer

Guy’s and St Thomas NHS Foundation active surveillance prostate cancer cohort: a characterisation of a prostate cancer active surveillance database

Prostate carcinomas mimicking a digestive malignancy

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