Is the systematic histological analysis of benign prostatic hyperplasia surgical specimen always necessary?

Coman, Radu Tudor; Anract, J.; Pinar, Ugo; Sibony, Mathilde; Peyromaure, Michaël; Delongchamps, Barry

doi:10.1007/s11255-022-03220-6

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…Инцидентальный РПЖ был выявлен у 94 (9,0 %) больных. Мультивариантный анализ показал, что возраст (р = 0,03) и плотность ПСА (р <0,001) были независимыми предиктивными факторами диагностики инцидентального РПЖ [6].…”

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Robot-assisted radical prostatectomy in patients after endoscopic surgeries on the prostate

Guliev,

Ilyin,

Kharchenko

et al. 2024

Onkourologiâ

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Background. In literature, data on the results of robot-assisted radical prostatectomy (RARP) in patients after transurethral resection of the prostate (TURP) are contradictory.Aim. To evaluate surgical, functional, and oncological outcomes of RARP after TURP.Materials and methods. At the Urology Center of the Mariinsky Hospital (Saint Petersburg), RARP was performed on 410 patients. Among them, 28 (6.8 %) patients (1st group) previously underwent TURP due to infravesical obstruction. Among them, 18 (64.3 %) patients were diagnosed with prostate cancer after pathomorphological examination of the tissue resected during TURP, and on them RARP was performed on average 3.2 months later. In 10 (35.7 %) patients, prostate cancer was diagnosed during transrectal biopsy due to increased prostate-specific antigen level; on them RARP was performed on average 42.0 months after TURP. The following parameters were evaluated: operative time, time of bladder neck reconstruction and urethrovesical anastomosis formation, blood loss volume, tumor pathological stage, Gleason score, surgical margin status, rates of urine continence and preservation of erectile function.Results. Mean operative time was higher in the 1st group compared to the 2nd: 210 ± 36 min versus 180 ± 25 min (р <0.0001). In the 1st group compared to the 2nd, reconstruction of bladder neck was necessary more frequently (82.1 % versus 10.7 %; р <0.0001), urethrovesical anastomosis took longer time (32 ± 2.3 min versus 24.5 ± 3.1 min; р <0.0001), mean blood loss volume was higher (240 ± 39 mL versus 170 ± 32 mL; р <0.0001). Frequencies of positive surgical margin were 14.3 and 10.7 % respectively in the 1st and 2nd groups (р = 0.840). Frequencies of all complications were 28.6 and 21.4 %, respectively. Severe complications (≥IIIb grade per the Clavien classification) were observed in 2 (7.1 %) patients in both groups. Frequency of anastomosis stricture after surgery was significantly higher in the 1st group: in 2 (7.1 %) and 1 (3.6 %) case, respectively (р <0.05). In the 1st group, total urinary continence was achieved in 14 (50.0 %), 20 (71.5 %), 22 (78.5 %) and 25 (89.3 %) patients at early and 3-, 6and 12-month follow-up after RARP; in the 2nd group, it was achieved in 18 (64.3 %), 22 (78.6 %), 24 (85.7 %) and 26 (92.9 %) patients in the same follow-up periods. After 6 and 12 months, in the 1st group among 15 (53.6 %) patients with normal initial erectile function, satisfactory erectile function was preserved in 46.7 and 93.3 % of patients; in the 2nd group among 19 (67.8 %) patients, in 57.8 and 94.7 % patients, respectively.Conclusion. RARP after TURP is a relatively complicated surgical intervention with long operative time and high blood loss volume. However, functional and short-term oncological outcomes of RARP in these patients do not differ at 12 months.

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Section: Discussionunclassified

Robot-assisted radical prostatectomy in patients after endoscopic surgeries on the prostate

Guliev,

Ilyin,

Kharchenko

et al. 2024

Onkourologiâ

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In vitro neuroendocrine differentiation of BPH-1 cells under β2 adrenergic receptor stimulation

Pigat,

Garrido Castillo,

Lefevre

et al. 2024

Preprint

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Epidemiologic and experimental animal studies have shown that stress can alter tumor growth and that adrenergic fibers from the sympathetic nervous system, acting through stromal beta2 adrenergic receptors, promote tumor cell survival during the initial phases of cancer development. Recent epidemiological data suggest that beta blocker intake improves survival of prostate cancer patients. Hypertension and high blood pressure have been suggested to increase likelihood of prostate cancer development, suggesting that the use of beta blockers in these patients could reduce prostate cancer risk. Signaling mediated by beta adrenergic receptors promotes neuroendocrine differentiation in the LNCaP prostate cancer cell line. Although neuroendocrine cells are a minor population in the epithelial compartment of normal prostate glands, the population of neuroendocrine-like cells that express markers such as SYN, Bcl-2, Dll-3, and AMACR correlates with cancer progression, androgen-independent state, and poor prognosis in prostate cancer patients. As recent studies show that an increase in neuroendocrine cell density occurs before development of benign prostatic hyperplasia, a non-lethal disease affecting the transition zone, in hypertensive rats, we investigated whether neuroendocrine differentiation is associated with benign prostatic hyperplasia. Our results showed that isobutyl-methyl-xanthine, which blocks cAMP degradation, and forskolin, an adenylate cyclase activator, triggered sustained activation of the cAMP/PKA pathway and led to an increase in neuroendocrine differentiation markers in BPH-1 cells, which are a benign prostatic hyperplasia cell line. Similar results were observed by combining the beta adrenergic receptors agonist isoproterenol with forskolin. The same treatments reduced BPH-1 cell proliferation rates by 40% and 60%, respectively. Effects on AMACR and SYN expression and cell proliferation were fully reversed by the β2 blocker carvedilol. These data suggest that beta adrenergic receptors are linked to the development of neuroendocrine-like cells and benign prostatic hyperplasia. As 20% of the prostate cancer tumors occur in this zone, this observation warrants further investigation.

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Is the systematic histological analysis of benign prostatic hyperplasia surgical specimen always necessary?

Cited by 2 publications

References 17 publications

Robot-assisted radical prostatectomy in patients after endoscopic surgeries on the prostate

Robot-assisted radical prostatectomy in patients after endoscopic surgeries on the prostate

In vitro neuroendocrine differentiation of BPH-1 cells under β2 adrenergic receptor stimulation

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