The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma

Kim²,

et al. 2018

Cancer Medicine

BackgroundWe evaluated the association between serum levels of insulin‐like growth factor‐1 (IGF‐1), bioavailable testosterone, and surgical Gleason score (GS).MethodsWe analyzed 793 patients who underwent radical prostatectomy and 272 men with negative prostate biopsy. Serum levels of IGF‐1 and testosterone were measured before surgery or biopsy.ResultsThe mean IGF‐1 levels of prostate cancer patients and men with a negative biopsy were 143.8 and 118.9 ng/mL, respectively (P < 0.001). Men with high serum IGF‐1 were more likely to have prostate cancer (highest vs lowest quartile, odds ratio [OR] = 3.35; P trend < 0.001). However, among men with prostate cancer, the mean IGF‐1 levels of those with low (GS ≤ 6), intermediate (GS = 7), and high surgical GS (GS ≥8) were 151.7, 144.1, and 132.9 ng/mL, respectively (P < 0.001). Using quartile analysis, high serum IGF‐1 levels were shown to be associated with a low risk of high surgical GS (OR = 0.464; P trend = 0.006). Serum bioavailable testosterone concentration was positively correlated with serum IGF‐1 level (r = 0.157, P < 0.001). High bioavailable testosterone level was also associated with a low risk of high surgical GS in patients without diabetes mellitus (OR = 0.569; P trend = 0.040). Among men with biopsy GS ≤ 3 + 4 (n = 460), upgrading to high surgical GS was more frequent in patients with low IGF‐1 level (≤116.0 ng/mL; 9.9%) or low bioavailable testosterone level (≤0.85 ng/mL; 9.3%) than in patients with normal IGF‐1 and bioavailable testosterone levels (2.6%; P = 0.004).ConclusionsSerum levels of IGF‐1 and bioavailable testosterone show inverse associations with high surgical GS. This suggests that high‐grade prostate cancer develops independently of these two substances.

Section: Methodsmentioning

confidence: 99%

Association between serum levels of insulin‐like growth factor‐1, bioavailable testosterone, and pathologic Gleason score

Kim²,

et al. 2018

Cancer Medicine

Prostate Cancer Prostatic Dis

“…Each tumor focus was graded according to the modified Gleason grading system. 15 Tumor size was estimated with the same method as that of MRI. Extracapsular cancer extension was also reported.…”

Section: Pathological Analysismentioning

confidence: 99%

Multiparametric MRI is helpful to predict tumor focality, stage, and size in patients diagnosed with unilateral low-risk prostate cancer

Delongchamps

Beuvon

Eiss³

et al. 2011

To study the staging accuracy of multiparametric magnetic resonance imaging (MRI) in patients showing unilateral low-risk cancer on prostate biopsy. A total of 58 consecutive patients with lowrisk cancer (D'Amico classification) and unilateral cancer involvement on prostate biopsies were included prospectively. All patients underwent multiparametric endorectal MRI before radical prostatectomy, including T2-weighted (T2W), diffusion-weighted (DW) and dynamic contrast enhanced (DCE) sequences. Each gland was divided in eight octants. Tumor foci 40.2 cm 3 identified on pathological analysis were matched with MRI findings. Pathological examination showed tumor foci 40.2 cm 3 in 50/58 glands (86%), and bilateral tumor (pathological stageXpT2c) in 20/58 (34%). For tumor detection in the peripheral zone (PZ), T2W þ DWI þ DCE performed significantly better than T2W þ DWI and T2W alone (Po0.001). In the transition zone (TZ), only T2W þ DWI performed better than T2W alone (P ¼ 0.02). With optimal MR combinations, tumor size was correctly estimated in 77% of tumor foci involving more than one octant. Bilateral tumors were detected in 80% (16/20) of cases. In patients with unilateral low-risk prostate cancer on biopsy, multiparametric MRI can help to predict bilateral involvement. Multiparametric MRI may therefore have a prognostic value and help to determine optimal treatment in such patients.

“…The criteria and their application are well documented but often require adjustment and standardisation if these criteria have not been applied by an expert urological pathologist (Foster, 1991;Deshmukh and Foster, 1998;Epstein et al, 2005;Berney et al, 2007a,b). Currently, the Gleason score is used as a prognostic indicator for individual PRCAs in the general population.…”

mentioning

confidence: 99%

Prostate cancer in male BRCA1 and BRCA2 mutation carriers has a more aggressive phenotype

et al. 2008

There is a high and rising prevalence of prostate cancer (PRCA) within the male population of the United Kingdom. Although the relative risk of PRCA is higher in male BRCA2 and BRCA1 mutation carriers, the histological characteristics of this malignancy in these groups have not been clearly defined. We present the histopathological findings in the first UK series of BRCA1 and BRCA2 mutation carriers with PRCA. The archived histopathological tissue sections of 20 BRCA1/2 mutation carriers with PRCA were collected from histopathology laboratories in England, Ireland and Scotland. The cases were matched to a control group by age, stage and serum PSA level of PRCA cases diagnosed in the general population. Following histopathological evaluation and re-grading according to current conventional criteria, Gleason scores of PRCA developed by BRCA1/2 mutation carriers were identified to be significantly higher (Gleason scores 8, 9 or 10, P ¼ 0.012) than those in the control group. Since BRCA1/2 mutation carrier status is associated with more aggressive disease, it is a prognostic factor for PRCA outcome. Targeting screening to this population may detect disease at an earlier clinical stage which may therefore be beneficial. British Journal of Cancer (2008) Prostate cancer (PRCA) is the most commonly diagnosed malignancy in men in the United Kingdom. It is thought to be composed of aggressive and indolent varieties. Indolent PRCA may exist for many years without causing symptoms or shortening life expectancy. Aggressive PRCA may cause symptoms difficult to palliate with conventional treatments and is likely to shorten life expectancy. Distinguishing which men are at risk of which types of disease could have far-reaching consequences not only in the treatment and follow-up of patients but also in the surveillance of groups at risk of aggressive PRCA.The morphology of breast cancer found in female BRCA1 and BRCA2 germline mutation carriers has been studied extensively. The histopathological features of breast tumours from patients with BRCA1 and BRCA2 mutations differ from each other and from sporadic breast cancers . BRCA1 and BRCA2 breast cancers are of higher grade (Lakhani, 2001). BRCA1-associated tumours are more likely to be oestrogen, progesterone receptor and Her2 receptor negative, express TP53 protein, and demonstrate medullary/atypical medullary morphology. Lakhani (2001) predicts that a woman diagnosed with high-grade, oestrogen receptor-negative breast cancer before the age of 30 years has a 40-45% chance of harbouring a BRCA1 mutation, compared with a 4-5% chance if these parameters are not met (Lakhani, 2001). Many of the features identified in breast cancer in women who are BRCA1 mutation carriers are associated with a poor prognosis. If similar data were available for men with PRCA who are carriers of these mutations, weighing up the options for radical treatment or active surveillance could be simplified with this added information.Despite studies on the incidence of PRCA in male BRCA1 and BRCA2 mutation...