Transrectal Ultrasonically-Guided Core Biopsies In The Assessment Of Local Cure Of Prostatic Cancer After Radical External Beam Radiotherapy

Ljung, Gunilla; Norberg, M.; Hansson, H; Torre, Manuel de la; Egevad, Lars; Holmberg, Lars; Busch, Christer; Nilsson, Sten

doi:10.3109/02841869509127210

Cited by 21 publications

(14 citation statements)

References 38 publications

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“…Very little is known about those residual tumor cells, but immunohistochemical staining techniques permit the possibility of obtaining further information about these cells. A previous report from our institute demonstrated residual tumor cells in 67% of patients in a long-term follow-up after radical radiation therapy [3]. In 94% and 64% of these cases, respectively, proliferative activity could be demonstrated by the presence of the proliferation markers PCNA and Ki-67 [4].…”

Section: Introductionmentioning

confidence: 93%

“…This may reflect radiation injury to the cells, but also a dedifferentiation of the cells over time (observed in 51% of cases [3]), with a loss or impairment of specialized cell functions. Furthermore, these results must be interpreted with caution because the pretreatment TURP specimens and posttreatment core biopsies reflect different parts of the prostate gland and may not be readily compared due to the notorious heterogeneity of prostatic adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…Fifty-five patients treated with radical external beam irradiation for localized prostatic adenocarcinoma underwent transrectal ultrasonically (TRUS)-guided sextant core biopsies to assess the histopathological local cure, after an average of 6.8 years after RRT [3]. In 37 cases (67%), residual tumor was found in one or several biopsies.…”

Section: Patients and Specimensmentioning

confidence: 99%

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Characterization of residual tumor cells following radical radiation therapy for prostatic adenocarcinoma; Immunohistochemical expression of prostate-specific antigen, prostatic acid phosphatase, and cytokeratin 8

et al. 1997

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BACKGROUND Our knowledge about the nature and biological activity of tumor cells residing in the prostate gland after radical radiotherapy (RRT) is limited. METHODS In the present study, residual tumor in core biopsies taken from 37 patients after an average of 6.8 years follow‐up after radiation, were investigated with immunohistochemistry for the biochemical markers prostate‐specific antigen (PSA), prostatic acid phosphatase (PAP), and the epithelial marker, cytokeratin 8 (CK8). RESULTS Tumor cells were cytokeratin‐positive in 33 of 34 evaluable specimens (97%). PSA and PAP were expressed in the tumor cells in 94% (34/36) and 81% (30/37) of cases, respectively. No significant correlation was observed between PSA/PAP expression and tumor grade after treatment. Endocrine treatment administered in addition to RRT in 12 of the 37 patients did not affect the expression of PSA or PAP. The expression of both biochemical markers was reduced after radiotherapy in 10 of the 12 cases for which pre‐ and post‐treatment specimens were available. CONCLUSIONS Tumor cells retain their epithelial characteristics immunohistochemically after radiation, though their morphology sometimes suggests an altered phenotype after treatment. PSA and PAP reactivity was demonstrated in tumor cells nearly 7 years after radiotherapy, which indicates that these cells maintain their biochemical integrity and protein synthesis to a certain extent. Furthermore, endocrine treatment did not abolish PSA or PAP expression in the tumor cells. Whether PSA and PAP immunoexpression provides independent prognostic information needs to be further investigated. Prostate 31:91–97, 1997. © 1997 Wiley‐Liss, Inc.

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Section: Introductionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Patients and Specimensmentioning

confidence: 99%

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Characterization of residual tumor cells following radical radiation therapy for prostatic adenocarcinoma; Immunohistochemical expression of prostate-specific antigen, prostatic acid phosphatase, and cytokeratin 8

et al. 1997

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“…By default, most investi-40% with a positive, compared with 7% with a negative biopsy. In a study by Ljung et al [19] on 55 patients gators [28] have arbitrarily chosen their laboratory's limits of normal as their criterion for reporting a normal with a mean follow-up time of 6.8 years, six biopsies were taken from each patient; biopsies suspicious for post-radiotherapy serum PSA. However, an alternative method defines the normal PSA level as that value cancer were found in 67% of the patients.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the local control in lymph‐node staged localized prostate cancer treated by external beam radiotherapy, assessed by digital rectal examination, serum prostate‐specific antigen and biopsy

Borghede¹,

Aldenborg²,

Wurzinger

et al. 1997

British Journal of Urology

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Objective To describe local disease control after radical external beam radiotherapy of prostatic carcinoma, as judged by digital rectal examination (DRE), transrectal ultrasonography (TRUS)‐guided biopsies and estimates of serum prostate‐specific antigen (PSA). Patients and methods The study comprised 175 patients (mean age 67.5 years, range 49–82; >90% aged ≥60 years) with localized prostatic carcinoma (T1‐T3C, N0, M0) who underwent external beam radiation therapy (70 Gy), and were then regularly followed with a DRE, measurements of serum PSA and TRUS‐guided biopsies to determine the outcome. Results The DRE revealed four patients with evidence of residual cancer in the prostate and biopsies showed no evidence of residual cancer in 131 (75%) of the patients. There was no correlation of residual cancer with tumour stage or grade but tumour size, as estimated by TRUS, correlated with the results of the biopsy. The nadir serum PSA level was ≤1.0 ng/mL in 116 (66%) of the patients, of whom 76 (43%) had a nadir serum PSA level of ≤0.5 ng/mL. The median time to the nadir level was 11 months. Serum PSA progression (>4.0 ng/mL) at the latest PSA measurement after reaching the nadir occurred in 13% of the patients with a nadir PSA of ≤0.5 ng/mL and in 25 of the 29 (86%) patients with a nadir serum PSA >2.0 ng/mL. Cox regression analysis showed that tumour size and rectal irradiation dose were the most important factors for local control. Conclusions Radiotherapy is effective in achieving local control in small prostate cancer tumours but less effective in large tumours. Tumour size and dorsal extension of the irradiated target, the rectal dose, were the two important factors for local control. A serum PSA level of ≤1.0 ng/mL was associated with a higher chance of prolonged disease control.

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“…When doses below 70 Gy have been used, a lower percentage of a histopathologically tumour free state have been reported [12]. The use of the conformal EBRT technique has made it possible to increase the dose to 78 Á88 Gy [13,14], without increasing the rate of side effects in the rectum or bladder.…”

Section: Clinical Outcomementioning

confidence: 99%

Clinical outcome in patients with prostate cancer treated with external beam radiotherapy and high dose-rate iridium 192 brachytherapy boost: A 6-year follow-up

et al. 2007

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Transrectal Ultrasonically-Guided Core Biopsies In The Assessment Of Local Cure Of Prostatic Cancer After Radical External Beam Radiotherapy

Cited by 21 publications

References 38 publications

Characterization of residual tumor cells following radical radiation therapy for prostatic adenocarcinoma; Immunohistochemical expression of prostate-specific antigen, prostatic acid phosphatase, and cytokeratin 8

Characterization of residual tumor cells following radical radiation therapy for prostatic adenocarcinoma; Immunohistochemical expression of prostate-specific antigen, prostatic acid phosphatase, and cytokeratin 8

Analysis of the local control in lymph‐node staged localized prostate cancer treated by external beam radiotherapy, assessed by digital rectal examination, serum prostate‐specific antigen and biopsy

Clinical outcome in patients with prostate cancer treated with external beam radiotherapy and high dose-rate iridium 192 brachytherapy boost: A 6-year follow-up

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