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Seminars in Nuclear Medicine Nov 2016The use of positron emission tomography (PET) with F-fluorodeoxyglucose (FDG) in prostate cancer depends on the phase of the disease along the natural history of this... (Review)
Review
The use of positron emission tomography (PET) with F-fluorodeoxyglucose (FDG) in prostate cancer depends on the phase of the disease along the natural history of this prevalent malignancy in men. Incidental high FDG uptake in the prostate gland, although rare, should prompt further investigation with at least a measurement of serum prostate specific antigen level. Although in general FDG uptake level may significantly overlap among normal, benign, and malignant tissues, aggressive primary tumors with Gleason score > 7 tend to display high FDG uptake. PET with FDG may be useful in staging of those patients with aggressive primary tumors and can localize the site of disease in a small fraction of men with biochemical failure and negative conventional imaging studies. FDG-PET may be quite useful in treatment response assessment and prognostication of patients with castrate-resistant metastatic prostate cancer.
Topics: Fluorodeoxyglucose F18; Humans; Male; Neoplasm Staging; Positron-Emission Tomography; Prostatic Neoplasms; Treatment Outcome
PubMed: 27825430
DOI: 10.1053/j.semnuclmed.2016.07.004 -
Seminars in Oncology Oct 2017Prostate cancer is a heterogeneous disease with a variable natural history. Therefore, optimal management remains challenging. While many men with newly diagnosed... (Review)
Review
Prostate cancer is a heterogeneous disease with a variable natural history. Therefore, optimal management remains challenging. While many men with newly diagnosed prostate cancer may be candidates for active surveillance, there are others who will benefit from aggressive local therapy. Radical prostatectomy is associated with improvements in cancer-specific mortality, metastasis-free survival, and need for palliative treatments when compared with observation in several randomized controlled trials. Additionally, radical prostatectomy may have some oncologic benefit over radiation therapy. All aggressive therapy for prostate cancer negatively impacts erectile function and urinary continence. The decision for which treatment modality to pursue should incorporate shared decision making and consider cancer risk and severity in addition to patient preferences.
Topics: Combined Modality Therapy; Humans; Male; Outcome Assessment, Health Care; Prostate-Specific Antigen; Prostatectomy; Prostatic Neoplasms
PubMed: 29580436
DOI: 10.1053/j.seminoncol.2018.01.003 -
Archivos Espanoles de Urologia Nov 2023Prostate cancer remains a significant global health challenge. Traditionally anchored by the Gleason score/Grade Group (GS/GG), the landscape of prostate cancer... (Review)
Review
Prostate cancer remains a significant global health challenge. Traditionally anchored by the Gleason score/Grade Group (GS/GG), the landscape of prostate cancer diagnosis is undergoing transformative steps, particularly in the domain of biopsy procedures. GS/GG continues to be pivotal in malignancy grading, but recent technological strides have augmented the diagnostic relevance of biopsies. Integral to this progression is the adoption of advanced imaging techniques, especially magnetic resonance imaging, which has refined biopsy accuracy and efficiency. A deep understanding of prostate cancer pathology reveals a cribriform pattern and intraductal carcinoma of the prostate as independent forms of malignancy, suggesting a potentially aggressive disease course. Furthermore, the distinct behaviour of ductal adenocarcinoma and small cell carcinoma of the prostate, compared with acinar adenocarcinoma, necessitates their accurate differentiation during biopsy. The genomic era ushers in a renewed emphasis on tissue samples obtained from prostate biopsies, especially as mutations in genes, such as /, and paves the way for precision medicine. This review encapsulates the evolving dynamics of prostate biopsy, from technological advancements to the profound implications on prostate cancer management and therapy.
Topics: Male; Humans; Prostate; BRCA1 Protein; BRCA2 Protein; Prostatic Neoplasms; Biopsy; Carcinoma, Intraductal, Noninfiltrating; Neoplasm Grading
PubMed: 38053418
DOI: 10.56434/j.arch.esp.urol.20237609.78 -
Seminars in Nuclear Medicine Jul 2019Accurate tumor detection and establishment of disease extent are important for optimal management of prostate cancer. Disease stage, beginning with identification of the... (Review)
Review
Accurate tumor detection and establishment of disease extent are important for optimal management of prostate cancer. Disease stage, beginning with identification of the index prostate lesion, followed by primary tumor, lymph node, and distant metastasis evaluation, provide crucial clinical information that not only have prognostic and predictive value, but guide patient management. A wide array of radiological imaging modalities including ultrasound, computed tomography, and magnetic resonance imaging have been used for the purpose of prostate cancer staging with variable diagnostic performance. Especially, the last years have seen remarkable technological advances in magnetic resonance imaging technology, enabling referring clinicians and radiologists to obtain even more valuable data regarding staging of prostate cancer. Marked improvements have been seen in detection of the index prostate lesion and evaluation of extraprostatic extension while further improvements are still needed in identifying metastatic lymph nodes. Novel approaches such as whole-body MRI are emerging for more accurate and reproducible assessment of bone metastasis. Post-treatment assessment of prostate cancer using radiological imaging is a topic with rapidly changing clinical context and special consideration is needed for the biochemical setting, that is, the relatively high serum prostate-specific antigen levels in studies assessing the value of radiological imaging for post-treatment assessment and emerging therapeutic approaches such as early salvage radiation therapy. The scope of this review is to provide the reader insight into the various ways radiology contribute to staging of prostate cancer in the context of both primary staging and post-treatment assessment. The strengths and limitations of each imaging modality are highlighted as well as topics that warrant future research.
Topics: Humans; Male; Neoplasm Metastasis; Neoplasm Staging; Prostatic Neoplasms; Radiology
PubMed: 31227052
DOI: 10.1053/j.semnuclmed.2019.02.007 -
Clinical Radiology Aug 2017In 2016, it is estimated 180,890 men are newly diagnosed with prostate cancer and 3,306,760 men live with prostate cancer in the United States. The introduction of... (Review)
Review
In 2016, it is estimated 180,890 men are newly diagnosed with prostate cancer and 3,306,760 men live with prostate cancer in the United States. The introduction of multiparametric (mp) magnetic resonance imaging (MRI) of the prostate, standardised interpretation guidelines such as Prostate Imaging Reporting and Data System (PI-RADS version 2), and MRI-based targeted biopsy has improved detection of clinically significant prostate cancer. Accurate risk stratification (Gleason grade/score and tumour stage) using imaging and image-guided targeted biopsy has become critical for the management of patients with prostate cancer. Recent advances in MRI-guided minimally invasive ablative treatment (MIAT) utilising cryoablation, laser ablation, high-intensity focused ultrasound ablation, have allowed accurate focal or regional delivery of optimal thermal energy to the biopsy proven, MRI-detected tumour, under real-time or near simultaneous MRI monitoring of the ablation zone. A contemporary review on prostate mpMRI, MRI-based targeted biopsy, and MRI-guided ablation techniques is presented.
Topics: Ablation Techniques; Humans; Image-Guided Biopsy; Magnetic Resonance Imaging; Male; Neoplasm Recurrence, Local; Patient Selection; Prostatic Neoplasms; Surgery, Computer-Assisted
PubMed: 28385253
DOI: 10.1016/j.crad.2017.02.010 -
Nature Reviews. Urology Jan 2017Advanced prostate cancer is a classic example of the intractability and consequent lethality that characterizes metastatic carcinomas. Novel treatments have improved the... (Review)
Review
Advanced prostate cancer is a classic example of the intractability and consequent lethality that characterizes metastatic carcinomas. Novel treatments have improved the survival of men with prostate cancer; however, advanced prostate cancer invariably becomes resistant to these therapies and ultimately progresses to a lethal metastatic stage. Consequently, detailed knowledge of the molecular mechanisms that control prostate cancer cell survival and progression towards this lethal stage of disease will benefit the development of new therapeutics. The transcription factor endothelial transcription factor GATA-2 (GATA2) has been reported to have a key role in driving prostate cancer aggressiveness. In addition to being a pioneer transcription factor that increases androgen receptor (AR) binding and activity, GATA2 regulates a core subset of clinically relevant genes in an AR-independent manner. Functionally, GATA2 overexpression in prostate cancer increases cellular motility and invasiveness, proliferation, tumorigenicity, and resistance to standard therapies. Thus, GATA2 has a multifaceted function in prostate cancer aggressiveness and is a highly attractive target in the development of novel treatments against lethal prostate cancer.
Topics: Biomarkers, Tumor; GATA2 Transcription Factor; Gene Expression Regulation, Neoplastic; Humans; Male; Neoplasm Invasiveness; Prostatic Neoplasms
PubMed: 27872477
DOI: 10.1038/nrurol.2016.225 -
Seminars in Nuclear Medicine Jul 2019Prostate cancer is a major global health care challenge. Due to the recent relevant improvements in the diagnosis, imaging and treatment, management of these patients is... (Review)
Review
Prostate cancer is a major global health care challenge. Due to the recent relevant improvements in the diagnosis, imaging and treatment, management of these patients is becoming extremely complex. However, new multiple diagnostic procedures and treatment options, tailored on the single patient, require a multidisciplinary effort. Molecular imaging is gaining importance in the decision making process of prostate cancer patients, playing a key role in the majority of clinical setting, including staging, restaging during biochemical recurrence and castration-resistant stage. Moreover recent significant advances are changing the management of these patients impacting on the choice of therapeutic strategy. In particular, prostate-specific membrane antigen PET imaging is assuming the role of the gatekeeper addressing patients to the correct treatment option and also, in the advanced stages, selecting patients potentially suitable for targeted α- or β-therapy bridging to the fascinating concept of theranostic. Even if radioligand therapy found its first clinical application in 1946, in the last few years several α- or β-radionuclide prostate-specific membrane antigen-labeled for targeted therapy have been proposed where other treatment options do not show a significant impact on survival. The theranostic field is experiencing a rapid growth in prostate cancer giving to nuclear medicine a central role that has to be confirmed by further prospective studies.
Topics: Humans; Male; Molecular Imaging; Neoplasm Staging; Prostatic Neoplasms; Safety
PubMed: 31227048
DOI: 10.1053/j.semnuclmed.2019.02.002 -
Minerva Urologica E Nefrologica = the... Sep 2015The aim of this paper was to examine the eligibility criteria, surveillance protocols and oncological outcomes of published active surveillance (AS) series. We also... (Review)
Review
The aim of this paper was to examine the eligibility criteria, surveillance protocols and oncological outcomes of published active surveillance (AS) series. We also assessed the evidence for utility of novel tools for optimal risk stratification and surveillance of men suitable for AS. A non-systematic literature search of the Medline, Embase, and Scopus databases was performed in April 2015 using medical subject headings and free-text protocol. The search was conducted by applying free-text protocol with the following search terms: "active surveillance", "prostate cancer", "prostatic neoplasm", "watchful waiting", "low risk prostate cancer" and "very low risk prostate cancer". The definition of insignificant disease remains debatable as criteria for patient selection vary among studies. Tools for better selection of candidates and monitoring of the disease process have evolved since the conception of AS, including new biomarkers like phi, mpMRI and alternate biopsy strategies. AS is a sound strategy for reducing overtreatment of men with low-risk, and potentially selected men with intermediate-risk prostate cancer and shorter life expectancy, without compromising overall and cancer specific survival. More data are needed on the optimal integration of the new tools on AS paradigms and on the long-term health impact of AS in different populations.
Topics: Evidence-Based Medicine; Humans; Male; Prostate-Specific Antigen; Prostatic Neoplasms; Watchful Waiting
PubMed: 26054412
DOI: No ID Found -
Seminars in Nuclear Medicine Nov 2016
Topics: Diagnostic Imaging; Humans; Male; Neoplasm Metastasis; Nuclear Medicine; Prostatic Neoplasms
PubMed: 27825427
DOI: 10.1053/j.semnuclmed.2016.07.010 -
Experimental Biology and Medicine... Aug 2015Prostate cancer is a frequently diagnosed cancer in males with high mortality in the world. As a heterogeneous tissue, the tumor mass contains a subpopulation that is... (Review)
Review
Prostate cancer is a frequently diagnosed cancer in males with high mortality in the world. As a heterogeneous tissue, the tumor mass contains a subpopulation that is called as cancer stem cells and displays stem-like properties such as self-renewal, epithelial-mesenchymal transition, metastasis, and drug resistance. Cancer stem cells have been identified in variant tumors and shown to be regulated by various molecules including microRNAs. MicroRNAs are a class of small non-coding RNAs, which can influence tumorigenesis via different mechanisms. In this review, we focus on the functions of microRNAs on regulating the stemness of prostate cancer stem cells with different mechanisms and propose the potential roles of microRNAs in prostate cancer therapy.
Topics: Drug Resistance, Neoplasm; Epithelial-Mesenchymal Transition; Gene Targeting; Humans; Male; MicroRNAs; Neoplasm Metastasis; Neoplastic Stem Cells; Prostatic Neoplasms; RNA, Neoplasm
PubMed: 25966983
DOI: 10.1177/1535370215584935