-
Arab Journal of Urology Dec 2020: To evaluate the current literature on the accuracy of fluoro-2-deoxy--glucose positron emission tomography-computed tomography (FDG PET-CT) for lymph node (LN) staging... (Review)
Review
Performance of fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography imaging for lymph node staging in bladder and upper tract urothelial carcinoma: a systematic review.
: To evaluate the current literature on the accuracy of fluoro-2-deoxy--glucose positron emission tomography-computed tomography (FDG PET-CT) for lymph node (LN) staging in urothelial carcinoma (UC), as robust evidence on the value of this technology in UC is still lacking. : The Medical Literature Analysis and Retrieval System Online (MEDLINE)/PubMed, Cochrane Library, and Scopus databases were searched for eligible studies. We included all original studies evaluating FDG PET-CT in bladder or upper tract UC. The search results were restricted to the English language, and included prospective and retrospective studies without time restriction. We included only studies reporting the sensitivity and specificity of FDG PET-CT in detecting UC LN metastases. : We identified 23 articles meeting our inclusion criteria. In the preoperative setting, the sensitivity of FDG PET-CT for detecting LN metastases in patients with bladder cancer was widely variable ranging from 23% to 89%; the specificity ranged from 81% to 100%; and the overall accuracy ranged from 65% to 89%. During bladder cancer monitoring the sensitivity for detecting LN metastases ranged from 75% to 92% and the specificity ranged from 60% to 92%. The sensitivity for LN staging in upper tract UC ranged between 82% and 95%, with a specificity of 84-91%. : Despite the inconsistencies in sensitivity between the reports, FDG PET-CT seems to have a high specificity for LN staging in patients with UC. Future prospective, well-designed studies are necessary to evaluate the role of FDG PET-CT in UC management. FDG: fluoro-2-deoxy--glucose; LN: lymph node; PET: positron emission tomography; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-analyses; PSMA: prostate-specific membrane antigen; (N)(P)PV: (negative) (positive) predictive value; QUADAS-2: Quality Assessment of Diagnostic Accuracy Studies-2; SUV: maximum standard uptake value; (UT)UC: (upper urinary tract) urothelial carcinoma.
PubMed: 33763249
DOI: 10.1080/2090598X.2020.1858012 -
Diagnostics (Basel, Switzerland) Feb 2021to explore the diagnostic accuracy of 18F-Fluciclovine positron-emission tomography (PET) in prostate cancer (PCa), considering both primary staging prior to radical... (Review)
Review
BACKGROUND
to explore the diagnostic accuracy of 18F-Fluciclovine positron-emission tomography (PET) in prostate cancer (PCa), considering both primary staging prior to radical therapy, biochemical recurrence, and advanced setting.
METHODS
A systematic web search through Embase and Medline was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies performed from 2011 to 2020 were evaluated. The terms used were "PET" or "positron emission tomography" or "positron emission tomography/computed tomography" or "PET/CT" or "positron emission tomography-computed tomography" or "PET-CT" and "Fluciclovine" or "FACBC" and "prostatic neoplasms" or "prostate cancer" or "prostate carcinoma". Only studies reporting about true positive (TP), true negative (TN), false positive (FP) and false negative (FN) findings of 18F-fluciclovine PET were considered eligible.
RESULTS
Fifteen out of 283 studies, and 697 patients, were included in the final analysis. The pooled sensitivity for 18F-Fluciclovine PET/CT for diagnosis of primary PCa was 0.83 (95% CI: 0.80-0.86), the specificity of 0.77 (95% CI: 0.74-0.80). The pooled sensitivity for preoperative LN staging was 0.57 (95% CI: 0.39-0.73) and specificity of 0.99 (95% CI: 0.94-1.00). The pooled sensitivity for the overall detection of recurrence in relapsed patients was 0.68 (95% CI: 0.63-0.73), and specificity of 0.68 (95% CI: 0.60-0.75).
CONCLUSION
This meta-analysis showed promising results in term of sensitivity and specificity for 18F-Fluciclovine PET/CT to stage the primary lesion and in the assessment of nodal metastases, and for the detection of PCa locations in the recurrent setting. However, the limited number of studies and the broad heterogeneity in the selected cohorts and in different investigation protocols are limitation affecting the strength of these results.
PubMed: 33668673
DOI: 10.3390/diagnostics11020304 -
Therapeutic Advances in Medical Oncology 2020The research objective was to systematically review evidence on neurotrophic tyrosine receptor kinase () gene fusion frequency in solid tumors.
INTRODUCTION
The research objective was to systematically review evidence on neurotrophic tyrosine receptor kinase () gene fusion frequency in solid tumors.
METHODS
Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review (SLR) was conducted of studies published from January 1987 to 2 January 2020. Selected studies were appraised for use in meta-analysis, with frequency reported as a point estimate with confidence intervals, to estimate gene fusion tumor incidence and prevalence.
RESULTS
The SLR identified 222 studies from North America ( = 122), Europe ( = 33), Asia ( = 41), Brazil ( = 5), Australia ( = 2), and multi-continental ( = 19) reporting gene fusion frequencies across 101 histologies. Studies were prospective ( = 43) and retrospective ( = 179). Testing methods involved DNA ( = 93), RNA ( = 72), combined DNA/RNA ( = 48), protein [immunohistochemistry (IHC), = 5], and unreported ( = 5). Sample sizes ranged from 1 to 66,871. Of the 222 studies, 107 were suitable for meta-analysis. Highest gene fusion frequencies were reported in rare cancers: infantile/congenital fibrosarcoma (90.56%, 95% CI 67.42-100.00), secretory breast cancer (92.87%, 95% CI 72.62-100.00), and congenital mesoblastic nephroma (21.52%, 95% CI 13.06-32.20). Lower frequencies were reported in non-small cell lung cancer (0.17%, 95% CI 0.09-0.25), colorectal adenocarcinoma (0.26%, 95% CI 0.15-0.36), cutaneous melanoma (0.31%, 95% CI 0.07-0.55), and non-secretory breast carcinoma (0.60%, 95% CI 0.00-1.50). Reported frequency was ~0% for some cancers: mesothelioma, renal cell carcinoma, prostate cancer, and bone sarcoma. Estimated global overall gene fusion tumour incidence and 5-year prevalence in 2018 was 0.52 and 1.52 per 100,000 persons, respectively.
CONCLUSION
This research confirms the rarity and varying frequency of gene fusion across tumor types. Limitations included relatively low historic gene fusion testing and reporting, limited study samples for some cancers, and suboptimal molecular testing methods. In this rapidly developing area, gold-standard testing methods and companion diagnostics are needed to capture all gene fusions.
PubMed: 33425024
DOI: 10.1177/1758835920975613 -
BJUI Compass Jan 2021Ductal adenocarcinoma (DAC) is relatively rare, but is nonetheless the second most common subtype of prostate cancer. First described in 1967, opinion is still divided... (Review)
Review
CONTEXT
Ductal adenocarcinoma (DAC) is relatively rare, but is nonetheless the second most common subtype of prostate cancer. First described in 1967, opinion is still divided regarding its biology, prognosis, and outcome.
OBJECTIVES
To systematically interrogate the literature to clarify the epidemiology, diagnosis, management, progression, and survival statistics of DAC.
MATERIALS AND METHODS
We conducted a literature search of five medical databases from inception to May 04 2020 according to PRISMA criteria using search terms "prostate ductal adenocarcinoma" OR "endometriod adenocarcinoma of prostate" and variations of each.
RESULTS
Some 114 studies were eligible for inclusion, presenting 2 907 170 prostate cancer cases, of which 5911 were DAC. [Correction added on 16 January 2021 after the first online publication: the preceding statement has been corrected in this current version.] DAC accounts for 0.17% of prostate cancer on meta-analysis (range 0.0837%-13.4%). The majority of DAC cases were admixed with predominant acinar adenocarcinoma (AAC). Median Prostate Specific Antigen at diagnosis ranged from 4.2 to 9.6 ng/mL in the case series.DAC was more likely to present as T3 (RR1.71; 95%CI 1.53-1.91) and T4 (RR7.56; 95%CI 5.19-11.01) stages, with far higher likelihood of metastatic disease (RR4.62; 95%CI 3.84-5.56; all -values < .0001), compared to AAC. Common first treatments included surgery (radical prostatectomy (RP) or cystoprostatectomy for select cases) or radiotherapy (RT) for localized disease, and hormonal or chemo-therapy for metastatic disease. Few studies compared RP and RT modalities, and those that did present mixed findings, although cancer-specific survival rates seem worse after RP.Biochemical recurrence rates were increased with DAC compared to AAC. Additionally, DAC metastasized to unusual sites, including penile and peritoneal metastases. Where compared, all studies reported worse survival for DAC compared to AAC.
CONCLUSION
When drawing conclusions about DAC it is important to note the heterogenous nature of the data. DAC is often diagnosed incidentally post-treatment, perhaps due to lack of a single, universally applied histopathological definition. As such, DAC is likely underreported in clinical practice and the literature. Poorer prognosis and outcomes for DAC compared to AAC merit further research into genetic composition, evolution, diagnosis, and treatment of this surprisingly common prostate cancer sub-type.
PATIENT SUMMARY
Ductal prostate cancer is a rare but important form of prostate cancer. This review demonstrates that it tends to be more serious at detection and more likely to spread to unusual parts of the body. Overall survival is worse with this type of prostate cancer and urologists need to be aware of the presence of ductal prostate cancer to alter management decisions and follow-up.
PubMed: 35474657
DOI: 10.1002/bco2.60 -
Frontiers in Oncology 2020To examine the potential prognostic significance of pretreatment De Ritis ratio (aspartate transaminase/alanine transaminase ratio) in urological cancers, including...
To examine the potential prognostic significance of pretreatment De Ritis ratio (aspartate transaminase/alanine transaminase ratio) in urological cancers, including upper tract urothelial cancer (UTUC), renal cell carcinoma (RCC), prostate cancer (PCa), bladder cancer (BCa). Potential literatures were searched with PubMed, Embase, Cochrane Library, and Web of Science in December 2019. Merged hazard ratios (HRs) and 95% confidence intervals (CIs) were used to evaluate the associations. Totally, 15 studies with 8,565 patients were included. Merged results showed that an elevated pretreatment De Ritis ratio was correlated with poorer OS (HR 1.80, 95% CI 1.61-2.01), CSS (HR 2.15, 95% CI 1.80-2.56), PFS (HR 1.57, 95% CI 1.34-1.85), BRFS (HR 1.67, 95% CI 1.11-2.53) for urological cancers. Subgroup analyses by cancer type for OS found that De Ritis ratio can be a predictor in UTUC (HR 1.91, 95% CI 1.57-2.33), RCC (HR 1.74, 95% CI 1.47-2.07), and BCa (HR 1.80, 95% CI 1.43-2.27). Similar results could be found for CSS (UTUC: HR 2.46, 95% CI 1.93-3.13; RCC: HR 1.90, 95% CI 1.46-2.47; BCa: HR 2.71, 95% CI 1.39-5.31) and PFS (UTUC: HR 1.59, 95% CI 1.15-2.20; RCC: HR 1.52, 95% CI 1.26-1.83; BCa: HR 1.79, 95% CI 1.18-2.72). There was no publication bias among these included studies. Pretreatment De Ritis ratio was a significant predictor for OS, CSS, PFS and BRFS in urological cancers, indicating that it could be a promising prognostic factor during clinical practice.
PubMed: 33014827
DOI: 10.3389/fonc.2020.01650 -
BioMed Research International 2020Exosomes are defined as small membranous vesicles. After RNA content was discovered in exosomes, they emerged as a novel approach for the treatment and diagnosis of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Exosomes are defined as small membranous vesicles. After RNA content was discovered in exosomes, they emerged as a novel approach for the treatment and diagnosis of cancer. Long noncoding RNAs (lncRNA), a kind of specific RNA transcript, have been reported to function as tumor growth, metastasis, invasion, and prognosis by regulating the tumor microenvironment in exosomes. This study aims at exploring the potential diagnostic of exosomal lncRNA in solid tumors.
METHODS
A meta-analysis conducted from January 2000 to October 2019 identified publications in the English language. We searched all relevant English literature from the Web of Science, EMBASE, and PubMed databases through October 1, 2019. The articles were strictly screened by our criteria and critiqued using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
RESULTS
There were 28 studies with 19 articles (4017 patients) identified, including studies on gastric cancer, laryngeal squamous cell carcinoma, colorectal cancer, cholangiocarcinoma, breast cancer, esophageal squamous cell carcinoma, hepatocellular carcinoma, nonsmall cell lung cancer, and prostate cancer. A meta-analysis showed that the combined value of sensitivity in 29 studies was 0.74 (95% confidence interval [CI], 0.7-0.78), and the combined value of specificity in the studies was 0.81 (95% CI, 0.78-0.83). This suggests the high diagnostic efficacy of liquid exosomes in cancer patients. It is statistically insignificant in terms of sex, ethnicity, and year. The diagnostic power of urinary system tumors was found to be higher than that of digestive system tumors by several subgroup analyses.
CONCLUSIONS
We performed a meta-analysis and literature review of 28 studies that included 4017 patients with 10 malignant cancer types. Mechanistically, our study demonstrated that lncRNAs in exosomes could be a promising bioindicator for the diagnosis and prognosis of solid tumors. INPLASY Registration Number: INPLASY202060083.
Topics: Biomarkers, Tumor; Breast Neoplasms; Exosomes; Female; Humans; Male; Neoplasms; Prostatic Neoplasms; RNA, Long Noncoding; Sensitivity and Specificity; Stomach Neoplasms
PubMed: 32879887
DOI: 10.1155/2020/6786875 -
Urologic Oncology Oct 2020To provide a review of high-risk urologic cancers and the feasibility of delaying surgery without impacting oncologic or mortality outcomes.
PURPOSE
To provide a review of high-risk urologic cancers and the feasibility of delaying surgery without impacting oncologic or mortality outcomes.
MATERIALS AND METHODS
A thorough literature review was performed using PubMed and Google Scholar to identify articles pertaining to surgical delay and genitourinary oncology. We reviewed all relevant articles pertaining to kidney, upper tract urothelial cell, bladder, prostate, penile, and testicular cancer in regard to diagnostic, surgical, or treatment delay.
RESULTS
The majority of urologic cancers rely on surgery as primary treatment. Treatment of unfavorable intermediate or high-risk prostate cancer, can likely be delayed for 3 to 6 months without affecting oncologic outcomes. Muscle-invasive bladder cancer and testicular cancer can be treated initially with chemotherapy. Surgical management of T3 renal masses, high-grade upper tract urothelial carcinoma, and penile cancer should not be delayed.
CONCLUSION
The majority of urologic oncologic surgeries can be safely deferred without impacting long-term cancer specific or overall survival. Notable exceptions are muscle-invasive bladder cancer, high-grade upper tract urothelial cell, large renal masses, testicular and penile cancer. Joint decision making among providers and patients should be encouraged. Clinicians must manage emotional anxiety and stress when decisions around treatment delays are necessary as a result of a pandemic.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Medical Oncology; Pandemics; Pneumonia, Viral; SARS-CoV-2; Time-to-Treatment; Urologic Neoplasms; Urology
PubMed: 32703636
DOI: 10.1016/j.urolonc.2020.06.028 -
Cancers Jul 2020Aquaporin (AQP) channels enable regulated transport of water and solutes essential for fluid homeostasis, but they are gaining attention as targets for anticancer...
Aquaporin (AQP) channels enable regulated transport of water and solutes essential for fluid homeostasis, but they are gaining attention as targets for anticancer therapies. Patterns of AQP expression and survival rates for patients were evaluated by systematic review (PubMed and Embase) and transcriptomic analyses of RNAseq data (Human Protein Atlas database). Meta-analyses confirmed predominantly negative associations between AQP protein and RNA expression levels and patient survival times, most notably for AQP1 in lung, breast and prostate cancers; AQP3 in esophageal, liver and breast cancers; and AQP9 in liver cancer. Patterns of AQP expression were clustered for groups of cancers and associated with risk of death. A quantitative transcriptomic analysis of AQP1-10 in human cancer biopsies similarly showed that increased transcript levels of AQPs 1, 3, 5 and 9 were most frequently associated with poor survival. Unexpectedly, increased AQP7 and AQP8 levels were associated with better survival times in glioma, ovarian and endometrial cancers, and increased AQP11 with better survival in colorectal and breast cancers. Although molecular mechanisms of aquaporins in pathology or protection remain to be fully defined, results here support the hypothesis that overexpression of selected classes of AQPs differentially augments cancer progression. Beyond fluid homeostasis, potential roles for AQPs in cancers (suggested from an expanding appreciation of their functions in normal tissues) include cell motility, membrane process extension, transport of signaling molecules, control of proliferation and apoptosis, increased mechanical compliance, and gas exchange. AQP expression also has been linked to differences in sensitivity to chemotherapy treatments, suggesting possible roles as biomarkers for personalized treatments. Development of AQP pharmacological modulators, administered in cancer-specific combinations, might inspire new interventions for controlling malignant carcinomas.
PubMed: 32679804
DOI: 10.3390/cancers12071911 -
Supportive Care in Cancer : Official... Mar 2021Incidental pulmonary embolism (IPE) is a common finding on computed tomography (CT). IPE is frequent in oncologic patients undergoing staging CT. The aim of this... (Meta-Analysis)
Meta-Analysis
PURPOSE
Incidental pulmonary embolism (IPE) is a common finding on computed tomography (CT). IPE is frequent in oncologic patients undergoing staging CT. The aim of this analysis was to provide the pooled frequency of IPE and frequencies of IPE in different primary tumors.
METHODS
MEDLINE, SCOPUS, and EMBASE databases were screened for studies investigating frequency of IPE in oncologic staging CT up to February 2020. Overall, 12 studies met the inclusion criteria and were included into the present study.
RESULTS
The pooled analysis yielded a total of 28,626 patients. IPE was identified in 963 patients (3.36%, 95% CI = 3.15; 3.57). The highest frequency was found in prostate cancer (8.59%, 95%CI = 3.74; 13.44), followed by hepatobiliary carcinoma (6.07%, 95%CI = 3.09; 9.05) and pancreatic cancer (5.65%, 95%CI = 3.54; 7.76). The lowest frequencies were identified in tumors of male reproductive organs (0.79%, 95%CI = 0.21; 1.37) and hematological diseases (1.11% 95%CI = 0.74; 1.48).
CONCLUSION
The overall frequency of IPE in oncologic patients was 3.36%. There are considerable differences in regard to primary tumors with the highest frequency in prostate cancer and pancreatic and hepatobiliary carcinomas.
Topics: Female; Humans; Male; Neoplasms; Pulmonary Embolism; Tomography, X-Ray Computed
PubMed: 32621266
DOI: 10.1007/s00520-020-05601-y -
Cancers Jun 2020Significant prostate carcinoma (sPCa) classification based on MRI using radiomics or deep learning approaches has gained much interest, due to the potential application...
UNLABELLED
Significant prostate carcinoma (sPCa) classification based on MRI using radiomics or deep learning approaches has gained much interest, due to the potential application in assisting in clinical decision-making.
OBJECTIVE
To systematically review the literature (i) to determine which algorithms are most frequently used for sPCa classification, (ii) to investigate whether there exists a relation between the performance and the method or the MRI sequences used, (iii) to assess what study design factors affect the performance on sPCa classification, and (iv) to research whether performance had been evaluated in a clinical setting Methods: The databases Embase and Ovid MEDLINE were searched for studies describing machine learning or deep learning classification methods discriminating between significant and nonsignificant PCa on multiparametric MRI that performed a valid validation procedure. Quality was assessed by the modified radiomics quality score. We computed the median area under the receiver operating curve (AUC) from overall methods and the interquartile range.
RESULTS
From 2846 potentially relevant publications, 27 were included. The most frequent algorithms used in the literature for PCa classification are logistic regression (22%) and convolutional neural networks (CNNs) (22%). The median AUC was 0.79 (interquartile range: 0.77-0.87). No significant effect of number of included patients, image sequences, or reference standard on the reported performance was found. Three studies described an external validation and none of the papers described a validation in a prospective clinical trial.
CONCLUSIONS
To unlock the promising potential of machine and deep learning approaches, validation studies and clinical prospective studies should be performed with an established protocol to assess the added value in decision-making.
PubMed: 32560558
DOI: 10.3390/cancers12061606