Deferred Treatment of Clinically Localized Low-Grade Prostate Cancer: Actual 10-Year and Projected 15-Year Follow-Up of the Karolinska Series

Adolfsson, Jan; Steineck, Gunnar; Hedlund, Per Olov

doi:10.1016/s0022-5347(01)63625-5

Cited by 18 publications

(25 citation statements)

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“…Improving on previous studies (Chodak et al, 1992;Albertsen et al, 1995Albertsen et al, , 2005Adolfsson et al, 1997;Holmberg et al, 2002;Johansson et al, 2004;Bill-Axelson et al, 2005), our analyses included centrally assigned Gleason scores determined by modern grading criteria and allowed comparisons with several additional clinical parameters. In agreement with Johansson et al (2004) and Albertsen et al (2005), we found Gleason score to be an important determinant of cancer-specific mortality, but baseline PSA and, to a lesser extent, stage of disease added further predictive value.…”

Section: Patient Cohortmentioning

confidence: 99%

Hsp-27 expression at diagnosis predicts poor clinical outcome in prostate cancer independent of ETS-gene rearrangement

et al. 2009

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Background: This study was performed to test the hypothesis that expression of small heat shock protein Hsp-27 is, at diagnosis, a reliable predictive biomarker of clinically aggressive prostate cancer. Methods: A panel of tissue microarrays constructed from a well-characterised cohort of 553 men with conservatively managed prostate cancer was stained immunohistochemically to detect Hsp-27 protein. Hsp-27 expression was compared with a series of pathological and clinical parameters, including outcome. Results: Hsp-27 staining was indicative of higher Gleason score ( P <0.001). In tissue cores having a Gleason score >7, the presence of Hsp-27 retained its power to independently predict poor clinical outcome ( P <0.002). Higher levels of Hsp-27 staining were almost entirely restricted to cancers lacking ERG rearrangements ( χ 2 trend=31.4, P <0.001), although this distribution did not have prognostic significance. Interpretation: This study has confirmed that, in prostate cancers managed conservatively over a period of more than 15 years, expression of Hsp-27 is an accurate and independent predictive biomarker of aggressive disease with poor clinical outcome ( P <0.001). These findings suggest that apoptotic and cell-migration pathways modulated by Hsp-27 may contain targets susceptible to the development of biologically appropriate chemotherapeutic agents that are likely to prove effective in treating aggressive prostate cancers.

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Section: Patient Cohortmentioning

confidence: 99%

Hsp-27 expression at diagnosis predicts poor clinical outcome in prostate cancer independent of ETS-gene rearrangement

et al. 2009

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“…In these series a large proportion of the patients remain without treatment for long periods of time or even until death caused by another disease. 2,3 The treatment given if necessary is most often hormonal treatment, ie not curative.…”

Section: Prognostic and Treatment-predictive Factors J Adolfsson And G mentioning

confidence: 99%

Prognostic and treatment-predictive factors—is there a difference?

Adolfsson

Steineck

2000

Prostate Cancer Prostatic Dis

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The terms risk factor, prognostic factor and predictive factor are often imprecisely used. We de®ned a prognostic factor as a patient characteristic that identi®es subgroups of untreated patients having different outcomes, and a factor predictive of treatment effect as a patient characteristic that identi®es subgroups of treated patients having different (as a consequence of treatment) outcomes. To illustrate this, theoretical graphical examples were constructed and data from the literature on prostate cancer were used to substantiate the theoretical examples. In most situations, but not necessarily always, a prognostic factor is also predictive of the effect of speci®c treatments. Whether a prognostic factor is also predictive of treatment effect or not can only be assessed in a valid comparative setting such as in a randomized trial. A factor that is predictive for treatment effect may not be predictive for another treatment. Prostate Cancer and Prostatic Diseases (2000) 3, 265±268.

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“…Improving on previous studies (Chodak et al, 1994;Albertsen et al, 1995;Adolfsson et al, 1997;Holmberg et al, 2002;Johansson et al, 2004;Albertsen et al, 2005;Bill-Axelson et al, 2005), our analyses included centrally assigned Gleason scores determined by modern grading criteria, and allowed comparisons with several additional clinical parameters. In agreement with Johansson et al (2004) and Albertsen et al (2005), we found Gleason score to be an important determinant of cancer-specific mortality, but baseline PSA and to a lesser extent stage of disease added further predictive value.…”

Section: Introductionmentioning

confidence: 99%

Duplication of the fusion of TMPRSS2 to ERG sequences identifies fatal human prostate cancer

Clark²,

et al. 2007

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New predictive markers for managing prostate cancer are urgently required because of the highly variable natural history of this disease. At the time of diagnosis, Gleason score provides the gold standard for assessing the aggressiveness of prostate cancer. However, the recent discovery of TMPRSS2 fusions to the ERG gene in prostate cancer raises the possibility of using alterations at the ERG locus as additional mechanism-based prognostic indicators. Fluorescence in situ hybridization (FISH) assays were used to assess ERG gene status in a cohort of 445 prostate cancers from patients who had been conservatively managed. The FISH assays detected separation of 5 0 (labelled green) and 3 0 (labelled red) ERG sequences, which is a consequence of the TMPRSS2-ERG fusion, and additionally identify interstitial deletion of genomic sequences between the tandemly located TMPRSS2 and ERG gene sequences on chromosome 21. Cancers lacking ERG alterations exhibited favourable cause-specific survival (90% survival at 8 years). We identify a novel category of prostate cancers, characterized by duplication of the fusion of TMPRSS2 to ERG sequences together with interstitial deletion of sequences 5 0 to ERG (called '2 þ Edel'), which by comparison exhibited extremely poor cause-specific survival (hazard ratio ¼ 6.10, 95% confidence ratio ¼ 3.33-11.15, Po0.001, 25% survival at 8 years). In multivariate analysis, '2 þ Edel' provided significant prognostic information (P ¼ 0.003) in addition to that provided by Gleason score and prostate-specific antigen level at diagnosis. Other individual categories of ERG alteration were associated with intermediate or good prognosis. We conclude that determination of ERG gene status, including duplication of the fusion of TMPRSS2 to ERG sequences in 2 þ Edel, allows stratification of prostate cancer into distinct survival categories.

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Deferred Treatment of Clinically Localized Low-Grade Prostate Cancer: Actual 10-Year and Projected 15-Year Follow-Up of the Karolinska Series

Cited by 18 publications

References 0 publications

Hsp-27 expression at diagnosis predicts poor clinical outcome in prostate cancer independent of ETS-gene rearrangement

Hsp-27 expression at diagnosis predicts poor clinical outcome in prostate cancer independent of ETS-gene rearrangement

Prognostic and treatment-predictive factors—is there a difference?

Duplication of the fusion of TMPRSS2 to ERG sequences identifies fatal human prostate cancer

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