Patterns of spread of adenocarcinoma in the prostate as related to cancer volume

McNeal, John E.; Haillot, O.

doi:10.1002/pros.1117

Cited by 111 publications

(103 citation statements)

References 9 publications

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“…In this study, AFMS cancers still confined to this zone and seen at MRI could be diagnosed by targeted biopsies, whereas they were not observed at this stage in previous series of RP before the DCE-MRI era (Fig. 2) [10]. Improvement in imaging necessitates better knowledge of depiction of these intraprostatic cancers from histopathological studies.…”

Section: Introductionmentioning

confidence: 48%

“…Prostatectomy specimens were inked, fixed and sectioned according to the Stanford protocol [10]. A histological map of each prostate was performed from whole-mount histological slides.…”

Section: Histological Reconstructionmentioning

confidence: 99%

“…Their development within glandular prostatic zones and anterior fibromuscular stroma (AFMS) depends on both the limits between these zones and the BPH evolution [4,7]. They tend to stay in the zone where they first developed until they have reached a volume between 2 and 4 cm 3 [10]. Preoperative identification of APC with DCE-MRI at a localized stage <4 cm 3 was recently described for the first time [11].…”

Section: Introductionmentioning

confidence: 99%

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Transition zone and anterior stromal prostate cancers: Zone of origin and intraprostatic patterns of spread at histopathology

et al. 2008

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BACKGROUND.To describe the precise location of transition zone (TZ) and anterior fibromuscular stroma (AFMS) prostate cancers (TZ/AFMS) within histological zones at various stages of development and to demonstrate their pattern of intraprostatic spread from their site of origin. METHODS. Anterior TZ/AFMS cancers excluding the anterolateral part of peripheral zone, were identified from radical prostatectomy specimens. Morphometric histopathological study included largest surface area, volume and spatial distribution. RESULTS. Out of 91 TZ/AFMS cancers, 79 were <4 cm 3 and 69 <2 cm 3 . Fifty percent and 70% of cancers <4 cm 3 were located in the anterior third and inferior half of TZ and/or AFMS, respectively. Cancers <2 cm 3 could be classified into three types according to their location related to histologic zone boundaries: TZ type 1 (40%) for cancers confined to one TZ lobe; TZ type 2 (35%) for cancers most represented in one TZ lobe but crossing its anterior boundary; type AFMS (25%) for cancers confined to AFMS. These results form the rationale for the hypothesis that AFMS cancers originate from anterior and medial TZ and due to benign prostatic hypertrophy they become excluded from TZ, anteriorly into AFMS. TZ anterior limit would then act as a barrier to their posterior extension. CONCLUSIONS. TZ/AFMS cancers contours and locations are predictable and conform to histological zones boundaries. Knowledge of these cancer origin and pattern of spread in TZ and AFMS are of importance for imaging diagnosis, guidance for biopsy and focal therapy.

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Section: Introductionmentioning

confidence: 48%

“…Prostatectomy specimens were inked, fixed and sectioned according to the Stanford protocol [10]. A histological map of each prostate was performed from whole-mount histological slides.…”

Section: Histological Reconstructionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transition zone and anterior stromal prostate cancers: Zone of origin and intraprostatic patterns of spread at histopathology

et al. 2008

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“…Transition zone tumors tend to stay in the zone where they first developed until they have reached a volume between 2 and 4 cm 3 . 36 Transition zone cancers are usually considered to have a better outcome at same volume and grade than their peripheral zone counterparts. [37][38][39] Demichelis et al 5 characterized the TMPRSS2-ERG fusion status in a population-based cohort of men with early prostate cancer diagnosed by transurethral resection of the prostate or transvesical adenoma enucleation for symptomatic benign prostatic hyperplasia.…”

Section: Discussionmentioning

confidence: 99%

ERG rearrangement is present in a subset of transition zone prostatic tumors

et al. 2010

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A majority of prostate cancers exhibit a recurrent gene rearrangement involving chromosome 21. In approximately 90% of cases, the rearrangement is characterized by fusion of the androgen-regulated gene TMPRSS2 with the oncogene ERG. A recent study suggested that TMPRSS2-ERG gene fusion is lacking in cancers arising from the transition zone of the prostate. A dominant transition zone cancer was detected in 62/397 (16%) patients who underwent radical prostatectomy at our institution and were reviewed and mapped by a single pathologist. In 46/62 specimens, a secondary tumor was identified in the peripheral zone of the prostate. A tissue microarray containing both transition and peripheral zone tumors was constructed and evaluated for gene fusion analysis. TMPRSS2-ERG fusion status was determined using a multicolor interphase fluorescence in situ hybridization assay for ERG break-apart. The median age of the patients was 59 years. Prostatectomy Gleason score was 6 in 21, 7 in 34, and Z8 in 7 cases. Median tumor volume was 200 mm 2 . TMPRSS2-ERG gene fusion was present in 7/59 (12%) transition zone, and in 12/35 (34%) peripheral zone tumors. Transition zone fusion-positive cases were larger than their negative counterparts. No significant correlation was found between fusion status and Gleason score or pathologic stage. Gene fusion through deletion occurred in 4/7 transition zone and 7/12 peripheral zone tumors. Transition zone prostate cancers are considered biologically and genetically different from peripheral zone tumors. Although ERG rearrangement is more common in peripheral zone tumors, we have detected TMPRSS2-ERG fusion in a subset of transition zone cancers (12%). The lower frequency of gene fusion in transition zone prostate cancer may suggest distinct molecular alterations from peripheral zone tumors and the association with a high tumor volume may indicate a growth advantage for transition zone tumors harboring the gene fusion. Further studies are necessary to confirm this hypothesis.

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“…However, the most common interaction between nerves and prostate epithelium during tumorigenesis is PNI. The biological and clinical significance of PNI in prostate cancer has been the subject of intense debate (15)(16)(17)(18). Numerous other authors have reported varying degrees of clinical prognostic significance for PNI (15, 17, 19 -23).…”

Section: Discussionmentioning

confidence: 99%

Growth and Survival Mechanisms Associated with Perineural Invasion in Prostate Cancer

Ayala

Dai²,

Ittmann³

et al. 2004

Cancer Research

208

149

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Perineural invasion (PNI) is the major mechanism of prostate cancer spread outside the prostate. Apoptotic and proliferation indices were determined in PNI cells using the PNI in vitro model and human PNI in tissue microarrays. RNA was extracted from the PNI model and controls and evaluated by cDNA microarray analysis. Differential expression of candidate genes was confirmed by real-time quantitative PCR, fluorescence, and immunohistochemistry using tissue microarrays. Genistein and BAY 11-7085 were added to the supernatant of cocultures and controls in microchamber cultures. The significance of nuclear factor B (NFB) nuclear translocation in human PNI was analyzed using Kaplan-Meier analysis. An increase in proliferation and a decrease in apoptosis were observed in human PNI cells and the PNI model as compared with controls. Three of 15 genes up-regulated in the cDNA microarray were involved in the apoptosis signaling pathway (NFB), and its downstream targets defender against cell death 1 and PIM-2. The increase was corroborated by real-time quantitative PCR and immunofluorescence. NFB nuclear translocation was seen in the in vitro model and human tissues, where strong nuclear expression was associated with a decrease in recurrence-free survival. Addition of genistein and BAY 11-7085 resulted in a decrease in NFB, PIM-2 and defender against cell death 1 as well as a reversal of the inhibition of apoptosis. This is the first description of a biological mechanism and functional significance of PNI. Cancer cells in a perineural location acquire a survival and growth advantage using a NFB survival pathway. Targeting PNI might help detain local spread of the tumor and influence survival.

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Patterns of spread of adenocarcinoma in the prostate as related to cancer volume

Abstract: Patterns and extent of spread of carcinoma in the prostate are stereotyped following a few principles regarding stromal interactions. Using these, sequential maps were presented of evolving prostate cancer contours at consecutive increasing volumes.

Cited by 111 publications

References 9 publications

Transition zone and anterior stromal prostate cancers: Zone of origin and intraprostatic patterns of spread at histopathology

Transition zone and anterior stromal prostate cancers: Zone of origin and intraprostatic patterns of spread at histopathology

ERG rearrangement is present in a subset of transition zone prostatic tumors

Growth and Survival Mechanisms Associated with Perineural Invasion in Prostate Cancer

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