Pretreatment Tumor Volume Estimation Based on Total Serum PSA in Patients with Localized Prostate Cancer

Kato, Raphael; Srougi, Victor; Salvadori, Fernanda Aburesi; Ayres, Pedro Paulo Marino Rodrigues; Leite, Kátia R. M.; Srougi, Miguel

doi:10.1590/s1807-59322008000600009

Cited by 17 publications

(11 citation statements)

References 16 publications

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“…In cases with high tumor volume, lymphovascular invasion and intraductal spread of carcinoma were frequently seen as well. Tumor volume correlates well with serum PSA levels, 30 which is consistent with our finding demonstrating the 50% difference in mean preoperative PSA levels between the 2 groups (12.2 ng/mL versus 8.1 ng/mL). By itself, a high level of preoperative PSA is associated with higher risk of LN þ .…”

Section: Commentsupporting

confidence: 91%

Gleason Score 7 Adenocarcinoma of the Prostate With Lymph Node Metastases: Analysis of 184 Radical Prostatectomy Specimens

Kryvenko

Gupta

Virani

et al. 2013

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Prostate cancer (PC) with lymph node metastases (LN þ ) is relatively rare, whereas it is relatively common in disease with a Gleason score (GS) 8 to 10 and virtually never seen in PC with GS 6 or less. It is most variable in GS 7 PC.Objective.-To determine clinicopathologic features associated with GS 7 PC with LN þ compared with a control group without lymph node metastases (LN À ). Design.-We analyzed 184 GS 7 radical prostatectomies with LN þ and the same number of LN À Gleasonmatched controls. The LN þ cases were GS 3 þ 4 ¼ 7 (n ¼ 64; 34.8%), GS 4 þ 3 ¼ 7 (n ¼ 66; 35.9%), GS 3 þ 4 ¼ 7 with tertiary 5 (n ¼ 10; 5.4%), and GS 4 þ 3 ¼ 7 with tertiary 5 (n ¼ 44; 23.9%).Results.-The LN þ cases demonstrated higher average values in preoperative prostate-specific antigen (12.2 versus 8.1 ng/mL), percentage of positive biopsy cores (59.1% versus 42.9%), prostate weight (54.4 versus 49.4 g), number of LNs submitted (12.7 versus 9.4), incidence of nonfocal extraprostatic extension (82.6% versus 63.6%), tumor volume (28.9% versus 14.8%), frequency of lymphovascular invasion (78.3% versus 38.6%), intraductal spread of carcinoma (42.4% versus 20.7%), incidence of satellite tumor foci (16.4% versus 4.3%), incidence of pT3b disease (49.5% versus 14.7%), and lymphovascular invasion in the seminal vesicles (52% versus 30%). There were differences in GS 4 patterns and cytology between LN þ and LN À cases, with the former having higher volumes of cribriform and poorly formed patterns, larger nuclei and nucleoli, and more-frequent macronucleoli. All P .05.Conclusion.-Gleason score 7 PC with LN þ has features highlighting a more-aggressive phenotype. These features can be assessed as prognostic markers in GS 7 disease on biopsy (eg, GS 4 pattern, intraductal spread, cytology) or at radical prostatectomies (all variables), even in men without LN dissection or LN À disease.

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Section: Commentsupporting

confidence: 91%

Gleason Score 7 Adenocarcinoma of the Prostate With Lymph Node Metastases: Analysis of 184 Radical Prostatectomy Specimens

Kryvenko

Gupta

Virani

et al. 2013

Archives of Pathology &Amp; Laboratory Medicine

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“…A general indicator of possible relapse is an increasing concentration of prostate-specific antigen (PSA) in the blood. PSA is generally regarded as a good biomarker for disease progression in primary PCa, and it is a well-studied surrogate of tumor burden [ 1 – 4 ]. However, at an early PCa recurrence or microscopic metastatic spread, PSA alone can seldom be used for staging and is generally associated with relatively low levels of serum PSA concentrations (< 0.2 ng/ml).…”

Section: Introductionmentioning

confidence: 99%

Hallmarks in prostate cancer imaging with Ga68-PSMA-11-PET/CT with reference to detection limits and quantitative properties

et al. 2018

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BackgroundGallium-68-labeled prostate-specific antigen positron emission tomography/computed tomography imaging (Ga68-PSMA-11-PET/CT) has emerged as a potential gold standard for prostate cancer (PCa) diagnosis. However, the imaging limitations of this technique at the early state of PCa recurrence/metastatic spread are still not well characterized. The aim of this study was to determine the quantitative properties and the fundamental imaging limits of Ga68-PSMA-11-PET/CT in localizing small PCa cell deposits.MethodsThe human PCa LNCaP cells (PSMA expressing) were grown and collected as single cell suspension or as 3D-spheroids at different cell numbers and incubated with Ga68-PSMA-11. Thereafter, human HCT116 cells (PSMA negative) were added to a total cell number of 2 × 105 cells per tube. The tubes were then pelleted and the supernatant aspirated. A whole-body PET/CT scanner with a clinical routine protocol was used for imaging the pellets inside of a cylindrical water phantom with increasing amounts of background activity. The actual activity bound to the cells was also measured in an automatic gamma counter. Imaging detection limits and activity recovery coefficients as a function of LNCaP cell number were obtained. The effect of Ga68-PSMA-11 mass concentration on cell binding was also investigated in samples of LnCaP cells incubated with increasing concentrations of radioligand.ResultsA total of 1 × 104 LNCaP cells mixed in a pellet of 2 × 105 cells were required to reach a 50% detection probability with Ga68-PSMA-11-PET/CT without background. With a background level of 1 kBq/ml, between 4 × 105 and 1 × 106 cells are required. The radioligand equilibrium dissociation constant was 27.05 nM, indicating high binding affinity. Hence, the specific activity of the radioligand has a profound effect on image quantification.ConclusionsGa68-PSMA-11-PET detects a small number of LNCaP cells even when they are mixed in a population of non-PSMA expressing cells and in the presence of background. The obtained image detection limits and characteristic quantification properties of Ga68-PSMA-11-PET/CT are essential hallmarks for the individualization of patient management. The use of the standardized uptake value for Ga68-PSMA-11-PET/CT image quantification should be precluded.

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“…Previously Kato et al (12) related that PSA level is proportional to prostate tumor volume, and since all cases selected had localized disease, PSA tend to be in the same range in both groups. Staging was a pre-selection variable, justifying the similarities between the two groups.…”

Section: Discussionmentioning

confidence: 90%

8 Socioeconomic Status Is an Independent Predictor of Biochemical Recurrence Among Patients With Prostate Cancer Who Undergo Radical Prostatectomy

Srougi¹,

Antunes²,

Reis³

et al. 2010

Journal of Urology

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Purpose: Socioeconomic status (SES) may influence cancer characteristics and behavior in several aspects. We analyzed PCa characteristics and behavior among low income uninsured men, and compare them to high income patients with health insurance in a developing country. Materials and Methods: A retrospective case-control study was performed on 934 patients with clinically localized PCa who underwent radical prostatectomy between March, 1999 and July, 2009. Patients were divided in two groups, according to their SES. In group 1 (n=380), all had low income, low educational levels and couldn't afford medical insurance. In group 2 (n=554), all had higher income, higher education and had medical insurance. Results: Patients from group 1 were older, had higher Gleason scores, higher rates of seminal vesicle and bladder neck involvement. The Kaplan Meier disease-free survival curve demonstrated that after a follow-up of four years, about 50% of uninsured patients had biochemical recurrence, versus 21% of insured patients (Log rank test: p < 0.001). A multivariate Cox regression analysis for the risk of disease recurrence demonstrated that only PSA levels, Gleason score, seminal vesicle involvement and SES were statistically significant variables. Patients with a low SES presented 1.8 times the risk of recurrence as compared to patients with a high SES. Conclusions: Patients with low SES were older, presented more aggressive PCa characteristics and a high rate of disease recurrence. A low SES constituted an independent predictor for disease recurrence.

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Pretreatment Tumor Volume Estimation Based on Total Serum PSA in Patients with Localized Prostate Cancer

Cited by 17 publications

References 16 publications

Gleason Score 7 Adenocarcinoma of the Prostate With Lymph Node Metastases: Analysis of 184 Radical Prostatectomy Specimens

Gleason Score 7 Adenocarcinoma of the Prostate With Lymph Node Metastases: Analysis of 184 Radical Prostatectomy Specimens

Hallmarks in prostate cancer imaging with Ga68-PSMA-11-PET/CT with reference to detection limits and quantitative properties

8 Socioeconomic Status Is an Independent Predictor of Biochemical Recurrence Among Patients With Prostate Cancer Who Undergo Radical Prostatectomy

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