The presence of primary circulating prostate cells is associated with upgrading and upstaging in patients eligible for active surveillance

Murray, Nigel P; Reyes, Eduardo; Fuentealba, Cynthia; Aedo, Sócrates

doi:10.3332/ecancer.2017.711

Cited by 8 publications

(8 citation statements)

References 32 publications

(33 reference statements)

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“…They also indicated that NLR was cheaper than the other tests and the applicability rate was higher . Murray et al investigated the circulating prostate cells (CPC) to predict upgrading and upstaging in prostate cancer. CPC positive patients had higher PSA, bioptic Gleason score pathology, and higher GU (%44.4) rates.…”

Section: Discussionmentioning

confidence: 99%

“…CPC positive patients had higher PSA, bioptic Gleason score pathology, and higher GU (%44.4) rates. The authors noted that the CPC test may be useful in patients who are considered AS because the rate of upgrading and upstaging may be higher in CPC‐positive patients . Prospective randomized controlled trials may be designed on how these tests can be adapted to the follow‐up protocols of AS patients.…”

Section: Discussionmentioning

confidence: 99%

“…They also indicated that NLR was cheaper than the other tests and the applicability rate was higher. 27 Murray et al 28 upstaging may be higher in CPC-positive patients. 28 Prospective randomized controlled trials may be designed on how these tests can be adapted to the follow-up protocols of AS patients.…”

Section: Reported a 44%mentioning

confidence: 99%

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The pathological upgrading after radical prostatectomy in low‐risk prostate cancer patients who are eligible for active surveillance: How safe is it to depend on bioptic pathology?

et al. 2019

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Background Active surveillance (AS) is one of the treatment alternatives in low‐risk prostate cancer (PCa). The pathological upgrading after radical prostatectomy (RP) were investigated in patients who were eligible for AS in the present study. Methods Between August 2006 and July 2017, 627 patients underwent RP in our institution. One hundred and thirty‐six patients who were eligible for AS at the time of RP were included in this study. The previously defined AS criteria Gleason 3 + 3=6 adenocarcinoma at maximum two biopsy cores, prostate‐specific antigen (PSA) < 10 ng/mL and clinical T stage ≤ 2a were used in the study. The demographics, clinical, and histopathological outcomes were retrospectively compared between two groups, which were divided in accordance with the upgrading status at final pathology as Group 1 (n = 67, upgrading) and Group 2 (n = 69, nonupgrading). Results Gleason upgrading (GU) was found in 67 (49.3%) patients, and 17 patients (12.5%) were upstaged to pT3a. The upgrading to Gleason 3 + 4 was reported in 38.7% of patients, however, 7.4%, and 3.7% of the patients were upgraded to Gleason 4 + 3, and Gleason 4 + 4, respectively. The 10.3% of the patients had extraprostatic involvement, and the rate (19.4% vs 1.4%, P = .002) was significantly higher in Group 1. PSA density (P = .001), tumor size (P < .001), tumor percentage (P < .001), apical involvement (P = .013), and perineural invasion (P < .001) in RP specimen were higher in Group 1. Multivariate analysis showed that perineural invasion (OR = 4.26; 95%CI: 1.76‐10.33; P = .001) and pathologic T stage (OR = 5.45; 95%CI: 1.08‐27.4; P = .04) were independently associated with GU. Conclusions Since 12.5% of the patients upstaged to pT3a disease, and there is a possible risk of Gleason 4 pattern, upgrading of the tumor should carefully be kept in mind before offering AS to low‐risk patients with PCa.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The pathological upgrading after radical prostatectomy in low‐risk prostate cancer patients who are eligible for active surveillance: How safe is it to depend on bioptic pathology?

et al. 2019

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“…[29] Additionally, it was reported that the number of cancer-propagating cells found in prostate cancer (CPCs) correlated with GSU. [30] In order to provide patients with a safe and effective treatment plan, it would be ideal to acquire all final histopathological information. However, since the common choices in the current management of prostate cancer include options such as active surveillance and RT, current data will not be enough to overcome the problem of GSU.…”

Section: Discussionmentioning

confidence: 99%

The factors predicting upgrading of prostate cancer by using International Society for Urological Pathology (ISUP) 2014 Gleason grading system

Turan

Güçlüer

Efiloğlu

et al. 2019

Turkish Journal of Urology

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Objective: To investigate the factors to predict Gleason score upgrading (GSU) of patients with prostate cancer who were evaluated by using the International Society for Urological Pathology (ISUP) 2014 Gleason grading system. Material and methods: Between January 2008 and December 2015, we retrospectively investigated patients who had undergone radical prostatectomy and followed up in the uro-oncology outpatient clinic. The pathologic specimens of the patients were evaluated based on the ISUP 2014 classification system. The patients were divided into two groups with or without upgraded Gleason scores. Factors that could be effective in predicting upgrading such as age, prostate-specific antigen (PSA), prostate volume, D'Amico risk classification, PSA density, cancer of the prostate risk assessment (CAPRA) scores, biopsy tumor percentage, body mass index, and clinical stage parameters were compared between both groups. Results: Of the 265 patients who could be evaluated and followed up regularly, Gleason score upgrades were observed in 110 (41.5%) patients. Advanced age (p= 0.009), PSA >20 ng/mL (p= 0.036), PSA density >0.35 (p=0.005), high CAPRA score (p=0.031), and high biopsy tumor percentage (p=0.009) were discovered to be correlated with Gleason score upgrade in univariate logistic regression analysis. Advanced age alone was a predictor for GSU in multivariate logistic regression analysis (p= 0.002). Five-year biochemical recurrence-free survival rate was 86% in the non-GSU group and 55% in the GSU group (p<0.001). Conclusion: GSU risk should be taken into consideration in making therapeutic decisions for older patients with prostate cancer, and precautions should be taken against development of aggressive disease.

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“…Whilst the concordance between the Gleason report on biopsy and the surgical specimen is greater [ 28 ] in terms of prognosis, there were no differences between the old Gleason 6 score and the new Gleason 3 + 4 score. In addition, comparisons between the historical and new results could be invalid [ 29 – 31 ]. For this reason, our study has kept the old Gleason grading system.…”

Section: Discussionmentioning

confidence: 99%

The presence of secondary circulating prostate tumour cells determines the risk of biochemical relapse for patients with low- and intermediate-risk prostate cancer who are treated only with external radiotherapy

Murray

Aedo

Fuentealba

et al. 2018

ecancer

Self Cite

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IntroductionThe classification of patients with prostate cancer is used to determine treatments based on risk factors. The presence of secondary circulating prostate tumour cells (CPCs) detected in peripheral blood after a curative treatment has been associated with a worse prognosis. We present a prospective study of CPC detection post radiotherapy and the oncological results.Patients and methodsAll of the patients classified as low and intermediate risk that were treated with radiotherapy were included. Three months after finishing treatment, an 8-ml blood sample was taken to detect CPCs. Mononuclear cells were obtained using gel centrifugation, and CPCs were identified using immunocytochemistry with anti-prostate-specific antigen. Patients were classified as low-risk CPC positive or negative and intermediate-risk CPC positive or negative. The biochemical relapse-free survival analysis was determined based on a follow-up of up to 15 years using the Kaplan–Meier and Cox regression models. Biochemical failure was defined according to the Pheonix II criteria.ResultsOf 241 patients, 181 (75.1%) were classified as low risk and 60 (24.9%) as intermediate risk. Biochemical failure was observed in 27.1% (49/181) of the low-risk prostate cancer participants and in 53.3% (32/60) of intermediate-risk participants after 15 years of follow-up. 20.4% (37/181) of the low-risk cancer participants had detectable CPCs in comparison with 43.3% (26/60) of the intermediate-risk cancer participants (p < 0.001 overall risk 2.98, confidence interval (CI) 95% 1.59–5.56; relative risk 2.12, CI 95% 1.41–3.19). Positive CPC patients had a worse prognosis, and a shorter time period until biochemical relapse, regardless of risk group. The biochemical relapse-free survival curves show that intermediate-risk participants who were CPC negative had a higher survival rate and slower disease progression than those participants who were low risk but CPC positive.ConclusionsCPC detection is a risk factor for biochemical relapse and could be useful in identifying patients that will need additional treatment.

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The presence of primary circulating prostate cells is associated with upgrading and upstaging in patients eligible for active surveillance

Cited by 8 publications

References 32 publications

The pathological upgrading after radical prostatectomy in low‐risk prostate cancer patients who are eligible for active surveillance: How safe is it to depend on bioptic pathology?

The pathological upgrading after radical prostatectomy in low‐risk prostate cancer patients who are eligible for active surveillance: How safe is it to depend on bioptic pathology?

The factors predicting upgrading of prostate cancer by using International Society for Urological Pathology (ISUP) 2014 Gleason grading system

The presence of secondary circulating prostate tumour cells determines the risk of biochemical relapse for patients with low- and intermediate-risk prostate cancer who are treated only with external radiotherapy

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