EMUC15 - Resource Centre - Search Results
394 results (Loading...)
P037: The value of seminal vesicle invasion (pT3b) in prognosis of patients with localized prostate cancer Parra Serván P., Ledo Cepero M.J., Ojeda Claro M.V., Rosety Rodriguez J., Cañete Bermúdez J., Amores Bermúdez J., Pérez-Lanzac A., Soto Villalba J., Álvarez-Ossorio J.L.
Introduction & Objectives
The incidence of seminal vesicle involvement has decreased due to the early detection of prostate cancer, it is about 11% in national recent series and 26% in historical series. The seminal vesicle invasion is a risk factor for biochemical recurrence. The impact on the prognosis depends on this and other variables associated with poor prognosis.
To evaluate the predictive value of the seminal vesicle invasion, the relationship with other clinical and pathological variables, long-term outcomes and the survival rates.
Material & Methods
We analyzed 300 cases of radical laparoscopic prostatectomy performed between 2009 and 2015 in our department and the finding of seminal vesicle involvement in the specimens. We realized a descriptive analysis and a bi/multivariate cox regression analysis to define the predictive variables as biochemical recurrence. Biochemical recurrence-free rate was calculated by the Kaplan-Meier method.
The incidence of pT3b was 7 % (20 patients): 70% cT1c, 10 % with first-degree affected relative, 35% with positive digital rectal examination, 30% with positive surgical margins, 80% with perineural invasion and 35% with pelvic lymphadenectomy performed. The median PSA value was 10,3 ng/ml.
These patients presented worse rates of biochemical and disease progression. The predictive variables were have a biopsy Gleason score ≥ 7, a clinical T1c stage, a greater cancer volume and a positive digital rectal examination, but not the PSA levels. Multivariate analysis showed that the specimen´s Gleason score of 8 was the main predictive variable.
The seminal vesicle invasion increases the risk of biochemical recurrence by three. The progression-free survival was 24 months (95% CI 15 to 33). The estimated biochemical recurrence-free rates of pathological T3b were at 12 months, 24 months and 5-year: 70%, 40% and 28% respectively. The risk of biochemical recurrence was 65 %. The association with other poor prognosis variables predicted a worse survival.
The patients with pT3b were not treated up to the biochemical recurrence. Adjuvant radiotherapy delayed the progression without modifying the survival. The complete seminal vesicles removal provides suitable functional continence results.
Seminal vesicle invasion is a poor prognostic factor and is associated with worse biochemical recurrence-free rate. To determine the seminal vesicle involvement is fundamental to optimize the treatment for offering the best prognosis and functional results.
P103: Targeting unfolded protein response sensitizes urothelial carcinoma cells to cisplatin chemotherapy Han K.S., Heo J.H., Lee S.E., Lee S.E., Hong S.K., Lee S.C., Kim J.J., Oh J.J., Byun S-S.
Introduction & Objectives
Chemotherapy deprives tumors of essential resources for cancer cell survival. These environmental stressors generally induce the accumulation of unfolded proteins in the Endoplasmic Reticulum (ER) of cancer cell. There, they elicit the Unfolded Protein Response (UPR), which is a general cellular defense mechanism that dampens non-essential global protein synthesis to protect cells from stress. We investigated a potential role of GRP78 as a combined therapeutic target in urothelial carcinoma treated with chemotherapy.
Material & Methods
Urothelial cancer cell lines (UC-3, T24, 253J and KU1919) were used to investigate the effect of GRP78 knockdown, which was performed by small interfering RNA. Stably GRP78 knocked-down UC-3 cells were developed to investigate the role of GRP78 in cancer cell. After transient transfection, crystal violet assay and cell cycle analysis using FACS were performed to check the effect of GRP78 on tumor growth and cell cycle. In vivo system expressing GRP78 by doxycycline were developed using UC-3 xenografts and treated with ciaplatin to evaluate in vivo combination effects of GRP78 inhibition during cisplatin.
GRP78 was highly expressed in UC-3 cells and moderately expressed in T24, 253J and KU1919 cells. Immunohistochemical staining showed increased expression of GRP78 in human bladder cancer tissues compared with normal bladder tissues. Transient knockdown of GRP78 using si-GRP78 inhibited tumor proliferation in UC-3 cells. GRP78 knockdown also increased sub G0 population of UC-3 cells in cell cycle analysis and also induced more apoptosis after cisplatin treatment compared to control. Western blot analysis showed increased expression of GRP78 protein during exposure to cisplatin in bladder cancer cells. Sequential cisplatin treatment after knockdown of GRP78 showed an additive effect but sequential GRP78 knockdown after cisplatin chemotherapy showed a synergistic effect in UC-3 xenografts.
UPR is induced in bladder cancer cells treated with cisplatin chemotherapy. GRP78 has a critical role in protecting urothelial carcinoma cells from apoptotic stress induced by chemotherapy. Targeting GRP78 sensitized urothelial carcinoma cells to cisplatin. These data suggest that GRP78 is a novel therapeutic target as a combination therapy with cisplatin in the management of urothelial carcinoma.
O6: Influence of cribriform/intraductal growth and percentage Gleason grade 4 on clinical outcome of men with biopsy Gleason score 3+4=7 prostate cancer Kweldam C.1, Kummerlin I.1, Nieboer D.2, Verhoef E.1, Steyerberg E.2, Incrocci L.3, Bangma C.4, Van Der Kwast T.5, Roobol M.4, Van Leenders G.1
Introduction & Objectives
Histopathology and clinical outcome of Gleason score 7 prostate cancer is variable. Relative increase of Gleason grade 4 (%GG4) pattern, and presence of invasive Cribriform and/or Intraductal Carcinoma (CR/IDC) have individually been associated with adverse outcome of Gleason score 3+4=7 tumours. The objective of this study was to investigate the relation of %GG4 and CR/IDC growth in Gleason score 3+4=7 prostate cancer biopsies.
Material & Methods
We reviewed 1031 diagnostic prostate cancer biopsies from the first round of the European Randomized Study of Screening for Prostate Cancer (1993-2000). A total of 370 men had revised overall Gleason score 3+4=7 (WHO/ISUP group 2). The relation of CR/IDC status and %GG4 with biochemical recurrence-free survival (BCRFS) after radical prostatectomy (n=146; 39%) and radiation therapy (n=195; 53%) was analysed using Cox regression.
Patients with increasing %GG4 and presence of CR/IDC both had significantly higher Prostate Specific Antigen (PSA) levels and biopsy tumour percentage. In men with CR/IDC the mean %GG4 was 28% (IQR 24-33%) and in men without CR/IDC 16% (IQR 12-24%) (P<0.001). CR/IDC occurred in 7/121 (6%) patients with 1-10% GG4 pattern, 29/131 (22%) with 10-25%, and 52/118 (44%) in men 25-50% GG4 (P<0.001). Presence of CR/IDC and 25-50% GG4 were individually associated with BCRFS after radical prostatectomy and radiation therapy. In bi-variate Cox regression analysis, CR/IDC was an independent predictor for BCRFS (HR 2.4; 95% CI 1.1-5.3; P=0.03) after radical prostatectomy, while percentage %GG4 (HR 1.1; 95% CI 0.9-1.4; P=0.5) was not. Likewise, CR/IDC was an independent predictor for BCRFS (HR 2.4; 95% CI 1.5-4.0; P<0.001) after radiation therapy and %GG4 (HR 1.0; 95% CI 1.0-1.03; P=0.14) not.
Increasing %GG4 was associated with occurrence of CR/IDC in prostate cancer biopsies. While CR/IDC was an independent parameter for BCRFS after both radical prostatectomy and radiation therapy, %GG4 was not. Biopsy CR/IDC status is a promising pathologic parameter for therapeutic stratification of Gleason score 3+4=7 prostate cancer patients.
Session: Oral presentations of the 6 best abstracts
Location: Saturday, 26 November 2016, 11:15 - 11:55, Auditorium
Session: Replay session: Pre-recorded videos of how I do it
Location: Thursday 24 November 2016, 11:00 - 12:10, Amber 1
PSMA-PET/mpMR for detection of primary prostate cancer and implementation for fusion biopsyS. Fanti, Bologna (IT)
Selection for prostate biopsy: Imaging vs. clinical criteria and biomarkersH. Gronberg, Stockholm (SE)
Session: Changing paradigms in prostate cancer diagnosis
Location: Thursday 24 November 2016, 08:35 - 10:30, Amber 1
Session: ESU course on Challenging the last changes in the management of advanced and metastatic prostate cancer: Multidisciplinary approach
Location: Thursday 24 November 2016, 09:00 - 12:00, Amber 7