EMUC15 - Resource Centre - Search Results

Resource Centre Back to Resource Centre

168 results (Loading...)

Video Filters×
  • organe

  • access

  • procedure

  • pathology

168 Abstracts

  • Introduction & Objectives

    Although several studies have reported prognostic factors in men treated with Abiraterone Acetate (AA) for Castration-Resistant Prostate Cancer (CRPC), there have not been established a prognostic model for Japanese patients. In this study, we analyzed prognostic factors in Japanese men treated with AA for CPRC.

    Material & Methods

    A total of 122 patients treated with AA for CRPC in 14 institutions were analyzed retrospectively. We examined the correlation between Overall Survival (OS) after AA and clinicopathological characteristics including initial PSA levels, Gleason scores, patients’ age, PSA levels at AA induction, previous treatment with docetaxel, and the time to CRPC from initial treatment.

    Results

    Median initial PSA level was 172.2 ng/mL and 82 patients (67.2 %) had Gleason score ≥8. Median age and PSA level at AA induction was 76.8 years and 26.8 ng/mL. Previous treatment with docetaxel was performed in 56 patients (45.9 %). Median time to CRPC was 12.5 months. At the median follow-up of 6.0 months, PSA reduction ≥50 % were observed in 34 patients (30.4 %), and median OS was 28.1 months. In multivariate analysis, two significant risk factors for OS were identified; PSA levels at AA induction (>26.8 ng/mL vs ≤26.8; HR 4.874, 95 % CI 1.649-14.404, p=0.004) and previous treatment with docetaxel (yes vs no; HR 3.586, 95 % CI 1.335-9.633, p=0.011).

    Conclusions

    PSA levels at AA induction and previous treatment with docetaxel could be the significant prognostic factors in Japanese men treated with AA for CRPC. These findings might support the clinical management of men with CRPC.

  • Introduction & Objectives

    Neutrophil to lymphocyte ratio (NLR) is a preoperative marker of systemic inflammation that has been related to worse oncological outcome and survival in a variety of malignancies. The aim of our study was to evaluate the association between preoperative NLR and various clinical and pathological characteristic of patients undergoing radical cystectomy (RC) due to bladder cancer and its utility as a prognostic preoperative biomarker.

    Material & Methods

    We performed a retrospective review of 164 CR performed at our center between September 2009 and January 2016. Then, we obtained the absolute values ​​of neutrophils and lymphocytes from the preoperative blood sample that helped us calculate the NLR for each patient. Patients were then divided into two groups according to the results of pathology analysis after the surgery (AP) cataloging them in good prognosis AP and poor prognosis AP (T3-4 or N>1). We checked if there were differences based in NLR regarding this division (U- Mann Whitney) and determined a cut off point for the NLR (ROC curve). Bivariate analysis was performed to study the association between NLR and other clinical- pathological features (BCG prior preoperative hemoglobin, hydronephrosis, etc.) with worse oncological results and cancer specific survival (Chi square and T- student). Finally, we carried out a comparative analysis of survival based in NLR groups (Kaplan Meier).

    Results

    We analyzed 164 patients (144 men and 20 women) with a mean age of 68'72 years (33- 85) and a postoperative follow up of 25'53 months (0- 84). The stablished cutoff value of NLR of 2’7 showed an area under the ROC curve of 61% (p=0'001). A NLR > 2.7 was associated with poor prognosis AP (p=0'001) and a trend towards increased cancer specific mortality (p=0'19- 0'98). Besides, the survival distributions according NLR showed statistically significant differences (p=0'024).

    Conclusions

    The value of preoperative NLR can be an economic and readily available prognostic marker, that along with other clinical variables, may help us stratify patients into risk groups and thus facilitate preoperative decisions such as the need of administrating neoadjuvant chemotherapy. However, prospective studies that include a greater number of patients are needed to increase the statistical power of our results.

  • Introduction & Objectives

    Nonagenarian population in the UK has doubled in the last 20 years. Old age is the greatest risk factor for developing bladder cancer. These patients usually face barriers with accessing and receiving healthcare; they are also known to get less aggressive treatment because of co-morbidities. We conducted a study of bladder cancer, recurrences and mortality rates in patients 90+ years.

    Material & Methods

    Patients with bladder cancers 90+ years between 2003 and 2015 in our hospital in North Wales were looked at retrospectively.

    Results

    Out of 652 patients with bladder cancer, 22 were nonagenarians at diagnosis, 21 Transitional Cell Carcinomas (TCC), and 1 neuroendocrine tumour (Females 59%; Mean Age 92.2 years, range 90-99). Tumour grades were G1 (N = 6, 27%), G2 (N = 5, 23%), and G3 (N = 11, 50%). Five out of seven patients with tumour recurrences died. Out of 15 patients without recurrences, 10 died (67%). There was no significant effect of recurrence on mortality (p = 0.82). The tumour staging of patients at presentation: pTA (N = 10, 46%), pT1 (N = 6, 27%) and pT2 (N = 6, 27%). Mortality across stages was pTA (N = 6, 60%), pT1 (N = 4, 67%) and pT2 (N = 5, 83%), this difference not being statistically significant (p = 0.62).
                

    Conclusions

    In our study, bladder tumours in nonagenarians are predominantly high grade (G3). Management should be dictated by associated co-morbidities and performance status not by age alone.

  • Introduction & Objectives

    In patients with prior negative prostate biopsies and a persisting suspicion on Prostate Cancer (PCa) clinical guidelines advise to perform MRI diagnostics, followed by Targeted Biopsy (TB) if tumour suspicious lesions are visible. Additionally Systematic Biopsies (SB) can be performed. In this interim analysis of the FUTURE trial the detection rates of (significant) PCa using TB are compared with the detection rates using SB.

    Material & Methods

    The FUTURE trial has been including patients with prior negative prostate biopsies and a suspicion on prostate cancer (PSA≥4 and/or abnormal DRE) since 2014. Patients are initially subjected to MRI diagnostics. Images are centrally evaluated by an expert radiologist (J.O.B.) using PIRADS v2. If imaging demonstrates tumour suspicious lesion (PIRADS≥3) patients are randomised 1:1:1 for one of three techniques of TB (MRI-TRUS fusion, cognitive TRUS, and in-bore MRI). In both the MRI-TRUS fusion and the cognitive TRUS groups, SB was performed in addition to TB. TB was performed initially, followed by SB using a standardised template irrespective of the location of MRI lesions. Overall PCa and significant PCa (Gleason≥7) detection rates were compared using McNemar test.

    Results

    Of the 362 patients subjected to MR imaging, 130 (35.9%) had PIRADS≥3 lesion on imaging. Of these patients 84 have undergone both TB and SB. See table 1 for baseline characteristics. Using TB PCa was detected in 52.4% (n=44) and significant PCa in 34.5% (n=29). Using SB PCa was detected in 33.3% (n=28) and significant PCa in 17.9% (n=15). See table 2 for a cross tabulation of biopsy outcomes. TB detected significantly more PCa (p=0.003) as well as significantly more significant PCa (p=0.001) than SB. In patients in whom SB did not detect PCa, TB detected PCa in 25% (n=21), and significant PCa in 14% (n=12). Alternatively in patients in whom TB did not detect PCa, SB detected PCa in 6% (n=5) and significant PCa in 1% (n=1)  
    Table 1

      All (n=84)
    Age (mean) 66.0
    PSA (mean) 10.8
    Volume TRUS (mean) 46.0 mL
    Clinical stage DRE
    ·                    cT0
    ·                    cT2a/b
    ·                    cT2c
    ·                    cT3a
     
    81.0%
    16.7%
    2.4%
    -
    Number of prior negative biopsies 1.6
    PIRADS v2
    ·                    1
    ·                    2
    ·                    3
    ·                    4
    ·                    5
     
    -
    -
    31.0%
    34.5%
    34.5%
    Number of TB cores (mean) 3.9
    Number of SB cores (mean) 10.0

     
    Table 2

    N=84   Systematic biopsy Total
        No cancer Gleason=6 Gleason≥7  
    Targeted biopsy No cancer 42% 5% 1% 40
    Gleason=6 11% 7% 0% 15
    Gleason≥7 14% 4% 17% 29
    Total   56 13 15 84

    Conclusions

    TB has significantly increased detection rates of all PCa, and significant PCa compared to SB in subjects with prior negative prostate biopsies and a persisting suspicion on PCa.

    Session: Oral presentations of the 6 best abstracts

    Location: Saturday, 26 November 2016, 11:15 - 11:55, Auditorium

  • Introduction & Objectives

    Circulating tumour cells serve as useful biomarkers with which to identify disease status associated with survival, metastasis and drug sensitivity. Here, we established a novel application for detecting PSA/PSMA-positive prostate cancer cells circulating in peripheral blood employing an adenovirus called Ad5/35E1aPSESE4.

    Material & Methods

    Ad5/35E1aPSESE4 utilized PSES, a chimeric enhancer derived from PSA/PSMA promoters that is highly active with and without androgen.

    Results

    A fluorescence signal mediated by GFP expression upon Ad5/35E1aPSESE4 infection was selectively amplified in PSA/PSMA-positive prostate cancer cells in vitro and ex vivo. Furthermore, for the in vivo model, blood drawn from TRAMP was tested for CTCs with Ad5/35E1aPSESE4 infection and was positive for CTCs at week 16. Validation was performed on patient blood at various clinical stages and found out 1-100 CTCs expressing GFP upon Ad5/35E1aPSESE4 infection. Interestingly, CTC from one patient was confirmed to be sensitive to docetaxel chemotherapeutic reagent and to abundantly express metastasis-related genes like MMP9, Cofilin1, and FCER1G through RNA-seq.

    Conclusions

    Our study established that the usage of Ad5/35E1aPSESE4 is effective in marking PSA/PSMA-positive prostate cancer cells in patient blood to improve the efficacy of utilizing CTCs as a biomarker.

×