Adjuvant Radiotherapy for Patients with Locally Advanced Prostate Cancer—A New Standard?
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Adjuvant radiotherapy
We analyzed the levels of selected micro-RNAs in normal prostate tissue to assess their potential to indicate tumor foci elsewhere in the prostate. Histologically normal prostate tissue samples from 31 prostate cancer patients and two cancer negative control groups with either unsuspicious or elevated prostate specific antigen (PSA) levels (14 and 17 individuals, respectively) were analyzed. Based on the expression analysis of 157 microRNAs in a pool of prostate tissue samples and information from data bases/literature, we selected eight microRNAs for quantification by real-time polymerase chain reactions (RT-PCRs). Selected miRNAs were analyzed in histologically tumor-free biopsy samples from patients and healthy controls. We identified seven microRNAs (miR-124a, miR-146a & b, miR-185, miR-16 and let-7a & b), which displayed significant differential expression in normal prostate tissue from men with prostate cancer compared to both cancer negative control groups. Four microRNAs (miR-185, miR-16 and let-7a and let-7b) remained to significantly discriminate normal tissues from prostate cancer patients from those of the cancer negative control group with elevated PSA levels. The transcript levels of these microRNAs were highly indicative for the presence of cancer in the prostates, independently of the PSA level. Our results suggest a microRNA-pattern in histologically normal prostate tissue, indicating prostate cancer elsewhere in the organ.
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Radical prostatectomy is an important treatment option for localised prostate cancer. As many as 30% of these patients do develop biochemical relapse over time. Some of them have high-risk features which are predictors of treatment failure. Giving immediate postoperative radiotherapy (adjuvant radiotherapy) may be an overtreatment for at least 40% of these patients who may not experience failure despite these high-risk features. They will be subjected to unnecessary toxicities of postoperative radiotherapy. Salvage radiotherapy is an approach where we select out the patients who are failing. There is some indication that lymph node-positive patients benefit by adjuvant radiotherapy and long-term hormonal therapy.
Adjuvant radiotherapy
Hormonal Therapy
Salvage therapy
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Adjuvant radiotherapy
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To evaluate the spatial distribution of prostate cancer detected at a single positive biopsy (PBx) and a repeat PBx (rPBx).We evaluated 533 consecutive men diagnosed with prostate cancer who underwent radical prostatectomy using a clinical map document based on XML (cMDX©)-based map model of the prostate. We determined the number of cancer foci, relative tumour volume, Gleason score, zone of origin, localisation, and pathological stage after stratification according to the number of PBx sessions (PBx vs rPBx). The distribution of 3966 prostate cancer foci was analysed and visualised on heat maps. The colour gradient of the heat map was reduced to six colours representing the frequency classification of prostate cancer using an image posterisation effect. Additionally, the spatial distribution of organ-confined prostate cancer between PBx and rPBx was evaluated.Prostate cancer diagnosed on PBx was mostly localised to the apical portion and the peripheral zone of the prostate. Prostate cancer diagnosed on rPBx was more frequently found in the anterior portion and the base of the prostate. Organ-confined prostate cancer foci were mostly localised in the dorsolateral zone of the prostate in men at PBx, whereas men at rPBx had more prostate cancer foci in the anterior portion.The spatial distribution of prostate cancer with rPBx differs significantly from the spatial distribution of prostate cancer with PBx. The whole anterior portion of the prostate should be considered by rPBx.
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Objective To investigate the expressions of mitosis regulative factor STK-15 in prostate cancer and the relationship between STK-15 and the biological behavior of prostate cancer.Methods The expressions of STK-15 were examined by using immunohistochemical staining on 63 cases of prostate cancer and 16 cases of normal prostate tissues.And the expressions of STK-15 mRNA were detected by using RT-PCR in 14 cases of prostate cancer,BPH,and normal prostate tissues respectively.Results The STK15 protein was expressed in 98%(62/63) of prostate cancer tissue and in 19%(3/16) of normal prostate tissues.The difference between these expression rates was significant(P0.001).Meanwhile,the positive expression rates of STK-15 mRNA in prostate cancer,BPH,and normal prostate tissue were 93%(13/14),21%(3/14) and 14%(2/14) respectively.Compared with those in BPH and normal prostate tissue,the STK-15 mRNA expression rate in prostate cancer was significantly high(P0.001).Meanwhile,there was no significant difference between those in BPH and normal prostate tissue(P0.05).Conclusion The expressions of STK-15 increase in prostate cancer tissues which may contribute to the prostate carcinogenesis.
Prostate Diseases
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Biochemical disease-free survival following radical prostatectomy can be improved with the use of adjuvant and salvage radiotherapy. However, there is a lack of consensus over the ideal timing to start adjuvant and salvage radiotherapy after surgery. The literature in relation to adjuvant and salvage radiotherapy following radical prostatectomy was reviewed, focusing specifically on the prognostic factors that influence the need for postoperative radiotherapy, outcomes following adjuvant and salvage radiotherapy and potential side effects. Post-surgery prognostic factors can be useful in identifying patients early on who may benefit from adjuvant radiotherapy. While there is literature examining the role of radiotherapy following radical prostatectomy, few dedicated trials investigate this area thoroughly.
Salvage therapy
Adjuvant radiotherapy
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This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To evaluate the effect of adjuvant radiotherapy following radical prostatectomy for prostate cancer compared with radical prostatectomy.
Adjuvant radiotherapy
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Adjuvant radiotherapy
Salvage therapy
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