Application of metastatic biopsy based on "When, Who, Why, Where, How (4W1H)" principle in diagnosis and treatment of metastatic castration-resistance prostate cancer.
Castration-resistant prostate cancer (CRPC)
bone
detection rate
metastasis biopsy
Journal
Translational andrology and urology
ISSN: 2223-4691
Titre abrégé: Transl Androl Urol
Pays: China
ID NLM: 101581119
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
entrez:
10
5
2021
pubmed:
11
5
2021
medline:
11
5
2021
Statut:
ppublish
Résumé
To determine the feasibility of secondary biopsy of metastatic castration-resistance prostate cancer based on the "4W1H-When, Who, Why, Where, How" principle and analyze the factors that affect tumor detection. Its application will further direct the patients for individualized precision therapy. A total of 55 patients were collected for secondary biopsy (27 prostate biopsies and 55 metastases biopsies). The parameters of biopsy location, computed tomography attenuation coefficient, lesion size, core number, laboratory tests, and the use of bone protection were evaluated. Histopathological data and the pathogenesis and etiology classification were used to guide precision treatment. Fifteen/27 patients had a positive prostate biopsy, and 47/55 had positive metastasis biopsy. Bone metastasis biopsy was positive in 21/29 of cases. Also, parenchymal organs and lymph node biopsies were positive. In the prostate rebiopsy, significant differences were observed between total prostate volume (P=0.028), prostate-specific antigen (PSA) density (P=0.047), PSA velocity (P=0.036), and positive biopsy results. In the bone metastasis biopsy, we divided the patients into biopsy-positive and -negative groups. The computed tomography attenuation coefficient, PSA, alkaline phosphatase, and hemoglobin were related to tumor positive detection. However, the lesion size, core number, bone-sparing agents and previous treatments did not affect tumor detection. In metastatic castration-resistant prostate cancer (mCRPC) patients, the "4W1H" principle was applied in the second biopsy. The biopsy site, image, and laboratory variables affected the positive of tumor tissue. Further pathological analysis of tumor tissue is essential to guide the precision medicine of mCRPC etiological classification.
Sections du résumé
BACKGROUND
BACKGROUND
To determine the feasibility of secondary biopsy of metastatic castration-resistance prostate cancer based on the "4W1H-When, Who, Why, Where, How" principle and analyze the factors that affect tumor detection. Its application will further direct the patients for individualized precision therapy.
METHODS
METHODS
A total of 55 patients were collected for secondary biopsy (27 prostate biopsies and 55 metastases biopsies). The parameters of biopsy location, computed tomography attenuation coefficient, lesion size, core number, laboratory tests, and the use of bone protection were evaluated. Histopathological data and the pathogenesis and etiology classification were used to guide precision treatment.
RESULTS
RESULTS
Fifteen/27 patients had a positive prostate biopsy, and 47/55 had positive metastasis biopsy. Bone metastasis biopsy was positive in 21/29 of cases. Also, parenchymal organs and lymph node biopsies were positive. In the prostate rebiopsy, significant differences were observed between total prostate volume (P=0.028), prostate-specific antigen (PSA) density (P=0.047), PSA velocity (P=0.036), and positive biopsy results. In the bone metastasis biopsy, we divided the patients into biopsy-positive and -negative groups. The computed tomography attenuation coefficient, PSA, alkaline phosphatase, and hemoglobin were related to tumor positive detection. However, the lesion size, core number, bone-sparing agents and previous treatments did not affect tumor detection.
CONCLUSIONS
CONCLUSIONS
In metastatic castration-resistant prostate cancer (mCRPC) patients, the "4W1H" principle was applied in the second biopsy. The biopsy site, image, and laboratory variables affected the positive of tumor tissue. Further pathological analysis of tumor tissue is essential to guide the precision medicine of mCRPC etiological classification.
Identifiants
pubmed: 33968660
doi: 10.21037/tau-21-23
pii: tau-10-04-1723
pmc: PMC8100831
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1723-1733Informations de copyright
2021 Translational Andrology and Urology. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tau-21-23). The authors have no conflicts of interest to declare.
Références
Histol Histopathol. 2007 Jan;22(1):107-18
pubmed: 17128417
Gan To Kagaku Ryoho. 2009 Dec;36(13):2495-501
pubmed: 20009446
Nat Rev Cancer. 2005 Jan;5(1):21-8
pubmed: 15630412
Prostate. 2013 Dec;73(16):1824-35
pubmed: 24037738
Radiology. 2008 Sep;248(3):962-70
pubmed: 18710986
Oncotarget. 2015 Jan 20;6(2):1202-16
pubmed: 25483103
Prostate Cancer Prostatic Dis. 2014 Dec;17(4):325-31
pubmed: 25091040
Prostate Cancer Prostatic Dis. 2002;5(2):144-51
pubmed: 12497005
Cancer. 1997 Oct 15;80(8 Suppl):1674-9
pubmed: 9362435
J Clin Oncol. 2008 Mar 1;26(7):1148-59
pubmed: 18309951
Cancer Cell. 2016 Apr 11;29(4):536-547
pubmed: 27050099
J Urol. 1998 May;159(5):1606-8
pubmed: 9554363
Cell. 2015 Jul 16;162(2):454
pubmed: 28843286
N Engl J Med. 2004 Apr 15;350(16):1655-64
pubmed: 15084698
Eur Urol. 2017 Apr;71(4):630-642
pubmed: 27591931
Cancer. 1995 Apr 1;75(7):1634-41
pubmed: 8826921
AJNR Am J Neuroradiol. 2004 Oct;25(9):1583-8
pubmed: 15502142
Radiology. 2013 Dec;269(3):816-23
pubmed: 23925271
CA Cancer J Clin. 2020 Jan;70(1):7-30
pubmed: 31912902
Urology. 1997 Mar;49(3A Suppl):16-22
pubmed: 9123731
Nature. 2015 Apr 16;520(7547):353-357
pubmed: 25830880
J Urol. 2011 Feb;185(2):471-6
pubmed: 21167525
Korean J Urol. 2010 Nov;51(11):752-6
pubmed: 21165194
Clin Cancer Res. 2005 Nov 15;11(22):8109-13
pubmed: 16299243
Br J Cancer. 1987 Jan;55(1):61-6
pubmed: 3814476
Eur Urol. 2011 Jan;59(1):61-71
pubmed: 21056534