THE "NEW" PROSTATE CANCER INFOLINK

Our third report today covers such topics as:

• A positive biopsy risk nomogram for men in New Zealand
• A review of current trends and priorities in surgical technique for radical prostatectomy
• A review of the potential of functional MRI-based systems for the diagnosis of prostate cancer
• Demonstration of a relationship between circulating tumor cells and circulating tumor-associated DNA in blood
• Evaluation of a new, biologically based IMRT treatment planning system

Lienert et al. have developed a nomogram based on patient age, DRE results, and PSA levels to project the probability of a positive transrectal ultrasound-guided prostate biopsy specifically for the population of New Zealand. The basis for development of the nomogram was data extracted from electronic records of prostate biopsies performed between 1995 and 2007 in Christchurch, New Zealand. The authors report that age-adjusted reference ranges did not improve prediction of cancer in this population, but the use of PSA density may enhance prostate cancer diagnosis.

Eastham et al., have examined and reviewed recent trends in radical prostatectomy, with a specific focus on surgical technique. The authors emphasize the increasing imperative to be able to remove sufficient periprostatic tissue to cure the cancer while preserving the nerves required for erectile function and the nerves and muscles required for normal urinary and bowel function.

Seitz et al. have reviewed available data on the combination of magnetic resonance imaging (MRI) with magnetic resonance spectroscopy imaging (MRSI), dynamic contrast-enhanced MRI (DCE-MRI), and diffusion-weighted MRI (DW-MRI) as promising tests for the diagnosis of prostate cancer. They state that, “A limited number of small studies suggest that functional MRI may improve the diagnosis and staging of prostate cancer. This finding needs further confirmation in larger studies, and cost-effectiveness needs to be established.”

Circulating cell-free DNA in the blood of cancer patients harbors tumor-specific aberrations. Schwarzenbach et al. have investigated whether this DNA reflected the presence of circulating tumor cells (CTC) in 81 prostate cancer patients. Based on their results, they report, for the first time, a relationship between the occurrence of CTCs and circulating tumor-associated DNA in blood. It is possible that such information could lead to new methods for monitoring metastatic progression in prosatte cancer patients.

Semenenko et al. have reported on their evaluation of a new, commercially available, biologically based IMRT treatment planning system. They report that this system does “demonstrate improved dose distributions for the majority of normal structures.”

Filed under: Diagnosis, Management, Risk, Treatment | Tagged: biopsy, blood, circulating tumor cells, CTCs, Diagnosis, DNA, functional, IMRT, MRI, New Zealand, nomogram, radical prostatectomy, risk, technique, treatment planning |