A new prognostic test can help determine whether a prostate cancer patient will go on to have a recurrence of the disease, even if surrounding lymph nodes initially appear negative for cancer, according to a study by University of Southern California researchers.
The test, developed at USC, "appears to be a very powerful test and better than anything else we know of for predicting recurrence," says Richard Cote, professor of pathology and urology at the Keck School of Medicine of USC. Current trials are also using the test to find hidden metastases in lymph nodes and bone marrow for breast and lung cancers.
The study, "Detection of Occult Lymph Node Metastases in Patients with Local Advanced (pT3) Node-Negative Prostate Cancer" appears this week in the Journal of Clinical Oncology.
Prostate cancer is the most common non-skin cancer in America, according to the Prostate Cancer Foundation. One in six American men will be diagnosed with prostate cancer, making men 35 percent more likely to be diagnosed with prostate cancer than women are to be diagnosed with breast cancer.
"Thanks to greater awareness, as well as increased and improved screening, we see men increasingly diagnosed with prostate cancer in its early stages," Cote says. "Most of these patients will do very well and will not require treatment beyond surgery or radiation therapy to cure their disease."
But a proportion of these patients have metastases of the prostate cancer appear later, even when the lymph nodes removed at the time of the cancer surgery appeared negative for cancer, he says.
Cote and his colleagues looked at 3,914 lymph nodes from 180 patients who were staged as having lymph nodes negative for cancer based on standardized histologic evaluation (visual scan under a microscope). The lymph nodes were then evaluated for occult (hidden) metastases using new specific immunohistochemistry tests that can detect cancer on a cell-by-cell level.
Their new analysis checks for cells that react with antibodies to cytokeratins and PSA. The team's testing found occult tumor cells in the lymph nodes of 24 of the patients whose lymph nodes had been previously been diagnosed as cancer-free.
The test used to detect the occult tumor cells is more sensitive than any clinical, pathologic or radiographic techniques, Cote says.
The group then compared cancer recurrence and survival in those patients with the hidden tumor cells versus those without the cells. The presence of occult tumor cells was associated with increased prostate cancer recurrence and decreased survival. In fact, "the outcome for patients with occult tumor cells was similar to those who were identified as having positive lymph nodes at the time of the surgery," Cote says.
"We have shown that occult tumor spread in lymph nodes is a significant predictor of disease recurrence," he says. "Once surgery is performed, the primary form of treatment is adjuvant systemic therapy. In patients with no evidence of metastasis, success of such therapy is assumed to be due to killing of occult tumor before it becomes clinically evident. Therefore, the ability to detect occult metastasis is pivotal to identification of patients who would most benefit from systemic therapy and also identify patients who may be spared from unnecessary therapy."
Jon Weiner | EurekAlert!
Unique brain 'fingerprint' can predict drug effectiveness
11.07.2018 | McGill University
Direct conversion of non-neuronal cells into nerve cells
03.07.2018 | Universitätsmedizin der Johannes Gutenberg-Universität Mainz
For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.
To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...
For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.
Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...
Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.
A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...
Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.
"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....
Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.
Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...
13.07.2018 | Event News
12.07.2018 | Event News
03.07.2018 | Event News
17.07.2018 | Information Technology
17.07.2018 | Materials Sciences
17.07.2018 | Power and Electrical Engineering