New criteria enhances prostate surgery outcomes

October 10, 2013 by Sophie Hepburn
New criteria enhances prostate surgery outcomes
Each year in Australia, close to 3,300 men die of prostate cancer and around 20,000 new cases are diagnosed (PCRA). Credit: iStock

A new method to pre-operatively identify transition zone prostate cancer has enabled surgeons to adopt a more targeted surgical approach to treatment.

The set of criteria for examining biopsy specimens was developed by researchers funded and supported by the West Australian Urological Research Organisation.

The prostate gland, although considered a single organ, is composed of different anatomical zones (peripheral, transition, and central), and tumours arising in these regions differ in biological behaviour.

The transition zone (Tz) is situated furthest away from the rectum through which biopsies are obtained, and identification of Tz cancer on biopsy almost always indicates a large cancer that tends to spread toward the bladder neck.

Co-author Stephen Lee from Uropath Pty Ltd, Western Australia, says that "prior to this study there was no way of distinguishing Tz cancer from tumours occurring in the other prostatic zones on pre-operative biopsy, and therefore no way to safely modify the surgical approach".

"About one-quarter of cancers originate in the Tz and these tumours are far less likely to involve the nerves important for erectile function," Dr Lee says.

"Further, these tumours invade the bladder neck and wider resection of this structure is needed to ensure cure."

The new biopsy test criterion identifies the Tz , pre-operatively, allowing surgeons to change their surgical approach to best retain full erectile function and recovery.

The method used for Tz tumour identification, uses a specific tissue fixative (Solufix) developed in WA over a decade ago.

The fixative preserves structures called prostate secretory granules (PSGs), which are retained in Tz tumours but not in cancers from the peripheral or central zone.

They evaluated four morphologic features to predict origins of tumours; the percentage of tumour cells retaining PSG, and the percentage of cells with pale cytoplasm, columnar shape, and luminal secretions.

The amount of PSG found in tumours was the most sensitive marker for Tz tumour origin in 44 surgically removed tumours and in 135 biopsy specimens preserved in Solufix.

When a PSG content of >50 per cent was combined with one of the other parameters the ability to correctly identify tumours that were not of Tz origin increased.

The results showed that testing for a combination of PSG content of >50 per cent (major criteria) with one of either; >30 per cent columnar cells, >30 per cent pale cells, or secretions (minor criteria) in biopsy specimens is a reliable predictor of Tz origin.

The group now successfully apply this set of criteria in routine practice.

Explore further: Discovery opens doors to new ovarian cancer treatments

Related Stories

Discovery opens doors to new ovarian cancer treatments

September 26, 2013
(Medical Xpress)—Scientists have identified a process associated with inflammation in cancer that they believe could lead to expanded treatment options for some types of ovarian tumours.

Scientists make brain tumours glow

April 24, 2013
Stereotactic needle biopsies are an established standard procedure in the diagnostic identification of brain lymphomas and certain brain tumours (gliomas). Up until now the tissue samples removed had to be examined for tumour ...

Halo of prostate cancer cells holds key to diagnosing disease

February 13, 2013
Men thought to have prostate cancer could receive a more accurate diagnosis thanks to a simple genetic test, research has shown.

Mutated stem cells trigger pituitary tumours in children

October 7, 2013
(Medical Xpress)—A type of pituitary tumour known as craniopharyngioma appears to form via a different mechanism to that thought to occur in more common tumours, according to a paper in the journal Cell Stem Cell.

Forcing cancer to digest itself

September 12, 2013
When tumour cells no longer degrade themselves, cancer may develop. Using black skin cancer as an example, Bern Researchers have now shown that a protein plays an important role in the process of degradation of tumour cells. ...

Children's brain tumors more diverse than previously believed

May 14, 2012
Paediatric brain tumours preserve specific characteristics of the normal cells from which they originate – a previously unknown circumstance with ramifications for how tumour cells respond to treatment. This has been ...

Recommended for you

Vitamin C may encourage blood cancer stem cells to die

August 17, 2017
Vitamin C may "tell" faulty stem cells in the bone marrow to mature and die normally, instead of multiplying to cause blood cancers. This is the finding of a study led by researchers from Perlmutter Cancer Center at NYU Langone ...

Outdoor light at night linked with increased breast cancer risk in women

August 17, 2017
Women who live in areas with higher levels of outdoor light at night may be at higher risk for breast cancer than those living in areas with lower levels, according to a large long-term study from Harvard T.H. Chan School ...

Scientists develop novel immunotherapy technology for prostate cancer

August 17, 2017
A study led by scientists at The Wistar Institute describes a novel immunotherapeutic strategy for the treatment of cancer based on the use of synthetic DNA to directly encode protective antibodies against a cancer specific ...

Toxic formaldehyde is produced inside our own cells, scientists discover

August 16, 2017
New research has revealed that some of the toxin formaldehyde in our bodies does not come from our environment - it is a by-product of an essential reaction inside our own cells. This could provide new targets for developing ...

Cell cycle-blocking drugs can shrink tumors by enlisting immune system in attack on cancer

August 16, 2017
In the brief time that drugs known as CDK4/6 inhibitors have been approved for the treatment of metastatic breast cancer, doctors have made a startling observation: in certain patients, the drugs—designed to halt cancer ...

Researchers find 'switch' that turns on immune cells' tumor-killing ability

August 16, 2017
Molecular biologists led by Leonid Pobezinsky and his wife and research collaborator Elena Pobezinskaya at the University of Massachusetts Amherst have published results that for the first time show how a microRNA molecule ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.