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What Will Happen If I Do Nothing? Natural Development of Prostate Cancer Under Consideration of Histopathological Patterns

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Focal Therapy of Prostate Cancer

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Abstract

The prolonged life expectancy and the advent of PSA testing in the western world have markedly increased the number of recognized prostate cancer cases and prostate cancer now represents the most common malignant tumor in men. It is characterized by highly variable clinical courses with a high proportion of relatively indolent cases, which is challenging to patients and clinicians alike. We had to acknowledge in the nineties of last century, that prostate cancer may not only be a common age related ailment, but a potentially life shortening disease worth treating, that is more prevalent than thought before. On the other hand, the high percentage of rather indolent cases may indicate that aggressive treatment may do more harm than good and ought to be used with caution to avoid overtreatment - which is the decisive question of today. This problem has induced our interest in the natural course of this disease, to better understand whom to treat and how to stratify optimal therapeutic options. These are recurring questions of newly diagnosed prostate cancer patients: Will I die from cancer? Will I need treatment? What are the options? And what are the biases in the decision process? And what will happen, if I did nothing? This chapter provides an overview of current data to help answering these questions.

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References

  1. Siegel R, et al. Cancer statistics, 2014. CA Cancer J Clin. 2014;64(1):9–29.

    Article  PubMed  Google Scholar 

  2. Carter HB, et al. Gleason score 6 adenocarcinoma: should it be labeled as cancer? J Clin Oncol. 2012;30(35):4294–6.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Gaynor EP. Zur Frage des Prostatakrebses. Virchows Arch. 1938;301(3):602–52.

    Article  Google Scholar 

  4. Breslow N, et al. Latent carcinoma of prostate at autopsy in seven areas. The International Agency for Research on Cancer, Lyons, France. Int J Cancer. 1977;20(5):680–8.

    Article  CAS  PubMed  Google Scholar 

  5. Sakr WA, et al. High grade prostatic intraepithelial neoplasia (HGPIN) and prostatic adenocarcinoma between the ages of 20–69: an autopsy study of 249 cases. In Vivo. 1994;8(3):439–43.

    CAS  PubMed  Google Scholar 

  6. Zlotta AR, et al. Prevalence of prostate cancer on autopsy: cross-sectional study on unscreened Caucasian and Asian men. J Natl Cancer Inst. 2013;105(14):1050–8.

    Article  CAS  PubMed  Google Scholar 

  7. Kaufmann E. Lehrbuch der speziellen pathologischen Anatomie, vol. 2. Berlin: Reimer; 1911.

    Google Scholar 

  8. Chodak GW, et al. Results of conservative management of clinically localized prostate cancer. N Engl J Med. 1994;330(4):242–8.

    Article  CAS  PubMed  Google Scholar 

  9. Albertsen PC, Hanley JA, Fine J. 20-year outcomes following conservative management of clinically localized prostate cancer. JAMA. 2005;293(17):2095–101.

    Article  CAS  PubMed  Google Scholar 

  10. Albertsen PC, et al. Competing risk analysis of men aged 55 to 74 years at diagnosis managed conservatively for clinically localized prostate cancer. JAMA. 1998;280(11):975–80.

    Article  CAS  PubMed  Google Scholar 

  11. Cuzick J, et al. Long-term outcome among men with conservatively treated localised prostate cancer. Br J Cancer. 2006;95(9):1186–94.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Bill-Axelson A, et al. Radical prostatectomy or watchful waiting in early prostate cancer. N Engl J Med. 2014;370(10):932–42.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Epstein JI, et al. The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma. Am J Surg Pathol. 2005;29(9):1228–42.

    Article  PubMed  Google Scholar 

  14. Wilt TJ, et al. Radical prostatectomy versus observation for localized prostate cancer. N Engl J Med. 2012;367(3):203–13.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. D’Amico AV, et al. Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA. 1998;280(11):969–74.

    Article  PubMed  Google Scholar 

  16. Johansson JE, et al. Natural history of early, localized prostate cancer. JAMA. 2004;291(22):2713–9.

    Article  CAS  PubMed  Google Scholar 

  17. Schroder FH, et al. Screening and prostate-cancer mortality in a randomized European study. N Engl J Med. 2009;360(13):1320–8.

    Article  PubMed  Google Scholar 

  18. Schroder FH, et al. Prostate-cancer mortality at 11 years of follow-up. N Engl J Med. 2012;366(11):981–90.

    Article  PubMed  Google Scholar 

  19. Kristiansen G, et al. The importance of pathology in the German prostate cancer study PREFERE. Pathologe. 2013;34(5):449–62.

    Article  CAS  PubMed  Google Scholar 

  20. Stockle M, Bussar-Maatz R. Localised prostate cancer: the PREFERE trial. Z Evid Fortbild Qual Gesundhwes. 2012;106(5):333–5; discussion 335.

    Article  PubMed  Google Scholar 

  21. Klotz L. Active surveillance not only reduces morbidity, It saves lives. Oncology (Williston Park). 2013;27(6):522, 593.

    Google Scholar 

  22. Klotz L, Emberton M. Management of low risk prostate cancer: active surveillance and focal therapy. Curr Opin Urol. 2014;24(3):270–9.

    Article  PubMed  Google Scholar 

  23. Thomsen FB, et al. Active surveillance for clinically localized prostate cancer – a systematic review. J Surg Oncol. 2014;109(8):830–5.

    Article  PubMed  Google Scholar 

  24. Stamey TA, et al. Localized prostate cancer. Relationship of tumor volume to clinical significance for treatment of prostate cancer. Cancer. 1993;71(3 Suppl):933–8.

    Article  CAS  PubMed  Google Scholar 

  25. Epstein JI, et al. Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer. JAMA. 1994;271(5):368–74.

    Article  CAS  PubMed  Google Scholar 

  26. Wolters T, et al. A critical analysis of the tumor volume threshold for clinically insignificant prostate cancer using a data set of a randomized screening trial. J Urol. 2011;185(1):121–5.

    Article  PubMed  Google Scholar 

  27. Bangma CH, Roobol MJ. Defining and predicting indolent and low risk prostate cancer. Crit Rev Oncol Hematol. 2012;83(2):235–41.

    Article  PubMed  Google Scholar 

  28. Van der Kwast TH, Roobol MJ. Defining the threshold for significant versus insignificant prostate cancer. Nat Rev Urol. 2013;10(8):473–82.

    Article  PubMed  Google Scholar 

  29. Wolters T, et al. Should pathologists routinely report prostate tumour volume? The prognostic value of tumour volume in prostate cancer. Eur Urol. 2010;57(5):821–9.

    Article  PubMed  Google Scholar 

  30. Zavaski ME, et al. Prostate biopsy volume predicts final tumor volume. Conn Med. 2014;78(3):167–72.

    PubMed  Google Scholar 

  31. Sebo TJ, et al. The percent of cores positive for cancer in prostate needle biopsy specimens is strongly predictive of tumor stage and volume at radical prostatectomy. J Urol. 2000;163(1):174–8.

    Article  CAS  PubMed  Google Scholar 

  32. Freedland SJ, et al. Percent prostate needle biopsy tissue with cancer is more predictive of biochemical failure or adverse pathology after radical prostatectomy than prostate specific antigen or Gleason score. J Urol. 2002;167(2 Pt 1):516–20.

    Article  PubMed  Google Scholar 

  33. Gaynor EP. Zur Frages des Prostatakrebses. Virchows Archiv. 1938;301(3): 602–52.

    Google Scholar 

  34. Byar DP, Mostofi FK. Carcinoma of the prostate: prognostic evaluation of certain pathologic features in 208 radical prostatectomies. Examined by the step-section technique. Cancer. 1972;30(1):5–13.

    Article  CAS  PubMed  Google Scholar 

  35. Rice KR, et al. Clinicopathological behavior of single focus prostate adenocarcinoma. J Urol. 2009;182(6):2689–94.

    Article  PubMed  Google Scholar 

  36. Gleason DF. Classification of prostatic carcinomas. Cancer Chemother Rep. 1966;50(3):125–8.

    CAS  PubMed  Google Scholar 

  37. Egevad L, et al. Standardization of Gleason grading among 337 European pathologists. Histopathology. 2013;62(2):247–56.

    Article  PubMed  Google Scholar 

  38. Helpap B, Egevad L. The significance of modified Gleason grading of prostatic carcinoma in biopsy and radical prostatectomy specimens. Virchows Arch. 2006;449(6):622–7.

    Article  PubMed  Google Scholar 

  39. Uemura H, et al. Usefulness of the 2005 International Society of Urologic Pathology Gleason grading system in prostate biopsy and radical prostatectomy specimens. BJU Int. 2009;103(9):1190–4.

    Article  PubMed  Google Scholar 

  40. Zareba P, et al. The impact of the 2005 International Society of Urological Pathology (ISUP) consensus on Gleason grading in contemporary practice. Histopathology. 2009;55(4):384–91.

    Article  PubMed  Google Scholar 

  41. Dong F, et al. Impact on the clinical outcome of prostate cancer by the 2005 international society of urological pathology modified Gleason grading system. Am J Surg Pathol. 2012;36(6):838–43.

    Article  PubMed  Google Scholar 

  42. Helpap B, et al. Classification, histologic and cytologic grading and regression grading of prostate cancer. Urologe A. 1985;24(3):156–9.

    CAS  PubMed  Google Scholar 

  43. Helpap B, Kollermann J. Combined histoarchitectural and cytological biopsy grading improves grading accuracy in low-grade prostate cancer. Int J Urol. 2012;19(2):126–33.

    Article  PubMed  Google Scholar 

  44. Helpap B, et al. Improving the reproducibility of the Gleason scores in small foci of prostate cancer–suggestion of diagnostic criteria for glandular fusion. Pathol Oncol Res. 2012;18(3):615–21.

    Article  CAS  PubMed  Google Scholar 

  45. Helpap B, et al. Significance of Gleason grading of low-grade carcinoma of the prostate with therapeutic option of active surveillance. Urol Int. 2013;90(1):17–23.

    Article  PubMed  Google Scholar 

  46. Harnden P, et al. The prognostic significance of perineural invasion in prostatic cancer biopsies: a systematic review. Cancer. 2007;109(1):13–24.

    Article  PubMed  Google Scholar 

  47. Robinson B, Magi-Galluzzi C, Zhou M. Intraductal carcinoma of the prostate. Arch Pathol Lab Med. 2012;136(4):418–25.

    Article  PubMed  Google Scholar 

  48. Robinson BD, Epstein JI. Intraductal carcinoma of the prostate without invasive carcinoma on needle biopsy: emphasis on radical prostatectomy findings. J Urol. 2010;184(4):1328–33.

    Article  PubMed  Google Scholar 

  49. Guo CC, Epstein JI. Intraductal carcinoma of the prostate on needle biopsy: Histologic features and clinical significance. Mod Pathol. 2006;19(12):1528–35.

    Article  PubMed  Google Scholar 

  50. Cohen RJ, et al. A proposal on the identification, histologic reporting, and implications of intraductal prostatic carcinoma. Arch Pathol Lab Med. 2007;131(7):1103–9.

    PubMed  Google Scholar 

  51. Kristiansen G. Diagnostic and prognostic molecular biomarkers for prostate cancer. Histopathology. 2012;60(1):125–41.

    Article  PubMed  Google Scholar 

  52. Bocking A, et al. Algorithm for a DNA-cytophotometric diagnosis and grading of malignancy. Anal Quant Cytol. 1984;6(1):1–8.

    CAS  PubMed  Google Scholar 

  53. Bocking A, et al. Cytology of prostatic carcinoma. Quantification and validation of diagnostic criteria. Anal Quant Cytol. 1984;6(2):74–88.

    CAS  PubMed  Google Scholar 

  54. Schroder F, et al. Clinical utility of cellular DNA measurements in prostate carcinoma. Consensus Conference on Diagnosis and Prognostic Parameters in Localized Prostate Cancer. Stockholm, Sweden, May 12-13, 1993. Scand J Urol Nephrol Suppl. 1994;162:51–63; discussion 15–27.

    CAS  PubMed  Google Scholar 

  55. Wang N, et al. Evaluation of tumor heterogeneity of prostate carcinoma by flow- and image DNA cytometry and histopathological grading. Anal Cell Pathol. 2000;20(1):49–62.

    Article  CAS  PubMed  Google Scholar 

  56. Cuzick J. Prognostic value of a cell cycle progression score for men with prostate cancer. Recent Results Cancer Res. 2014;202:133–40.

    Article  PubMed  Google Scholar 

  57. Knezevic D, et al. Analytical validation of the Oncotype DX prostate cancer assay – a clinical RT-PCR assay optimized for prostate needle biopsies. BMC Genomics. 2013;14:690.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  58. Wu CL, et al. Development and validation of a 32-gene prognostic index for prostate cancer progression. Proc Natl Acad Sci U S A. 2013;110(15):6121–6.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  59. Gerlinger M, et al. Intratumor heterogeneity and branched evolution revealed by multiregion sequencing. N Engl J Med. 2012;366(10):883–92.

    Article  CAS  PubMed  Google Scholar 

  60. Schroder FH. Screening for prostate cancer: current status of ERSPC and screening-related issues. Recent Results Cancer Res. 2014;202:47–51.

    Article  PubMed  Google Scholar 

  61. Villa L, et al. The number of cores taken in patients diagnosed with a single microfocus at initial biopsy is a major predictor of insignificant prostate cancer. J Urol. 2013;189(3):854–9.

    Article  PubMed  Google Scholar 

  62. Wolters T, et al. False-negative prostate needle biopsies: frequency, histopathologic features, and follow-up. Am J Surg Pathol. 2010;34(1):35–43.

    Article  PubMed  Google Scholar 

  63. Van der Kwast TH, et al. Variability in diagnostic opinion among pathologists for single small atypical foci in prostate biopsies. Am J Surg Pathol. 2010;34(2):169–77.

    Article  PubMed  Google Scholar 

  64. Singh RV, et al. Interobserver reproducibility of Gleason grading of prostatic adenocarcinoma among general pathologists. Indian J Cancer. 2011;48(4):488–95.

    Article  CAS  PubMed  Google Scholar 

  65. Allsbrook Jr WC, et al. Interobserver reproducibility of Gleason grading of prostatic carcinoma: urologic pathologists. Hum Pathol. 2001;32(1):74–80.

    Article  PubMed  Google Scholar 

  66. Allsbrook Jr WC, et al. Interobserver reproducibility of Gleason grading of prostatic carcinoma: general pathologist. Hum Pathol. 2001;32(1):81–8.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Institute of Pathology, University Hospital of Bonn (UKB), Sigmund-Freud-Strasse 25, Bonn, 53127, Germany

    Glen Kristiansen MD

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  1. Glen Kristiansen MD
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Correspondence to Glen Kristiansen MD .

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Editors and Affiliations

  1. Department of Urology, Klinikum München-Harlaching, München, Germany

    Stefan Thüroff

  2. Department of Urology, University of Regensburg Caritas Hospital St. Josef, Regensburg, Germany

    Christian G. Chaussy

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Kristiansen, G. (2015). What Will Happen If I Do Nothing? Natural Development of Prostate Cancer Under Consideration of Histopathological Patterns. In: Thüroff, S., Chaussy, C. (eds) Focal Therapy of Prostate Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-14160-2_1

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  • DOI: https://doi.org/10.1007/978-3-319-14160-2_1

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