Metastatic patterns of prostate cancer: An autopsy study of 1,589 patients

ArticleinHuman Pathlogy 31(5):578-83 · June 2000with1,657 Reads
Source: PubMed
Abstract
The prognosis of prostate cancer is mainly determined by the presence or absence of metastases. Nevertheless, the metastatic pathways in prostate cancer are not entirely understood. Among 19,316 routine autopsies performed from 1967 to 1995 on men older than 40 years of age, the reports from those 1,589 (8.2%) with prostate cancer were analyzed. Hematogeneous metastases were present in 35% of 1,589 patients with prostate cancer, with most frequent involvement being bone (90%), lung (46%), liver (25%), pleura (21%), and adrenals (13%). Several lines of evidence suggested the existence of a backward metastatic pathway through veins from the prostate to the spine in addition to classical hematogeneous tumor spread via the vena cava. First, there was an inverse relationship between spine and lung metastases, suggesting that metastasis to the spine is independent of lung metastasis. Second, the maximum frequency of spine involvement occurred in smaller tumors (4 to 6 cm) as compared with the maximum spread to lung (6 to 8 cm) and liver (>8 cm), suggesting that spine metastases precede lung and liver metastases in many prostate cancers. Third, there was a gradual decrease in spine involvement from the lumbar to the cervical level (97% v 38%), which is consistent with a subsequent upward metastatic spread along spinal veins after initial lumbar metastasis. The results of this study show that bone, lung, and liver are the most frequent sites of distant prostate cancer metastases. Besides the cava-type of metastasis through lung passage, there are strong arguments for the existence and clinical significance of a backward venous spread to the spine, which is likely to occur early in the metastatic process.
    • "Renal and retroperitoneal metastasis from prostatic origin is an extremely rare clinical entity. Although prostate cancer has a recognizable pattern of spread, most often to regional lymph nodes and to the skeleton [1], many patients might present with atypical metastases at diag- nosis [2] . We present a 74-year-old man who had a history of abnormally elevated prostate specific antigen (PSA) level. "
    [Show abstract] [Hide abstract] ABSTRACT: Background Diffuse renal and retroperitoneal metastasis of prostatic origin is an uncommon spread pattern of prostate cancer. Case presentation We described a 74-year-old male patient who was admitted because of dysuria and nocturia. Physical examination and imaging study indicated prostate mass, and laboratory analysis revealed elevated prostate specific antigen (PSA). The diagnosis of prostate cancer was established after biopsy. In the further evaluation, diffuse renal and retroperitoneal metastasis of prostate cancer was confirmed. Radiotherapy combined with endocrine therapy was given. Conclusions Our present case emphasized that the routine metastatic work-up was quite necessary, since a small proportion of men with advanced prostate cancer might experience metastases in atypical sites.
    Full-text · Article · Dec 2016
    • "The process of metastasis [21] appears abruptly as a reminiscent of hard, first order transitions, the chances of survival are lower compared to the previous stages, thus exhibiting a higher robustness and a higher level of hierarchy. The tumor now competes with the different levels of hierarchical and functional organization of the body (those which play vital roles), so it is considered like a cancer tumor, given its ability to metastasize [22]. Empirically based on the evidence discussed above without loss of generality, to describe the dynamics of this process we propose a heuristic mechanism for three basic stages [9]: avascular, vascular tumor growth and metastasis based on a chemical network model; the equations are shown in Fig. 1. "
    Dataset · Jul 2016 · Pharmaceuticals
    • "Prostate cancer (PCa) development starts from epithelial cells in the peripheral zone of the prostate and is androgen-controlled [2]. In its first stages, the cancer develops slowly and remains localized, while in later stages the prostate capsule barrier can be crossed, and PCa becomes invasive, often leading to metastasis in lymph nodes and later mainly in the bone, liver and lung [3]. Metastasis development in the late PCa stages is the main cause of mortality due to PCa. "
    [Show abstract] [Hide abstract] ABSTRACT: Prostate cancer (PCa) is one of the most frequently diagnosed cancers in developed countries. Several studies suggest that variations in calcium homeostasis are involved in carcinogenesis. Interestingly, (Transient Receptor Potential Melastatin member 8) TRPM8 calcium permeable channel expression is differentially regulated during prostate carcinogenesis, thereby suggesting a potential functional role for this channel in those cell processes, which are important for PCa evolution. Indeed, several studies have shown that TRPM8 plays a key role in processes such as the proliferation, viability and cell migration of PCa cells. Where cell migration is concerned, TRPM8 seems to have a protective anti-invasive effect and could be a particularly promising therapeutic target. The goal of this review is to inventory advances in understanding of the role of TRPM8 in the installation and progression of PCa.
    Full-text · Article · Jul 2016
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