BERKELEY, CA (UroToday.com) - In the February, 2011 issue of the Journal of Urology, a group of Italian and American investigators report on the clinical and prognostic significance of a single focus of prostate cancer (SF-CaP) in radical prostatectomy (RP) specimens. Approximately 80% of men have multifocal CaP found at RP, but usually there is a dominant tumor lesion. They sought to find whether a SF-CaP had different molecular of biological characteristics.
Between 2004 and 2009, they identified 106 cases of SF-CaP from 1,100 consecutive RP specimens (9.6%). Tissue microarrays (TMAs) were used to evaluate ERG gene fusion status by FISH. Clinical and pathological data was recorded and evaluated. The median patient age for a SF-CaP was 59 years, median preoperative PSA 5.1ng/ml and median prostate volume 49.6cc. The median tumor volume was 0.5cc and all were acinar CaP except for one case of ductal adenocarcinoma. Among the 65 SF-CaP cases that had suitable TMAs, 40 (68%) were positive for ERG rearrangement. All except 3 tumors showed homogeneity for ERG rearrangement status in the tumor. Compared with fusion negative tumors, fusion positive tumors were larger, although this difference was only statistically significant in cases with fusion positivity by deletion. There were no significant differences in patient age, PSA, DRE findings, Gleason score, extra-prostatic extension, seminal vesicle invasion or pathological stage in fusion positive vs. negative cases. In multivariate analysis, tumor volume was the only variable statistically associated pathologic stage pT3 disease status. The homogeneity of the SF-CaP tumors suggests that they arise from a single clone of malignant cells.
Falzarano SM, Zhou M, Hernandez AV, Klein EA, Rubin MA, Magi-Galluzzi C
J Urol. 2011 Feb;185(2):489-94
10.1016/j.juro.2010.09.093
PubMed Abstract
PMID: 21167530