Cristian I Surcel1, Inge M van Oort2, Prasanna Sooriakumaran3, Alberto Briganti4, Peter J L De Visschere5, Jurgen J Fütterer6, Pirus Ghadjar7, Hendrik Isbarn8, Piet Ost9, Roderick C N van den Bergh10, Ofer Yossepowitch11, Gianluca Giannarini12, Guillaume Ploussard13. 1. Centre of Urological Surgery, Dialysis and Renal Transplantation, Fundeni Clinical Institute, Bucharest, Romania. 2. Department of Urology, Radboud University Medical Centre, Nijmegen, The Netherlands. 3. Surgical Intervention Trials Unit, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. 4. Division of Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy. 5. Department of Radiology, Ghent University Hospital, Ghent, Belgium. 6. Department of Radiology, Radboud University Medical Centre, Nijmegen, The Netherlands. 7. Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany. 8. Department of Urology, Regio Clinic Wedel, Wedel, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 9. Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, Ghent, Belgium. 10. Department of Urology, University Medical Centre Utrecht, Utrecht, The Netherlands. 11. Department of Urology, Rabin Medical Center-Beilinson, Petach-Tikva, Israel; Sackler Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel. 12. Department of Experimental and Clinical Medical Sciences, Urology Unit, University of Udine, Udine, Italy. 13. Department of Urology, CHU Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris 7 Diderot, Paris, France. Electronic address: g.ploussard@gmail.com.
Abstract
BACKGROUND: The multiple pathways that are involved in neuroendocrine differentiation (NED) in prostate cancer (PCa) are poorly elucidated. Evidence suggests that several environmental triggers induce NED leading to the adaptation of PCa to its close environment to maintain cell proliferation. Nevertheless, there is conflicting evidence regarding the prognostic role of NED in PCa. METHODS: In this review, we aimed to summarize all available data about NED and to assess the prognostic role of NED in disease progression and therapy resistance, and its role in routine clinical practice. This review was based on articles found through a PubMed literature search between 1993 and 2013. The study outcome measure was the effect of NED on oncologic outcomes at each PCa stage. RESULTS: In total, 59 articles reporting on the effect of NED on oncologic outcomes have been selected. In clinical practice, immunostaining for NED markers could have interesting predictive value for assessing the oncologic outcomes in patients receiving androgen-deprivation therapy. Thus, patients with high NED burden may be candidates for more aggressive treatment strategies targeting NED pathways. Conversely, strong evidence is lacking concerning its potential independent prognostic value in hormone-naïve PCa. CONCLUSIONS: Current published data are not sufficient to recommend the use of NE markers in routine practice, particularly at early PCa stage.
BACKGROUND: The multiple pathways that are involved in neuroendocrine differentiation (NED) in prostate cancer (PCa) are poorly elucidated. Evidence suggests that several environmental triggers induce NED leading to the adaptation of PCa to its close environment to maintain cell proliferation. Nevertheless, there is conflicting evidence regarding the prognostic role of NED in PCa. METHODS: In this review, we aimed to summarize all available data about NED and to assess the prognostic role of NED in disease progression and therapy resistance, and its role in routine clinical practice. This review was based on articles found through a PubMed literature search between 1993 and 2013. The study outcome measure was the effect of NED on oncologic outcomes at each PCa stage. RESULTS: In total, 59 articles reporting on the effect of NED on oncologic outcomes have been selected. In clinical practice, immunostaining for NED markers could have interesting predictive value for assessing the oncologic outcomes in patients receiving androgen-deprivation therapy. Thus, patients with high NED burden may be candidates for more aggressive treatment strategies targeting NED pathways. Conversely, strong evidence is lacking concerning its potential independent prognostic value in hormone-naïve PCa. CONCLUSIONS: Current published data are not sufficient to recommend the use of NE markers in routine practice, particularly at early PCa stage.
Authors: C Morell; A Bort; D Vara; A Ramos-Torres; N Rodríguez-Henche; I Díaz-Laviada Journal: Prostate Cancer Prostatic Dis Date: 2016-06-21 Impact factor: 5.554