Biochemical recurrence after chemohormonal therapy followed by robot-assisted radical prostatectomy in very-high-risk prostate cancer patients.

Robot-assisted radical prostatectomy (RARP) has become one of the standard radical treatments for prostate cancer (PCa). A retrospective single-center cohort study was conducted on patients with PCa who underwent RARP at Gifu University Hospital between September 2017 and September 2022. In this study, patients were classified into three groups based on the National Comprehensive Cancer Network risk classification: low/intermediate-risk, high-risk, and very-high-risk groups. Patients with high- and very-high-risk PCa who were registered in the study received neoadjuvant chemohormonal therapy prior to RARP. Biochemical recurrence-free survival (BRFS) after RARP in patients with PCa was the primary endpoint of this study. The secondary endpoint was the relationship between biochemical recurrence (BCR) and clinical covariates. We enrolled 230 patients with PCa in our study, with a median follow-up of 17.0 months. When the time of follow-up was over, 19 patients (8.3%) had BCR, and the 2 years BRFS rate for the enrolled patients was 90.9%. Although there was no significant difference in BRFS between the low- and intermediate-risk group and the high/very-high-risk group, the 2 years BRFS rate was 100% in the high-risk group and 68.3% in the very-high-risk group (P = 0.0029). Multivariate analysis showed that positive surgical margins were a significant predictor of BCR in patients with PCa treated with RARP. Multimodal therapies may be necessary to improve the BCR in patients with very-high-risk PCa.

Organ-confined plasmacytoid urothelial carcinoma: implication of the lack of expression of the receptor tyrosine kinase MET.

Plasmacytoid urothelial carcinoma (PUC), a morphological variant of urothelial carcinoma (UC), is composed of cancer cells that resemble plasma cells, monocytes, or both, and is clinicopathologically distinguished by its aggressive, non-organ-confined features. Here, we present a case of a patient with PUC with early invasion at diagnostic transurethral resection. Histopathologically, no residual cancer or lymph node metastasis was observed by total cystectomy. The patient remains disease-free after 18 months, without undergoing adjuvant chemotherapy. Interestingly, the immunoreactivity of MET, a receptor tyrosine kinase expressed in many invasive UCs, was minimal in the cancer cells. In contrast, archival pathological, non-organ-confined PUC cells exhibited strong MET immunoreactivity. The present case may imply a role for the MET protein in the aggressive behavior of PUCs. We propose the putative usefulness of MET inhibitors for the treatment of aggressive PUCs.