Deconstructing neutrophil to lymphocyte ratio (NLR) in early breast cancer: lack of prognostic utility and biological correlates across tumor subtypes.

PURPOSE: The prognostic utility and biological correlates of neutrophil to lymphocyte ratio (NLR), a potential biomarker of the balance between immune response and the inflammatory status, are still uncertain in breast cancer (BC). METHODS: We analysed a cohort of 959 women with early breast cancer, mostly treated with neoadjuvant or adjuvant chemotherapy. Clinical and pathological data, survival, NLR (continuous and categorical) and stromal tumor infiltrating lymphocytes (sTIL) were evaluated. RESULTS: NLR was only weakly associated with Ki67, while no association was found for grade, histology, immunohistochemical subtype or stage. Lymphocyte infiltration of the tumor did not correlate with NLR (Rho: 0.05, p = 0.30). These results were similar in the whole group and across the different BC subtypes, with no differences in triple negative BC. Relapse free interval (RFI), breast cancer specific survival (BCSS) and overall survival (OS) changed according to pre-treatment NLR neither in the univariate nor in the multivariate Cox models (RFI: HR 0.948, p = 0.61; BCSS: HR 0.920, p = 0.57; OS: HR 0.96, p = 0.59). CONCLUSION: These results question the utility of NLR as a prognostic biomarker in early breast cancer and suggest the lack of correlation of NLR with tumor microenvironment immune response.

A new prognostic model including immune biomarkers, genomic proliferation tumor markers (AURKA and MYBL2) and clinical-pathological features optimizes prognosis in neoadjuvant breast cancer patients.

Background: Up to 30% of breast cancer (BC) patients treated with neoadjuvant chemotherapy (NCT) will relapse. Our objective was to analyze the predictive capacity of several markers associated with immune response and cell proliferation combined with clinical parameters. Methods: This was a single-center, retrospective cohort study of BC patients treated with NCT (2001-2010), in whom pretreatment biomarkers were analyzed: neutrophil-to-lymphocyte ratio (NLR) in peripheral blood, CD3+ tumor-infiltrating lymphocytes (TILs), and gene expression of AURKA, MYBL2 and MKI67 using qRT-PCR. Results: A total of 121 patients were included. Median followup was 12 years. In a univariate analysis, NLR, TILs, AURKA, and MYBL2 showed prognostic value for overall survival. In multivariate analyses, including hormone receptor, HER2 status, and response to NCT, NLR (HR 1.23, 95% CI 1.01-1.75), TILs (HR 0.84, 95% CI 0.73-0.93), AURKA (HR 1.05, 95% CI 1.00-1.11) and MYBL2 (HR 1.19, 95% CI 1.05-1.35) remained as independent predictor variables. Conclusion: Consecutive addition of these biomarkers to a regression model progressively increased its discriminatory capacity for survival. Should independent cohort studies validate these findings, management of early BC patients may well be changed.

Clinical Meaning of Stromal Tumor Infiltrating Lymphocytes (sTIL) in Early Luminal B Breast Cancer.

Luminal breast cancer (BC) is associated with less immune activation, and the significance of stromal lymphocytic infiltration (sTIL) is more uncertain than in other BC subtypes. The aim of this study was to investigate the predictive and prognostic value of sTIL in early luminal BC. The study was performed with an observational design in a prospective cohort of 345 patients with predominantly high-risk luminal (hormone receptor positive, HER2 negative) BC and with luminal B features (n = 286), in which the presence of sTIL was analyzed with validated methods. Median sTIL infiltration was 5% (Q1-Q3 range (IQR), 0-10). We found that sTIL were associated with characteristics of higher biological and clinical aggressiveness (tumor and lymph node proliferation and stage, among others) and that the percentage of sTIL was predictive of pathologic complete response in patients treated with neoadjuvant chemotherapy (OR: 1.05, 95%CI 1.02-1.09, p < 0.001). The inclusion of sTIL (any level of lymphocytic infiltration: sTIL > 0%) in Cox regression multivariable prognostic models was associated with a shorter relapse-free interval (HR: 4.85, 95%CI 1.33-17.65, p = 0.016) and significantly improved its performance. The prognostic impact of sTIL was independent of other clinical and pathological variables and was mainly driven by its relevance in luminal B BC.

Prognostic and Predictive Effects of Tumor and Plasma miR-200c-3p in Locally Advanced and Metastatic Breast Cancer.

While the role of miR-200c in cancer progression has been established, its expression and prognostic role in breast cancer is not completely understood. The predictive role of miR-200c in response to chemotherapy has also been suggested by some studies, but only limited clinical evidence is available. The purpose of this study was to investigate miR-200c-3p in the plasma and primary tumor of BC patients. The study design included two cohorts involving women with locally advanced (LABC) and metastatic breast cancer. Tumor and plasma samples were obtained before and after treatment. We found that miR-200c-3p was significantly higher in the plasma of BC patients compared with the controls. No correlation of age with plasma miR-200c-3p was found for controls or for BC patients. MiR-200c-3p tumor expression was also associated with poor overall survival in LABC patients treated with neoadjuvant chemotherapy, independently of pathological complete response or clinical stage. Our findings suggest that plasmatic miR-200c-3p levels could be useful for BC staging, while the tumor expression of miR-200c-3p might provide further prognostic information beyond residual disease in BC treated with neoadjuvant chemotherapy.

External validation of a prognostic model based on total tumor load of sentinel lymph node for early breast cancer patients.

BACKGROUND: A prognostic model based on the results of molecular analysis of sentinel lymph nodes (SLN) is needed to replace the information that staging the entire axilla provided. The aim of the study is to conduct an external validation of a previously developed model for the prediction of 5-year DFS in a group of breast cancer patients that had undergone SLN biopsy assessed by the One Step Nucleic Acid Amplification (OSNA) method. METHODS: We collected retrospective data of 889 patients with breast cancer, who had not received systemic treatment before surgery, and who underwent SLN biopsy and evaluation of all SLN by OSNA. The discrimination ability of the model was assessed by the area under the ROC curve (AUC ROC), and its calibration by comparing 5-years DFS Kaplan-Meier estimates in quartile groups of model predicted probabilities (MPP). RESULTS: The AUC ROC ranged from 0.78 (at 2 years) to 0.73 (at 5 years) in the training set, and from 0.78 to 0.71, respectively, in the validation set. The MPP allowed to distinguish four groups of patients with heterogeneous DFS (log-rank test p < 0.0001). In the highest risk group, the HR were 6.04 [95% CI 2.70, 13.48] in the training set and 4.79 [2.310, 9.93] in the validation set. CONCLUSIONS: The model for the prediction of 5-year DFS was successfully validated using the most stringent form of validation, in centers different from those involved in the development of the model. The external validation of the model confirms its utility for the prediction of 5-year DFS and the usefulness of the TTL value as a prognostic variable.

Clinical and biological impact of miR-18a expression in breast cancer after neoadjuvant chemotherapy.

PURPOSE: The analysis of breast cancer residual tumors after neoadjuvant chemotherapy (nCT) may be useful for identifying new biomarkers. MicroRNAs are known to be involved in oncogenic pathways and treatment resistance of breast cancer. Our aim was to determine the role of miR-18a, a member of the miR-17-92a cluster, in breast cancer behavior and outcome after nCT. METHODS: Pre- and post-nCT tumor miR-18a expression was retrospectively assessed by qRT-PCR in 121 patients treated with nCT and was correlated with survival outcomes and with clinical and pathological characteristics. Breast cancer-derived MCF-7 and MDA-MB-231 cell lines were transfected with miR-18a and anti-miR-18a to evaluate the biological effects of this molecule. In addition, whole-transcriptome expression analysis was performed. RESULTS: High miR-18a expression in post-nCT residual tumors was found to be associated with a significantly worse overall survival [hazard ratio (HR): 2.80, 95% confidence interval (CI): 1.01-7.76] and a strong trend towards a poorer disease-free survival (HR: 2.44, 95% CI: 0.99-5.02) compared to low miR-18a expressing post-nCT residual tumors. Clinical and experimental data were found to be in conformity with the proliferative effects of miR-18a, which showed a significant correlation with Ki67 and MYBL2 expression, both in pre- and post-nCT tumors and in public databases. In vitro analysis of the role of miR-18a in breast cancer-derived cell lines showed that a high expression of miR-18a was associated with a low expression of the estrogen receptor (ER), a decreased sensitivity to tamoxifen and an enrichment in luminal B and endocrine resistance gene expression signatures. CONCLUSIONS: From our data we conclude that post-nCT miR-18a expression in breast cancer serves as a negative prognostic marker, especially in luminal tumors. Clinical, in vitro and in silico data support the role of miR-18a in breast cancer cell proliferation and endocrine resistance and suggest its potential utility as a biomarker for additional adjuvant treatment in patients without a pathologic complete response to neoadjuvant therapy.

Angiogenic role of miR-20a in breast cancer.

BACKGROUND: Angiogenesis is a key process for tumor progression and a target for treatment. However, the regulation of breast cancer angiogenesis and its relevance for clinical resistance to antiangiogenic drugs is still incompletely understood. Recent developments on the contribution of microRNA to tumor angiogenesis and on the oncogenic effects of miR-17-92, a miRNA cluster, point to their potential role on breast cancer angiogenesis. The aim of this work was to establish the contribution of miR-20a, a member of miR-17-92 cluster, to tumor angiogenesis in patients with invasive breast carcinoma. METHODS: Tube-formation in vitro assays with conditioned medium from MCF7 and MDA-MB-231 breast cancer cell lines were performed after transfection with miR-20a and anti-miR20a. For clinical validation of the experimental findings, we performed a retrospective analysis of a series of consecutive breast cancer patients (n = 108) treated with neoadjuvant chemotherapy and with a full characterization of their vessel pattern and expression of angiogenic markers in pre-treatment biopsies. Expression of members of the cluster miR-17-92 and of angiogenic markers was determined by RT-qPCR after RNA purification from FFPE samples. RESULTS: In vitro angiogenesis assays with endothelial cells and conditioned media from breast cancer cell lines showed that transfection with anti-miR20a in MDA-MB-231 significantly decreased mean mesh size and total mesh area, while transfection with miR-20a in MCF7 cells increased mean mesh size. MiR-20a angiogenic effects were abrogated by treatment with aflibercept, a VEGF trap. These results were supported by clinical data showing that mir-20a expression was higher in tumors with no estrogen receptor or with more extensive nodal involvement (cN2-3). A higher miR-20a expression was associated with higher mean vessel size (p = 0.015) and with an angiogenic pattern consisting in larger vessels, higher VEGFA expression and presence of glomeruloid microvascular proliferations (p<0.001). This association was independent of tumor subtype and VEGFA expression. CONCLUSIONS: Transfection of breast cancer cells with miR-20a induces vascular changes in endothelial tube-formation assays. Expression of miR-20a in breast invasive carcinomas is associated with a distinctive angiogenic pattern consisting in large vessels, anomalous glomeruloid microvascular proliferations and high VEGFA expression. Our results suggest a role for miR-20a in the regulation of breast cancer angiogenesis, and raise the possibility of its use as an angiogenic biomarker.

Carcinoma de tiroides incidental versus no incidental: presentación clínica, tratamiento quirúrgico y pronóstico / Incidental versus non-incidental thyroid carcinoma: clinical presentation, surgical management and prognosis

Antecedentes y objetivo: El cáncer tiroideo puede manifestarse clínicamente por la presencia de un nódulo cervical, o constituir un hallazgo casual en el estudio histológico de la glándula extirpada con diagnóstico, a priori, benigno. El objetivo del presente estudio fue estudiar las diferencias clínicas, de manejo quirúrgico y curso evolutivo entre los tumores tiroideos incidentales y los tumores detectados clínicamente. Material y métodos: Estudio retrospectivo de pacientes intervenidos por enfermedad tiroidea, ya fuese benigna o maligna, en el período comprendido entre enero de 2000 y marzo de 2014. De 1.415 pacientes que se sometieron a algún tipo de cirugía tiroidea se identificaron un total de 264 neoplasias, de las cuales 170 fueron incidentales. Se realizó comparación entre carcinomas incidentales versus no incidentales. Además, entre los incidentales se compararon los casos cuya indicación quirúrgica fue enfermedad de Graves frente a bocio multinodular. Resultados: Los carcinomas incidentales presentaron estadios más precoces y requirieron cirugía menos agresiva. No se observaron diferencias en las complicaciones quirúrgicas entre ambos grupos, aunque tanto la mortalidad como las tasas de recidiva fueron notablemente mayores en el grupo de no incidentales (4,4% vs 0% y 13,2% vs 4,8% respectivamente). Los carcinomas desarrollados sobre enfermedad de Graves no mostraron diferencias respecto al resto de los tumores incidentales, respecto a complicaciones, mortalidad o recidiva tras la cirugía. Conclusiones: El cáncer tiroideo en estadios iniciales presenta mayor supervivencia y mejor respuesta al tratamiento quirúrgico (AU)

Background and objective: Thyroid cancer may be clinically evident as a tumor mass in the neck or as a histopathological incidental finding after thyroid surgery for an apparent benign condition. Our objective was to assess the differences in clinical signs, surgical management, and course between incidental and clinically diagnosed thyroid tumors. Methods: A retrospective study was conducted on patients operated on for benign or malignant thyroid disease from January 2000 to March 2014. Among the 1415 patients who underwent any thyroid surgery, 264 neoplasms were found, of which 170 were incidental. A comparison was made of incidental versus non-incidental carcinomas. Among incidental carcinomas, cases whose indication for surgery was Graves’ disease were compared to those with multinodular goiter. Results: Incidental carcinomas were in earlier stages and required less aggressive surgery. There were no differences in surgical complications between incidental and clinical tumors, but mortality and relapses were markedly higher in non-incidental cancers (4.4% vs 0% and 13.2% vs 4.8% respectively). Carcinomas developing on Graves’ disease showed no differences from all other incidental tumors in terms of complications, mortality, or relapse after surgery. Conclusions: Early stage thyroid cancer has better survival and prognosis after surgical treatment (AU)

Incidental versus non-incidental thyroid carcinoma: Clinical presentation, surgical management and prognosis. / Carcinoma de tiroides incidental versus no incidental: presentación clínica, tratamiento quirúrgico y pronóstico.

BACKGROUND AND OBJECTIVE: Thyroid cancer may be clinically evident as a tumor mass in the neck or as a histopathological incidental finding after thyroid surgery for an apparent benign condition. Our objective was to assess the differences in clinical signs, surgical management, and course between incidental and clinically diagnosed thyroid tumors. METHODS: A retrospective study was conducted on patients operated on for benign or malignant thyroid disease from January 2000 to March 2014. Among the 1415 patients who underwent any thyroid surgery, 264 neoplasms were found, of which 170 were incidental. A comparison was made of incidental versus non-incidental carcinomas. Among incidental carcinomas, cases whose indication for surgery was Graves' disease were compared to those with multinodular goiter. RESULTS: Incidental carcinomas were in earlier stages and required less aggressive surgery. There were no differences in surgical complications between incidental and clinical tumors, but mortality and relapses were markedly higher in non-incidental cancers (4.4% vs 0% and 13.2% vs 4.8% respectively). Carcinomas developing on Graves' disease showed no differences from all other incidental tumors in terms of complications, mortality, or relapse after surgery. CONCLUSIONS: Early stage thyroid cancer has better survival and prognosis after surgical treatment.

Effects of conventional neoadjuvant chemotherapy for breast cancer on tumor angiogenesis.

The effects of breast cancer conventional chemotherapy on tumor angiogenesis need to be further characterized. Neoadjuvant chemotherapy is an ideal model to evaluate the results of chemotherapy, allowing intra-patient direct comparison of antitumor and antiangiogenic effects. We sought to analyze the effect of neoadjuvant chemotherapy on tumor angiogenesis and its clinical significance in breast cancer. Breast cancer patients (n = 108) treated with neoadjuvant sequential anthracyclines and taxanes were studied. Pre- and post-chemotherapy microvessel density (MVD) and mean vessel size (MVS) were analyzed after CD34 immunohistochemistry and correlated with tumor expression of pro- and antiangiogenic factors (VEGFA, THBS1, HIF1A, CTGF, and PDGFA) by qRT-PCR. Angiogenic measures at diagnosis varied among breast cancer subtypes. Pre-treatment higher MVS was associated with triple-negative subtype and more advanced disease. Higher MVS was correlated with higher VEGFA (p = 0.003), while higher MVD was correlated with lower antiangiogenic factors expression (THBS1, p < 0.0001; CTGF, p = 0.001). Increased angiogenesis at diagnosis (high MVS and glomeruloid microvascular proliferation) and higher VEGFA expression were associated with tumor recurrence (p = 0.048 and 0.009, respectively). Chemotherapy-induced angiogenic response (defined as decreased MVD) was present in 35.2 % of patients. This response correlated with an increase in antiangiogenic factors (THBS1) without changes in VEGFA expression, and it was associated with tumor downstaging, but not with clinical response, pathologic complete response, or prognosis. Global effects of chemotherapy mainly consisted in an increased expression of antiangiogenic factors (THBS1, CTGF), with significant changes neither of tumor VEGFA nor of MVS. Conventionally scheduled neoadjuvant chemotherapy exerts antiangiogenic effects, through an increase in antiangiogenic factors, THBS1 and CTGF, but the expression of VEGFA is maintained after treatment. Better markers of angiogenic response and a better understanding of the cooperation of chemotherapy and antiangiogenic therapy in the neoadjuvant clinical scenario are needed.

Predictive value of peripheral blood lymphocyte count in breast cancer patients treated with primary chemotherapy.

Peripheral blood lymphocyte (PBL) count may reflect the immune status of cancer patients. We retrospectively analyzed the predictive and prognostic impact of baseline and post-chemotherapy PBL counts in a homogeneous group of 103 breast cancer patients treated with neoadjuvant chemotherapy (anthracyclines and taxanes). In univariate analysis, baseline PBL under 1500 × 10(6)/L (p = 0.013; hazard ratio [HR]: 2.80, 95%CI 1.24-6.61), and PBL decrease >200 × 10(6)/L after the first cycle of chemotherapy (p = 0.047; HR: 2.82, 95%CI 1.01-7.86) were significantly related to disease free survival. In multivariate analysis, both baseline PBL count less than 1500 × 10(6)/L (p = 0.034; HR: 3.32, 95%CI 1.09-10.02) and PBL decrease >200 × 10(6)/L after first cycle (p = 0.032; HR: 3.25, 95%CI 1.10-9.56) showed independent prognostic value for worse disease free survival. No effect was observed for overall survival. Our data support the relevance of pre- and post-chemotherapy PBL for breast cancer recurrence after neoadjuvant chemotherapy.

El análisis molecular intraoperatorio (one-step nucleic acid amplification) del ganglio centinela como alternativa al estudio histopatológico diferido en el cáncer de mama: análisis coste-beneficio / One-step nucleic acid amplification (OSNA) assay for sentinel lymph node metastases as an alternative to conventional postoperative histology in breast cancer: A cost-benefit analysis

Introducción: El análisis molecular intraoperatorio del ganglio centinela con el método one-step nucleic acid amplification (OSNA) es una técnica ya validada para la detección de metástasis ganglionares en el cáncer de mama. Los autores comparan el coste económico de este nuevo método frente al estudio histopatológico convencional diferido. Metodología Estudio retrospectivo de análisis coste-beneficio que incluyó a pacientes con cáncer de mama operable y axila clínica y ecográficamente negativa que fueron intervenidas desde el 15 de octubre de 2008 hasta el 15 de diciembre de 2009. El análisis del ganglio centinela se realizó en el Grupo 1 (45 pacientes) mediante estudio histopatológico convencional diferido, mientras que en el Grupo 2 (35 pacientes) se realizó según el método OSNA. Se analizaron las siguientes variables: edad, tamaño tumoral, tipo histológico, número de ganglios centinela, resultado de la biopsia, tiempo quirúrgico, días de hospitalización, complicaciones postoperatorias, ganglios positivos en caso de linfadenectomía axilar, coste por paciente, coste por hospitalización y coste por intervención. Resultados El tiempo quirúrgico de la primera intervención en el Grupo 1 fue significativamente menor, pero el tiempo total fue mayor en el Grupo 1. La estancia media fue mayor en el Grupo 1 (p<0,001). El coste medio de la estancia hospitalaria fue mayor en el Grupo 1 frente al Grupo 2 (p<0,001), con una diferencia de medias de 199,69 €. El coste medio de la intervención fue mayor en el Grupo 1(p<0,001), con una diferencia de medias de 157,49 €. El (..) (AU)

Introduction: Intraoperative molecular analysis for sentinel lymph node (SLN) metastasesusing the OSNA (one-step nucleic acid amplification) method has been already validated in breast cancer. The authors compared the cost of OSNA versus the conventional postoperative histopathologic evaluation in patients with breast cancer. Methodology: Patients with operable breast cancer and clinically and sonographic negative evaluation of the axilla, and who subsequently were operated on between the 15th of October 2008 and the 15th of December 2009 were included in this retrospective cost-benefit analysis. The SLN was assessed by conventional postoperative histological evaluation in Group 1 (45 patients), and by OSNA in Group 2 (35 patients). The following variables were analysed: age, tumour size, histological type, number of SLNs, biopsy result, duration of surgery, days in hospital, postoperative complications, positive lymph nodes in the case of axillary lymphadectomy, cost per patient, hospitalisation cost, and cost per operation. Results: The duration of surgery of the first operation in Group 1 was significantly shorter, but the total time was also higher in this group. The mean hospital stay was longer in Group1 (P < .001). The mean cost of the hospital stay was higher in Group 1 compared to Group 2(P < .001), with a mean difference of 199.69 s. The mean cost of the surgery was higher in Group 1 (P < .001), with a mean difference of 157.49 s. The mean cost per SLN analysis was significantly higher in Group 1, with a mean difference of 162.5 s. The cost per patient was significantly higher in Group 1 (P < .005). A mean saving of 439.67 s per patient was achieved by using the OSNA method. Conclusion: Intraoperative molecular analysis for SLN metastases using the OSNA method reduces the number of admission days, duration of surgery, and achieves a saving of439.67 s per patient (AU)

[One-step nucleic acid amplification (OSNA) assay for sentinel lymph node metastases as an alternative to conventional postoperative histology in breast cancer: A cost-benefit analysis]. / El análisis molecular intraoperatorio (one-step nucleic acid amplification) del ganglio centinela como alternativa al estudio histopatológico diferido en el cáncer de mama: análisis coste-beneficio.

INTRODUCTION: Intraoperative molecular analysis for sentinel lymph node (SLN) metastases using the OSNA (one-step nucleic acid amplification) method has been already validated in breast cancer. The authors compared the cost of OSNA versus the conventional postoperative histopathologic evaluation in patients with breast cancer. METHODOLOGY: Patients with operable breast cancer and clinically and sonographic negative evaluation of the axilla, and who subsequently were operated on between the 15th of October 2008 and the 15th of December 2009 were included in this retrospective cost-benefit analysis. The SLN was assessed by conventional postoperative histological evaluation in Group 1 (45 patients), and by OSNA in Group 2 (35 patients). The following variables were analysed: age, tumour size, histological type, number of SLNs, biopsy result, duration of surgery, days in hospital, postoperative complications, positive lymph nodes in the case of axillary lymphadectomy, cost per patient, hospitalisation cost, and cost per operation. RESULTS: The duration of surgery of the first operation in Group 1 was significantly shorter, but the total time was also higher in this group. The mean hospital stay was longer in Group 1 (P<.001). The mean cost of the hospital stay was higher in Group 1 compared to Group 2 (P<.001), with a mean difference of 199.69 €. The mean cost of the surgery was higher in Group 1 (P<.001), with a mean difference of 157.49 €. The mean cost per SLN analysis was significantly higher in Group 1, with a mean difference of 162.5 €. The cost per patient was significantly higher in Group 1 (P<.005). A mean saving of 439.67 € per patient was achieved by using the OSNA method. CONCLUSION: Intraoperative molecular analysis for SLN metastases using the OSNA method reduces the number of admission days, duration of surgery, and achieves a saving of 439.67 € per patient.

Adenocarcinoma mucinoso de próstata. Presentación de un nuevo caso y revisión de la literatura / Mucinous adenocarcinoma of the prostate: case report and literature rewieu

OBJETIVOS: Presentación de un nuevo caso de adenocarcinoma mucinoso de próstata, con descripción general de sus características, así como de los estudios histoquímicos e inmunohistoquímicos que demuestran su origen prostático, y realizamos una revisión de la literatura. MÉTODOS Y RESULTADO: Varón de 53 años que acude a nuestra consulta para revisión prostática sin sintomatología previa. Presentaba un tacto rectal normal y un PSA de 35 ng/ml, por lo que se realizó biopsia prostática con el resultado de adenocarcinoma de próstata Gleason 3+3. Con estudio de extensión negativo, se practicó prostatectomía radical con un resultado anatomopatológico de adenocarcinoma mucinoso de próstata. El paciente sigue vivo sin evidencia de enfermedad tras un año de seguimiento, con normalización de los valores de PSA. CONCLUSIONES: El adenocarcinoma mucinoso de próstata es una rara variedad anatomopatológica, con una historia natural y un pronóstico no bien conocido en la actualidad, y que en líneas generales no responde a ninguna terapéutica, siendo característica la hormonorresistencia (AU)

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