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TL;DR: One hundred and fifty cases of tumor of the bladder have been studied as to age, symptomatology, type of tumor, treatment and end result and thirty-seven autopsies have been analyzed.
Abstract: 1. 1. One hundred and fifty cases of tumor of the bladder have been studied as to age, symptomatology, type of tumor, treatment and end result. 2. 2. Thirty-seven autopsies have been analyzed as to type and grade of cancer, presence and distribution of metastases, and existence of other pathological conditions.
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TL;DR: Unlike most other malignancies, prostate cancer metastasizes preferentially to the skeleton and elicits osteoblastic reactions.
Abstract: BACKGROUND
Unlike most other malignancies, prostate cancer metastasizes preferentially to the skeleton and elicits osteoblastic reactions.
METHODS
We present a hypothesis, based upon results obtained from our laboratory and others, on the nature of progression of prostate cancer cells and their predilection to growth and metastasis in the bone microenvironment. We propose the hypothesis that osseous metastatic prostate cancer cells must be osteomimetic in order to metastasize, grow, and survive in the skeleton. The reciprocal interaction between prostate cancer and bone stromal growth factors, including basic fibroblast growth factor (bFGF), hepatocyte growth factor/scatter factor (HGF/SF), and especially the insulin growth factor (IGF) axis initiates bone tropism, and is enhanced by prostate secreted endothelin-1 (ET-1) and urokinase-type plasminogen activator (uPA). Growth factors and peptides that have differentiating activity, such as transforming growth factor beta (TGF-β), parathyroid hormone-related protein (PTH-rp), and the bone morphogenetic proteins (BMPs), can shift local homeostasis to produce the characteristic blastic phenotype, via interaction with prostate-secreted human kalikrein 2 (hK2), and prostate-specific antigen (PSA). This proposal asserts that altering the expression of certain critical transcription factors, such as Cbfa and MSX in prostate cancer cells, which presumably are under the inductive influences of prostate or bone stromal cells, can confer profiles of gene expression, such as osteopontin (OPN), osteocalcin (OC), and bone sialoprotein (BSP), that mimic that of osteoblasts.
RESULTS AND CONCLUSIONS
Elucidation of common proteins, presumably driven by the same promoters, expressed by both prostate cancer and bone stromal cells, could result in the development of novel preventive and therapeutic strategies for the treatment of prostate cancer skeletal metastasis. Agents developed using these strategies could have the potential advantage of interfering with growth and enhancing apoptosis in both prostate cancer and bone stromal compartments. The selective application of gene therapy strategy, driven by tissue-specific and tumor-restricted promoters for the safe delivery and expression of therapeutic genes in experimental models of prostate cancer metastasis, is discussed. Prostate 39:246–261, 1999. © 1999 Wiley-Liss, Inc.
442 citations
TL;DR: The present study highlights the heterogeneity--histologically and immunophenotypically--of metastatic CaP, and suggests that therapy directed to the phenotype of 1 metastasis may have no effect on other metastases in the same patient because of phenotypic heterogeneity.
302 citations
TL;DR: The relevance of the marked variability and unpredictability in the natural history of prostatic cancer thus revealed to treatment decisions and interpretations of the results of treatment in the aging host are indicated.
Abstract: Various possibilities in the stage progression of prostatic carcinoma in the untreated host are supported by an analysis of pertinent literature. The relevance of the marked variability and unpredictability in the natural history of prostatic cancer thus revealed to treatment decisions and interpretations of the results of treatment in the aging host are indicated.
253 citations
TL;DR: Based on the prospective data generated in this study lymphatic metastasis appears to be an early event in the spread of prostatic cancer.
252 citations
TL;DR: High stage, large size and poor histological differentiation were associated with a significantly higher probability of pelvic node metastases and the response of the primary tumor to irradiation was significantly higher among patients with small stage B tumors and/or those with negative pelvic lymph nodes.
191 citations