| OUTCOME FOLLOWING
RADICAL PROSTATECTOMY New markers for Prostate Cancer Mr Simon R J Bott, Professor John R Masters
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What has been done and what will be next?
Over the past year the foundations have been laid for the laboratory-based research which will shortly begin and papers on clinical data gleaned from the radical prostatectomy database have been published and presented.
Laboratory based
Patients for this study have been selected from the database of over 900 patients. Patients with T3 disease have been chosen and two groups of patients have been matched: those that have relapsed within 2 years of surgery – and have presumed occult metastases (Pound 1997) at the time of surgery and those who are relapse free for at least 3 years. Two groups of 26 patients have been matched for preoperative PSA, Gleason grade and pathological stage – 30 patients are needed in each cohort for statistical analysis. The radical prostatectomy wholemounts have been retrieved together with the corresponding slides and Dr Connie Parkinson has marked the largest areas of tumour, which contain at least 70% malignant cells. The wholemounts have been sectioned at 10μm intervals and stained with haematoxylin and eosin to facilitate tumour identification. Malignant tissue has been exised from 30 patients using laser capture microdissection in collaboration with The Institute of Cancer Research, Fulham Road. DNA has been extracted using the DNAeasy kit (Quigen) and preliminary polymerase chain reaction experiments have been performed to confirm adequate DNA extraction.
In the next few weeks we anticipate concluding the matching process, retrieving the remaining wholemount blocks and lymph node blocks to act as the ‘normal’ DNA control. We will then be able to extract the DNA of the remaining patients and begin properly the Loss of Heterozygosity (LOH) studies. Immunoflourescent primers have been identified for this work.
Clinically based research
A paper entitled 'Anterior prostate cancer: is it more difficult to diagnose?' has been written and sent to the BJU international. This data collected from the prostate cancer database has been presented at the British Association of Urological Surgeons annual meeting in Dublin and in poster format at the British Prostate Group meeting in Manchester 2001. A paper entitled ‘Is anterior prostate cancer more difficult to diagnose’ was presented at the Royal Society of Medicine and won the AstraZeneca travelling fellowship to the American Urological Association in Los Angeles.
A questionnaire was devised and sent to 333 patients who underwent radical prostatectomy, performed by one surgeon. This examined cancer control, continence and potency after this procedure. The findings were presented at the Royal Society of Medicine and in poster format at the European Association of Urology.
Further work will look at the preoperative and postoperative characteristics in NHS compared with private patients. We are looking at the correlation between low cancer yield at prostate biopsy compared with the tumour volume on radical prostatectomy wholemounts and conversely the biopsy findings in patients who have tumours of <0.2mls on their wholemount sections.
Activity in the last year:
Publications
- Avoidance and management of positive surgical margins after radical prostatectomy. Bott SRJ, Parkinson MC, Kirby RS. Review article. Prostate Cancer and prostatic disease. Accepted August 2001
- Urethral wands for impotence. Bott SRJ, Eaton JD, Kirby RS. BJU International 2001; 87(4): 411
- Metallic stents in malignant strictures of the ureter. Bott SRJ, Kahn L, Copland RFP. BJU International 2000; 86(3): 407
- Anterior prostate cancer: is it more difficult to diagnose? Bott SRJ, Young MA, Parkinson MP. BJU International
- A prolapsing lesion from the ureteric orifice. Bott SRJ, Richmond P, Copland RFP. British Journal of Obstetrics and Gynaecology
- Urine extravasation from a needle vasotomy site - a rare complication of vasography. Bott SRJ, Arya M, Patel HRH, Ralph DJ. J Urol
Presentations
- Anterior prostate cancers and the difficulty of diagnosis. Bott SRJ et al BAUS June 2001
- The impact of radical retropubic prostatectomy on sexual function and urinary continence. Bott SRJ, Thomas K, Kirby RS. European Urological Association, Geneva. April 2001
- The effect of tumour location on diagnosis in prostate cancer. Bott SRJ, Young MA, Parkinson MP. British Prostate Group. March 2001
- Does the site of prostate cancer effect the chance of diagnosis? Bott SRJ, Young MA, Parkinson MP. RSM Section Urology. February 2001 - Prize Winner
- The impact of radical retropubic prostatectomy on urinary continence and sexual health. RSM Section Urology. November 2000.
Book Chapters
- BPH and Men’s health (book chapter: edited Prof CC Schulman)
- Future Strategies in BPH (book chapter: edited V Vincente)
- Medical management of BPH - chapter for RSM Key Facts series
Magazine articles
- The Management of BPH. Bott SRJ, Kirby RS. The Prescriber 2001, 12: 71-82
- PSA screening. Bott SRJ, Kirby RS The Practioner June 2001
- Lithotripsy – chapter in Inside the Human Body (patient magazine)
Research progress report by Mr SRJ Bott.
Project 2000/12. This work is continued in Project 2002/13 where further reports can be found