Publication: Histopathological changes induced by therapies in the benign prostate and prostate adenocarcinoma
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Date
2007
Authors
Petraki, C. ; Sfikas, C.P.
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
The effect of androgen deprivation and other
hormonal therapies, radiation therapy, thermal ablation
therapies, chemotherapy, and other systemic treatments
is evident in the histology of non-neoplastic and
neoplastic human prostate gland. Androgen deprivation
may be achieved with: a. orchidectomy, b. exogenous
oestrogen administration, c. drugs with the capacity to
deplete the hypothalamus of luteinizing hormonereleasing
hormone, d. antiandrogens administration:
drugs, which block the conversion of testosterone to its
active form of 5-alpha dihydrotestosterone (i.e.
finasteride, dutasteride), and drugs which block the
androgen receptor on individual cells (i.e. flutamide).
Androgen deprivation therapies cause atrophy of nonneoplastic
and neoplastic prostatic epithelium, as the
result of apoptosis, and are mainly used as a palliative
measure in metastatic prostate cancer or as neoadjuvant
or adjuvant treatment, in clinically localized prostate cancer. Morphological tumour regression may
complicate the recognition and grading of treated
carcinomas in radical prostatectomy specimens.
Radiation therapy may be applied in the form of external
beam, interstitial implantation (brachytherapy), or a
combination, as a mainstay or adjuvant (external beam)
treatment in localized prostate cancer. The primary effect
is the damage of endothelial cells, which cause ischemia
that leads to atrophy. The difficulty of post-radiation
prostate needle biopsy interpretation includes the
distinction of treatment effect in normal prostatic tissue
from recurrent or residual tumour. Histological changes
after thermal ablation mainly include lesions observed in
prostatic infarcts due to periurethral coagulative type
necrosis of variable volume. The correlation between the
histopathological effects of the above therapies and their
clinical significance is not absolutely clear.
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