The increasing incidence and prevalence of prostate cancer in the United States has emphasized the need for methods that enhance early detection of clinically important tumors. The dilemma that remains is that many men harbor prostatic carcinomas that do not become clinically significant in their lifetimes. A better understanding of the early natural history and morphometric characteristics of this disease could provide a basis for more meaningful intervention efforts. Specimens from needle biopsies and radical prostatectomies have provided much information regarding the morphologic characteristics of this disease. However, analysis of such specimens is hampered by the fact that a given patient can be biopsied only a limited number of times and can have a prostatectomy only once. Computer models based on reconstructions of autopsy prostates or radical prostatectomy specimens provide a solution to this problem. This application outlines the rationales and methods to use computer simulations to address a series of translational issues including: 1) optimization of needle biopsy techniques, 2) identification of under-sampled regions of the prostate, 3) definition of clinically significant and insignificant tumors, 4) differences between palpable and non-palpable carcinomas, 5) estimation of tumor volume by needle biopsies, 6) influence of serum PSA on biopsy strategies, 7) influence of age and race on carcinoma characteristics, 8) strategies for successive biopsies and 9)changes in carcinoma characteristics attributable to changes in clinical practice. In addition, immunohistochemical data will be incorporated to address tumor heterogeneity and sampling limitations. The overall goal is to provide more quantitative information about the biomorphometric characteristics of the early stages of prostatic cancer that can be used to improve the clinical management of this increasingly important disease.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
2R01CA066161-03
Application #
2503987
Study Section
Special Emphasis Panel (ZRG2-MEP (02))
Program Officer
Jacobson, James W
Project Start
1996-02-21
Project End
2001-01-31
Budget Start
1998-02-01
Budget End
1999-01-31
Support Year
3
Fiscal Year
1998
Total Cost
Indirect Cost
Name
University of Colorado Denver
Department
Pathology
Type
Schools of Medicine
DUNS #
065391526
City
Aurora
State
CO
Country
United States
Zip Code
80045
Werahera, Priya N; Crawford, E David; La Rosa, Francisco G et al. (2013) Anterior tumors of the prostate: diagnosis and significance. Can J Urol 20:6897-906
Werahera, Priya N; Sullivan, Kathryn; La Rosa, Francisco G et al. (2012) Optimization of prostate cancer diagnosis by increasing the number of core biopsies based on gland volume. Int J Clin Exp Pathol 5:892-9
Werahera, Priya N; Glode, L Michael; La Rosa, Francisco G et al. (2011) Proliferative tumor doubling times of prostatic carcinoma. Prostate Cancer 2011:301850
Crawford, E David; Wilson, Shandra S; Torkko, Kathleen C et al. (2005) Clinical staging of prostate cancer: a computer-simulated study of transperineal prostate biopsy. BJU Int 96:999-1004
Werahera, Priya N; Miller, Gary J; Torkko, Kathleen et al. (2004) Biomorphometric analysis of human prostatic carcinoma by using three-dimensional computer models. Hum Pathol 35:798-807
Kawata, Nozomu; Miller, Gary J; Crawford, E David et al. (2003) Laterally directed biopsies detect more clinically threatening prostate cancer: computer simulated results. Prostate 57:118-28
Miller, G J; Torkko, K C (2001) Natural history of prostate cancer--epidemiologic considerations. Epidemiol Rev 23:14-8
Ruijter, E T; Miller, G J; van de Kaa, C A et al. (1999) Molecular analysis of multifocal prostate cancer lesions. J Pathol 188:271-7
Hirano, D; Werahera, P N; Crawford, E D et al. (1998) Morphological analysis and classification of latent prostate cancer using a 3-dimensional computer algorithm: analysis of tumor volume, grade, tumor doubling time and life expectancy. J Urol 159:1265-9
Crawford, E D; Hirano, D; Werahera, P N et al. (1998) Computer modeling of prostate biopsy: tumor size and location--not clinical significance--determine cancer detection. J Urol 159:1260-4

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