S. Joniau MD, PhD

BRCA2 gene mutation and risk of aggressive prostate cancer

Summary

BRCA2 mutation carriers generally present with prostate cancer at a younger age, with more aggressive disease and with a higher risk of nodal involvement or distant metastases at diagnosis. We present a patient with metastatic castrate resistant prostate cancer with a BRCA2 gene mutation and its clinical significance for daily practice.

(BELG J MED ONCOL 2016;10(6):223–227)

Genomic analysis of high-risk prostate cancer

Summary

Whole exome sequencing was performed on 38 high-risk prostate cancer samples. We confirmed recurrent mutations in prostate cancer-specific genes, but also identified genes not reported to be mutated, like TET1. This DNA hydroxymethylase converts methylcytosines to hydroxymethylcytosines as a first step in DNA demethylation. By immunohistochemistry, we detected decreased TET1 protein levels in tumour compared to surrounding non-tumour tissue. DNA hydroxymethylation followed the same course. Furthermore, TET1 mRNA expression levels are an independent predictor of metastasis-free survival in a larger retrospective cohort, indicating an important role for TET1 and hydroxymethylation in prostate cancer.
The LNCaP and C4-2B cell lines form an excellent preclinical model to study the development of metastatic castration-resistant prostate cancer. Both exome and transcriptome sequencing was performed: more than half of the mutations found in the exomes were confirmed in the RNA-sequencing data. Combining C4-2B-specific mutations with differentially expressed genes allowed the detection of changes in focal adhesion and ECM-receptor interactions, which might contribute to the metastatic potential of C4-2B cells.

(BELG J MED ONCOL 2016;10(4):139–142)

Prostatopubic fistula and osteomyelitis of the pubic bone as severe complication after salvage high intensity focused ultrasound for prostate cancer: report of two cases

Summary

High-intensity focused ultrasound has been used as an alternative treatment for prostate cancer, as both primary or salvage treatment. It is considered a minimally invasive treatment modality. We recently needed to care for two patients with severe osteomyelitis of the pubic bone as a result of a prostatopubic fistula, after they underwent salvage high-intensity focused ultrasound treatment post-radiotherapy.

(BELG J MED ONCOL 2015;9(7):290–95)

Resection of two metachronous solitary pulmonary metastases of prostate cancer after radical prostatectomy: an exceptional case

A solitary pulmonary metastasis of prostate cancer is not considered a surgical lesion. However, growing evidence supports that highly selected patients could benefit from metastasectomy of a solitary pulmonary metastasis. We present an exceptional case of resection of two metachronous pulmonary metastases of prostate cancer after previous radical prostatectomy, resulting in nearly undetectable prostate-specific antigen (0.04 ng/ml).

(BELG J MED ONCOL 2014;8(5):217–9)

High-risk localised prostate cancer: the role of surgery and the development of clinical outcome prediction models

This PhD thesis is aimed at elucidating some very important issues on high-risk prostate cancer: How can high-risk prostate cancer best be defined? Can we clearly define demarcated prognostic subgroups within the high-risk prostate cancer group which could allow improved patient counselling, comparison of different treatment strategies and proper trial design? What are the outcomes of surgery in high-risk prostate cancer and how can we identify those patients within the heterogeneous group of high-risk prostate cancer who would benefit most from surgery?

(BELG J MED ONCOL 2014;8(5):220–3)

Current perspectives on the use of the Gleason grading system for prostate cancer

For more than four decades the Gleason score is the most widely accepted histopathological grading system for prostate cancer. It is a 5-tier grading system that correlates with tumour differentiation and is solely based on architectural patterns within the tumour. Although robust over time, revision of Gleason grading became unavoidable as diagnosis and treatment of prostate cancer also underwent an enormous evolution over time. In 2005 the International Society of Urological Pathology (ISUP) proposed several modifications to the Gleason system which should keep this grading system timely. This review compares the original system to the modified Gleason system and especially focuses on the prognostic relevance of the modifications. It further deals with the question if the Gleason system will be able to keep its prominent role in the diagnostic and prognostic algorithm for prostate carcinoma, especially in the nearby molecular era. (BELG J MED ONCOL 2012;6:45–51)