[Is tumour grade applicable to finasteride-treated prostate cancer?].
The treatment of prostate cancer by endocrine therapy induces histological changes of benign or malignant prostate glands. Treated cancers often have a more suspicious architecture, resulting in a higher Gleason score, while their nuclear grade (WHO) appears to be more reliable due to a reduction of the size of nuclei. Most authors appear to agree that cancers discovered by biopsy in patients treated with endocrine therapy should not be graded. A review of the literature appears to indicate that finasteride has less marked histomorphological consequences than other hormone-suppressor treatments and could have a lesser effect on the Gleason score. This paper, based on a review of the literature on this subject, emphasizes: (1) the extent of histological changes after androgen deprivation endocrine therapy; (2) histological changes after Finasteride and the difficulties of histological interpretation, particularly the risk of overestimating the Gleason histoprognostic score; (3) the need for urologists to indicate any treatment by 5-alpha-reductase inhibitors or androgen deprivation when requesting histological examination; (4) the value of collecting and documenting cases observed in the Uropathology Club in collaboration with the Oncology committee of the Association Française d'Urologie.
Molinié
Vincent
V
Fondation Hôpital Saint Joseph, Paris, France. vmolinie@hospital-saint-joseph.org
Ruffion
Alain
A
Allory
Yves
Y
Leroy
Xavier
X
Cochand Priollet
Béatrix
B
Paraf
François
F
de la Taille
Alexandre
A
D058891:5-alpha Reductase Inhibitors; D000818:Animals; D001284:Atrophy; D002986:Clinical Trials as Topic; D004791:Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D018120:Finasteride / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011467:Prostate / Q000187:drug effects / Q000473:pathology*; D011470:Prostatic Hyperplasia / Q000188:drug therapy / Q000473:pathology; D019048:Prostatic Intraepithelial Neoplasia / Q000188:drug therapy / Q000473:pathology; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000473:pathology*
D058891:5-alpha Reductase Inhibitors; D004791:Enzyme Inhibitors; D018120:Finasteride