Comprehensive treatment for metastatic castration-resistant prostate cancer with neuroendocrine differentiation:a case report

Retrospective analysis of the progression of a case of metastatic castration-resistant prostate cancer with neuroendocrine differentiation:the patient was a 65 year old man with prostate adenocarcinoma on prostate biopsy,Gleason 4+4 score=8,70%,ISUP4 group,localized invasion of nerves.Progressed to metastatic castration-resistant prostate cancer after 8 months of novel endocrine therapy,persistent elevated PSA after endocrine therapy,chemotherapy,and radiation,abdominal metastasis,brain metastasis,gastric metastasis,and staging as neuroendocrine differentiation after second prostate biopsy,which is a highly malignant subtype and has been concerned as a mechanism of resistance to targeted therapies.We discuss how to choose a more optimal treatment plan and outline the patient's diagnostic and therapeutic course.We provide a reflection for the clinical study of metastatic castration-resistant prostate cancer with neuroendocrine type.

Clinical significance of serum TK1 and PNI in the prognosis of geriatric patients with advanced non-small cell lung cancer:a retrospective study

Objective:This study was designed to evaluate the clinical significance of the serum thymidine kinase 1(TK1)and prognosis nutrition index(PNI)in the prognosis of elderly patients with advanced non-small cell lung cancer(NSCLC).Methods:A total of 126 elderly patients with advanced non-small cell lung cancer from Jan.2015 to Apr.2016 were enrolled.The clinical,pathological and survival information were collected.The serum TK1 level was measured as well as PNI was calculated when the patient was admitted to our hospital for the first time.The relationship between serum TK1,PNI,and clinical prognostic characteristics was analyzed.The clinical significance of serum TK1 and PNI in the prognosis of elderly patients with advanced non-small cell lung cancer was investigated.Results:The results showed that the survival time of the patients was related to TK1 and PNI.The further Kaplan-Meier method and log-rank tests showed that the long-term outcome of the high-TK1 group was significantly worse than low-TK1 group(mOS,27 m vs.15 m,P=0.047).Besides,the Kaplan-Meier method and log-rank tests also showed that the long-term outcome of high-PNI group was significantly better than low-PNI group(mOS,31.5 m vs.16 m,P=0.015).However,the Spearman’s correlation analysis showed there was no correlation between PNI and TK1.The univariate and multivariate analysis showed that TK1,PNI and the number of metastatic sites were independent prognostic factors.Conclusions:The study confirmed the TK1 and PNI were independent prognostic factors of advanced NSCLC in the elderly.More attention worth is paid in routine clinical practice for patients cell proliferation and nutritional status.