OT- SpectroscopyNOW- Reflecting on the prostate: Cancer margins

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Reflecting on prostate cancer

Light reflectance spectroscopy, which measure backscattered light, can be used to differentiate between malignant and benign prostatic tissue with 85 percent accuracy, according to US researchers. The finding might be used in real-time tissue analysis to guide the surgeon during prostate cancer.

Urologist Jeffrey Cadeddu of the University of Texas Southwestern Medical Center and colleagues, Aaron Lay, Payal Kapur and Claus Roehrborn, explain that the surgical removal of all cancerous tissue and the sparing of the surrounding healthy tissue during a prostatectomy is not always a completely successful procedure. The removal of healthy tissue can cause problems but leaving behind malignant cells can lead to the recurrence of the prostate cancer.

A real-time approach to guide the surgeon's knife more precisely than ever before could improve the outcome for thousands of men undergoing treatment each year. Radical surgery to remove the prostate gland is often called for, but traditional techniques to assess how much surrounding tissue needs to be removed concurrently are time consuming and do not have proven clinical utility, although cutting too shallow can leave behind problematic cells, "positive surgical margins."

Minimal invasion

"We used a novel light reflectance spectroscopy probe to evaluate surgical margins on radical prostatectomy tissue specimens and correlated the findings with pathological examination," explains Cadeddu; he and his team published details in The Journal of Urology recently. Follow-up studies will be needed to confirm how well the spectroscopic technique might work in the operating theatre.

The team enrolled men with intermediate to high-risk disease requiring radical prostatectomy and examined the prostate tissue following removal with spectroscopic technique, focusing specifically on suspicious malignant and benign prostate margins. Each sample was analyzed and correlated with pathological samples, which were analysed after surgery. In total light reflectance spectroscopy was carried out on 17 prostate gland specimens of which 11 were proven positive histologically; 22 negative surgical margins were measured. The team found that their optical probe could predict positive surgical margins with 85 percent sensitivity, 86 percent specificity, and 86 percent accuracy.

Survival improver?

"This study highlights one of a growing number of technology platforms that aim to improve the outcomes of cancer surgery," explains Cadeddu, an expert in minimally invasive urological surgical techniques. "Further study is required to determine whether such analysis may be used in real time to improve surgical decision-making and decrease the amount of tissue surgeons need to remove."

Prostate cancer is the most common form of the disease in men, second only to skin cancer. It is the second biggest cancer killer in men after lung cancer with more than one in ten affected dying of the disease. "Our next step is to expand to more patients and develop a larger experience to further improve accuracy of technology," Cadeddu told SpectroscopyNOW. "Ultimately, we hope to see the technology commercialize