Relationship between serum markers and volume of liver metastases in castration-resistant prostate cancer.

BACKGROUND: Prostate cancer patients with liver metastases have a poor prognosis. To date, no study exists investigating the relationship between liver tumor burden and clinical laboratory markers. MATERIALS AND METHODS: Metastatic castrate-resistant prostate cancer (mCRPC) patients with radiographic evidence of liver metastases were selected for this study. Volumetric measurements of liver metastases were ascertained for all available patients. Prostate specific antigen (PSA), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin (ALB), total bilirubin and hemoglobin (HGB) levels were then assessed to coincide with the scan dates. Univariate and multivariate mixed-model regression analysis were performed to evaluate the relationship between laboratory markers and liver lesion volume. Data sets with non-normal distribution were logarithmically transformed. Akaike information criteria (AIC) was used to identify the most reliable multivariate model. RESULTS: In our heavily pretreated liver-metastatic patient population, univariate analysis demonstrated a statistically significant positive correlation between PSA (p = 0.0002), ALP (p = 0.0305), AST (p < 0.0001), ALT (p = 0.0049), and LDH (p = 0.0019) and liver lesion volume. Additionally, ALB (p = 0.0006) and HGB (p = 0.0103) had statistically significant negative correlation. Multivariate analysis identified AST and hemoglobin assessments as the best predictors of increasing liver lesion burden. Preliminary data on circulating tumor DNA (ctDNA) mutational and amplification findings are also reported. CONCLUSIONS: Analysis identified AST and hemoglobin as optimal predictors of liver lesion volume. These patients have a heavy burden of ctDNA abnormalities. Further studies with a larger patient population are needed to verify these results. Micro Abstract: This study investigates the association between liver lesion burden and clinical laboratory markers in castrate-resistant prostate cancer patients with hepatic metastases. Our univariate analysis identified multiple laboratory markers as significant indicators of worsening hepatic disease. Multivariate analysis demonstrated that AST and hemoglobin were the most effective predictors of change in liver lesion volume.

Radiology Case of the Month: Rising Creatinine in an Elderly Woman.

To assess an elevated creatinine, a 67-year old woman underwent renal ultrasound which incidentally revealed an abdominal aortic aneurysm (AAA).

Radiology case of the month. 49-year-old female with an anterior mediastinal mass.

Castleman's disease is an uncommon benign lymphoproliferative disorder characterized by hypervascular lymphoid hyperplasia. Two distinct histologic variants of Castleman's disease exist - hyaline vascular type and plasma cell type. The etiology is uncertain; however, it is thought to be inflammatory or hamartomatous in nature. Castleman's disease can occur at any age with a peak incidence in the third to fourth decade. This article presents a case of Castleman's disease in a female patient and aims to educate about the natural history, diagnosis, and management of the disease.