1.Expert consensus on whole-course management of prostate cancer (2025 edition).
Chinese Journal of Oncology 2025;47(7):617-634
Prostate cancer represents a prevalent malignancy within the male genitourinary system. In recent years, its incidence in China has gradually increased, becoming a significant public health issue. While early detection correlates strongly with improved prognosis, the majority of newly diagnosed prostate cancer patients in China are already in intermediate or advanced stages, precluding curative-intent interventions and contributing to marked survival disparities. The progression of prostate cancer is lengthy, typically encompassing diagnosis, treatment, progression, metastasis, and death, accompanied by a decline in quality of life. Personalized treatment plans should be developed based on the disease stage and patient preferences. In non-metastatic prostate cancer, where the tumor is confined to the prostate, surgery and radiotherapy are the primary treatments, supplemented by neoadjuvant and adjuvant therapies to delay metastasis. For metastatic prostate cancer, systemic therapy is prioritized to prolong survival. In metastatic hormone-sensitive prostate cancer, controlling androgen levels is crucial, while treatment options for metastatic castration resistant prostate cancer are relatively limited, necessitating individualized and precise treatment. During prostate cancer management, prostate-specific antigen levels are closely linked to prognosis and require monitoring. Bone metastasis, the most common site in prostate cancer patients, often triggers skeletal-related events, demanding effective prevention and management. Treatment-related adverse reactions are also a clinical challenge, requiring balanced risk-benefit assessments and judicious drug selection to preserve quality of life. Rapid advancements in screening technologies, surgical innovations, drug development, and China-specific epidemiological factors further complicate decision-making in holistic prostate cancer management. To optimize the standardization of prostate cancer diagnosis and treatment in China, the Genitourinary Oncology Committee of Chinese Anti-cancer Association synthesized global guidelines, clinical evidence and clinical expertise, and addressed critical challenges in the whole-course management of prostate cancer to formulate a multidisciplinary consensus. The expert consensus on whole-course management of prostate cancer (2025 edition) establishes standardized protocols to guide clinical practice, improve treatment outcomes, and enhance patient quality of life.
Humans
;
Male
;
Prostatic Neoplasms/diagnosis*
;
Consensus
;
Prostate-Specific Antigen/blood*
;
Quality of Life
;
Prostatic Neoplasms, Castration-Resistant/pathology*
;
China
;
Bone Neoplasms/secondary*
;
Androgen Antagonists/therapeutic use*
2.Incomplete multimodal bone tumor image classification based on feature decoupling and fusion.
Qinghai ZENG ; Chuanpu LI ; Wei YANG ; Liwen SONG ; Yinghua ZHAO ; Yi YANG
Journal of Southern Medical University 2025;45(6):1327-1335
OBJECTIVES:
To construct a bone tumor classification model based on feature decoupling and fusion for processing modality loss and fusing multimodal information to improve classification accuracy.
METHODS:
A decoupling completion module was designed to extract local and global bone tumor image features from available modalities. These features were then decomposed into shared and modality-specific features, which were used to complete the missing modality features, thereby reducing completion bias caused by modality differences. To address the challenge of modality differences that hinder multimodal information fusion, a cross-attention-based fusion module was introduced to enhance the model's ability to learn cross-modal information and fully integrate specific features, thereby improving the accuracy of bone tumor classification.
RESULTS:
The experiment was conducted using a bone tumor dataset collected from the Third Affiliated Hospital of Southern Medical University for training and testing. Among the 7 available modality combinations, the proposed method achieved an average AUC, accuracy, and specificity of 0.766, 0.621, and 0.793, respectively, which represent improvements of 2.6%, 3.5%, and 1.7% over existing methods for handling missing modalities. The best performance was observed when all the modalities were available, resulting in an AUC of 0.837, which still reached 0.826 even with MRI alone.
CONCLUSIONS
The proposed method can effectively handle missing modalities and successfully integrate multimodal information, and show robust performance in bone tumor classification under various complex missing modality scenarios.
Humans
;
Bone Neoplasms/diagnosis*
;
Multimodal Imaging/methods*
;
Magnetic Resonance Imaging
;
Tomography, X-Ray Computed
;
Image Processing, Computer-Assisted/methods*
;
Algorithms
4.Expert consensus on clinical diagnosis and treatment of bone metastases and bone-related diseases of prostate cancer (2021 edition).
Chinese Journal of Oncology 2021;43(10):1016-1026
The morbidity and mortality of prostate cancer ascend yearly, which seriously threatens the health of the male population. Bone is the main metastasis site of prostate cancer, with bone metastases and skeletal-related events (SREs) occuring in more than 70% of patients with advanced prostate cancer. Bone metastases and the resulting SREs, such as spinal cord compression and pathological fracture, seriously affect the life quality of the patients. Although the active treatments of the primary disease is important, the application of bone-modifying agents to prevent SREs cannot be overlooked. However, there is no standard treatment procedure for the bone metastasis of prostate cancer at present. According to the clinical status, the Genitourinary Oncology Committee of Chinese Anti-cancer Association formulated this consensus, which integrated clinical evidence and real world clinical practices in China and abroad, to help clinicians make more accurate diagnosis and treatment for the bone metastases of prostate cancer with multidisciplinary strategies.
Bone Neoplasms
;
Bone and Bones
;
Consensus
;
Humans
;
Male
;
Prostatic Neoplasms/diagnosis*
;
Spinal Cord Compression/etiology*
5.Chinese expert consensus on multidisciplinary treatment of bone metastasis from colorectal cancer (2020 version).
Chinese Journal of Oncology 2020;42(6):433-437
With the extension of survival period and the improvement of imaging technology, the incidence of bone metastasis from colorectal cancer gradually increases. Therefore, the early diagnosis and treatment of bone metastasis should not be neglected while the primary lesion was controlled.Currently, the available evidence for bone metastasis from colorectal cancer is very limited. In this article, the Chinese Society of Colorectal Cancer organized multi-disciplinary experts to integrate the relevant studies worldwide and combine with clinical practice, focused on the issues and controversies about clinical characteristics, diagnosis and treatment, and follow-up of bone metastatic patients with colorectal cancer.After discussion and voting, Chinese expert consensus on multidisciplinary treatment of bone metastasis from colorectal cancer (2020 version) was formed. This consensus could provide clinicians with more detailed multidisciplinary treatment strategies for bone metastasis from colorectal cancer.
Asian Continental Ancestry Group
;
Bone Neoplasms
;
pathology
;
secondary
;
therapy
;
China
;
Colonic Neoplasms
;
diagnosis
;
therapy
;
Colorectal Neoplasms
;
diagnosis
;
therapy
;
Consensus
;
Humans
;
Interdisciplinary Communication
;
Patient Care Team
;
Practice Guidelines as Topic
;
Treatment Outcome
6.Clinical Characteristics of Temporal Bone Metastases
Kunho SONG ; Ki Wan PARK ; Jae Hyung HEO ; Ik Chan SONG ; Yong Ho PARK ; Jin Woong CHOI
Clinical and Experimental Otorhinolaryngology 2019;12(1):27-32
OBJECTIVES: The purposes of this study were to evaluate the clinical characteristics of temporal bone metastasis (TBM) and to determine whether the characteristics differed according to primary malignancy. METHODS: We retrospectively analyzed data on 20 patients diagnosed with TBM between January 2000 and January 2017. Demographics, the period from diagnosis of primary malignancy to TBM diagnosis, the period from TBM diagnosis to death, the type and staging of primary malignancy, otologic manifestations, and TBM sites were assessed. After the primary malignancies were divided into solid cancers and hematologic malignancies, each parameter was compared between the two groups. RESULTS: The most common primary malignancy with TBM was lung cancer (45%). The most common otologic symptoms and signs were facial palsy (30.5%) and hearing loss (30.5%). The temporal squama (23%) and the facial nerve (20%) were the most commonly involved. Most TBMs occurred late in the disease process after the primary malignancy first metastasized to other organs. Hematologic malignancies metastasized significantly more frequently to the external auditory canal and the middle ear/mastoid compared to solid cancers (P=0.001 and P=0.004, respectively). CONCLUSION: If otologic manifestations such as facial palsy and hearing loss are presented in patients at advanced stages of malignancy, TBM of primary malignancy should be suspected. In addition, hematologic malignancies tend to metastasize to the external auditory canal and the middle ear cleft more commonly than solid cancers do.
Demography
;
Diagnosis
;
Ear Canal
;
Ear, Middle
;
Facial Nerve
;
Facial Paralysis
;
Head and Neck Neoplasms
;
Hearing Loss
;
Hematologic Neoplasms
;
Humans
;
Leukemia
;
Lung Neoplasms
;
Neoplasm Metastasis
;
Retrospective Studies
;
Temporal Bone
7.Craniofacial Polyostotic Fibrous Dysplasia Initially Diagnosed in a Primary Care Unit.
Korean Journal of Family Medicine 2019;40(1):58-60
Fibrous dysplasia (FD) is a non-malignant bone tumor that typically behaves as a slow and indolent growing mass lesion. We report the case of a female patient presenting with headache and facial deformity and later diagnosed with polyostotic fibrous dysplasia (PFD). A 29-year-old woman visited Mealhada Primary Health Care Unit complaining of headache, nasal congestion, and hyposmia for several weeks. She also presented with facial deformity and painful swelling of the upper left orbit. X-ray imaging revealed a suspicious opacity in the left frontal sinus and a right shift of the nasal septum. Computed tomography and bone scintigraphy later confirmed a tumor involving the ethmoid and frontal bone. The patient was referred to the neurosurgery and otorhinolaryngology departments of a central hospital and the suspected diagnosis of PFD was confirmed. A watchful waiting approach with regular imaging screenings was proposed and accepted by the patient, who is now free of symptoms and more acceptant of the benign condition of her tumor. With this case, we aim to make family physicians more aware of this rare but relevant condition that can be difficult to diagnose. FD is a rare but benign tumor that occurs mainly in adolescents and young adults. Symptoms depend on the location and type of the tumor and include facial deformity, vision changes, nasal congestion, and headache. No clear guidelines exist for its treatment, and options include monitoring the progression of the tumor, in addition to medical or surgical approaches.
Adolescent
;
Adult
;
Bone Neoplasms
;
Congenital Abnormalities
;
Diagnosis
;
Estrogens, Conjugated (USP)
;
Female
;
Fibrous Dysplasia of Bone
;
Fibrous Dysplasia, Polyostotic*
;
Frontal Bone
;
Frontal Sinus
;
Headache
;
Humans
;
Mass Screening
;
Nasal Septum
;
Neurosurgery
;
Orbit
;
Otolaryngology
;
Physicians, Family
;
Primary Health Care*
;
Radionuclide Imaging
;
Watchful Waiting
;
Young Adult
8.A Report of Bone Marrow Metastasis of Colon Cancer as a Primary Diagnosis, Supported by Cytokeratin Immunohistochemical Staining
Laboratory Medicine Online 2019;9(2):103-106
Bone marrow metastasis of colon cancer is rare. Here, we report a 56-year-old female patient who presented with pancytopenia. She was diagnosed with colon cancer accompanied by lung and axial skeleton metastasis. The bone marrow study showed metastatic carcinoma. Immunohistochemical (IHC) staining with anti-cytokeratin 7 (CK7) and anti-cytokeratin 20 (CK20) antibodies showed that the bone marrow samples were negative for CK7 and positive for CK20, consistent with metastatic colon cancer. To the best of our knowledge, there has been only one other reported case of bone marrow metastasis of colon cancer as the primary diagnosis in an adult patient in Korea. Bone and bone marrow metastases of colon cancer are regarded as uncommon. However, for proper management, bone marrows should be promptly examined in patients with solid tumors when unexplained cytopenia is noted, even if the origin of the tumor is known to be rarely metastatic to bone marrow. In addition, the use of cytokeratin IHC staining is helpful for determining the origin of metastatic carcinoma.
Adult
;
Antibodies
;
Bone Marrow
;
Colon
;
Colonic Neoplasms
;
Diagnosis
;
Female
;
Humans
;
Immunohistochemistry
;
Keratins
;
Korea
;
Lung
;
Middle Aged
;
Neoplasm Metastasis
;
Pancytopenia
;
Skeleton
9.Effects of Thyrotropin Suppression on Bone Health in Menopausal Women with Total Thyroidectomy
Eun Heui KIM ; Yun Kyung JEON ; Kyoungjune PAK ; In Joo KIM ; Seong Jang KIM ; Seunghyeon SHIN ; Bo Hyun KIM ; Sang Soo KIM ; Byung Joo LEE ; Jeong Gyu LEE ; Tae Sik GOH ; Keunyoung KIM
Journal of Bone Metabolism 2019;26(1):31-38
BACKGROUND: This study examined the change in the trabecular bone score (TBS), areal bone mineral density (aBMD), and osteoporosis in postmenopausal women who underwent thyrotropin (TSH)-suppressive therapy for treating papillary thyroid cancer after a total thyroidectomy procedure. METHODS: We evaluated 36 postmenopausal women who received a total thyroidectomy for papillary thyroid cancer and were undergoing TSH suppressive therapy with levothyroxine. Postmenopausal women (n=94) matched for age and body mass index were recruited as healthy controls. The aBMD and TBS of the lumbar spine were compared between dual energy X-ray absorptiometry (DXA) at baseline and at follow-up after an average of 4.92 years. RESULTS: There was no significant difference in the rate of diagnoses of osteoporosis, osteopenia, or normal bone status between the 2 groups during the baseline DXA evaluation. However, the TBS was significantly lower whereas aBMD did not show significant difference at the time of baseline DXA measurement (1st DXA, 1.343±0.098 vs. 1.372±0.06317, P < 0.001; 2nd DXA, 1.342±0.095 vs. 1.370±0.062, P < 0.001). The TBS and aBMD did not differ significantly between the initial and follow-up DXA images in both groups of TSH suppressive patients and controls. CONCLUSIONS: The average value of TBS and aBMD did not significantly change during the follow-up period. The TSH suppressive therapy was revealed as not a significant factor for the progressive deterioration of bone status during long term follow-up.
Absorptiometry, Photon
;
Body Mass Index
;
Bone Density
;
Bone Diseases, Metabolic
;
Diagnosis
;
Female
;
Follow-Up Studies
;
Humans
;
Osteoporosis
;
Postmenopause
;
Spine
;
Thyroid Neoplasms
;
Thyroidectomy
;
Thyrotropin
;
Thyroxine
10.A Case of Bone Marrow Necrosis in B-Acute Lymphoblastic Leukemia with Philadelphia Chromosome at Presentation.
In Hwa JEONG ; Gyu Dae AN ; Hyeon Ho LIM ; Kwang Sook WOO ; Kyeong Hee KIM ; Jeong Man KIM ; Ji Hyun LEE ; Jin Yeong HAN
Laboratory Medicine Online 2018;8(4):171-176
Bone marrow necrosis (BMN) is a pathologic state which is derived from various disease entities. Most commonly, it is accompanied by hematologic malignancies such as acute leukemia. The patients with marrow necrosis are generally known to have dismal prognoses but variations exist according to early diagnosis. Here we report a case of BMN in an acute lymphoblastic leukemia patient with Philadelphia chromosome at presentation.
Bone Marrow*
;
Early Diagnosis
;
Hematologic Neoplasms
;
Humans
;
Leukemia
;
Necrosis*
;
Philadelphia Chromosome*
;
Precursor Cell Lymphoblastic Leukemia-Lymphoma*
;
Prognosis

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