Tolkach Y, Kristiansen G (2018) The heterogeneity of prostate cancer: A practical approach. Pathobiology 85:108–116. https://doi.org/10.1159/000477852

Article  CAS  PubMed  Google Scholar 

Haffner MC, Zwart W, Roudier MP, True LD, Nelson WG, Epstein JI, Marzo AMD, Nelson PS, Yegnasubramanian S (2021) Genomic and phenotypic heterogeneity in prostate cancer. Nat Rev Urol 18:79–92. https://doi.org/10.1038/s41585-020-00400-w

Article  PubMed  Google Scholar 

Sathianathen NJ, Konety BR, Crook J, Saad F, Lawrentschuk N (2018) Landmarks in prostate cancer. Nat Rev Urol 15:627–642. https://doi.org/10.1038/s41585-018-0060-7

Article  PubMed  Google Scholar 

Huang CC, Deng FM, Kong MX, Ren Q, Melamed J, Zhou M (2014) Re-evaluating the concept of ‘dominant/index tumor nodule’ in multifocal prostate cancer. Virchows Arch 464:589–594. https://doi.org/10.1007/s00428-014-1557-y

Article  CAS  PubMed  Google Scholar 

Ibeawuchi C, Schmidt H, Voss R, Titze U, Abbas M, Neumann J, Eltze E, Hoogland AM, Jenster G, Brandt B, Semjonow A (2013) Genome-wide investigation of multifocal and unifocal prostate cancer-are they genetically different? Int J Mol Sci 14:11816–11829. https://doi.org/10.3390/ijms140611816

Article  CAS  PubMed  PubMed Central  Google Scholar 

Karavitakis M, Ahmed HU, Abel PD, Hazell S, Winkler MH (2011) Tumor focality in prostate cancer: Implications for focal therapy. Nat Rev Clin Oncol 8:48–55. https://doi.org/10.1038/nrclinonc.2010.190

Article  PubMed  Google Scholar 

Stamatiou KN, Dilernia GC, Ilias GK, Daskalopoulos GK, Koutelekos IK, Marianou SN, Sofras FA (2009) The phenomenon of multifocality does not affect the biologic behavior of histologic prostate carcinoma. Med Sci Monit 15:61–63

Google Scholar 

Choi YH, Yu JW, Jeong BC, Seo SI, Jeon SS, Lee HM, Jeon HG (2019) Histological characteristics of the largest and secondary tumors in radical prostatectomy specimens and implications for focal therapy. Diagn Pathol 14:1–6. https://doi.org/10.1186/s13000-019-0782-8

Article  Google Scholar 

Zhang W, Wang T, Wang Y, Zhu F, Shi H, Zhang J, Wang Z, Qu M, Zhang H, Wang T, Qian Y, Yang J, Gao X, Li J (2022) Intratumor heterogeneity and clonal evolution revealed in castration-resistant prostate cancer by longitudinal genomic analysis. Transl Oncol 16:101311. https://doi.org/10.1016/j.tranon.2021.101311

Article  CAS  PubMed  Google Scholar 

Xu J, Isaacs WB, Mamawala M et al (2021) Association of prostate cancer polygenic risk score with number and laterality of tumor cores in active surveillance patients. Prostate 81:703–709. https://doi.org/10.1002/pros.24140

Article  CAS  PubMed  PubMed Central  Google Scholar 

Wu B, Lu X, Shen H, Yuan X, Wang X, Yin N, Sun L, Shen P, Hu C, Jian H, Wang D (2020) Intratumoral heterogeneity and genetic characteristics of prostate cancer. Int J Cancer 146:3369–3378. https://doi.org/10.1002/ijc.32961

Article  CAS  PubMed  Google Scholar 

De Vargas RL, Jacobs A, Rueschoff JH et al (2022) Single-cell proteomics defines the cellular heterogeneity of localized prostate cancer. Cell Reports Med 3:100604. https://doi.org/10.1016/j.xcrm.2022.100604

Article  CAS  Google Scholar 

Løvf M, Zhao S, Axcrona U et al (2019) Multifocal Primary Prostate Cancer Exhibits High Degree of Genomic Heterogeneity. Eur Urol 75:498–505. https://doi.org/10.1016/j.eururo.2018.08.009

Article  CAS  PubMed  Google Scholar 

Boutros PC, Fraser M, Harding NJ et al (2015) Spatial genomic heterogeneity within localized, multifocal prostate cancer. Nat Genet 47:736–745. https://doi.org/10.1038/ng.3315

Article  CAS  PubMed  Google Scholar 

Salami SS, Hovelson DH, Kaplan JB et al (2018) Transcriptomic heterogeneity in multifocal prostate cancer. JCI insight 3:e123468. https://doi.org/10.1172/jci.insight.123468

Article  PubMed  PubMed Central  Google Scholar 

Andreoiu M, Cheng L (2010) Multifocal prostate cancer: biologic, prognostic, and therapeutic implications. Hum Pathol 41:781–793. https://doi.org/10.1016/j.humpath.2010.02.011

Article  PubMed  Google Scholar 

Vendramin R, Litchfield K, Swanton C (2021) Cancer evolution: Darwin and beyond. EMBO J 40:e108389. https://doi.org/10.15252/embj.2021108389

Article  CAS  PubMed  PubMed Central  Google Scholar 

Erickson A, Hayes A, Rajakumar T, Verrill C, Bryant RJ, Hamdy FC, Wedge DC, Woodcock DJ, Mills IG, Lamb AD (2021) A Systematic Review of Prostate Cancer Heterogeneity: Understanding the Clonal Ancestry of Multifocal Disease. Eur Urol Oncol 4:358–369. https://doi.org/10.1016/j.euo.2021.02.008

Article  PubMed  Google Scholar 

Abeshouse A, Ahn J, Akbani R et al (2015) The Molecular Taxonomy of Primary Prostate Cancer. Cell 163:1011–1025. https://doi.org/10.1016/j.cell.2015.10.025

Article  CAS  Google Scholar 

Wang X, Grasso CS, Jordahl KM et al (2020) Copy number alterations are associated with metastatic-lethal progression in prostate cancer. Prostate Cancer Prostatic Dis 23:494–506. https://doi.org/10.1038/s41391-020-0212-8

Article  CAS  PubMed  PubMed Central  Google Scholar 

Hernández-Llodrà S, Juanpere N, de Muga S et al (2017) ERG overexpression plus SLC45A3 (prostein) and PTEN expression loss : Strong association of the triple hit phenotype with an aggressive pathway of prostate cancer progression. Oncotarget 8:74106–74118. https://doi.org/10.18632/oncotarget.18266

Article  PubMed  PubMed Central  Google Scholar 

Segalés L, Juanpere N, Lorenzo M, Albero-González R, Fumadó L, Cecchini L, Bellmunt J, Lloreta-Trull J, Hernández-Llodrà S (2019) Strong cytoplasmic ETV1 expression has a negative impact on prostate cancer outcome. Virchows Arch 475:457–466. https://doi.org/10.1007/s00428-019-02573-1

Article  CAS  PubMed  Google Scholar 

Hernández-Llodrà S, Segalés L, Juanpere N, Lorenzo M, Salido M, Nonell L, López D, Rodríguez-Vida A, Bellmunt J, Fumadó L, Cecchini L (2021) Lloreta-Trull J (2021) SPOP and CHD1 alterations in prostate cancer: Relationship with PTEN loss, tumor grade, perineural infiltration, and PSA recurrence. Prostate 81:1267–1277. https://doi.org/10.1002/pros.24218

Article  CAS  PubMed  Google Scholar 

Hernández S, Font-Tello A, Juanpere N, de Muga S, Lorenzo M, Salido M, Fumadó L, Serrano L, Cecchini L, Serrano S, Lloreta J (2016) Concurrent TMPRSS2-ERG and SLC45A3-ERG rearrangements plus PTEN loss are not found in low grade prostate cancer and define an aggressive tumor subset. Prostate 76:854–865. https://doi.org/10.1002/pros.23176

Article  CAS  PubMed  Google Scholar 

Salgado R, Aftimos P, Sotiriou C, Desmedt C (2015) Evolving paradigms in multifocal breast cancer. Semin Cancer Biol 31:111–118. https://doi.org/10.1016/j.semcancer.2014.07.002

Article  PubMed  Google Scholar 

Simmer F, van der Linden RLA, Ligtenberg MJL et al (2021) Multifocal Colorectal Cancer—Do Intraluminal Metastases Occur? Gastroenterology 160:1853–1855. https://doi.org/10.1053/j.gastro.2020.12.010

Article  PubMed  Google Scholar 

Leventakos K, Peikert T, Midthun DE et al (2017) Management of Multifocal Lung Cancer: Results of a Survey. J Thorac Oncol 12:1398–1402. https://doi.org/10.1016/j.jtho.2017.05.013

Article  PubMed  PubMed Central  Google Scholar 

Karavitakis M, Ahmed HU, Abel PD, Hazell S, Winkler MH (2012) Anatomically versus biologically unifocal prostate cancer: A pathological evaluation in the context of focal therapy. Ther Adv Urol 4:155–160. https://doi.org/10.1177/1756287212447092

Article  PubMed  PubMed Central  Google Scholar 

Tourinho-Barbosa R, Srougi V, Nunes-Silva I, Baghdadi M, Rembeyo G, Eiffel SS, Barret E, Rozet F, Galiano M, Cathelineau X, Sanchez-Salas R (2018) Biochemical recurrence after radical prostatectomy : what does it mean? Int Braz J urol 44:14–21. https://doi.org/10.1590/S1677-5538.IBJU.2016.0656

Article  PubMed  PubMed Central  Google Scholar 

Kneppers J, Krijgsman O, Melis M, de Jong J, Peeper DS, Bekers E, van der Poel HG, Zwart W, Bergman AM (2019) Frequent clonal relations between metastases and non-index prostate cancer lesions. JCI Insight 4:e124756. https://doi.org/10.1172/jci.insight.124756

Article  PubMed  PubMed Central  Google Scholar 

Rice KR, Furusato B, Chen Y, McLeod DG, Sesterhenn IA, Brassell SA (2009) Clinicopathological Behavior of Single Focus Prostate Adenocarcinoma. J Urol 182:2689–2694. https://doi.org/10.1016/j.juro.2009.08.055

Article  PubMed  Google Scholar 

Masterson TA, Cheng L, Mehan RM, Koch MO (2011) Tumor focality does not predict biochemical recurrence after radical prostatectomy in men with clinically localized prostate cancer. J Urol 186:506–510. https://doi.org/10.1016/j.juro.2011.03.106

Article  PubMed  Google Scholar 

Iremashvili V, Pelaez L, Manoharan M, Acosta K, Rosenberg DL, Soloway MS (2012) Tumor focality is not associated with biochemical outcome after radical prostatectomy. Prostate 72:762–768. https://doi.org/10.1002/pros.21481

Article  PubMed  Google Scholar 

Arora K, Barbieri C (2018) Molecular Subtypes of Prostate Cancer. Curr Oncol Rep 20:55–58. https://doi.org/10.1007/s11912-018-0707-9

Article  CAS