Francisco G. La Rosa, MD

Francisco G. La Rosa, MD

University of Colorado, Denver

Aurora, Colorado

Francisco G. La Rosa, MD, is an Associate Professor in the Department of Pathology at the University of Colorado Anschutz Medical Campus in Denver. He is also a member of the University of Colorado Cancer Center. He is an active clinician, researcher, and teacher, and is board-certified in anatomic and clinical pathology. Additionally, Dr. La Rosa specializes in genitourinary, renal, and heart pathology, and is an expert in pathology informatics. Dr. La Rosa has more than 90 publications in peer-reviewed journals. He is an active member of many national and international organizations, including the College of American Pathologists, the American Urological Association, the Catholic Medical Association, the American Telemedicine Association, Asociación Iberoamericana de Teleslud y Telemedicina, and the Peruvian American Medical Association. As an investigator in genitourinary pathology, he is a member and study coordinator for the Southwest Oncology Group (SWOG) Genitourinary Committee, and a collaborator with the research groups led by Drs. E. David Crawford and Thomas W. Flaig in innovative technology for the diagnosis and treatment of prostate and urinary cancer.


Talks by Francisco G. La Rosa, MD

The Third Dimension in Prostate Cancer Diagnosis

Francisco G. La Rosa, MD, Associate Professor in the Department of Pathology at the University of Colorado Anschutz in Denver, discusses in vivo 3D imaging and how it can benefit physicians in treating prostate cancer. He explains that, unfortunately, most views of the prostate are just 2D, but clinicians require a 3D view to really understand a lesion. Dr. La Rosa then introduces his own process of creating a 3D model of the pelvic area and producing a 3D model of a prostate that could be used to practice biopsies and other procedures at the Butcher Symposium on Genomics and Biotechnology Workshop in 2007. He displays an image of a transrectal ultrasound (TRUS)-guided biopsy procedure, explaining that going through the rectum is challenging because of probe inflexibility but a system that takes a biopsy through both the rectum and perineum can solve this challenge. Dr. La Rosa’s proposed system uses a template through which a biopsy can be done through the perineum and information from the biopsy cores and ultrasound are run through in vivo 3D biomapping software. He concludes with a discussion of how multifocality can be more challenging to overcome and states that in vivo 3D examination provides physicians and patients with a reliable assessment of grade and stage of disease and the opportunity to choose the most appropriate therapeutic options, while also showing a highly accurate ability to detect clinically significant prostate cancer lesions as compared with 3D reconstruction of prostatectomy specimens.

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Can We Trust TRUS Biopsies?

Francisco G. La Rosa, MD, Associate Professor in the Department of Pathology at the University of Colorado Anschutz Medical Campus in Denver, evaluates the efficacy of transrectal ultrasonography (TRUS) biopsy and contrasts the technique with transperineal prostate mapping biopsy (TPMB). He describes the development of biopsy techniques, explains how to select a biopsy sample size, and demonstrates why the 360-degree view of the prostate offered by TPMB is advantageous. Dr. La Rosa underscores that sampling should be volume-dependent as the percentage of prostate cancer and high-grade prostatic intraepithelial neoplasia detected using a conventional 8-12 core biopsy declines as the volume of the prostate gland increases. He recommends a scaled approach, beginning with eight biopsy cores for glands up to 15cc and increasing up to 14-20 cores for glands over 50cc. Dr. La Rosa then contrasts TRUS with TPMB, remarking that the latter diagnoses prostate cancer in twice the number of patients and can detect or rule out more aggressive disease. Additionally, two-thirds of men with a previous negative TRUS biopsy were later diagnosed with prostate cancer after undergoing TPMB. Dr. La Rosa concludes that TPMB, which also has lower complication rates, is more reliable than TRUS biopsy.

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Second Opinion Diagnosis in Prostate Pathology

Francisco G. La Rosa, MD, discusses how poor preparation of biopsy and prostatectomy specimens, as well as pathologists’ misreadings, can lead to significant discrepancies in the diagnosis of prostate cancer. He emphasizes the importance of reevaluation by in-house urologic pathologists of all outside specimens before evaluating treatment options for patients.

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