Francisco G. La Rosa | Grand Rounds in Urology

Francisco G. La Rosa, MD

University of Colorado, Anschutz Medical Campus

Aurora, Colorado

Francisco G. La Rosa, MD, FCAP, serves as an Associate Professor in the Department of Pathology at the University of Colorado Anschutz Medical Campus and is a distinguished member of the University of Colorado Cancer Center. He originally graduated as an M.D. in Lima, Peru, with Residency in Clinical Pathology, followed by Residency in Anatomic and Clinical Pathology at the “University of Colorado.” He is Board Certified in anatomic and clinical pathology, and specializes in genitourinary, renal, and heart pathology. He is also recognized as an expert in pathology informatics. Dr. La Rosa actively engages in clinical practice, research, and education with over 100 publications in refereed journals. His primary hobbies include photography and videography, both of which he has utilized for educational purposes by creating several websites dedicated to the teaching of pathology. Dr. La Rosa holds memberships in several national and international organizations, including the College of American Pathologists, American Urological Association, Peruvian American Medical Association, Catholic Medical Association and Association for Pathology Informatics. His research involvement extends to collaboration on various research grants in genitourinary pathology, and he serves as a member and study coordinator at the Southwest Oncology Group (SWOG), Genitourinary Committee. Most notably, he collaborates closely with Dr. E. David Crawford and his team on cutting-edge technology for diagnosing and treating prostate and urinary cancers. As a faculty member of Grand Rounds in Urology, he actively participates in various innovative educational activities within the field of urology. As a graduate from the Teaching Scholar Program at the University of Colorado, Dr. La Rosa imparts his knowledge to medical students, as well as pathology residents and fellows. His commitment to excellence in teaching has earned him several recognitions. Beyond national borders, Dr. La Rosa is recognized as an Honorary Professor at the Medical School Hipolito Unanue of the National University Federico Villarreal in Lima, Peru. He also serves as the co-founder and current Administrator of the Asociación Iberoamericana de Telesalud y Telemedicina (AITT) and holds the position of founder and Editor-in-Chief of the international journal Revista de la AITT (ISSN 2411-3840). The mission of these endeavors is to promote and coordinate programs and activities in telehealth and telemedicine among Latin American countries. Additionally, he serves on several international scientific committees and editorial boards of scientific journals, further contributing to the global advancement of pathology.

Disclosures:

Talks by Francisco G. La Rosa, MD

The Third Dimension in Prostate Cancer Diagnosis

Posted by Francisco G. La Rosa, MD | Sep 2021

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.

Can We Trust TRUS Biopsies?

Posted by Francisco G. La Rosa, MD | Aug 2021

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.

Second Opinion Diagnosis in Prostate Pathology

Posted by Francisco G. La Rosa, MD | Jun 2019

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.

Q&A Ask the Expert | Re-Evaluating Patients with Gleason 8

Posted by Francisco G. La Rosa, MD | Nov 2017

E. David Crawford, MD asked expert Francisco G. La Rosa, MD, FACS about reporting Gleason grades....