Long-Term Assessment Of Prostate Cancer Progression Free Survival

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Cancer / Oncology
Article Date: 13 Oct 2008 - 3:00 PDT

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UroToday.com - In the online version of The Prostate, Dr. Robert W. Veltri and his colleagues from Johns Hopkins University reported on the correlation of molecular pathways and progression-free survival (PFS) in prostate cancer (CaP). The researchers investigated the prognostic significance of nuclear roundness variance (NRV), molecular biomarkers of cell proliferation (Ki67, PCNA), apoptosis (BCL2), neuroendocrine differentiation (Chromogranin A), angiogenesis (CD31), and Her-2/neu oncogene in radical prostatectomy (RP) specimens from 105 patients. The patients underwent surgery from 1975 to 1991 and had a mean follow-up of 17.3 years. Tissue blocks, re-embedded in fresh paraffin, were used for H&E staining and immunohistochemical staining for biomarkers. Biomarkers were scored by at least two experienced pathologists.

Almost all patients had stage T2 disease. CaP progression was defined as a PSA rise to 0.2ng/ml and above, or a positive bone scan or biopsy documenting recurrence. Spearman's rank correlation coefficients evaluated pathologic parameters with the biomarkers. Only NRV showed a significant correlation with the Gleason score. In multivariate regression analyses, the significant univariate predictors were included (Gleason score, organ confined status, non-focal extra-prostatic extension, NRV, Her-2/neu expression, CD31, and Ki-67). Gleason score, NRV and Her-2/neu expression remained significant in multivariate analysis. NRV was the most important predictor of PFS. Using parameters having greater than 50% inclusion frequency (Gleason score, NRV, and Her-2/neu) resulted in a concordance index of 0.77 for prediction of PFS. Only the small sample size and evaluation of parameters in clinical stage T2 disease were acknowledged limitations by the authors.

Veltri RW, Isharwal S, Miller MC, Epstein JI, Mangold LA, Humphreys E, Partin AW
Prostate. 2008 Sep 2. Epub ahead of print.
doi:10.1002/pros.20848

Written by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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