Tumor size, vascular density and proliferation as prognostic markers in GS 6 and GS 7 prostate tumors in patients with long follow-up and non-curative treatment

• Objectives: To investigate the prognostic value of potential markers in localized, Gleason score 6 and 7 prostate cancer (PC). Methods: From a consecutive series of men with PC diagnosed at transurethral resection (1975-1990),. specimens from 132 patients without metastases, with Gleason score (GS) 6 (n = 80) or 7 (n = 52) tumors followed with watchful waiting were examined. The fraction of resected prostate tissue containing cancer, the micro-vessel density (v.d.) when stained for endoglin or von Willebrand factor (vWf), and the percentage of Ki-67 labeled tumor cells were measured using immunohistochemistry. Results: High levels of vWf v.d., endoglin v.d., and percent cancer of the TURP specimen were significantly associated with short cancer-specific survival in Kaplan-Meier analysis of all patients with GS 6 and 7 tumors. Interestingly, a combined estimate of percent cancer and vWF v.d. could be used to identify a large subset (50%) of GS 6 tumors with only a 2.5% risk of PC death within 15 years. None of the tested markers gave independent prognostic information for the GS 7 tumors. Conclusions: Estimates of tumor size and vascular density may identify a large proportion of non-aggressive GS 6, but not GS 7, tumors.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Urology and Nephrology (hsv//eng)

Nyckelord

Age Factors

Aged

Aged; 80 and over

Antigens; CD/metabolism

Follow-Up Studies

Humans

Immunohistochemistry

Ki-67 Antigen/metabolism

Male

Middle Aged

Neoplasm Staging

Neovascularization; Pathologic/blood/surgery

Predictive Value of Tests

Prognosis

Proportional Hazards Models

Prostate/*blood supply

Prostatic Neoplasms/blood/blood supply/*pathology/surgery

Receptors; Cell Surface/metabolism

Risk Factors

Severity of Illness Index

Survival Analysis

Time Factors

Transurethral Resection of Prostate

Tumor Burden

Tumor Markers; Biological/*blood

von Willebrand Factor/metabolism

Publikations- och innehållstyp

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