title: Neuroendocrine differentiation is not prognostic of failure after radical prostatectomy but correlates with tumor volume.
abstract: OBJECTIVE
  To study neuroendocrine (NE) tumor cell differentiation in prostate cancer in relation to failure after radical prostatectomy.
  
  
  METHODS
  Radical prostatectomy specimens from 103 of 111 patients randomized to 3-month neoadjuvant luteinizing hormone-releasing hormone-analogue treatment (neoadjuvant group) or to surgery alone (control group) were available for analysis. Immunohistochemistry using antibodies to chromogranin A (CGA) enabled detection of tumor cells with NE differentiation. NE differentiation was scored as NE-negative (0 to 1+) or NE-positive (2 to 3+). The number of CGA-positive cells/cm(2) tumor area on the slides was assessed in a separate analysis. The patients were followed up for 39 months after surgery, and a prostate-specific antigen value of 0.5 ng/mL or greater in two consecutive blood samples was considered biochemical failure.
  
  
  RESULTS
  Kaplan-Meier analysis stratified for neoadjuvant hormonal treatment showed the failure rate to be significantly greater among those with NE-positive tumors than among those with NE-negative tumors. However, the number of CGA-positive cells/cm(2) was not a variable of prognostic significance. Instead, both NE differentiation and the CGA-positive cell count correlated with the tumor area on the slides (P = 0.0001). Multivariate analysis revealed the tumor area on the slide (P <0.0001) and positive surgical margins (P = 0.03) to be the only significant predictors of biochemical failure.
  
  
  CONCLUSIONS
  The extension of NE differentiation in prostate cancer correlates with tumor volume and is not an independent prognostic factor of failure after radical prostatectomy.
authors: Department of Urology, University Hospital, Malmö, Malmö, Sweden.
authors: G
authors: G
authors: Ahlegren
authors: K
authors: K
authors: Pedersen
authors: S
authors: S
authors: Lundberg
authors: G
authors: G
authors: Aus
authors: J
authors: J
authors: Hugosson
authors: P
authors: P
authors: Abrahamsson
mesh_terms: D014408:Biomarkers, Tumor / Q000737:chemistry*; D053379:Chromogranin A; D002864:Chromogranins / Q000032:analysis; D018572:Disease-Free Survival; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D020360:Neoadjuvant Therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D011467:Prostate / Q000473:pathology* / Q000601:surgery; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor; D053379:Chromogranin A; D002864:Chromogranins; D007987:Gonadotropin-Releasing Hormone