Independent prognostic importance of microvessel density in clinically localized prostate cancer.
BACKGROUND
Previous studies have reported a possible prognostic importance of microvessel density (MVD) in prostate cancer, although the significance after radical prostatectomy is not clear. The purpose of this study was to assess the prognostic value of MVD in clinically localized prostatic adenocarcinomas, focusing on moderately-differentiated tumours.


METHODS
We examined a series of 104 patients treated for presumed organ-confined cancer in the period 1988-94. The area of highest tumour grade was selected from the prostatectomy specimens and vessels were high-lighted by staining for factor-VIII-related antigen. MVD was quantitated in the "hot spot" area and related to biochemical failure and clinical recurrence.


RESULTS
In moderately differentiated tumours (WHO grade) (n = 66), MVD was associated with preoperative s-PSA and positive surgical margins. In univariate 5-year analysis, microvessel density (MVDmean > 122 mm-2, median) (p = 0.0074), s-PSA, tumour dimension, capsular penetration, seminal vesicle invasion and positive surgical margins were all significant predictors of biochemical failure, while MVDmean (p = 0.0084) was the only statistically significant predictor of clinical recurrence. In multivariate Cox' analysis, MVDmean (p = 0.0003), capsular penetration and tumour dimension remained as independent predictors of biochemical failure.


CONCLUSIONS
Assessment of MVD in moderately differentiated prostatic adenocarcinomas may improve the prognostic stratification of patients after radical prostatectomy.
Department of Pathology, Gade Institute, Haukeland University Hospital, N-5021 Bergen, Norway. Ole.Halvorsen@gades.uib.no
O J
OJ
Halvorsen
S
S
Haukaas
P A
PA
Høisaeter
L A
LA
Akslen
D000230:Adenocarcinoma / Q000098:blood supply* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000368:Aged; D000704:Analysis of Variance; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008833:Microcirculation / Q000473:pathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000098:blood supply* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012669:Seminal Vesicles / Q000473:pathology; D015996:Survival Rate; D014841:von Willebrand Factor / Q000032:analysis
D014841:von Willebrand Factor; D017430:Prostate-Specific Antigen