title: The role of volume-weighted mean nuclear volume in predicting tumour biology and clinical behaviour in patients with prostate cancer undergoing watchful waiting.
abstract: OBJECTIVE
  To investigate whether the volume-weighted mean nuclear volume (MNV, the only means by which unbiased estimates of three-dimensional variables can be obtained from a two-dimensional section by stereological methods) at diagnosis correlates with tumour biology and clinical behaviour in patients with prostate cancer treated by watchful waiting.
  
  
  METHODS
  In a prognostic study, 64 patients with clinically localized prostate cancer were followed prospectively with initial expectant management. The median (mean, range) follow-up was 22 (27, 6.0-68) months. The prostate specific antigen (PSA) doubling time (PSADT) was calculated by linear regression. The MNV was estimated using biopsy specimens, based on a stereological method, and compared with PSADT and traditional clinicopathological variables.
  
  
  RESULTS
  PSADT was significantly associated with MNV, but not with other clinicopathological variables. The PSA 'rapid-riser' subset (PSADT<median value) had significantly larger MNVs than did the PSA 'slow-riser' (PSADT>or=median value) and PSA-stable subsets (P = 0.0017 and 0.004, respectively). On multivariate analysis using a stepwise Cox proportional hazards regression, only MNV remained independently significant as a predictor of clinical progression among the clinicopathological variables (P < 0.001).
  
  
  CONCLUSIONS
  These findings suggest that cancer cell nuclear volume is significantly associated with tumour biology and behaviour in patients with prostate cancer. Although further study with a larger patient population is needed to confirm the findings, estimates of MNV may be an important prognostic indicator in men treated with watchful waiting.
authors.affiliation: Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan. ya6143@kchnet.or.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Arai
authors.forename: S
authors.initials: S
authors.lastname: Egawa
authors.forename: S
authors.initials: S
authors.lastname: Kuwao
authors.forename: K
authors.initials: K
authors.lastname: Ogura
authors.forename: S
authors.initials: S
authors.lastname: Baba
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002467:Cell Nucleus / Q000473:pathology*; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000378:metabolism*; D011471:Prostatic Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy
chemical_list: D017430:Prostate-Specific Antigen