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.
OBJECTIVE
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.
Medical Biosciences, Pathology, Umeå University, SE 901 85 Umeå, Sweden.
Andreas
A
Josefsson
Pernilla
P
Wikström
Torvald
T
Granfors
Lars
L
Egevad
Lars
L
Karlberg
Pär
P
Stattin
Anders
A
Bergh
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000097:blood*; D000071063:Endoglin; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000097:blood / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011467:Prostate / Q000098:blood supply*; D011471:Prostatic Neoplasms / Q000097:blood / Q000098:blood supply / Q000473:pathology* / Q000601:surgery; D011956:Receptors, Cell Surface / Q000378:metabolism; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D020728:Transurethral Resection of Prostate; D047368:Tumor Burden; D014841:von Willebrand Factor / Q000378:metabolism
D015703:Antigens, CD; D014408:Biomarkers, Tumor; C064206:ENG protein, human; D000071063:Endoglin; D019394:Ki-67 Antigen; D011956:Receptors, Cell Surface; D014841:von Willebrand Factor