title: Prognostic role of cell apoptotic rate in prostate cancer: outcome of a long-time follow-up study.
abstract: The tumour apoptotic pattern is described as a good predictor of outcome in patients with prostate cancer (PCa). So far no authors have evaluated the role of apoptotic characteristics in patients who have undergone radical prostatectomy (RRP) alone. The aim of the present study is to estimate the prognostic role of the apoptotic index (AI) in a group of patients with prostatic adenocarcinoma subjected to RRP with no adjuvant therapy. Fifty patients underwent RRP according to standardised techniques and the surgical specimens were analysed histologically. In order to evaluate the AI and correlate these results with the follow-up data, we used a standardised apoptotic regulatory terminal deoxynucleotidyl transferase-mediated biotinylated deoxyuridine-triphosphate-biotin nick end-labelling technique (Becton Dickinson Immunocytometry Systems, San Jose, CA, USA). The mean follow-up period was 66 months. Significant correlations were found between the AI and pathological features, such as stage (p<0.001) and grade (p<0.001). Out of 50 patients, 13 (26%) had biochemical recurrence and clinical disease progression, with an AI of 1.93 (range, 0.76-5.22), while 37 patients (74%) who did not report any disease progression, had an AI of 0.58 (range, 0.1-3.12). Furthermore, the AI significantly correlated with status at the end of follow-up (r=0.75, p=0.002), these data being confirmed by Kaplan-Meier curve analysis (p<0.001). On multivariate analysis, the AI proved to be an independent prognostic factor of progression-free probability (p<0.001). Our results highlight the utility of AI analysis in assessing the probability risk of clinical progression in PCa patients who are treated with RRP.
authors.affiliation: Department of Urology, Hospital of Monopoli, Bari, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Dachille
authors.forename: Tommaso
authors.initials: T
authors.lastname: Cai
authors.forename: Giuseppe Mario
authors.initials: GM
authors.lastname: Ludovico
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vestita
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pagliarulo
authors.forename: Gabriella
authors.initials: G
authors.lastname: Nesi
authors.forename: Sandra
authors.initials: S
authors.lastname: Mazzoli
authors.forename: Francesca
authors.initials: F
authors.lastname: Meacci
authors.forename: Nicola
authors.initials: N
authors.lastname: Mondaini
authors.forename: Beatrice
authors.initials: B
authors.lastname: Detti
authors.forename: Riccardo
authors.initials: R
authors.lastname: Bartoletti
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000368:Aged; D017209:Apoptosis; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome