Large scale genomic instability as an additive prognostic marker in early prostate cancer.
BACKGROUND
The clinical outcome for the individual prostate cancer patient is often difficult to predict, due to lack of reliable independent prognostic biomarkers. We tested DNA ploidy as a prognostic factor for clinical outcome in 186 patients treated with radical prostatectomy.


METHODS
DNA ploidy was measured using an automatic image cytometry system and correlated with preoperative PSA, age at surgery, Mostofi grade, surgical margins and Gleason score.


RESULTS
The mean follow up time after operation was 73.3 months (range 2-176 months). Of the 186 prostatectomies, 96 were identified as diploid, 61 as tetraploid and 29 as aneuploid. Twenty-three per cent, 36% and 62% of the diploid, tetraploid and aneuploid cases respectively, suffered from relapse during the observation time. DNA ploidy, Gleason score, Mostofi grading, surgical margins and preoperative PSA were all significant predictors of relapse in a univariate analysis. On multivariate analysis, only Gleason score and DNA ploidy proved to be independently predictors of disease recurrence. Furthermore, among the 68 cases identified with Gleason score 7, DNA ploidy was the only significant predictor of disease recurrence.


CONCLUSIONS
Our data suggest that DNA ploidy should be included as an important additive prognostic factor for prostate cancer, especially for patients identified with Gleason score 7 tumours.
Pretorius
Maria E
ME
Institute for Medical Informatics, Rikshospitalet University Hospital, Oslo, Norway.
Waehre
Håkon
H
Abeler
Vera M
VM
Davidson
Ben
B
Vlatkovic
Ljiljana
L
Lothe
Ragnhild A
RA
Giercksky
Karl-Erik
KE
Danielsen
Håvard E
HE
D000368:Aged; D005500:Follow-Up Studies; D042822:Genomic Instability; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011003:Ploidies; D011379:Prognosis; D011467:Prostate / Q000473:pathology / Q000601:surgery; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000473:pathology / Q000601:surgery