title: Intratumoral inflammation is associated with more aggressive prostate cancer.
abstract: OBJECTIVE
  Inflammation may play a role in the development and progression of many cancers, including prostate cancer. We sought to test whether histological inflammation within prostate cancer was associated with more aggressive disease.
  
  
  METHODS
  The slides of prostatectomy specimens were reviewed by a board-certified pathologist on 287 men from a Veterans Affairs Medical Center treated with radical prostatectomy from 1992 to 2004. The area with the greatest tumor burden was scored in a blinded manner for the degree of inflammation: absent, mild, or marked. We used logistic and Cox proportional hazards regression analysis to examine whether categorically coded inflammation score was associated with adverse pathology and biochemical progression, respectively.
  
  
  RESULTS
  No inflammation was found in 49 men (17%), while 153 (53%) and 85 (30%) had mild and marked inflammation. During a median follow-up of 77 months, biochemical recurrence occurred among 126 (44%) men. On multivariate analysis, more inflammation was associated with greater risk of positive margins, capsular penetration, and seminal vesicle invasion (all p < 0.05). Marked inflammation was associated with increased PSA recurrence risk when adjusting for preoperative features only (HR 2.08, 95% CI 1.02-4.24), but not after adjusting for pathologic features.
  
  
  CONCLUSIONS
  Inflammation within prostate cancer was associated with more advanced disease, although it is unclear whether aggressive disease caused increased inflammation or inflammation caused aggressive disease.
authors.affiliation: Urology Section, Department of Surgery, Veterans Affairs Medical Center, Durham, NC, USA, klinkj@ccf.org.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Klink
authors.forename: Lionel L
authors.initials: LL
authors.lastname: Bañez
authors.forename: Leah
authors.initials: L
authors.lastname: Gerber
authors.forename: Amy
authors.initials: A
authors.lastname: Lark
authors.forename: Robin T
authors.initials: RT
authors.lastname: Vollmer
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Freedland
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D000368:Aged; D001706:Biopsy; D018450:Disease Progression; D006801:Humans; D007249:Inflammation / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011467:Prostate / Q000473:pathology* / Q000601:surgery; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index
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