title: Adenocarcinoma on needle prostatic biopsies: does reactive stroma predicts biochemical recurrence in patients following radical prostatectomy?
abstract: OBJECTIVE
  There is evidence that reactive stroma in different cancers may regulate tumor progression. The aim of this study is to establish any possible relation of reactive stroma grading on needle prostatic biopsies to biochemical recurrence.
  
  
  METHODS
  The study group comprised 266 biopsies from consecutive patients submitted to radical prostatectomy. Reactive stroma was defined as stroma surrounding neoplastic tissue and graded as 0 (absent), 1 (slight), 2 (moderate), and 3 (intense) according to tumor stroma area relative to total tumor area.
  
  
  RESULTS
  From the total of 266 needle prostatic biopsies, 143 (53.8%), 55 (20.7%), 54 (20.3%), and 14 (5.3%) showed grades 0, 1, 2, and 3, respectively. Increasing reactive stroma grade was significantly associated with clinical stage T2, higher preoperative PSA, higher biopsy and radical prostatectomy Gleason score, more extensive tumors in radical prostatectomy, and pathologic stage > T2. Only grade 3 was significantly associated with time and risk to biochemical recurrence. On multivariate analysis only preoperative PSA and 2 methods of biopsy tumor extent evaluation were independent predictors.
  
  
  CONCLUSIONS
  Increasing reactive stroma grade on biopsies is significantly associated with several clinicopathologic adverse findings, however, only grade 3 predicts time and risk to biochemical recurrence following radical prostatectomy on univariate but not on multivariate analysis. We have not been able to show that reactive stroma grade 3 on biopsies is an independent predictor of biochemical recurrence beyond that of preoperative PSA and other pathologic findings on biopsy.
authors.affiliation: Department of Anatomic Pathology, School of Medical Sciences, State University of Campinas (Unicamp), Sao Paulo, Brazil. athanase@fcm.unicamp.br
authors.forename: Athanase
authors.initials: A
authors.lastname: Billis
authors.forename: Luciana
authors.initials: L
authors.lastname: Meirelles
authors.forename: Leandro L L
authors.initials: LL
authors.lastname: Freitas
authors.forename: Aline S
authors.initials: AS
authors.lastname: Polidoro
authors.forename: Hamilton A
authors.initials: HA
authors.lastname: Fernandes
authors.forename: Mariana M
authors.initials: MM
authors.lastname: Padilha
authors.forename: Luis A
authors.initials: LA
authors.lastname: Magna
authors.forename: Leonardo O
authors.initials: LO
authors.lastname: Reis
authors.forename: Ubirajara
authors.initials: U
authors.lastname: Ferreira
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D044963:Biopsy, Fine-Needle / Q000379:methods; D018450:Disease Progression; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology*; D012307:Risk Factors; D017154:Stromal Cells / Q000473:pathology*; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen