title: Lymphatic Vascularization in Prostate Adenocarcinoma: Correlation with Tumor Grade, Androgen Withdrawal and Prognosis.
abstract: OBJECTIVE
  The lymphatic system plays an active role in the metastatic process by directly facilitating recruitment of cancer cells into the vessels. The present study aimed to assess the lymphatic vessel area and the lymphatic vessel density in prostate adenocarcinoma and to correlate these parameters with patients prognosis and outcome.
  
  
  METHODS
  The lymphatic vessel area and the lymphatic vessel density were evaluated using the D2-40 monoclonal antibody in 153 patients with prostate adenocarcinoma who had been treated by radical prostatectomy, in comparison to 152 non-neoplastic controls. We also estimated the lymphatic vessel area in a set of 139 patients who had undergone radical prostatectomy after neoadjuvant treatment with combined androgen blockade.
  
  
  RESULTS
  Lymphatic vessel area was higher in periglandular than in interglandular stroma, inversely correlated with tumor differentiation (in untreated patients) and was influenced by hormonal treatment. Lymphatic vessel density was not significantly different between the non-tumoral and the high-grade prostate intraepithelial neoplasm compartment, whereas it was higher in tumoral than in non-tumoral compartments, mainly in periglandular stroma. In addition, it increased in parallel to the tumor grade progression and positively correlated with all the main prognostic factors of prostate adenocarcinoma.
  
  
  CONCLUSIONS
  The evaluation of lymphatic vessel density on radical prostatectomy with positive nodes may help to discriminate those patients at higher risk of developing an aggressive disease, which may need early androgen deprivation therapy to delay the worsening of clinical disease.
authors.affiliation: Department of Medical Biotechnologies, Section of Pathology, University of Siena, Siena, Italy maradot@libero.it.
authors.forename: Maria R
authors.initials: MR
authors.lastname: Ambrosio
authors.affiliation: Department of Medical Biotechnologies, Section of Pathology, University of Siena, Siena, Italy Pathology Unit, Ospedale di Circolo di Busto Arsizio, Presidio Ospedaliero di Saronno, Saronno, Italy.
authors.forename: Bruno J
authors.initials: BJ
authors.lastname: Rocca
authors.affiliation: Department of Medical Biotechnologies, Section of Pathology, University of Siena, Siena, Italy.
authors.forename: Aurora
authors.initials: A
authors.lastname: Barone
authors.affiliation: Department of Medical Biotechnologies, Section of Pathology, University of Siena, Siena, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ginori
authors.affiliation: Pathology Unit, Ospedale di Circolo di Busto Arsizio, Presidio Ospedaliero di Saronno, Saronno, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Crivelli
authors.affiliation: Department of Medicine, Surgery and Neurosciences, Section of Pathology and Radiological Sciences, University of Siena, Siena, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Pirtoli
authors.affiliation: Department of Medicine, Surgery and Neurosciences, Section of Pathology and Radiological Sciences, University of Siena, Siena, Italy.
authors.forename: Maria T
authors.initials: MT
authors.lastname: Del Vecchio
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000628:therapy; D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D042601:Lymphatic Vessels / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000473:pathology*; D011379:Prognosis; D011467:Prostate / Q000473:pathology*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000628:therapy; D015996:Survival Rate
chemical_list: D000726:Androgen Antagonists
keywords: Prostate adenocarcinoma; combined androgen blockade therapy; lymphatic vessel density