In the late 1980s and early 1990s, the number of newly diagnosed prostate cancers in the United States increased dramatically, surpassing lung cancer as the most common cancer in men. 1 Experts generally believe that these changes resulted from prostate-specific antigen (PSA) screening that detected many earlystage prostate cancers. For example, the percentage of patients with low-risk disease has increased (45.3% in 1999-2001 vs. 29.8% in 1989-1992; P < .0001). 2 The incidence of prostate cancer increased 2.0% annually from 1995 to 2001 and has since declined. In 2009, an estimated 192,280 new cases were diagnosed and prostate cancer was expected to account for 25% of new cancer cases in men. 1 Fortunately, the age-adjusted death rates from prostate cancer have also declined

Clinical and pathologic data of 54 patients with clinically localized transitional cell tumors of the upper urinary tract were reviewed to determine the significance of tumor grade and stage on patient survival. There were 43 tumors of the renal pelvis (one bilateral) and 11 tumors of the ureter. The primary tumor was staged by the new TNM classification into low stage (Ta: limited to mucosa; TI: lamina propria invasion) and high stage (Tz: muscularis invasion; TJ; invasion beyond the muscularis). Tumors were low stage (T./TI) in 28 cases (51.8%) and advanced (Tz/TJ) in 26 cases (48.2%). Twenty-five of 54 (46.3%) of the patients had low grade (Grades 1 and 2) and 29 of 54 (53.7%) had high grade (Grades 3 and 4) tumors. Median survival for all patients from date of diagnosis was 31 months, with a 5-year survival rate of 45.8%. Grade (low/high) matched stage (low/high) in 45 of 54 patients (83%). Median survival for patients with low grade tumors was 66.8 months compared to 14.1 months in patients with high grade tumors. Median survival for low stage tumors was 91.1 months and for high stage tumors was 12.9 months. These differences in survival related to both tumor stage (P = 0.001) and grade (P = 0.004) were statistically significant by log-rank test. Fourteen of the 54 patients (25.9%) developed local recurrence and 29 (53.7%) developed distant metastases. The lung was the most common site of metastasis. Eighteen patients (33.3%) had or developed transitional cell carcinoma of the bladder, which preceded the diagnosis of transitional cell carcinoma of the upper tract in seven cases and developed subsequently in 11 cases. Primary tumor stage by the new TNM classification is a better predictor of prognosis than tumor grade, although both variables are strongly predictive of patient course and survival. The advantages of the new TNM classification are discussed. Cancer 62:2016-2020, 1988. RANSITIONAL CELL carcinoma of the upper urinary T tract is an uncommon disease, accounting for 4.5% to 9% of all renal tumors and 5% to 6% of all urothelial tumors.'-5 Tumors of the renal pelvis are more common than ureteral tumors by a ratio of 3: 1 or 4: 1 .637 The incidence of bilateral synchronous occurrence of upper tract tumors is approximately 1.5% to 2%, and the incidence of asynchronous bilateral development is 6% to 8%.s38 The incidence of subsequent development of bladder tumors in patients with tumors of the renal pelvis or ureter varies between 20% and 30%.6,7 The incidence of ipsilateral recurrence varies between 6% for low grade tumors to 28% to 43% for high grade tumors.9-" There is usually a good correlation between grade and stage of upper tract rumors and subsequent progno~is.~-~ Herein all cases of transitional cell carcinoma of the

A case-control study of 371 prostate cancer patients and comparable control subjects admitted to Roswell Park Memorial Institute (RPMI), Buffalo, New York, was conducted. Data were obtained from routine epidemiologic questionnaires administered to all patients on admission. An index of beta-carotene intake was computed based on the vitamin A activity of 27 fruits and vegetables included in a food frequency checklist. A similar measure of fat intake from meats was computed based on nine meats included in the checklist. Intake frequencies of common and alcoholic beverages also were studied. A significant age-adjusted and residence-adjusted protective effect for high levels of beta-carotene intake was observed (relative risk [RR], 0.60; 95% confidence interval [CI], 0.37 to 0.99). This effect was evident particularly among men 68 years of age and younger (RR, 0.30; 95% CI, 0.13 to 0.66), but not among subjects older than 68 years of age. A trend toward increased risk for fat intake was not significant. However, the reported usual consumption of high-fat milk was associated with increased risk (RR, 1.92; 95% CI, 1.05 to 3.50). A greater reported frequency of whole milk intake was similarly associated with increased risk. Men who reported drinking three or more glasses of whole milk daily had an RR of 2.49 (95% CI, 1.27 to 4.87), compared with men who reported never drinking whole milk. When these findings are evaluated in the context of other recent studies, the weight of the evidence appears to favor the hypothesis that animal fat intake is related to increased risk of prostate cancer.

DNA histograms were measured by flow cytometry for 656 human solid tumors (365 primary and 291 metastatic). The proportion of aneuploid cells in cell suspensions obtained by mechanical disaggregation was significantly higher than those obtained after enzymatic disaggregation (collagenase + DNAse) of the same tumor. A strong correlation was observed between the values of DNA-indices measured after staining with propidium iodide and with 4',-6-diamidino-2-phenylindole (r = 0.97). Aneuploid cells were observed in 430 tumors (66%); 30 of these had two aneuploid stcmlincs, and two had three aneuploid stemlines. The overall frequency of aneuploidy was 61% among primary and 71% among metastatic tumors. The median value of the DNA index was 1.67 for 224 primary aneuploid tumors and 1.68 for 206 metastatic aneuploid tumors. For most diseases, the largest proportion of aneuploid primary and metastatic tumors had DNA-indices in the hypertriploid region. No major differences in frequency and degree of aneuploidy was observed between primary and metastatic tumors. For carcinomas of the bladder and prostate, frequency of aneuploidy was higher among poorly differentiated, than among moderately and welldifferentiated tumors. For carcinomas of the breast and for sarcomas, tumors with DNAindices of >2.0 were observed mostly in the poorly differentiated group. For patients with carcinomas of the bladder and prnstat,e mnst, tumors at earlier stages of disease were diploid; whereas most tumors at later stages of disease were aneuploid. For patients with carcinomas of the ovary, colon, and kidney, no relationship between stage of disease and aneuploidy was evident.Key terms: Aneuploidy, DNA, solid tumors, metastases, flow cytometry A significant number of human solid tumors are characterized by abnormalities in cellular DNA content (DNA-aneuploidy) (1-3,lO-12,14-17,19-21). The percentage of tumors with aneuploid cells varies for different types of tumor and also varies for the the same type of tumor when reported by different investigators. This variability indicates that more data should be accumulated before a final classification of tumors according to abnormalities of DNA content can be made, and so that a relationship between this parameter and clinical prognosis may be established.Flow cytometry (FCM) provides a fast and precise method for determination of DNA-aneuploidy index. Using mechanical disaggregation and staining of nonfixed cells, results may be obtained in less than 1 h. However, the usefulness of this parameter for clinical prognosis, selection of treatment, and prediction of response has not been conclusively demonstrated. Although some reports suggest a correlation between DNA-aneuploidy and clinical characteristics of the tumor (17,21), detailed and prolonged observations with larger numbers of patients are necessary to firmly establish such correlations. The relationship between DNA-aneuploidy and metastatic capability is a topic of significant interest and also needs to be studied in a large number of patients....

Summary Estimates were made of the rates at which cancer cells were released directly into the renal vein in patients undergoing radical nephrectomy for primary renal cancer. Cancer cells were counted in blood samples taken from the renal vein using a density gradient centrifugation procedure, and identified using immunocytochemical techniques, on the basis of their cytoskeletal intermediate filament proteins. Cancer cells were released as single cells and multicell emboli in 8/10 patients, in numbers varying widely between 14-7509 emboli ml -of blood. Despite a calculated median input into the metastatic process of 3.7 x I07 cancer cells per day for at least 180 days, only 3/10 patients had extraperitoneal metastases prior to surgery and only of the remaining disease-free patients subsequently developed distant metastases over a maximum 35 month period. These results are discussed in terms of primary tumour kinetics and metastatic inefficiency.