Proliferative Index Determination in Prostatic Carcinoma Tissue: Is There Any Additional Prognostic Value Greater Than That of Gleason Score, Ploidy and Pathological Stage?

Coetzee, L.; Layfield, Lester J.; Hars, Veronika; Paulson, David F.

doi:10.1016/s0022-5347(01)65329-1

Cited by 39 publications

(26 citation statements)

References 23 publications

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“…Standard prognostic markers in prostate cancer include serum PSA (13)(14)(15)(16)(17), Gleason score (2, 18 -24), and pathologic stage (25)(26)(27)(28). DNA ploidy is generally accepted by many as an independent prognostic marker, particularly if the cancer is extraprostatic at the time of RRP (1-3, 5, 9, 29).…”

Section: Discussionmentioning

confidence: 99%

Factors That Influence the Measurement of Prostate Cancer DNA Ploidy and Proliferation in Paraffin Embedded Tissue Evaluated by Flow Cytometry

Cheville

Katzmann

et al. 2001

Modern Pathology

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DNA ploidy (1-6) and proliferation (7,8) have been shown to provide prognostic information for prostate cancer. Studies examining the relationship between ploidy and proliferation and patient outcome are often based upon flow cytometry (FCM) data using formalin-fixed, paraffin-embedded tissue from radical retropubic prostatectomy (RRP) specimens. However, FCM cannot readily distinguish among benign epithelial, stromal, and inflammatory cells, high grade prostatic intraepithelial neoplasia (HGPIN), and cancer cells. Furthermore, studies that do not show DNA ploidy and proliferation as independent prognostic markers emphasize the strong correlation of cancer Gleason score with DNA ploidy and proliferation (9 -11).To the best of our knowledge, there are no published reports directly assessing the degree to which non-invasive tumor components in paraffinembedded tissue blocks are associated with prostate cancer ploidy and proliferation results determined by FCM. In this study, we evaluated hematoxylin and eosin (H&E) histologic features from 322 RRP formalin-fixed, paraffin-embedded tissue specimens used for determining DNA ploidy,

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Section: Discussionmentioning

confidence: 99%

Factors That Influence the Measurement of Prostate Cancer DNA Ploidy and Proliferation in Paraffin Embedded Tissue Evaluated by Flow Cytometry

Cheville

Katzmann

et al. 2001

Modern Pathology

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“…9,10 Evidence for the predictive role of Ki-67 LI in determining prostate cancer outcomes has been established for men that are treated radically. [11][12][13][14][15][16][17][18] In most studies, Ki-67 LI has been evaluated on cancer tissue obtained from transurethral resection (TURP) or radical prostatectomy specimens, although two of the studies used pre-treatment needle biopsies taken from patients who subsequently received radiotherapy. 14,18 The prognostic role of Ki-67 LI has also been established for prostate cancer-specific survival in patients managed by watchful waiting.…”

Section: Introductionmentioning

confidence: 99%

Biopsy tissue microarray study of Ki-67 expression in untreated, localized prostate cancer managed by active surveillance

Jhavar

Bartlett

Kovács

et al. 2008

Prostate Cancer Prostatic Dis

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Active surveillance provides a unique opportunity to study biomarkers of prostate cancer behaviour, although only small volumes of tumor tissue are typically available. We have evaluated a technique for constructing tissue microarrays (TMAs) from needle biopsies for assessing immunohistochemical markers in localized prostate cancer managed by active surveillance. TMAs were constructed from diagnostic prostate biopsies for 60 patients with localized prostatic adenocarcinoma in a prospective cohort study of active surveillance. Radical treatment was recommended for a prostate-specific antigen (PSA) velocity greater than 1 ng ml À1 per year or adverse histology in repeat biopsies, defined as Gleason score X4 þ 3 or 450% of cores involved. Sections from the TMAs were stained with H&E, P63/AMACR and Ki-67. Time to radical treatment was analysed with respect to clinical characteristics and Ki-67 LI. At a median follow up of 36 months, 25/60 (42%) patients had received radical treatment. On univariate analysis, PSA density (P ¼ 0.001), Gleason score (P ¼ 0.001), clinical T stage (P ¼ 0.01), Ki-67 LI (P ¼ 0.02) and initial PSA (P ¼ 0.04) were associated with time to radical treatment. On multivariate analysis, PSA density (P ¼ 0.01), Ki-67 LI (P ¼ 0.03) and Gleason score (P ¼ 0.04) were independent determinants of progression to radical treatment. TMAs constructed from prostate needle biopsies can be used to assess immunohistochemical markers in localized prostate cancer managed by active surveillance. Ki-67 LI merits further study as a possible biomarker of early prostate cancer behaviour.

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“…In fact, pathological stage and Gleason sum are the most crucial predictors of oncological outcome [1][2][3][4]. Ultrasound-guided biopsy findings and the Gleason sum are commonly used for predicting outcome, but unfortunately the results of these two methods often diverge from the final pathological analysis and when used alone are inadequate [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Ultrasound-Guided Biopsies and Prostatectomy Specimens: Predictive Accuracy of Gleason Score and Tumor Site

Gregori¹,

Vieweg²,

Dahm³

et al. 2001

Urol Int

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Objective: To critically evaluate the accuracy of sextant biopsies in predicting Gleason score and the site of tumor location in patients with clinically localized prostate cancer treated by radical perineal prostatectomy. Methods: The case records of 289 patients with clinically localized prostate cancer who underwent radical perineal prostatectomy were reviewed, comparing the Gleason score and tumor site location as determined by sextant ultrasound-guided core biopsies with the Gleason score and tumor distribution within the surgical specimens. The prostatectomy specimens were further characterized by extent of disease as organ-confined, specimen-confined or margin-positive. Results: The Gleason score was identical in 126 (43.5%) patients. An upgrading in the surgical specimen occurred in 118 (40.8%) cases, a downgrading in 43 (14.8%). Overall, 193 (66.7%) patients had a unilateral positive biopsy, while 96 (33.2%) patients had bilateral positive biopsies. Sixty-four (33.1%) patients with a unilateral positive biopsy had cancer confined to one side of the gland, while 127 (65.8%) showed bilateral disease; 142 (73.5%) patients had organ-confined tumors versus 51 (26.4%) patients with capsular penetration. In the 96 patients with bilateral positive biopsies, 64 (66.6%) patients had intracapsular cancer versus 32 (33.3%) patients with either specimen-confined or margin-positive disease. The overall rate of positive margins was 14%. Fifty-one (61.4%) of the 83 patients with non-organ-confined disease had posterolateral capsular penetration in the region of the superior pedicle of the neurovascular bundle, while 28 (33.7%) patients had apical capsular penetration, in the region of the inferior neurovascular pedicle. Conclusions: The ability of sextant ultrasound-guided biopsies to estimate the pathological grading is satisfactory: when we consider a difference of ± 1 in the final Gleason score, the overall correlation is 80%. In 66% of the cases, sextant biopsies predicted unilateral disease when bilateral disease existed. A unilateral positive biopsy does not predict unilateral disease.

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Proliferative Index Determination in Prostatic Carcinoma Tissue: Is There Any Additional Prognostic Value Greater Than That of Gleason Score, Ploidy and Pathological Stage?

Cited by 39 publications

References 23 publications

Factors That Influence the Measurement of Prostate Cancer DNA Ploidy and Proliferation in Paraffin Embedded Tissue Evaluated by Flow Cytometry

Factors That Influence the Measurement of Prostate Cancer DNA Ploidy and Proliferation in Paraffin Embedded Tissue Evaluated by Flow Cytometry

Biopsy tissue microarray study of Ki-67 expression in untreated, localized prostate cancer managed by active surveillance

Comparison of Ultrasound-Guided Biopsies and Prostatectomy Specimens: Predictive Accuracy of Gleason Score and Tumor Site

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