HISTOPATHOLOGICAL GRADING AND DNA-PLOIDY AS PROGNOSTIC MARKERS IN METASTATIC PROSTATIC-CANCER

The present study compares the prognostic potential of tumour grade an d DNA ploidy status in patients with advanced-stage prostatic cancer. Two outcome groups were selected on the basis of time to progression a nd survival after orchiectomy. A poor-outcome group consisted of 32 th erapy-resistant patients who experienced disease progression during th e first year after orchiectomy and subsequently death due to prostatic cancer during the following year. A good-outcome group consisted of 2 7 therapy-responsive patients who showed disease regression and no sig ns of progression during a 3 year follow-up. The primary tumours were graded twice according to WHO and Gleason classification systems by tw o pathologists. Final agreement between the pathologists was obtained after a consensus meeting. The analysis revealed no prognostic importa nce of the two histological classification systems (P = 0.62 and P = 0 .70) and disclosed weak inter- and intra-observer reproducibility (kap pa<0.70). DNA ploidy analyses were performed by image cytometry on for malin-fixed, paraffin-embedded samples of the primary tumours. Overall , 48% of the tumours were diploid, 20% tetraploid and 32% anueploid. D NA ploidy status did not discriminate between the two outcome groups ( P = 0.46). Histological grade and DNA ploidy showed no prognostic impo rtance in patients with prostatic cancer and skeletal metastases.