NUCLEAR SHAPE AND PROGNOSIS FOLLOWING ORCHIECTOMY IN STAGE D-2 PROSTATE-CANCER

In this study, we have examined whether tumor grade and morphometric n uclear features can predict the outcome of treatment by orchiectomy in patients with stage D-2 prostate cancer. Two outcome groups based on duration of survival postorchiectomy were examined, a bad outcome grou p of 63 patients who died from prostate cancer within 12 months and a good outcome group of 34 patients who survived beyond 5 years. Tumors were histologically classified as well (17%), moderate (17%), or poorl y differentiated (66%). Tumor grade and patient outcome were significa ntly associated (Mann-Whitney test; P < 0.005), with 76% of poorly dif ferentiated tumors in the bad outcome group, and 65% of well-different iated tumors in the good outcome group. Using discriminant function an alysis, tumor grade correctly predicted outcome in 70% of cases. A sta tistically significant difference was also detected in nuclear shape v alues between the two outcome groups (P < 0.05) and histological grade s (P < 0.05). Using discriminant function analysis, 51% of cases were correctly classified into outcome groups using nuclear shape factors, a figure which rose to 65% when all nuclear morphometric features were used. This demonstrates that nuclear morphometric features are of no clinical value in predicting the outcome of treatment in stage D-2 dis ease. Furthermore, these evaluations cannot select patients who might be spared orchiectomy on the basis of a predicted poor response. Howev er, nuclear shape and variance measurements of benign glandular epithe lial cells within cancerous prostates were significantly different fro m those of malignant cells (P < 0.005). We conclude that, while video image analysis of prostatic nuclear shape can reliably discriminate be tween benign and malignant cells, nuclear morphometric features are of minimal prognostic value in men with stage D-2 prostate cancer treate d by androgen ablation. (C) 1994 Wiley-Liss, Inc.