S. Vesalainen et al., PROGRESSION AND SURVIVAL IN PROSTATIC ADENOCARCINOMA - A COMPARISON OF CLINICAL STAGE, GLEASON GRADE, S-PHASE FRACTION AND DNA-PLOIDY, British Journal of Cancer, 70(2), 1994, pp. 309-314
Clinical data were reviewed in 325 patients with prostatic adenocarcin
oma followed up for a mean of 13 years. Paraffin-embedded tumour biops
y specimens from the primary rumours were available for Bow cytometry
(FCM) in 273 cases. Intra-tumour heterogeneity in DNA index (DI) was f
ound in 4% of the tumours (54 cases were analysed). S-phase fraction (
SPF) and DNA ploidy were significantly interrelated. Aneuploidy and hi
gh SPF were significantly related to both a high T category and high G
leason score. The progression in T1-2M0 tumours was related to Gleason
score (P=0.009), DNA ploidy (P=0.006) and SPF (P=0.007), while the Gl
eason score (P=0.0013), DNA ploidy (P=0.002) and SPF (P<0.001) had pro
gnostic value in univariate survival analysis. In the entire cohort, t
he T category (P<0.001), M category (P<0.001), Gleason score (P<0.001)
, DNA ploidy (P<0.001) and SPF (P<0.001) were significant prognostic f
actors. In Cox's analysis, the M category (P<0.001), Gleason score (P<
0.001), T category (P=0.003), age (P=0.001) and SPF (P=0.087) were ind
ependently related to prognosis. In the T1-2M0 tumours, Gleason score
(P<0.001), T category (P=0.022) and SPF (P=0.058) were independent pre
dictors. A novel classification system in which the DNA ploidy or SPF
and the Gleason score were combined was found to be of significant pro
gnostic value in all MO tumours (P<0.001). The results suggest that FC
M can be used as an adjunct to conventional histological assessments f
or determination of the correct prognostic category in prostatic adeno
carcinoma.