CLINICAL UTILITY OF CELLULAR DNA MEASUREMENTS IN PROSTATE CARCINOMA

At a WHO consensus conference on Early Diagnosis and Prognostic Parame ters in Localized Prostate Cancer, a working group discussed the clini cal utility of DNA measurements in stages T2 and T3 prostate carcinoma . Incidentally discovered prostate cancer of stage T1 was excluded. Th e members of the working group, representing various clinical and labo ratory disciplines, discussed technical considerations of DNA measurem ents by flow and image analysis, pretreatment prediction of prognosis, and posttreatment clinical relevance. The group agreed to subdivide t umors into diploid, tetraploid and non-tetraploid aneuploid, expressin g various degrees of aggressiveness and gave guidance for the definiti on of limits of these groups. The panel agreed that knowledge on DNA p loidy prior to treatment is of value in treatment decisions, particula rly when surveillance is a treatment option. Aneuploid tumors can be e xpected to respond very poorly to either irradiation oi endocrine ther apy, and the presence of aneuploid tumor, either on pretreatment biops ies or in radical prostatectomy specimens, is an ominous sign. The ide ntification of a group of patients with a uniformly poor prognosis sho uld encourage medical oncologists and basic scientists to develop adeq uate treatment options for this particular group. The panel expressed a strong opinion that DNA ploidy should be uniformly studied in clinic al trials, particularly in patients with localized prostate cancer.