PREDICTION OF PATIENT OUTCOME IN PATHOLOGICAL STAGE T2 ADENOCARCINOMAOF THE PROSTATE - LACK OF SIGNIFICANCE FOR MICROVESSEL DENSITY ANALYSIS

Objectives. Some patients with palpable intermediate-and high-grade, m argin-free, organ-confined prostate cancer experience recurrence follo wing prostatectomy. We studied the ability of microvessel density and other factors to predict recurrence in such patients with pathologic S tage T2 cancer. Methods. Between 1987 and 1991, 307 patients underwent radical prostatectomy for Gleason score 6 to 9, margin-free, organ-co nfined prostate cancer at Mayo Clinic, Rochester, Minnesota. Specimens from 147 patients with sufficient cancer tissue for immunohistochemic al staining with Factor VIII-related antigen were studied by computer- assisted digital image analysis for optimized microvessel density (OMV D). The correlation of deoxyribonucleic acid (DNA) ploidy, Gleason sco re, OMVD, unilateral disease, bilateral disease, and preoperative pros tate-specific antigen (PSA) to cancer recurrence was assessed using th e Cox model. Biochemical recurrence was defined as postoperative incre ase in PSA of greater than 0.2 ng/mL, and clinical recurrence was defi ned as positive biopsy or metastasis on bone scan. Results, Mean follo w-up for all patients was 6.1 years, with 12 deaths (1 due to prostate cancer) and 58 cases of clinical and/or biochemical recurrence. OMVD was not significantly associated with DNA ploidy, Gleason grade, unila teral disease, bilateral disease, or preoperative PSA. Preoperative PS A was the strongest predictor of clinical and/or biochemical recurrenc e in both univariate and multivariate analysis. OMVD was not a signifi cant univariate or multivariate predictor of clinical and/or biochemic al recurrence. The estimated relative risk of clinical and biochemical recurrence associated with a change in OMVD from the 25th percentile (OMVD 45) to the 75th percentile (OMVD 84) was 1.08 (95% confidence in terval 0.79 to 1.47). Conclusions. Preoperative PSA was the strongest predictor of clinical and/or biochemical recurrence of prostate cancer in this group of patients. Optimized microvessel density did not pred ict outcome in a select cohort of patients with palpable intermediate- and high-grade, margin-free, organ-confined prostate cancer (TNM stage T2NOMO). (C) 1998, Elsevier Science Inc. All rights reserved.