THE PROGNOSTIC VALUE OF P53 FOR LONG-TERM AND RECURRENCE-FREE SURVIVAL FOLLOWING RADICAL PROSTATECTOMY

In the present study, 76 specimens (T-1-T-4) from 76 randomly selected patients undergoing radical prostatectomy at Hannover University as w ell as in the Josef Hospital Regensburg (13 patients) between 1980 and 1992 for whom tissue sections for immunohistochemical investigation w ere available, were investigated for different biological and clinical characteristics as predictors for long-term and recurrence-free survi val: age, depth of tumour infiltration, histological grade, lymph node status, as well as overexpression of the p53 protein (monoclonal anti body DO-I). After a median follow-up of 50 months, 6 of 18 patients (3 3%) with more than 20% of tumour cells stained positively for p53 died from tumour progression compared with 9 of 58 patients (16%) with les s than 20% of tumour cells positive for p53. During univariate analysi s, p53 overexpression (P=0.011), histological grading (P=0.009) and tu mour stage (P=0.024) were significant prognostic factors for survival, among which only p53 overexpression (P=0.026) remained an independent significant predictor in multivariate analysis. Additionally, 18 of 6 6 patients (27%) with less than 40% positivity for p53 suffered tumour recurrence in contrast to 6 of 10 patients (60%) with more than 40% t umour cells exhibiting a positive staining reaction. In multivariate a nalysis, p53 overexpression was identified as the only prognostic para meter for recurrence-free survival (P=0.005). Prospective studies are needed to confirm the independent prognostic potential of p53 overexpr ession in patients with localised prostate cancer. The availability of more refined prognostic factors should assist decision making regardi ng the value of radical prostatectomy versus a surveillance strategy f or prognostically defined subgroups of patients. (C) 1998 Elsevier Sci ence Ltd. All rights reserved.