Elevated levels of peritumoral chondroitin sulfate are predictive of poor prognosis in patients treated by radical prostatectomy for early-stage prostate cancer

The disease course of localized prostate cancer is highly variable, and pat ients potentially curable by aggressive management are not readily identifi ed by current clinical practice. Chondroitin sulfate (CS glycosaminoglycan is a candidate biomarker as elevated levels of CS in peritumoral stroma of prostate cancer have been associated with prostate-specific antigen (PSA) f ailure, Immunoreactive CS was measured using image analysis of archived rad ical prostatectomy tissues, obtained from 157 men with a median of 47 month s (range, 16-111 months) clinical follow-up, CS level, Gleason score, and p reoperative serum PSA levels were independent predictors of PSA failure by Cox's multivariate analysis, Patients with low CS levels had significantly fewer PSA failures after radical prostatectomy than patients with high leve ls of CS (Kaplan-Meier plot; 32% PSA failures at 5 years for CS mean integr ated absorbance cut point <7.0 versus 50% for CS greater than or equal to 7 .0, P = 0.0001), In the subgroup of patients with preoperative serum PSA le vels <10 ng/ml, CS was particularly useful in discriminating retrospectivel y those patients most suited for surgery Kaplan-Meier plot; 14% PSA failure s at 5 years for CS mean integrated absorbance cut point <7.0 versus 47% fo r CS greater than or equal to 7.0, P = 0.0001). We conclude that measuremen ts of CS level can assist in predicting patient outcome after surgery, Addi tionally, our data suggest that the combination of CS and PSA measurements may improve outcome prediction for patients with intermediate Gleason score s.