The worst histologic elements predict prognosis in moderately-differentiated prostate cancer patients with androgen-withdrawal endocrine therapy

Objectives: We evaluated the prognostic value of the worst histologic eleme nts in 155 patients with moderately-differentiated prostate cancer (Gleason sum 5-7) treated with androgen-withdrawal endocrine therapy. Methods: In i ndividual cases, the proportion (%) of medullary/solid combined with column s-and-cords/trabcular (MED & C-C), regarded as the worst histologic element s, determined according to WHO-Mostofi's classification of histologic patte rns, within the total adenocarcinoma area obtained from needle specimens wa s estimated. Results: Patients with proportion of MED & C-C >5% had a signi ficantly poorer prognosis than those with <5% (p < 0.05). A significant dif ference was also found in the survival curves of patients grouped by stage (p < 0.01). There was no significant difference among the patients with Gle ason sum of 5, 6 and 7, Multivariate analysis showed that stage and MED & C -C had independent prognostic value. Conclusions: Proportion of MED & C-C m ay provide useful prognostic information about patients with moderately-dif ferentiated, Gleason sum 5-7, prostate cancer treated with androgen-withdra wal endocrine therapy.