Relationship of p21(WAF1) expression with disease-free survival and biochemical recurrence in prostate adenocarcinomas (PCa)

BACKGROUND. The p21(WAF1) gene is considered to be one of the major regulat ors of the cell cycle. Its level of expression has been shown to correlate with pathologic stage and Gleason score in prostatic cancer. However, its r elationship to clinical outcome is not yet well-characterized. METHODS. Immunohistochemical staining for p21(WAF1) protein expression was performed in 62 consecutive radical prostatectomy specimens from our instit ution. The results were correlated with the disease-free survival and bioch emical recurrence of the patients. RESULTS. Thirty-four of the 62 patients were Caucasian and 28 were African American. There was a significant correlation between p21(WAF1) expression and biochemical recurrence after radical prostatectomy (P < 0.0095). Howeve r, while p21(WAF1) staining in prostate cancer was a prognostic indicator o f disease-free survival in Caucasians (P < 0.0001), it appeared not to be a factor in African-American men (P = 0.908). CONCLUSIONS. This study suggests that p21(WAF1) may have a role in the path ogenesis and progression of prostate carcinoma, and may serve as a predicto r of biochemical recurrence of this tumor. The differences in the values of p21(WAF1) as a prognostic marker of disease-free survival in Caucasians vs . African Americans suggest that progression of prostate cancer may have di fferent mechanisms in different ethnic groups. (C) 1999 Wiley-Liss, Inc.