High-grade inflammation in prostate cancer as a prognostic factor for biochemical recurrence after radical prostatectomy

Objectives. To assess the prognostic value of prostatic stromal inflammatio n in surgically treated localized prostate carcinoma for biochemical recurr ence-free survival. Methods. Stromal prostatic inflammation grading was studied in 161 patients who underwent radical prostatectomy for prostate cancer without involvemen t of the lymph nodes and who did not receive preoperative or postoperative radiotherapy or hormonal therapy until recurrence occurred. Inflammation wa s graded as high-grade inflammation if confluence of inflammatory cell infi ltrate and/or glandular epithelium disruption associated with interstitial inflammatory infiltrate were present and as low-grade inflammation otherwis e. Each specimen was graded separately first in the stroma surrounding nonm alignant glands and second in the stroma surrounding malignant glands. Bioc hemical recurrence based on serum prostate-specific antigen (PSA) level was defined as two successive PSA measurements greater than 1 ng/mL. Results. Malignant tissue was significantly less involved in high-grade inf lammation than benign adjacent tissue (9.3% and 19.9%, respectively; P < 0. 01). In a univariate Kaplan-Meler analysis, the 5-year recurrence-free surv ival rate for patients with high-grade and low-grade classified prostates w as 61.0% and 66.7% in benign tissue and 27.0% and 65.3% in malignant tissue , respectively, with a significant difference between grades only in malign ant tissue (P < 0.02). In a multivariate analysis controlling for Cleason g rade, preoperative serum PSA, pathologic stage, and inflammation grade in m alignant tissue, the latter factor remained significantly predictive of bio chemical recurrence (P = 0.03). Conclusions. Patients with high-grade inflammation surrounding malignant gl ands in radical prostatectomy specimens had significantly more postoperativ e biochemical recurrence than patients with low-grade inflammation. (C) 199 9, Elsevier Science Inc.