PROGNOSTIC FACTORS IN PATIENTS WITH METASTATIC (STAGE D2) PROSTATE-CANCER - EXPERIENCE FROM THE SCANDINAVIAN PROSTATIC-CANCER GROUP STUDY-2

Purpose: Nuclear texture reflects the overall structures of the chroma tin organization. We recently reported the principles and prognostic i mportance of image analysis of nuclei from metastatic prostate cancer. Immunohistochemical up regulation of the adhesion molecule sialyl Lew is(x) is also reported to be a prognostic parameter. Presently we anal yzed statistically the prognostic impact of these 2 new parameters com pared to well-known clinical parameters in metastatic prostate cancer. Materials and Methods: Prognostic factors, such as sedimentation rate , alkaline and acid phosphatases, hemoglobin, testosterone, performanc e status, pain due to metastasis, T category, histological grade and p atient age, were included in a multivariate Cox proportional hazards r egression analysis based on 262 patients from the Scandinavian Prostat ic Cancer Group Study-2. Extent of bone lesions, deoxyribonucleic acid ploidy, texture analysis and sialyl Lewis(x) molecules based on subse ts of these 262 patients were also analyzed in the same multivariate m odel. Results: This test identified chromatin texture as the most impo rtant factor (p <0.001), followed by reaction of the oligosaccharide s ialyl Lewis(x) (p <0.01). Among the routine clinical and laboratory da ta, sedimentation rate, alkaline phosphatase and hemoglobin (p <0.05) showed prognostic importance. Performance status, pain due to metastas is and extent of bone lesions showed prognostic value in the univariat e analysis (p <0.05). Conclusions: These data indicate that computeriz ed nuclear texture analysis as well as up regulation of sialyl Lewis(x ) molecules may be new important prognostic factors in metastatic pros tate cancer. Furthermore the prognostic importance of sedimentation ra te, alkaline phosphatase and hemoglobin was confirmed.