Independent prognostic importance of microvessel density in clinically localized prostate cancer

Background: Previous studies have reported a possible prognostic importance of microvessel density (MVD) in prostate cancer, although the significance after radical prostatectomy is not clear. The purpose of this study was to assess the prognostic value of MVD in clinically localized prostatic adeno carcinomas, focusing on moderately-differentiated tumours. Materials and Me thods: We examined a series of 104 patients treated for presumed organ-conf ined cancer in the period 1988 - 94. The area of highest tumour grade was s elected from the prostatectomy specimens and vessels were high-lighted by s taining for factor-VIII-related antigen. MVD was quantitated in the "hot sp ot" area and related to biochemical failure and clinical recurrence. Result s: In moderately differentiated tumours (WHO grade) (n=66), MVD was associa ted with preoperative s-PSA and positive surgical margins. In univariate 5- year analysis, microvessel density (MVDmean > 122 mm(-2), median) (p = 0.00 74), s-density PSA, tumour dimension, capsular penetration, seminal vesicle invasion and positive surgical margins were all significant predictors of biochemical failure, while MVDmean (p = 0.0084) was the only statistically significant predictor of clinical recurrence. In multivariate Cox' analysis , MVDmean (p = 0.0003), capsular penetration and tumour dimension remained as independent predictors of biochemical failure. Conclusion: Assessment of MVD in moderately differentiated prostatic adenocarcinomas may improve the prognostic stratification of patients after radical prostatectomy.