Adenocarcinoma on needle prostatic biopsies: Does reactive stroma predicts biochemical recurrence in patients following radical prostatectomy?

Abstract

Objective: There is evidence that reactive stroma in different cancers may regulate tumor progression. The aim of this study is to establish any possible relation of reactive stroma grading on needle prostatic biopsies to biochemical recurrence. Materials and Methods:The study group comprised 266 biopsies from consecutive patients submitted to radical prostatectomy. Reactive stroma was defined as stroma surrounding neoplastic tissue and graded as 0 (absent), 1 (slight), 2 (moderate), and 3 (intense) according to tumor stroma area relative to total tumor area. Results: From the total of 266 needle prostatic biopsies, 143 (53.8%), 55 (20.7%), 54 (20.3%), and 14 (5.3%) showed grades 0, 1, 2, and 3, respectively. Increasing reactive stroma grade was significantly associated with clinical stage T2, higher preoperative PSA, higher biopsy and radical prostatectomy Gleason score, more extensive tumors in radical prostatectomy, and pathologic stage > T2. Only grade 3 was significantly associated with time and risk to biochemical recurrence. On multivariate analysis only preoperative PSA and 2 methods of biopsy tumor extent evaluation were independent predictors. Conclusion: Increasing reactive stroma grade on biopsies is significantly associated with several clinicopathologic adverse findings, however, only grade 3 predicts time and risk to biochemical recurrence following radical prostatectomy on univariate but not on multivariate analysis. We have not been able to show that reactive stroma grade 3 on biopsies is an independent predictor of biochemical recurrence beyond that of preoperative PSA and other pathologic findings on biopsy.

Gray level entropy matrix is a superior predictor than multiplex ELISA in the detection of reactive stroma and metastatic potential of high‐grade prostatic adenocarcinoma

“…It has been shown that increasing reactive stroma grade on biopsies is significantly associated with several clinicopathologic adverse findings; however, only grade 3 predicts time and risk to biochemical recurrence following radical prostatectomy on univariate but not on multivariate analysis . However, this study has not been able to provide evidence that reactive stroma grade 3 on biopsies is an independent predictor of biochemical recurrence beyond that of preoperative PSA and other pathologic findings on biopsy.…”

The prognostic value of reactive stroma on prostate needle biopsy: A population‐based study

“…A further study by the same research group showed that the total area of RSG 3 in prostatectomy specimens was correlated with the risk of PCSM . In a recent and independent study by Billis et al, RSG 3 in prostate biopsies from patients undergoing prostatectomy was associated with biochemical failure in univariate analysis, but not when adjusting for other clinicopathologic parameters . They could not find a correlation between RSG 0 and poor outcome.…”

Characterization of reactive stroma in prostate cancer: involvement of growth factors, metalloproteinase matrix, sexual hormones receptors and prostatic stem cells

“…Yanagisawa ( 29 ) analyzed prostatic biopsies of 205 patients and demonstrated a significant difference between high and low reactive RSTr and concluded that the intensity of RStr may be considered a prognostic factor independent of biochemical recurrence. Also, Ayala ( 15 ), after analyzing samples from radical prostatectomy and Billis ( 30 ), that analyzed 266 needle prostatic biopsies showed that RStr could only be considered an prognostic factor independent of biochemical recurrence when it showed intense stromal reactivity. Still, RStr with intense stromal reactivity was observed in Ayala ( 15 ), Yanagisawa ( 29 ) and Billis ( 30 ) studies in 9.0%, 6.7% and 5.3% of samples respectively, with very similar frequencies among the studies.…”

“…Also, Ayala ( 15 ), after analyzing samples from radical prostatectomy and Billis ( 30 ), that analyzed 266 needle prostatic biopsies showed that RStr could only be considered an prognostic factor independent of biochemical recurrence when it showed intense stromal reactivity. Still, RStr with intense stromal reactivity was observed in Ayala ( 15 ), Yanagisawa ( 29 ) and Billis ( 30 ) studies in 9.0%, 6.7% and 5.3% of samples respectively, with very similar frequencies among the studies. However, RStr with low stromal reactivity frequencies were very distinct among these three papers: 6.25% (Ayala, 15), 0.5% (Yanagisawa, 29) and 53.8% (Billis, 30).…”