Use of Gleason Score, Prostate Specific Antigen, Seminal Vesicle and Margin Status to Predict Biochemical Failure After Radical Prostatectomy

Blute, Michael L.; Bergstralh, Erik J.; Iocca, Angelo J.; Scherer, Beth G.; Zincke, Horst

doi:10.1097/00005392-200101000-00030

Cited by 262 publications

(157 citation statements)

References 20 publications

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“…48 However, nearly two thirds of patients diagnosed with prostate cancer have the preoperative PSA range 4-10 ng/ml, with T1C disease and a biopsy Gleason score of 5-7. [47][48][49][50][51][52] For such patients, one or a combination of accurate prognostic indicators could improve the physicians' ability to identify aggressive disease, so that more individualized treatments could be offered. In this study, preoperative PSA level and COX-2 expression were found to provide independent prognostic information.…”

Section: Determination Of Sensitivity Specificity Accuracy Ppv Andmentioning

confidence: 99%

Cyclooxygenase‐2 (cox‐2) expression is an independent predictor of prostate cancer recurrence

Cohen

Gómez

Omori

et al. 2006

Intl Journal of Cancer

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Lack of reliable prognostic markers hinders accurate prediction of disease progression in prostate cancer. The inducible proinflammatory enzyme cyclooxygenase-2 (COX-2) is implicated in prostate carcinogenesis, but its role in cancer progression is less clear. We examined whether COX-2 expression evaluated by immunohistochemistry (IHC) in radical prostatectomy (RP) specimens can predict biochemical recurrence. Archival prostate cancer specimens (n 5 60) were obtained from patients who underwent RP, but had not received neoadjuvant hormonal therapy. Twentythree patients had biochemical or clinical recurrence (mean time of recurrence: 38.2 months), and 37 patients were recurrence free (mean follow-up: 95 months). COX-2 expression was determined by IHC, using an anti-COX-2 antibody. Three individuals scored the staining independently, as high-or low-expression. COX-2 was expressed in prostate cancer cells, in adjacent normal glands and in specimens from patients who later progressed. At 62-months follow-up, COX-2 staining predicted progression with 82.4% sensitivity and 81.3% specificity. Sensitivity (86.4%) and specificity (86.7%) improved at 100-months follow-up. In univariate analysis, Gleason score, preoperative PSA, extraprostatic extension, margin, seminal vesicle invasion, and high COX-2 expression were significant predictors of biochemical recurrence (p < 0.05). In multivariate analysis, preoperative PSA (hazard ratio/unit PSA change 1.080; p 5 0.0036) and COX-2 expression (hazard ratio 16.442; p < 0.0001) were independent prognostic indicators. Patients with PSA > 7 ng/ml and high COX-2 expression had the highest probability of recurrence (Kaplan-Meier analysis). COX-2 expression is an independent predictor of prostate cancer progression following RP and underscores the significance of inflammatory factors in this process. ' 2006 Wiley-Liss, Inc.Key words: inflammation; immunohistochemistry; PSA; cancer progression; prognostic indicators; multivariate analysis; tumor markers Cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) are prostaglandin endoperoxide synthases, which are rate limiting enzymes in the conversion of the fatty acid arachidonic acid into physiologically active eicosanoids such as prostaglandin, thromboxane and prostacyclin. 1 COX-2 is the inducible form of COX that is frequently elevated in cancer tissues. [2][3][4] Although the mechanism of COX-2 action in carcinogenesis or progression is not well established, COX-2 inhibitors have been shown to be chemopreventive in cancer, specifically in colorectal cancer. [5][6][7] The expression and role of COX-2 in prostate cancer has been a topic of several reports over the decade. 8,9 There exists some controversy over the expression, detection and the putative role of COX-2 in prostate carcinogenesis and progression. While early studies reported high-level expression of COX-2 in prostate, findings from subsequent studies have been mixed. [10][11][12] Typically, later studies reported low or no expression in normal, benign prostatic hyperplasi...

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Section: Determination Of Sensitivity Specificity Accuracy Ppv Andmentioning

confidence: 99%

Cyclooxygenase‐2 (cox‐2) expression is an independent predictor of prostate cancer recurrence

Cohen

Gómez

Omori

et al. 2006

Intl Journal of Cancer

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“…1 As such, margin status has been incorporated as a component of multiple prostate cancer outcome predictive models, 2,3 and as a criterion for enrollment in adjuvant therapy trials. 4,5 However, as surgical margin status has been linked to other clinicopathological features such as tumor stage, Gleason score, tumor volume and even year of surgery, 1,[6][7][8][9] the independent impact of margin status on patient outcome has been challenged.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological predictors of systemic progression and prostate cancer mortality in patients with a positive surgical margin at radical prostatectomy

Boorjian

Tollefson

Rangel

et al. 2011

Prostate Cancer Prostatic Dis

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BACKGROUND: Although a positive surgical margin (PSM) at radical prostatectomy (RRP) has been consistently linked to an increased risk of biochemical recurrence, the impact of margin status on patient survival continues to be debated. We evaluated long-term outcomes of patients with a PSM at RRP and determined predictors of systemic progression (SP) and mortality in these men. METHODS:We reviewed our institutional registry of 16 749 patients who underwent RRP between 1990 and 2008 to identify 2895 patients with a PSM. Median follow-up was 10.6 years. Postoperative survival was estimated using the Kaplan-Meier method. Cox proportional hazard regression models were used to analyze clinicopathological variables associated with SP and death from prostate cancer. RESULTS:A 15-year SP-free and cancer-specific survival was 90 and 93%, respectively. On multivariate analysis, higher tumor volume, increased pathological Gleason score and advanced pathological tumor stage were associated with significantly increased risks of SP and death from prostate cancer, whereas number and location of PSM did not predict mortality. CONCLUSIONS:The risks of SP and prostate cancer death in patients with a PSM remain low on long-term follow-up. Tumor variables are the primary determinants of cancer death. These results should be considered when evaluating patients with a PSM for adjuvant therapy.

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“…Oversikt over arbeider der man har studert den prognostiske verdien av DNA-ploidianalyser for pasienter med prostatakarsinom (2000 -16 De fleste av disse studiene (fem av syv) viste at aneuploide svulster er assosiert med dårligere prognose (32,(34)(35)(36)(37), mens i to studier så man ingen sammenheng mellom aneuploiditet og sykdomsoverlevelse (31, 33). I de arbeidene som inkluderte flest pasienter (n > 2 500), ble det observert en signifikant sammenheng mellom DNA-ploiditet og prostatakreftresidiv (32,36).…”

Section: Tabellunclassified

“…I de arbeidene som inkluderte flest pasienter (n > 2 500), ble det observert en signifikant sammenheng mellom DNA-ploiditet og prostatakreftresidiv (32,36). Pasienter med aneuploide svulster fikk signifikant oftere tilbakefall av sykdom enn pasienter med diploide svulster (henholdsvis 60 % og 81 % progredieringsfri femårsoverlevelse) (32,36).…”

Section: Tabellunclassified

Egenskaper ved kreftcellenes DNA påvirker prognosen

et al. 2017

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Use of Gleason Score, Prostate Specific Antigen, Seminal Vesicle and Margin Status to Predict Biochemical Failure After Radical Prostatectomy

Cited by 262 publications

References 20 publications

Cyclooxygenase‐2 (cox‐2) expression is an independent predictor of prostate cancer recurrence

Cyclooxygenase‐2 (cox‐2) expression is an independent predictor of prostate cancer recurrence

Clinicopathological predictors of systemic progression and prostate cancer mortality in patients with a positive surgical margin at radical prostatectomy

Egenskaper ved kreftcellenes DNA påvirker prognosen

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