The worst histologic elements predict prognosis in moderately-differentiated prostate cancer patients with androgen-withdrawal endocrine therapy.

Abstract

We evaluated the prognostic value of the worst histologic elements in 155 patients with moderately-differentiated prostate cancer (Gleason sum 5-7) treated with androgen-withdrawal endocrine therapy. In individual cases, the proportion (%) of medullary/solid combined with columns-and-cords/trabecular (MED & C-C), regarded as the worst histologic elements, determined according to WHO-Mostofi's classification of histologic patterns, within the total adenocarcinoma area obtained from needle specimens was estimated. Patients with proportion of MED & C-C >5% had a significantly poorer prognosis than those with <5% (p < 0.05). A significant difference was also found in the survival curves of patients grouped by stage (p < 0.01). There was no significant difference among the patients with Gleason sum of 5, 6 and 7. Multivariate analysis showed that stage and MED & C-C had independent prognostic value. Proportion of MED & C-C may provide useful prognostic information about patients with moderately-differentiated, Gleason sum 5-7, prostate cancer treated with androgen-withdrawal endocrine therapy.