Prognostic Factors in Prostate Cancer

Author:

Bostwick David G.1,Grignon David J.1,Hammond M. Elizabeth H.1,Amin Mahul B.1,Cohen Michael1,Crawford David1,Gospadarowicz Mary1,Kaplan Richard S.1,Miller Daniel S.1,Montironi Rodolfo1,Pajak Thomas F.1,Pollack Alan1,Srigley John R.1,Yarbro John W.1

Affiliation:

1. From Bostwick Laboratories, Richmond, Va (Dr Bostwick); Wayne State University, Detroit, Mich (Dr Grignon); LDS Hospital and University of Utah School of Medicine, Salt Lake City, Utah (Dr Hammond); Emory University, Atlanta, Ga

Abstract

Abstract Background.—Under the auspices of the College of American Pathologists, a multidisciplinary group of clinicians, pathologists, and statisticians considered prognostic and predictive factors in prostate cancer and stratified them into categories reflecting the strength of published evidence and taking into account the expert opinions of the Prostate Working Group members. Materials and Methods.—Factors were ranked according to the previous College of American Pathologists categorical rankings: category I, factors proven to be of prognostic importance and useful in clinical patient management; category II, factors that have been extensively studied biologically and clinically but whose importance remains to be validated in statistically robust studies; and category III, all other factors not sufficiently studied to demonstrate their prognostic value. Factors in categories I and II were considered with respect to variations in methods of analysis, interpretation of findings, reporting of data, and statistical evaluation. For each factor, detailed recommendations for improvement were made. Recommendations were based on the following aims: (1) increasing uniformity and completeness of pathologic evaluation of tumor specimens, (2) enhancing the quality of data collected pertaining to existing prognostic factors, and (3) improving patient care. Results and Conclusions.—Factors ranked in category I included preoperative serum prostate-specific antigen level, TNM stage grouping, histologic grade as Gleason score, and surgical margin status. Category II factors included tumor volume, histologic type, and DNA ploidy. Factors in category III included perineural invasion, neuroendocrine differentiation, microvessel density, nuclear roundness, chromatin texture, other karyometric factors, proliferation markers, prostate-specific antigen derivatives, and other factors (oncogenes, tumor suppressor genes, apoptosis genes, etc).

Publisher

Archives of Pathology and Laboratory Medicine

Subject

Medical Laboratory Technology,General Medicine,Pathology and Forensic Medicine

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