Abstract
We analysed ploidy and S-phase fraction (SPF) from 78 paraffin-embedded primary prostatic carcinomas by DNA flow cytometry. DNA aneuploidy and above median (4.2%) SPF were both associated with high tumour grade, large size of prostate and presence of distant metastases. Both aneuploidy and high SPF (greater than 4.2%) indicated short 10-year progression-free (P = 0.01 for ploidy and P = 0.0002 for SPF), overall (P = 0.004 and P less than 0.0001) as well as prostate cancer survival (P = 0.002 and P less than 0.0001). Ten-year overall survival rate was 45% in cases with SPF below 4.2% and 0% in those with higher values, whereas the corresponding prostate cancer-specific survival rates were 80% and 11%, respectively. None of the seven tumours with SPF above 12% showed an objective response to endocrine therapy, whereas 26/49 (52%) of those with lower SPF values responded (P = 0.01). DNA ploidy, tumour grade, T-stage or M-stage did not significantly correlate with endocrine responsiveness. SPF was also the best predictor of progression free survival in patients treated hormonally. In conclusion, detection of high SPF in prostate cancer may indicate lack of hormonal responsiveness and poor prognosis.
Highlights
Few investigators have studied S-phase fraction (SPF) from prostatic carcinomas
DNA aneuploidy was significantly associated with high tumour grade, large size of prostate and the presence of distant metastases (MI) at the time of diagnosis (Table I)
High SPF was associated with poorly differentiated high-grade tumours, large size of prostate, locally advanced tumours (T3-T4) and the presence of distant metastases (MI) (Table I)
Summary
Few investigators have studied SPF from prostatic carcinomas. SPF appears to be higher in carcinomas than in benign prostate lesions (Schultz et al, 1985) as well as in poorly differentiated carcinomas as compared to welldifferentiated ones (Neill et al, 1989). SPF has been found to be higher in DNA-aneuploid tumours than in DNA diploid ones (Frankfurt et al, 1984). The actual prognostic value of SPF in prostate cancer has remained unknown. In the present study we compared the significance of tumour DNA ploidy and SPF in the assessment of longterm prognosis and responsiveness to endocrine therapy in 78 primary prostatic carcinoma patients. A new software program was used to more accurately analyse SPFs from DNA histograms obtained from paraffin-embedded tissues (Kallioniemi et al, 1991)
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