Abstract
We aimed to identify tissue biomarkers that predict early biochemical recurrence (BCR) in patients with high-risk prostate cancer (PC), toward the goal of increasing the benefits of neoadjuvant hormonal therapy (NHT). In 2005–2012, prostatectomy specimens were collected from 134 PC patients who had received NHT and radical prostatectomy. The expression of 13 tissue biomarkers was assessed in the specimens via immunohistochemistry. Time to BCR and factors predictive of BCR were determined by using the Cox proportional hazards model. During the follow-up period (median, 57.5 months), 67 (50.0%) patients experienced BCR. Four (3.0%) patients were tumor-free in the final pathology assessment, and 101 (75.4%) had negative resection margins. Prostate stem cell antigen (PSCA) was the only significant prognostic tissue biomarker of BCR [hazard ratio (HR), 2.58; 95% confidence interval (CI), 1.06–6.27; p = 0.037] in a multivariable analysis adjusted by the clinicopathological variables that also significantly predicted BCR; these were seminal vesicle invasion (HR, 2.39; 95% CI, 1.32–4.34), initial prostate serum antigen level (HR 1.01; 95% CI, 1.001–1.020), prostate size (HR, 0.93; 95% CI, 0.90–0.97), and the Gleason score of preoperative biopsies (HR, 1.34; 95% CI, 1.01–1.79). We suggest that PSCA is a useful tissue marker for predicting BCR in patients with high risk PC receiving NHT and radical prostatectomy.
Highlights
Owing to advances in diagnostic screening and therapeutic procedures including surgery, clinical outcomes in prostate cancer (PC) have recently improved
Non-metastatic advanced PC that extends beyond the prostate gland has a relatively high chance of biochemical recurrence (BCR) after radical prostatectomy (RP) and a 5-year BCR-free survival rate of only 10–40% [1, 2]
Toward the goal of identifying significant prognostic factors for BCR, we examined a set of tissue biomarkers in whole-mounted RP specimens, as well as clinicopathological variables, in patients with high risk PC who received neoadjuvant hormonal therapy (NHT)
Summary
Owing to advances in diagnostic screening and therapeutic procedures including surgery, clinical outcomes in prostate cancer (PC) have recently improved. To improve the clinical outcome, as assessed via changes in local disease burden, of locally advanced PCs and high risk PCs, neoadjuvant hormonal therapy (NHT) has been performed before RP in the past two decades [3]. Doing so has improved the pathological outcome of undetected micro-metastases in clinical trials with different endpoints owing to a more complete resection with a higher possibility of organ-confined disease, a lower possibility of extracapsular extension, positive surgical margins, and lymph node involvement, and a greater reduction in testosterone and prostate-specific antigen (PSA) levels [4]. Morphological signs of tumor regression such as apoptosis-induced atrophy of non-neoplastic and neoplastic prostatic epithelium are consistently seen; they complicate the recognition and grading of treated carcinomas, which is an objective means of assessing the success of therapy in histopathological follow-ups monitoring local PC regression
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