Significance of Tumour Biological Markers for Overall Survival and Clinical Parameters for Disease-Free Survival in Patients with Prostate Cancer after Radical Prostatectomy

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Objective: The aim of the study was to assess the prognostic significance of pretreatment serum PSA level, immunohistochemical expression (labelling index, LI) of Ki-67, prostate-specific membrane antigen (PSMA), glucose-1 transporter (GLUT-1), vascular endothelial growth factor (VEGF), human telomerase reverse transcriptase (hTERT), as well as micro vessel density (MVD) for overall survival (OS), local recurrence-free survival (LRFS), metastatic-free survival (MFS) and disease-free survival (DFS) in a group of 130 prostate cancer (PCa) patients treated with radical prostatectomy (RP) between 2007 and 2011. Methods: In order to investigate the prognostic value of the analyzed variables in univariate and multivariate Cox analysis, the patients were divided into two subgroups based on the marker cut-off points selected by the receiver operating characteristic curves. Results: There were 83 (63.8%) cases staged pT1-2 and 47 (36.1%) staged pT3-4. The majority of tumours (53.1%) were well-differentiated (grade group G1), 49 (37.7%) moderately differentiated (G2-3) and 12 (9.2%) poorly differentiated (G4-5). In 85 patients (65.4%) the surgery was radical, 59 (45.4%) had positive surgical margins (PSM), and in 23 (17.7%) seminal vesicle(s) involvement was diagnosed. Median followup was 79 (1-148) months, during which 55 (42.3%) men died, in 12 (9.2%) local relapse and in 13 (10%) distant metastases occurred. In multivariate Cox analysis, independent negative prognostic factors for OS were: Ki-67LI >6.7% (p=0.010), PSMALI ≤51.7% (p=0.009), hTERTLI ≤20.5% (p=0.004) and lack of adjuvant treatment (AT) (p=0.013), while for MFS: seminal vesicle(s) involvement (p=0.007) and hTERTLI ≤43.8% (p=0.011). However, non-radical surgery (p=0.007), PSM (p=0.005) and AT (p=0.037) were negatively associated with DFS. Conclusion: Tumour biological markers are significant for OS and clinical parameters for DFS in PCa patients’ after RP.