THE “NEW” PROSTATE CANCER INFOLINK

More news of a relatively theoretical nature today:

• The relevance of nuclear roundness variance in predicting risk of disease progression
• Incorporation of the PCA3 gene marker into the PCPT risk calculator
• Saving the neurovascular bundles has no impact on long-term continence

The shape of the cell nucleus in prostate cancer cells has long been considered a potential factor in the risk for edisease progression. In other words, there seems to be something about nuclear structure that may predict the aggressiveness of pprostate cancer in individual patients. Veltri et al. have assessed the prognostic value of selected parameters in 105 clinically localized prostate cancer tumors with long-term follow-up after radical prostatectomy for progression-free survival (PFS). In particular they assessed the impact of nuclear roundness variance (NRV), together with the expression of Ki67, PCNA (proliferation), Chromogranin A (neuroendocrine differentiation), CD31 (angiogenesis), BCL2 (apoptosis), and Her-2/neu (oncogene) in the tumors. Their results showed that Gleason score, focal vs. non-focal extraprostatic extension, organ-confined status, NRV, Her-2/neu, CD-31, and Ki67 were all significant independent predictors of PFS. In this study, NRV was the most significant prognostic indicator for PFS. The authors suggest that integration of image analysis-based NRV and selected molecular biomarkers (most particularly expression of the Her-2/neu oncogene) with pathologic parameters should be considered for validation in the prediction of PFS.

Ankerst et al. have suggested that by incorporating data about the prostate cancer gene 3 (PCA3) biomarker into the Prostate Cancer Prevention Trial (PCPT) risk calculator it may be possible to improve the diagnostic accuracy of the PCPT risk calculator. They developed their model using a cohort of 521 men who underwent prostate biopsy and then validated the updated risk calculator by assessing its predictive value compared to other forms of risk assessment in a cohort of 443 European patients.

Marien and Lepor have reported on the association between the preservation of the neurovascular bundles (NVBs), potency, and urinary continence after open radical retropubic prostatectomy (ORRP) in 1,110 consecutive, continent patients operated on by a single surgeon betwwen 2002 and 2005. Their bottom line appears to be that continence is not affected by the preservation of the nerve bundles; that men who are potent or impotent following surgery have closely comparable continence rates; and that therefore preserving the NVBs is not justified in men who are impotent prior to surgery.