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Stage C Prostatic Adenocarcinoma: Flow Cytometric Nuclear DNA Ploidy Analysis

      Flow cytometric nuclear DNA ploidy analysis was used to study pathologic stage C prostatic adenocarcinoma (pT3, N0, M0) in 146 patients who underwent radical retropubic prostatectomy and bilateral pelvic lymphadenectomy between 1967 and 1981. Of these tumors, 46% had a DNA diploid pattern, 47% had a DNA tetraploid pattern, and 7% had a DNA aneuploid pattern. Abnormal ploidy patterns were associated more frequently with histologic high-grade tumors than with low-grade tumors. Considered alone, DNA ploidy pattern showed a strong association with subsequent prognosis. The median interval to progression for tumors with DNA tetraploid and DNA aneuploid patterns was 7.8 and 3.5 years, respectively. For the DNA diploid tumors, only 23% progressed within 18 years, the longest follow-up. At 10 years, only 10% of patients with DNA diploid tumors had died of prostatic cancer, in comparison with 28% of the DNA tetraploid and 36% of the DNA aneuploid groups (P<0.01). By analysis of a combination of histologic tumor grade and nuclear DNA ploidy pattern, an even stronger association with prognosis was demonstrated. For the 38 patients with histologic low-grade and DNA diploid tumors, progression-free survival was 92% at 10 years, in comparison with 57% for 23 patients with low-grade DNA nondiploid tumors. Patients with high-grade tumors had a poorer prognosis whether the DNA ploidy pattern was diploid or nondiploid. Nuclear DNA ploidy pattern is an important and independent prognostic variable for patients with pathologic stage C prostatic cancer treated by radical prostatectomy.
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      REFERENCES

        • De Vere White R
        • Paulson DF
        • Glenn JF
        The clinical spectrum of prostate cancer.
        J Urol. 1977; 117: 323-327
        • Catalona WJ
        • Scott WW
        Carcinoma of the prostate: a review.
        J Urol. 1978; 119: 1-8
        • Kirk D
        Prostatic carcinoma.
        Br Med J. 1985; 290: 875-876
        • Fordham MVP
        • Burdge AH
        • Matthews J
        • Williams G
        • Cooke T
        Prostatic carcinoma cell DNA content measured by flow cytometry and its relation to clinical outcome.
        Br J Surg. 1986; 73: 400-403
        • Benson MC
        • Walsh PC
        The application of flow cytometry to the assessment of tumor cell heterogeneity and the grading of human prostatic cancer: preliminary results.
        J Urol. 1986; 135: 1194-1198
        • Tribukait B
        Flow cytometry in assessing the clinical aggressiveness of genito-urinary neoplasms.
        World J Urol. 1987; 5: 108-122
        • Stephenson RA
        • James BC
        • Gay H
        • Fair WR
        • Whitmore Jr, WF
        • Melamed MR
        Flow cytometry of prostate cancer: relationship of DNA content to survival.
        Cancer Res. 1987; 47: 2504-2507
        • Winkler HZ
        • Rainwater LM
        • Myers RP
        • Farrow GM
        • Therneau TM
        • Zincke H
        • Lieber MM
        Stage D1 prostatic adenocarcinoma: significance of nuclear DNA ploidy patterns studied by flow cytometry.
        Mayo Clin Proc. 1988; 63: 103-112
        • Utz DC
        • Farrow GM
        Pathologic differentiation and prognosis of prostatic carcinoma.
        JAMA. 1969; 209: 1701-1703
        • Gleason DF
        • Mellinger GT
        • Veterans Aministration Cooperative Urological Research Group
        Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging.
        J Urol. 1974; 111: 58-64
        • Zincke H
        • Fleming TR
        • Furlow WL
        • Myers RP
        • Utz DC
        Radical retropubic prostatectomy and pelvic lymphadenectomy for high-stage cancer of the prostate.
        Cancer. 1981; 47: 1901-1910
        • Hedley DW
        • Friedlander ML
        • Taylor IW
        • Rugg CA
        • Musgrove EA
        Method for analysis of cellular DNA content of paraffin-embedded pathological material using flow cytometry.
        J Histochem Cytochem. 1983; 31: 1333-1335
        • Vindeløv LL
        • Christensen IJ
        • Nissen NI
        A detergent-trypsin method for the preparation of nuclei for flow cytometric DNA analysis.
        Cytometry. 1983; 3: 323-327
        • Dean PN
        • Jett JH
        Mathematical analysis of DNA distributions derived from flow microfluorometry.
        J Cell Biol. 1974; 60: 523-527
        • Kaplan EL
        • Meier P
        Nonparametric estimation from incomplete observations.
        J Am Stat Assoc. 1958; 53: 457-481
        • Peto R
        • Peto J
        Asymptomatically efficient rank invariant test procedures.
        J R Stat Soc [A]. 1972; 135: 185-206
        • Lee SE
        • Currin SM
        • Paulson DF
        • Walther PJ
        Flow cytometric determination of ploidy in prostatic adenocarcinoma: a comparison with seminal vesicle involvement and histopathological grading as a predictor of clinical recurrence.
        J Urol. 1988; 140: 769-774