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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© 1989 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
