Histologic changes associated with neoadjuvant chemotherapy are predictive of nodal metastases in patients with high-risk prostate cancer

Catherine O'Brien, Lawrence D. True, Celestia S. Higano, Brooks L.S. Rademacher, Mark Garzotto, Tomasz M. Beer

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Clinical trials are evaluating the effect of neoadjuvant chemotherapy on men with high-risk prostate cancer. Little is known about the clinical significance of postchemotherapy tumor histopathologic features. We assessed the prognostic and predictive value of histologic features (intraductal carcinoma, vacuolated cell morphologic features, inconspicuous glands, cribriform architecture, and inconspicuous cancer cells) observed in 50 high-risk prostate cancers treated with preprostatectomy docetaxel and mitoxantrone. At a median follow-up of 65 months, the overall relapse-free survival (RFS) rates at 2 and 5 years were 65% and 49%, respectively. In univariate analyses (using the Kaplan-Meier method and log-rank tests), intraductal (P = .001) and cribriform (P = .014) histologic features were associated with shorter RFS. In multivariate analyses, using the Cox proportional hazards regression, baseline prostate-specific antigen (P = .004), lymph node metastases (P < .001), and cribriform histologic features (P = .007) were associated with shorter RFS. In multivariable logistic regression analysis, only intraductal pattern (P = .007) predicted lymph node metastases. Intraductal and cribriform histologic features apparently predict postchemotherapy outcome.

Original languageEnglish (US)
Pages (from-to)654-661
Number of pages8
JournalAmerican journal of clinical pathology
Volume133
Issue number4
DOIs
StatePublished - Apr 2010

Keywords

  • Carcinoma
  • Chemotherapy
  • Cribriform
  • Intraductal
  • Neoadjuvant
  • Prostate

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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