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 (Tom) Beer

Research output: Contribution to journalArticle

32 Citations (Scopus)

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

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Prostatic Neoplasms
docetaxel
Neoplasm Metastasis
Recurrence
Drug Therapy
Lymph Nodes
Mitoxantrone
Carcinoma, Intraductal, Noninfiltrating
Survival
Kaplan-Meier Estimate
Prostate-Specific Antigen
Neoplasms
Multivariate Analysis
Survival Rate
Logistic Models
Regression Analysis
Clinical Trials

Keywords

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

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Histologic changes associated with neoadjuvant chemotherapy are predictive of nodal metastases in patients with high-risk prostate cancer. / O'Brien, Catherine; True, Lawrence D.; Higano, Celestia S.; Rademacher, Brooks L S; Garzotto, Mark; Beer, Tomasz (Tom).

In: American Journal of Clinical Pathology, Vol. 133, No. 4, 04.2010, p. 654-661.

Research output: Contribution to journalArticle

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