Prognostic criteria in patients with stage D2 prostate cancer. Correlation with mean nuclear volume

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Abstract
Background. Histologic grading, especially the Gleason score (GS), is considered to be of value in determining the prognosis of patients with prostate cancer. However, subjective histologic grading is characterized by low reproducibility. Conversely, estimates of mean nuclear volume (MNV), developed by Gunderson and Jensen based on a stereologic technique, is a method with high reproducibility. Furthermore, it has been reported that MNV provides an accurate prognosis of bladder cancer. In this study MNV was compared with two histologic grading methods in determining the prognosis of Stage D2 prostate cancer. Methods. A retrospective, prognostic study of 31 patients with Stage D2 prostate cancer treated with trans-urethral resection of the prostate or needle biopsy between January, 1983, and July, 1994, was performed. Unbiased estimates of MNV were compared with age at the time of diagnosis, histologic grading according to World Health Organization (WHO) classification, and GS on the prognostic value. Results. Age at the time of diagnosis, WHO classification and GS had no value as prognostic criteria, and only MNV correlated significantly with prognosis of Stage D2 prostate cancer (P = 0.0017). Conclusion. Results of this study indicate that MNV is prognostically superior to morphologic grading of malignancy, such as GS and WHO classification, in Stage D2 prostate cancer.