Mitotic activity and prognosis in prostatic adenocarcinoma

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Abstract
Mitotic figures were quantitated by two different methods (number of mitotic figures in 10 high power fields, MI; number of mitotic figures/mm2of neoplastic epithelium, M/V) in a series of 303 prostatic adenocarcinomas, and the results were related to clinical and histological features as well as to prognosis. Gleason score and mitotic indices were significantly interrelated. Invasive T3–4 tumors showed higher mitosis counts than did the local ones, and metastasis at the time of diagnosis was related to mitotic indices as well. Progression and progression‐free survival were related significantly to Gleason score and mitoric indices. In univariate survival analysis, T‐category, M‐category, Gleason score, MI, and M/V were significant prognostic factors. In multivariate analysis, independent predictors of survival were M‐category, T‐category, Gleason score, patient age, and the M/V index. If the Gleason score was not included, M/V included all the available prognostic information in T1–2M0 carcinomas. The results show that, in addition to the conventional Gleason grading system, mitotic indices are useful prognostic parameters while evaluating the long‐term prognosis in prostatic adenocarcinoma.