Prognostic factors in prostatic adenocarcinoma assessed by means of quantitative histology

A series of 91 patients with prostatic adenocarcinoma were retrospectively followed up for an average of 15.6 years. The biopsies of the primary tumours were analysed using morphometry for six nuclear features, mitotic-activity index (MAI) and volume-corrected mitotic index. The histological grading of the tumours into three grades was done, and perineural infiltration and lymphatic infiltration were estimated. Clinical stage (p = 0.0137), lymphatic infiltration (p = 0.076) and histological grade (p = 0.1603) were the best predictors of survival in univariate analysis. A multiparameter analysis of progression in T category disclosed the MAI to be the most important single prognostic factor (p = 0.0276). Histological grade predicted progression in M category (p = 0.0166) in the same analysis. In intracapsular T1-T2 tumours, the SD of nuclear perimeter (p = 0.008) was shown by a multivariate analysis to be the most important predictor of progression. Progressed T1-T2 tumours had higher mitotic index values (p = 0.0215). The results advocate the use of mitotic indexes and morphometric measurements instead or as an adjunct of the conventional histological grading while predicting the progression of prostatic adenocarcinoma.