Prostate cancer: indicators of aggressiveness

In spite of the slow progression rates common to most prostate cancers, it is well recognized that a subset of patients will experience a more aggressive course with many losing their lives to this malignancy. As the number of patients diagnosed with prostate cancer continues to increase, there is a growing pressure to refine and supplement the three most important prognostic parameters for this disease (tumor pathologic stage, its histologic differentiation (Gleason score) and the level of prostate specific antigen). While this review emphasizes the value of these factors in stratifying patients into risk groups, it also explores the prognostic significance of additional commonly used and evolving non-traditional markers (DNA ploidy, proliferation, tumor angiogenesis, and the status of tumor suppressor genes).