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Prognostic markers in clinically localized prostate cancer
1Department of Urology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Techniques in Urology
|May 6, 1998
Summary
Predicting outcomes for localized prostate cancer is challenging. Current clinical and pathological factors offer a preliminary prognosis, but molecular markers may improve accuracy for treatment decisions.
Area of Science:
- Urology
- Oncology
- Pathology
Background:
- Managing localized prostate cancer involves complex decisions regarding treatment intensity and modality.
- Accurate prognostication is crucial for tailoring treatment and managing patient expectations.
Purpose of the Study:
- To review the current ability to predict outcomes in localized prostate cancer patients.
- To evaluate the prognostic value of clinical, pathological, and novel molecular markers.
Main Methods:
- Analysis of contemporary series of patients treated with radical prostatectomy and external-beam radiation therapy.
- Review of prognostic information from pretherapy prostate-specific antigen (PSA) levels, Gleason score, and pathological stage.
- Examination of novel markers of biological aggressiveness, including p53, bcl-2, Ki-67, and microvessel density.
Main Results:
- Pretherapy PSA and Gleason score provide independent prognostic information for a subset of patients.
- Pathological stage is a powerful outcome predictor after radical prostatectomy, aided by clinical stage, Gleason score, and PSA.
- Novel molecular markers are being evaluated for their role in predicting prostate cancer progression and metastasis.
Conclusions:
- Current clinical and pathological parameters offer a "ballpark" estimate of prognosis for localized prostate cancer.
- Further research into molecular events could lead to more accurate prognostic markers.
- Improved prognostication will aid in selecting appropriate treatments and predicting outcomes for individual patients.