Introduction: This study was designed to test whether early castration-induced short-term cellular changes in primary prostate tumours could predict clinical outcome in advanced disease.

Nina Ohlson^a, Anders Bergh^a, Katarina Nygren^b, Pär Stattin^b, Pernilla Wikström^a
aDepartments of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden
^bSurgery and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden

Accepted 4 October 2005 published online 19 December 2005.

Abstract

Introduction

This study was designed to test whether early castration-induced short-term cellular changes in primary prostate tumours could predict clinical outcome in advanced disease.

Patients and methods

Biopsies from 83 patients obtained before and within two weeks after surgical castration were investigated. Tumour epithelial cell apoptosis, proliferation, and prostate specific antigen (PSA) levels were quantified using immunohistochemistry, laser capture micro-dissection, and real time RT-PCR. Cellular effects were related to changes in serum PSA levels and clinical outcome.

Results

Decreased proliferation and PSA mRNA levels, and increased apoptosis were observed in most tumours. These early cellular responses were not correlated to each other and did not predict serum PSA response or cancer-specific survival. A nadir PSA level below 1ng/ml predicted a longer cancer-specific survival after castration therapy.

Conclusion

Castration therapy causes primary tumour regression in most patients with advanced prostate cancer, but these primary tumour effects are not predictive for systemic disease control. Studies of early changes in metastases during hormonal therapy will probably give more predictive information for clinical outcome than further studies in primary tumours.

European Urology - 2006 04 (Vol. 49, Issue 4) p.675-684 Full Text

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