Histologically Overt Stromal Response and the Risk of Progression after Radical Prostatectomy for Prostate Cancer.

Given the variable clinical course of prostate cancer and the limitations of current prognostic factors, this study was conducted to investigate the impact of a histologically overt stromal response (HOST-response) to prostate cancer on clinical outcomes after radical prostatectomy.

This retrospective analysis utilized The Cancer Genome Atlas (TCGA) to evaluate data from individuals with a confirmed diagnosis of prostate cancer who underwent radical prostatectomy and had available pathology slides. These slides were assessed for the presence of a HOST-response, similar to desmoplasia. The primary endpoint was progression-free survival (PFS). A multivariable competing risk regression analysis was used to assess whether a significant association existed between HOST-response and PFS, adjusting for known prostate cancer prognostic factors.

Among the 348 patients analyzed, 166 (47.70%) demonstrated a HOST-response. After a median follow-up of 37.87 months (IQR: 21.20, 65.50), the presence of a HOST-response was significantly associated with a shorter PFS (SDHR, 2.10; 95% CI, 1.26 to 3.50; p = 0.004), after adjusting for covariates.

HOST-response in prostate cancer patients treated with radical prostatectomy is significantly associated with reduced PFS, suggesting a potential benefit from adjuvant therapy and highlighting the need for further investigation in a prospective randomized clinical trial.

Cancers. 2024 May 14*** epublish ***

Mutlay Sayan, Yetkin Tuac, Samet Kucukcolak, Mary D Rowan, Grace K Pratt, Cagdas Aktan, Elza Tjio, Dilara Akbulut, Shalini Moningi, Jonathan E Leeman, Peter F Orio, Paul L Nguyen, Anthony V D'Amico, Mahmut Akgul

Department of Radiation Oncology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA., Department of Statistics, Ankara University, 06100 Ankara, Türkiye., Department of Pathology and Laboratory Medicine, Rutgers University, New Brunswick, NJ 07102, USA., Department of Medical Biology, Faculty of Medicine, Bandirma Onyedi Eylul University, 10250 Balikesir, Türkiye., Histopathology Department, Harrogate District Hospital, Harrogate HG2 7SX, UK., Laboratory of Pathology, Center for Cancer Research, National Institutes of Health, Bethesda, MD 20892, USA., Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY 12208, USA.