Prostate cancer dedifferentiation following antiandrogen therapy: a morphological finding or an increased tumor aggressiveness?

Neoadjuvant androgen deprivation in prostate cancer induces tumor volume regression but does not improve outcome of the patient. A possible explanation for this phenomenon could be an increase of the residual tumor aggressiveness brought about by antiandrogen therapy. The purpose of the present stud...

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Bibliographic Details
Published in:Revista da Associação Médica Brasileira (1992) 2005-03, Vol.51 (2), p.117-120
Main Authors: Moritz, Rogério, Srougi, Miguel, Ortiz, Valdemar, Leite, Kátia Ramos Moreira, Nesrallah, Luciano, Dall'Oglio, Marcos, Sant'Anna, Alexandre Crippa
Format: Magazinearticle
Language:Portuguese
Subjects:
Aged
Androgen Antagonists - therapeutic use
Humans
Immunohistochemistry
Male
Middle Aged
Neoadjuvant Therapy
Neoplasm Invasiveness - pathology
Neoplasm Staging
Proliferating Cell Nuclear Antigen - drug effects
Proliferating Cell Nuclear Antigen - metabolism
Prostate-Specific Antigen - blood
Prostatic Neoplasms - drug therapy
Prostatic Neoplasms - pathology
Prostatic Neoplasms - surgery
Retrospective Studies
Treatment Outcome
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Summary:Neoadjuvant androgen deprivation in prostate cancer induces tumor volume regression but does not improve outcome of the patient. A possible explanation for this phenomenon could be an increase of the residual tumor aggressiveness brought about by antiandrogen therapy. The purpose of the present study was to evaluate the frequency of tumor dedifferentiation following androgen blockade in prostate cancer and to determine if the remaining tumor shows signs of increased aggressiveness. Thirty patients bearing locally advanced prostate cancer (stages T2c - T3) were submitted to neoadjuvant anti-androgenic therapy during four months followed by radical prostatectomy. Gleason scores from biopsy and surgical specimens were compared. Furthermore, the cell proliferation index was evaluated by immunohistochemistry assay for PCNA, tests with strong nuclear staining were considered positive. The percentage of positive nuclei, counted in 500 cells, was determined in several categories of the Gleason score from surgical specimens. In 11(37%) surgical specimens the Gleason score was equal or lower than that found in the biopsy and in 19 (63%) the total score was higher in the surgical specimens (p0.05). The median of cell proliferation indexes was 9% for glandular or specimen confined tumors and was 17% for extraprostatic tumors (p
ISSN:0104-4230