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Prognostic significance of neuroendocrine expression in lymph node positive prostate cancer



Prognostic significance of neuroendocrine expression in lymph node positive prostate cancer



Journal of Clinical Oncology 23(16_Suppl): 4647-4647



NlmCategory="UNASSIGNED">4647 Background: Neuroendocrine (NE) cells likely play an important regulatory role in cellular growth and differentiation in both normal and pathologic conditions of the prostate. We determined the expression of chromogranin A, a marker for NE differentiation in patients with lymph node positive prostate cancer to determine its prognostic significance. We reviewed 140 patients with lymph node positive prostate adenocarcinoma treated with radical prostatectomy and bilateral pelvic lymphadenectomy. Median follow-up was 10.9 years (range: 0.8 to 19.7 years). Immunohistochemical staining for chromogranin A was evaluated in areas of benign epithelium, primary prostate cancer, and the lymph node metastasis. The association between chromogranin expression and clinical and pathologic factors (preoperative serum PSA, Gleason score, stage) and clinical outcomes, including overall and recurrence-free survival was evaluated. Staining was positive in 86% of benign areas, 61% of primary cancers, and 12% of lymph node deposits. Preoperative serum PSA level, Gleason score, and pathologic stage of the primary tumor did not show any statistical correlation with NE staining in any of the areas. Only NE expression in the primary tumor was associated with clinical recurrence, with 10-year recurrence-free survival for those with <5% staining of 67% compared with 35% for those with ≥5% staining (p=0.03). Furthermore, after adjusting for age, higher NE expression in the primary tumor (RR=2.15, p=0.02) and lymph node deposit (RR=2.03, p=0.03) was associated with poorer overall survival. NE expression in the primary tumor and lymph node metastasis of patients with node positive prostate cancer treated with radical prostatectomy may provide further prognostic stratification in these high-risk patients. No significant financial relationships to disclose.

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Accession: 058637222

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PMID: 27947020


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