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Vascular morphology differentiates prostate cancer mortality risk among men with higher Gleason grade

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Abstract

Background

Higher Gleason grade is associated with prostate cancer mortality; however, there is significant heterogeneity in this association. We evaluated whether vessel morphology, a biomarker of angiogenesis, aided in distinguishing mortality risks among men with high Gleason grading.

Methods

We characterized vessel morphology (area and irregularity) among 511 patients diagnosed with prostate cancer during 1986 to 2000, re-reviewed Gleason grade, and followed men through 2012. Men were grouped according to integrated vessel lumen irregularity and vessel area across Gleason grade. The more angiogenic group was identified as those with more irregular vessel lumen and smaller vessel area. Crude rates (95 % confidence intervals) and survival probability were estimated across Gleason grade and vessel morphology.

Results

During a median 14-year follow-up, 62 men developed bone metastases or died of prostate cancer. Lethality rates were uniformly low within Gleason grade categories 6 and 7(3 + 4), regardless of vessel morphology. However, among men with Gleason grades of 7(4 + 3) or 8–10, the more angiogenic group was associated with fourfold higher risk of lethal outcomes compared to those with less angiogenic potential. Ten-year survival probability ranged from 95 to 74 % according to the extent of vessel morphology (p < 0.0001, log-rank test).

Conclusions

Vessel morphology may aid Gleason grading in predicting prostate cancer mortality risks among men diagnosed with high-grade Gleason cancers.

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Fig. 1

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Acknowledgments

This study was supported by funding from the National Institutes of Health (Grant Nos. PO1 CA055075, CA141298, and CA13389, UM1 CA167552), the US Army Prostate Cancer Research Program Idea Development Award PC060389, the DF/HCC Prostate SPORE Career Development Award NIH/NCI P50 CA90381, and the Ohio State University NIH P30 CA16058. JRR and LAM are Prostate Cancer Foundation Young Investigators. The funding bodies had no influence in the design or conduct of the study, analysis and interpretation of the data, or preparation of the article. We would like to thank the participants and staff of the Health Professionals Follow-up Study for their valuable contributions. We would also like to thank the following state cancer registries for their help: AL, AZ, AR, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA, WY. The authors assume full responsibility for analyses and interpretation of these data.

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Authors and Affiliations

  1. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA

    Meng Yang, Ke Zu, Meir J. Stampfer & Edward Giovannucci

  2. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA

    Lorelei A. Mucci, Jennifer R. Rider, Michelangelo Fiorentino, Meir J. Stampfer & Edward Giovannucci

  3. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, 02115, USA

    Lorelei A. Mucci, Jennifer R. Rider, Meir J. Stampfer & Edward Giovannucci

  4. Pathology Unit, Addarii Institut, S.Orsola-Malpighi Hospital, 40138, Bologna, Italy

    Michelangelo Fiorentino

  5. The Division of Medical Oncology, The Department of Internal Medicine, The Ohio State University, Columbus, OH, 43210, USA

    Steven K. Clinton

  6. Department of Pathology, Harvard Medical School, Boston, MA, 02115, USA

    Massimo Loda

  7. Department of Pathology, Dana-Farber Cancer Institute, Boston, MA, 02215, USA

    Massimo Loda

Authors
  1. Meng Yang
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  2. Ke Zu
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  3. Lorelei A. Mucci
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  4. Jennifer R. Rider
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  5. Michelangelo Fiorentino
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  6. Steven K. Clinton
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  7. Massimo Loda
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  8. Meir J. Stampfer
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  9. Edward Giovannucci
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Corresponding author

Correspondence to Meng Yang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Yang, M., Zu, K., Mucci, L.A. et al. Vascular morphology differentiates prostate cancer mortality risk among men with higher Gleason grade. Cancer Causes Control 27, 1043–1047 (2016). https://doi.org/10.1007/s10552-016-0782-x

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  • DOI: https://doi.org/10.1007/s10552-016-0782-x

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