Expression of CD44s in incidental prostate cancer is more strongly associated with Gleason scores on subsequent radical prostatectomies than conventional prognostic parameters.

OBJECTIVE

Incidental prostate cancer (IPC) has a substantially variable clinical course which cannot be predicted by conventional histopathologic examination of transurethral resection specimens of the prostate (TURP chips). Therefore, efforts should be directed towards defining the natural history of individual IPC. Recently, expression of CD44s (standard isoform), a transmembranous glycoprotein, has been linked to prognostic outcome in prostate cancer, but its prognostic role in IPC has been neglected so far.

METHODS

We present a multicentre study which evaluates immunohistochemically the largest cohort of IPC patients to date, aiming to correlate CD44s expression in the TURP chips with histopathologic outcome parameters (Gleason scores and histologic staging) performed on subsequent radical prostatectomies (RPs) in a cohort of 54 patients who underwent prostatectomy due to IPC.

RESULTS

CD44s expression recorded in the TURP chips showed a stronger (inverse) association with Gleason scores performed on the corresponding RPs than did other conventional prognostic variables and, therefore, might become a valuable adjunct to better predict outcome in IPC prior to radical prostatectomy.

CONCLUSION

Advanced prospective studies should aim to define cut-point values of CD44s expression for separating aggressive tumours from their indolent counterparts, and should also assess possible associations with clinical follow-up data (e.g. progression-free survival) in IPC.