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

  • Yang, Meng1
  • Zu, Ke1
  • Mucci, Lorelei A.2, 3
  • Rider, Jennifer R.2, 3
  • Fiorentino, Michelangelo2, 4
  • Clinton, Steven K.5
  • Loda, Massimo6, 7
  • Stampfer, Meir J.1, 2, 3
  • Giovannucci, Edward1, 2, 3
  • 1 Harvard T.H. Chan School of Public Health, Department of Nutrition, Boston, MA, 02115, USA , Boston (United States)
  • 2 Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, 02115, USA , Boston (United States)
  • 3 Brigham and Women’s Hospital and Harvard Medical School, Channing Division of Network Medicine, Department of Medicine, Boston, MA, 02115, USA , Boston (United States)
  • 4 S.Orsola-Malpighi Hospital, Pathology Unit, Addarii Institut, Bologna, 40138, Italy , Bologna (Italy)
  • 5 The Ohio State University, The Division of Medical Oncology, The Department of Internal Medicine, Columbus, OH, 43210, USA , Columbus (United States)
  • 6 Harvard Medical School, Department of Pathology, Boston, MA, 02115, USA , Boston (United States)
  • 7 Dana-Farber Cancer Institute, Department of Pathology, Boston, MA, 02215, USA , Boston (United States)
Published Article
Cancer Causes & Control
Publication Date
Jul 05, 2016
DOI: 10.1007/s10552-016-0782-x
Springer Nature


BackgroundHigher 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.MethodsWe 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.ResultsDuring 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).ConclusionsVessel morphology may aid Gleason grading in predicting prostate cancer mortality risks among men diagnosed with high-grade Gleason cancers.

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