Tumor size, vascular density and proliferation as prognostic markers in GS 6 and GS 7 prostate tumors in patients with long follow-up and non-curative treatment

Eur Urol. 2005 Oct;48(4):577-83. doi: 10.1016/j.eururo.2005.05.016.


Objectives: To investigate the prognostic value of potential markers in localized, Gleason score 6 and 7 prostate cancer (PC).

Methods: From a consecutive series of men with PC diagnosed at transurethral resection (1975-1990), specimens from 132 patients without metastases, with Gleason score (GS) 6 (n=80) or 7 (n=52) tumors followed with watchful waiting were examined. The fraction of resected prostate tissue containing cancer, the micro-vessel density (v.d.) when stained for endoglin or von Willebrand factor (vWf), and the percentage of Ki-67 labeled tumor cells were measured using immunohistochemistry.

Results: High levels of vWf v.d., endoglin v.d., and percent cancer of the TURP specimen were significantly associated with short cancer-specific survival in Kaplan-Meier analysis of all patients with GS 6 and 7 tumors. Interestingly, a combined estimate of percent cancer and vWF v.d. could be used to identify a large subset (50%) of GS 6 tumors with only a 2.5% risk of PC death within 15 years. None of the tested markers gave independent prognostic information for the GS 7 tumors.

Conclusions: Estimates of tumor size and vascular density may identify a large proportion of non-aggressive GS 6, but not GS 7, tumors.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antigens, CD / metabolism
  • Biomarkers, Tumor / blood*
  • Endoglin
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Ki-67 Antigen / metabolism
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Neovascularization, Pathologic* / blood
  • Neovascularization, Pathologic* / surgery
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Prostate / blood supply*
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / blood supply
  • Prostatic Neoplasms / pathology*
  • Prostatic Neoplasms / surgery
  • Receptors, Cell Surface / metabolism
  • Risk Factors
  • Severity of Illness Index
  • Survival Analysis
  • Time Factors
  • Transurethral Resection of Prostate
  • Tumor Burden
  • von Willebrand Factor / metabolism


  • Antigens, CD
  • Biomarkers, Tumor
  • ENG protein, human
  • Endoglin
  • Ki-67 Antigen
  • Receptors, Cell Surface
  • von Willebrand Factor