The prognostic value of neuroendocrine differentiation in adenocarcinoma of the prostate in relation to progression of disease after endocrine therapy

J Urol. 1997 Jul;158(1):171-4. doi: 10.1097/00005392-199707000-00054.


Purpose: We evaluated the prognostic impact of neuroendocrine differentiation in prostate cancer with regard to the onset of endocrine therapy failure.

Materials and methods: A retrospective study was performed on 72 transurethral resection specimens from patients who subsequently underwent endocrine therapy for prostate cancer and were followed for 44 to 95 months. Progression-free interval was recorded. Distribution pattern and proportion of neuroendocrine cells were examined in transurethral resection specimens. Neuroendocrine cells were identified based on immunoreactivity for chromogranin A.

Results: Of 32 patients with progressive disease 27 died of prostate cancer. Chromogranin A positive cells were found in 40 of the 72 prostate cancers (55%). In a Cox proportional hazards analysis neuroendocrine differentiation of the tumor showed a negative correlation with progression-free survival (p = 0.022), which proved to be independent of the Gleason score (p < 0.001).

Conclusions: Our results support the view that neuroendocrine differentiation in prostatic adenocarcinomas is a prognostic factor for progressive disease under subsequent endocrine therapy. This prognosticator acts independently of tumor grade.

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / therapy
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Cell Differentiation
  • Disease Progression
  • Disease-Free Survival
  • Flutamide / therapeutic use
  • Follow-Up Studies
  • Gonadotropin-Releasing Hormone / agonists
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neurosecretory Systems / pathology
  • Orchiectomy
  • Prognosis
  • Proportional Hazards Models
  • Prostatic Neoplasms / pathology*
  • Prostatic Neoplasms / therapy
  • Retrospective Studies


  • Antineoplastic Agents, Hormonal
  • Gonadotropin-Releasing Hormone
  • Flutamide