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  3. Vol. 21 No. 02 (2024): March-April 2024
  4. ORIGINAL PAPER(UROLOGICAL ONCOLOGY)

Vol. 21 No. 02 (2024)

March 2024

DNA Ploidy as a Potential Adjunct Prognostic Marker of Low-Risk Prostate Cancer Progression after Radical Prostatectomy

  • Miha Pukl
  • Matthieu George
  • Arash Javanmardi
  • Anita Carraro
  • Jagoda Korbelik
  • Rebecca White
  • Calum MacAulay
  • Branko Palcic
  • Mira Keyes
  • Metka Volavšek
  • Martial Guillaud

Urology Journal, Vol. 21 No. 02 (2024), 24 March 2024 , Page 80-86
https://doi.org/10.22037/uj.v20i.7324 Published: 2024-03-24

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Abstract

Purpose: Post prostatectomy PSA kinetics and General Grade Groups (GGG) are the strongest prognostic markers
of biochemical recurrence (BCR) and prostate cancer (PCa)-specific mortality after radical prostatectomy. Despite
having low-risk PCa, some patients will experience BCR, for some, clinically significant BCR. There is a need for
an objective prognostic marker at the time of prostatectomy to improve risk stratification within this population. In
this study, we investigated the prognostic potential of DNA ploidy.
Materials and Methods: Prostatectomy samples from 97 patients with GGG1 and GGG2 with a low-risk
CAPRA-S score were included in this study. PCa tissue with the worst Gleason pattern underwent tissue disaggregation, cell isolation and staining with a DNA stoichiometric stain. Using image cytometry, DNA ploidy was
measured and a Ploidy Score (PS) was generated.
Results: Among the 97 patients, 79 had no BCR, 18 experienced BCR, of which 14 had a PSA doubling time
(PSA-DT) >1 year (low-risk group) and 4 had a PSA-DT of <1 year (high-risk group). Using Logistic regression
analysis, only pathological T stage (pT) and PS independently predicted BCR with PS being the most significant
(p = 0.001). The number of aneuploid cells was significantly higher in the high-risk group compared to the other
groups (p = 1.7x10-11). PS combined with GGG diagnosis further stratified risk groups of biochemical recurrence
free survival within CAPRA-S low-risk cohort.
Conclusion: DNA ploidy is an independent prognostic marker of BCR in low-risk PCa after radical prostatectomy,
which could early on identify potentially aggressive PCa recurrences and introduce a more personalized approach
to salvage treatments.

Keywords:
  • prostate cancer, DNA ploidy, biochemical recurrence, image cytometry, prognostic marker
  • 7324/pdf

How to Cite

Pukl, M., George, M., Javanmardi, A., Carraro, A., Korbelik, J., White, R., MacAulay, C., Palcic, B., Keyes, M., Volavšek , M., & Guillaud, M. (2024). DNA Ploidy as a Potential Adjunct Prognostic Marker of Low-Risk Prostate Cancer Progression after Radical Prostatectomy. Urology Journal, 21(02), 80–86. https://doi.org/10.22037/uj.v20i.7324
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