Cancer Res Treat.  2010 Sep;42(3):157-162.

Bcl-2 as a Predictive Factor for Biochemical Recurrence after Radical Prostatectomy: An Interim Analysis

• Cho IC
• Chung HS
• Cho KS
• Kim JE
• Joung JY
• Seo HK
• Chung J
• Park WS
• Hong EK
• Lee KH

Abstract

PURPOSE
The objective of this study was to determine Bcl-2 expression in localized prostate cancer and its potential role as a predictive factor for biochemical recurrence (BCR).
MATERIALS AND METHODS
This study included 171 Korean patients with newly diagnosed adenocarcinoma of the prostate who underwent radical prostatectomy (RP) without neoadjuvant therapy at a single center between February 2005 and May 2009. RP specimens obtained from these patients were analyzed for the expression of Bcl-2 using tissue microarray. The values of Bcl-2 and other clinicopathologic factors were evaluated. Statistical analysis was performed with contingency table analysis, chi-square tests, and a Cox proportional hazard model.
RESULTS
Bcl-2 expression was immunohistologically-confirmed in 42 patients (24.6%). Bcl-2 expression was not associated with conventional clinicopathologic factors. Bcl-2 negative patients had a significantly longer mean BCR-free survival than Bcl-2-positive patients (p=0.036). Among several variables, a high Gleason score in the RP specimen (> or =8), extraprostatic extension, seminal vesicle invasion (SVI), lymphovascular invasion (LVI), and Bcl-2 expression were significant predictors of BCR based on univariate analysis. Multivariate Cox proportional hazards analysis revealed that BCR was significantly associated with a high prostate specific antigen level (p=0.047), SVI (p<0.001), a positive surgical margin (p=0.004) and Bcl-2 expression (p=0.012).
CONCLUSION
Bcl-2 expression in RP specimens is associated with a significantly worse outcome, suggesting a potential clinical role for Bcl-2. Post-operative Bcl-2 could be a significant predictor of outcome after RP.

Keyword

Prostatic neoplasms; Proto-oncogene proteins; B-cell leukemia/lymphoma 2; Recurrence; Prostatectomy

MeSH Terms

Adenocarcinoma
Humans
Neoadjuvant Therapy
Neoplasm Grading
Proportional Hazards Models
Prostate
Prostate-Specific Antigen
Prostatectomy
Prostatic Neoplasms
Proto-Oncogene Proteins
Recurrence
Seminal Vesicles
Prostate-Specific Antigen
Proto-Oncogene Proteins

Figure

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  Fig. 1 Prostate prognostic tissue microarray (TMA) containing specimens from 171 tumors. (A) TMA section stained with hematoxylin and eosin (×100). (B) TMA section with Bcl-2 staining (×100). (a) Intensity of immunostaining for Bcl-2: negative group (×400). (b) Intensity of immunostaining for Bcl-2: weak group (×400). (c) Intensity of immunostaining for Bcl-2: moderate group (×400). (d) Intensity of immunostaining for Bcl-2: strong group (×400).

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  Fig. 2 Kaplan-Meier biochemical recurrence (BCR)-free survival curves according to the expression of Bcl-2.

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