This study was planned and initiated in 1992 while Dr. Veltri was serving as Vice President & GM for Research and Development of the UroCor Inc. in collaboration with Drs. Don Coffey, Jonathan Epstein and Alan Partin of the Johns Hopkins University School of Medicine. The plan was to assess nuclear structure, DNA ploidy and several biomarkers for their prognostic value to assess recurrence, metastasis and/or PCa-specific death. Two of the biomarkers presented in this manuscript were Her-2/neu and DNA ploidy expression. Clearly, both of these biomarkers remain controversial and the most studies have a limited number of cases with short-term follow-up. However, the strength of our study lies in long-term follow-up (range: 1-25 years; median: 17.0 years; mean: 15.3 years) after radical prostatectomy, a large sample size and prediction of three endpoint of prostate cancer (PCa) i.e. progression, metastasis and PCa-specific Death using the same cohort.
“What is the value of well-annotated PCa databases”?
As a result of our collaborations; we were able to study the importance of nuclear morphometry and the potential role of several molecular biomarkers that involve tumor cell proliferation, angiogenesis, neuroendocrine differentiation, and programmed cell death (apoptosis) to predict the PCa aggressive phenotype. The excellent management and maintenance of the pathology tissues and the follow-up bioinformatics using a well annotated database for all the cases has produced extremely valuable knowledge of potential value to the PCa patient. [Veltri RW et al The Prostate, 2008 DOI 10.1002/pros.20848; Veltri RW et al. Clin. Cancer Res. 2004; 10: 3465-3473; Veltri RW et al. Urology 48: 685-691]. Further, these PCa databases have resulted in the development of the Partin Tables and other algorithms that can predict PCa disease stage for example. [Makarov DV et al. Urology, 69: 2007; 1095-101; Haese A et al. Cancer, 97: 969-978].
What is “the take-home message”?
In our report in the International Journal of Cancer, clinically localized (organ-confined) PCa patients with Her-2/neu positive and high %DNA indices are at a higher risk for disease progression, metastasis and PCa-specific death. Further, Her2/neu expression and %DNA index can be used with clinicopathologic parameters for prediction of long-term prognosis in radical prostatectomy tissue specimens.
What does the future hold for the PCa Patient?”
Computer-assisted microscopy hardware and well engineered, user friendly software, needs to be developed to take advantage of the PCa knowledge base already generated from our studies and from those of other PCa investigators. The goal should be to create a cost-effective and commercially available tool to deliver pathology and biomarker results that will result in early intervention to prevent disease progression. Today there are several companies with the hardware and others with the software capabilities to create patient-specific (personalized) solutions for effective PCa early disease management.