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In Reply: The extraordinary variability in prostate cancer clinical outcomes poses a significant challenge to anyone counseling patients about treatment for clinically localized disease. Clinicians have relied on stage and grade to quantify prognosis accurately. Gleason and Mellinger and members of the Veterans Administration Cooperative Urological Research Group developed a low-power scoring system that standardized prostate cancer readings worldwide.¹ Unfortunately, as indicated by Dr Koss, the system is inherently subjective and therefore prone to differing interpretations. In its place, Dr Koss suggests an analysis of DNA content.

Although we agree with Dr Koss’ criticism, we do not believe that DNA ploidy analysis provides any additional independent prognostic information. Studies have shown that ploidy in prostate cancer may vary from area to area within the carcinoma specimen.² For this reason, researchers have explored various molecular markers in an attempt to identify one or several markers that can accurately predict the clinical . . . [Full Text of this Article]

Peter C. Albertsen, MD, MS
albertsen@nso.uchc.edu
University of Connecticut Health Center
Farmington

James A. Hanley, PhD
McGill University
Montreal, Quebec

Judith Fine, BA
University of Connecticut
Farmington

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