Tumor angiogenesis as an early marker of long-term prostate cancer mortality

Evaluation of: Mucci LA, Powolny A, Giovanni E et al.: Prospective study of prostate tumor angiogenesis and cancer-specific mortality in the health professionals follow-up study. J. Clin. Oncol. 27, 5627-5633 (2009). Most prostate cancer patients are diagnosed with localized disease, Long-term prostate cancer mortality is low, and many patients have been overtreated. Better prediction tools are needed to distinguish clinically insignificant, low-risk prostate cancers from lethal diseases. Tumor microvessel density, a marker of angiogenesis, has been shown to be related to the development of prostate cancer metastasis and even mortality. Mucci et al. found that morphologic characteristics of tumor microvessels, such as vessel size and irregularity, from prostatectomy specimen may be better than microvessel density as indicators of active angiogenesis, cancer aggressiveness and metastatic potential, and potentially prostate cancer-specific mortality. Prognostic tools combining angiogenesis biomarkers and clinical features led to marked improvement in the prediction of lethal prostate cancer. If these results are confirmed with studies from prostate biopsy samples, this novel prognosis tool will be of significant importance to guide clinical decision-making for localized prostate cancer,