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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention

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A Prospective Study of Intraprostatic Inflammation, Focal Atrophy, and Progression to Lethal Prostate Cancer

Yiwen Zhang, Cindy Ke Zhou, Emily M. Rencsok, Katja Fall, Tamara L. Lotan, Massimo Loda, Francesca Giunchi, Elizabeth A. Platz, Angelo M. De Marzo, Lorelei A. Mucci, Michelangelo Fiorentino and Ericka M. Ebot
Yiwen Zhang
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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  • ORCID record for Yiwen Zhang
Cindy Ke Zhou
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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Emily M. Rencsok
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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Katja Fall
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.Department of Clinical Epidemiology and Biostatistics, School of Health and Medical Sciences, Orebro University Hospital, Orebro, Sweden.
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Tamara L. Lotan
Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Massimo Loda
Department of Oncologic Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts.Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York.
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Francesca Giunchi
Department of Pathology, Addarii Institute of Oncology, S.Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy.
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Elizabeth A. Platz
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Angelo M. De Marzo
Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.
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Lorelei A. Mucci
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
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Michelangelo Fiorentino
Department of Pathology, Addarii Institute of Oncology, S.Orsola-Malpighi Teaching Hospital, University of Bologna, Bologna, Italy.
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Ericka M. Ebot
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
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  • For correspondence: enoonan@hsph.harvard.edu
DOI: 10.1158/1055-9965.EPI-19-0713 Published December 2019
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Abstract

Background: Inflammation and focal atrophy are common features adjacent to prostate tumors. Limited evidence exists on whether these features have prognostic significance.

Methods: In the Health Professionals Follow-Up Study and Physicians' Health Study, we studied 1,035 men diagnosed with prostate cancer. A genitourinary pathologist centrally reviewed tumor and normal areas of hematoxylin and eosin slides from prostate cancer specimens for the presence of acute and chronic inflammation, and four subtypes of focal atrophy. Cox proportional hazards models adjusted for potential confounders were used to estimate HRs and 95% confidence intervals (CI) for the association of these features with lethal prostate cancer, defined as development of metastatic disease or death during follow-up.

Results: During a median of 12 years of follow-up, 153 men developed lethal prostate cancer. A total of 84% of men had histologic evidence of chronic inflammation and 30% had acute inflammation. Both chronic and acute inflammation were inversely associated with lethal prostate cancer in age- and lifestyle-adjusted models. Chronic inflammation remained inversely associated with lethal prostate cancer after additionally adjusting for prognostic clinical features (HR = 0.45; 95% CI, 0.30–0.69 for mild and HR = 0.51; 95% CI, 0.33–0.80 for moderate to severe). None of the atrophic lesions were associated with lethal prostate cancer.

Conclusions: Our data suggest that the presence of inflammation, particularly chronic inflammation, in prostate cancer tissue is associated with better prognosis among patients with prostate cancer.

Impact: This is the largest prospective cohort study to examine the association between inflammation, focal atrophy, and lethal prostate cancer.

Footnotes

  • Note: Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).

  • Cancer Epidemiol Biomarkers Prev 2019;28:2047–54

  • Received June 21, 2019.
  • Revision received August 15, 2019.
  • Accepted September 11, 2019.
  • Published first September 18, 2019.
  • ©2019 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 28 (12)
December 2019
Volume 28, Issue 12
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A Prospective Study of Intraprostatic Inflammation, Focal Atrophy, and Progression to Lethal Prostate Cancer
Yiwen Zhang, Cindy Ke Zhou, Emily M. Rencsok, Katja Fall, Tamara L. Lotan, Massimo Loda, Francesca Giunchi, Elizabeth A. Platz, Angelo M. De Marzo, Lorelei A. Mucci, Michelangelo Fiorentino and Ericka M. Ebot
Cancer Epidemiol Biomarkers Prev December 1 2019 (28) (12) 2047-2054; DOI: 10.1158/1055-9965.EPI-19-0713

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A Prospective Study of Intraprostatic Inflammation, Focal Atrophy, and Progression to Lethal Prostate Cancer
Yiwen Zhang, Cindy Ke Zhou, Emily M. Rencsok, Katja Fall, Tamara L. Lotan, Massimo Loda, Francesca Giunchi, Elizabeth A. Platz, Angelo M. De Marzo, Lorelei A. Mucci, Michelangelo Fiorentino and Ericka M. Ebot
Cancer Epidemiol Biomarkers Prev December 1 2019 (28) (12) 2047-2054; DOI: 10.1158/1055-9965.EPI-19-0713
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