1 DNA-Cytometric Grading of Prostate Cancer- Systematic Review of the Literature

„Active surveillance “ is an internationally accepted alternative therapeutic strategy for patients with clinically insignificant microcarcinomas of the prostate. Gleason-score (GS) =< 6 in core biopsies represent the most crucial criterion for inclusion. Yet, Interobserver reproducibility of even the updated GS is low (48-70%) and its prognostic validity remains unsatisfactory. An option to complementary and objectively assess the malignant potential of prostatic carcinomas are DNA-ploidy-measurements on existing biopsies. For that purpose chromosomal heterogeneity is indirectly quantified by DNA-cytometry resulting in DNA-grades of malignancy 1-4. This review systematically trawls and evaluates all scientific publications on the potential diagnostic and prognostic validity and heterogeneity of DNA-ploidy measurements in cancers of the prostate between 1966 and 2013. 113 scientific articles had to be excluded because of different methodological reasons. All but one of the 67 methodologically acceptable articles report on a significant diagnostic resp. prognostic significance of DNA measurements in cancer