High percent tumor volume predicts biochemical recurrence after radical prostatectomy in pathological stage T3a prostate cancer with a negative surgical margin. (20th November 2013)

• Record Type: Journal Article
• Authors: You, Dalsan; Jeong, In Gab; Song, Cheryn; Cho, Yong Mee; Hong, Jun Hyuk; Kim, Choung‐Soo; Ahn, Hanjong
• Is Part Of: International journal of urology. Volume 21:Number 5(2014)
• Page Start: 484
• Page End: 489
• Publication Date: 2013-11-20
• Subjects: Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.12348
• Languages: English
• ISSNs: 0919-8172

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="iju12348-sec-0001" sec-type="section"> <title>Objectives</title> <p>To evaluate the impact of percent tumor volume and surgical margin status on biochemical recurrence in pT3–T4 prostate cancer.</p> </sec> <sec id="iju12348-sec-0002" sec-type="section"> <title>Methods</title> <p>A total of 397 patients who had pT3–T4N0 diseases and did not receive neoadjuvant or adjuvant therapy were included for analysis.</p> </sec> <sec id="iju12348-sec-0003" sec-type="section"> <title>Results</title> <p>In the entire cohort, prostate‐specific antigen (per 1 ng/mL increase; hazard ratio 1.019; <italic>P</italic> = 0.002), pathological stage (T3b–T4 <italic>vs</italic> T3a; hazard ratio 2.283; <italic>P</italic> < 0.001), Gleason score (≥8 <italic>vs</italic> ≤6; hazard ratio 5.290; <italic>P</italic> = 0.005), surgical margin status (multiple positive <italic>vs</italic> negative; hazard ratio 1.839; <italic>P</italic> = 0.003) and lymphovascular invasion (present <italic>vs</italic> absent; hazard ratio 1.641; <italic>P</italic> = 0.008) were independent predictors of recurrence. Percent tumor volume was an independent predictor of recurrence in T3a diseases with negative surgical margins. In analysis using receiver operating characteristic curve, a threshold of 12% showed the best balance of sensitivity and specificity, 66% and 67%, respectively. The 5‐year recurrence‐free survival rates of pT3a diseases with negative surgical margin were 85.2% for percent tumor volume ≤12% and 57.7% for percent tumor volume >12% (<italic>P</italic> < 0.001). Patients with pT3a with negative surgical margins and percent tumor volume >12% showed comparable 5‐year recurrence‐free survival rate compared with those with pT3a with positive surgical margin (57.7% <italic>vs</italic> 57.6%; <italic>P</italic> = 0.763).</p> </sec> <sec id="iju12348-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Despite having less impact on recurrence than other clinicopathological variables in pT3–T4 prostate cancer, percent tumor volume can further improve recurrence risk stratification in pT3a diseases with negative surgical margins.</p> </sec> </abstract>