OBJECTIVES: To evaluate the impact of percent tumor volume and surgical margin status on biochemical recurrence in pT3-T4 prostate cancer.
METHODS: A total of 397 patients who had pT3-T4N0 diseases and did not receive neoadjuvant or adjuvant therapy were included for analysis.
RESULTS: In the entire cohort, prostate-specific antigen (per 1 ng/mL increase; hazard ratio 1.019; P = 0.002), pathological stage (T3b-T4 vs T3a; hazard ratio 2.283; P < 0.001), Gleason score (≥8 vs ≤ 6; hazard ratio 5.290; P = 0.005), surgical margin status (multiple positive vs negative; hazard ratio 1.839; P = 0.003) and lymphovascular invasion (present vs absent; hazard ratio 1.641; P = 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% (P < 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% vs 57.6%; P = 0.763).
CONCLUSIONS: 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.
Written by:
You D, Jeong IG, Song C, Cho YM, Hong JH, Kim CS, Ahn H. Are you the author?
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Reference: Int J Urol. 2013 Nov 20. Epub ahead of print.
doi: 10.1111/iju.12348
PubMed Abstract
PMID: 24256352
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