A multivariable analysis of clinical factors predicting for pathological features associated with local failure after radical prostatectomy for prostate cancer

1994 ◽  
Vol 30 (2) ◽  
pp. 293-302 ◽  
Author(s):  
Anthony V. D'Amico ◽  
Richard Whittington ◽  
S. Bruce Malkowicz ◽  
Mitch Schnall ◽  
John Tomaszewski ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Multivariable Analysis ◽  
Local Failure ◽  
Pathological Features ◽  
Clinical Factors

Detecting lower in addition to the highest Gleason score prostate cancer on core biopsy and the odds of upgrading at radical prostatectomy.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16026-e16026
Author(s):  
John G Phillips ◽  
Ayal A. Aizer ◽  
Ming-Hui Chen ◽  
Michelle S. Hirsch ◽  
Jerome P. Richie ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Multivariable Analysis ◽  
High Rate ◽  
Study Cohort ◽  
Clinical Factors ◽  
Validation Data ◽  
Data Set ◽  
The Impact

e16026 Background: We evaluated the odds of upgrading at radical prostatectomy when a biopsy core with a lower Gleason score (GS) compared to the core with the highest GS was present (ComboGS) versus not at diagnosis and in a concurrent submission, test ComboGS in a validation data set on the endpoint of prostate cancer-specific mortality. Methods: The study cohort consisted of 134 men with clinically localized PC diagnosed between 4/08 and 9/11 using a 12-core prostate needle biopsy. GS at biopsy and RP were assigned by an expert genitourinary pathologist. Logistic regression multivariable analysis (Table) was performed to assess the impact that ComboGShad on the odds of upgrading at RP adjusting for known predictors of upgrading. Results: Of 134 patients, 46 (34%) were upgraded. Both increasing percent positive biopsies (ppb) (p < 0.001) and PSA level (p=0.001) were associated with an increased odds of upgrading, whereas ComboGSwas associated with a decreased odds of upgrading (0.18 [95% CI: 0.04-0.76); p = 0.02). Men whose ppb was ≥ 33% (median) were upgraded in 47% (28 of 60) versus 14% (3 of 21) of cases (p = 0.009) when ComboGSwas absent versus present. These respective estimates in men with a PSA ≥ 5.2 ng/ml (median) were 43% and 12% (p = 0.019). Conclusions: In men with clinical factors associated with upgrading namely, increasing ppb and PSA, ComboGSis a favorable prognostic factor associated with a high rate of downgrading (> 40%) and a low rate (< 15%) of upgrading. Adjusted odds ratios and associated 95% confidence intervals and p values representing the impact of clinical factors at diagnosis on upgrading at radical prostatectomy. [Table: see text]

The value of urinary prostate cancer gene 3 (PCA3) scores in predicting pathological features at radical prostatectomy

2012 ◽  
Vol 110 (1) ◽  
pp. 43-49 ◽  
Author(s):  
Xavier Durand ◽  
Evanguelos Xylinas ◽  
Camelia Radulescu ◽  
Rachel Haus-Cheymol ◽  
Stephane Moutereau ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Cancer Gene ◽  
Pathological Features ◽  
Prostate Cancer Gene 3

scholarly journals Clinical factors affecting prostate-specific antigen levels in prostate cancer patients undergoing radical prostatectomy: a retrospective study

2021 ◽  
Vol 7 (3) ◽  
pp. FSO643
Author(s):  
Giovanni Tarantino ◽  
Felice Crocetto ◽  
Concetta Di Vito ◽  
Raffaele Martino ◽  
Savio Domenico Pandolfo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Chronic Obstructive Pulmonary Disease ◽  
Retrospective Study ◽  
Radical Prostatectomy ◽  
Cancer Patients ◽  
Specific Antigen ◽  
Heavy Drinking ◽  
Chronic Obstructive ◽  
Clinical Factors ◽  
Obstructive Pulmonary Disease

Background: Since prostate-specific antigen (PSA) levels can be influenced by some routinely available clinical factors, a retrospective study was conducted to explore the influence of obesity, smoking habit, heavy drinking and chronic obstructive pulmonary disease on PSA levels in men with histologically confirmed prostate cancer. Patients & methods: We reviewed the medical records of 833 prostate cancer patients undergoing radical prostatectomy. Results: Serum PSA levels at the time of surgery were not associated with either BMI or history of chronic obstructive pulmonary disease or heavy drinking. Conversely, PSA levels were associated with smoking status. Conclusion: Among the clinical factors explored in this homogeneous population, only tobacco use was associated with PSA levels, which should be considered when using PSA-based screening in male smokers.

Prostate Cancer: Pathological Significance in 12 Cases Subjected to Radical Prostatectomy

1998 ◽  
Vol 65 (1_suppl) ◽  
pp. 62-64
Author(s):  
G. Borgonovo ◽  
D. Belussi ◽  
E. Micheli ◽  
G. Deiana ◽  
D. Sironi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Prostatic Cancer ◽  
Locally Advanced ◽  
Pathological Features ◽  
Radical Treatment

We analysed 12 radical prostatectomy specimens of patients with T1c prostatic cancer in order to evaluate clinical, bioptical and pathological features. Of the tumours, 8/12 (67%) were locally advanced, with Gleason score of 6 or 7. The majority of our stage T1c tumours were significant and required radical treatment.

P53 as a predictor of clinical outcome in localized prostate cancer.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 57-57 ◽  
Author(s):  
Kate Lynette Mahon ◽  
Phillip Stricker ◽  
James Kench ◽  
Judith Grogan ◽  
Warick Delprado ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Human Cancer ◽  
Multivariable Analysis ◽  
Lymph Node Status ◽  
Biochemical Relapse ◽  
P53 Expression ◽  
Metastatic Relapse ◽  
Specific Mortality ◽  
Cancer Specific Mortality

57 Background: p53 is one of the most common genetic aberrations in human cancer and is associated with poor outcomes with hormone therapy in advanced prostate cancer (PCa). p53 is a well-established predictor of biochemical relapse in PCa, however, increasing evidence from ICECaP has demonstrated that metastatic relapse (MR) not biochemical relapse (BCR) is a surrogate for prostate-cancer specific mortality (PCSM). Furthermore, there are now a range of novel therapeutic strategies targeting p53 mutations and their downstream effector pathways. This study aimed to assess the association between p53 expression and MR/PCSM in men with localized PCa. Methods: The study consisted of 271 men with localized PCa treated with radical prostatectomy. Surgical cancer specimens were stained for p53 by immunohistochemistry (IHC) and scored as a) percentage of p53-positive tumor nuclei in all major foci of cancer within the prostate; and (b) clustering, where the presence of 12 or more p53-positive cells within a x200 power field was deemed “cluster positive”. Results: At a median follow-up of 15.8 years (range 4 months - 24.3 years), 57.5% (156/271) had a biochemical relapse, 18% (49/271) had suffered a metastatic relapse, and 9.5% (25/271) had died of prostate cancer. Increasing percentage of p53 positive nuclei was significantly associated with shorter time to BCR (p < 0.001), MR (p < 0.001) and PCSM (p < 0.001). Half of patients were p53 cluster positive. P53 cluster positivity was significantly associated with all clinical endpoints (BCR: HR 2.0, 95% CI 1.51-2.65, p < 0.001; MR: HR 4.1, 95%CI 2.02-8.14, p < 0.001; PCSM: HR 12.2, 95%CI 1.6-93; p = 0.016). These associations were independent of other established prognostic variables including lymph node status, baseline PSA, Gleason and ISUP grade on multivariable analysis. Conclusions: This study has confirmed the association of p53 in radical prostatectomy tissue with clinically relevant endpoints of metastatic relapse and prostate cancer specific mortality. p53 is a potential stratification factor and may be useful for identifying those who will most benefit from adjuvant therapy. Incorporation of p53 status into ongoing clinical trials is now warranted.

The impact of race on adverse pathologic features at the time of radical prostatectomy in men with prostate cancer and implications for adjuvant radiotherapy.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 75-75
Author(s):  
Gregory Arthur Jordan ◽  
Richa Bhasin ◽  
Alec Block ◽  
Alex Gorbonos ◽  
Marcus Lee Quek ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Black Men ◽  
Adjuvant Radiotherapy ◽  
Locally Advanced ◽  
Multivariable Analysis ◽  
Positive Margins ◽  
Advanced Tumor ◽  
Pathologic Features ◽  
The Impact

75 Background: Patients with adverse pathologic features (≥pT3 disease or positive margins) at the time of radical prostatectomy (RP) have higher biochemical recurrence (BR). Adjuvant radiotherapy (ART) reduces BR, but has potential toxicities. Also, studies suggest Black men are more likely to have aggressive prostate cancer. Our objective was to identify whether black men undergoing RP are more likely to have adverse pathologic features (APF) that lead to an indication for ART. Methods: We conducted a retrospective cohort study of men with cT1-4 Nx/0 Mx/0 prostate adenocarcinoma in the National Cancer Database who underwent RP. Race was divided into 3 groups (Caucasian, Black, Other). Chi-square tests and analysis of variance (ANOVA) tests were used to compare clinical and socioeconomic covariates between race groups. Univariate (UVA) and multivariable analysis (MVA) were performed using logistic regression (LR) to identify covariates predicting for APF. LR was performed to identify the impact of race on pT3 disease and positive margins. Results: A total of 313,013 patients diagnosed between 2004-2014 and undergoing RP were included. 256,315 (85%) were Caucasian, 33,725 (11%) were Black, and 12,973 (4%) were Other race. Fewer Black men had Gleason group 1 (33% vs. 41%) but more had Gleason group 2 disease (46% vs. 38%, p < 0.001). Black men more frequently had PSA ≥10 ng/ml (18% vs. 16%, p < 0.001) and ≥cT2b disease (18% vs. 14%, p < 0.001). On UVA, Black men were more likely to have APF (Odds Ratio [OR] 1.18; 95% Confidence Interval [CI] 1.15-1.21; [p < 0.001]). On MVA, black race was independently associated with having APF (OR 1.21; 95% CI 1.18-1.24; p < 0.001). Black men were more likely to have positive margins (OR 1.26; 95% CI 1.22-1.29; p < 0.001) but less likely to have ≥pT3 disease (OR 0.77; 95% CI 0.74-0.79; p < 0.001). Conclusions: Independent of socioeconomic and clinical factors, Black men undergoing RP are more likely to have APF, increasing the risk of BR in this group, and more frequently creating an indication for ART. This appears to be more due to positive margins than locally advanced tumor. The underlying cause of this disparity warrants further exploration.

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