Determining the cut-off values of tumor diameter, degree of extraprostatic extension, and extent of surgical margin positivity with regard to biochemical recurrence of prostate cancer after radical prostatectomy

2020 ◽  
Vol 44 ◽  
pp. 151431
Author(s):  
Gozde Kir ◽  
Evsen Apaydin Arikan ◽  
Hatice Seneldir ◽  
Handan Ankarali ◽  
Seca Oznergiz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Surgical Margin ◽  
Tumor Diameter ◽  
Extraprostatic Extension

scholarly journals Evaluation of The Tumor Volume From Surgical Specimens After Radical Prostatectomy and Its Clinical Impact on The Prognosis of Patients With Localized Prostate Cancer

2021 ◽  
Author(s):  
Hyeong Dong Yuk ◽  
Seok-Soo Byun ◽  
Sung Kyu Hong ◽  
Hakmin Lee
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Tumor Volume ◽  
Risk Group ◽  
Surgical Margin ◽  
Localized Prostate Cancer ◽  
Positive Surgical Margin ◽  
Continuous Variables ◽  
The Mean

Abstract We evaluated the contribution of tumor volume (TV) to localized prostate cancer (PCa) patients’ prognosis. We retrospectively analyzed the data of 2,394 patients who underwent radical prostatectomy (RP) for localized PCa. The effect of TV volume on prostate cancer patients' prognosis was analyzed through Kaplan-Meier and Cox-proportional analysis. The mean prostate volume for all patients was 36.5 ± 15.4 cc, and the mean TV was 5.9 ± 8.3 cc. A significant positive relationship was observed between the classification by risk group in D’ Amico risk classification and the National Comprehensive Cancer Network risk group. (P < 0.001). The high TV showed significantly worse pathologic outcomes than the low TV in terms of high rates of extra-capsular extension, seminal vesicle invasion, and positive surgical margin (P < 0.05). The patients with high TV had significantly shorter biochemical recurrence-free survivals than those with low TV (P < 0.001). Finally, based on multivariate Cox-proportional analyses, TV was revealed to be an independent predictor of postoperative biochemical recurrence as both categorical (hazard ratio [HR]: 1.42, 95% confidence interval [CI]: 1.13–1.78, P = 0.003] and continuous variables (HR: 1.04, 95% CI: 1.04–1.05, P < 0.001). TV was revealed to be an independent prognostic factor in the postoperative biochemical recurrence. Patients with a high number of positive core and longer tumor length were significantly related to higher TV.

scholarly journals The Clinical Impact of pT3a Lesions in Patients With pT3b Prostate Cancer Undergoing Radical Prostatectomy

2021 ◽  
Author(s):  
Numbereye Numbere ◽  
Yuki Teramoto ◽  
Pratik M. S. Gurung ◽  
Takuro Goto ◽  
Zhiming Yang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Bladder Neck ◽  
Tumor Volume ◽  
Specific Antigen ◽  
Surgical Margin ◽  
Clinical Impact ◽  
Outcome Analysis ◽  
Positive Surgical Margin ◽  
Extraprostatic Extension

Context.— Seminal vesicle invasion (SVI) by prostate cancer (pT3b disease) has been considered as a key prognostic factor. Objective.— To assess the clinical impact of T3a lesions (ie, extraprostatic extension other than bladder neck invasion [BNI] or SVI [EPE], microscopic bladder neck invasion [mBNI]) in pT3b disease. Design.— We compared radical prostatectomy findings and long-term oncologic outcomes in 248 patients with pT3b disease, with versus without EPE/mBNI. Results.— Extraprostatic extension/mBNI was found in 219 (88.3%)/48 (19.4%) cases, respectively. Extraprostatic extension was significantly associated with higher preoperative prostate-specific antigen (PSA) level, higher rates of positive surgical margin (pSM) and lymphovascular invasion (LVI), and larger tumor volume. Similarly, mBNI was significantly associated with higher PSA level, higher rates of Grade Group(s) 4-5 or 5, pSM, LVI, and pN1, and larger tumor volume. Significant differences in all of these clinicopathologic features (except lymph node metastasis) between EPE−/mBNI+ or EPE+/mBNI− and EPE+/mBNI+ cases were also observed. Outcome analysis revealed that patients with EPE (P &lt; .001) or mBNI (P &lt; .001) had a significantly higher risk of disease progression than respective controls. Notably, there were significant differences in progression-free survival between EPE−/mBNI+ or EPE+/mBNI− cases and EPE−/mBNI− (P = .001) or EPE+/mBNI+ (P &lt; .001) cases. In multivariate analysis, EPE (hazard ratio [HR] = 6.53, P = .009) and mBNI (HR = 2.33, P = .003), as well as EPE−/mBNI+ or EPE+/mBNI− (HR = 11.7, P = .01) and EPE+/mBNI+ (HR = 25.9, P = .002) (versus EPE−/mBNI−), showed significance for progression. Conclusions.— From these significant findings, we propose a novel pT3b subclassification: pT3b1 (SVI alone without EPE or mBNI), pT3b2 (SVI with either EPE or mBNI), and pT3b3 (SVI with both EPE and mBNI).

scholarly journals Factors affecting biochemical recurrence of prostate cancer after radical prostatectomy in patients with positive and negative surgical margin

2020 ◽  
Vol 8 (4) ◽  
pp. 178-184
Author(s):  
Serdar Celik ◽  
Anıl Eker ◽  
İbrahim Halil Bozkurt ◽  
Deniz Bolat ◽  
İsmail Basmacı ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Surgical Margin ◽  
Factors Affecting

The prognostic value of zonal origin and extraprostatic extension of prostate cancer for biochemical recurrence after radical prostatectomy

2019 ◽  
Vol 37 (9) ◽  
pp. 575.e19-575.e25 ◽  
Author(s):  
Kimiharu Takamatsu ◽  
Kazuhiro Matsumoto ◽  
Kazunori Shojo ◽  
Nobuyuki Tanaka ◽  
Toshikazu Takeda ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Prognostic Value ◽  
Extraprostatic Extension

scholarly journals Revisiting extraprostatic extension based on invasion depth and number for new algorithm for substaging of pT3a prostate cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Cheol Keun Park ◽  
Yeon Seung Chung ◽  
Young Deuk Choi ◽  
Won Sik Ham ◽  
Won Sik Jang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Radial Distance ◽  
Image Analyzer ◽  
Two Dimensional ◽  
Invasion Depth ◽  
Free Survival ◽  
Extraprostatic Extension

AbstractExtraprostatic extension (EPE) is a factor in determining pT3a stage in prostate cancer. However, the only distinction in EPE is whether it is focal or non-focal, causing diagnostic and prognostic ambiguity. We substaged pT3a malignancies using classification of EPE to improve personalized prognostication. We evaluated 465 radical prostatectomy specimens with a digital image analyzer by measuring the number, radial distance and two-dimensional square area of the EPE. The most significant cut-off value was proposed as an algorithm for the pT3a substaging system to predict biochemical recurrence (BCR). A combination of the radial distance and the number of EPEs predicted BCR the most effectively. The optimal cut-off criteria were 0.75 mm and 2 mm in radial distance and multifocal EPE (hazard ratio: 2.526, C-index 0.656). The pT3a was subdivided into pT3a1, < 0.75 mm and any number of EPEs; pT3a2, 0.75–2 mm and one EPE; and pT3a3, > 2 mm and any number of EPEs or 0.75–2 mm and ≥ 2 EPEs. This combined tier was highly significant in the prediction of BCR-free survival. The combination of radial distance and number of EPEs could be used to subdivide pT3a prostate cancer and may aid in the prediction of BCR.

scholarly journals Predictors of biochemical recurrence of prostate cancer

2017 ◽  
Vol 98 (6) ◽  
pp. 890-894 ◽  
Author(s):  
F A Guliev
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Prostate Specific Antigen ◽  
Biochemical Recurrence ◽  
Tumor Volume ◽  
Prognostic Significance ◽  
Specific Antigen ◽  
Surgical Margin ◽  
Surgical Margins ◽  
Operative Risk

Aim. To study the role of postoperative parameters in predicting the probability of development of biochemical recurrence in patients with prostate cancer with low pre-operative risk of its progression. Methods. 95 patients who underwent radical prostatectomy, were included in the study, the average age being 59.5±0.7 (44-76) years. The average levels of total and free prostate-specific antigen were 5.8±0.2 (1.71-9.9) and 1.03±0.07 (0.2-3.6) ng/ml respectively. Biochemical recurrence was defined as the level of prostate-specific antigen higher than 0.2 ng/ml after radical prostatectomy. Results. 8 (8.4%) patients during the follow-up period were diagnosed with biochemical recurrence. The average period to biochemical recurrence development was 45.8±6.7 (24-84) months. Pathomorphological examination revealed presence of tumor cells at surgical margin in 18 (18.9%) cases. Biochemical recurrence was diagnosed in 5 out of 77 (6.5%) patients with negative surgical margins and in 3 out of 18 (1.7%) patients with positive surgical margins. In our study, no correlation between the state of surgical margin and biochemical recurrence development was revealed (χ2=1.958; р=0.162). In the study group postoperative Gleason score was not prognostically significant as well (р=0.294). The average tumor volume in resected material was 11.8±1.0% (1-55%) of prostate volume (мм3). Extraprostatic extension was diagnosed in 10 (10.5%) cases. Results of univariate dispersion analysis of postoperative parameters revealed prognostic significance of tumor volume in removed specimen (р=0.007) and extracapsular extension (р=0.027). Conclusion. In our study we determined that tumor volume and extracapsular extention are independent risk factors for biochemical recurrence in prostate cancer patients with low pre-operative risk of disease progression.

The impact of DNA methylation on the identification of recurrent prostate cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21086-21086
Author(s):  
J. J. Alumkal ◽  
Z. Zhang ◽  
E. B. Humphreys ◽  
C. Bennett ◽  
L. A. Mangold ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Dna Methylation ◽  
Radical Prostatectomy ◽  
Biochemical Recurrence ◽  
Methylation Status ◽  
Surgical Margin ◽  
Multivariable Logistic Regression Analysis ◽  
Tissue Samples ◽  
Increased Risk ◽  
The Impact

21086 Purpose: Biochemical (PSA) recurrence of prostate cancer following radical prostatectomy remains a major problem. Better biomarkers are needed to identify high and low-risk patients. DNA methylation of promoter regions leads to gene silencing in many cancers. In this study, we assessed the impact of changes in DNA methylation on biochemical recurrence in men with prostate cancer. Methods: We examined the methylation status of fifteen genes using MSP (Methylation Specific PCR) on tissue samples from 151 patients with clinically localized prostate cancer for whom at least five years of follow-up after prostatectomy was available. Results: In a multivariable logistic regression analysis, extra capsular penetration, high Gleason score, and involvement of the lymph nodes, seminal vesicles, or surgical margin were associated with an increased risk of recurrence. In addition, samples with methylation of 2 specific genes involved in cell-cell adhesion and apoptosis were associated with biochemical recurrence with an odds ratio of 5.64 (95% CI=1.47–21.7, p=0.012) compared to samples without methylation of both of these genes. The methylation status of these 2 genes had a higher sensitivity (72.3%; 95% CI=57–84.4%) for detecting recurrences than all the clinico-pathological variables (p<0.02) except extra-capsular penetration (p=0.346). The methylation status of these 2 genes had a similar negative predictive value (79.0%; 95% CI=66.8–88.3%) as the individual clinico-pathological variables examined. Conclusion: DNA Methylation of specific genes is independently associated with an increased risk of biochemical recurrence after radical prostatectomy even one considers the prognostic clinico-pathologic variables used in the clinic today. Our findings should be validated on another larger group of patients with prostate cancer who have undergone radical prosatetectomies. No significant financial relationships to disclose.

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