scholarly journals Development and External Validation of a Novel Nomogram to Predict Side-specific Extraprostatic Extension in Patients with Prostate Cancer Undergoing Radical Prostatectomy

2020 ◽  
Author(s):  
Timo F.W. Soeterik ◽  
Harm H.E. van Melick ◽  
Lea M. Dijksman ◽  
Heidi Küsters-Vandevelde ◽  
Saskia Stomps ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
External Validation ◽  
Extraprostatic Extension

Limited Sampling of Radical Prostatectomy Specimens With Excellent Preservation of Prognostic Parameters of Prostate Cancer

2009 ◽  
Vol 133 (8) ◽  
pp. 1278-1284
Author(s):  
Kyungeun Kim ◽  
Pil June Pak ◽  
Jae Y. Ro ◽  
Dongik Shin ◽  
Soo-Jin Huh ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Sampling Method ◽  
Resection Margin ◽  
Gleason Grade ◽  
Posterior Half ◽  
Margin Involvement ◽  
Partial Sampling ◽  
Prostate Cancers ◽  
Extraprostatic Extension

Abstract Context.—The widespread use of the serum prostate-specific antigen test has increased the early detection of prostate cancer and consequently reduced grossly definable prostate cancers. Objective.—To find the most efficient gross sampling method for radical prostatectomy specimens not only preserving important prognostic factors but also being cost effective. Design.—We initially analyzed clinicopathologic features of the entire prostate sections from 148 radical prostatectomy specimens, which then were used to examine the impact of 5 partial sampling methods on tumor stage, Gleason score, extraprostatic extension, resection margin status, and paraffin block numbers. The methods included submission of (1) alternative slices, (2) alternative slices plus biopsy-positive posterior quarters, (3) every posterior half, (4) every posterior half plus one midanterior half, and (5) alternative slices plus peripheral 3-mm rim of the remaining prostate. Results.—Prostate cancers and their extraprostatic extension and resection margin involvement were commonly located in the right posterior portion of the prostate. Method 5 was most efficient, detecting all cases with extraprostatic extension and resection margin involvement and reducing 25% of paraffin blocks compared with the entire sampling of the prostate. The Gleason scores were retained in most of cases, except reversal of the primary and secondary Gleason grade component in only 2 cases (1%). Only 4 cases (3%) were downstaged within the same T2 stage. Conclusions.—These results demonstrate that sampling of alternative slices plus peripheral rim of the remaining prostate is the most efficient partial sampling method for radical prostatectomy specimens.

431 External validation of a model predicting survival of men with recurrent prostate cancer after radical prostatectomy

2016 ◽  
Vol 15 (3) ◽  
pp. e431
Author(s):  
P. Dell'Oglio ◽  
N. Suardi ◽  
S. Boorjian ◽  
N. Fossati ◽  
G. Gandaglia ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
External Validation ◽  
Recurrent Prostate Cancer

Development and external validation of a novel risk score to identify insignificant prostate cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 5073-5073
Author(s):  
Lorenzo Dutto ◽  
Jorn H. Witt ◽  
Katarina Urbanova ◽  
Christian Wagner ◽  
Andreas Schuette ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Risk Score ◽  
External Validation ◽  
Tumour Volume ◽  
Risk Scores ◽  
Clinical Predictors ◽  
Predictive Tools ◽  
Tertiary Referral Center ◽  
Insignificant Prostate Cancer

5073 Background: Active surveillance is increasingly used for insignificant prostate cancer (PCa). In order to identify suitable patients, risk scores have been developed which use pre-operative factors. We evaluated the accuracy of 9 separate tools developed to identify patients harbouring insignificant PCa in 2613 patients who underwent radical prostatectomy for Gleason 3+3 PCa. We have developed and validated a novel risk score to correctly identify insignificant PCa for use in unscreened patient cohorts using non-dichotomised clinical predictors. Methods: 2799 patients who would have been candidates for AS (Gleason score 6 only) patients underwent robotic radical prostatectomy between 2006 and 2016 at a tertiary referral center. The volume and grade of tumour in the resected prostate was analysed. Inignificant PCa was defined as Gleason 3+3 only, index tumour volume <1.3 cm3 , total tumour volume <2.5 cm3 (updated ERSPC definition). 2613 patients were included in the final analysis. We computed the accuracy (specificity, sensitivity and area under the curve (AUC) of the receiver operator characteristic) of 9 predictive tools. Multivariate logistic regression with elastic net regularisation was used to develop a novel tool to predict insignificant prostate cancer using age at diagnosis, baseline PSA, TRUS volume, clinical T-stage, number of positive cores and percentage of positive cores as predictors. This tool was validated in an external cohort of 441 unscreened patients undergoing surgery for Gleason 6 PCa. Results: All of the predefined tools rated poorly as predictors of insignificant disease as none of them reached the required AUC threshold of 0.7. The new tool performed well in training and validation cohorts. Conclusions: Pre-existing predictive tools to identify indolent PCa have a poor predictive value when applied to an unscreened cohort of patients. Our novel tool shows good predictive power for insignificant PCa in this population in training and validation cohorts. The inherent selection bias due to analysis of a surgical cohort is acknowledged. [Table: see text]

1327 THE PRESENCE OF EXTRAPROSTATIC EXTENSION INCREASES THE RISK OF DEATH FROM PROSTATE CANCER AFTER RADICAL PROSTATECTOMY FOR PATIENTS WITH PT3B DISEASE

2012 ◽  
Vol 187 (4S) ◽  
Author(s):  
John Hubanks ◽  
Stephen Boorjian ◽  
Igor Frank ◽  
Laureano Rangel ◽  
Matthew Gettman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Risk Of Death ◽  
Extraprostatic Extension

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).

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