scholarly journals MP07-02 THE IMPACT OF QUANTITY AND TYPE OF GLEASON PATTERN 4 ON BIOCHEMICAL RECURRENCE FOLLOWING RADICAL PROSTATECTOMY FOR PROSTATE CANCER

2016 ◽  
Vol 195 (4S) ◽  
Author(s):  
Blake Anderson ◽  
Shane Pearce ◽  
Bonnie Choy ◽  
Gregory Zagaja ◽  
Gladell Paner ◽  
...  
2017 ◽  
Vol 35 (6_suppl) ◽  
pp. e595-e595
Author(s):  
Pengfei Shen ◽  
Guangxi Sun ◽  
Hao Zeng ◽  
Xingming Zhang

e595 Background: Perineural invasion (PNI) is a distinct pathologic entity and a recognized source of tumor spread. However, the role of PNI in high-risk prostate cancer (PCa) has not been explored. We investigated the impact of the severity of PNI on biochemical recurrence (BCR) and optimal timing of adjuvant androgen deprivation therapy (ADT) post radical prostatectomy (RP). Methods: Of 265 prostatectomies, median follow-up 45 months, were assessed for the presence of PNI and its intensity (unifocal PNI and multifocal PNI) in RP specimen. Kaplan-Merier curves were used to estimate BCR probabilities. Cox proportional hazard models were used to address predictors of BCR. Harrell’s C-index was conducted to further validate prognostic value of multi-PNI. Results: A total of 123 patients (46.4%) were PNI positive, among which, 91 (74%) and 32 (26%) had unifocal PNI (uni-PNI) and multifocal PNI (multi-PNI), respectively. Other than uni-PNI, the presence of multi-PNI was strongly associated with increasing incidence of BCR (HR = 3.87, 95% CI: 1.66-9.01, p = 0.002). Patients with uni-PNI seemed to have a similar BCR rate to those without PNI after adjuvant ADT. For men with multi-PNI, immediate ADT obviously appeared to be superior to delayed ADT in decreasing biochemical failure. Conclusions: Multi-PNI detected in high-risk RP specimens could be a prognosticator for early biochemical relapse post-surgery. Our findings suggest that patients with multi-PNI appear appropriate to choose adjuvant therapy as soon as possible after surgery.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21086-21086
Author(s):  
J. J. Alumkal ◽  
Z. Zhang ◽  
E. B. Humphreys ◽  
C. Bennett ◽  
L. A. Mangold ◽  
...  

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.


2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 176-176
Author(s):  
Shintaro Narita ◽  
Koji Mitsuzuka ◽  
Takahiro Yoneyama ◽  
Sadafumi Kawamura ◽  
Yoichi Arai ◽  
...  

176 Background: To determine the impact of body mass index (BMI) on the clinicopathological characteristics and biochemical recurrence of prostate cancer (PCa) after radical prostatectomy (RP) in Japanese men. Methods: The medical records of 1,257 men with PCa treated by radical prostatectomy without neoadjuvant therapy at four medical centers between 2001 and 2009 were retrospectively reviewed. Patients were categorized into four groups using the WHO BMI classification and recommended BMI quartiles. Associations of the various BMI categories with clinicopathological characteristics and biochemical recurrences were statistically evaluated. Biochemical recurrence was defined as a prostate specific antigen (PSA) level of >0.2 ng/ml. Results: Of the 1,257 patients, 230 (18.1%) experienced biochemical recurrence during the median follow-up period of 49 months. The median BMI was 23.8 kg/m2, and 1.4% patients were underweight, 65.4% were of normal weight, 30.9% were overweight, and 2.4% were obese (WHO classification). Preoperative PSA levels and PSA density (PSAD) were significantly higher in the underweight group than in the other groups. Pathological characteristics did not differ significantly among BMI categories. As per the WHO classification and quartile categories, biochemical recurrence rate was comparable among the BMI groups. After adjusting for other pre- and perioperative covariables, multivariate Cox proportional hazards analysis revealed that a high BMI did not have an independent impact on biochemical recurrence-free survival. Conclusions: Underweight Japanese PCa patients who underwent radical prostatectomy had higher preoperative PSA levels and PSAD. However, high BMI was not associated with increased biochemical recurrence rate.


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