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Prediction of Capsular Perforation and Seminal Vesicle Invasion in Prostate Cancer

1996; Lippincott Williams & Wilkins; Volume: 155; Issue: 4 Linguagem: Inglês

10.1016/s0022-5347(01)66267-0

1527-3792

David G. Bostwick, Junqi Qian, Erik J. Bergstralh, Paul A. Dundore, Dugan James, Robert P. Myers, Joseph E. Oesterling,

Urologic and reproductive health conditions

No AccessJournal of UrologyClinical Urology: Original Article1 Apr 1996Prediction of Capsular Perforation and Seminal Vesicle Invasion in Prostate Cancer David G. Bostwick, Junqi Qian, Erik Bergstralh, Paul Dundore, Dugan James, Robert P. Myers, and Joseph E. Oesterling David G. BostwickDavid G. Bostwick , Junqi QianJunqi Qian , Erik BergstralhErik Bergstralh , Paul DundorePaul Dundore , Dugan JamesDugan James , Robert P. MyersRobert P. Myers , and Joseph E. OesterlingJoseph E. Oesterling View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)66267-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Capsular perforation and seminal vesicle invasion are unfavorable, prognostic factors in prostate cancer. Accurate preoperative prediction of these factors would be clinically useful for planning treatment, especially in patients being considered for radiation therapy, nerve sparing radical prostatectomy and watchful waiting. However, current methods are imprecise at predicting the presence and extent of these factors. We determined which combination of commonly available preoperative variables provides the best prediction of capsular perforation and seminal vesicle invasion in patients with clinically localized prostate cancer. Materials and Methods: We reviewed the preoperative medical records and biopsy findings from 314 patients with clinical stages T1cN0M0 to T2cN0M0 cancer who underwent radical retropubic prostatectomy and bilateral pelvic lymphadenectomy between September 1991 and June 1993. Radical prostatectomy specimens were embedded and evaluated by whole mount sections. Results: Capsular perforation was observed in 104 patients (33.1 percent) and seminal vesicle invasion was noted in 46 (14.6 percent). Preoperative variables predictive of capsular perforation and seminal vesicle invasion on univariate analysis were serum prostate specific antigen (PSA) concentration, clinical stage, Gleason primary and secondary patterns, Gleason score, nuclear grade, perineural invasion and percent cancer in the biopsy specimens. On multivariate analysis independent prognostic factors for capsular perforation and seminal vesicle invasion were PSA, Gleason score and percent cancer in the biopsy specimens. Conclusions: The combination of serum PSA concentration, Gleason score and percent cancer in the biopsy specimens provides the best prediction of capsular perforation and seminal vesicle invasion. Models based on this combination of factors may be clinically useful to stratify patients for nonoperative treatment. 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Volume 155Issue 4April 1996Page: 1361-1367 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information David G. Bostwick More articles by this author Junqi Qian More articles by this author Erik Bergstralh More articles by this author Paul Dundore More articles by this author Dugan James More articles by this author Robert P. Myers More articles by this author Joseph E. Oesterling Current Address: Department of Urology, University of Michigan, Ann Arbor, Michigan 48109. More articles by this author Expand All Advertisement PDF downloadLoading ...