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Is Tumor Volume an Independent Predictor of Progression Following Radical Prostatectomy? A Multivariate Analysis of 185 Clinical Stage B Adenocarcinomas of the Prostate with 5 Years of Followup

1993; Lippincott Williams & Wilkins; Volume: 149; Issue: 6 Linguagem: Inglês

10.1016/s0022-5347(17)36421-2

1527-3792

Jonathan I. Epstein, Marné J. Carmichael, Alan W. Partin, Patrick C. Walsh,

Renal cell carcinoma treatment

No AccessJournal of Urology1 Jun 1993Is Tumor Volume an Independent Predictor of Progression Following Radical Prostatectomy? A Multivariate Analysis of 185 Clinical Stage B Adenocarcinomas of the Prostate with 5 Years of Followup Jonathan I. Epstein, Marné Carmichael, Alan W. Partin, and Patrick C. Walsh Jonathan I. EpsteinJonathan I. Epstein , Marné CarmichaelMarné Carmichael , Alan W. PartinAlan W. Partin , and Patrick C. WalshPatrick C. Walsh View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)36421-2AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Tumor volume has been shown to be proportionate to Gleason grade, capsular penetration, seminal vesicle invasion, lymph node metastases and capsular margins of resection. Because these variables are often interrelated, it is crucial to determine which of these parameters provides independent prediction of prognosis in prostate cancer. The current study analyzed 185 men who underwent radial retropubic prostatectomy for clinical stage B adenocarcinoma of the prostate. Patients with seminal vesicle invasion or lymph node metastases were excluded, since these findings are almost invariably associated with progression. All patients were followed for a minimum of 5 years after radical prostatectomy. Only 2 men received postoperative adjuvant therapy. At 5 years after radical prostatectomy 58 men (31%) experienced progression, defined by either an elevated postoperative serum prostate specific antigen level, local recurrence or distant metastases. Although by themselves capsular penetration, tumor volume and per cent of the prostate involved by tumor predicted progression, in a stepwise regression analysis they did not provide independent prognostic information. In this multivariate analysis Gleason score was the best predictor of progression (p <0.0001); surgical margin was the only other variable that enhanced prediction, although it was less influential than grade (p = 0.018). This strong predictability provided by Gleason score was all the more impressive given the relatively few patients in our study with either low or high grade tumor. Although an accurate preoperative assessment of tumor volume remains desirable for the management of patients with prostate cancer, our study demonstrates that measurement of tumor volume in radical prostatectomy specimens need not be performed as part of the routine pathological analysis of radical prostatectomy specimens, since it does not provide additional information beyond that of Gleason score and the status of capsular margins. © 1993 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byBahler C, Green M, Hutchins G, Cheng L, Magers M, Fletcher J and Koch M (2019) Prostate Specific Membrane Antigen Targeted Positron Emission Tomography of Primary Prostate Cancer: Assessing Accuracy with Whole Mount PathologyJournal of Urology, VOL. 203, NO. 1, (92-99), Online publication date: 1-Jan-2020.Ito Y, Udo K, Vertosick E, Sjoberg D, Vickers A, Al-Ahmadie H, Chen Y, Gopalan A, Sirintrapun S, Tickoo S, Scardino P, Eastham J, Reuter V 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Volume 149Issue 6June 1993Page: 1478-1481 Advertisement Copyright & Permissions© 1993 by The American Urological Association Education and Research, Inc.Keywordsadenocarcinomaprostatectomyprostatic neoplasmsneoplasm stagingneoplasm metastasisMetricsAuthor Information Jonathan I. Epstein More articles by this author Marné Carmichael More articles by this author Alan W. Partin More articles by this author Patrick C. Walsh More articles by this author Expand All Advertisement PDF downloadLoading ...