Percent tumor involvement and risk of biochemical progression after radical prostatectomy.
Published
Journal Article
PURPOSE: Percent tumor involvement has been associated with biochemical progression in organ confined disease, although its role in predicting outcome in men with more advanced disease pathology is unclear. We hypothesized percent tumor involvement may be a good correlate of outcome in all stages of prostate cancer. MATERIALS AND METHODS: We examined the association between percent tumor involvement in the radical prostatectomy specimen and the outcome measures of pathological stage and biochemical progression using multivariate logistic regression and Cox proportional hazards analysis, respectively, in 2,220 patients from the Duke Prostate Center radical prostatectomy database. RESULTS: On multivariate analysis, percent tumor involvement significantly predicted the risk of positive margins (p <0.001), extracapsular extension (p <0.001), seminal vesicle invasion (p <0.001) and biochemical progression (HR 1.16, 95% CI 1.01-1.33, p = 0.035). The percent tumor involvement cut points of 5% or less, 6% to 20%, 21% to 50% and greater than 50% significantly separated men in groups with differing biochemical progression risk (p <0.001). In addition, these cut points were further able to stratify men among those with organ confined margin negative disease (p <0.001), either positive margins or extracapsular extension (p <0.001), and those with seminal vesicle invasion (p = 0.02). CONCLUSIONS: Percent tumor involvement was a significant predictor of biochemical progression and was able to further stratify men who were already assigned to narrowly defined pathological groups. If confirmed in other studies, percent tumor involvement may enable the clinician to identify the high risk patient who stands to benefit the most from adjuvant therapy.
Full Text
Duke Authors
Cited Authors
- Rampersaud, EN; Sun, L; Moul, JW; Madden, J; Freedland, SJ
Published Date
- August 2008
Published In
Volume / Issue
- 180 / 2
Start / End Page
- 571 - 576
PubMed ID
- 18554662
Pubmed Central ID
- 18554662
Electronic International Standard Serial Number (EISSN)
- 1527-3792
Digital Object Identifier (DOI)
- 10.1016/j.juro.2008.04.017
Language
- eng
Conference Location
- United States