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Prostate cancer laterality as a rationale of focal ablative therapy for the treatment of clinically localized prostate cancer.

Publication ,  Journal Article
Mouraviev, V; Mayes, JM; Sun, L; Madden, JF; Moul, JW; Polascik, TJ
Published in: Cancer
August 15, 2007

BACKGROUND: Early detection of small-volume prostate cancer (PCa) has led to the concept of focal therapy to treat PCa as an organ-sparing, minimally invasive procedure. The authors sought to determine the frequency of unilateral cancers in the contemporary prostate-specific antigen (PSA) era to determine the percentage of patients who would be candidates for hemiablation of the prostate by using focal therapy while preserving the contralateral lobe. METHODS: Paraffin-embedded radical prostatectomy specimens (1184 specimens) from consecutive patients between 2002 and 2006 with pathologic organ confined PCa were analyzed. Pathologic assessment focused on tumor laterality and percentage of tumor involvement (PTI) along with other routine parameters such as pathological T-classification (pT), pathological Gleason Score (pGS), extracapsular extension (ECE), and surgical margins (SM). Clinical and pathologic parameters were analyzed by univariate and multivariate methods. RESULTS: Completely unilateral cancers were identified in 227 (19.2%) of 1184 patients. Of these patients, 164 (72.2%) had PTI of < or =5%, 40 (17.6%) had a PTI of 5.01%-10%, 9 (4.0%) had a PTI of 10.01%-15%, and 14 (6.2%) had a PTI of > 15%, respectively (P < .0005). African-American men had bilateral cancers more commonly that non-African-American men, eg, 90.8% versus 79.2%, respectively (P < .0005). Race, PTI, pGS, and SM were independent predictors by multivariate logistic regression (P < or = .05). CONCLUSIONS: This study suggests that 1 in 5 men diagnosed with PCa have small volume, completely unilateral cancers that may be amenable to hemiablation of the prostate. Further study is needed to develop predictive models to select candidates for focal therapy.

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Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

August 15, 2007

Volume

110

Issue

4

Start / End Page

906 / 910

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Prostatic Neoplasms
  • Prostatectomy
  • Prostate
  • Oncology & Carcinogenesis
  • Neoplasm Invasiveness
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Humans
 

Citation

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ICMJE
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Mouraviev, V., Mayes, J. M., Sun, L., Madden, J. F., Moul, J. W., & Polascik, T. J. (2007). Prostate cancer laterality as a rationale of focal ablative therapy for the treatment of clinically localized prostate cancer. Cancer, 110(4), 906–910. https://doi.org/10.1002/cncr.22858
Mouraviev, Vladimir, Janice M. Mayes, Leon Sun, John F. Madden, Judd W. Moul, and Thomas J. Polascik. “Prostate cancer laterality as a rationale of focal ablative therapy for the treatment of clinically localized prostate cancer.Cancer 110, no. 4 (August 15, 2007): 906–10. https://doi.org/10.1002/cncr.22858.
Mouraviev V, Mayes JM, Sun L, Madden JF, Moul JW, Polascik TJ. Prostate cancer laterality as a rationale of focal ablative therapy for the treatment of clinically localized prostate cancer. Cancer. 2007 Aug 15;110(4):906–10.
Mouraviev, Vladimir, et al. “Prostate cancer laterality as a rationale of focal ablative therapy for the treatment of clinically localized prostate cancer.Cancer, vol. 110, no. 4, Aug. 2007, pp. 906–10. Pubmed, doi:10.1002/cncr.22858.
Mouraviev V, Mayes JM, Sun L, Madden JF, Moul JW, Polascik TJ. Prostate cancer laterality as a rationale of focal ablative therapy for the treatment of clinically localized prostate cancer. Cancer. 2007 Aug 15;110(4):906–910.
Journal cover image

Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

August 15, 2007

Volume

110

Issue

4

Start / End Page

906 / 910

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Prostatic Neoplasms
  • Prostatectomy
  • Prostate
  • Oncology & Carcinogenesis
  • Neoplasm Invasiveness
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Humans