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Quantification of extraprostatic extension in prostate cancer: different parameters correlated to biochemical recurrence after radical prostatectomy.

Abstract：

AIMS:Different methods to substage extraprostatic extension (EPE) were correlated with biochemical recurrence (BCR) after radical prostatectomy (RP). METHODS AND RESULTS:  A total of 157 consecutive RP specimens with EPE were completely embedded. Twenty-three patients with adjuvant therapy or detectable postoperative PSA levels were excluded, leaving 134 patients for BCR analysis. Data were analysed using Kaplan-Meier survival and Cox regression analyses. In univariate analysis, maximal radial distance (RD) was associated with BCR as continuous (P = 0.006) and dichotomous (P = 0.002) parameters. In multivariate analysis, independent predictors of BCR were preoperative prostate-specific antigen (PSA) (P = 0.006), Gleason score (P = 0.001), positive surgical margins (P = 0.005), maximal RD dichotomized at 0.6 mm [= one high-power field (HPF)]; hazard ratio (HR) 3.4; 95% confidence interval (CI) 1.48-7.85; P = 0.004), total RD (P = 0.009) and EPE quantification according to Epstein (P = 0.002) and to Wheeler (P = 0.004). The 5-year risk of BCR was 20% (95% CI 0.65-0.94) in patients with RD ≤ 0.6 mm and 47% (95% CI: 0.41-0.65) with RD > 0.6 mm. The restriction of focal EPE in no more than two slides (Epstein and Wheeler) gave no better results. CONCLUSIONS:Maximal RD dichotomized at one HPF is an objective method to subdivide EPE and a strong, independent predictor for BCR after RP. Its use is recommended for substaging pT3a in future TNM classifications.

journal_name

Histopathology

journal_title

Histopathology

authors

van Veggel BA,van Oort IM,Witjes JA,Kiemeney LA,Hulsbergen-van de Kaa CA

doi

10.1111/j.1365-2559.2011.03986.x

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

692-702

issue

4

eissn

0309-0167

issn

1365-2559

journal_volume

59

pub_type

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