Anterior-predominant prostatic tumors: Zone of origin and pathologic outcomes at radical prostatectomy
Anterior-predominant prostatic tumors: Zone of origin and pathologic outcomes at radical prostatectomy
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DOI：
10.1097/pas.0b013e31812f7b27
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发表时间：
2008-02-01
影响因子：
5.6
通讯作者：
Fine, Samson W.
中科院分区：
文献类型：
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作者：
Al-Ahmadie, Hikmat A.;Tickoo, Satish K.;Fine, Samson W.
积极的筛查和前列腺穿刺活检方案已成功地早期发现低体积后方肿瘤。因此，我们观察到前占优势的前列腺癌的发病率增加。然而，这组肿瘤的起源区域，扩散模式和前列腺外扩展模式尚未得到很好的研究。在4.5年的时间里，在我们机构进行的1312例根治性尿道切除术中，197例在全固定根治性尿道切除术标本中具有尿道前的主要（最大）肿瘤。对该队列进行了详细的组织病理学分析，强调前列腺前部解剖结构从顶端到底部的变异性，以确定起源区和病理分期。使用该方法，97/197例（49.2%）前占优势的肿瘤（AT）被分配到前周边区（APZ），70例（35.5%）移行区（TZ），16例（8.1%）不确定区，14例（7.1%）两个区。比较APZ和TZ肿瘤，在Gleason评分、前列腺外侵犯发生率、总体手术切缘阳性率或偏侧性方面没有显著差异。TZ区肿瘤累及前纤维肌性间质的可能性更大（P
Aggressive screening and prostate needle biopsy protocols have been successful in early detection of low-volume posterior tumors. Consequently, we have observed an increased incidence of anterior-predominant prostate cancers. However, the zones of origin, patterns of spread, and patterns of extraprostatic extension of this group of tumors have not been well studied. Of 1312 radical prostatectomies performed at our institution over a span of 4.5 years, 197 had predominant (largest) tumors anterior to the urethra in whole-mounted radical prostatectomy specimens. Detailed histopathologic analysis of this cohort was undertaken emphasizing the variability in anterior prostatic anatomy from apex through base to determine zone of origin and pathologic staging. Using this approach, 97/197 (49.2%) anterior-predominant tumors (ATs) were assigned to the anterior peripheral zone (APZ), 70 (35.5%) to the transition zone (TZ), 16 (8.1%) were of indeterminate zone, and 14 (7.1%) were of both zones. Comparing APZ and TZ tumors, there were no significant differences in Gleason scores, incidence of extraprostatic extension, overall surgical margin positivity rate, or laterality. Involvement of the anterior fibromuscular stroma was significantly more likely in tumors of TZ origin (P