Prognostic significance of tumor volume after radical prostatectomy: A Multivariate analysis of pathological prognostic factors
Prognostic significance of tumor volume after radical prostatectomy: A Multivariate analysis of pathological prognostic factors
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DOI：
10.1016/s0302-2838(02)00493-1
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发表时间：
2003-01-01
期刊：
影响因子：
23.4
通讯作者：
Abbou, CC
中科院分区：
文献类型：
--
作者：
Salomon, L;Levrel, O;Abbou, CC
目的：分析根治性前列腺切除术后前列腺癌进展中Gleason评分、分期、切缘状态与肿瘤体积的关系。方法：对200例连续根治性前列腺切除术标本进行分析。记录术前临床分期、PSA、前列腺活检结果及病理结果。生化复发定义为单个术后可检测的PSA水平（>0.2 ng/ml）。将肿瘤体积与术后分期、Gleason评分和手术切缘状态进行比较，以预测肿瘤进展。采用逐步逻辑回归进行单因素和多因素分析，以确定具有附加预后价值的参数。结果：前列腺切除术标本病理结果显示pT2a-b肿瘤149例（74.5%），pT3a肿瘤29例（14.5%），pT3b肿瘤22例（11%）。肿瘤体积pT2a为0.57 cc， pT2b为1.2 cc， pT3a为1.7 cc， pT3b为2.9 cc （p < 0.05）。总的来说，pT2和pT3的平均体积分别为1.06和2.2 cc （p < 0.0001）。5年无进展精算生存率为69.7%。通过单因素分析，肿瘤进展与最终Gleason评分（p < 0.0007）、阳性手术切缘（p = 0.02）、肿瘤体积（p = 0.009）和分期（p < 0.0001）相关。在多变量分析中，肿瘤进展仅与最终Gleason评分（p = 0.04）和分期（p = 0.0002）相关。结论：Gleason评分和病理分期是预测根治性前列腺切除术后前列腺癌进展的独立因素。当这些参数已知时，肿瘤体积不能提供额外的信息。(C) 2002 Elsevier Science b.v.版权所有
Objectives: To analyze the association between Gleason score, stage and status of surgical margins with tumor volume in prostate cancer progression after radical prostatectomy.Methods: 200 consecutive radical prostatectomy specimens were analyzed. Preoperative clinical stage, PSA, results of prostate biopsies as well as pathological results were noted. A biochemical recurrence was defined as a single, postoperative detectable PSA level (>0.2 ng/ml). Tumor volume was compared to postoperative staging, Gleason score, and surgical margin status to predict tumor progression. Univariate and multivariate analysis using stepwise logistic regression were used to identify parameters with additional prognostic value.Results: Pathological results of the prostatectomy specimens showed 149 (74.5%) pT2a-b, 29 (14.5%) pT3a and 22 (11%) pT3b tumors. Tumor volume was 0.57 cc for pT2a, 1.2 cc for pT2b, 1.7 cc for pT3a and 2.9 cc for pT3b, respectively (p < 0.05). Taken together, mean volume for pT2 and pT3 were 1.06 and 2.2 cc, respectively (p < 0.0001). Five-year progression-free actuarial survival was 69.7%. Using univariate analysis, tumor progression correlated with final Gleason score (p < 0.0007), positive surgical margins (p = 0.02), tumor volume (p = 0.009) and stage (p < 0.0001). In a multivariate analysis, tumor progression correlated only with the final Gleason score (p = 0.04) and stage (p = 0.0002).Conclusion: Gleason score and pathological stage are independent factors to predict prostate cancer progression after radical prostatectomy. When these parameters are known, tumor volume does not provide additional information. (C) 2002 Elsevier Science B.V All rights reserved.