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- Title
255: The preoperative predictors for pathological organ-confinement of clinical T3 prostate cancer.
- Authors
Kwak, Kyung Won; Lee, Hye Won; Park, Jong Wook; Kim, Wan Suk; Lee, Hyun Moo; Choi, Han Yong
- Abstract
Introduction: Radical prostatectomy has been a treatment option for the patients with locally confined prostate cancer but traditionally discouraged for locally advanced prostate cancer. Correct staging of T3 prostate cancer is difficult to achieve, hence, overstaging and understaging are common, presenting a dilemma for proper treatment decision. In this study, we investigated the pre-operative predictors for pathological organ-confined disease of cT3 prostate cancer. Methods: Seventy-one patients with cT3 prostate cancer which underwent radical prostatectomy between February 1998 and May 2007 were included in this study. The patients with insufficient clinical information and neoadjuvant hormone therapy were excluded. We retrospectively reviewed the clinical and biopsy findings of 71 men. Results: Among all patients, 57 (80.3%) had organ-confined disease (=pT2c). Median preoperative PSA, PSA density (PSAD), the percentage of positive core and maximum tumor volume on biopsy was 9ng/ml (1.54-67.48), 0.34 (0.07-3.32), 40% (10-100) and 60% (5-100). High-grade carcinoma (Gleason score 7 or more) was found in 44 men (62%). In univariate analysis, PSAD (=0.35 versus >0.35) and biopsy Gleason score (2-6 versus 7 versus 8-10) were associated with down-staging of cT3 disease, however, the percentage of positive core and maximum tumor volume were not. These variables were also significant independent predictors for pathological organ-confined disease of cT3 disease on multivariate analysis. Conclusions: The cT3 prostate cancer patients with =0.35 of PSAD or biopsy Gleason score of less than 8 had high chances of organ-confined disease at radical prostatectomy specimen, indicating radical prostatectomy as a definite treatment option.
- Subjects
PROSTATE cancer; PROSTATECTOMY; CANCER treatment; CANCER patients; ADJUVANT treatment of cancer; TUMORS
- Publication
Indian Journal of Urology, 2008, Vol 24, pS133
- ISSN
0970-1591
- Publication type
Article