Determining the cut-off values of tumor diameter, degree of extraprostatic extension, and extent of surgical margin positivity with regard to biochemical recurrence of prostate cancer after radical prostatectomy

Kır, Gözde; Arikan, Evsen Apaydin; Şeneldir, Hatice; Ankaralı, Handan; Oznergiz, Seca; Olgun, Zeynep Cagla; Yıldırım, Asıf

doi:10.1016/j.anndiagpath.2019.151431

Cited by 8 publications

(10 citation statements)

References 31 publications

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“…Many predictive values of EPE related to BCR have been investigated 4 – 15 . Focal EPEs contain a few neoplastic glands exterior to the prostate, and established EPEs show more extensive extraprostatic spread 4 , 5 .…”

Section: Discussionmentioning

confidence: 99%

“…Several attempts have been made to optimize these definitions and documented optimal cut-off radial distances at 0.75 mm 9 , 0.6 mm (high power restriction) 6 , or 1.1 mm (low power restriction) 12 . Recently, one study observed that EPEs > 1 mm and a length of surgical margin positivity > 2 mm was an independent predictor of BCR (AUC 0.713) 15 . In this study, we revealed that radial distance of EPE is significantly associated with EPE and showed excellent interobserver agreement (interclass correlation coefficient = 0.999, P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

“…A recent study analyzed radial and circumferential length individually and found that both factors were significantly associated with BCR 15 . There have been, however, no investigations into the 2D square area of EPE.…”

Section: Discussionmentioning

confidence: 99%

“…Although the concept of pT3a was first proposed by Epstein et al in 1993 4 , 5 , some articles have defined adequate cut-off criteria 6 – 15 . In the initial large-scale analysis by Epstein et al, a radial EPE distance of 0.5 mm was proposed as a reasonable cut-off criterion 4 .…”

Section: Introductionmentioning

confidence: 99%

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Revisiting extraprostatic extension based on invasion depth and number for new algorithm for substaging of pT3a prostate cancer

Park

Chung

Choi

et al. 2021

Sci Rep

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Extraprostatic extension (EPE) is a factor in determining pT3a stage in prostate cancer. However, the only distinction in EPE is whether it is focal or non-focal, causing diagnostic and prognostic ambiguity. We substaged pT3a malignancies using classification of EPE to improve personalized prognostication. We evaluated 465 radical prostatectomy specimens with a digital image analyzer by measuring the number, radial distance and two-dimensional square area of the EPE. The most significant cut-off value was proposed as an algorithm for the pT3a substaging system to predict biochemical recurrence (BCR). A combination of the radial distance and the number of EPEs predicted BCR the most effectively. The optimal cut-off criteria were 0.75 mm and 2 mm in radial distance and multifocal EPE (hazard ratio: 2.526, C-index 0.656). The pT3a was subdivided into pT3a1, < 0.75 mm and any number of EPEs; pT3a2, 0.75–2 mm and one EPE; and pT3a3, > 2 mm and any number of EPEs or 0.75–2 mm and ≥ 2 EPEs. This combined tier was highly significant in the prediction of BCR-free survival. The combination of radial distance and number of EPEs could be used to subdivide pT3a prostate cancer and may aid in the prediction of BCR.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Revisiting extraprostatic extension based on invasion depth and number for new algorithm for substaging of pT3a prostate cancer

Park

Chung

Choi

et al. 2021

Sci Rep

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“… 24 Finally, Kir has proposed to use TVP as one parameter to be taken into account when considering adjuvant therapy for localized prostate cancer. 25 …”

Section: Discussionmentioning

confidence: 99%

Can Tumour Volume Percentage in Radical Prostatectomy Predict Cancer Biochemical Recurrence? Determining a Cut-off Point and Composite Risk Factors Approach

Alenezi¹,

Ismail

Eden

2021

RRU

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Background Incidence of biochemical recurrence (BCR) after radical prostatectomy is relatively high and overall survival can be poor. Debate exists whether tumour volume predicts BCR and when treatments should be administered. In this study, we aimed to i) assess the impact of tumour volume percentage (TVP) as a predictor for BCR, ii) determine TVP cut-off point for BCR and iii) evaluate single and composite predictors of BCR. Methods From March 2000 to December 2013, 1777 patients underwent laparoscopic radical prostatectomy for localized prostate cancer. None received neoadjuvant or adjuvant therapy. One hundred and forty-six patients experienced BCR (range 3 months-10 years). Using D’Amico classification, 146 matched controls without BCR were compared. Liu cut-point analysis was used to identify TVP with optimal sensitivity and specificity. Single and composite BCR risk predictors were analyzed using Cox hazards regression in cases and controls. Results Median TVP was 10% (range 1–90%). Most of BCR peaked after 3 years of follow-up. TVP ≥8% was an independent predictor of BCR with HR 1.6 (p= 0.001, 95% CI= 1.11–2.48). TVP of 8% was associated with the highest accuracy: sensitivity 74% and specificity 53% (ROC curve= 0.7). At TVP ≥8%, pathological stage pT3 was associated with 1.7-fold higher risk of BCR compared to T2. Lymph node invasion was associated with 1.4-fold higher risk of BCR compared to no invasion. Combining TVP ≥8%, pT3 and lymph node invasion, HR jumped to 3.73 (p< 0.001, 95% CI= 2.27–6.14), whereas combining TVP ≥8%, positive surgical margin and lymph node invasion, HR was 2.68 (p= 001, 95% CI= 1.50–4.77). Conclusion TVP can be used as an independent predictor of BCR after radical prostatectomy for prostate cancer. TVP cut-point of ≥8% allows the best discrimination. TVP should be considered in combination with other clinico-pathological factors to improve prediction of long-term oncological outcomes and to stratify BCR risk.

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Management of Extracapsular Extension and Positive Surgical Margins Following Robot-Assisted, Laparoscopic Radical Prostatectomy

Greenberg

Nguyen

Carroll

2022

Robotic Urologic Surgery

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Determining the cut-off values of tumor diameter, degree of extraprostatic extension, and extent of surgical margin positivity with regard to biochemical recurrence of prostate cancer after radical prostatectomy

Cited by 8 publications

References 31 publications

Revisiting extraprostatic extension based on invasion depth and number for new algorithm for substaging of pT3a prostate cancer

Revisiting extraprostatic extension based on invasion depth and number for new algorithm for substaging of pT3a prostate cancer

Can Tumour Volume Percentage in Radical Prostatectomy Predict Cancer Biochemical Recurrence? Determining a Cut-off Point and Composite Risk Factors Approach

Management of Extracapsular Extension and Positive Surgical Margins Following Robot-Assisted, Laparoscopic Radical Prostatectomy

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