Race and Prostate Weight as Independent Predictors for Biochemical Recurrence After Radical Prostatectomy

Schroeck, Florian R.; Sun, Leon; Levy, Donna E.; Bryan, Kadi-Ann N; Freedland, Stephen J.; Jayachandran, Jayakrishnan; Price, Marva M.; Williams, Rachael; Moul, Judd W.

doi:10.1016/s0022-5347(08)60574-1

Cited by 8 publications

(17 citation statements)

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“…The size of a normal prostate is 20-30 cc 25, 26 and reported medians in the literature set the median for diseased prostate volume around 35-45 cc. 2, 12,13,15,24 In our study the median prostate volume was 38.4 cc, with only 25% of men having prostates larger than 50 cc and 10% larger than 64 cc. As a result, our finding that men with prostate volumes less than 35 cc have a 25% increased risk for PSAR compared to men with larger volume prostates provides clinicians with a clinically relevant value by which to assess patients risk for PSAR following RP.…”

Section: Commentmentioning

confidence: 42%

“…Previous studies from this team and others showed that men with small PV had higher risk of PSAR. 2,12,14,15 The reason for this remains unknown, however a number of potential explanations exist. It has been suggested that men with smaller prostates may have lower levels of testosterone which has been shown to correlate with more aggressive prostate cancer 22 .…”

Section: Commentmentioning

confidence: 99%

“…12,13 Men with smaller prostates have been shown to have higher grade and more advanced disease 14 and men with larger prostates have been shown to have lower rates of PSAR. 15,16 …”

Section: Introductionmentioning

confidence: 99%

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Tumor Volume, Tumor Percentage Involvement, or Prostate Volume: Which Is Predictive of Prostate-specific Antigen Recurrence?

Uhlman

Sun

Stackhouse

et al. 2010

Urology

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Objective To compare the effects of tumor volume (TV), tumor percentage involvement (TPI) and prostate volume (PV) on PSA recurrence (PSAR) following radical prostatectomy (RP). Methods A cohort of 3528 patients receiving RP between 1988 and 2008 was retrieved from the Duke Prostate Center. Patients were stratified by TV (<3cc, 3-6cc, >6cc), TPI (<10%, 10-20%, >20%) and PV (<35cc, 35-45cc, >45cc) and their effects on PSAR evaluated using Kaplan-Meier (KM) analysis. Clinico-pathological variables included in univariate analysis were age at surgery, race, year of surgery, PSA, pathological Gleason score, pathological tumor stage, margin status, extra capsular extension (ECE) and seminal vesicle invasion (SVI). The effects of TV, TPI and PV (as continuous and categorical variables) on PSAR were compared using Cox analysis. Results TPI, TV and PV were predictive of PSAR (p <0.05) in KM. In multivariate analysis as continuous variables, TPI and PV were predictive of PSAR (Odds ratio (OR) = 1.16 and OR = 0.65, p <0.05). As categorical variables, TPI > 20% and PV 10-35cc were predictive of PSAR (OR = 1.45 and OR = 1.25, p <0.05). TV was not predictive of PSAR in either analysis. Pathological Gleason score ≥ 7, PSA, positive margins, SVI and tumor stage T3/4 were found to be predictors of PSAR (p <0.05). Conclusions TV, TPI and PV were predictive of PSAR in univariate analysis, but only TPI and PV were predictive in multivariate analysis. TPI and PV should be considered when evaluating, assessing and counseling patients about PSAR risk.

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Section: Commentmentioning

confidence: 42%

Section: Commentmentioning

confidence: 99%

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Tumor Volume, Tumor Percentage Involvement, or Prostate Volume: Which Is Predictive of Prostate-specific Antigen Recurrence?

Uhlman

Sun

Stackhouse

et al. 2010

Urology

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“…Additional postoperative treatments were at the judgment of the patient and treating physician. In both SEARCH and DPC, BCR was defined as a postoperative PSA level ≥ 0.2 ng/mL or secondary treatment for an elevated PSA 12 . For our study purposes, the definition adopted, which slightly differs from the American Urologic Association (AUA) definition, 13 provides a better classification for patients with rising PSA who received early secondary treatment.…”

Section: Methodsmentioning

confidence: 99%

Postoperative prostate‐specific antigen nadir improves accuracy for predicting biochemical recurrence after radical prostatectomy: Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) and Duke Prostate Center databases

et al. 2010

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Objectives We previously showed that prostate-specific antigen (PSA) nadir after radical prostatectomy (RP) significantly predicts biochemical recurrence (BCR). Herein, we sought to explore the effect of including PSA nadir into commonly used models on their accuracy to predict BCR after RP. Methods This was a retrospective analysis of 943 and 1792 subjects from the Shared Equal Access Regional Cancer Hospital (SEARCH) and Duke Prostate Cancer (DPC) databases, respectively. The discrimination accuracy for BCR of seven previously published models was assessed using concordance index and compared with and without adding PSA nadir level in SEARCH. Using data from SEARCH, we developed a new nomogram incorporating PSA nadir to other known predictors (preoperative PSA, pathological Gleason score, PSA nadir level, surgical findings, prostate weight, body mass index and race) of BCR and externally validated it in the DPC. Results In SEARCH, the mean concordance index across all seven nomograms was 0.687. After the inclusion of PSA nadir, the concordance index increased by nearly 7% (mean = 0.753). The concordance index of the new nomogram in SEARCH was 0.779 (bias-corrected = 0.767), which was 5% better than the next best model. In DPC, the new nomogram yielded a concordance index of 0.778. Conclusion The addition of postoperative PSA nadir to commonly used nomograms increased their accuracies by nearly 7%. Based upon this, we developed and externally validated a new nomogram, which was well calibrated and highly accurate, and is a potentially valuable tool for patients and physicians to predict BCR after RP.

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“…[1][2][3][4] This may be because men with larger prostates have higher prostatespecific antigen levels and may be subjected to biopsy earlier in the course of their disease. Men with small prostates may have lower testosterone levels, a feature that correlates with aggressive cancers.…”

Section: Introductionmentioning

confidence: 99%

Kidney Volume Correlates With Tumor Diameter in Renal Cell Carcinoma and Is Associated With Histological Poor Prognostic Features

Hayes

Finn

2013

Int J Surg Pathol

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We aimed to correlate kidney volume (KV) in renal cell carcinoma nephrectomy specimens with tumor diameter (TD), macroscopic growth pattern, and histological features associated with poor prognosis. Histopathology reports, macroscopic specimen photographs, and selected glass slides were retrospectively reviewed. KV was approximated to the volume of an ellipsoid. A total of 273 specimens were identified with median KV 245 cm(3). Kidneys larger than this contained larger tumors (7.5 vs 4.5 cm). KV was significantly greater in tumors of high grade, involving perinephric fat, exhibiting venous invasion, and involving renal sinus. There was a robust linear correlation between KV and TD (r = 0.602) and a weaker correlation between kidney diameter (KD) and TD (r = 0.53). In pT1 tumors, KV (r = 0.40) also correlated better with TD than did KD (r = 0.27). By multiple regression analysis, both TD and venous invasion independently predicted both KD (R (2) = 38.27%) and KV (R (2) = 51.97%). KV and KD correlate well with TD and histopathological features of aggressiveness, although KD correlates better overall and in the pT1 subset.

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Race and Prostate Weight as Independent Predictors for Biochemical Recurrence After Radical Prostatectomy

Cited by 8 publications

References 0 publications

Tumor Volume, Tumor Percentage Involvement, or Prostate Volume: Which Is Predictive of Prostate-specific Antigen Recurrence?

Tumor Volume, Tumor Percentage Involvement, or Prostate Volume: Which Is Predictive of Prostate-specific Antigen Recurrence?

Postoperative prostate‐specific antigen nadir improves accuracy for predicting biochemical recurrence after radical prostatectomy: Results from the Shared Equal Access Regional Cancer Hospital (SEARCH) and Duke Prostate Center databases

Kidney Volume Correlates With Tumor Diameter in Renal Cell Carcinoma and Is Associated With Histological Poor Prognostic Features

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