Tumor Volume, Tumor Percentage Involvement or Prostate Volume: Which Is Predictive of Psa Recurrence?

Uhlman, Matthew A.; Sun, Leon; Stackhouse, Danielle A.; Caire, Arthur; Polascik, Thomas J.; Mouraviev, Vladimir; Robertson, Cary N.; Albala, David; Moul, Judd W.

doi:10.1016/s0022-5347(09)60774-6

Cited by 1 publication

(4 citation statements)

References 26 publications

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“…For instance, when Gleason score was included with volume in the analysis, studies were split equally as to effect of volume. Eight studies documented that volume was a significant factor [4,5,7,8,14,16,17,31]; seven did not [6,[9][10][11][12][13]15].…”

Section: Resultsmentioning

confidence: 99%

“…In the nine studies where presenting serum prostate specific antigen (PSA) was added to the MVA [4,5,7,10,11,13,16,17,31], concordance rose to 67%, favoring an effect of volume on outcome. When a measure of surgical margin status or extra-capsular extension of disease was added to the MVA, concordance rose to 75% of the remaining studies [4,5,7,10,11,16,17,31]. Four studies also added a factor of lymph node involvement to the MVA [4,5,7,11]; in them, concordance rose to 75%.…”

Section: Resultsmentioning

confidence: 99%

“…Articles were included if published after 1990; this was done to include data from the PSA era. Twenty-four initial search and related articles were reviewed for content and inclusion 31,32]; fifteen articles were accepted as below. Three articles were excluded based on the specimen examined: one did not study the entire radical prostatectomy specimen [18], one used cystoprostatectomy specimens [19], and one only reported tumor volume in the seminal vesicles [20].…”

Section: Methodsmentioning

confidence: 99%

“…As visual estimation has been shown to correlate with actual tumor volumes measured by planimetry [26,27], we included the above seven studies in our analysis. Finally, Uhlman et al [31] reported in abstract form the results of MVA using tumor volume (in grams), and tumor percentage involvement (TPI). For the purpose of this analysis, TPI was considered the volume metric of interest.…”

Section: Methodsmentioning

confidence: 99%

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The Role of Tumor Volume on Outcome in Prostate Cancer after Prostatectomy

Brannan

Johnstone

2009

British Journal of Medical and Surgical Urology

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Objective: Significant study has been made of the role of tumor volume contributing to outcome in prostate cancer: almost two dozen studies have been published on the subject, without clear results either for or against a relationship. Methods: An extensive MEDLINE and PUBMED search yielded fourteen articles involving >10,600 patients describing analyses of institutional prostate cancer experiences including tumor volume after radical prostatectomy (RP). Studies were included if multivariate analysis (MVA) was performed including a variable related to tumor volume. All studies had a common outcome of biochemical disease-free (bNED) survival. Results: The more rigorous the MVA performed, the more likely tumor volume was to be independently predictive. When the analysis included only tumor volume and Gleason score, studies agreed on outcome half the time. As more variables were added to the analysis, the degree of concordance increased. The two studies with most complete MVAs concur in a volume effect on outcome in over 1470 patients. Conclusion: While no meta-analysis on the subject is possible without knowing particulars of each reported case, tumor volume as a predictive variable is likely to be less important than more frequently analyzed factors such as Gleason score and PSA. However, the studies that most completely address the complex and competing variables impacting bNED survival in prostate cancer are those that describe a relationship of tumor volume on outcome.

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