Visual estimation of the tumor volume in prostate cancer: a useful means for predicting biochemical-free survival after radical prostatectomy?

Abstract

Absolute and relative (ratio absolute tumor volume to gland volume) tumor volumes were visually estimated in 528 prostatectomy specimens. Surveying a mean post-surgical follow-up of 49 months, both parameters were analyzed regarding their aptitude for prognostication. We found relative tumor volumes exceeding 25% to independently predict biochemical recurrence reflected by postsurgical prostate-specific antigen progression, which was also determined to be increased to 28% when absolute tumor volumes exceeded 10 cm 3 . However, this cutoff failed to be an independent prognosticator. Because the visual estimation of both parameters can easily be performed, they are felt to be formidable candidates for deriving prognostic information during routine procedures.

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

“…However, for TV and TPI, conflicting studies exist. [1][2][3][4][5][6][7][8][9][10][11] Though all three variables have been analyzed independently in the past, to our knowledge, this is the first study examining the variables within the same population in both univariate and multivariate analysis. Additionally, it is the largest cohort of patients analyzed in such a study.…”

“…It has been shown to be predictive of PSAR in both organ confined disease 8,9 and all stages of disease. 6,10 On the contrary, Epstein et al 11 showed that TPI offered no prognostic information for patients with stage pT2 prostate cancer.…”

“…These findings were in agreement with a number of previous studies. 5,6,11 There are two ways to measure TV. One is to use three dimensional reconstruction of radical prostatectomy specimens 18 and the other is to use TPI and PV to calculate TV.…”

The association between tumour density and prostate cancer recurrence following radical prostatectomy

“…Other factors postulated as potential prognostic markers include: high-grade tumour volume, maximal tumour diameter, perineural invasion, DNA ploidy and molecular markers (E-cadherin, Ki-67, p53 expression). 4,5 While many of these factors are associated with prognosis, they are not highly predictive of outcome after adjusting for stage, grade, PSA and SM status.…”

“…Well-established prognostic factors following RP are pathologic stage, Gleason score (grade), preoperative prostate-specific antigen (PSA) and surgical margin (SM) status. 4 These factors are used to determine prognosis, assess potential benefit of adjuvant therapy, and stratify patients in clinical trials. Other factors postulated as potential prognostic markers include: high-grade tumour volume, maximal tumour diameter, perineural invasion, DNA ploidy and molecular markers (E-cadherin, Ki-67, p53 expression).…”