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• W2895529058 abstract "No AccessJournal of UrologyAdult Urology1 Mar 2019Clinical Usefulness of Prostate and Tumor Volume Related Parameters following Radical Prostatectomy for Localized Prostate Cancer Yujiro Ito, Kazuma Udo, Emily A. Vertosick, Daniel D. Sjoberg, Andrew J. Vickers, Hikmat A. Al-Ahmadie, Ying-Bei Chen, Anuradha Gopalan, S. Joseph Sirintrapun, Satish K. Tickoo, Peter T. Scardino, James A. Eastham, Victor E. Reuter, and Samson W. Fine Yujiro ItoYujiro Ito Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Kazuma UdoKazuma Udo Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Emily A. VertosickEmily A. Vertosick Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Daniel D. SjobergDaniel D. Sjoberg Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Andrew J. VickersAndrew J. Vickers Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York Financial interest and/or other relationship with Arctic Partners and Opko Diagnostics. More articles by this author , Hikmat A. Al-AhmadieHikmat A. Al-Ahmadie Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Ying-Bei ChenYing-Bei Chen Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Anuradha GopalanAnuradha Gopalan Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , S. Joseph SirintrapunS. Joseph Sirintrapun Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Satish K. TickooSatish K. Tickoo Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Peter T. ScardinoPeter T. Scardino Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , James A. EasthamJames A. Eastham Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , Victor E. ReuterVictor E. Reuter Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author , and Samson W. FineSamson W. Fine †Correspondence: Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., Room C502, New York, New York10065 (telephone: 212-639-5066; FAX: 646-422-2070; e-mail: E-mail Address: [email protected]). Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.09.060AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated whether the prediction of biochemical recurrence after radical prostatectomy is enhanced by any of 6 parameters, including prostate volume, total tumor volume, high grade total tumor volume, the ratio of high grade total tumor volume to total tumor volume, the ratio of total tumor volume to prostate volume and/or the ratio of high grade total tumor volume to prostate volume. Materials and Methods: A total of 1,261 patients who underwent radical prostatectomy during a 3-year period had tumor maps constructed with the Gleason pattern denoted as low—3 or high—4 or 5 and volumetric data generated using commercially available software. Univariate Cox regression models were used to assess whether each volume related parameter was associated with biochemical recurrence after radical prostatectomy. A multivariable Cox regression base model (age, prostate specific antigen, Gleason score/grade group, pathological stage and margin status) was compared with 6 additional models (base model plus each volume related parameter) to evaluate enhancement in predictive accuracy. Decision curve analysis was performed to determine the clinical utility of parameters that enhanced predictive accuracy. Results: On univariate analysis each parameter was significantly associated with biochemical recurrence except prostate volume. Predictive accuracy of the multivariable base model was high (c-index = 0.861). Adding volume related parameters marginally enhanced discrimination. Decision curve analysis failed to show added benefit even for high grade total tumor volume/total tumor volume, which was the parameter with the highest discriminative improvement. Conclusions: Tumor volume related parameters are significantly associated with radical prostatectomy but do not add important discrimination to standard clinicopathological variables for radical prostatectomy prediction or provide benefit across a range of clinically relevant decision thresholds. Volume related measurement is not warranted in routine pathological evaluation and reporting. References 1. : Cancer volume and site of origin of adenocarcinoma in the prostate: relationship to local and distant spread. Hum Pathol 1992; 23: 258. Google Scholar 2. : Tumor volume is an independent predictor of prostate-specific antigen recurrence in patients undergoing radical prostatectomy for clinically localized prostate cancer. BJU Int 2006; 97: 1169. Google Scholar 3. : Biological determinants of cancer progression in men with prostate cancer. JAMA 1999; 281: 1395. Crossref, Medline, Google Scholar 4. : Is tumor volume an independent prognostic factor in clinically localized prostate cancer?J Urol 2004; 172: 508. Link, Google Scholar 5. : Prognostic significance of tumor volume after radical prostatectomy: a multivariate analysis of pathological prognostic factors. Eur Urol 2003; 43: 39. Google Scholar 6. : Percent carcinoma in radical prostatectomy specimen is associated with risk of recurrence after radical prostatectomy in patients with pathologically organ confined prostate cancer. J Urol 2004; 172: 137. Link, Google Scholar 7. : Percent tumor involvement and risk of biochemical progression after radical prostatectomy. J Urol 2008; 180: 571. Link, Google Scholar 8. : Tumor volume, tumor percentage involvement, or prostate volume: which is predictive of prostate-specific antigen recurrence?Urology 2010; 75: 460. Google Scholar 9. : Is tumor volume an independent predictor of progression following radical prostatectomy? A multivariate analysis of 185 clinical stage B adenocarcinomas of the prostate with 5 years of followup. J Urol 1993; 149: 1478. Link, Google Scholar 10. : Percentage of Gleason pattern 4 and 5 predicts survival after radical prostatectomy. Cancer 2007; 110: 1967. Google Scholar 11. : The combined percentage of Gleason patterns 4 and 5 is the best predictor of cancer progression after radical prostatectomy. J Clin Oncol 2005; 23: 2911. Google Scholar 12. : Tumour volume and high grade tumour volume are the best predictors of pathologic stage and biochemical recurrence after radical prostatectomy. Eur J Cancer 2007; 43: 536. Google Scholar 13. : Percentage of high-grade tumour volume does not meaningfully improve prediction of early biochemical recurrence after radical prostatectomy compared with Gleason score. BJU Int 2014; 113: 399. Google Scholar 14. College of American Pathologists: Cancer Protocol Templates, Prostate Gland. Available at http://cap.org/cancerprotocols. Accessed January 29, 2018. Google Scholar 15. : Tumor volume improves the long-term prediction of biochemical recurrence-free survival after radical prostatectomy for localized prostate cancer with positive surgical margins. World J Urol 2017; 35: 199. Google Scholar 16. : Anatomy of the anterior prostate and extraprostatic space: a contemporary surgical pathology analysis. Adv Anat Pathol 2007; 14: 401. Google Scholar 17. : Postoperative radiotherapy after radical prostatectomy for high-risk prostate cancer: long-term results of a randomized controlled trial (EORTC trial 22911). Lancet 2012; 380: 2018. 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Google Scholar 23. : Pretreatment total testosterone level predicts pathologic stage in patients with localized prostate cancer treated with radical prostatectomy. J Urol 2003; 169: 1670. Link, Google Scholar 24. : Small prostate size and high grade disease—biology or artifact?J Urol 2011; 185: 2108. Link, Google Scholar 25. : Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging. J Urol 1974; 111: 58. Abstract, Google Scholar 26. : Prognostic Gleason grade grouping: data based on the modified Gleason scoring system. BJU Int 2013; 111: 753. Google Scholar 27. : A contemporary prostate cancer grading system: a validated alternative to the Gleason system. Eur Urol 2016; 69: 428. Google Scholar 28. : International Society of Urological Pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens. Working group 2: T2 substaging and prostate cancer volume. Mod Pathol 2011; 24: 16. Google Scholar 29. : Maximum tumor diameter: a simple independent predictor for biochemical recurrence after radical prostatectomy. Prostate Cancer Prostatic Dis 2010; 13: 244. Google Scholar 30. : Maximum tumor diameter is not an independent prognostic factor in high-risk localized prostate cancer. World J Urol 2008; 26: 237. Google Scholar The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. Supported by MSKCC (Memorial Sloan Kettering Cancer Center) Core Grant P30 CA008748 and The Sidney Kimmel Center for Prostate and Urologic Cancers, MSKCC. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Editor's Note: This article is the third of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 630 and 631. © 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byMatsumoto K, Omura M, Takeda T, Kosaka T, Hashiguchi A, Takamatsu K, Yasumizu Y, Tanaka N, Morita S, Mizuno R, Asanuma H and Oya M (2021) Grading of Multifocal Prostate Cancer Cases in which the Largest Volume and the Highest Grade Do Not Coincide within One LesionJournal of Urology, VOL. 206, NO. 2, (338-345), Online publication date: 1-Aug-2021.Smith J (2019) This Month in Adult UrologyJournal of Urology, VOL. 201, NO. 3, (411-413), Online publication date: 1-Mar-2019. Volume 201Issue 3March 2019Page: 535-540 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.Keywordstumor burdenneoplasm recurrenceprostatectomyprostatic neoplasmspathologyMetricsAuthor Information Yujiro Ito Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Kazuma Udo Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Emily A. Vertosick Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Daniel D. Sjoberg Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Andrew J. Vickers Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York Financial interest and/or other relationship with Arctic Partners and Opko Diagnostics. More articles by this author Hikmat A. Al-Ahmadie Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Ying-Bei Chen Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Anuradha Gopalan Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author S. Joseph Sirintrapun Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Satish K. Tickoo Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Peter T. Scardino Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author James A. Eastham Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Victor E. Reuter Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York More articles by this author Samson W. Fine Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York †Correspondence: Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Ave., Room C502, New York, New York10065 (telephone: 212-639-5066; FAX: 646-422-2070; e-mail: E-mail Address: [email protected]). More articles by this author Expand All The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. Supported by MSKCC (Memorial Sloan Kettering Cancer Center) Core Grant P30 CA008748 and The Sidney Kimmel Center for Prostate and Urologic Cancers, MSKCC. No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Editor's Note: This article is the third of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 630 and 631. Advertisement PDF downloadLoading ..." @default.
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