Korean J Urol.  2007 Aug;48(8):797-803. 10.4111/kju.2007.48.8.797.

A Study on the Incidence and Preoperative Predicting Factors of Extraprostatic Extension in T1c Prostate Cancers

• Jeong SJ
• Chang IH
• Han JH
• Yu JH
• Han BK
• Hong SK
• Byun SS
• Lee SE

• KMID: 2061272
• DOI: http://doi.org/10.4111/kju.2007.48.8.797

Abstract

PURPOSE
To evaluate the incidence and identify the predicting factors of extraprostatic extension(EPE) in T1c prostate cancers.
MATERIALS AND METHODS
Of 267 consecutive men who underwent radical retropubic prostatectomy(RRP) as initial treatment for prostate cancers, 131(49.1%) presented with a clinical stage T1c disease. Clinicopathological data were collected, and factors related to biopsy collected; i.e. the number of positive cores(No.(+) core); the percentage of positive cores(%(+) core); the maximal tumor length(Max. mm cancer); the sum of tumor length (Total mm cancer); the maximal ratio of tumor/core length(Max. % mm cancer) and the mean ratio of tumor/core length(Mean % mm cancer). A logistical regression analysis was performed after dividing the cases into organ-confined(OC) and EPE.
RESULTS
Of the T1c tumors, 107(81.7%) and 24(18.3%) were found to be OC and to have EPE after RRP, respectively. The preoperative factors that showed a significant difference between the two groups(OC vs. EPE) were %free prostate-specific antigen(17.7 vs. 11.1%), prostate volume(43.5 vs. 34.6ml), Gleason score(6.4 vs. 6.8), %(+) core(17.9 vs. 27%), Max. mm cancer(3.5 vs. 6.7mm) and Max. % mm cancer(24.0 vs. 41.6%). Of these factors, those significantly predicting EPE in the receiver operator characteristics curve were: the Gleason score, %(+) core, Max. mm cancer and Max. % mm cancer. Of these, only the %(+) core and Max. mm cancer were significant in predicting EPE in the multivariate logistical regression. When the cutoff of %(+) core was 19%, the risk of EPE increased 2.3 times, and when the cutoff of Max. mm cancer was 5mm the risk increased 3.6 times.
CONCLUSIONS
Max. mm cancer and %(+) core during a biopsy are preoperative factors that predict the EPE of a clinical stage T1c disease, and should be considered for modifying the surgical technique and in establishing treatment plans.

Keyword

Prostate cancer; Extraprostatic extension; Prostatectomy

MeSH Terms

Biopsy
Humans
Incidence*
Male
Neoplasm Grading
Prostate*
Prostatectomy
Prostatic Neoplasms*

Figure

• 

  Fig. 1 Receiver operator characteristics curve of four preoperative parameters that predict extraprostatic extension. GS: Gleason score, % (+) core: percentage of positive cores, Max. mm cancer: maximal tumor length, Max. % mm cancer: maximal ratio of tumor/core length, AUC: area under curve.

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