World J Mens Health.  2016 Aug;34(2):123-128. 10.5534/wjmh.2016.34.2.123.

The Effect of Tumor-Prostate Ratio on Biochemical Recurrence after Radical Prostatectomy

• Cho SY
• Choi YD

• KMID: 2349848
• DOI: http://doi.org/10.5534/wjmh.2016.34.2.123

Abstract

PURPOSE
Prostate tumor volume calculated after surgery using pathologic tissue has been shown to be an independent risk factor for biochemical recurrence. Nonetheless, prostate size varies among individuals, regardless of the presence or absence of cancer. We assumed to be lower margin positive rate in the surgical operation, when the prostate volume is larger and the tumor lesion is same. Thus, we defined the tumor-prostate ratio in the ratio of tumor volume to prostate volume. In order to compensate the prostate tumor volume, the effect of tumor-prostate ratio on biochemical recurrence was examined.
MATERIALS AND METHODS
This study included 251 patients who underwent open retropubic radical prostatectomy for prostate cancer in a single hospital. We analyzed the effects of tumor volume and tumor-prostate ratio, as well as the effects of known risk factors for biochemical recurrence, on the duration of disease-free survival.
RESULTS
In the univariate analysis, the risk factors that significantly impacted disease-free survival time were found to be a prostate-specific antigen level ≥10 ng/mL, a tumor volume ≥5 mL, tumor-prostate ratio ≥10%, tumor capsular invasion, lymph node invasion, positive surgical margins, and seminal vesicle invasion. In the multivariate analysis performed to evaluate the risk factors found to be significant in the univariate analysis, positive surgical margins (hazard ratio=3.066) and a tumor density ≥10% (hazard ratio=1.991) were shown to be significant risk factors for biochemical recurrence.
CONCLUSIONS
Tumor-prostate ratio, rather than tumor volume, should be regarded as a significant risk factor for biochemical recurrence.

Keyword

Prostatectomy; Prostatic neoplasms; Risk factors

MeSH Terms

Disease-Free Survival
Humans
Lymph Nodes
Multivariate Analysis
Prostate
Prostate-Specific Antigen
Prostatectomy*
Prostatic Neoplasms
Recurrence*
Risk Factors
Seminal Vesicles
Tumor Burden
Prostate-Specific Antigen

Figure

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  Fig. 1 Biochemical recurrence-free survival according to tumor density, using a cutoff of 10% (p=0.007).

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  Fig. 2 A schematic illustrating a hypothetical scenario in which one patient has a larger prostate than the other, with identical tumor volumes. The patient with the smaller prostate will likely have a worse prognosis.

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