Maximum tumor diameter is not an independent prognostic factor in high-risk localized prostate cancer

I.M. van Oort, J.A. Witjes, D.E.G. Kok, L.A. Kiemeney, C.A. Hulsbergen-van de Kaa

Research output: Contribution to journalArticleAcademicpeer-review

27 Citations (Scopus)

Abstract

Previous studies suggest that maximum tumor diameter (MTD) is a predictor of recurrence in prostate cancer (PC). This study investigates the prognostic value of MTD for biochemical recurrence (BCR) in patients with PC, after radical prostatectomy (RP), with emphasis on high-risk localized prostate cancer. Methods RP specimens of 542 patients were evaluated with a median follow-up of 39.5 months (range 0.6¿150 months). MTD was defined as the largest diameter of the largest tumor; high-risk as ¿T2c or PSA level > 20 ng/ml or Gleason score ¿8 and BCR as two consecutive PSA levels > 0.10 ng/ml. Proportional hazards multivariable regression models were composed to determine prognostic factors for BCR. Results Overall, 114 patients developed BCR after RP. The overall 5-year risk of BCR was 25% (95% CI = 20.4¿29.6), and median MTD was 24 mm (range 1¿65). MTD in the total and high-risk group was associated with total tumor volume, volume of the largest tumor, pre-operative PSA levels, and Gleason score. In a univariable analyses, MTD was weakly associated with risk of BCR (HR = 1.02 per mm increase, 95% CI = 1.002¿1.035, P = 0.024) in the total group; in the high-risk group this association was lost (HR = 1.01, 95%CI = 0.99¿1.03, P = 0.18). Multivariable analyses indicated that positive surgical margins, higher Gleason score, advanced pathological stage, and multiple tumors were the main prognostic factors for BCR irrespective of the risk profile. MTD did not provide additional information. Conclusions MTD is not an independent prognostic factor for BCR in patients treated with RP, irrespective of the risk profile
Original languageEnglish
Pages (from-to)237-241
JournalWorld Journal of Urology
Volume26
Issue number3
DOIs
Publication statusPublished - 2008

Fingerprint

Prostatic Neoplasms
Recurrence
Neoplasms
Prostatectomy
Neoplasm Grading
Tumor Burden

Keywords

  • radical prostatectomy
  • multivariate-analysis
  • antigen recurrence
  • specimens
  • predictor
  • volume
  • carcinoma
  • failure
  • progression
  • men

Cite this

van Oort, I.M. ; Witjes, J.A. ; Kok, D.E.G. ; Kiemeney, L.A. ; Hulsbergen-van de Kaa, C.A. / Maximum tumor diameter is not an independent prognostic factor in high-risk localized prostate cancer. In: World Journal of Urology. 2008 ; Vol. 26, No. 3. pp. 237-241.
@article{31a9813cabb24f59a6585844e428569c,
title = "Maximum tumor diameter is not an independent prognostic factor in high-risk localized prostate cancer",
abstract = "Previous studies suggest that maximum tumor diameter (MTD) is a predictor of recurrence in prostate cancer (PC). This study investigates the prognostic value of MTD for biochemical recurrence (BCR) in patients with PC, after radical prostatectomy (RP), with emphasis on high-risk localized prostate cancer. Methods RP specimens of 542 patients were evaluated with a median follow-up of 39.5 months (range 0.6¿150 months). MTD was defined as the largest diameter of the largest tumor; high-risk as ¿T2c or PSA level > 20 ng/ml or Gleason score ¿8 and BCR as two consecutive PSA levels > 0.10 ng/ml. Proportional hazards multivariable regression models were composed to determine prognostic factors for BCR. Results Overall, 114 patients developed BCR after RP. The overall 5-year risk of BCR was 25{\%} (95{\%} CI = 20.4¿29.6), and median MTD was 24 mm (range 1¿65). MTD in the total and high-risk group was associated with total tumor volume, volume of the largest tumor, pre-operative PSA levels, and Gleason score. In a univariable analyses, MTD was weakly associated with risk of BCR (HR = 1.02 per mm increase, 95{\%} CI = 1.002¿1.035, P = 0.024) in the total group; in the high-risk group this association was lost (HR = 1.01, 95{\%}CI = 0.99¿1.03, P = 0.18). Multivariable analyses indicated that positive surgical margins, higher Gleason score, advanced pathological stage, and multiple tumors were the main prognostic factors for BCR irrespective of the risk profile. MTD did not provide additional information. Conclusions MTD is not an independent prognostic factor for BCR in patients treated with RP, irrespective of the risk profile",
keywords = "radical prostatectomy, multivariate-analysis, antigen recurrence, specimens, predictor, volume, carcinoma, failure, progression, men",
author = "{van Oort}, I.M. and J.A. Witjes and D.E.G. Kok and L.A. Kiemeney and {Hulsbergen-van de Kaa}, C.A.",
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language = "English",
volume = "26",
pages = "237--241",
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Maximum tumor diameter is not an independent prognostic factor in high-risk localized prostate cancer. / van Oort, I.M.; Witjes, J.A.; Kok, D.E.G.; Kiemeney, L.A.; Hulsbergen-van de Kaa, C.A.

In: World Journal of Urology, Vol. 26, No. 3, 2008, p. 237-241.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Maximum tumor diameter is not an independent prognostic factor in high-risk localized prostate cancer

AU - van Oort, I.M.

AU - Witjes, J.A.

AU - Kok, D.E.G.

AU - Kiemeney, L.A.

AU - Hulsbergen-van de Kaa, C.A.

N1 - .

PY - 2008

Y1 - 2008

N2 - Previous studies suggest that maximum tumor diameter (MTD) is a predictor of recurrence in prostate cancer (PC). This study investigates the prognostic value of MTD for biochemical recurrence (BCR) in patients with PC, after radical prostatectomy (RP), with emphasis on high-risk localized prostate cancer. Methods RP specimens of 542 patients were evaluated with a median follow-up of 39.5 months (range 0.6¿150 months). MTD was defined as the largest diameter of the largest tumor; high-risk as ¿T2c or PSA level > 20 ng/ml or Gleason score ¿8 and BCR as two consecutive PSA levels > 0.10 ng/ml. Proportional hazards multivariable regression models were composed to determine prognostic factors for BCR. Results Overall, 114 patients developed BCR after RP. The overall 5-year risk of BCR was 25% (95% CI = 20.4¿29.6), and median MTD was 24 mm (range 1¿65). MTD in the total and high-risk group was associated with total tumor volume, volume of the largest tumor, pre-operative PSA levels, and Gleason score. In a univariable analyses, MTD was weakly associated with risk of BCR (HR = 1.02 per mm increase, 95% CI = 1.002¿1.035, P = 0.024) in the total group; in the high-risk group this association was lost (HR = 1.01, 95%CI = 0.99¿1.03, P = 0.18). Multivariable analyses indicated that positive surgical margins, higher Gleason score, advanced pathological stage, and multiple tumors were the main prognostic factors for BCR irrespective of the risk profile. MTD did not provide additional information. Conclusions MTD is not an independent prognostic factor for BCR in patients treated with RP, irrespective of the risk profile

AB - Previous studies suggest that maximum tumor diameter (MTD) is a predictor of recurrence in prostate cancer (PC). This study investigates the prognostic value of MTD for biochemical recurrence (BCR) in patients with PC, after radical prostatectomy (RP), with emphasis on high-risk localized prostate cancer. Methods RP specimens of 542 patients were evaluated with a median follow-up of 39.5 months (range 0.6¿150 months). MTD was defined as the largest diameter of the largest tumor; high-risk as ¿T2c or PSA level > 20 ng/ml or Gleason score ¿8 and BCR as two consecutive PSA levels > 0.10 ng/ml. Proportional hazards multivariable regression models were composed to determine prognostic factors for BCR. Results Overall, 114 patients developed BCR after RP. The overall 5-year risk of BCR was 25% (95% CI = 20.4¿29.6), and median MTD was 24 mm (range 1¿65). MTD in the total and high-risk group was associated with total tumor volume, volume of the largest tumor, pre-operative PSA levels, and Gleason score. In a univariable analyses, MTD was weakly associated with risk of BCR (HR = 1.02 per mm increase, 95% CI = 1.002¿1.035, P = 0.024) in the total group; in the high-risk group this association was lost (HR = 1.01, 95%CI = 0.99¿1.03, P = 0.18). Multivariable analyses indicated that positive surgical margins, higher Gleason score, advanced pathological stage, and multiple tumors were the main prognostic factors for BCR irrespective of the risk profile. MTD did not provide additional information. Conclusions MTD is not an independent prognostic factor for BCR in patients treated with RP, irrespective of the risk profile

KW - radical prostatectomy

KW - multivariate-analysis

KW - antigen recurrence

KW - specimens

KW - predictor

KW - volume

KW - carcinoma

KW - failure

KW - progression

KW - men

U2 - 10.1007/s00345-008-0242-7

DO - 10.1007/s00345-008-0242-7

M3 - Article

VL - 26

SP - 237

EP - 241

JO - World Journal of Urology

JF - World Journal of Urology

SN - 0724-4983

IS - 3

ER -