Controversial predictors of biochemical recurrence after radical prostatectomy: a study from a Latin American (Brazilian) Institution
Int. braz. j. urol
; 39(6): 779-792, Nov-Dec/2013. tab, graf
Article
in En
| LILACS
| ID: lil-699128
Responsible library:
BR1.1
ABSTRACT
Purpose To analyze controversial clinicopathologic predictors of biochemical recurrence after surgery age, race, tumor extent on surgical specimen, tumor extent on needle biopsy, Gleason score 3 + 4 vs 4 + 3, and amount of extent of extraprostatic extension and positive surgical margins. Materials and Methods The needle biopsies and the correspondent surgical specimens were analyzed from 400 patients. Time to recurrence was analyzed with the Kaplan-Meier curves and risk of shorter time to recurrence using Cox univariate and multivariate analysis. Results Except for age, race, maximum percentage of cancer per core, and number of cores with cancer, all other variables studied were significantly predictive of time to biochemical recurrence using the Kaplan-Meier curves. In univariate analysis, except for focal extraprostatic extension, age, race, focal positive surgical margins, and maximum extent and percentage of cancer per core, all other variables were significantly predictive of shorter time to recurrence. On multivariate analysis, diffuse positive surgical margins and preoperative PSA were independent predictors. Conclusions Young patients and non-whites were not significantly associated with time to biochemical recurrence. The time consuming tumor extent evaluation in surgical specimens seems not to add additional information to other well established predictive findings. The higher predictive value of Gleason score 4 + 3 = 7 vs 3 + 4 = 7 discloses the importance of grade 4 as the predominant pattern. Extent and not simply presence or absent of extraprostatic extension should be informed. Most tumor extent evaluations on needle biopsies are predictive of time to biochemical recurrence, however, maximum percentage of cancer in all cores was the strongest predictor. .
Key words
Full text:
1
Index:
LILACS
Main subject:
Prostate
/
Prostatectomy
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Prostatic Neoplasms
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Neoplasm Recurrence, Local
Type of study:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limits:
Adult
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Aged
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Humans
/
Male
Country/Region as subject:
America do sul
/
Brasil
Language:
En
Journal:
Int. braz. j. urol
Journal subject:
UROLOGIA
Year:
2013
Type:
Article