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
Dans Anglais
| LILACS
| ID: lil-699128
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. .
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Prostate
/
Prostatectomie
/
Tumeurs de la prostate
/
Récidive tumorale locale
Type d'étude:
Étude observationnelle
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Adulte
/
Adulte très âgé
/
Humains
/
Mâle
Pays comme sujet:
Amérique du Sud
/
Brésil
langue:
Anglais
Texte intégral:
Int. braz. j. urol
Thème du journal:
Urologie
Année:
2013
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
State University of Campinas (Unicamp)/BR
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