Prognostic value of the percentage of positive fragments in biopsies from patients with localized prostate cancer
Int. braz. j. urol
;
31(1): 34-41, Jan.-Feb. 2005. tab, graf
Artigo
em Inglês
| LILACS
| ID: lil-400095
RESUMO
OBJECTIVE:
To assess the prognostic value of the percentage of positive fragments (PPF) in biopsies from patients with localized prostate cancer (PCa) undergoing radical prostatectomy. MATERIALS ANDMETHODS:
During the period from March 1991 to November 2000, 440 patients were selected. Cases receiving neoadjuvant or adjuvant hormone therapy, or adjuvant radiotherapy, were excluded, as were cases presenting Gleason scores higher than 6 at biopsy. PPF was defined as the total number of fragments divided by the total number of biopsy fragments times 100. This variable was initially divided into categories from 0 to 25 percent, 25.1 percent to 50 percent, 50.1 to 75 percent and 75 percent to 100 percent. During the postoperative period, patients were assessed every 2 months for 1 year, then every 6 months for 5 years, and then yearly. Biochemical recurrence was defined as serum PSA higher than or equal to 0.4 ng/mL. Median follow-up was 60 months.RESULTS:
One hundred and nine (24.8 percent) of the 440 patients under study had biochemical recurrence. In the univariate analysis, PPF significantly influenced disease-free survival (log-rank, p < 0.001), and patients with PPF between 75 and 100 percent presented a risk of a biochemical recurrence of the disease 3 times higher than patients with PPF between 0 and 25 percent (p < 0.001). After the Cox regression analysis, both serum PSA (p = 0.001) and PPF (p < 0.001) showed to be independent predictive factors for disease-free survival following surgery.CONCLUSION:
PPF measurement in biopsy is a simple and practical method, which should be routinely used as a predictive factor for biochemical recurrence in patients with PCa presenting Gleason scores between 2 and 6.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Prostatectomia
/
Neoplasias da Próstata
/
Biópsia
Tipo de estudo:
Estudo de etiologia
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Int. braz. j. urol
Assunto da revista:
Urologia
Ano de publicação:
2005
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Federal University of Sao Paulo/BR
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