کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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3928905 | 1253211 | 2007 | 9 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: A Pretreatment Table for the Prediction of Final Histopathology after Radical Prostatectomy in Clinical Unilateral T3a Prostate Cancer A Pretreatment Table for the Prediction of Final Histopathology after Radical Prostatectomy in Clinical Unilateral T3a Prostate Cancer](/preview/png/3928905.png)
ObjectivesPartin tables are the most widely used tool to predict histopathologic stage after radical prostatectomy (RP) in organ-confined tumors. Such a predictive table in clinical T3 disease is still lacking. Our objective was to create a reference table for clinical unilateral T3a prostate cancer.Patients and methodsBetween 1987 and 2004, 200 patients with clinical unilateral T3a disease underwent a RP and bilateral pelvic lymphadenectomy at our institution. No patient had received neoadjuvant treatment. Patients were divided into three prostate-specific antigen (PSA) subgroups (≤10 ng/ml, >10–20 ng/ml, and >20 ng/ml) and two biopsy Gleason sum (GS) subgroups (≤7 [3+4] and ≥7 [4+3]). These parameters were used in the table as predictors for final histopathology. Margin and nodal status were also recorded. The multinomial log-linear regression analysis was used to construct the table.ResultsThe table stratifies patients into six demarcated risk groups. In the first group, consisting of patients with PSA ≤10 and GS ≤7 (3+4), understaging was only 6% (5% pT3b and 1% pT4). The risk for understaging cT3a prostate cancer increases further with increasing PSA and GS. In the sixth group, consisting of patients with PSA >20 and GS ≥7 (4+3), understaging was as high as 68% (44% pT3b and 22% pT4). Receiver operating characteristic analyses showed good accurate predictive ability of the table for seminal vesicle involvement and adjacent structure involvement, with moderate predictive ability for extraprostatic extension only.ConclusionsWe present a table combining preoperative serum PSA and biopsy GS to predict histopathologic results in clinical unilateral T3a prostate cancer. The table may provide a basis for decision-making and patient counseling before treating this cancer.
Journal: European Urology - Volume 51, Issue 2, February 2007, Pages 388–396