In organ-confined prostate cancer, tumor quantitation not found to aid in prediction of biochemical recurrence Journal Article


Authors: Ito, Y.; Vertosick, E. A.; Sjoberg, D. D.; Vickers, A. J.; Al-Ahmadie, H. A.; Chen, Y. B.; Gopalan, A.; Sirintrapun, S. J.; Tickoo, S. K.; Eastham, J. A.; Scardino, P. T.; Reuter, V. E.; Fine, S. W.
Article Title: In organ-confined prostate cancer, tumor quantitation not found to aid in prediction of biochemical recurrence
Abstract: In the eighth edition AJCC staging, all organ-confined disease is assigned pathologic stage T2, without subclassification. We investigated whether total tumor volume (TTV) and/or maximum tumor diameter (MTD) of the index lesion are useful in improving prediction of biochemical recurrence (BCR) in pT2 patients. We identified 1657 patients with digital tumor maps and quantification of TTV/MTD who had pT2 disease on radical prostatectomy (RP). Multivariable Cox regression models were used to assess whether TTV and/or MTD are independent predictors of BCR when adjusting for a base model incorporating age, preoperative prostate-specific antigen, RP grade group, and surgical margin status. If either tumor quantification added significantly, we calculated and reported the c-index. Ninety-five patients experienced BCR after RP; median follow-up for patients without BCR was 5.7 years. The c-index was 0.737 for the base model. Although there was some evidence of an association between TTV and BCR (P=0.088), this did not meet conventional levels of statistical significance and only provided a limited increase in discrimination (0.743; c-index improvement: 0.006). MTD was not associated with BCR (P>0.9). In analyses excluding patients with grade group 1 on biopsy who would be less likely to undergo RP in contemporary practice (622 patients; 59 with BCR), TTV/MTD was not a statistically significant predictor (P=0.4 and 0.8, respectively). Without evidence that tumor quantitation, in the form of either TTV or MTD of the index lesion, is useful for the prediction of BCR in pT2 prostate cancer, we cannot recommend its routine reporting. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: tumor volume; prostate cancer; biochemical recurrence; tumor diameter; ajcc; organ-confined; pt2
Journal Title: American Journal of Surgical Pathology
Volume: 43
Issue: 8
ISSN: 0147-5185
Publisher: Lippincott Williams & Wilkins  
Date Published: 2019-08-01
Start Page: 1061
End Page: 1065
Language: English
DOI: 10.1097/pas.0000000000001291
PUBMED: 31107718
PROVIDER: scopus
PMCID: PMC6629508
DOI/URL:
Notes: Article -- Source: Scopus
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MSK Authors
  1. Peter T Scardino
    624 Scardino
  2. Satish K Tickoo
    375 Tickoo
  3. Anuradha Gopalan
    292 Gopalan
  4. Yingbei Chen
    242 Chen
  5. Andrew J Vickers
    579 Vickers
  6. Daniel D. Sjoberg
    148 Sjoberg
  7. James Eastham
    437 Eastham
  8. Samson W Fine
    335 Fine
  9. Victor Reuter
    976 Reuter
  10. Yujiro Ito
    3 Ito