Premium
Volume‐weighted mean nuclear volume predicts tumor biology of clinically organ‐confined prostate cancer
Author(s) -
Arai Yoichi,
Okubo Kazutoshi,
Terada Naoki,
Matsuta Yosuke,
Egawa Shin,
Kuwao Sadahito,
Ogura Keiji
Publication year - 2001
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/1097-0045(20010201)46:2<134::aid-pros1017>3.0.co;2-9
Subject(s) - medicine , prostatectomy , prostate cancer , urology , prostate specific antigen , prostate , stereology , biopsy , univariate analysis , multivariate analysis , cancer , pathology , oncology
Background Estimates of volume‐weighted mean nuclear volume (MNV) are the only means by which unbiased estimates of three‐dimensional parameters can be obtained from a single two‐dimensional section, with stereological methods. The present study was conducted to elucidate the role of MNV in predicting tumor biology for patients treated with radical prostatectomy. Methods A retrospective prognostic study of 71 patients with T1/T2 disease, treated with radical prostatectomy alone, was performed. MNV was estimated using biopsy specimens based on a stereological method, and was compared with other preoperative clinical variables. For patients with prostate‐specific antigen (PSA) failure, we determined the correlation of MNV with PSA doubling time (PSA DT) which was calculated using PSA values obtained with an ultrasensitive assay. Results Mean MNVs for pathologically organ‐confined and non‐organ‐confined tumors were 198.9 and 236.3 μm3, respectively; this difference was significant ( P = 0.0364). Univariate analysis showed that PSA, MNV, and Gleason score were significant predictors of prognosis ( P = 0.0126, 0.0148, and 0.0375, respectively). Multivariate analysis revealed that MNV and preoperative PSA were powerful independent predictors of prognosis ( P = 0.0160 and P = 0.0147, respectively), but the Gleason score was not correlated with prognosis ( P = 0.4120). For patients with PSA failure, PSA DT was significantly correlated with MNV ( r = −0.597, P = 0.0099). When these patients were classified using median PSA DT at 6 months into two groups, MNV was significantly greater in PSA rapid‐riser group than in the slow‐riser group ( P = 0.0008), but no differences were observed between these groups in PSA, the Gleason score, or cancer volume. Conclusions The findings of the present study suggest that MNV is a powerful predictor of PSA failure for patients with clinically organ‐confined disease treated with radical prostatectomy. More importantly, they suggest that MNV can be a useful new parameter for prediction of tumor biology for patients with PSA failure after radical prostatectomy. Prostate 46:134–141, 2001. © 2001 Wiley‐Liss, Inc.