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The independent value of tumour volume in a contemporary cohort of men treated with radical prostatectomy for clinically localized disease
Author(s) -
Porten Sima P.,
Cooperberg Matthew R.,
Carroll Peter R.
Publication year - 2010
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2009.08774.x
Subject(s) - prostatectomy , medicine , prostate cancer , proportional hazards model , prostate specific antigen , univariate analysis , biochemical recurrence , urology , stage (stratigraphy) , hazard ratio , cohort , prostate , oncology , cancer , multivariate analysis , pathological , survival analysis , confidence interval , paleontology , biology
Study Type – Prognosis (case series)
Level of Evidence 4 OBJECTIVE To determine if prostate tumour volume is an independent prognostic factor in a contemporary cohort of men who had a radical prostatectomy (RP) for clinically localized disease, as the effect of tumour volume on prostate cancer outcomes has not been consistently shown in the era of widespread screening with prostate‐specific antigen (PSA). PATIENTS AND METHODS The study included 856 men who had RP from 1998 to 2007 for localized prostate cancer. Tumour volume based on pathology was analysed as a continuous and categorized (<0.26, 0.26–0.50, 0.51–1.00, 1.01–2.00, 2.01–4.00, >4.00 mL) variable using Cox proportional hazards regression and Kaplan‐Meier analysis. A multivariable analysis was also conducted controlling for PSA level, Gleason grade, surgical margins, and pathological stage. RESULTS Tumour volume had a positive association with grade and stage, but did not correlate with biochemical recurrence‐free survival on univariate analysis as a continuous variable (hazard ratio 1.00, P = 0.09), and was only statistically significant for volumes of >4 mL as a categorical variable. No tumour volume was an independent predictor of prostate cancer recurrence on multivariate analysis. There was no difference between tumour volume and time to cancer recurrence for organ‐confined tumours using Kaplan‐Meier analysis. In low‐risk patients (PSA level <10 ng/mL, Gleason score ≤6, clinical stage T1c/T2a) tumour volume did not correlate with biochemical recurrence‐free survival in univariate or multivariable analysis. CONCLUSIONS There is no evidence that tumour volume is an independent predictor of prostate cancer outcome and it should not be considered as a marker of tumour risk, behaviour or prognosis.