Visual estimate of the percentage of carcinoma is an independent predictor of prostate carcinoma recurrence after radical prostatectomy

Gustavo F. Carvalhal, Peter A. Humphrey, Phataraporn Thorson, Yan Yan, Christian G. Ramos, William J. Catalona

Research output: Contribution to journalArticlepeer-review

69 Scopus citations

Abstract

BACKGROUND. The importance of tumor size measurements as predictors of disease recurrence after radical prostatectomy in patients with prostate carcinoma remains somewhat controversial, and many pathologists do not report these measurements routinely. The authors studied the correlation between the visual estimate of the percentage of carcinoma in prostatic tissue from radical prostatectomy specimens and prostate carcinoma recurrence rates in a series of 595 patients who underwent radical prostatectomy. METHODS. A total of 595 men with clinically localized prostate carcinoma were treated by the same surgeon (W.J.C.) from 1993 through 1997. The percentage of carcinoma in radical prostatectomy specimens from these patients was assessed microscopically through visual estimate. The authors used Kaplan-Meier product limit estimates, log-rank statistics, and the Cox proportional hazards model to evaluate the percentage of carcinoma in the pathologic specimens as predictors of recurrence free survival. RESULTS. Of the 595 patients, 46 (8%) had evidence of tumor recurrence. The mean percentage of carcinoma in the prostatectomy specimen was 11.3% in the group of patients who did not have disease recurrence and 23.8% in the group of patients who did experience disease recurrence. The percentage of carcinoma, preoperative prostate specific antigen levels, tumor differentiation (histologic Gleason grade), and pathologic stage all were significant predictors of disease recurrence according to the Kaplan-Meier method (all log-rank P values < 0.0001). Using the Cox proportional hazards model, controlling for all of these variables, only pathologic tumor stage, Gleason score, and percentage of carcinoma proved to be independent predictors of disease recurrence. In the final model, which included pathologic stage, Gleason score, and percentage of carcinoma, for each 5% increase in the percentage of carcinoma in the surgical specimen, there was an 11% incremental increase in the chance of tumor recurrence. CONCLUSIONS. The visual estimate of the percentage of carcinoma in prostatic tissue specimens from patients who undergo radical prostatectomy is a practical, simple, and inexpensive method that provides important prognostic information after radical prostatectomy. (C) 2000 American Cancer Society.

Original languageEnglish
Pages (from-to)1308-1314
Number of pages7
JournalCancer
Volume89
Issue number6
DOIs
StatePublished - Sep 15 2000

Keywords

  • Carcinoma
  • Prognosis
  • Prostate
  • Prostate specific antigen
  • Prostatectomy

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