Significance of Predicted Tumor Volume as a Predictor of Pathologic Stage in Patients Undergoing Radical Prostatectomy
구자현, 문경철, 곽철, 김현회,
소속 상세정보
구자현 ( Ku Ja-Hyeon )
Seoul National University College of Medicine Department of Urology
문경철 ( Moon Kyung-Chul )
Seoul National University College of Medicine Department of Pathology
곽철 ( Kwak Cheol )
Seoul National University College of Medicine Department of Urology
김현회 ( Kim Hyeon-Hoe )
Seoul National University College of Medicine Department of Urology
KMID : 0358320110520010024
Abstract
Purpose: The purpose of this study was to evaluate whether predicted tumor volume could predict pathologic stage in patients undergoing radical prostatectomy.
Materials and Methods: The clinical and pathologic data of 236 patients who underwent a 12-core needle biopsy followed by radical prostatectomy were obtained from our database and reviewed retrospectively.
Results: Observed tumor volume correlated best with serum prostate-specific antigen (PSA) level (r=0.677, p<0.001) and the number of positive biopsy cores (r=0.489, p<0.001). Stepwise multiple linear regression analysis was used to develop a model for predicting tumor volume before radical prostatectomy. All explanatory variables except PSA and the number of positive biopsy cores were eliminated, yielding the equation ([predicted tumor volume]=0.381x[PSA]+0.921x[No. of positive biopsy cores]-0.992). Tumor volume predicted by this equation correlated strongly with observed tumor volume (r=0.722, p<0.001). This was also true when a different cohort of 159 patients was analyzed (r=0.638, p<0.001). The areas under the receiver operating characteristic curves of predicted tumor volume were 68.5% for extracapsular extension, 75.7% for seminal vesicle invasion, and 70.4% for positive surgical margin. Kaplan-Meier curves revealed that predicted tumor volume correlated significantly with biochemical recurrence-free survival (p<0.001; log-rank test).
Conclusions: Our findings suggest that tumor volume predicted on the basis of PSA levels and number of positive biopsy cores may predict pathologic stage with reasonable accuracy.
키워드
Prostatectomy; Prostatic neoplasms; Treatment outcome; Tumor burden
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