| Maximal tumor diameter and the risk of PSA failure in men with specimen-confined prostate cancer. | |
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MedLine Citation:
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PMID: 16286117 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To evaluate whether the maximal tumor diameter (MTD) is significantly associated with the time to postoperative prostate-specific antigen (PSA) failure. METHODS: Between 1986 and 2002, 781 men with clinical Stage T1c-T2 prostate cancer underwent radical prostatectomy. The MTD was recorded as the maximal dimension of the largest single focus of cancer from all 3-mm step sections. The median follow-up was 5.4 years (range 0.1 to 14.9); 242 men (31%) experienced PSA failure. A Cox regression analysis was used to determine the predictors of time to postoperative PSA failure. Kaplan-Meier estimates of PSA failure-free survival were made, dichotomized about the median MTD value, and compared using a two-sided log-rank test. RESULTS: The value of the MTD was significantly associated with the time to PSA failure (adjusted hazard ratio 1.04, 95% confidence interval 1.01 to 1.07, P = 0.004), controlling for preoperative PSA level (P < 0.0001), prostatectomy Gleason score (P < 0.0001), and T stage (P < 0.0001). When margin status was added (P = 0.0004), the MTD approached statistical significance (P = 0.07). For patients with a preoperative PSA level of less than 10 ng/mL, prostatectomy Gleason score of 3 + 4 = 7 or less, Stage pT2-T3a, and negative margins, the value of the MTD significantly (P = 0.05) stratified the time to PSA failure, when dichotomized about the median value (13 mm), with 7-year PSA failure estimates of 17% versus 8%. CONCLUSIONS: Whether patients with traditionally low-risk but large MTD prostate cancer fare better when treated with adjuvant radiotherapy compared with salvage radiotherapy remains to be answered in the setting of a randomized trial. |
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Authors:
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Tomas Dvorak; Ming-Hui Chen; Andrew A Renshaw; Marian Loffredo; Jerome P Richie; Anthony V D'Amico |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Urology Volume: 66 ISSN: 1527-9995 ISO Abbreviation: Urology Publication Date: 2005 Nov |
Date Detail:
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Created Date: 2005-11-15 Completed Date: 2005-12-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0366151 Medline TA: Urology Country: United States |
Other Details:
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Languages: eng Pagination: 1024-8 Citation Subset: IM |
Affiliation:
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Department of Radiation Oncology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Follow-Up Studies Humans Male Middle Aged Prostate-Specific Antigen / blood* Prostatectomy Prostatic Neoplasms / blood*, pathology*, surgery Risk Factors Time Factors Treatment Failure |
| Chemical | |
Reg. No./Substance:
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EC 3.4.21.77/Prostate-Specific Antigen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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