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Total intraglandular and index tumor volumes predict biochemical recurrence in prostate cancer

 Su-Jin Shin  ;  Cheol Keun Park  ;  Sung Yoon Park  ;  Won Sik Jang  ;  Joo Yong Lee  ;  Young Deuk Choi  ;  Nam Hoon Cho 
 Virchows Archiv, Vol.469(3) : 305-312, 2016 
Journal Title
 Virchows Archiv 
Issue Date
Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Prostate-Specific Antigen/metabolism* ; Prostatectomy/methods ; Prostatic Neoplasms/diagnosis* ; Prostatic Neoplasms/pathology* ; Recurrence ; Reproducibility of Results ; Tumor Burden/physiology
Neoplasm grading ; Prostatic neoplasms ; Recurrence ; Tumor burden
Prognostic value of tumor volume for biochemical recurrence of prostate cancer remains controversial. We aimed to determine which tumor volume definition would optimally correlate with established prognostic factors and classify macroscopic tumor configuration. Radical prostatectomy specimens with follow-up to biochemical recurrence in the period between 2009 and 2012 were retrieved. Newly proposed categories of reconstructed three-dimensional macroscopic tumor configuration were nodular, medial prominence, subcapsular spreading, and miliary types. Several algorithms were applied to identify optimal tumor volume including (1) combined volume of all nodules, (2) volume of largest nodule as index tumor, and (3) volume of nodule with strongest evidence of poor prognosis. Macroscopic typing correlated well with radiologic findings, and nodular type was most common (70.7 %). In most multifocal tumors, the largest nodule showed the highest Gleason score (90.8 %) as well as extraprostatic extension or seminal vesicle invasion (93.5 %). Total tumor and index tumor volumes were significant predictors of biochemical recurrence (both, P < 0.0001). Tumor volume, classified in three groups with cutoff values at 2 and 5 cm(3), was independently predictive of recurrence-free survival in multivariate analysis (P < 0.05) and surpassed bilaterality even in stage pT2. In pT2 disease, recurrence-free survival was significantly associated with total tumor volume (P = 0.003) and index tumor volume (P = 0.002), but not with pT2 substage (P = 0.278). The proposed macroscopic classification system can be correlated with preoperative imaging findings. Total tumor or index tumor volume significantly predicts biochemical recurrence. Tumor volume classification is easy to apply in practice with high reproducibility and offsets the limitations of pT classification.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
박성윤(Park, Sung Yoon)
신수진(Shin, Su Jin)
이주용(Lee, Joo Yong) ORCID logo https://orcid.org/0000-0002-3470-1767
장원식(Jang, Won Sik) ORCID logo https://orcid.org/0000-0002-9082-0381
조남훈(Cho, Nam Hoon) ORCID logo https://orcid.org/0000-0002-0045-6441
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
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