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Revisiting extraprostatic extension based on invasion depth and number for new algorithm for substaging of pT3a prostate cancer

Authors
 Cheol Keun Park  ;  Yeon Seung Chung  ;  Young Deuk Choi  ;  Won Sik Ham  ;  Won Sik Jang  ;  Nam Hoon Cho 
Citation
 SCIENTIFIC REPORTS, Vol.11(1) : 13952, 2021-07 
Journal Title
SCIENTIFIC REPORTS
Issue Date
2021-07
MeSH
Aged ; Humans ; Kaplan-Meier Estimate ; Male ; Margins of Excision ; Multivariate Analysis ; Neoplasm Grading ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local / pathology ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Prostatic Neoplasms / pathology* ; Survival Analysis
Abstract
Extraprostatic extension (EPE) is a factor in determining pT3a stage in prostate cancer. However, the only distinction in EPE is whether it is focal or non-focal, causing diagnostic and prognostic ambiguity. We substaged pT3a malignancies using classification of EPE to improve personalized prognostication. We evaluated 465 radical prostatectomy specimens with a digital image analyzer by measuring the number, radial distance and two-dimensional square area of the EPE. The most significant cut-off value was proposed as an algorithm for the pT3a substaging system to predict biochemical recurrence (BCR). A combination of the radial distance and the number of EPEs predicted BCR the most effectively. The optimal cut-off criteria were 0.75 mm and 2 mm in radial distance and multifocal EPE (hazard ratio: 2.526, C-index 0.656). The pT3a was subdivided into pT3a1, < 0.75 mm and any number of EPEs; pT3a2, 0.75-2 mm and one EPE; and pT3a3, > 2 mm and any number of EPEs or 0.75-2 mm and ≥ 2 EPEs. This combined tier was highly significant in the prediction of BCR-free survival. The combination of radial distance and number of EPEs could be used to subdivide pT3a prostate cancer and may aid in the prediction of BCR.
Files in This Item:
T202105737.pdf Download
DOI
10.1038/s41598-021-93340-3
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Park, Cheol Keun(박철근) ORCID logo https://orcid.org/0000-0001-7689-0386
Jang, Won Sik(장원식) ORCID logo https://orcid.org/0000-0002-9082-0381
Chung, Yeon Seung(정연승)
Cho, Nam Hoon(조남훈) ORCID logo https://orcid.org/0000-0002-0045-6441
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Ham, Won Sik(함원식) ORCID logo https://orcid.org/0000-0003-2246-8838
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187447
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