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Tumor Volume Adds Prognostic Value in Patients with Organ-Confined Prostate Cancer

 Kwang Hyun Kim  ;  Sey Kiat Lim  ;  Tae-Young Shin  ;  Dae Ryong Kang  ;  Woong Kyu Han  ;  Byung Ha Chung  ;  Koon Ho Rha  ;  Sung Joon Hong 
 ANNALS OF SURGICAL ONCOLOGY, Vol.20(9) : 3133-3139, 2013 
Journal Title
Issue Date
Aged ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Recurrence, Local/diagnosis* ; Neoplasm Recurrence, Local/surgery ; Neoplasm Staging ; Prognosis ; Prostatectomy* ; Prostatic Neoplasms/pathology* ; Prostatic Neoplasms/surgery ; Retrospective Studies ; Tumor Burden*
Tumour Volume ; Prostate Specific Antigen ; Radical Prostatectomy ; Gleason Score ; Predictive Accuracy
PURPOSE: This study was designed to assess the independent prognostic value of tumor volume (TV) and whether adding TV provides additional prognostic information for predicting biochemical recurrence (BCR) after radical prostatectomy. METHODS: We reviewed the medical records of 1,129 patients who underwent radical prostatectomy between July 2005 and July 2011. TV was categorized as minimal (≤1.0 ml), moderate (1.1-5.0 ml), or extensive (>5.0 ml). Cox regression analysis was performed to identify independent predictors of BCR. The predictive accuracies of Cox's proportional hazard regression models with and without TV were quantified and compared using time-dependent receiver operating characteristic curve analysis. RESULTS: Increasing TV was associated with higher prostate specific antigen, pathological Gleason score, and pathologic tumor stage. TV was an independent predictor of BCR in multivariate analysis (p<0.001). When patients were stratified by organ-confined and nonorgan-confined tumor groups, TV remained an independent predictor of BCR in organ-confined tumors (p<0.001). In the nonorgan-confined tumor group, a significant difference was found only between extensive versus minimal TV (p=0.023). The predictive accuracy of the Cox regression model increased significantly by adding TV in organ-confined tumor group (0.748 vs. 0.704, p<0.05) but not in nonorgan-confined group (0.742 vs. 0.734, p>0.05). CONCLUSIONS: TV was an independent prognostic predictor of BCR in organ-confined prostate cancers and provided additional prognostic information with increased predictive accuracy. In contrast, TV did not increase the predictive accuracy in nonorgan-confined tumor. TV should be considered as a prognosticator in organ-confined tumors.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Dae Ryong(강대용)
Kim, Kwang Hyun(김광현)
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Shin, Tae Young(신태영)
Lim, Sey Kiat(임세이캣)
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Han, Woong Kyu(한웅규) ORCID logo https://orcid.org/0000-0002-2527-4046
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
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