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Radical prostatectomy for incidental (stage T1a-T1b) prostate cancer: analysis of predictors for residual disease and biochemical recurrence.
Eur Urol. 2008 Jul; 54(1):118-25.EU

Abstract

BACKGROUND

Controversies exist about the most appropriate management for patients with incidental prostate cancer after surgery for benign prostatic hyperplasia (BPH).

OBJECTIVES

To test the accuracy of preoperative clinical variables in predicting the presence of residual disease and biochemical recurrence in patients with incidental prostate cancer treated with radical retropubic prostatectomy.

DESIGN, SETTING, AND PARTICIPANTS

We analyzed 126 T1a-T1b prostate cancers diagnosed at surgery for BPH between 1995 and 2007.

INTERVENTION

All patients underwent radical retropubic prostatectomy within 6 mo of surgery for BPH.

MEASUREMENTS

Univariate and multivariate logistic regression models addressed the association between the predictors (age, prostate-specific antigen [PSA] before and after surgery for BPH, T1a-T1b stage, prostate volume, and Gleason score at surgery for BPH) and the presence of residual cancer at radical retropubic prostatectomy. Cox proportional hazards regression analyses tested the relationship between the same predictors and the rate of biochemical recurrence after radical retropubic prostatectomy.

RESULTS AND LIMITATIONS

Seventy-five (59.5%) patients were stage T1a and 51 (40.5%) were stage T1b. At radical retropubic prostatectomy, 21 (16.7%) patients were pT0 and seven (5.6%) patients had extraprostatic disease (pT3). PSA before and after surgery for BPH and Gleason score at surgery for BPH were the only independent predictors of residual cancer at radical retropubic prostatectomy (all p<0.04). Stage (T1a vs T1b) did not predict residual cancer or the rate of biochemical recurrence. With a mean follow-up of 57 mo, the 5- and 10-yr biochemical recurrence-free survival rates were 92% and 87%, respectively. PSA after surgery for BPH and Gleason score at surgery for BPH were the only significant multivariate predictors of biochemical recurrence (all p<0.04). The main limitation of this study is the requirement of an external validation before implementation of the clinical recommendations.

CONCLUSION

PSA measured before and after surgery for BPH and Gleason score at surgery for BPH were the only significant predictors of the presence of residual cancer at radical retropubic prostatectomy. PSA measured after surgery for BPH and Gleason score at surgery for BPH were the only independent predictors of biochemical recurrence after radical retropubic prostatectomy.

Authors+Show Affiliations

Department of Urology, University Vita-Salute San Raffaele, Scientific Institute Hospital San Raffaele, Milan, Italy. capitanio.umberto@hsr.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18314255

Citation

Capitanio, Umberto, et al. "Radical Prostatectomy for Incidental (stage T1a-T1b) Prostate Cancer: Analysis of Predictors for Residual Disease and Biochemical Recurrence." European Urology, vol. 54, no. 1, 2008, pp. 118-25.
Capitanio U, Scattoni V, Freschi M, et al. Radical prostatectomy for incidental (stage T1a-T1b) prostate cancer: analysis of predictors for residual disease and biochemical recurrence. Eur Urol. 2008;54(1):118-25.
Capitanio, U., Scattoni, V., Freschi, M., Briganti, A., Salonia, A., Gallina, A., Colombo, R., Karakiewicz, P. I., Rigatti, P., & Montorsi, F. (2008). Radical prostatectomy for incidental (stage T1a-T1b) prostate cancer: analysis of predictors for residual disease and biochemical recurrence. European Urology, 54(1), 118-25. https://doi.org/10.1016/j.eururo.2008.02.018
Capitanio U, et al. Radical Prostatectomy for Incidental (stage T1a-T1b) Prostate Cancer: Analysis of Predictors for Residual Disease and Biochemical Recurrence. Eur Urol. 2008;54(1):118-25. PubMed PMID: 18314255.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radical prostatectomy for incidental (stage T1a-T1b) prostate cancer: analysis of predictors for residual disease and biochemical recurrence. AU - Capitanio,Umberto, AU - Scattoni,Vincenzo, AU - Freschi,Massimo, AU - Briganti,Alberto, AU - Salonia,Andrea, AU - Gallina,Andrea, AU - Colombo,Renzo, AU - Karakiewicz,Pierre I, AU - Rigatti,Patrizio, AU - Montorsi,Francesco, Y1 - 2008/02/26/ PY - 2007/10/11/received PY - 2008/02/13/accepted PY - 2008/3/4/pubmed PY - 2008/10/24/medline PY - 2008/3/4/entrez SP - 118 EP - 25 JF - European urology JO - Eur Urol VL - 54 IS - 1 N2 - BACKGROUND: Controversies exist about the most appropriate management for patients with incidental prostate cancer after surgery for benign prostatic hyperplasia (BPH). OBJECTIVES: To test the accuracy of preoperative clinical variables in predicting the presence of residual disease and biochemical recurrence in patients with incidental prostate cancer treated with radical retropubic prostatectomy. DESIGN, SETTING, AND PARTICIPANTS: We analyzed 126 T1a-T1b prostate cancers diagnosed at surgery for BPH between 1995 and 2007. INTERVENTION: All patients underwent radical retropubic prostatectomy within 6 mo of surgery for BPH. MEASUREMENTS: Univariate and multivariate logistic regression models addressed the association between the predictors (age, prostate-specific antigen [PSA] before and after surgery for BPH, T1a-T1b stage, prostate volume, and Gleason score at surgery for BPH) and the presence of residual cancer at radical retropubic prostatectomy. Cox proportional hazards regression analyses tested the relationship between the same predictors and the rate of biochemical recurrence after radical retropubic prostatectomy. RESULTS AND LIMITATIONS: Seventy-five (59.5%) patients were stage T1a and 51 (40.5%) were stage T1b. At radical retropubic prostatectomy, 21 (16.7%) patients were pT0 and seven (5.6%) patients had extraprostatic disease (pT3). PSA before and after surgery for BPH and Gleason score at surgery for BPH were the only independent predictors of residual cancer at radical retropubic prostatectomy (all p<0.04). Stage (T1a vs T1b) did not predict residual cancer or the rate of biochemical recurrence. With a mean follow-up of 57 mo, the 5- and 10-yr biochemical recurrence-free survival rates were 92% and 87%, respectively. PSA after surgery for BPH and Gleason score at surgery for BPH were the only significant multivariate predictors of biochemical recurrence (all p<0.04). The main limitation of this study is the requirement of an external validation before implementation of the clinical recommendations. CONCLUSION: PSA measured before and after surgery for BPH and Gleason score at surgery for BPH were the only significant predictors of the presence of residual cancer at radical retropubic prostatectomy. PSA measured after surgery for BPH and Gleason score at surgery for BPH were the only independent predictors of biochemical recurrence after radical retropubic prostatectomy. SN - 0302-2838 UR - https://www.unboundmedicine.com/medline/citation/18314255/Radical_prostatectomy_for_incidental__stage_T1a_T1b__prostate_cancer:_analysis_of_predictors_for_residual_disease_and_biochemical_recurrence_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(08)00190-5 DB - PRIME DP - Unbound Medicine ER -