Impact of the Proportion of Biopsy Positive Core in Predicting Biochemical Recurrence in Patients with Pathological Pt2 and Negative Resection Margin Status after Radical Prostatectomy

Oikawa, Masaaki; Tanaka, Toshikazu; Narita, Takuma; Noro, Daisuke; Iwamura, Hiromichi; Tobisawa, Yuki; Yoneyama, T.; Kodama, Hirotake; Hashimoto, Yasuhiro; Koie, Takuya; Οhyama, Chikara

doi:10.1007/s12253-019-00762-6

Cited by 3 publications

(5 citation statements)

References 28 publications

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“…On the multivariate analyses, serum PSA level and pathological Gleason score of 7 or above were significantly associated with BCR in men with organ-confined prostate cancer with negative surgical margins. Oikawa et al reported that the 5- and 10-year BCR-free survival rates were 89.0% and 87.8% after radical prostatectomy in patients with those statuses [ 3 ]. Multivariate analysis revealed that the proportion of biopsy-positive cores was significantly associated with BCR.…”

Section: Discussionmentioning

confidence: 99%

“…However, some patients experience BCR even with negative surgical margins, at a rate is about 87-96% [5,16,17]. The preoperative serum PSA level, Gleason score, pathological T stage, and margin status are widely accepted as significant prognostic factors in those patients [3][4][5]. A report from the USA showed significant risk factors for BCR in patients with organ-confined prostate cancer and negative surgical margins, including African American race, suspicious digital rectal examination, serum PSA level, and ISUP grades 4 and 5 on prostatectomy pathology [16].…”

Section: Discussionmentioning

confidence: 99%

“…The primary goal of radical prostatectomy is to achieve negative surgical margins, indicating the absence of cancer cells. However, some patients experience biochemical recurrence (BCR) after radical prostatectomy, even with negative surgical margins [1][2][3][4][5]. Robotic surgery has recently become mainstream in radical prostatectomy; therefore, the number of patients with negative surgical margins will continue to increase.…”

Section: Introductionmentioning

confidence: 99%

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Index tumor location affected early biochemical recurrence after radical prostatectomy in patients with negative surgical margin: a retrospective study

Ogata,

Akatsuka,

Endo

et al. 2024

BMC Urol

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Background Index tumors are the most aggressive tumors of the prostate. However, their clinical significance remains unclear. This study aimed to assess the incidence of index tumor location according to the zonal origin and whether these locations affect the prognosis after radical prostatectomy in patients with negative surgical margins. Methods This single-centered, retrospective study evaluated 1,109 consecutive patients who underwent radical prostatectomies. An index tumor was defined as the largest tumor in the prostate gland. We detected these locations based on McNeal's zonal origin using whole-mount sections. Biochemical recurrence (BCR) free survival curves were generated using the Kaplan–Meier method. Univariate and multivariate analyses using the Cox proportional hazards model were performed to determine the predictive factors for early BCR (within 1-year). Results A total of 621 patients with negative surgical margins who did not receive adjuvant therapy were included in this study. The index tumor were located in the transitional zone in 191 patients (30.8%), the peripheral zone in 399 patients (64.3%), and the central zone in 31 patients (5.0%). In total, 22 of 621 patients (3.5%) experienced early BCR and 70 patients (11.2%) experienced overall BCR at a median follow-up of 61.7 months. According to the index tumor location, the early BCR-free rates were 99.5%, 95.7 %, and 83.3% in the transitional, peripheral, and central zones, respectively. On multivariate analysis, the index tumor in the central zone was an independent predictor of early BCR with negative surgical margins following radical prostatectomy, followed by prostatectomy pathological grade, index tumor in the peripheral zone, and high prostate-specific antigen level. Conclusions We assessed the significance of index tumor location in patients with negative surgical margins following radical prostatectomy. Index tumors located in the central zone, although infrequent, were the strongest predictive factors for early BCR. Our results may allow urologists and patients to reconsider the therapeutic strategies for prostate cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Index tumor location affected early biochemical recurrence after radical prostatectomy in patients with negative surgical margin: a retrospective study

Ogata,

Akatsuka,

Endo

et al. 2024

BMC Urol

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“…In addition to higher PSA titers, our study reaffirms the association between positive biopsy core percentages and the presence of PSMs. Previous studies have shown that positive biopsy core percentages are a significant predictor of PCa death and biochemical recurrence [ 33 , 34 ]. Moreover, in a recent study of 624 PCa patients undergoing nerve-sparing RP, van der Slot et al [ 35 ] found that a positive biopsy core percentage was a significant predictor of a posterolateral PSM after RP.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Parameters Could Predict International Society of Urological Pathology Risk Groups of Prostate Cancers on Radical Prostatectomy

Chang,

Lin,

Wong

et al. 2023

Life

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Background: The International Society of Urological Pathology (ISUP) grade and positive surgical margins (PSMs) after radical prostatectomy (RP) may reflect the prognosis of prostate cancer (PCa) patients. This study aimed to investigate whether DCE-MRI parameters (i.e., Ktrans, kep, and IAUC) could predict ISUP grade and PSMs after RP. Method: Forty-five PCa patients underwent preoperative DCE-MRI. The clinical characteristics and DCE-MRI parameters of the 45 patients were compared between the low- and high-risk (i.e., ISUP grades III-V) groups and between patients with or without PSMs after RP. Multivariate logistic regression analysis was used to identify the significant predictors of placement in the high-risk group and PSMs. Results: The DCE parameter Ktrans-max was significantly higher in the high-risk group than in the low-risk group (p = 0.028) and was also a significant predictor of placement in the high-risk group (odds ratio [OR] = 1.032, 95% confidence interval [CI] = 1.005–1.060, p = 0.021). Patients with PSMs had significantly higher prostate-specific antigen (PSA) titers, positive biopsy core percentages, Ktrans-max, kep-median, and kep-max than others (all p < 0.05). Of these, positive biopsy core percentage (OR = 1.035, 95% CI = 1.003–1.068, p = 0.032) and kep-max (OR = 1.078, 95% CI = 1.012–1.148, p = 0.020) were significant predictors of PSMs. Conclusion: Preoperative DCE-MRI parameters, specifically Ktrans-max and kep-max, could potentially serve as preoperative imaging biomarkers for postoperative PCa prognosis based on their predictability of PCa risk group and PSM on RP, respectively.

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“…Recurrence rate of prostate cancer after definitive local therapies varies based on aggressiveness of initial tumor and type of treatment; approximately 20-40% of patients who have undergone radical prostatectomy experience biochemical recurrence of PCa [51,52]. The current gold standard for monitoring PCa recurrence includes serial PSA testing.…”

Section: Treatmentmentioning

confidence: 99%

Role of metabolic imaging in diagnosis of primary, metastatic, and recurrent prostate cancer

Hadavand¹,

Mayer

Chen³

et al. 2020

Current Opinion in Oncology

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Purpose of review: The present review describes the current role of metabolic imaging techniques such as multiparametric MRI (mpMRI), magnetic resonance spectroscopic imaging (MRSI), hyperpolarized MRSI, and positron emission tomography (PET) in the diagnosis of primary prostate cancer, surveillance of low-grade disease, detection of metastases, and evaluation of biochemical recurrence after therapy. Recent Findings: The natural history of prostate cancer ranges from indolent disease that is optimally monitored by active surveillance, to highly aggressive disease that can be lethal. Current diagnostic methods remain imperfect in noninvasively distinguishing between silent versus aggressive tumors. Hence, there is a high demand for noninvasive imaging techniques that offer insight into biological behavior of prostate cancer cells. Characterization of prostate cancer metabolism is a promising area to provide such insights. Summary: Metabolic imaging may allow for greater detection and ultimately characterization of tumor based on aggressiveness and spread. Hence, it has the potential to monitor tumor activity, predict prognostic outcomes, and guide individualized therapies.

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Impact of the Proportion of Biopsy Positive Core in Predicting Biochemical Recurrence in Patients with Pathological Pt2 and Negative Resection Margin Status after Radical Prostatectomy

Cited by 3 publications

References 28 publications

Index tumor location affected early biochemical recurrence after radical prostatectomy in patients with negative surgical margin: a retrospective study

Index tumor location affected early biochemical recurrence after radical prostatectomy in patients with negative surgical margin: a retrospective study

Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Parameters Could Predict International Society of Urological Pathology Risk Groups of Prostate Cancers on Radical Prostatectomy

Role of metabolic imaging in diagnosis of primary, metastatic, and recurrent prostate cancer

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