Is substaging necessary in patients with pathological stage T2 prostate cancer?

Abstract

Objective: To determine whether pathological T2 subgroups of prostate cancer can be predicted using preoperative data and to investigate whether there is any difference between pathological T2 subgroups in terms of biochemical recurrence. Materials and methods:Patients who underwent radical prostatectomy in our clinic between 2001 and 2010 and who had a tumor confined to the prostate were classified into pathological T2 subgroups according to the 1992/2002 and 1997 TNM staging system. These patients were compared in terms of clinical stage, preoperative prostate-specific antigen (PSA), biopsy tumor percentage, biopsy and prostatectomy Gleason score, and biochemical recurrence.Results: According to the 1992/200 2 TNM staging system, the clinical stages, biopsy Gleason scores, and tumor size of the pT2 subgroups were different, while the biopsy tumor percentage, preoperative PSA, and prostatectomy Gleason scores of the pT2 subgroups were similar. There was no correlation between biopsy tumor percentage and tumor volume. PSA recurred in 1, 1, and 2 patients in the pT2a, pT2b, and pT2c subgroups, respectively. According to the 1997 TNM classification, the clinical stage, biopsy and prostatectomy Gleason scores, biopsy tumor percentage and preoperative PSA of pT2 subgroups were similar, while the tumor volumes differed among the pT2 subgroups. Conclusion:It is impossible to predict T2 subgroups using preoperative data. There is no difference among groups in terms of the rates of biochemical recurrence. It is not convenient to use the biopsy tumor percentage in order to predict tumor volumes or pathological subgroups.