Maximum tumor diameter: a simple independent predictor for biochemical recurrence after radical prostatectomy

Abstract

Previous studies have suggested that maximum tumor diameter (MTD) is a predictor of PSA recurrence or biochemical recurrence (BCR) in prostate cancer after radical prostatectomy (RP). The significance of MTD in BCR prediction was evaluated using RP specimens of 364 patients with a BCR of 18% (n ¼ 66) during a mean follow-up of 37.4 months (range: 10-109 months). MTD was defined as the largest diameter of the largest tumor, and its median MTD was 15 mm (range: 0.9-50 mm). MTD was significantly associated with pre-operative PSA levels, pathological T stage, Gleason's score and positive surgical margin. In a univariate analysis, pathological T stage, Gleason's score, positive surgical margin and MTD were associated significantly with the risk of BCR. Patients with 420 mm MTD had a significantly higher risk of BCR than did those with p20 mm MTD (Po0.001). Cox multivariate models indicated that pathological stage, Gleason's score, positive surgical margin and MTD were independent prognostic factors for BCR. MTD would be a useful tool for predicting BCR, as calculation of MTD is a simple and reliable measure.

Correlation of quantitative diffusion‐weighted and dynamic contrast‐enhanced MRI parameters with prognostic factors in prostate cancer

“…NCCN risk groups were stratified into low, intermediate and high risk as defined by current guidelines . MTD was based on T2‐weighted MRI and was stratified into two groups using a threshold of 2 cm, which was selected based on published data showing higher PSA failure in patients with MTD > 2 cm . Clinical T stage was stratified into T1 vs. T2.…”

Prognostic Factors for the Development of Biochemical Recurrence after Radical Prostatectomy

“…Fukuhara et al used the maximum tumour diameter (MTD) as an estimate for tumour volume, to correlate with BCR [40]. They noted that, although both PSA and MTD significantly correlated with BCR on univariate analysis, only MTD independently predicted BCR on multivariate analysis.…”

Comparison of contemporary methods for estimating prostate tumour volume in pathological specimens

“…TV is of prognostic significance on univariate analysis and correlates closely with Gleason score, stage and surgical margin status of RP specimens. Given this close correlation, it is not surprising that TV loses its independence as a prognostic factor on multivariate analysis . Due to the lack of independent prognostic significance and difficulties in accurately measuring TV, many pathologists choose not to give a quantifiable measure of TV .…”