Preoperative Prediction of Extracapsular Tumor Extension at Radical Retropubic Prostatectomy in Taiwanese Patients with T1c Prostate Cancer

doi:10.1093/jjco/hyf036

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Japanese Journal of Clinical Oncology 32:172-176 (2002)
© 2002 Foundation for Promotion of Cancer Research

Preoperative Prediction of Extracapsular Tumor Extension at Radical Retropubic Prostatectomy in Taiwanese Patients with T1c Prostate Cancer

Yen-Chuan Ou¹^,2, Jung-Ta Chen²^,3, Chi-Rei Yang¹^,2, Chen-Li Cheng¹, Hao-Chung Ho¹, Yu-Lin Kao¹, Jiunn-Liang Ko⁴ and Yih-Shou Hsieh⁵^,+

¹ Division of Urology, Department of Surgery and ³ Department of Pathology, Taichung Veterans General Hospital, National Yang-Ming University School of Medicine and ² Institute of Medicine, ⁴ Institute of Toxicology and ⁵ Institute of Biochemistry, Chung Shan Medical University, Taiwan

Background: To find a predictor for extracapsular tumor extensionat radical retropubic prostatectomy (RRP) in Taiwanese patientswith stage T1c prostate cancer (PC), preoperative transrectalsonoguiding prostate biopsy outcomes and clinicopathologicaldata obtained from these patients were reviewed.

Methods: Fifty-five consecutive men who underwent radical retropubicprostatectomy for stage T1c PC were included. Preoperative sextantneedle biopsies of the prostate were performed and whole-mountprostatectomy specimens were processed. The pathological endpoint was tumor capsular perforation extending entirely throughthe prostate capsule. Preoperative prostate-specific antigen(PSA), free-to-total PSA ratio, prostate volume, PSA density,Gleason score, number of positive biopsy cores, percentage cancerof sextant biopsies, percentage cancer of one lobe and percentagecancer of one core were analyzed for their ability to predictextracapsular tumor extension at RRP.

Results: Eighteen of the 55 specimens showed evidence of tumorcapsular perforation. Those with extracapsular tumor extension(ECE) had higher PSA than organ-confined disease (OCD) (18.4vs 8.3 ng/ml, P < 0.01). The ECE had a higher PSA densitythan OCD (0.556 vs 0.226, P < 0.01). The percentage of cancerin biopsies, percentage cancer of one lobe and percentage cancerof one core were all higher in ECE than OCD (P < 0.05). TheECE had a higher biopsy Gleason score than OCD (5.6 vs 4.5,P < 0.01).

Conclusions: The four strongest predictors for extracapsulartumor extension of patients with T1c PC were PSA density $>=$ 0.35,biopsy Gleason score $>=$ 6, $>=$ 20% cancer in biopsies and PSA $>=$ 10 ng/ml.

⁺ For reprints and all correspondence: Chi-Rei Yang, 160, Sec.3, Taichung-Kang Road, Division of Urology, Department of Surgery,Taichung Veterans General Hospital, Taichung 40705, Taiwan. E-mail: ycou@vghtc.vghtc.gov.tw

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This article has been cited by other articles:

Y.-C. Ou, J.-T. Chen, C.-L. Cheng, H.-C. Ho, and C.-R. Yang
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