The tumor volume or extent measurement in radical prostatectomy (RP) specimens is time-consuming and technically difficult. We aimed at studying the independent prognostic value of tumor extent for biochemical progression-free following RP once it is controversial. This retrospective study was based on 305 consecutive patients submitted to RP. In whole-mount and totally embedded surgical specimens, tumor extent was evaluated with a point-count semi-quantitative method and correlated to several clinical and pathological variables. Biochemical progression was defined as PSA ≥ 0.2 ng/ml; time to progression-free outcome was studied using the Kaplan-Meier product-limit analysis and univariate and multivariate analyses using the Cox stepwise logistic regression. More extensive tumors showed significantly higher preoperative PSA (P<0.01), higher clinical stage (P = 0.03), higher positive surgical margins (P<0.01), higher pathological stage (P<0.01), and higher Gleason score on needle biopsies (P<0.01) and on surgical specimens (P<0.01). On univariate analysis, biochemical progression correlated with tumor extension (P<0.01), preoperative PSA (P<0.01), Gleason score on needle biopsies (P = 0.02) and on surgical specimens (P<0.01), positive surgical margins (P = 0.01), and pathological stage (P = 0.01). There was no difference related to time of biochemical recurrence comparing less extensive with more extensive tumors (P = 0.20). In multivariate analysis, tumor extent was not predictive of biochemical progression combined to any one of the variables studied (P>0.05).
Tumor extent did not provide in our study additional predictive information for biochemical progression following RP beyond preoperative PSA, Gleason score, positive surgical margins, and pathological stage.
Tumor extent in radical prostatectomy specimens: is it an independent prognostic factor for biochemical (PSA) progression following surgery?