Correlation of tumor location and biochemical recurrence in localized and locally-advanced prostate cancer in post-robotic radical prostatectomy patients.
- Author:
John Ivan S. Alonzo
;
Jason L. Letran
- Publication Type:Journal Article
- Keywords:
prostate cancer;
biochemical recurrence;
radical prostatectomy
- From:
Philippine Journal of Urology
2019;29(1):40-44
- CountryPhilippines
- Language:English
-
Abstract:
OBJECTIVE:This study aims to determine the tumor location of prostate adenocarcinoma in patientswho underwent Robotic Radical Prostatectomy (RRP) for localized and locally-advanced prostatecancer and the correlation of the tumor location with the incidence of biochemical recurrence.
PATIENTS AND METHODS:The authors reviewed the patient database of a single Urological Oncologistfrom January 2015 to April 2017 for patients who underwent RRP for localized or locally-advancedprostate cancer. They also reviewed the histopathologic report of the prostatectomy specimens todetermine pathologic T-stage, prostate volume, and post-operative Gleason score. The histopathologicexamination of specimens was interpreted by a single Urological Pathologist based on the 2014International Society of Urological Pathology Gleason Scoring System. Eligible patients were thendivided into three groups: those with pure anterior tumor location, pure posterior tumor location,and mixed tumor location. Presence of positive surgical margins, mean follow-up period, andbiochemical recurrence were determined for these groups. Patient demographic data were analyzedusing test of proportions. Correlation of tumor location with biochemical recurrence was derivedusing Pearson chi-square test.
RESULTS:Of the 113 patients included in the study, 63 (55.8%) were clinically-staged T2 patients while27 (23.9%) and 23 (20.3%) were clinical stage T1 and T3, respectively. On pre-operative prostatebiopsy, 27 (23.9%) patients had a Gleason score of 8-10. Thirty-eight (33.6%) and 30 (26.6%) had aGleason score of 6 (3+3) or 7 (3+4), respectively Average prostate volume was 42.8 grams. Ninety-five (84.1%) of the patients had mixed tumor location, 11 (11.6%) had pure posterior tumor location,and only 7 (6.2%) had pure anterior tumor location. In those with pure anterior or posterior tumorlocations, majority were low-grade prostate cancers (Gleason 6(3+3) and Gleason 7(3+4)) whilethose with mixed tumor location had low to high-grade prostate cancers (Gleason 7 (3+4) and Gleason7 (4+3.)) Majority of the patients had pathologic T2c and T3a tumors across all groups. Positivesurgical margins were present in 31% of those with mixed tumor location and only 0.9% in those withpure anterior or posterior tumor location, respectively. Only 10 patients from the population hadbiochemical recurrence, 9 of which had mixed tumor location while 1 had pure posterior tumorlocation. Pearson chi-square test shows no significant relationship between tumor location andbiochemical recurrence at 95% CI (p= regional involvement 0.695.) Furthermore, there is a very weak positive correlation (R=0.069) between tumor location and biochemical recurrence.
CONCLUSION:Majority of patients who underwent RRP have mixed tumor location. There is poorcorrelation between prostate cancer tumor location and biochemical recurrence.
- Full text:Correlation of tumor location and biochemical recurrence.pdf
