Clinical Significance of Calculated Prostate Cancer Volume as the Predictor of Pathologic Stage

Lee, Kyoung Rae; Cheon, Jun

Abstract

PURPOSE: Pathologic tumor volume is closely related with pathologic stage, pathologic Gleason grade, surgical margin status, and disease progression after radical prostatectomy. Therefore, an accurate assessment of prostate cancer volume is essential in prediction of pathologic stage. We evaluated that the calculated prostate cancer volume (cVca), a new clinical parameter, can predict for pathologic stage T3 in patients with clinical stage T1, 2 prostate cancer.
MATERIALS AND METHODS
The cVca was determined in 26 men treated with radical prostatectomy in clinically localized prostate cancer (clinical stage T1, T2) based on pretreatment PSA, biopsy Gleason score, and prostate ultrasound volume. Logistic regression analysis evaluating the value of the PSA, biopsy Gleason score, cVca was performed.
RESULTS
The mean of cVca was 4.07cm3 and the mean of cVca in localized and extensive prostate cancer was 1.77cm3 and 6.74cm3, respectively. The difference between the mean of cVca in localized and extensive prostate cancer was statistically significant (p<0.05). PSA and cVca were significant predictors of pathologic stage T3 disease in patients with clinical stage T1, T2 disease on univariate analysis, but cVca was only significant predictor on multivariate analysis.
CONCLUSIONS
The cVca was more reliable parameter than PSA and Gleason score in predicting of pathologic stage T3 disease in patients with clinical stage T1 and T2 prostate cancer. Therefore, this new parameter can be used to select patients who are likely to have pathologic organ-confined disease.