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Tumor Volume Adds Prognostic Value in Patients with Organ-Confined Prostate Cancer

  • Urologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

This study was designed to assess the independent prognostic value of tumor volume (TV) and whether adding TV provides additional prognostic information for predicting biochemical recurrence (BCR) after radical prostatectomy.

Methods

We reviewed the medical records of 1,129 patients who underwent radical prostatectomy between July 2005 and July 2011. TV was categorized as minimal (≤1.0 ml), moderate (1.1–5.0 ml), or extensive (>5.0 ml). Cox regression analysis was performed to identify independent predictors of BCR. The predictive accuracies of Cox’s proportional hazard regression models with and without TV were quantified and compared using time-dependent receiver operating characteristic curve analysis.

Results

Increasing TV was associated with higher prostate specific antigen, pathological Gleason score, and pathologic tumor stage. TV was an independent predictor of BCR in multivariate analysis (p < 0.001). When patients were stratified by organ-confined and nonorgan-confined tumor groups, TV remained an independent predictor of BCR in organ-confined tumors (p < 0.001). In the nonorgan-confined tumor group, a significant difference was found only between extensive versus minimal TV (p = 0.023). The predictive accuracy of the Cox regression model increased significantly by adding TV in organ-confined tumor group (0.748 vs. 0.704, p < 0.05) but not in nonorgan-confined group (0.742 vs. 0.734, p > 0.05).

Conclusions

TV was an independent prognostic predictor of BCR in organ-confined prostate cancers and provided additional prognostic information with increased predictive accuracy. In contrast, TV did not increase the predictive accuracy in nonorgan-confined tumor. TV should be considered as a prognosticator in organ-confined tumors.

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Acknowledgment

The Research Foundation of Korea (NRF) grant funded by the Korea government (MEST) (2011-0029348) supported this work.

Conflict of interest

No author has any conflict of interest.

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Authors and Affiliations

  1. Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea

    Kwang Hyun Kim MD, Sey Kiat Lim MBBS, MRCS, MMed, FAMS, Tae-Young Shin MD, Woong Kyu Han MD, PhD, Byung Ha Chung MD, PhD, Koon Ho Rha MD, PhD, FACS & Sung Joon Hong MD, PhD

  2. Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea

    Dae Ryong Kang PhD

Authors
  1. Kwang Hyun Kim MD
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  2. Sey Kiat Lim MBBS, MRCS, MMed, FAMS
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Correspondence to Sung Joon Hong MD, PhD.

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Kim, K.H., Lim, S.K., Shin, TY. et al. Tumor Volume Adds Prognostic Value in Patients with Organ-Confined Prostate Cancer. Ann Surg Oncol 20, 3133–3139 (2013). https://doi.org/10.1245/s10434-013-3016-4

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  • DOI: https://doi.org/10.1245/s10434-013-3016-4

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