Adult UrologyPrediction of Patient Outcome in Pathologic Stage T2 Adenocarcinoma of the Prostate: Lack of Significance for Microvessel Density Analysis
Section snippets
Patients
The study cohort was selected from a group of 904 patients with margin-free pathologic Stage T2 prostate cancer previously reported by Lerner et al.[4]Patients with Gleason scores of 5 and less were excluded due to low recurrence rates in the follow-up interval (data not shown), resulting in 331 potential patients. Twenty patients with clinical T1 disease as well as 3 patients restaged as pathologic Stage T3 were excluded, leaving 308 patients with palpable margin-free organ-confined prostate
Patient Characteristics
Clinical and pathologic findings for study patients were compiled following prostatectomy (Table I). The mean age at prostatectomy was 67.5 years (range 50 to 81). Median preoperative PSA was 8.4 ng/mL (range 0.08 to 76.6). Mean (median) follow-up for all patients was 6.1 (6.6) years. At the close of the study, 12 patients were dead (one of prostate cancer).
When clinical and pathologic findings of study patients were compared to the 161 patients excluded for insufficient prostatectomy
Comment
Cancer recurrence in patients with palpable organ-confined margin-negative prostate cancer after prostatectomy remains incompletely understood.1, 2, 3, 4Prediction of patients at highest risk would be valuable in considering adjuvant treatment. We evaluated OMVD, Gleason grade, preoperative PSA, and DNA ploidy as predictors of cancer recurrence in these patients. OMVD for all patients was not predictive of biochemical or clinical recurrence within the mean 6.1 years of follow-up. Conversely,
Conclusions
We found that preoperative PSA was the most significant predictor of recurrence in patients with palpable intermediate- and high-grade margin-free pathologic Stage T2 adenocarcinoma of the prostate. In our narrow study population, Gleason grade tended toward significance in predicting cancer recurrence. Optimized microvessel density was not predictive of biochemical or clinical recurrence in this group of patients.
Acknowledgements
Acknowledgment.
To Jeff M. Slezak, B.S., for statistical analysis and programming support.
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