Radical Prostatectomy for Incidental (Stage T1a-T1b) Prostate Cancer: Analysis of Predictors for Residual Disease and Biochemical Recurrence

Umberto Capitanio, Vincenzo Scattoni, Massimo Freschi, Alberto Briganti, Andrea Salonia, Andrea Gallina, Renzo Colombo, Pierre I. Karakiewicz, Patrizio Rigatti, Francesco Montorsi

Research output: Contribution to journalArticle

Abstract

Background: Controversies exist about the most appropriate management for patients with incidental prostate cancer after surgery for benign prostatic hyperplasia (BPH). Objectives: To test the accuracy of preoperative clinical variables in predicting the presence of residual disease and biochemical recurrence in patients with incidental prostate cancer treated with radical retropubic prostatectomy. Design, Setting, and Participants: We analyzed 126 T1a-T1b prostate cancers diagnosed at surgery for BPH between 1995 and 2007. Intervention: All patients underwent radical retropubic prostatectomy within 6 mo of surgery for BPH. Measurements: Univariate and multivariate logistic regression models addressed the association between the predictors (age, prostate-specific antigen [PSA] before and after surgery for BPH, T1a-T1b stage, prostate volume, and Gleason score at surgery for BPH) and the presence of residual cancer at radical retropubic prostatectomy. Cox proportional hazards regression analyses tested the relationship between the same predictors and the rate of biochemical recurrence after radical retropubic prostatectomy. Results and Limitations: Seventy-five (59.5%) patients were stage T1a and 51 (40.5%) were stage T1b. At radical retropubic prostatectomy, 21 (16.7%) patients were pT0 and seven (5.6%) patients had extraprostatic disease (pT3). PSA before and after surgery for BPH and Gleason score at surgery for BPH were the only independent predictors of residual cancer at radical retropubic prostatectomy (all p <0.04). Stage (T1a vs T1b) did not predict residual cancer or the rate of biochemical recurrence. With a mean follow-up of 57 mo, the 5- and 10-yr biochemical recurrence-free survival rates were 92% and 87%, respectively. PSA after surgery for BPH and Gleason score at surgery for BPH were the only significant multivariate predictors of biochemical recurrence (all p <0.04). The main limitation of this study is the requirement of an external validation before implementation of the clinical recommendations. Conclusion: PSA measured before and after surgery for BPH and Gleason score at surgery for BPH were the only significant predictors of the presence of residual cancer at radical retropubic prostatectomy. PSA measured after surgery for BPH and Gleason score at surgery for BPH were the only independent predictors of biochemical recurrence after radical retropubic prostatectomy.

Original languageEnglish
Pages (from-to)118-125
Number of pages8
JournalEuropean Urology
Volume54
Issue number1
DOIs
Publication statusPublished - Jul 2008

Fingerprint

Prostatic Hyperplasia
Prostatectomy
Prostatic Neoplasms
Recurrence
Neoplasm Grading
Prostate-Specific Antigen
Residual Neoplasm
Logistic Models
Prostate
Survival Rate
Regression Analysis

Keywords

  • Biochemical recurrence
  • Prostate cancer
  • Radical prostatectomy

ASJC Scopus subject areas

  • Urology

Cite this

Radical Prostatectomy for Incidental (Stage T1a-T1b) Prostate Cancer : Analysis of Predictors for Residual Disease and Biochemical Recurrence. / Capitanio, Umberto; Scattoni, Vincenzo; Freschi, Massimo; Briganti, Alberto; Salonia, Andrea; Gallina, Andrea; Colombo, Renzo; Karakiewicz, Pierre I.; Rigatti, Patrizio; Montorsi, Francesco.

In: European Urology, Vol. 54, No. 1, 07.2008, p. 118-125.

Research output: Contribution to journalArticle

@article{e83decaee4b4400bbfcc007a515019cb,
title = "Radical Prostatectomy for Incidental (Stage T1a-T1b) Prostate Cancer: Analysis of Predictors for Residual Disease and Biochemical Recurrence",
abstract = "Background: Controversies exist about the most appropriate management for patients with incidental prostate cancer after surgery for benign prostatic hyperplasia (BPH). Objectives: To test the accuracy of preoperative clinical variables in predicting the presence of residual disease and biochemical recurrence in patients with incidental prostate cancer treated with radical retropubic prostatectomy. Design, Setting, and Participants: We analyzed 126 T1a-T1b prostate cancers diagnosed at surgery for BPH between 1995 and 2007. Intervention: All patients underwent radical retropubic prostatectomy within 6 mo of surgery for BPH. Measurements: Univariate and multivariate logistic regression models addressed the association between the predictors (age, prostate-specific antigen [PSA] before and after surgery for BPH, T1a-T1b stage, prostate volume, and Gleason score at surgery for BPH) and the presence of residual cancer at radical retropubic prostatectomy. Cox proportional hazards regression analyses tested the relationship between the same predictors and the rate of biochemical recurrence after radical retropubic prostatectomy. Results and Limitations: Seventy-five (59.5{\%}) patients were stage T1a and 51 (40.5{\%}) were stage T1b. At radical retropubic prostatectomy, 21 (16.7{\%}) patients were pT0 and seven (5.6{\%}) patients had extraprostatic disease (pT3). PSA before and after surgery for BPH and Gleason score at surgery for BPH were the only independent predictors of residual cancer at radical retropubic prostatectomy (all p <0.04). Stage (T1a vs T1b) did not predict residual cancer or the rate of biochemical recurrence. With a mean follow-up of 57 mo, the 5- and 10-yr biochemical recurrence-free survival rates were 92{\%} and 87{\%}, respectively. PSA after surgery for BPH and Gleason score at surgery for BPH were the only significant multivariate predictors of biochemical recurrence (all p <0.04). The main limitation of this study is the requirement of an external validation before implementation of the clinical recommendations. Conclusion: PSA measured before and after surgery for BPH and Gleason score at surgery for BPH were the only significant predictors of the presence of residual cancer at radical retropubic prostatectomy. PSA measured after surgery for BPH and Gleason score at surgery for BPH were the only independent predictors of biochemical recurrence after radical retropubic prostatectomy.",
keywords = "Biochemical recurrence, Prostate cancer, Radical prostatectomy",
author = "Umberto Capitanio and Vincenzo Scattoni and Massimo Freschi and Alberto Briganti and Andrea Salonia and Andrea Gallina and Renzo Colombo and Karakiewicz, {Pierre I.} and Patrizio Rigatti and Francesco Montorsi",
year = "2008",
month = "7",
doi = "10.1016/j.eururo.2008.02.018",
language = "English",
volume = "54",
pages = "118--125",
journal = "European Urology",
issn = "0302-2838",
publisher = "Elsevier B.V.",
number = "1",

}

TY - JOUR

T1 - Radical Prostatectomy for Incidental (Stage T1a-T1b) Prostate Cancer

T2 - Analysis of Predictors for Residual Disease and Biochemical Recurrence

AU - Capitanio, Umberto

AU - Scattoni, Vincenzo

AU - Freschi, Massimo

AU - Briganti, Alberto

AU - Salonia, Andrea

AU - Gallina, Andrea

AU - Colombo, Renzo

AU - Karakiewicz, Pierre I.

AU - Rigatti, Patrizio

AU - Montorsi, Francesco

PY - 2008/7

Y1 - 2008/7

N2 - Background: Controversies exist about the most appropriate management for patients with incidental prostate cancer after surgery for benign prostatic hyperplasia (BPH). Objectives: To test the accuracy of preoperative clinical variables in predicting the presence of residual disease and biochemical recurrence in patients with incidental prostate cancer treated with radical retropubic prostatectomy. Design, Setting, and Participants: We analyzed 126 T1a-T1b prostate cancers diagnosed at surgery for BPH between 1995 and 2007. Intervention: All patients underwent radical retropubic prostatectomy within 6 mo of surgery for BPH. Measurements: Univariate and multivariate logistic regression models addressed the association between the predictors (age, prostate-specific antigen [PSA] before and after surgery for BPH, T1a-T1b stage, prostate volume, and Gleason score at surgery for BPH) and the presence of residual cancer at radical retropubic prostatectomy. Cox proportional hazards regression analyses tested the relationship between the same predictors and the rate of biochemical recurrence after radical retropubic prostatectomy. Results and Limitations: Seventy-five (59.5%) patients were stage T1a and 51 (40.5%) were stage T1b. At radical retropubic prostatectomy, 21 (16.7%) patients were pT0 and seven (5.6%) patients had extraprostatic disease (pT3). PSA before and after surgery for BPH and Gleason score at surgery for BPH were the only independent predictors of residual cancer at radical retropubic prostatectomy (all p <0.04). Stage (T1a vs T1b) did not predict residual cancer or the rate of biochemical recurrence. With a mean follow-up of 57 mo, the 5- and 10-yr biochemical recurrence-free survival rates were 92% and 87%, respectively. PSA after surgery for BPH and Gleason score at surgery for BPH were the only significant multivariate predictors of biochemical recurrence (all p <0.04). The main limitation of this study is the requirement of an external validation before implementation of the clinical recommendations. Conclusion: PSA measured before and after surgery for BPH and Gleason score at surgery for BPH were the only significant predictors of the presence of residual cancer at radical retropubic prostatectomy. PSA measured after surgery for BPH and Gleason score at surgery for BPH were the only independent predictors of biochemical recurrence after radical retropubic prostatectomy.

AB - Background: Controversies exist about the most appropriate management for patients with incidental prostate cancer after surgery for benign prostatic hyperplasia (BPH). Objectives: To test the accuracy of preoperative clinical variables in predicting the presence of residual disease and biochemical recurrence in patients with incidental prostate cancer treated with radical retropubic prostatectomy. Design, Setting, and Participants: We analyzed 126 T1a-T1b prostate cancers diagnosed at surgery for BPH between 1995 and 2007. Intervention: All patients underwent radical retropubic prostatectomy within 6 mo of surgery for BPH. Measurements: Univariate and multivariate logistic regression models addressed the association between the predictors (age, prostate-specific antigen [PSA] before and after surgery for BPH, T1a-T1b stage, prostate volume, and Gleason score at surgery for BPH) and the presence of residual cancer at radical retropubic prostatectomy. Cox proportional hazards regression analyses tested the relationship between the same predictors and the rate of biochemical recurrence after radical retropubic prostatectomy. Results and Limitations: Seventy-five (59.5%) patients were stage T1a and 51 (40.5%) were stage T1b. At radical retropubic prostatectomy, 21 (16.7%) patients were pT0 and seven (5.6%) patients had extraprostatic disease (pT3). PSA before and after surgery for BPH and Gleason score at surgery for BPH were the only independent predictors of residual cancer at radical retropubic prostatectomy (all p <0.04). Stage (T1a vs T1b) did not predict residual cancer or the rate of biochemical recurrence. With a mean follow-up of 57 mo, the 5- and 10-yr biochemical recurrence-free survival rates were 92% and 87%, respectively. PSA after surgery for BPH and Gleason score at surgery for BPH were the only significant multivariate predictors of biochemical recurrence (all p <0.04). The main limitation of this study is the requirement of an external validation before implementation of the clinical recommendations. Conclusion: PSA measured before and after surgery for BPH and Gleason score at surgery for BPH were the only significant predictors of the presence of residual cancer at radical retropubic prostatectomy. PSA measured after surgery for BPH and Gleason score at surgery for BPH were the only independent predictors of biochemical recurrence after radical retropubic prostatectomy.

KW - Biochemical recurrence

KW - Prostate cancer

KW - Radical prostatectomy

UR - http://www.scopus.com/inward/record.url?scp=44149117944&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=44149117944&partnerID=8YFLogxK

U2 - 10.1016/j.eururo.2008.02.018

DO - 10.1016/j.eururo.2008.02.018

M3 - Article

C2 - 18314255

AN - SCOPUS:44149117944

VL - 54

SP - 118

EP - 125

JO - European Urology

JF - European Urology

SN - 0302-2838

IS - 1

ER -