TY - JOUR
T1 - When should we expect no residual tumor (pT0) once we submit incidental T1a-b prostate cancers to radical prostatectomy?
AU - Capitanio, Umberto
AU - Briganti, Alberto
AU - Suardi, Nazareno
AU - Gallina, Andrea
AU - Salonia, Andrea
AU - Freschi, Massimo
AU - Rigatti, Patrizio
AU - Montorsi, Francesco
PY - 2011/2
Y1 - 2011/2
N2 - Objectives: To date, no tool exists to predict pT0 at radical prostatectomy (RP) in patients with T1a-T1b prostate cancer (PCa) after surgery for benign prostatic hyperplasia (SxBPH). We aimed to fill this gap by developing a user-friendly flowchart to assist urologists when incidental PCa is diagnosed and a clinical decision is required. Methods: We analyzed 158 T1a-T1b prostate cancers patients who underwent RP between 1996 and 2009. A risk stratification tool was developed applying the tree modeling technique of classification and regression tree analysis (CART) and relying on all the available pre-RP characteristics (age, prostate-specific antigen [PSA] before SxBPH, PSA after SxBPH, cT1a-T1b stage, prostate volume and Gleason sum at SxBPH). Then, the accuracy of the proposed model using 200 bootstrap resamples for internal validation was calculated. Results: A total of 95 patients (60.1%) were stage T1a, and 63 (39.9%) were stage T1b. The median values of PSA before and after SxBPH were 4.2 and 1.1ng/mL, respectively. A total of 22 patients (13.9%) showed no residual tumor (pT0) at RP. The CART analyses identified three groups at risk of having residual disease at RP: (i) PSA after SxBPH>1.0ng/mL (pT0 prevalence: 3.8%); (ii) PSA after SxBPH2.0ng/mL (pT0 prevalence: 14.8%); and (iii) PSA after SxBPH
AB - Objectives: To date, no tool exists to predict pT0 at radical prostatectomy (RP) in patients with T1a-T1b prostate cancer (PCa) after surgery for benign prostatic hyperplasia (SxBPH). We aimed to fill this gap by developing a user-friendly flowchart to assist urologists when incidental PCa is diagnosed and a clinical decision is required. Methods: We analyzed 158 T1a-T1b prostate cancers patients who underwent RP between 1996 and 2009. A risk stratification tool was developed applying the tree modeling technique of classification and regression tree analysis (CART) and relying on all the available pre-RP characteristics (age, prostate-specific antigen [PSA] before SxBPH, PSA after SxBPH, cT1a-T1b stage, prostate volume and Gleason sum at SxBPH). Then, the accuracy of the proposed model using 200 bootstrap resamples for internal validation was calculated. Results: A total of 95 patients (60.1%) were stage T1a, and 63 (39.9%) were stage T1b. The median values of PSA before and after SxBPH were 4.2 and 1.1ng/mL, respectively. A total of 22 patients (13.9%) showed no residual tumor (pT0) at RP. The CART analyses identified three groups at risk of having residual disease at RP: (i) PSA after SxBPH>1.0ng/mL (pT0 prevalence: 3.8%); (ii) PSA after SxBPH2.0ng/mL (pT0 prevalence: 14.8%); and (iii) PSA after SxBPH
KW - Benign prostatic hyperplasia
KW - Prostate cancer
KW - Radical prostatectomy
KW - T1a
KW - T1b
KW - Transurethral resection
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U2 - 10.1111/j.1442-2042.2010.02689.x
DO - 10.1111/j.1442-2042.2010.02689.x
M3 - Article
C2 - 21198944
AN - SCOPUS:79251566469
VL - 18
SP - 148
EP - 153
JO - International Journal of Urology
JF - International Journal of Urology
SN - 0919-8172
IS - 2
ER -