MP45-06 CHARACTERIZATION OF ANATOMICAL EXTENSION PATTERN OF LOCALIZED PROSTATE CANCER ARISING IN THE PERIPHERAL ZONE

Abstract

You have accessJournal of UrologyProstate Cancer: Localized III1 Apr 2014MP45-06 CHARACTERIZATION OF ANATOMICAL EXTENSION PATTERN OF LOCALIZED PROSTATE CANCER ARISING IN THE PERIPHERAL ZONE Mototsugu Muramaki, Hideaki Miyake, and Masato Fujisawa Mototsugu MuramakiMototsugu Muramaki More articles by this author , Hideaki MiyakeHideaki Miyake More articles by this author , and Masato FujisawaMasato Fujisawa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1203AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Despite the intensive efforts investigating difference in the clinicopathological characteristic between peripheral zone cancer (PZC) and transition zone cancer (TZC), there have been few studies systematically analyzing the extension pattern of each disease within the prostate gland. However, we previously reported that tumors derived from the PZ seem to spread through the PZ and/or across the capsule, but not through the TZ (BJU Int 2004; 93: 57-9); therefore, in this study, we precisely analyzed the radical prostatectomy (RP) specimens obtained from patients diagnosed as having disease arising from the PZ in order to clarify the extension pattern of PZC and to determine its prognostic significance in patients undergoing RP. Methods Of 174 consecutive patients with clinically localized prostate cancer undergoing RP without any neoadjuvant therapies, 128 patients diagnosed as having PZC based on the evaluation of RP specimens were enrolled in this study. Maximum tumor area (MTA) and maximum tumor volume (MTV) in RP specimens were measured using digital planimetry. A circle with an area equal to MTA, in which the central point was the intersection of the longest line of MTA and the line perpendicularly bisecting the first line, was defined as a hypothetical extension area regardless of anatomical structure. The area within this circle that did not overlap MTA was defined as ΔTA. Results There was a significant correlation between MTV and ΔTA/MTA, introduced as a parameter representing the degree of PZC extension along the anatomical shape of the PZ. ΔTA/MTA in patients with MTV larger than 5 ml was significantly greater than that in those with MTV 5 ml or smaller. Furthermore, ΔTA/MTA was significantly associated with several prognostic indicators, including extracapsular extension, surgical margin status and perineural invasion. Multivariate analysis identified ΔTA/MTA in addition to preoperative serum prostate-specific antigen, extracapsular extension and surgical margin status as independent predictors of biochemical recurrence following RP. Conclusions These findings suggest that PZC extends along the anatomical shape of the PZ during the process of extension in the prostate gland, and that the extension pattern of PZC could be closely represented by the ΔTA/MTA value. Despite the need for further studies, ΔTA/MTA, which is significantly associated with certain kinds of adverse pathological factors, could be used as an independent indicator of biochemical outcome in patients undergoing RP. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e461 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Mototsugu Muramaki More articles by this author Hideaki Miyake More articles by this author Masato Fujisawa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...