Pathologic T2 Stage Subgroups and Recurrence-Free Survival After Radical Prostatectomy

Abstract

To determine whether present subclassifications for pathologic T2 (pT2) prostate cancer are predictive for recurrence-free survival (RFS) after radical prostatectomy. The study sample included 906 patients who underwent radical prostatectomy between 1990 and 2004 and were subsequently staged as having pT2 disease. The estimated 5- and 10-year RFS for patients with pT2a, pT2b, and pT2c was calculated by using the Kaplan-Meier method. Multivariate analysis was performed by using Cox Proportional Hazards models to determine differences in RFS among the 3 groups, and their association with preoperative variables, including prostate-specific antigen (PSA) and biopsy Gleason score. Preoperative PSA and Gleason score were strongly predictive for RFS (P <0.0001). Although patients with pT2a disease had greater RFS at 5 and 10 years when compared with pT2b and pT2c groups, the difference did not reach statistical significance (P = 0.13). The association between pathologic stage and outcome was further weakened on multivariate analysis after incorporating preoperative PSA and biopsy Gleason score. Although multiple studies have shown that present subgroupings for clinical T2 disease have prognostic significance, the same does not appear to apply to pathologic T2 subgroups. These latter groups are not independently associated with disease-free survival, and may therefore have little prognostic significance.