Abstract
ABSTRACTPurpose:The 8th edition of the TNM has been updated and improved in order to ensure a high degree of clinical relevance. A major change in prostate includes pathologically organ - confined disease to be considered pT2 and no longer subclassified by extent of involvement or laterality. The aim of this study was to validate this major change.Materials and Methods:Prostates were step - sectioned from 196 patients submitted to radical prostatectomy with organ confined disease (pT2) and negative surgical margins. Tumor extent was evaluated by a semiquantitative point count method. The dominant nodule extent was recorded as the maximal number of positive points of the largest single focus of cancer from the quadrants. Laterality was considered as either total tumor extent (Group 1) or index tumor extent (Group 2). Time to biochemical recurrence was analyzed with the Kaplan - Meier product limit analysis and prediction of shorter time to biochemical recurrence with Cox proportional hazards model.Results:In Group 1, 43 / 196 (21.9%) tumors were unilateral and 153 / 196 (78.1%) bilateral and in Group 2, 156 / 196 (79.6%) tumors were unilateral and 40 / 196 (20.4%) bilateral. In both groups, comparing unilateral vs bilateral tumors, there was no significant clinicopathological difference, and no significant association with time as well as prediction of shorter time to biochemical recurrence following surgery.Conclusions:Pathologic sub - staging of organ confined disease does not convey prognostic information either considering laterality as total tumor extent or index tumor extent. Furthermore, no correlation exists between digital rectal examination and pathologic stage.
Highlights
The 8th edition of the TNM has been updated and improved in order to ensure a high degree of clinical relevance [1, 2]
Major changes in prostate include: 1) Pathologically organ - confined disease is considered pT2 and is no longer subclassified by extent of involvement or laterality; 2) Tumor grading includes both the Gleason score and the grade group; 3) Prognostic stage group III includes select, organ - confined disease based on prostate - specific antigen and Gleason / grade group status; and, ibju | Validation TNM pT2 prostate cancer
We studied the possible correlation between digital rectal examination and pathological stage
Summary
The 8th edition of the TNM has been updated and improved in order to ensure a high degree of clinical relevance [1, 2]. Major changes in prostate include: 1) Pathologically organ - confined disease is considered pT2 and is no longer subclassified by extent of involvement or laterality; 2) Tumor grading includes both the Gleason score (as in the seventh edition criteria) and the grade group (introduced in the eighth edition criteria); 3) Prognostic stage group III includes select, organ - confined disease based on prostate - specific antigen and Gleason / grade group status; and, ibju | Validation TNM pT2 prostate cancer. The aim of this study was to validate the major change 1 of the 8th edition of the TNM. To the best of our knowledge there is no other study considering index tumor extent in sub - staging. We studied the possible correlation between digital rectal examination and pathological stage
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