Predictive value of pathological features for progression after radical prostatectomy

European Urology
V RaveryL Boccon-Gibod

Abstract

10-30% of patients with T1/T2 prostate cancer submitted to radical prostatectomy ultimately fail. It may be important to detect failure as early as possible in order to evaluate the extent of recurrent/residual disease and initiate adjuvant therapy. 100 consecutive patients with localized prostate cancer treated by radical prostatectomy have been monitored using the hypersensitive Pros-check prostate-specific antigen (PSA) assay (detection level 0.1 ng/ml). The predictive value of positive surgical margins, involvement of seminal vesicles and perineural spaces as well as Gleason's score for biological failure (persistent or recurrent detectable PSA) has been retrospectively evaluated. Overall 40% of the patients had biological failure (defined as persistence of a detectable or rising PSA after undetectability) and 38% had positive surgical margins. The three main predictive criteria of biological failure were capsular perforation, involvement of seminal vesicles and/or positive margins. All patients in whom these criteria were positive progressed. Seminal vesicle invasion was associated with biological failure in 95% of the cases. 66.7% of the patients with extracapsular disease but no seminal vesicle invasion progressed. 15% o...Continue Reading

Citations

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