Correlations Between Preoperative Indicators and Postoperative Histopathological Outcomes in Prostate Cancer Patients
Article Sidebar
Main Article Content
Abstract
Objective: Prostate cancer continues to pose a significant health challenge, with diverse prognoses influenced by preoperative and postoperative assessments. This study aims to elucidate the correlation between preoperative clinical indicators and postoperative histopathological outcomes to enhance prognostic models. The primary objective of this study is to investigate the predictive value of preoperative factors, such as age, Prostate-Specific Antigen (PSA) level, prostate volume (PV), and tumor volume (TV), on postoperative outcomes, specifically focusing on extracapsular invasion (ECI), seminal vesicle invasion (SVI), and positive surgical margins (PSM).
Materials and Methods: We retrospectively analyzed the data of 63 patients with prostate cancer who underwent radical prostatectomy. Preoperative clinical data, including age, PSA level, PV, and TV, were collected. Postoperative histopathological data were gathered for ECI, SVI, and PSM. Statistical analyses, including correlation coefficients and median comparisons, were employed to identify significant predictors of postoperative outcomes.
Results: The cohort had a mean age of 64.1 years, with PSA levels ranging from 3.65 to 112 ng/ml. Patients with ECI had a median PSA of 14.9 ng/ml, whereas those without had 8.2 ng/ml (p=0.001). Median PV and TV were significantly higher in patients with ECI (PV: 55 cc, TV: 8.07 cc) than in those without ECI (PV: 49 cc, TV: 4.25 cc, p=0.001). Similar significant differences were noted for SVI and PSM, with higher PSA, PV, and TV values in patients with these features (p≤0.042). Age did not significantly affect the outcomes.
Conclusion: Preoperative PSA level, prostate volume, and tumor volume were significant predictors of adverse postoperative histopathological features in patients with prostate cancer. These findings highlight the need for a multifactorial approach in preoperative evaluation and advocate the development of enhanced predictive models for improved clinical decision-making and patient management.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Accepted 2023-12-07
Published 2023-12-10
References
Ageeli W, Soha N, Zhang X, Szewcyk-Bieda M, Wilson J, Li C, et al. Preoperative imaging accuracy in size determination of prostate cancer in men undergoing radical prostatectomy for clinically localised disease. Insights into Imaging. 2023;14(1):1-13.
Hansomwong T, Saksirisampant P, Isharwal S, Aussavavirojekul P, Woranisarakul V, Jitpraphai S, et al. Role of preoperative magnetic resonance imaging on the surgical outcomes of radical prostatectomy: Does preoperative tumor recognition reduce the positive surgical margin in a specific location? Experience from a Thailand Prostate Cancer Specialized Center. Asian Journal of Urology. 2022.
Joyce DD, Soligo M, Morlacco A, Latuche LJR, Schulte PJ, Boorjian SA, et al. Effect of Preoperative Multiparametric Magnetic Resonance Imaging on Oncologic and Functional Outcomes Following Radical Prostatectomy. European Urology Open Science. 2023;47:87-93.
Pinsky PF, Parnes H. Screening for prostate cancer. New England Journal of Medicine. 2023;388(15):1405-14.
Litwin MS, Tan H-J. The diagnosis and treatment of prostate cancer: a review. Jama. 2017;317(24):2532-42.
Cooperberg MR, Moul JW, Carroll PR. The changing face of prostate cancer. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2005;23(32):8146-51.
Teo MY, Rathkopf DE, Kantoff P. Treatment of advanced prostate cancer. Annual review of medicine. 2019;70:479-99.
Van Poppel H, Roobol MJ, Chapple CR, Catto JW, N’Dow J, Sønksen J, et al. Prostate-specific antigen testing as part of a risk-adapted early detection strategy for prostate cancer: European Association of Urology position and recommendations for 2021. European Urology. 2021;80(6):703-11.
Bell N, Gorber SC, Shane A, Joffres M, Singh H, Dickinson J, et al. Recommendations on screening for prostate cancer with the prostate-specific antigen test. Cmaj. 2014;186(16):1225-34.
Hayes JH, Barry MJ. Screening for prostate cancer with the prostate-specific antigen test: a review of current evidence. Jama. 2014;311(11):1143-9.
King CR. Patterns of prostate cancer biopsy grading: trends and clinical implications. International journal of cancer. 2000;90(6):305-11.
Ahdoot M, Wilbur AR, Reese SE, Lebastchi AH, Mehralivand S, Gomella PT, et al. MRI-targeted, systematic, and combined biopsy for prostate cancer diagnosis. New England Journal of Medicine. 2020;382(10):917-28.
Gordetsky JB, Thomas JV, Nix JW, Rais-Bahrami S. Higher prostate cancer grade groups are detected in patients undergoing multiparametric MRI-targeted biopsy compared with standard biopsy. The American journal of surgical pathology. 2017;41(1):101-5.
Skolarus TA, Wolf AM, Erb NL, Brooks DD, Rivers BM, Underwood III W, et al. American Cancer Society prostate cancer survivorship care guidelines. CA: a cancer journal for clinicians. 2014;64(4):225-49.
Chen RC, Rumble B, Loblaw A, Finelli A, Ehdaie B, Cooperberg MR, et al. Active surveillance for the management of localized prostate cancer (Cancer Care Ontario Guideline): American Society of Clinical Oncology clinical practice guideline endorsement. Journal of Clinical Oncology. 2016;34(18).
Rastinehad AR, Baccala AA, Chung PH, Proano JM, Kruecker J, Xu S, et al. D'Amico risk stratification correlates with degree of suspicion of prostate cancer on multiparametric magnetic resonance imaging. The Journal of urology. 2011;185(3):815-20.
D’Amico AV, Moul J, Carroll PR, Sun L, Lubeck D, Chen M-H. Cancer-specific mortality after surgery or radiation for patients with clinically localized prostate cancer managed during the prostate-specific antigen era. Journal of clinical oncology. 2003;21(11):2163-72.
Basch E, Oliver TK, Vickers A, Thompson I, Kantoff P, Parnes H, et al. Screening for prostate cancer with prostate-specific antigen testing: American Society of Clinical Oncology Provisional Clinical Opinion. Journal of Clinical Oncology. 2012;30(24):3020.
Milonas D, Kinčius M, Skulčius G, Matjošaitis AJ, GudinavičienĖ I, Jievaltas M. Evaluation of D'Amico criteria for low-risk prostate cancer. Scandinavian Journal of Urology. 2014;48(4):344-9.