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Contemporary Pathological Stage Distribution After Radical Prostatectomy in North American High-Risk Prostate Cancer Patients

. 2022 Oct ; 20 (5) : e380-e389. [epub] 20220421

Language English Country United States Media print-electronic

Document type Journal Article

Links

PubMed 35618597
DOI 10.1016/j.clgc.2022.04.005
PII: S1558-7673(22)00080-5
Knihovny.cz E-resources

PURPOSE: To investigate pathological stage at radical prostatectomy (RP) using the "Partin tables" approach in NCCN high-risk (HR) prostate cancer (PCa) patients. MATERIALS AND METHODS: Within the SEER 2010 to 2016 database, we identified 7,718 NCCN HR PCa patients. Cross-tabulation was used to illustrate the distribution of organ confined disease (OC, pT2), extra-prostatic extension (EPE, pT3a), seminal vesicles invasion (SVI, pT3b), lymph node invasion (LNI, pT2N1), extra-prostatic and lymph node invasion (EPE + LNI, pT3aN1), and seminal vescicale and lymph node invasion (SVI + LNI, pT3bN1), according to preoperative criteria, which consisted in PSA, clinical T stage, biopsy Gleason Score (GS). Binomial 95%CI was constructed for the reported proportions. RESULTS: Median (IQR) PSA levels was 9 (6-20) ng/ml. The majority of patient harbored cT1c (51%) followed by cT2 (35%) and cT3 (14%) stage. Most patients exhibited GS 4+4 (43%). Overall, 87 vs. 15 vs. 2% of patients harbored only 1 vs. 2 vs. all 3 HR criteria. At RP, OC, EPE, SVI, and LNI rates were respectively 36%, 27%, 17%, and 19%. Highest levels of OC were recorded for cT1c, PSA <10 ng/mL and biopsy GS4+4. Conversely, EPE, SVI and LNI were the highest in patients with cT3, PSA ≥20 ng/mL and GS 5+5. After stratification according to clinical stages, OC rates decreased with increasing PSA levels and GS. Conversely, EPE, SVI and LNI rates increased with increasing PSA and GS. CONCLUSION: We provide a lookup table to illustrate the relationship between clinical and pathological characteristics in NCCN HR PCa patients.

Cancer Prognostics and Health Outcomes Unit Division of Urology University of Montréal Health Center Montréal Québec Canada

Cancer Prognostics and Health Outcomes Unit Division of Urology University of Montréal Health Center Montréal Québec Canada; Department of Maternal Child and Urological Sciences Sapienza Rome University Policlinico Umberto 1 Hospital Rome Italy

Cancer Prognostics and Health Outcomes Unit Division of Urology University of Montréal Health Center Montréal Québec Canada; Department of Urology University Hospital Frankfurt Frankfurt am Main Germany

Cancer Prognostics and Health Outcomes Unit Division of Urology University of Montréal Health Center Montréal Québec Canada; Division of Experimental Oncology Unit of Urology URI Urological Research Institute IRCCS San Raffaele Scientific Institute Milan Italy

Cancer Prognostics and Health Outcomes Unit Division of Urology University of Montréal Health Center Montréal Québec Canada; Martini Klinik Prostate Cancer Center University Hospital Hamburg Eppendorf Hamburg Germany

Department of Maternal Child and Urological Sciences Sapienza Rome University Policlinico Umberto 1 Hospital Rome Italy

Department of Surgical and Diagnostic Integrated Sciences University of Genova Genova Italy; Cancer Prognostics and Health Outcomes Unit Division of Urology University of Montréal Health Center Montréal Québec Canada

Department of Surgical and Diagnostic Integrated Sciences University of Genova Genova Italy; Department of Urology IRCCS Policlinico San Martino Genova Italy

Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria; Departments of Urology Weill Cornell Medical College New York NY; Department of Urology University of Texas Southwestern Dallas TX; Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic; Institute for Urology and Reproductive Health 1 M Sechenov 1st Moscow State Medical University Moscow Russia; Division of Urology Department of Special Surgery Jordan University Hospital The University of Jordan Amman Jordan

Department of Urology University Hospital Frankfurt Frankfurt am Main Germany

Division of Experimental Oncology Unit of Urology URI Urological Research Institute IRCCS San Raffaele Scientific Institute Milan Italy

Martini Klinik Prostate Cancer Center University Hospital Hamburg Eppendorf Hamburg Germany

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