�UroToday.com - In the August 2008 issue of Cancer, Dr. Felix Chun and associates present information to separate between workforce with indolent and authoritative prostate crab (CaP) to help stratify those electing active surveillance (AS). The authors peak out that even the criteria suggested by Dr. Epstein and the nomograph by Dr. Kattan will only take in about 80% accuracy at radical prostatectomy (RP) for estimating insignificant prostate crab (ICaP). The criteria to the highest degree commonly applied are no more than 2 positive biopsy cores positive with up to 50% crab involvement, biopsy Gleason amount of 6 or less, and PSA density less than 0.15.
Between 1992 and 2003, clinical and diseased data prospectively gathered on 1,153 men with CaP world Health Organization underwent RP at the investigators' institution was ill-used for the analysis. Clinically ICaP was defined as organ-confined disease with add together volume
The mean and median pretreatment PSA levels were 9.6 and 7.2ng/ml. Clinical stages T1c and T2a accounted for 79.2% of cases. Biopsy Gleason sums of 6, and 7-10 occurred in 56% and 40.5%, respectively. Tumor volumes greater than 0.5cc were recorded in 93.6%. Pathologic criteria of ICaP were fulfilled in 5.7% of patients. Of the ICaP predictors, no statistically important cutoff was identified for serum PSA. However, 4 cutoffs were identified for the variable defining the length of CaP tissue paper in the biopsy cores. In multivariate analyses, all examined variables were independent predictors of ICaP at final pathology. After fast backward variable quantity removal PSA, biopsy Gleason sum, cumulative cancer length and percent positive cores remained in the model and contributed to 90.4% accuracy for forecasting of ICaP at RP. Application of the Kattan nomogram resulted in an accuracy of 80.6%, overestimating ICaP in this study cohort.
Chun FK, Haese A, Ahyai SA, Walz J, Suardi N, Capitanio U, Graefen M, Erbersdobler A, Huland H, Karakiewicz PI
Cancer. 2008 Jun 13. Epub ahead of print.
doi:10.1002/cncr.23610
Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS
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