934 PROSTATE SIZE AND RISK OF CAPSULAR INCISION AT RADICAL PROSTATECTOMY (2010)

You have accessJournal of UrologyProstate Cancer: Localized IV1 Apr 2010934 PROSTATE SIZE AND RISK OF CAPSULAR INCISION AT RADICAL PROSTATECTOMY Andrea Lantz, Chris Morash, Anthony Bella, James Eastham, Peter Scardino, and Ilias Cagiannos Andrea LantzAndrea Lantz Ottawa, Canada More articles by this author , Chris MorashChris Morash Ottawa, Canada More articles by this author , Anthony BellaAnthony Bella Ottawa, Canada More articles by this author , James EasthamJames Eastham New York, NY More articles by this author , Peter ScardinoPeter Scardino New York, NY More articles by this author , and Ilias CagiannosIlias Cagiannos Ottawa, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1750AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In clinically localized, organ confined prostate cancer, capsular incision (CI) into tumor (stage pT2 with positive surgical margins) during radical prostatectomy has been shown to have an adverse impact on biochemical recurrence (BCR). It has been reported that CI has outcomes similar to a pT3a tumor with positive surgical margins. Smaller prostates have also been associated with higher rates of BCR in some studies. No published studies have investigated the relationship between prostate size and risk of CI. The objective of this study is to determine if prostate size influences the risk of CI during radical prostatectomy and to determine if tumor volume is related to CI. METHODS Between 1985 and 2008, 8110 patients with prostate cancer were treated with radical prostatectomy at the Memorial Sloan-Kettering Cancer Center (New York, NY) and the Ottawa Hospital (Ottawa, ON, Canada). 968 patients were excluded due to pre-operative hormonal treatment. This study included 3412 cases that had complete data including prostate volume, patient age, PSA, and Gleason score. Univariate and multivariate logistic regression analyses were conducted to assess the association between prostate size and CI. Prostate size was treated as a categorical variable with 3 groups: <30cc, 30-50cc, and >50cc. Multivariate analysis controlled for age, pre-operative PSA, and Gleason score. A second analysis was performed using 648 patients that had data available for tumor volume. RESULTS Univariate analysis showed that as prostate size increased, the risk of CI decreased. The smaller glands (<30cc) had the highest risk of CI. Compared to this group, the odds ratio (OR) for CI was 0.42 (0.20, 0.88; p=0.02) for the 30-50cc group and 0.18 (0.08, 0.39; p=<0.0001) for the >50cc group. This finding remained significant on multivariate analysis. The OR for 30-50cc glands was 0.41 (0.20, 0.88; p=0.02) and 0.28 (0.15, 0.54; p=<0.0001) for glands >50cc. Tumor volume was not significantly associated with risk of CI (OR 1.006 (0.84, 1.20); p=0.95). CONCLUSIONS The risk of CI during radical prostatectomy is highest with smaller prostates, which appears to be unrelated to tumor volume. As prostate size increases, the risk of CI decreases. This is a novel finding and may help to explain the higher biochemical failure rate associated with smaller prostate volume. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e364 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrea Lantz Ottawa, Canada More articles by this author Chris Morash Ottawa, Canada More articles by this author Anthony Bella Ottawa, Canada More articles by this author James Eastham New York, NY More articles by this author Peter Scardino New York, NY More articles by this author Ilias Cagiannos Ottawa, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...