Tumor Location and a Tumor Volume over 2.8 cc Predict the Prognosis for Japanese Localized Prostate Cancer
by
, ,
Haruki Baba
1,†,
Shinichi Sakamoto
1,*,†,
Xue Zhao
1,†,
Yasutaka Yamada
1,
Junryo Rii
1,
Ayumi Fujimoto
1,
Manato Kanesaka
1,
Nobuyoshi Takeuchi
1,
Tomokazu Sazuka
1,
Yusuke Imamura
1,
Koichiro Akakura
2 and
Tomohiko Ichikawa
1 1
Department of Urology, Chiba University Graduate School of Medicine, Chiba 260-8670, Japan
2
Department of Urology, Japan Community Health-Care Organization Tokyo Shinjuku Medical Center, Tokyo 162-8543, Japan
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Cancers 2022, 14(23), 5823; https://doi.org/10.3390/cancers14235823
Submission received: 5 November 2022
/
Revised: 23 November 2022
/
Accepted: 24 November 2022
/
Published: 25 November 2022
(This article belongs to the Special Issue High-Risk Localized and Locally Advanced Prostate Cancer)
Simple Summary
About 40% of men with localized prostate cancer experience biochemical recurrence after radical prostatectomy. The early detection of disease progression is important for optimal post-operative treatment and follow-up. Our study reviewed 557 patients with prostate cancer who underwent radical prostatectomy and found that a tumor volume over 2.8 cc was a novel independent predictive factor for biochemical recurrence. We further established a novel risk assessment model based on tumor volume and location (posterior and peripheral zone). We confirmed that the risk model could stratify patients’ prognoses. In addition to the previously reported biomarkers, these novel factors obtained from the surgical specimen may provide better prognostic information in patients with prostate cancer.
Abstract
(1) Objective: Our study investigated the prognostic value of tumor volume and location in prostate cancer patients who received radical prostatectomy (RP). (2) Methods: The prognostic significance of tumor volume and location, together with other clinical factors, was studied using 557 patients who received RP. (3) Results: The receiver operating characteristic (ROC) curve identified the optimal cutoff value of tumor volume as 2.8 cc for predicting biochemical recurrence (BCR). Cox regression analysis revealed that a tumor in the posterior area (p = 0.031), peripheral zone (p = 0.0472), and tumor volume ≥ 2.8 cc (p < 0.0001) were predictive factors in univariate analysis. After multivariate analysis, tumor volume ≥ 2.8 cc (p = 0.0225) was an independent predictive factor for BCR. Among them, a novel risk model was established using tumor volume and location in the posterior area and peripheral zone. The progression-free survival (PFS) of patients who met the three criteria (unfavorable group) was significantly worse than other groups (p ≤ 0.001). Furthermore, multivariate analysis showed that the unfavorable risk was an independent prognostic factor for BCR. The prognostic significance of our risk model was observed in low- to intermediate-risk patients, although it was not observed in high-risk patients. (4) Conclusion: Tumor volume (≥2.8 cc) and localization (posterior/peripheral zone) may be a novel prognostic factor in patients undergoing RP.
