The clinical features of anterior prostate cancers

Theresa Koppie, Fernando J. Bianco, Kentaro Kuroiwa, Victor E. Reuter, Bertrand Guillonneau, James A. Eastham, Peter T. Scardino

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

OBJECTIVE: To identify the clinical characteristics of anterior prostate cancers (APCs) and to compare these with posterior prostate cancers (PPCs). PATIENTS AND METHODS: We reviewed 1290 consecutive open and laparoscopic radical prostatectomies (RPs) at the authors' institution from January 2000 to March 2004. Prostates were processed using a whole-mount technique. Each surgical specimen was reviewed by one pathologist, and tumour areas were marked, measured and mapped. Positive surgical margins (PSMs) were defined as the presence of cancer cells at the inked surface of the specimen. Specimens were then categorized by the location of their dominant tumour, i.e. pure anterior, anterior > posterior, posterior > anterior, or pure posterior. We compared the clinical and pathological characteristics of 259 patients in the pure-anterior group with the 594 in the pure-posterior group. RESULTS: Before RP, APCs had a significantly lower biopsy Gleason score (78% vs 68% with Gleason 4-6), fewer mean biopsy cores positive (2.0 vs 2.6), a smaller median percentage of positive cores (17% vs 26%), lower clinical stage (T1 in 79% vs 62%), and higher progression-free probability estimated by preoperative nomogram (86% vs 84%) than PPCs. Patients with APCs also had more previous negative biopsy sessions. The pathological analysis of RP specimens showed that those with APCs had higher tumour volume (1.6 vs 0.83 mL) and had a higher PSM rate (12% vs 7%) than those with PPCs, despite specimens with PPCs having higher rates of extraprostatic extension (10% vs 19%). CONCLUSIONS: APCs have lower Gleason grade and lower rates of extraprostatic extension, yet patients with anterior tumours have higher overall tumour volumes and higher PSM rates. Because current tools for detecting and staging prostate cancer can underestimate the extent of anterior prostate disease, improved methods are needed for localizing and characterizing anterior cancers.

Original languageEnglish (US)
Pages (from-to)1167-1171
Number of pages5
JournalBJU International
Volume98
Issue number6
DOIs
StatePublished - Dec 2006
Externally publishedYes

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Prostatic Neoplasms
Prostatectomy
Neoplasms
Tumor Burden
Biopsy
Prostate
Nomograms
Neoplasm Grading
Margins of Excision

Keywords

  • Neoplasm staging
  • Prostatectomy
  • Prostatic neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Koppie, T., Bianco, F. J., Kuroiwa, K., Reuter, V. E., Guillonneau, B., Eastham, J. A., & Scardino, P. T. (2006). The clinical features of anterior prostate cancers. BJU International, 98(6), 1167-1171. https://doi.org/10.1111/j.1464-410X.2006.06578.x

The clinical features of anterior prostate cancers. / Koppie, Theresa; Bianco, Fernando J.; Kuroiwa, Kentaro; Reuter, Victor E.; Guillonneau, Bertrand; Eastham, James A.; Scardino, Peter T.

In: BJU International, Vol. 98, No. 6, 12.2006, p. 1167-1171.

Research output: Contribution to journalArticle

Koppie, T, Bianco, FJ, Kuroiwa, K, Reuter, VE, Guillonneau, B, Eastham, JA & Scardino, PT 2006, 'The clinical features of anterior prostate cancers', BJU International, vol. 98, no. 6, pp. 1167-1171. https://doi.org/10.1111/j.1464-410X.2006.06578.x
Koppie T, Bianco FJ, Kuroiwa K, Reuter VE, Guillonneau B, Eastham JA et al. The clinical features of anterior prostate cancers. BJU International. 2006 Dec;98(6):1167-1171. https://doi.org/10.1111/j.1464-410X.2006.06578.x
Koppie, Theresa ; Bianco, Fernando J. ; Kuroiwa, Kentaro ; Reuter, Victor E. ; Guillonneau, Bertrand ; Eastham, James A. ; Scardino, Peter T. / The clinical features of anterior prostate cancers. In: BJU International. 2006 ; Vol. 98, No. 6. pp. 1167-1171.
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abstract = "OBJECTIVE: To identify the clinical characteristics of anterior prostate cancers (APCs) and to compare these with posterior prostate cancers (PPCs). PATIENTS AND METHODS: We reviewed 1290 consecutive open and laparoscopic radical prostatectomies (RPs) at the authors' institution from January 2000 to March 2004. Prostates were processed using a whole-mount technique. Each surgical specimen was reviewed by one pathologist, and tumour areas were marked, measured and mapped. Positive surgical margins (PSMs) were defined as the presence of cancer cells at the inked surface of the specimen. Specimens were then categorized by the location of their dominant tumour, i.e. pure anterior, anterior > posterior, posterior > anterior, or pure posterior. We compared the clinical and pathological characteristics of 259 patients in the pure-anterior group with the 594 in the pure-posterior group. RESULTS: Before RP, APCs had a significantly lower biopsy Gleason score (78{\%} vs 68{\%} with Gleason 4-6), fewer mean biopsy cores positive (2.0 vs 2.6), a smaller median percentage of positive cores (17{\%} vs 26{\%}), lower clinical stage (T1 in 79{\%} vs 62{\%}), and higher progression-free probability estimated by preoperative nomogram (86{\%} vs 84{\%}) than PPCs. Patients with APCs also had more previous negative biopsy sessions. The pathological analysis of RP specimens showed that those with APCs had higher tumour volume (1.6 vs 0.83 mL) and had a higher PSM rate (12{\%} vs 7{\%}) than those with PPCs, despite specimens with PPCs having higher rates of extraprostatic extension (10{\%} vs 19{\%}). CONCLUSIONS: APCs have lower Gleason grade and lower rates of extraprostatic extension, yet patients with anterior tumours have higher overall tumour volumes and higher PSM rates. Because current tools for detecting and staging prostate cancer can underestimate the extent of anterior prostate disease, improved methods are needed for localizing and characterizing anterior cancers.",
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AU - Koppie, Theresa

AU - Bianco, Fernando J.

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AU - Eastham, James A.

AU - Scardino, Peter T.

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N2 - OBJECTIVE: To identify the clinical characteristics of anterior prostate cancers (APCs) and to compare these with posterior prostate cancers (PPCs). PATIENTS AND METHODS: We reviewed 1290 consecutive open and laparoscopic radical prostatectomies (RPs) at the authors' institution from January 2000 to March 2004. Prostates were processed using a whole-mount technique. Each surgical specimen was reviewed by one pathologist, and tumour areas were marked, measured and mapped. Positive surgical margins (PSMs) were defined as the presence of cancer cells at the inked surface of the specimen. Specimens were then categorized by the location of their dominant tumour, i.e. pure anterior, anterior > posterior, posterior > anterior, or pure posterior. We compared the clinical and pathological characteristics of 259 patients in the pure-anterior group with the 594 in the pure-posterior group. RESULTS: Before RP, APCs had a significantly lower biopsy Gleason score (78% vs 68% with Gleason 4-6), fewer mean biopsy cores positive (2.0 vs 2.6), a smaller median percentage of positive cores (17% vs 26%), lower clinical stage (T1 in 79% vs 62%), and higher progression-free probability estimated by preoperative nomogram (86% vs 84%) than PPCs. Patients with APCs also had more previous negative biopsy sessions. The pathological analysis of RP specimens showed that those with APCs had higher tumour volume (1.6 vs 0.83 mL) and had a higher PSM rate (12% vs 7%) than those with PPCs, despite specimens with PPCs having higher rates of extraprostatic extension (10% vs 19%). CONCLUSIONS: APCs have lower Gleason grade and lower rates of extraprostatic extension, yet patients with anterior tumours have higher overall tumour volumes and higher PSM rates. Because current tools for detecting and staging prostate cancer can underestimate the extent of anterior prostate disease, improved methods are needed for localizing and characterizing anterior cancers.

AB - OBJECTIVE: To identify the clinical characteristics of anterior prostate cancers (APCs) and to compare these with posterior prostate cancers (PPCs). PATIENTS AND METHODS: We reviewed 1290 consecutive open and laparoscopic radical prostatectomies (RPs) at the authors' institution from January 2000 to March 2004. Prostates were processed using a whole-mount technique. Each surgical specimen was reviewed by one pathologist, and tumour areas were marked, measured and mapped. Positive surgical margins (PSMs) were defined as the presence of cancer cells at the inked surface of the specimen. Specimens were then categorized by the location of their dominant tumour, i.e. pure anterior, anterior > posterior, posterior > anterior, or pure posterior. We compared the clinical and pathological characteristics of 259 patients in the pure-anterior group with the 594 in the pure-posterior group. RESULTS: Before RP, APCs had a significantly lower biopsy Gleason score (78% vs 68% with Gleason 4-6), fewer mean biopsy cores positive (2.0 vs 2.6), a smaller median percentage of positive cores (17% vs 26%), lower clinical stage (T1 in 79% vs 62%), and higher progression-free probability estimated by preoperative nomogram (86% vs 84%) than PPCs. Patients with APCs also had more previous negative biopsy sessions. The pathological analysis of RP specimens showed that those with APCs had higher tumour volume (1.6 vs 0.83 mL) and had a higher PSM rate (12% vs 7%) than those with PPCs, despite specimens with PPCs having higher rates of extraprostatic extension (10% vs 19%). CONCLUSIONS: APCs have lower Gleason grade and lower rates of extraprostatic extension, yet patients with anterior tumours have higher overall tumour volumes and higher PSM rates. Because current tools for detecting and staging prostate cancer can underestimate the extent of anterior prostate disease, improved methods are needed for localizing and characterizing anterior cancers.

KW - Neoplasm staging

KW - Prostatectomy

KW - Prostatic neoplasms

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