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Preoperative Predictors Of Extraprostatic Extension Of Prostate Cancer (pT3a) In A Contemporary Indian Cohort

S. Arora, G. Gautam, R. Khera, R. Ahlawat
Published 2017 · Medicine

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We present our experience with robotic radical prostatectomy and analyse the predictors for extracapsular extension (EPE) in a cohort of Indian patients. Four hundred fifty-three patients underwent robotic radical prostatectomy from May 2010 to October 2015. Post hoc analysis of prospectively maintained data was done. Multivariable regression analysis was used on variables which had significant association with EPE on univariable analysis. Receiver operating characteristic (ROC) curves were plotted for the independent predictors of EPE. Mean age was 64.62 ± 6.44 years. Mean BMI 26.03 ± 4.01 kg/m2. Median prostate-specific antigen (PSA) was 13.38 ng/ml (IQR 8.1–23.5). Seventy-seven (16.99%) patients had Gleason >7. Mean core positivity (percentage of cores positive) was 48,93 ± 27.29% and mean maximum percentage of tumour in a core was 33,04 ± 31.16%. Positive surgical margins were present in 141/453 (31.15%). Lymph nodes were positive in 21.2% of those who had nodes removed (77/364). Maximum cancer in a core (p < 0.001), core positivity (p = 0.002) and Gleason score ≥4 + 3 (p = 0.028) were significant predictors of EPE, independent of BMI, PSA, PNI and clinical stage. Receiver operating characteristic (ROC) analysis for core positivity showed an area under the curve (AUC) of 0.775, and a 76% core positivity predicted EPE with a sensitivity of 65% and a specificity of 87.1%, respectively. ROC curve for maximum cancer in a core showed an area under the curve of 0.898. Seventy per cent cancer in a single core predicted EPE with a sensitivity of 80.6% and a specificity of 85.9% Indian patients present with more advanced disease, higher PSA and have higher incidence of EPE. Maximum cancer in a core, ratio of positive cores and Gleason score ≥4 + 3 are predictors of EPE independent of PSA and clinical stage.
This paper references
10.1016/J.EURURO.2006.10.019
Robotic-assisted laparoscopic prostatectomy: functional and pathologic outcomes with interfascial nerve preservation.
K. Zorn (2007)
10.1001/JAMA.1997.03540420041027
Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancer. A multi-institutional update.
A. Partin (1997)
10.4103/0970-1591.142061
Current concepts in robotic radical prostatectomy
N. Gupta (2014)
10.4103/0970-1591.85428
Pathological outcomes and strategies to achieve optimal cancer control during robotic radical prostatectomy in Asian-Indian men
A. Tewari (2011)
10.1016/j.urology.2008.01.014
Potential of magnetic resonance spectroscopic imaging in predicting absence of prostate cancer in men with serum prostate-specific antigen between 4 and 10 ng/ml: a follow-up study.
R. Kumar (2008)
10.4103/0974-7796.130555
Extraperitoneal robot-assisted laparoscopic radical prostatectomy: Initial experience
P. N. Dogra (2014)
10.4103/0019-509X.92275
Correlation between the preoperative serum prostate specific antigen, Gleason score, and clinical staging with pathological outcome following robot-assisted radical prostatectomy: an Indian experience.
P. Singh (2011)
Diabetes and cardiovascular disease during androgen deprivation therapy: observational study of veterans with prostate cancer.
N. Keating (2012)
10.1016/J.UROLOGY.2007.03.042
Updated nomogram to predict pathologic stage of prostate cancer given prostate-specific antigen level, clinical stage, and biopsy Gleason score (Partin tables) based on cases from 2000 to 2005.
D. Makarov (2007)
10.1016/S0022-5347(05)67998-0
The percent of cores positive for cancer in prostate needle biopsy specimens is strongly predictive of tumor stage and volume at radical prostatectomy.
T. Sebo (2000)
10.1016/j.ijrobp.2008.04.082
External validation of the updated partin tables in a cohort of French and Italian men.
N. Bhojani (2009)
10.1097/01.JU.0000103929.91486.29
Tumor length and location of cancer on biopsy predict for side specific extraprostatic cancer extension.
Y. Naya (2004)
Robotic Radical Prostatectomy: our technique
R Ahlawat (2013)
10.4103/0970-1591.139575
Continence outcomes following robotic radical prostatectomy: Our experience from 150 consecutive patients
N. Gupta (2014)
10.7314/APJCP.2012.13.12.6245
Estimation of time trends of incidence of prostate cancer--an Indian scenario.
K. Lalitha (2012)
10.4103/0970-1591.156918
Predictive factors for lymph node positivity in patients undergoing extended pelvic lymphadenectomy during robot assisted radical prostatectomy
Vikram Batra (2015)
10.4103/0970-1591.98480
Robotic-assisted inguinal lymph node dissection – Initial experience
A. Saini (2012)
10.4103/0970-1591.98454
Perioperative outcome of initial 190 cases of robot-assisted laparoscopic radical prostatectomy – A single-center experience
P. N. Dogra (2012)
10.3346/jkms.2010.25.10.1443
Preoperative Nomograms for Predicting Extracapsular Extension in Korean Men with Localized Prostate Cancer: A Multi-institutional Clinicopathologic Study
J. S. Chung (2010)
10.1016/j.mgene.2014.07.007
Epidemiology of prostate cancer in India
S. Jain (2014)
10.4103/0019-509X.118715
Prostate cancer disease characteristics for foreign-born South Asian men living in the United States.
T. Patel (2013)
10.1016/S0090-4295(01)01441-8
Contemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium.
A. Partin (2001)
10.1038/pcan.2016.24
Impact of the extent of extraprostatic extension defined by Epstein’s method in patients with negative surgical margins and negative lymph node invasion
T. Maubon (2016)
10.4103/0970-1591.185096
Assessment of the performance of Partin's nomogram (2007) in contemporary Indian cohort
R. Yadav (2016)



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