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Abstract
Purpose
We investigate the impact of tumor multifocality on the biochemical recurrence rate after radical prostatectomy.
Materials and Methods
Data was collected from 525 patients who underwent radical prostatectomy for clinically localized prostate cancer from 2003 to 2007. We evaluated the potential associations of multifocality with various clinical and pathologic factors. The ability to predict extracapsular extension (ECE) was tested by logistic regression models, whereas biochemical recurrence (BCR) was assessed via Kaplan-Meier analyses and Cox-hazard regression models. The BCR was defined as a level of serum prostate-specific antigen (PSA) of 0.2ng/ml or greater on consecutive evaluations.
Results
Multifocality was observed to be significantly associated with the presence of a high grade Gleason pattern (p=0.014), the pT stage (p＜ 0.001), ECE (p=0.005) and a positive surgical margin (PSM) (p=0.019). Moreover, it was the independent predictor of ECE on multivariate logistic regression analyses (p=0.039). However, although multifocality had a significant influence on biochemical recurrence on the Kaplan-Meier analyses (log rank test, p=0.019), only the PSA level and the Gleason score were significant predictors of BCR on the multivariated Cox-hazard analyses.
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Table 1.
Descriptive characteristics of the total patients
Table 2.
Characteristics of the pathologic factors of the 525 men reated for radical prostatectomy
Table 3.
Multivariate logistic regression models predicting ECE at the final pathology
Table 4.
Cox proportional hazard analysis of the factors predicting biochemical recurrence after radical prostatectomy
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