Comparison of clinical and pathological stage and grade of prostate cancer
Article published in Urologia Polska 2007/60/1.

authors

Jakub Dobruch ¹, Andrzej Borówka ¹, Gerard Grotthuss ¹, Tomasz Dzik ¹, Piotr Chłosta ², Artur A. Antoniewicz ¹: ¹ Klinika Urologii Centrum Medycznego Kształcenia Podyplomowego, I Zespół Dydaktyki Urologicznej - Oddział Urologii Międzyleskiego Szpitala Specjalistycznego w Warszawie
² Dział Urologii Świętokrzyskiego Centrum Onkologii w Kielcach

keywords

prostate, prostate cancer, stage, radical prostatectomy

summary

The aim of the study. The aim of the present study is to determine the prevalence of under and over staging as well as under and over grading in contemporary patients undergoing radical prostatectomy (RP) and define important predictors of under staging.

Material and methods. Data of men who were subjected to open retropubic radical prostatectomy from 1st January 2001 to 31st March 2006 were analyzed.

Results. 128 (97%) and 4 (3%) patients were operated on due to clinically organ confined and locally advanced prostate cancer respectively. Mean age, sPSA and PSAD as well as mean number of positive cores in men with extraprostatic extension of PCa and in men with organ confined PCa did not differ significantly and resulted 62.3 (+/-6.1) and 61.9 (+/-5.5), 9.9 (+/-5.8) and 9.6 (+/-4.8), 0.29 (+/-0.21) and 0.26 (+/-0.17) and 3.9 (+/-2.4) i 3.1 (+/-2.0) respectively, median values were 62 and 61, 8.0 and 8.2, 0.22 and 0.21 and 3 i 3 respectively. In contrast mean Gl.s. evaluated before RP, percentage of positive cores and maximum percent of cancer within the core as well as mean GL.s. evaluated after RP were significantly greater and resulted 5,6 (+/-1.5) and 5.0 (+/-1.3) (p=0.01), 67.0 (+/-27,7) and 50,6 (+/-26.9) (p<0.01), 62.2 (+/-2.1) and 37,5 (+/-2.4) (p<0.001) and 6,3 (+/-1.4) and 5,4 (+/-1.1) (p<0.001) respectively, median values of these parameters were 5 and 5, 70 and 50, 68 and 37 and 7 i 5 respectively. Under grading occurred in 27 (20.5%) patients, and under staging occurred in 62 (47.0%) patients.

Conclusions. Extraprostatic extension and under staging of prostate cancer was found almost in half of the patient subjected to radical prostatectomy. Biopsy parameters are becoming strongly predictive as far as prostate pathology is considered. Under grading of prostate cancer was shown in 1/5 of operated men.

references

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correspondence