Billis Athanase, Magna Luis A, Watanabe Isabela C, Costa Matheus V, Telles Gilliatt H, Ferreira Ubirajara
Department of Anatomic Pathology, School of Medicine, State University of Campinas (Unicamp), Campinas, SP, Brazil.
Int Braz J Urol. 2006 Mar-Apr;32(2):165-71. doi: 10.1590/s1677-55382006000200006.
A recent study has found that PSA recurrence rate for clinical T1c tumors is similar to T2 tumors, indicating a need for further refinement of clinical staging system. To test this finding we compared clinicopathologic characteristics and the time to PSA progression following radical retropubic prostatectomy of patients with clinical stage T1c tumors to those with stage T2, T2a or T2b tumors.
From a total of 186 consecutive patients submitted to prostatectomy, 33.52% had clinical stage T1c tumors, 45.45% stage T2a tumors and 21.02% stage T2b tumors. The variables studied were age, preoperative PSA, prostate weight, Gleason score, tumor extent, positive surgical margins, extraprostatic extension (pT3a), seminal vesicle invasion (pT3b), and time to PSA progression. Tumor extent was evaluated by a point-count method.
Patients with clinical stage T1c were younger and had the lowest mean preoperative PSA. In the surgical specimen, they had higher frequency of Gleason score < 7 and more organ confined cancer. In 40.54% of the patients with clinical stage T2b tumors, there was extraprostatic extension (pT3a). During the study period, 54 patients (30.68%) developed a biochemical progression. Kaplan-Meier product-limit analysis revealed no significant difference in the time to PSA progression between men with clinical stage T1c versus clinical stage T2 (p = 0.7959), T2a (p = 0.6060) or T2b (p = 0.2941) as well as between men with clinical stage T2a versus stage T2b (p = 0.0994).
Clinicopathological features are not similar considering clinical stage T1c versus clinical stages T2, T2a or T2b.
最近一项研究发现，临床T1c期肿瘤的前列腺特异性抗原（PSA）复发率与T2期肿瘤相似，这表明需要进一步完善临床分期系统。为验证这一发现，我们比较了临床分期为T1c期肿瘤患者与T2、T2a或T2b期肿瘤患者在耻骨后根治性前列腺切除术后的临床病理特征及PSA进展时间。
在连续接受前列腺切除术的186例患者中，33.52%为临床T1c期肿瘤，45.45%为T2a期肿瘤，21.02%为T2b期肿瘤。研究的变量包括年龄、术前PSA、前列腺重量、Gleason评分、肿瘤范围、手术切缘阳性、前列腺外侵犯（pT3a）、精囊侵犯（pT3b）以及PSA进展时间。肿瘤范围采用点数法评估。
临床T1c期患者较年轻，术前平均PSA最低。在手术标本中，他们的Gleason评分<7的频率更高，且更多为器官局限性癌。在40.54%的临床T2b期肿瘤患者中存在前列腺外侵犯（pT3a）。在研究期间，54例患者（30.68%）出现生化进展。Kaplan-Meier乘积限分析显示，临床T1c期男性与临床T2期（p = 0.7959）、T2a期（p = 0.6060）或T2b期（p = 0.2941）男性之间以及临床T2a期与T2b期男性之间的PSA进展时间无显著差异（p = 0.0994）。
考虑临床T1c期与临床T2、T2a或T2b期，临床病理特征并不相似。
