Department of Pathology, Erasmus MC, Rotterdam, The Netherlands; Department of Urology, Erasmus MC, Rotterdam, The Netherlands.
Eur Urol. 2010 May;57(5):821-9. doi: 10.1016/j.eururo.2009.07.027. Epub 2009 Jul 29.
The independent prognostic value of tumour volume in radical prostatectomy (RP) specimens is controversial, and it remains a matter of debate whether pathologists should report a measure of tumour volume. In addition, tumour volume might be of value in substaging of pathologic tumour stage (pT2) prostate cancer (PCa).
To assess the prognostic value of PCa tumour volume.
DESIGN, SETTING, AND PARTICIPANTS: The cohort consisted of 344 participants in the European Randomised Study of Screening for Prostate Cancer (ERSPC), Rotterdam section, whose PCa was treated with RP. Mean time of follow-up was 96.2 mo.
Tumour volume was measured in totally embedded RP specimens with a morphometric, computer-assisted method and assessed as a continuous variable, as relative tumour volume (tumour volume divided by prostate volume), and in a binary fashion (≥ 0.5 ml or < 0.5 ml). These variables were related to prostate-specific antigen (PSA) progression, local recurrence, or distant metastasis and PCa-related mortality using univariate and multivariable Cox proportional hazards analyses. The analyses were repeated in the subgroup with pT2 tumours.
Tumour volume was related to tumour stage, Gleason score, seminal vesicle invasion (SVI), and surgical margin status. In univariate analyses, tumour volume and relative tumour volume were predictive for all outcome variables. In multivariable analyses, including age, tumour stage, Gleason score, SVI, and surgical margin status, neither tumour volume nor relative volume were independent predictors of progression or mortality. Tumour volume ≥ 0.5 ml was predictive for PSA recurrence and local and/or distant progression in univariate analyses but not in multivariable analyses. Tumour volume was not predictive for recurrence or mortality in univariate or multivariable analyses in the pT2 subgroup.
Tumour volume did not add prognostic value to routinely assessed pathologic parameters. Therefore, there seems to be little reason to routinely measure tumour volume in RP specimens.
在根治性前列腺切除术（RP）标本中，肿瘤体积的独立预后价值存在争议，病理学家是否应该报告肿瘤体积的测量值仍存在争议。此外，肿瘤体积在前列腺癌（PCa）的病理肿瘤分期（pT2）亚分期中可能具有价值。
评估 PCa 肿瘤体积的预后价值。
设计、设置和参与者：该队列由荷兰鹿特丹欧洲前列腺癌筛查随机研究（ERSPC）的 344 名接受 RP 治疗的 PCa 患者组成。中位随访时间为 96.2 个月。
使用形态计量学、计算机辅助方法测量完全嵌入的 RP 标本中的肿瘤体积，并将其作为连续变量、相对肿瘤体积（肿瘤体积除以前列腺体积）和二分类变量（≥0.5ml 或<0.5ml）进行评估。使用单变量和多变量 Cox 比例风险分析，将这些变量与前列腺特异性抗原（PSA）进展、局部复发或远处转移以及 PCa 相关死亡率相关联。在 pT2 肿瘤亚组中重复了这些分析。
肿瘤体积与肿瘤分期、Gleason 评分、精囊侵犯（SVI）和手术切缘状态有关。在单变量分析中，肿瘤体积和相对肿瘤体积是所有结局变量的预测因素。在包括年龄、肿瘤分期、Gleason 评分、SVI 和手术切缘状态在内的多变量分析中，肿瘤体积和相对体积均不是进展或死亡的独立预测因素。肿瘤体积≥0.5ml 在单变量分析中是 PSA 复发以及局部和/或远处进展的预测因素，但在多变量分析中并非如此。在 pT2 亚组中，肿瘤体积在单变量或多变量分析中均不能预测复发或死亡率。
肿瘤体积未为常规评估的病理参数提供额外的预后价值。因此，在 RP 标本中常规测量肿瘤体积似乎没有什么意义。
