Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Prostate Cancer Prostatic Dis. 2010 Sep;13(3):244-7. doi: 10.1038/pcan.2010.17. Epub 2010 Jun 22.
Previous studies have suggested that maximum tumor diameter (MTD) is a predictor of PSA recurrence or biochemical recurrence (BCR) in prostate cancer after radical prostatectomy (RP). The significance of MTD in BCR prediction was evaluated using RP specimens of 364 patients with a BCR of 18% (n=66) during a mean follow-up of 37.4 months (range: 10-109 months). MTD was defined as the largest diameter of the largest tumor, and its median MTD was 15 mm (range: 0.9-50 mm). MTD was significantly associated with pre-operative PSA levels, pathological T stage, Gleason's score and positive surgical margin. In a univariate analysis, pathological T stage, Gleason's score, positive surgical margin and MTD were associated significantly with the risk of BCR. Patients with >20 mm MTD had a significantly higher risk of BCR than did those with < or =20 mm MTD (P<0.001). Cox multivariate models indicated that pathological stage, Gleason's score, positive surgical margin and MTD were independent prognostic factors for BCR. MTD would be a useful tool for predicting BCR, as calculation of MTD is a simple and reliable measure.
先前的研究表明，在根治性前列腺切除术（RP）后，最大肿瘤直径（MTD）是前列腺癌 PSA 复发或生化复发（BCR）的预测指标。在中位随访 37.4 个月（范围：10-109 个月）期间，使用 364 例 BCR 为 18%（n=66）的 RP 标本评估了 MTD 在 BCR 预测中的意义。MTD 定义为最大肿瘤的最大直径，其中位数 MTD 为 15 毫米（范围：0.9-50 毫米）。MTD 与术前 PSA 水平、病理 T 分期、Gleason 评分和阳性手术切缘显著相关。在单因素分析中，病理 T 分期、Gleason 评分、阳性手术切缘和 MTD 与 BCR 的风险显著相关。MTD>20 毫米的患者与 MTD<或=20 毫米的患者相比，BCR 的风险显著更高（P<0.001）。Cox 多因素模型表明，病理分期、Gleason 评分、阳性手术切缘和 MTD 是 BCR 的独立预后因素。MTD 将是预测 BCR 的有用工具，因为 MTD 的计算是一种简单可靠的测量方法。
