Predicting tumor volume in radical prostatectomy specimens from patients with prostate cancer.

Tumor volume has prognostic value in numerous malignant neoplasms; however, the determination of tumor volume in prostatic adenocarcinoma remains problematic. We tested the hypothesis that the diameter of the largest focus of carcinoma in whole-mount prostate sections predicts the volume of adenocarcinoma in the entire prostate. We evaluated 184 radical prostatectomy specimens by whole-mount processing of the entire prostate. The maximum diameter of the largest focus of carcinoma was measured directly on glass slides. Tumor volume in the entire prostate was calculated by the grid method. The maximum tumor diameter ranged from 0.1 to 4.1 cm (median, 1.6 cm). The total tumor volume ranged from 0.1 to 12.5 cm3 (median, 1.6 cm3). There were significant correlations between maximum tumor diameter and tumor volume (Spearman correlation coefficient = 0.84; P < .0001), surgical margin status (P < .001), perineural invasion (P < .001), serum prostate-specific antigen level at diagnosis (P = .004), Gleason score (P = .004), and pathologic stage (P < .0001). Maximum tumor diameter is a predictor of tumor volume and might be useful for the assessment of tumor volume in routinely processed prostatectomy specimens.

[1]  P. Scardino,et al.  A comparison of the morphological features of cancer arising in the transition zone and in the peripheral zone of the prostate. , 1991, The Journal of urology.

[2]  M W Kattan,et al.  Distinguishing clinically important from unimportant prostate cancers before treatment: value of systematic biopsies. , 1996, The Journal of urology.

[3]  A. D'Amico,et al.  Neoplasms of the Prostate , 2003 .

[4]  T. Stamey,et al.  Biological determinants of cancer progression in men with prostate cancer. , 1999, JAMA.

[5]  D. Bostwick,et al.  The extent and multicentricity of high-grade prostatic intraepithelial neoplasia in clinically localized prostatic adenocarcinoma. , 1997, Human pathology.

[6]  D. Bostwick,et al.  Staging of early prostate cancer: a proposed tumor volume-based prognostic index. , 1993, Urology.

[7]  A S Whittemore,et al.  Localized prostate cancer. Relationship of tumor volume to clinical significance for treatment of prostate cancer , 1993, Cancer.

[8]  E. Jones,et al.  Resection margin status in radical retropubic prostatectomy specimens: relationship to type of operation, tumor size, tumor grade and local tumor extension. , 1990, The Journal of urology.

[9]  R T Vollmer,et al.  Percentage carcinoma as a measure of prostatic tumor size in radical prostatectomy tissues. , 1997, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[10]  D. Bostwick,et al.  Correlation of margin status and extraprostatic extension with progression of prostate carcinoma , 1999, Cancer.

[11]  P. Scardino,et al.  The distribution of residual cancer in radical prostatectomy specimens in stage A prostate cancer. , 1991, The Journal of urology.

[12]  David G. Bostwick,et al.  Urologic Surgical Pathology , 1997 .

[13]  T. Stamey,et al.  Morphometric and clinical studies on 68 consecutive radical prostatectomies. , 1988, The Journal of urology.

[14]  J. McNeal,et al.  Patterns of spread of adenocarcinoma in the prostate as related to cancer volume , 2001, The Prostate.

[15]  E. Bergstralh,et al.  Prostate specific antigen detected prostate cancer (clinical stage T1c): an interim analysis. , 1996, The Journal of urology.

[16]  T. Stamey,et al.  Assessment of morphometric measurements of prostate carcinoma volume , 2000, Cancer.

[17]  D. Gleason,et al.  Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging. , 1974, The Journal of urology.

[18]  D. Bostwick,et al.  Preoperative prediction of surgical margin status in patients with prostate cancer treated by radical prostatectomy. , 2000, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[19]  L. Liotta,et al.  Evidence of independent origin of multiple tumors from patients with prostate cancer. , 1998, Journal of the National Cancer Institute.

[20]  A W Partin,et al.  Is tumor volume an independent predictor of progression following radical prostatectomy? A multivariate analysis of 185 clinical stage B adenocarcinomas of the prostate with 5 years of followup. , 1993, The Journal of urology.

[21]  M E Hammond,et al.  Prognostic factors in colorectal cancer. College of American Pathologists Consensus Statement 1999. , 2000, Archives of pathology & laboratory medicine.

[22]  A. Renshaw.  Visual estimate of the percentage of carcinoma is an independent predictor of prostate carcinoma recurrence after radical prostatectomy , 2002, Cancer.

[23]  J. Cheville,et al.  Cancer volume of lymph node metastasis predicts progression in prostate cancer. , 1998, The American journal of surgical pathology.

[24]  D. Bostwick,et al.  Recommendations for the reporting of resected prostate carcinomas , 1997, Human pathology.

[25]  R. Fechner.  Recommendations for the reporting of resected prostate carcinomas , 1996, Virchows Archiv.

[26]  D. Bostwick,et al.  Staging of prostate cancer. , 1994, Seminars in surgical oncology.

[27]  P. Humphrey,et al.  Prospective characterization of pathological features of prostatic carcinomas detected via serum prostate specific antigen based screening. , 1996, The Journal of urology.

[28]  A. Renshaw.  Correlation of gross morphologic features with histologic features in radical prostatectomy specimens. , 1998, American journal of clinical pathology.

[29]  P. Walsh,et al.  Pathological factors that influence prognosis in stage A prostatic cancer: the influence of extent versus grade. , 1981, The Journal of urology.

[30]  T. Stamey,et al.  The pathological features and prognosis of prostate cancer detectable with current diagnostic tests. , 1994, The Journal of urology.

[31]  T. Stamey,et al.  PATTERNS OF PROGRESSION IN PROSTATE CANCER , 1986, The Lancet.

[32]  A. Renshaw,et al.  Estimation of tumor volume in radical prostatectomy specimens in routine clinical practice. , 1997, American journal of clinical pathology.

[33]  M E Hammond,et al.  Updated protocol for the examination of specimens from patients with carcinomas of the prostate gland: a basis for checklists. Cancer Committee. , 2000, Archives of pathology & laboratory medicine.

[34]  A. Renshaw,et al.  Maximum diameter of prostatic carcinoma is a simple, inexpensive, and independent predictor of prostate-specific antigen failure in radical prostatectomy specimens. Validation in a cohort of 434 patients. , 1999, American journal of clinical pathology.

[35]  D. Bostwick,et al.  The definition and preoperative prediction of clinically insignificant prostate cancer. , 1996, JAMA.

[36]  D. Bostwick,et al.  Recommendations for the reporting of resected prostate carcinomas. Association of Directors of Anatomic and Surgical Pathology. , 1996, American journal of clinical pathology.

[37]  R. Haggitt,et al.  Association of Directors of Anatomic and Surgical Pathology: recommendations for the reporting of resected esophageal carcinomas. , 2000, Virchows Archiv : an international journal of pathology.

[38]  P. Humphrey,et al.  Intraglandular tumor extent and prognosis in prostatic carcinoma: application of a grid method to prostatectomy specimens. , 1990, Human pathology.

[39]  Daniel S. Miller,et al.  Prognostic factors in prostate cancer. College of American Pathologists Consensus Statement 1999. , 2000, Archives of pathology & laboratory medicine.

[40]  Liang Cheng,et al.  Anatomic distribution of periprostatic adipose tissue , 2003, Cancer.

[41]  P. Troncoso,et al.  Tumor volume and prostate specific antigen: implications for early detection and defining a window of curability. , 1995, The Journal of urology.