The association between tumour density and prostate cancer recurrence following radical prostatectomy

Authors

  • Luke T. Lavallée Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON
  • Rodney H. Breau Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON
  • Mark A. Preston Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON
  • Gayanna Raju Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON
  • Christopher Morash Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON
  • Steve Doucette Ottawa Hospital Research Institute, Ottawa, ON
  • Ronald G. Gerridzen Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON
  • James Eastham Department of Surgery, Urology Service, Memorial Sloan-Kettering Cancer Center, New York, NY
  • Ilias Cagiannos Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON

DOI:

https://doi.org/10.5489/cuaj.727

Abstract

Purpose: Tumour density (TD) may be an independent prognostic
factor in men with prostate cancer. The purpose of this study was
to evaluate the association between prostate cancer TD and recurrence
following radical prostatectomy.

Materials and Methods: Between 1995 and 2007, 645 patients
from The Ottawa Hospital or Memorial Sloan-Kettering Cancer
Center who had cancer and prostate volumes measured from radical
prostatectomy specimens. Tumour density was defined as the
relative tumour to prostate volume (tumour volume/prostate volume)
and recurrence was defined as a prostate-specific antigen
(PSA) >0.2 ng/mL and rising, or postoperative use of radiation or
hormonal therapy. Associations between TD and recurrence are
adjusted for preoperative PSA, prostatectomy Gleason sum, tumour
stage and margin status.

Results: Median follow-up was 40.8 months. Tumour density was
associated with preoperative PSA, Gleason sum, tumour stage and
surgical margin status (all p < 0.0001). As a continuous variable,
TD predicted recurrence-free survival (adjusted HR 1.34 per 10%
increase in TD; p = 0.04). As a categorical variable, the group
of patients with a TD of >10% had a 2.7 times greater hazard of
recurrence compared to patients with a TD <5% (95%CI 1.41,
5.19; p = 0.003). Despite the independent association between
TD and recurrence, the clinical value of TD remains in question as
the discriminative performance (area under the curve) of predictive
models only improved from 0.865 to 0.876.

Conclusions: Prostate cancer TD is associated with known prognostic
factors and is also independently predictive of recurrence
following radical prostatectomy.

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Author Biographies

Luke T. Lavallée, Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON

Rodney H. Breau, Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON

Mark A. Preston, Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON

Gayanna Raju, Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON

Christopher Morash, Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON

Steve Doucette, Ottawa Hospital Research Institute, Ottawa, ON

Ronald G. Gerridzen, Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON

James Eastham, Department of Surgery, Urology Service, Memorial Sloan-Kettering Cancer Center, New York, NY

Ilias Cagiannos, Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, ON

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How to Cite

Lavallée, L. T., Breau, R. H., Preston, M. A., Raju, G., Morash, C., Doucette, S., … Cagiannos, I. (2013). The association between tumour density and prostate cancer recurrence following radical prostatectomy. Canadian Urological Association Journal, 5(6), 397–401. https://doi.org/10.5489/cuaj.727

Issue

Vol. 5 No. 6 (2011): December

Section

Original Research

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