Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Maximum tumor diameter: a simple independent predictor for biochemical recurrence after radical prostatectomy

Abstract

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 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.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Han M, Partin AW, Pound CR, Epstein JI, Walsh PC . Long-term biochemical disease-free and cancer-specific survival following anatomic radical retropubic prostatectomy. The 15-year Johns Hopkins experience. Urol Clin North Am 2001; 28: 555–565.

    Article  CAS  PubMed  Google Scholar 

  2. Ward JF, Moul JW . Rising prostate-specific antigen after primary prostate cancer therapy. Nat Clin Pract Urol 2005; 2: 174–182.

    Article  PubMed  Google Scholar 

  3. Kupelian P, Katcher J, Levin H, Zippe C, Klein E . Correlation of clinical and pathologic factors with rising prostate-specific antigen profiles after radical prostatectomy alone for clinically localized prostate cancer. Urology 1996; 48: 249–260.

    Article  CAS  PubMed  Google Scholar 

  4. Hernandez DJ, Nielsen ME, Han M, Trock BJ, Partin AW, Walsh PC et al. Natural history of pathologically organ-confined (pT2), Gleason score 6 or less, prostate cancer after radical prostatectomy. Urology 2008; 72: 172–176.

    Article  PubMed  Google Scholar 

  5. Carvalhal GF, Humphrey PA, Thorson P, Yan Y, Ramos CG, Catalona WJ . Visual estimate of the percentage of carcinoma is an independent predictor of prostate carcinoma recurrence after radical prostatectomy. Cancer 2000; 89: 1308–1314.

    Article  CAS  PubMed  Google Scholar 

  6. Stamey TA, McNeal JE, Yemoto CM, Sigal BM, Johnstone IM . Biological determinants of cancer progression in men with prostate cancer. JAMA 1999; 281: 1395–1400.

    Article  CAS  PubMed  Google Scholar 

  7. Mizuno R, Nakashima J, Mukai M, Ookita H, Nakagawa K, Oya M et al. Maximum tumor diameter is a simple and valuable index associated with the local extent of disease in clinically localized prostate cancer. Int J Urol 2006; 13: 951–955.

    Article  PubMed  Google Scholar 

  8. Mizuno R, Nakashima J, Mukai M, Okita H, Kosugi M, Kikuchi E et al. Tumour length of the largest focus predicts prostate-specific antigen-based recurrence after radical prostatectomy in clinically localized prostate cancer. BJU Int 2009; 104: 1215–1218.

    Article  PubMed  Google Scholar 

  9. Nelson BA, Shappell SB, Chang SS, Wells N, Farnham SB, Smith Jr JA et al. Tumour volume is an independent predictor of prostate-specific antigen recurrence in patients undergoing radical prostatectomy for clinically localized prostate cancer. BJU Int 2006; 97: 1169–1172.

    Article  PubMed  Google Scholar 

  10. Epstein JI, Carmichael M, Partin AW, Walsh PC . 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 follow-up. J Urol 1993; 149: 1478–1481.

    Article  CAS  PubMed  Google Scholar 

  11. Salomon L, Levrel O, Anastasiadis AG, Irani J, De La Taille A, Saint F et al. Prognostic significance of tumor volume after radical prostatectomy: a multivariate analysis of pathological prognostic factors. Eur Urol 2003; 43: 39–44.

    Article  PubMed  Google Scholar 

  12. Kikuchi E, Scardino PT, Wheeler TM, Slawin KM, Ohori M . Is tumor volume an independent prognostic factor in clinically localized prostate cancer? J Urol 2004; 172: 508–511.

    Article  PubMed  Google Scholar 

  13. Ohori M, Kattan M, Scardino PT, Wheeler TM . Radical prostatectomy for carcinoma of the prostate. Mod Pathol 2004; 17: 349–359.

    Article  PubMed  Google Scholar 

  14. Mouraviev V, Mayes JM, Polascik TJ . Pathologic basis of focal therapy for early-stage prostate cancer. Nat Rev Urol 2009; 6: 205–215.

    Article  PubMed  Google Scholar 

  15. Noguchi M, Stamey TA, McNeal JE, Nolley R . Prognostic factors for multifocal prostate cancer in radical prostatectomy specimens: lack of significance of secondary cancers. J Urol 2003; 170: 459–463.

    Article  PubMed  Google Scholar 

  16. Wise AM, Stamey TA, McNeal JE, Clayton JL . Morphologic and clinical significance of multifocal prostate cancers in radical prostatectomy specimens. Urology 2002; 60: 264–269.

    PubMed  Google Scholar 

  17. Renshaw AA, Richie JP, Loughlin KR, Jiroutek M, Chung A, D’Amico AV . 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. Am J Clin Pathol 1999; 111: 641–644.

    Article  CAS  PubMed  Google Scholar 

  18. Renshaw AA, Richie JP, Loughlin KR, Jiroutek M, Chung A, D’Amico AV . The greatest dimension of prostate carcinoma is a simple, inexpensive predictor of prostate specific antigen failure in radical prostatectomy specimens. Cancer 1998; 83: 748–752.

    Article  CAS  PubMed  Google Scholar 

  19. Eichelberger LE, Koch MO, Daggy JK, Ulbright TM, Eble JN, Cheng L . Predicting tumor volume in radical prostatectomy specimens from patients with prostate cancer. Am J Clin Pathol 2003; 120: 386–391.

    Article  PubMed  Google Scholar 

  20. Eichelberger LE, Koch MO, Eble JN, Ulbright TM, Juliar BE, Cheng L . Maximum tumor diameter is an independent predictor of prostate-specific antigen recurrence in prostate cancer. Mod Pathol 2005; 18: 886–890.

    Article  PubMed  Google Scholar 

  21. van Oort IM, Witjes JA, Kok DE, Kiemeney LA, Hulsbergen-vandeKaa CA . Maximum tumor diameter is not an independent prognostic factor in high-risk localized prostate cancer. World J Urol 2008; 26: 237–241.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Dvorak T, Chen MH, Renshaw AA, Loffredo M, Richie JP, D’Amico AV . Maximal tumor diameter and the risk of PSA failure in men with specimen-confined prostate cancer. Urology 2005; 66: 1024–1028.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to H Fukuhara.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fukuhara, H., Kume, H., Suzuki, M. et al. Maximum tumor diameter: a simple independent predictor for biochemical recurrence after radical prostatectomy. Prostate Cancer Prostatic Dis 13, 244–247 (2010). https://doi.org/10.1038/pcan.2010.17

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/pcan.2010.17

Keywords

This article is cited by

Search

Quick links