Larger tumours tied to prostate cancer biochemical recurrence

In patients with localized prostate cancer (PCa), higher tumour volume (TV) appears to cut biochemical recurrence-free survival short, a recent study has found.

Researchers conducted a retrospective analysis of 2,394 PCa patients who had undergone radical prostatectomy (RP). Kaplan-Meier and Cox proportional analyses were performed to assess the impacts of TV and the tumour-prostate ratio (TV/PV) on patient postoperative prognosis.

The mean prostate and TVs at baseline were 36.5 and 5.9 cc, respectively. Receiver operating curve analysis showed that at a TV of 5.27 cc, the Youden’s score for biochemical recurrence would reach its maximum value. Such a threshold for TV/PV was found to be at 16.7 percent.

Using such thresholds, participants were grouped into high and low TV and TV/PV subgroups. Those in the high TV and TV/PV groups had significantly worse clinical characteristics, including prostate-specific antigen levels and tumour pathologic stage.

Kaplan-Meier analysis revealed that compared with patients of low TV and TV/PV, biochemical recurrence-free survival was significantly shorter in those with high TV and TV/PV (p<0.001). Such an effect was confirmed in multivariate analysis, which identified both TV (hazard ratio [HR], 1.01, 95 percent confidence interval [CI], 1.00–1.02; p<0.001) and TV/PV (HR, 1.00, 95 percent CI, 0.99–1.01; p=0.003) as significant correlates of biochemical recurrence-free survival.

“We believe that we provided the most recent data regarding the actual epidemiology of TV in patients treated with radical prostatectomy, which makes our study clinically meaningful,” the researchers said. “Further study with more detailed data on tumour location and multifocality is required to understand the nature of PCa.”