Carini, Marco

Gontero, P.

Lanciotti, Michele

Mantella, A.

Marchioro, G.

Masieri, L.

Minervini, Andrea

Serni, S.

Zaramella, S.

English

Florence Research

Eur Urol Suppl 2008;7(3):153P20 PROSTATE CANCER: PROGNOSTIC FACTORS AND PREDICTORS OF OUTCOMEThursday, 27 March, 09.15-10.45, Yellow Hall 2-3 328PSA DENSITY IS A STRONGER PROGNOSTIC FACTOR THANPSA FOR ADVERSE FINAL HISTOPATHOLOGIC OUTCOMES AND BIOCHEMICAL PROGRESSION FREE SURVIVAL IN CT3A PROSTATECANCERJoniau S., Hsu C.Y., Van Poppel H.University Hospital Leuven, Dept. of Urology, Leuven, BelgiumIntroduction & Objectives: We were interested in factors that allow the best PRE-treatment prognostic information in ????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????Nevertheless, PSA and bGS are poor predictors of biochemical progression free survival (BPFS). The objective of this study ??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????Material & Methods: ?????????????????????????????????????????????????????????????????????????????????????????????????????examination, underwent RP and bilateral lymphadenectomy at our institution. The preoperative serum PSA, PSAD and bGS of each patient were recorded. Outcome variables were margin status, seminal vesicle invasion, nodal status and BPFS. ??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????PSAD and PSA, corrected for bGS.Results: ???? ?????????????????????????????????????? ??????????????????????? ???????????????????????? ??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????at 10 years. In both uni-and multivariate logistic regression analysis and Cox analysis, PSAD proved to be an independent, ?????????????????????????????????????????????????????????????????????????????????????????????????????????????????Univariate MultivariateHR 95%CI p HR 95%CI pMargin PSAD ???? ?????????? <0.01 PSAD bGS 8.82 2.92-26.61 <0.01PSA 1.04 1.02-1.07 <0.01 1.15 0.89-1.48 0.27bGS 1.15 0.91-1.47 0.24 PSA bGS 1.04 1.02-1.07 <0.011.17 0.91-1.50 0.22Node PSAD 6.22 ?????????? <0.01 PSAD bGS 5.95 ?????????? <0.01PSA 1.02 0.99-1.05 0.08 1.29 ????????? 0.25bGS ???? ????????? 0.20 PSA bGS 1.02 0.99-1-05 0.08???? 086-2.05 0.20SVI PSAD 10.94 ?????????? <0.01 PSAD bGS 11.55 ?????????? <0.01PSA 1.07 1.04-1.11 <0.01 ???? ????????? ????bGS 1.41 ????????? ???? PSA bGS 1.08 1.04-1.12 <0.011.51 1.07-2.12 0.02Cox regression analysisUnivariate MultivariateHR 95%CI p HR 95%CI pBPFS PSAD ???? 2.14-7.12 <0.01 PSAD bGS ???? 2.12-7.07 <0.01PSA 1.02 ????????? <0.01 ???? ????????? 0.74bGS 1.05 0.88-1.26 0.19 PSA bGS 1.02 ????????? <0.011.05 0.87-1.26 0.62Conclusions: PSAD is an independent prognostic factor, and is stronger than PSA, in the prediction of adverse ????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????advanced prostate cancer.329THE PROGNOSTIC ROLE OF PREOPERATIVE CHROMOGRANIN A IN CLINICALLY LOCALISED PROSTATE CANCER TREATED WITHRADICAL PROSTATECTOMYMasieri L.1, Gontero P.2, Serni S.1, Marchioro G.?, Mantella A.1, Lanciotti M.1, Zaramella S.?,Minervini A.1, Carini M.11University of Florence, Careggi Hospital, Dept. of Urology, Florence, Italy, 2University of Turin, Dept. of Urology, Turin, Italy, ?University of Piemonte Orientale, Dept. of Urology, Novara, ItalyIntroduction & Objectives: The aim of the present study was to analyze the prognostic values of preoperative CgA as a marker of poor prognosis and recurrence after radical prostatectomy. ????????????????????????????????????????????????????????????????????????????????Material & Methods: ?????????????????????????????????????????????????? ??????????????????????????prospectively recruited who underwent radical prostatectomy from January 2000 to May 2005. A blood sample for the determination of serum preoperative Chromogranine A value (radioimmuno assay CGA-RIACT) was obtained in all cases. All radical prostatectomy specimens were formalin ???????????????????????????????????????????????????????????????????????????????????????????????????2002 American Joint Committee on Cancer (AJCC) staging system. Spearman correlation test was used to compare CgA values and other continuous variables. Kruskal-wallis test was used ??????????????? ?????????????????????????????????????????????????????????????????????????????the Mann Whitney test was used for 2 grouping variables (status). The probability of survival was ???? ???????????????????????????????????????????????????????????????????? ?????????????????????levels of the analyzed variables.Results: ?????????????????????????????????? ??????????????????????????????????????? ???????????????????????????????? ??????????????????????????? ?????????? ?????????????????????????????????????????(p<0.001). Moreover, patients were divided in two groups based on the median age (<68 and ???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????Gleason score (GS 2-6, 7, 8-10) and preoperative PSA (< 10ng/ml, 10-20 ng/ml, > 20 ng/ml) did not ????????????????????????????????????????????????? ???????????????????????????????????????? ??????(18, 1-55 months). Of the 281 patients included in the survival analysis, 208 (74%) were free from ???????????? ??????????? ????????????? ?????????????????????????????? ??????????? ?????????????????????????????????? ???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????Conclusions: Studies on a possible prognostic role in localized hormone naïve prostate cancer ????? ????????? ??????????? ????????? ??? ???? ?????? ???????????? ??????? ????? ?????? ?????????? ??? ????????? ?????? ?? ??????????? ????????? ???????????? ??? ??????????????? ????? ???? ??? ??????????? ????????????correlation with other available variables and progression free survival. A possible explanation of our results could be that NE cells are not enough to raise circulating levels of CgA when dosed inpatients with localized prostate cancers.330PREDICTION OF UNI OR BILATERAL PROSTATE CANCER GLAND’SINVOLVEMENT. IMPLICATIONS FOR NEURO-VASCULAR BUNDLESPRESERVATIONRaventos C.X.1, Orsola A.1, Cecchini L.L.1, Planas J.1, Trilla E.1, De Torres I.2, Morote J.11Hospital Vall d’Hebron, Dept. of Urology, Barcelona, Spain, 2Hospital Vall d’Hebron, Dept. of Pathology, Barcelona, SpainIntroduction & Objectives: ????????? ????????????????????????????????????????????????????????undergo a radical prostatectomy. Cancer distribution on the gland could determine the surgical management of the neurovascular bundles (NVB). The preoperative knowledge of the uni or bilateral gland’s involvement may be useful for NVB preservation. The objective of this study is to know which clinical and biopsy pathological variables can predict uni/bilateral cancer extension on the gland.Material & Methods: We analysed 274 patients who underwent radical prostatectomy. According to cancer gland’s extension on the radical prostatectomy specimen, patients were divided into two groups: one lobe involvement (44,2%) and bilateral disease (55,8%). Clinical variables and parameters based on biopsy were studied as predictors of uni or ?????????????????????????????????????????????????????????????????????????????????????????????of the predictive variables were selected. Besides, correlation between uni/bilateral cancer extension on the gland and prostate cancer burden was studied.Results: ?????????????????????????????????????????????????????????????????????????????????volume, biopsy Gleason interval (<=6 vs. >=7), number of positive cylinders (NPC), percentage of positive cylinders (%PC) and uni-bilaterality of biopsy positive cores. Total ??????????????????? ??????????????????????????????????????????????????????????????????????????On multiple logistic regression, prostate volume (p 0,026) and interval of biopsy Gleason (p 0,016) raised as independent predictors of uni-bilaterality on the specimen. Of note, 50% of unilateral positive biopsy cases had bilateral extension on the gland. This bilateral ???????????????????????? ????????????????????????????????????????????????????????????????????????????????????? ???????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????a prostate volume threshold of >=60cc and biopsy Gleason score <=6 we obtain 94% ????????????????????????????????????????????????Conclusions: Unilateral positive biopsy does not predict one lobe involvement and should not be used as a criteria for NVB preservation. Instead, both prostate volume and biopsy Gleason score might be useful to address NVB preservation. Small glands with biopsy gleason >=7 will more probably present bilateral cancer extension while larger glands with ???????????????????????????????????????????????????? ????? ?????????????????????????? ????NVB preservation.331IS THERE A DIFFERENCE IN SUPERSENSITIVE PSA (SPSA)LEVEL WITH THE SITE OF POSITIVE MARGIN POST RADICALPROSTATECTOMY?Vaidyanathan R.1, Rao A.1, Motiwala H.1, Laniado M.1, Brown R.S.D.2, Karim O.11Wexham Park Hospital, Dept. of Urology, Slough, United Kingdom, 2Wexham Park Hospital, Dept. of Clinical Oncology, Slough, United KingdomIntroduction & Objectives: The apex is a common site for a positive margin post radical prostatectomy. A positive apical margin is, however, not invariably associated ?????????????????????? ???????????????????????????????????????????????????????????????? ????? ??? ???????? ???????? ????????? ??? ?? ????????? ??????? ??? ?????? ?????????margin in prostate cancer.Material & Methods: 159 consecutive radical prostatectomy patients, followed for a minimum of 12 months, were studied retrospectively. Patients were grouped according to pathological stage and sPSA nadir was determined 6 weeks post surgery.Results: ????????????????? ????????????????????????????????????? ?????????????????????????????????????? ???????????????????????? ???????????????????????????????????????????????????????????????????????????????????????Histology Group Number sPSA nadir (mg/L) *P value????????????? ?????????? 96 ????????????Margin Positive (+ve)Apex +ve 18 ???????????? 0.24Other margin +ve 45 ??????????? ?????????????????????????????????????????????????????Conclusions: ??????????? ????????? ????????????????????????? ?????? ????????????????lower in apex positive margin prostate cancer compared to other margins. This ??????? ??? ???????????????? ???? ???????????? ????? ?? ????????? ?????????????? ????? ????invariably indicate residual cancer

THE PROGNOSTIC ROLE OF PREOPERATIVE CHROMOGRANIN A IN CLINICALLY LOCALISED PROSTATE CANCER TREATED WITH RADICAL PROSTATECTOMY

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THE PROGNOSTIC ROLE OF PREOPERATIVE CHROMOGRANIN A IN CLINICALLY LOCALISED PROSTATE CANCER TREATED WITH RADICAL PROSTATECTOMY

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