[Radical prostatectomy in prostate adenocarcinoma. Clinical factors influencing the pathological stage. Diagnostic model].
METHODS
Study on the efficacy of stage diagnosis, how to support it based on clinical objective data and description of a prognostic model. Analysis of 160 patients diagnosed with localized prostate adenocarcinoma undergoing radical prostatectomy in the Clínica Universitaria de Navarra between 1988-1997. The statistical study used Fisher's or Pearson's tests for the comparison of qualitative variables. A logistic regression multivariate analysis was run to avoid confounding factors in the pathological stage.


RESULTS
85/160 (53%) were correctly staged. Incorrect staging occurred in patients with higher clinical stage (T1-T2a: 25%; T2bc: 65%). The univariate study shows that the pathological stage is significantly correlated to: a) serum PSA levels (15 ng/mL in P2 vr. 25 ng/mL in P3-4), the most suitable cutoff value being 15 ng/mL. b) digital rectal examination and Gleason. Negatively influencing factors in the multivariate study were: PSA greater than 15 ng/mL, Gleason greater than 5 and a T2bc clinical stage. Risk groups: 4 risk groups are established based on the above factors (inclusion in group 1 involves an 8% risk of having P3, 30% in group 2, 56% in group 3 and 84% in group 4).


CONCLUSIONS
The clinical factors with influence in the pathological stage are PSA, Gleason and clinical stage. The reliability of the risk groups established based on these factors is remarkable.
Zudaire Bergera
J J
JJ
Servicio de Urología, Clínica Universitaria de Navarra, Universidad de Navarra, Pamplona.
Martín-Marquina Aspiunza
A
A
Sánchez Zalabardo
D
D
Arocena García-Tapia
J
J
Sanz Pérez
G
G
Díez-Caballero Alonso
F
F
Rosell Costa
D
D
Robles García
J E
JE
Berián Polo
J M
JM
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D016015:Logistic Models; D008297:Male; D009367:Neoplasm Staging; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D012306:Risk
Prostatectomía radical en adenocarcinoma de próstata. Factores clínicos influyentes en el estadio patológico. Modelo diagnóstico.