title: The maximum tumour length in biopsy cores as a predictor of outcome after radical prostatectomy.
abstract: OBJECTIVE
  To evaluate maximum tumour length (MTL) in biopsy cores as a predictor of prostate-specific antigen (PSA)-failure, systemic failure, and death from prostate cancer after radical prostatectomy (RP).
  
  
  METHODS
  We assessed 209 men with clinically localized prostate cancer treated with RP; preoperative variables were correlated with unfavourable pathological characteristics in the RP specimens and with outcome after surgery, using univariate and multivariate analysis.
  
  
  RESULTS
  The median (range) MTL was 4 (0.2-19) mm and correlated with adverse pathological findings, including specimen Gleason score (P = 0.003), pT3 (P < 0.001), seminal vesicle invasion (P < 0.001) and lymph node involvement (P = 0.019) in multivariate analysis. Preoperative PSA (P < 0.001), biopsy Gleason score (P = 0.002), and MTL (P = 0.045) were independent predictors of PSA failure, whereas only MTL remained a predictor of systemic-failure (P < 0.001) and death from prostate cancer (P = 0.004). The median (range) follow-up after surgery was 90 (17-152) months, during which 83 patients had PSA failure, 20 developed systemic failure and 15 died from prostate cancer.
  
  
  CONCLUSIONS
  The MTL correlates well with adverse pathological findings and appears to be an independent predictor of outcome after RP. Patients with a greater MTL might have cancer with an aggressive phenotype and therefore be candidates for more aggressive therapies.
authors.affiliation: Department of Urology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan. norihiro@jikei.ac.jp
authors.forename: Norihiro
authors.initials: N
authors.lastname: Hayashi
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Urashima
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Kuruma
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Arai
authors.forename: Sadahito
authors.initials: S
authors.lastname: Kuwao
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Iwamura
authors.forename: Shin
authors.initials: S
authors.lastname: Egawa
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D012044:Regression Analysis; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen