Should pathologists routinely report prostate tumour volume? The prognostic value of tumour volume in prostate cancer.
BACKGROUND
The independent prognostic value of tumour volume in radical prostatectomy (RP) specimens is controversial, and it remains a matter of debate whether pathologists should report a measure of tumour volume. In addition, tumour volume might be of value in substaging of pathologic tumour stage (pT2) prostate cancer (PCa).


OBJECTIVE
To assess the prognostic value of PCa tumour volume.


METHODS
The cohort consisted of 344 participants in the European Randomised Study of Screening for Prostate Cancer (ERSPC), Rotterdam section, whose PCa was treated with RP. Mean time of follow-up was 96.2 mo.


METHODS
Tumour volume was measured in totally embedded RP specimens with a morphometric, computer-assisted method and assessed as a continuous variable, as relative tumour volume (tumour volume divided by prostate volume), and in a binary fashion (≥ 0.5 ml or < 0.5 ml). These variables were related to prostate-specific antigen (PSA) progression, local recurrence, or distant metastasis and PCa-related mortality using univariate and multivariable Cox proportional hazards analyses. The analyses were repeated in the subgroup with pT2 tumours.


CONCLUSIONS
Tumour volume was related to tumour stage, Gleason score, seminal vesicle invasion (SVI), and surgical margin status. In univariate analyses, tumour volume and relative tumour volume were predictive for all outcome variables. In multivariable analyses, including age, tumour stage, Gleason score, SVI, and surgical margin status, neither tumour volume nor relative volume were independent predictors of progression or mortality. Tumour volume ≥ 0.5 ml was predictive for PSA recurrence and local and/or distant progression in univariate analyses but not in multivariable analyses. Tumour volume was not predictive for recurrence or mortality in univariate or multivariable analyses in the pT2 subgroup.


CONCLUSIONS
Tumour volume did not add prognostic value to routinely assessed pathologic parameters. Therefore, there seems to be little reason to routinely measure tumour volume in RP specimens.
Wolters
Tineke
T
Department of Pathology, Erasmus MC, Rotterdam, The Netherlands; Department of Urology, Erasmus MC, Rotterdam, The Netherlands. t.wolters@erasmusmc.nl
Roobol
Monique J
MJ
van Leeuwen
Pim J
PJ
van den Bergh
Roderick C N
RC
Hoedemaeker
Robert F
RF
van Leenders
Geert J L H
GJ
Schröder
Fritz H
FH
van der Kwast
Theodorus H
TH
D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D009929:Organ Size; D010336:Pathology / Q000592:standards; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate