title: Preoperative predictors of pathologic stage T2a in low-risk prostate cancer: implications for focal therapy.
abstract: OBJECTIVE
  To assess preoperative parameters that may be predictive of pathologic stage T2a disease in low-risk prostate cancer patients.
  
  
  METHODS
  Data from a cohort of 1,495 consecutive men with low-risk prostate cancer who underwent a radical prostatectomy between 1993 and 2009 were evaluated. Preoperative parameter assessment focused on age, race, clinical stage, diagnostic PSA level, biopsy tumor laterality and diagnostic Gleason score. Preoperative parameters were analyzed by univariate and multivariate methods. Kaplan-Meier method was used to evaluate the biochemical disease-free survival.
  
  
  RESULTS
  Among the 1,495 men, 236 (15.8%) had pT2a disease. In univariate analysis, biopsy tumor unilaterality (p < 0.001), diagnostic PSA ≤ 4 ng/ml (p < 0.001) and non-African-American race (p = 0.009) were significant variables. In multivariate analysis, biopsy tumor laterality (OR 0.377; p < 0.001), diagnostic PSA ≤ 4 ng/ml (OR 0.621; p = 0.002) and race (OR 0.583; p = 0.029) were independent predictors. Low-risk patients with pT2a disease showed a better PSA recurrence-free survival rate, compared with men with >pT2a diseases (p = 0.012).
  
  
  CONCLUSIONS
  Biopsy tumor unilaterality, diagnostic PSA ≤ 4 ng/ml and race are independent predictors of pT2a in low-risk prostate cancer. These three preclinical variables may be a useful reference to begin the selection process for focal therapy in men with low-risk prostate cancer.
authors.affiliation: Division of Urology, Department of Surgery, Duke Prostate Center, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Fu
authors.forename: Judd W
authors.initials: JW
authors.lastname: Moul
authors.forename: Lionel L
authors.initials: LL
authors.lastname: Bañez
authors.forename: Leon
authors.initials: L
authors.lastname: Sun
authors.forename: Vladimir
authors.initials: V
authors.lastname: Mouraviev
authors.forename: Donghua
authors.initials: D
authors.lastname: Xie
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Polascik
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D001706:Biopsy / Q000379:methods; D015331:Cohort Studies; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D017430:Prostate-Specific Antigen / Q000096:biosynthesis; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000601:surgery*; D012008:Recurrence; D012306:Risk
chemical_list: D017430:Prostate-Specific Antigen