Appropriate Candidates for Hemiablative Focal Therapy Are Infrequently Encountered Among Men Selected for Radical Prostatectomy in Contemporary Cohort

Basir Tareen, Alexander I. Sankin, Guilherme Godoy, Steve Temkin, Herbert Lepor, Samir S. Taneja

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objectives: To assess the prevalence and pathologic features of men with unilateral prostate cancer at radical prostatectomy (RP), because it has recently been proposed that men with small-volume, well-differentiated, unilateral prostate cancer can be treated with focal therapy. Methods: The records of 1467 consecutive men who underwent open RP by a single surgeon from January 2000 to June 2007 were reviewed after institutional review board approval. The RP pathologic reports were analyzed to determine the frequency of unilateral or bilateral disease, surgical margin status, presence of extracapsular extension, seminal vesicle invasion, Gleason score, percentage of tumor involvement (PTI), prostate-specific antigen (PSA) level, and prostate volume. Logistic regression analysis was performed to analyze the relationship between these factors and the detection of unilateral disease. Results: Unilateral cancer was identified in 313 of 1467 patients (21.3%). Of these patients, 206 had a PTI of ≤5%, 40 had a PTI of 5%-10%, 8 had a PTI of 10%-15%, and 40 had a PTI >15%. The factors significantly associated with unilateral disease on univariate analysis were PTI, PSA level, pathologic Gleason score, seminal vesicle invasion, and extracapsular extension. The PSA level and seminal vesicle invasion remained significant predictors on multivariate analysis. Overall, 163 men (11.1%) had unilateral, low-risk disease (defined as a PSA level

Original languageEnglish (US)
Pages (from-to)351-354
Number of pages4
JournalUrology
Volume73
Issue number2
DOIs
StatePublished - Feb 2009
Externally publishedYes

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Prostatectomy
Prostate-Specific Antigen
Seminal Vesicles
Neoplasms
Neoplasm Grading
Therapeutics
Prostatic Neoplasms
Research Ethics Committees
Prostate
Multivariate Analysis
Logistic Models
Regression Analysis

ASJC Scopus subject areas

  • Urology

Cite this

Appropriate Candidates for Hemiablative Focal Therapy Are Infrequently Encountered Among Men Selected for Radical Prostatectomy in Contemporary Cohort. / Tareen, Basir; Sankin, Alexander I.; Godoy, Guilherme; Temkin, Steve; Lepor, Herbert; Taneja, Samir S.

In: Urology, Vol. 73, No. 2, 02.2009, p. 351-354.

Research output: Contribution to journalArticle

Tareen, Basir ; Sankin, Alexander I. ; Godoy, Guilherme ; Temkin, Steve ; Lepor, Herbert ; Taneja, Samir S. / Appropriate Candidates for Hemiablative Focal Therapy Are Infrequently Encountered Among Men Selected for Radical Prostatectomy in Contemporary Cohort. In: Urology. 2009 ; Vol. 73, No. 2. pp. 351-354.
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abstract = "Objectives: To assess the prevalence and pathologic features of men with unilateral prostate cancer at radical prostatectomy (RP), because it has recently been proposed that men with small-volume, well-differentiated, unilateral prostate cancer can be treated with focal therapy. Methods: The records of 1467 consecutive men who underwent open RP by a single surgeon from January 2000 to June 2007 were reviewed after institutional review board approval. The RP pathologic reports were analyzed to determine the frequency of unilateral or bilateral disease, surgical margin status, presence of extracapsular extension, seminal vesicle invasion, Gleason score, percentage of tumor involvement (PTI), prostate-specific antigen (PSA) level, and prostate volume. Logistic regression analysis was performed to analyze the relationship between these factors and the detection of unilateral disease. Results: Unilateral cancer was identified in 313 of 1467 patients (21.3{\%}). Of these patients, 206 had a PTI of ≤5{\%}, 40 had a PTI of 5{\%}-10{\%}, 8 had a PTI of 10{\%}-15{\%}, and 40 had a PTI >15{\%}. The factors significantly associated with unilateral disease on univariate analysis were PTI, PSA level, pathologic Gleason score, seminal vesicle invasion, and extracapsular extension. The PSA level and seminal vesicle invasion remained significant predictors on multivariate analysis. Overall, 163 men (11.1{\%}) had unilateral, low-risk disease (defined as a PSA level",
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