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Contemporary Pathological Stage Distribution After Radical Prostatectomy in North American High-Risk Prostate Cancer Patients

  • Author Footnotes
    # The two authors contributed equally to the manuscript and should be considered co-first authors.
    Francesco Chierigo
    Correspondence
    Address for correspondence: Francesco Chierigo, MD, Department of Urology, Policlinico San Martino Hospital, University of Genova, Largo Rosanna Benzi 10, 16132, Genova, Italy
    Footnotes
    # The two authors contributed equally to the manuscript and should be considered co-first authors.
    Affiliations
    Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy

    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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  • Author Footnotes
    # The two authors contributed equally to the manuscript and should be considered co-first authors.
    Marco Borghesi
    Footnotes
    # The two authors contributed equally to the manuscript and should be considered co-first authors.
    Affiliations
    Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy

    Department of Urology, IRCCS Policlinico San Martino, Genova, Italy
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  • Christoph Würnschimmel
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada

    Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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  • Rocco Simone Flammia
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada

    Department of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I Hospital, Rome, Italy
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  • Gabriele Sorce
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada

    Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
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  • Benedikt Hoeh
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada

    Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
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  • Lukas Hohenhorst
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada

    Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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  • Zhe Tian
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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  • Fred Saad
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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  • Derya Tilki
    Affiliations
    Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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  • Michele Gallucci
    Affiliations
    Department of Maternal-Child and Urological Sciences, Sapienza Rome University, Policlinico Umberto I Hospital, Rome, Italy
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  • Alberto Briganti
    Affiliations
    Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
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  • Francesco Montorsi
    Affiliations
    Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
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  • Felix K.H. Chun
    Affiliations
    Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
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  • Shahrokh F. Shariat
    Affiliations
    Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

    Departments of Urology, Weill Cornell Medical College, New York, NY

    Department of Urology, University of Texas Southwestern, Dallas, TX

    Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic

    Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia

    Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
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  • Guglielmo Mantica
    Affiliations
    Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy

    Department of Urology, IRCCS Policlinico San Martino, Genova, Italy
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  • Nazareno Suardi
    Affiliations
    Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy

    Department of Urology, IRCCS Policlinico San Martino, Genova, Italy
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  • Carlo Terrone
    Affiliations
    Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy

    Department of Urology, IRCCS Policlinico San Martino, Genova, Italy
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  • Pierre I. Karakiewicz
    Affiliations
    Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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  • Author Footnotes
    # The two authors contributed equally to the manuscript and should be considered co-first authors.
Published:April 21, 2022DOI:https://doi.org/10.1016/j.clgc.2022.04.005

      Abstract

      Purpose

      To investigate pathological stage at radical prostatectomy (RP) using the “Partin tables” approach in NCCN high-risk (HR) prostate cancer (PCa) patients.

      Materials and Methods

      Within the SEER 2010 to 2016 database, we identified 7,718 NCCN HR PCa patients. Cross-tabulation was used to illustrate the distribution of organ confined disease (OC, pT2), extra-prostatic extension (EPE, pT3a), seminal vesicles invasion (SVI, pT3b), lymph node invasion (LNI, pT2N1), extra-prostatic and lymph node invasion (EPE + LNI, pT3aN1), and seminal vescicale and lymph node invasion (SVI + LNI, pT3bN1), according to preoperative criteria, which consisted in PSA, clinical T stage, biopsy Gleason Score (GS). Binomial 95%CI was constructed for the reported proportions.

      Results

      Median (IQR) PSA levels was 9 (6-20) ng/ml. The majority of patient harbored cT1c (51%) followed by cT2 (35%) and cT3 (14%) stage. Most patients exhibited GS 4+4 (43%). Overall, 87 vs. 15 vs. 2% of patients harbored only 1 vs. 2 vs. all 3 HR criteria. At RP, OC, EPE, SVI, and LNI rates were respectively 36%, 27%, 17%, and 19%.
      Highest levels of OC were recorded for cT1c, PSA <10 ng/mL and biopsy GS4+4. Conversely, EPE, SVI and LNI were the highest in patients with cT3, PSA ≥20 ng/mL and GS 5+5. After stratification according to clinical stages, OC rates decreased with increasing PSA levels and GS. Conversely, EPE, SVI and LNI rates increased with increasing PSA and GS.

      Conclusion

      We provide a lookup table to illustrate the relationship between clinical and pathological characteristics in NCCN HR PCa patients.

      Keywords

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