Scientific Reports (Jul 2021)

Revisiting extraprostatic extension based on invasion depth and number for new algorithm for substaging of pT3a prostate cancer

  • Cheol Keun Park,
  • Yeon Seung Chung,
  • Young Deuk Choi,
  • Won Sik Ham,
  • Won Sik Jang,
  • Nam Hoon Cho

DOI
https://doi.org/10.1038/s41598-021-93340-3
Journal volume & issue
Vol. 11, no. 1
pp. 1 – 10

Abstract

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Abstract Extraprostatic extension (EPE) is a factor in determining pT3a stage in prostate cancer. However, the only distinction in EPE is whether it is focal or non-focal, causing diagnostic and prognostic ambiguity. We substaged pT3a malignancies using classification of EPE to improve personalized prognostication. We evaluated 465 radical prostatectomy specimens with a digital image analyzer by measuring the number, radial distance and two-dimensional square area of the EPE. The most significant cut-off value was proposed as an algorithm for the pT3a substaging system to predict biochemical recurrence (BCR). A combination of the radial distance and the number of EPEs predicted BCR the most effectively. The optimal cut-off criteria were 0.75 mm and 2 mm in radial distance and multifocal EPE (hazard ratio: 2.526, C-index 0.656). The pT3a was subdivided into pT3a1, 2 mm and any number of EPEs or 0.75–2 mm and ≥ 2 EPEs. This combined tier was highly significant in the prediction of BCR-free survival. The combination of radial distance and number of EPEs could be used to subdivide pT3a prostate cancer and may aid in the prediction of BCR.