Does big mean bad? The correlation between prostate cancer tumour volume and oncological outcomes
BAUS ePoster online library. Raison N. 11/10/20; 304258; P10-9
Mr. Nicholas Raison
Mr. Nicholas Raison
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Does big mean bad? The correlation between prostate cancer tumour volume and oncological outcomes

Raison N1, Bertoncelli M1, Shah T1, Servian P1, Ahmed H1,2, Winkler M1,2
1Imperial College Healthcare NHS Trust, London, United Kingdom, 2Imperial College London, United Kingdom

Introduction:
Risk stratification in prostate cancer remains inadequate. Many approaches lack granularity whilst more advanced models are complex and poorly validated. We examine the role of tumour volume in predicting oncological outcomes following radical prostatectomy.

Patients and Methods:
A prospectively collected multi-surgeon database of patients undergoing minimally invasive radical prostatectomy was analysed. Demographic data, tumour volume measured on the final specimen and oncological outcomes (biochemical recurrence (BCR), metastases, time to further treatment) were collected with a minimum of 2 years follow up. Univariate analyses of the association between tumour volume and rate of BCR and metastases was performed using independent T tests. Cox's regression was used to assess survival time to adjuvant treatment (ADT or radiotherapy) between large and small tumour volume as determined by the previous univariate analysis controlling for prostate size, PSA, BMI, T stage, grade group, specimen size.

Results:
465 patients were included with a complete mean follow up of 88.9 ± 34.3 months. Statistically significant differences in tumour size were seen in patients with and without BCR (4.9mm vs 2.6mm, p<0.0001) and metastases (11.2mm vs 3.2mm, p<0.0001). Survival analysis demonstrated significantly higher risk of adjuvant treatment with tumour sizes over 4.86mm, p<0.0001 with tumour volume a significant independent predictor, Exp (B)= 2.35, p=0.001).

Conclusions:
Our analysis shows that tumour volume is an independent marker for disease severity. Conventional pathological staging parameters such as ECE may be surrogates of tumour volume. Preoperative MRI imaging offers the potential for preoperative tumour volume assessment to aid risk stratification.
Does big mean bad? The correlation between prostate cancer tumour volume and oncological outcomes

Raison N1, Bertoncelli M1, Shah T1, Servian P1, Ahmed H1,2, Winkler M1,2
1Imperial College Healthcare NHS Trust, London, United Kingdom, 2Imperial College London, United Kingdom

Introduction:
Risk stratification in prostate cancer remains inadequate. Many approaches lack granularity whilst more advanced models are complex and poorly validated. We examine the role of tumour volume in predicting oncological outcomes following radical prostatectomy.

Patients and Methods:
A prospectively collected multi-surgeon database of patients undergoing minimally invasive radical prostatectomy was analysed. Demographic data, tumour volume measured on the final specimen and oncological outcomes (biochemical recurrence (BCR), metastases, time to further treatment) were collected with a minimum of 2 years follow up. Univariate analyses of the association between tumour volume and rate of BCR and metastases was performed using independent T tests. Cox's regression was used to assess survival time to adjuvant treatment (ADT or radiotherapy) between large and small tumour volume as determined by the previous univariate analysis controlling for prostate size, PSA, BMI, T stage, grade group, specimen size.

Results:
465 patients were included with a complete mean follow up of 88.9 ± 34.3 months. Statistically significant differences in tumour size were seen in patients with and without BCR (4.9mm vs 2.6mm, p<0.0001) and metastases (11.2mm vs 3.2mm, p<0.0001). Survival analysis demonstrated significantly higher risk of adjuvant treatment with tumour sizes over 4.86mm, p<0.0001 with tumour volume a significant independent predictor, Exp (B)= 2.35, p=0.001).

Conclusions:
Our analysis shows that tumour volume is an independent marker for disease severity. Conventional pathological staging parameters such as ECE may be surrogates of tumour volume. Preoperative MRI imaging offers the potential for preoperative tumour volume assessment to aid risk stratification.
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