Pompe RS, Neumann T, Kühnke L, Preisser F, Gild P, Tennstedt P, Salomon G, Huland H, Tilki D. Validation of the updated eighth edition of AJCC for prostate cancer: Removal of
pT2 substages - Does extent of tumor involvement matter?
Urol Oncol 2020;
38:637.e1-637.e7. [PMID:
32245678 DOI:
10.1016/j.urolonc.2020.01.005]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/02/2020] [Accepted: 01/11/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND
Updates in the eighth edition of the AJCC prostate cancer staging manual include removal of the organ-confined (pT2) substages.
METHODS
Retrospective analyses of 12,028 pT2 patients that underwent radical prostatectomy between 2003 and 2016 and did not receive neo- or adjuvant treatments. Kaplan-Meier curves as well as multivariable Cox-regression analyses compared biochemical recurrence (BCR), metastatic progression (MP) and overall mortality (OM) between the 3 subcategories (pT2a, pT2b and pT2c).
RESULTS
After surgery, 1,441 patients were classified as pT2a, 126 as pT2b and 10.495 as pT2c. Five-year BFS rates for pT2a, pT2b and pT2c were 92.0% vs. 97.4% vs. 88.0%. For the same groups, 5-year MP-FS rates were 99.5% vs. 100% vs. 99.0% and 5-year OS rates were 98.0% vs. 98.2% vs. 97.7%. In multivariable analyses pT2 substratification did not reach independent predictor status for biochemical recurrence, MP or overall mortality.
CONCLUSIONS
Substratification of pT2 prostate cancer was not predictive for further disease progression. Therefore, removing the substages simplifies the staging system without loss of important information.
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