Correlation between Prostate Cancer Volume Determined by Three-Dimensional Computer-Aided Reconstruction of Radical Prostatectomy Specimens and Preoperative PCA3 Score
CW Hann von Weyhern, D Schilling, J Hennenlotter, AE Pelzer, A Stenzl, F Fend. University of Tuebingen, Tuebingen, Germany
Background: DRE (digital-rectal examination) and serum PSA have traditionally been used to aid in biopsy-based diagnosis and decision making for prostate carcinoma. Serum PSA is a widely used marker, but is significantly prone to bias. Recently, a non-invasive test for prostate cancer gene 3 (PCA3) has been developed using voided urine samples. PCA3 is a prostate specific non-coding RNA which is highly overexpressed in more than 95% of primary prostate tumors, with a median 66-fold up-regulation compared with adjacent non-cancer prostate tissues. In this study, we correlated PCA3-score, PSA and overall Gleason score with the tumor volume, tumor location and prostate volume.
Design: 55 patients with biopsy-proven cancer were included in this study between April and September 2008. Initial PCA3 score in voided urine post-DRE and serum PSA were quantified pre-operatively. Radical prostatectomy including regional lymph node dissection was performed. Prostatectomy specimens were whole-mounted and sectioned. Cancer areas were marked on the slides and computer-aided 3D-reconstruction along the urethra was performed.
Results: Mean total serum PSA was 7.6ng/ml (range 3.5-17ng/ml), mean PCA3-score was 48 (range 5-233), mean tumor volume was 1.4ccm (range 0.3-9.9ccm), and the mean prostate specimen volume 28ccm (range 13-95ccm). Using the colliculus spermaticus as topographic reference, tumors were divided in groups according to their distance from the prostatic part of the urethra, using 8, 16 and 32 mm radius as cutoff points. Statistical correlation of PCA3-score with location and tumor volume revealed no significant correlation with overall tumor volume but slight tendency of association (p<0.7) with periurethal location. No correlation was observed between overall Gleason score and more aggressive behaviour (Gleason 7a vs. 7b).
Conclusions: PCA3 is a new diagnostic preoperative tool for diagnosis of prostate cancer which is independent of tumor volume, but shows a trend to higher scores for periurethral tumor localization. No correlation was observed regarding overall Gleason-score. Thus, PCA3-Score is a helpful tool in diagnosis of prostate cancer independent of features like tumor volume at diagnosis or grading. PCA3-score was not dependent of prostate volume or other random bias in contrast to PSA.
Category: Genitourinary (including renal tumors)
Monday, March 22, 2010 1:00 PM
Poster Session II # 128, Monday Afternoon