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Tumour Volume in prostate cancer: Some more evidence for it’s importance.

TissuPath research

We were recently chatting amongst ourselves about the link between calculated tumour volume and pathological variables known to be prognostically significant (eg. extraprostatic extension (EPE), positive pathological margins etc). One of the things raised was whether there was any identifiable breakpoints or specific relationship between tumour volume and these adverse pathological variables.

As part of a review of data from the surgical cases from two of our clinicians for another study (Mr Mark Frydenberg and Mr Laurence Harewood), we looked at the relationship between tumour volume, extraprostatic extension (EPE), seminal vesicle invasion (SVI) and primary Gleason pattern. The graphs of these data are quite informative.

Fig 1. Relation between calculated prostate tumour volume and other pathological prognostic variables

Fig 2. Tumor Volume in prostate cancer: Some more evidence for it's importance.

We ascertained several trends from the analysis which are evident on the above diagrams (Fig 1 and 2)

  • tumours of <1 cm³ seem to have a very low risk of having either EPE or SVI, with no tumours <0.5cm³ showing either variable.
  • the risk of EPE steadily increases in tumours >1 cm³.
  • SVI was not seen in tumours of <2cm³, then becomes more prevalent as tumour volume increases, with a sharp increase around a tumour volume of 10cm³.
  • Interestingly, tumours with primary Gleason pattern 4/5 are found at all tumour volumes, admittedly with a lower frequency at lower volumes.

This is certainly in keeping with the “insiginificant” prostate cancer, but also provides a rational for getting the high Gleason grade tumours out before they get too big.

Very happy to hear and discuss others thoughts and opinions on the topic so leave a message below or speak to one of us directly through the lab

Prof John Mills and Dr Andrew Ryan.

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