Maximum diameter of prostatic carcinoma is a simple, inexpensive, and independent predictor of prostate-specific antigen failure in radical prostatectomy specimens - Validation in a cohort of 434 patients

The amount of tumor in radical prostatectomy specimens can be determined wi th several techniques. Maximum tumor diameter correlates well with total tu mor volume and can readily be obtained in incompletely submitted specimens. Initial results in a small series suggested that this measure also may pre dict for prostate-specific antigen (PSA)failure. We studied whether maximum tumor diameter was an independent predictor of PSA failure in a series of 434 men who underwent radical prostatectomy because of prostatic adenocarci noma; 118 (27.2%) had PSA failure. Preoperative PSA, Gleason score, patholo gic stage, margin status, and largest tumor diameter were determined, and m ultivariate logistic modeling was performed on the outcome of PSA failure. Maximum tumor diameter was an independent risk factor for PSA failure, alon g with preoperative serum PSA level, and Gleason score greater than or equa l to 8. Only 15% of men with firmer with maximum diameter <1 cm had PSA fai lure, compared with 73% of men with tumor with maximum diameter >2. Maximum tumor diameter of prostatic carcinoma is a simple, inexpensive, and indepe ndent predictor of PSA failure that can be obtained readily from partially submitted radical prostatectomy specimens.