Visual estimate of percent of carcinoma predicts recurrence after radical prostatectomy

M. Manoharan, Francisco Civantos, Sandy S. Kim, Pablo Gomez, Mark S Soloway

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Purpose: Tumor volume is an important prognosticator for predicting prostate cancer recurrence following radical prostatectomy (RP). We assessed the ability of the visual estimate of the percent of carcinoma (VEPC) to predict recurrence. Methods and Materials: As performed by 1 surgeon (MSS), 1,114 men underwent radical prostatectomy between 1992 and February 2002. Patients who had less than 12 months of followup, who underwent salvage RP or in whom VEPC was not assessed in the pathology specimen were excluded. VEPC and other clinical variables were analyzed. We performed univariate analysis using the Kaplan-Meier log rank test. Multivariate analysis using Cox proportional hazards regression was performed. Results: A total of 692 patients with a mean age of 61 ± 7 years met the criteria for this analysis. Mean followup was 52 ± 30 months. Of the patients 17% had biochemical recurrence. Mean VEPC was 25% and 13% in those with and without recurrence, respectively. On univariate analysis all variables were significant predictors of recurrence. However, multivariate analysis showed that the only significant predictors of recurrence were patient age, initial prostate specific antigen 10 ng/ml or greater, RP Gleason 8 to 10, extraprostatic extension, seminal vesicle involvement and VEPC. Based on disease-free survival curves patients were stratified into 3 broad groups, namely low, intermediate and high volume. The HR for biochemical recurrence was 2.1 for the intermediate VEPC group (9.1% to 20%) and 2.7 for the high VEPC group (greater than 20%). In the reference group it was less than 9% (low volume). Conclusions: VEPC is a simple and inexpensive method that is an independent predictor of recurrence after RP.

Original languageEnglish (US)
Pages (from-to)1194-1198
Number of pages5
JournalJournal of Urology
Issue number4 I
StatePublished - Oct 1 2003


  • Local neoplasm recurrence
  • Prostate
  • Prostatectomy
  • Prostatic neoplasms

ASJC Scopus subject areas

  • Urology


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