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KMID : 0358320060470060578
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Korean Journal of Urology
2006 Volume.47 No. 6 p.578 ~ p.585
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The Anatomic Distribution and Pathological Characteristics of Prostate Cancer: A Mapping Analysis
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Kang Tae-jin
Song Cheryn
Song Gee-Hyun
Shin Gil-Hyun
Shin Dong-Ik
Kim Choung-Soo
Ahn Han-Jong
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Abstract
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Purpose: We mapped the location of prostate cancer in Korean men, and investigated the volume and tumor distribution in relation to clinicopathological variables.
Materials and Methods: The volume of cancer and the anatomic location of each tumor foci were determined from 186 radical prostatectomy specimens, which were digitized to fit into a prototype prostate model. Using the computer-based digital images, the zonal cancer volume and distributional frequency were analyzed with respect to the clinical and pathological parameters, which were demonstrated in gray scales.
Results: The preoperative serum prostate-specific antigen(PSA) level ranged from 2.0 to 38.9ng/ml. The mean cancer volume of the 186 specimens was 4.5ml(median 1.9ml, range 0.01-37.7). The impalpable cancers were located more anteriorly and in the transition zone, and were also were smaller in volume(2.7ml vs. 5.5ml, p=0.004) than the palpable cancers. Cancers with seminal vesicle invasion were located more medially in the peripheral zone, and were larger in volume than organ-confined cancers or cancers with extracapsular extension (13.2ml vs. 3.0ml, p＜0.001). For Gleason scores of 2-6, 7, and 8-10, the mean cancer volumes were 2.2, 3.7 and 8.2ml, respectively (p＜0.001). High grade cancers were located more medially in the peripheral zone, especially when approaching the apex.
Conclusions: T1c cancers are located more anteriorly and in the transition zone; therefore, inclusion of these areas for targeted biopsy may help to improve the detection of cancer in patients with elevated PSA levels and impalpable prostate cancer. A medial location of seminal vesicle invasive cancers may imply an ejaculatory ducts route of invasion rather than a direct extracapsular extension. (Korean J Urol 2006;47:578-585)
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KEYWORD
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Prostate neoplasms, Maps, Tumor burden
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