[TNM-Classification of localized prostate cancer : The clinical T-category does not correspond to the required demands].

Autor: Herden J; Klinik und Poliklinik für Urologie, Uro-Onkologie, spezielle urologische und roboter-assistierte Chirurgie, Universitätsklinikum Köln, Kerpener Straße 62, 50937, Köln, Deutschland. jan.herden@uk-koeln.de., Heidenreich A; Klinik und Poliklinik für Urologie, Uro-Onkologie, spezielle urologische und roboter-assistierte Chirurgie, Universitätsklinikum Köln, Kerpener Straße 62, 50937, Köln, Deutschland., Weißbach L; Stiftung Männergesundheit, Berlin, Deutschland.
Jazyk: němčina
Zdroj: Der Urologe. Ausg. A [Urologe A] 2016 Dec; Vol. 55 (12), pp. 1564-1572.
DOI: 10.1007/s00120-016-0264-5
Abstrakt: Background: The TNM staging system for localized prostate cancer (PCa) divides tumors based on clinical parameters into a clinical (c)T category and, after radical prostatectomy (RP), a pathological (p)T category.
Objectives: This study examines the extent to which the cT and the pT category correspond to each other and whether the two categories differ in their prediction for organ-confined disease.
Patients and Methods: Data of 687 RP patients were collected in a prospective, noninterventional, multicenter health service research study for the treatment of localized PCa (HAROW). Group comparisons were performed by analysis of variance and student t‑test as well as the chi-squared test or the Fisher exact test.
Results: Clinical cT1 category (62.9%) and pathological pT2c category (56.6%) were diagnosed most frequently. The correspondence of cT and pT category was 15% for cT2a , 10.5% for cT2b, and 55% for cT2c. An extraprostatic extension (≥pT3) was observed for the categories cT1 and cT2 in 23.5% and 36.4% (p < 0.001), differences in the subcategories cT2a-c were not significant: cT2a = 28.8%, cT2b = 42.1%, and cT2c = 38.8% (p = 0.194). Tumors with a pathologically extraprostatic extension were not recognized clinically in >50%.
Conclusions: For localized PCa there is low agreement between clinical and pathologic T category, thus, often leading to understaging. An adaptation of the T classification of the TNM system with division into "not palpable" and "palpable" appears sufficient for a prognostic prediction.
Databáze: MEDLINE
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