A Modified Partın Table to Better Predict Extracapsular Extensıon in Clinically Localized Prostate Cancer.

Area of Science:

• Urology
• Oncology
• Pathology

Background:

• Accurate prediction of extracapsular extension (ECE) in clinically localized prostate cancer (PCa) is vital for surgical planning.
• ECE influences treatment decisions, including the extent of surgery and need for adjuvant therapy.

Purpose of the Study:

• To identify predictors of ECE before radical prostatectomy.
• To determine cut-off values for these predictors.
• To compare their accuracy with Partin Table parameters for improved tumor staging.

Main Methods:

• Retrospective analysis of 374 patients with clinically localized PCa undergoing open radical retropubic prostatectomy (RRP).
• Investigation of clinical and pathological variables including Gleason Score, PSA, PSAD, tumor length, and tumor percentage in biopsy cores.

Main Results:

• Prostate-specific antigen density (PSAD), tumor percentage, and tumor length were identified as significant predictors of ECE.
• Established cut-off values: PSA > 8.90 ng/mL, PSAD > 0.26 ng/mL², maximum tumor length > 5mm, and maximum tumor percentage > 50%.

Conclusions:

• Incorporating PSAD, tumor percentage, and tumor length into Partin tables can enhance ECE prediction in PCa.
• These cut-off values aid in treatment strategy, lymphadenectomy, and nerve-sparing surgery decisions during radical prostatectomy.