Anterior or Posterior Prostate Cancer Tumor Nodule Location Predicts Adverse Outcomes at Radical Prostatectomy

A study aimed to assess the significance of tumor nodule (TN) location with respect to extraprostatic extension (EPE), seminal vesicle invasion (SV+), and positive margin status (SM+) in radical prostatectomy (RP) for prostate cancer. The results were published in Archives of Pathology & Laboratory Medicine.

To conduct this analysis, researchers graded, staged, and assessed TN at RP. TNs with at least 80% of their volume occupying either the anterior or posterior part of the prostate were categorized accordingly and included for analysis. In total, this analysis scored a total of 3,570 TNs (37% anterior TNs, and 63% posterior TNs).

Posterior TNs were more likely to be higher grade and exhibit EPE (18.0% versus 9.4%; P <0.001) and SV+ (4.0% versus 0.2%; P <0.001). Anterior TNs with EPE were more likely to exhibit SM+ than posterior TNs with EPE (62% versus 30.8%, P <0.001). TN location, grade, and volume were significant factors associated with adverse RP outcomes in our univariable analysis. When controlled for grade and tumor volume in a multivariable analysis using anterior TN location as a reference, posterior TN location was shown to be an independent predictor of EPE and SV+ and was less likely to be associated with SM+ (odds ratio=3.1, 81.5, and 0.7, respectively).

The investigators concluded that these findings “may be useful in preoperative surgical planning, particularly with respect to improving radiographic analysis of prostate cancer.”