CLINICO"MORPHOLOGICAL PREDICTORS OF DISTANT METASTASES AFTER RADICAL PROSTATECTOMY IN PATIENTS WITH PROSTATE CANCER

Abstract

THE AIM of the investigation was to reveal clinicomorphological predictors of distant metastases after radical retropubic prostatectomy in prostate cancer patients and to create a prognostic mathematical model of the appearance of this complication. РATIENTS AND METHODS. An analysis of incidence of distant metastases was made in 150 patients with localized forms of prostate cancer after radical retropubic prostatectomy with special reference to clinicomorphological factors of risk of this complication. The maximal period of the dynamic followup was 5 years. RESULTS. It was found that the leading risk factors of the appearance of distant metastases proved to be clinical and morphological factors: ingrowth of the tumor into the seminal vesicles by the data of transrectal ultrasonography (F=20.94; p<0.00001) and the degree of tumor differentiation in transrectal biopsy of the prostate (F=26.51; p<0.00001), as well as extracapsular spread of the tumor by the data of a morphological examination of the operation material (F=21.84; p<0.000001). The linear discriminant analysis was used to make a mathematical model which allowed prognosis of the appearance of distant metastases of prostate cancer in 96.6% of cases (l=0.54; p<0.000001). CONCLUSION. Prediction of the appearance of distant metastases of prostate cancer after radical prostatectomy should be made with regard for clinicomorphological factors of risk of this complication.