Perineural invasion and XXXX positivity in addition to Gleason score are significant preoperative predictors of progression after radical retropubic prostatectomy for @entity263 .

@entity1 @entity263 @entity5 @entity3 @entity1758 @entity1486
We assessed the use of clinical stage, serum @entity1486 , DNA ploidy, proliferation, and traditional histologic findings from the biopsy to predict @entity263 progression after radical retropubic prostatectomy. Between 1995 and 1998, 454 consecutive @entity1 with @entity5 on biopsy were treated by radical retropubic prostatectomy. Preoperative serum @entity1486 , clinical stage, Gleason score, percentage of cores and surface area positive for @entity5 , @entity3 , and DNA ploidy and @entity1758 immunostain quantitation by image analysis were evaluated in a multivariate Cox proportional hazards regression model to predict @entity5 progression. @entity5 progression was defined as a postoperative serum @entity1486 level of > or = 0.4 ng/mL, local recurrence, or systemic progression. Mean follow-up was 3.4 years (range 17 days to 5.8 years). @entity5 progression was observed in 73 @entity1 with a mean time to progression of 2.1 years (range 33 days to 5.1 years). Gleason score (p <0.001), @entity1758 @entity5 proliferation (p = 0.008), and @entity3 (p = 0.008) were significantly associated with progression. @entity1 with @entity5 Gleason scores of 7 and >7 had a 2.5-fold and nearly 4-fold increased risk, respectively, of @entity5 progression compared with @entity1 with @entity5 Gleason scores of < or = 6. @entity1 with @entity3 at biopsy were twice as likely to progress compared with @entity1 without @entity3 . Each 1-unit increase in @entity1758 on the natural logarithmic scale increased the risk of @entity5 progression by 64%. @entity5 progression models that include serum @entity1486 and clinical stage may require revision to incorporate @entity3 and @entity1758 proliferative activity in addition to Gleason score.
