A Modified Partin Table to Better Predict Extracapsular Extension in Clinically Localized Prostate Cancer

Purpose: Prediction of extracapsular extension (ECE) before radical prostatectomy in clinically localized prostate cancer (PCa) is very important for clinical practice. ECE affects our decision on treatment strategy. The aim of this study is to identify the predictors of ECE, determine cut-off values, and compare them with the accuracy of Partin Table parameters to improve tumor staging in clinical practice. Materials and Methods: 374 patients with clinically localized PCa who underwent open radical retropubic prostatectomy (RRP) were included in this study. Gleason Score (GS), age, digital rectal examination (DRE), prostate specific antigen (PSA), prostate specific antigen density (PSAD), free PSA, Free/Total PSA, prostate volume (PV), number of cores involved, tumor length, and tumor percentage in maximum involved core in biopsy were investigated. Results: PSAD, tumor percentage, and tumor length are predictive factors of ECE. The cut-off values of PSA, PSAD, maximum tumor length, and maximum tumor percentages in predicting ECE are: > 8.90 ng/mL, > 0.26 ng/mL2, >5mm, and >50%, respectively. The cut-off values for Partin extraprostatic extension (EPE) and organ confined (OC) disease are >29% and <= 64%, respectively. Conclusion: Partin tables could better predict extracapsular extension in clinically localized PCa if they include PSAD, tumor percentage, and tumor length. The cut-off values of these predictive factors can be beneficial in treatment strategies and in the decisions of lymphadenectomy and nerve-sparing surgery at radical prostatectomy.