Selection criteria for radical prostatectomy based on morphometric studies in prostate carcinoma.

Morphometric reconstruction of 122 consecutive radical prostatectomy specimens were analyzed for cancer volume and grade, seminal vesicle (SV) invasion, lymph node (LN) metastasis, and complete capsular penetration. The mean cancer volume for 91 specimens without SV invasion or LN metastasis was 3.7 cm3; for 14 with only SV invasion, 9.0 cm3; for 17 with LN metastasis, 15.2 cm3; and for 12 with both SV invasion and LN metastasis, 17.8 cm3. The mean cancer volume for 60 specimens without capsular penetration was 2.5 cm3, and for 62 it was 9.0 cm3. Grade of cancer correlated well with tumor volume. We believe that radical prostatectomy for cure should be performed on patients with tumors less than 3.8 cm3 in volume. Methods for accurate assessment of tumor volume before surgery should be given research priorities.