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Pathological upgrading in prostate cancer patients eligible for active surveillance: Does prostate-specific antigen density matter?

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Author(s)
Byung-Soo JinSeok-Hyun KangDuk-Yoon KimHoon-Gyu OhChun-Il KimGi-Hak MoonTae-Gyun KwonJae-Shin Park
Keimyung Author(s)
Kim, Chun Il
Department
Dept. of Urology (비뇨의학)
Journal Title
Korean Journal of Urology
Issued Date
2015
Volume
56
Issue
9
Keyword
Neoplasm gradingProstate specific antigenProstatectomy
Abstract
Purpose: To evaluate prospectively the role of prostate-specific antigen (PSA) density in predicting Gleason score upgrading in
prostate cancer patients eligible for active surveillance (T1/T2, biopsy Gleason score≤6, PSA≤10 ng/mL, and ≤2 positive biopsy
cores).
Materials and Methods: Between January 2010 and November 2013, among patients who underwent greater than 10-core transrectal
ultrasound-guided biopsy, 60 patients eligible for active surveillance underwent radical prostatectomy. By use of the modified
Gleason criteria, the tumor grade of the surgical specimens was examined and compared with the biopsy results.
Results: Tumor upgrading occurred in 24 patients (40.0%). Extracapsular disease and positive surgical margins were found in 6
patients (10.0%) and 8 patients (17.30%), respectively. A statistically significant correlation between PSA density and postoperative
upgrading was found (p=0.030); this was in contrast with the other studied parameters, which failed to reach significance, including
PSA, prostate volume, number of biopsy cores, and number of positive cores. Tumor upgrading was also highly associated with
extracapsular cancer extension (p=0.000). The estimated optimal cutoff value of PSA density was 0.13 ng/mL2, obtained by receiver
operating characteristic analysis (area under the curve=0.66; p=0.020; 95% confidence interval, 0.53–0.78).
Conclusions: PSA density is a strong predictor of Gleason score upgrading after radical prostatectomy in patients eligible for active
surveillance. Because tumor upgrading increases the potential for postoperative pathological adverse findings and prognosis, PSA
density should be considered when treating and consulting patients eligible for active surveillance.
Keimyung Author(s)(Kor)
김천일
Publisher
School of Medicine
Citation
Byung-Soo Jin et al. (2015). Pathological upgrading in prostate cancer patients eligible for active surveillance: Does prostate-specific antigen density matter? Korean Journal of Urology, 56(9), 624–629. doi: 10.4111/kju.2015.56.9.624
Type
Article
ISSN
2005-6737
DOI
10.4111/kju.2015.56.9.624
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33388
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Urology (비뇨의학)
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