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Pelzer A.E., Bektic J., Steiner E., Akkad T., Schwentner C., Schaefer G., Bartsch G., Horninger W.
Presented on March, 22 2007
INTRODUCTION & OBJECTIVES: The purpose of the study was to evaluate the clinical and pathological characteristics of screen vs. non screen detected prostate cancers in order to determine if there is a difference even in the same tPSA range.
MATERIAL & METHODS: 997 radical prostatectomy patients operated in between February 1999 and March 2006 at the department of Urology, Innsbruck; Tyrol were evaluated. 806 were Tyrolean screening volunteers, 191 patients were from outside of Tyrol and represent the non screening prostate cancer group. Preoperative tPSA, age, prostate volume and pathological characteristics were assessed. For statistical analyses, the chi-square test was used and a p-value below 0.05 was considered as statistically significant.
RESULTS: The mean age of the patients in the screening population was 60.1 years and 59.8 in the referral population (not statistically significant, p<0.05). Mean tPSA, prostate volume, pathological stage, Gleason score and percentages of positive surgical margins for the two subgroups are shown in the table below:
*p<0.05
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Screening population
(n=806)
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Referral Population
(n=191)
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Mean PSA (range)
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6,2
(0,7 - 30ng/ml)
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7,1
(1.7 - 24ng/ml)
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PV (ml)
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33,9
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43,9
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% pT2a
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22,6%*
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12,90%*
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% pT2b
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35,2%*
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23,66%*
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% pT2c
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24,8%*
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31,72%*
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% ≥pT3
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17,4%*
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31,72%*
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GS<6
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14,4%
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11,5%
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GS=6
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39,2%*
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25,7%*
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GS≥7
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46,4%*
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62,8%*
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pos. surg. margins
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11.7%*
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24,4%*
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CONCLUSIONS: This study suggest that screening volunteers have a statistically significant higher rate of organ confined prostate cancers, a statistically significant lower rate of extracapsular extension and positive surgical margins compared to their counterparts in the referral population even in the same fPSA range. Since the pathological stage and surgical margins status are significant predictors of recurrence, these findings support the concept of PSA screening.
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