OBJECTIVE:The aim of this study was to identify the rate of clinical significant disease (Gleason score>6 or tumor volume>0.5 cc in the RP specimen) among patients who had an insignificant prostate cancer on biopsy, evaluating the presence of prognostic factors.
PATIENTS AND METHODS: Patients who fulfilled the following criteria were included: PSA ≤ 10ng/ml, T1c disease, biopsy Gleason Score ≤ 6 affecting < 5% of only 1 core and who had undergone a radical prostatectomy. The following variables were studied: Age, PSA, dPSA, free/total PSA ratio and prostatic volume assessed by transrectal ultrasound.
RESULTS: In a series of 2424 biopsies, 77 patients completely fulfilled the inclusion criteria, with 66.23% (n=51) of clinical significant disease in the prostatectomy specimen. No differences were observed between these patients and those with insignificant disease in age, PSA, free/total PSA ratio. However, prostatic volume was significantly greater and PSA density significantly lower in those patients with an insignificant disease. Statistical analysis using a logistical regression showed that dPSA was the only prognostic factor (OR: 25067.10, CI 95%: 26.79-2.34×10(7), P=.004).
CONCLUSIONS: These findings suggest that a high rate of patients who have a suspected insignificant prostate cancer on biopsy have a clinical significant disease, being dPSA the only independent prognostic factor.
Written by:
Hernández-Medina JA, García-Morata F, Diez-Calzadilla N, Martínez-Jabaloyas JM, Rodriguez-Navarro R, Soriano-Sarria P, Chuan-Nuez P. Are you the author?
Servicio de Urología, Hospital Clínico Universitario de Valencia, Valencia, España.
Reference: Actas Urol Esp. 2012 Apr 4. Epub ahead of print.
PubMed Abstract
PMID: 22482934
Article in English, Spanish.
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