In:
Urologia Internationalis, S. Karger AG, Vol. 90, No. 3 ( 2013), p. 301-305
Abstract:
〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 The aim of this study was to identify patients with low-volume Gleason score 3+4 (GS3+4) prostate cancer (PCa) who may be candidates for active surveillance (AS) by analyzing the incidence of upgrading and upstaging following radical prostatectomy (RP). 〈 b 〉 〈 i 〉 Patients and Methods: 〈 /i 〉 〈 /b 〉 Of 907 patients who underwent RP at our institute over the last 5 years, 66 men diagnosed with low-volume GS3+4 PCa at needle biopsy were identified. The incidence of upstaging and upgrading was assessed. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The overall rate of upgrading and upstaging was 31.8 and 25.6%, respectively. Preoperative PSA levels were significantly higher in patients who were upgraded (p = 0.015). The optimal preoperative PSA cutoff level for the prediction of upgrading was 4.73 ng/ml (sensitivity 85.7%, specificity 57.8%). Patients with 〈 15% of maximum cores positive had significantly lower upstaging rate than those with 〉 15% of maximum cores positive (p = 0.035). Clinical stage and number of positive cores had marginal association with upgrading and upstaging statistically (p = 0.061 and 0.081, respectively). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 In patients with low-volume GS3+4 PCa at biopsy, underestimation may be effectively avoided when we select patients with PSA 〈 4.73 and % maximum cancer involvement on positive cores 〈 15%.
Type of Medium:
Online Resource
ISSN:
0042-1138
,
1423-0399
Language:
English
Publisher:
S. Karger AG
Publication Date:
2013
detail.hit.zdb_id:
1464417-4
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