BACKGROUND: The aim of this study was to analyze the pathological features of prostatectomy specimens from patients with low-risk prostate cancer eligible for active surveillance (AS) and evaluate preoperative data suitable for predicting upstaged (≥pT3) or upgraded disease (Gleason score of ≥7), defined as 'reclassification'. METHODS: A retrospective analysis of 521 consecutive radical prostatectomy procedures (January 2005 through to December 2011) performed at our institution without neoadjuvant hormonal therapy was performed. Eighty-four patients fulfilled the following criteria-clinical T1 or T2 disease, prostate-specific antigen (PSA) level of ≤10 ng/ml, one or two positive biopsies, and Gleason score of <7. Clinicopathological features at diagnosis were compared between patients with and without reclassification after radical prostatectomy. RESULTS: Forty of 84 patients (47.6 %) had a Gleason score of ≥7, and 8 (9.5 %) had upstaged disease (≥pT3). Seven patients with upstaged disease also showed upgraded reclassification. Two patients with reclassification showed biochemical recurrence at 59 and 89 months after surgery, respectively. Preoperative parameters evaluated included age, PSA level, PSA density (PSAD), clinical T stage, and number and percentage of positive prostate cores. Among 82 patients with complete data, univariate analysis showed that PSAD (ng/ml(2)) was a significant parameter to discriminate patients with reclassified disease and those without reclassified disease (p < 0.001). Multivariate analysis revealed that PSAD was the only independent variable to predict disease with reclassification (p = 0.006). CONCLUSIONS: Preoperative PSAD may be a good indicator for selecting patients eligible for AS in the Japanese population.
BACKGROUND: The aim of this study was to analyze the pathological features of prostatectomy specimens from patients with low-risk prostate cancer eligible for active surveillance (AS) and evaluate preoperative data suitable for predicting upstaged (≥pT3) or upgraded disease (Gleason score of ≥7), defined as 'reclassification'. METHODS: A retrospective analysis of 521 consecutive radical prostatectomy procedures (January 2005 through to December 2011) performed at our institution without neoadjuvant hormonal therapy was performed. Eighty-four patients fulfilled the following criteria-clinical T1 or T2 disease, prostate-specific antigen (PSA) level of ≤10 ng/ml, one or two positive biopsies, and Gleason score of <7. Clinicopathological features at diagnosis were compared between patients with and without reclassification after radical prostatectomy. RESULTS: Forty of 84 patients (47.6 %) had a Gleason score of ≥7, and 8 (9.5 %) had upstaged disease (≥pT3). Seven patients with upstaged disease also showed upgraded reclassification. Two patients with reclassification showed biochemical recurrence at 59 and 89 months after surgery, respectively. Preoperative parameters evaluated included age, PSA level, PSA density (PSAD), clinical T stage, and number and percentage of positive prostate cores. Among 82 patients with complete data, univariate analysis showed that PSAD (ng/ml(2)) was a significant parameter to discriminate patients with reclassified disease and those without reclassified disease (p < 0.001). Multivariate analysis revealed that PSAD was the only independent variable to predict disease with reclassification (p = 0.006). CONCLUSIONS: Preoperative PSAD may be a good indicator for selecting patients eligible for AS in the Japanese population.
Authors: Jean-Baptiste Beauval; Guillaume Ploussard; Michel Soulié; Christian Pfister; Simon Van Agt; Sébastien Vincendeau; Sébastien Larue; Jérome Rigaud; Nicolas Gaschignard; Morgan Rouprêt; Sarah Drouin; Mickael Peyromaure; Jean Alexandre Long; Francois Iborra; Guy Vallancien; Francois Rozet; Laurent Salomon Journal: Urology Date: 2012-07-07 Impact factor: 2.649
Authors: Amita Shukla-Dave; Hedvig Hricak; Michael W Kattan; Darko Pucar; Kentaro Kuroiwa; Hui-Ni Chen; Jessica Spector; Jason A Koutcher; Kristen L Zakian; Peter T Scardino Journal: BJU Int Date: 2007-01-12 Impact factor: 5.588
Authors: Daniel O'Brien; Stacy Loeb; Gustavo F Carvalhal; Barry B McGuire; Donghui Kan; Matthias D Hofer; Jessica T Casey; Brian T Helfand; William J Catalona Journal: J Urol Date: 2011-04-15 Impact factor: 7.450
Authors: Kenneth S Tseng; Patricia Landis; Jonathan I Epstein; Bruce J Trock; H Ballentine Carter Journal: J Urol Date: 2010-03-20 Impact factor: 7.450
Authors: Marc A Dall'Era; Peter C Albertsen; Christopher Bangma; Peter R Carroll; H Ballentine Carter; Matthew R Cooperberg; Stephen J Freedland; Laurence H Klotz; Christopher Parker; Mark S Soloway Journal: Eur Urol Date: 2012-06-07 Impact factor: 20.096
Authors: Nicholas J van As; Andrew R Norman; Karen Thomas; Vincent S Khoo; Alan Thompson; Robert A Huddart; Alan Horwich; David P Dearnaley; Christopher C Parker Journal: Eur Urol Date: 2008-03-07 Impact factor: 20.096
Authors: Marc A Dall'Era; Badrinath R Konety; Janet E Cowan; Katsuto Shinohara; Frank Stauf; Matthew R Cooperberg; Maxwell V Meng; Christopher J Kane; Nanette Perez; Viraj A Master; Peter R Carroll Journal: Cancer Date: 2008-06-15 Impact factor: 6.860