OBJECTIVE: To evaluate the effect of prostate-specific antigen (PSA) fluctuation on Gleason score (GS) upgrading, disease upstaging, oncological outcomes in low-risk prostate cancer (PCa) patients who underwent robot-assisted laparoscopic radical prostatectomy (RARP) and met the inclusion criteria for active surveillance (AS). MATERIAL AND METHODS: Data of 354 low-risk PCa patients who underwent RARP were retrospectively evaluated. Patients were divided into two groups: PSA fluctuation rate<9.5%/month (Group 1, n=192) and >9.5%/month (Group 2, n=162). Mainly compared parameters were GS upgrading, disease upstaging, biochemical recurrence (BCR) and surgical margin positivity (SMP) rates. RESULTS: GS upgrading, disease upstaging and SMP were detected in 128 (36.2%), 56 (15.8%) and 42 (11.9%) patients, respectively. After a median follow-up of 46 months, BCR was observed in 40 (11.3%) patients. GS upgrading (41.1% vs. 30.2%, p=0.033), disease upstaging (19.8% vs. 11.1%, p=0.028), SMP (15.1% vs. 8%, p=0.035) and BCR development (15.6% vs. 6.2%, p=0.005) rates were statistically significantly higher in Group 1 than Group 2. In multivariate analysis, digital rectal examination positivity, the presence of two positive cores and low PSA fluctuation rate were found to be significant predictors of GS upgrading. CONCLUSION: Low PSA fluctuation rate is associated with higher GS upgrading.
OBJECTIVE: To evaluate the effect of prostate-specific antigen (PSA) fluctuation on Gleason score (GS) upgrading, disease upstaging, oncological outcomes in low-risk prostate cancer (PCa) patients who underwent robot-assisted laparoscopic radical prostatectomy (RARP) and met the inclusion criteria for active surveillance (AS). MATERIAL AND METHODS: Data of 354 low-risk PCa patients who underwent RARP were retrospectively evaluated. Patients were divided into two groups: PSA fluctuation rate<9.5%/month (Group 1, n=192) and >9.5%/month (Group 2, n=162). Mainly compared parameters were GS upgrading, disease upstaging, biochemical recurrence (BCR) and surgical margin positivity (SMP) rates. RESULTS:GS upgrading, disease upstaging and SMP were detected in 128 (36.2%), 56 (15.8%) and 42 (11.9%) patients, respectively. After a median follow-up of 46 months, BCR was observed in 40 (11.3%) patients. GS upgrading (41.1% vs. 30.2%, p=0.033), disease upstaging (19.8% vs. 11.1%, p=0.028), SMP (15.1% vs. 8%, p=0.035) and BCR development (15.6% vs. 6.2%, p=0.005) rates were statistically significantly higher in Group 1 than Group 2. In multivariate analysis, digital rectal examination positivity, the presence of two positive cores and low PSA fluctuation rate were found to be significant predictors of GS upgrading. CONCLUSION: Low PSA fluctuation rate is associated with higher GS upgrading.
Authors: Marco Auprich; Felix K-H Chun; John F Ward; Karl Pummer; Richard Babaian; Herbert Augustin; Ferdinand Luger; Stefan Gutschi; Lars Budäus; Margit Fisch; Hartwig Huland; Markus Graefen; Alexander Haese Journal: Eur Urol Date: 2010-10-20 Impact factor: 20.096
Authors: Robert E Gerstenbluth; Allen D Seftel; Gregory T MacLennan; R Nagarjun Rao; Eric W Corty; Kelly Ferguson; Martin I Resnick Journal: J Urol Date: 2002-05 Impact factor: 7.450
Authors: Simon L Conti; Marc Dall'era; Vincent Fradet; Janet E Cowan; Jeffery Simko; Peter R Carroll Journal: J Urol Date: 2009-02-23 Impact factor: 7.450
Authors: Stephen A Boorjian; R Jeffrey Karnes; Paul L Crispen; Laureano J Rangel; Eric J Bergstralh; Thomas J Sebo; Michael L Blute Journal: J Urol Date: 2008-11-13 Impact factor: 7.450
Authors: Diana Elizabeth Alcantara-Zapata; Shrikant I Bangdiwala; Daniel Jiménez; Manolis Kogevinas; Nella Marchetti; Carolina Nazzal Journal: Occup Environ Med Date: 2021-05-11 Impact factor: 4.948