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Does extent of prostate-specific antigen fluctuation can predict Gleason score upgrading in low-risk prostate cancer patients?

Authors :
Hamidi, Nurullah
Atmaca, Ali Fuat
Canda, Abdullah Erdem
Keske, Murat
Ardıçoğlu, Arslan
Source :
Turkish Journal of Urology; 2019 Supplement, Vol. 45, pS42-S48, 7p
Publication Year :
2019

Abstract

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. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
13005804
Volume :
45
Database :
Complementary Index
Journal :
Turkish Journal of Urology
Publication Type :
Academic Journal
Accession number :
141184503
Full Text :
https://doi.org/10.5152/tud.2018.41017