1921 DIFFERENCES IN PROSTATE CANCER DETECTION RATES ACCORDING TO THE LEVEL OF GLOMERULAR FILTRATION RATE IN PATIENTS WHOSE PSA LEVELS OF 4.0 TO 10.0 NG/ML

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You have accessJournal of UrologyProstate Cancer: Detection and Screening III1 Apr 20121921 DIFFERENCES IN PROSTATE CANCER DETECTION RATES ACCORDING TO THE LEVEL OF GLOMERULAR FILTRATION RATE IN PATIENTS WHOSE PSA LEVELS OF 4.0 TO 10.0 NG/ML Jae-Seung Yeon, Jae Hyun Jung, Sung Yong Cho, Seung Bae Lee, Hwancheol Son, and Hyeon Jeong Jae-Seung YeonJae-Seung Yeon Seoul, Korea, Republic of More articles by this author , Jae Hyun JungJae Hyun Jung s, Korea, Republic of More articles by this author , Sung Yong ChoSung Yong Cho Seoul, Korea, Republic of More articles by this author , Seung Bae LeeSeung Bae Lee Seoul, Korea, Republic of More articles by this author , Hwancheol SonHwancheol Son Seoul, Korea, Republic of More articles by this author , and Hyeon JeongHyeon Jeong Seoul, Korea, Republic of More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2078AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To investigate differences in prostate cancer detection rates according to the level of glomerular filtration rates (GFR). METHODS Patients with PSA levels within 4.0 to 10.0 ng/ml were analyzed. Age, serum creatinine, estimated GFR, body mass index, total PSA (tPSA), free PSA (fPSA), percent free PSA (%fPSA), comorbidities, biopsy Gleason sum, and percent positive core were retrospectively reviewed. All parameters were compared to show whether patients with GFR <60 ml/min/1.73m2 (group A) have higher risk of prostate cancer than patients with GFR ¡Ã60 (group B). The primary endpoint was cancer detection rate and the secondary endpoints were differences in mean tPSA, fPSA, %fPSA and pathologic outcomes. RESULTS A total of 524 men (127 cancer cases) were included. Mean age was 66.6 ¡¾ 7.7 yr. No differences in age and tPSA were found between groups A and B. Mean fPSA, %fPSA and cancer detection rate were significantly higher in group A than group B. The incidence of %fPSA <25% was significantly lower in group A than in group B. Old age, GFR <60, and %fPSA <25% were significant predictors for being prostate cancer. For groups A and B, the probability of being prostate cancer was 35.7% vs 22.9% (p = 0.036). CONCLUSIONS Cancer detection rates were higher in group A than in group B whose PSA levels are within 4.0 to 10.0 ng/ml. Performing prostate biopsy should be actively considered in healthy-looking patients with well-controlled CKD. Table. Differences in cancer-related parameters between patients with CKD stage 3 or higher versus stages 1 and 2. Total Group A Group B p-value n (%) 524 56(10.6%) 468(89.4%) Age (year) 65.8 65.4 ± 8.9 66.3 ± 7.5 40-59, n(%) 96(18.3%) 9(16.1%) 87(18.6%) 60-69, n (%) 242(46.2%) 16(28.6%) 226(48.3%) 70-79, n (%) 186(35.5%) 31(55.4%) 155(33.1%) Body mass index 24.4 ± 2.3 24.7 ± 2.9 24.4 ± 2.2 0.471 Diabetes, n (%) 81(15.5%) 14(25.0%) 67(14.3%) 0.040* Hypertension, n (%) 230(43.9%) 42(75.0%) 188(40.2%) <0.001* GFR (ml/min/1.73m2) 80.6 ± 36.1 40.6 ± 16.8 85.4 ± 34.8 <0.001* ≥ 90 (stage 1), n (%) 0(0%) 125(23.9%) 60-89 (stage 2), n (%) 0(0%) 343(65.5%) 30-59 (stage 3), n (%) 40(7.6%) 0(0%) 15-29 (stage 4), n (%) 10(1.9%) 0(0%) < 15 (stage 5), n (%) 6(1.1%) 0(0%) PSA (ng/ml) 6.0 ± 1.7 6.2 ± 1.7 5.9 ± 1.7 0.208 Free PSA (ng/ml) 1.3 ± 0.6 1.6 ± 0.6 1.3 ± 0.6 <0.001* Percent free PSA (%) 22.0 ± 8.9 26.3 ± 8.2 21.4 ± 8.8 <0.001* Prostate volume (ml) 43.5 ± 22.4 42.2 ± 14.2 44.3 ± 23.1 0.208 Cancer detection rates 127(24.2%) 20(35.7%) 107(22.9%) 0.034* Percent free PSA (< 25%) 374(71.4%) 26(46.4%) 348(74.4%) <0.001* Biopsy Gleason sum 6 62(48.8%) 9(45.0%) 53(49.5%) 0.931 7 39(30.7%) 7(35.0%) 32(29.9%) 8 20(15.7%) 3(15.0%) 17(15.9%) 9 4(3.1%) 1(5.0%) 3(2.8%) 10 2(1.6%) 0(0%) 0(0%) Biopsy Gleason sum (⩾8) 26(20.5%) 4(20.0%) 22(20.6%) 0.955 Percent positive core (%) 27.4 ± 15.8 29.2 ± 14.5 27.1 ± 16.1 0.580 © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e775 Peer Review Report Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jae-Seung Yeon Seoul, Korea, Republic of More articles by this author Jae Hyun Jung s, Korea, Republic of More articles by this author Sung Yong Cho Seoul, Korea, Republic of More articles by this author Seung Bae Lee Seoul, Korea, Republic of More articles by this author Hwancheol Son Seoul, Korea, Republic of More articles by this author Hyeon Jeong Seoul, Korea, Republic of More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...