714 OUTCOMES IN PATIENTS WITH GLEASON SCORE 8–10 PROSTATE CANCER: RELATION TO PRE-OPERATIVE PSA LEVEL

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced1 Apr 2011714 OUTCOMES IN PATIENTS WITH GLEASON SCORE 8–10 PROSTATE CANCER: RELATION TO PRE-OPERATIVE PSA LEVEL Barry B. McGuire, Daniel C. O'Brien, Stacy Loeb, Cheng Li, Kimberly A. Delli-Zotti, Brian T. Helfand, and William J. Catalona Barry B. McGuireBarry B. McGuire Chicago, IL More articles by this author , Daniel C. O'BrienDaniel C. O'Brien Chicago, IL More articles by this author , Stacy LoebStacy Loeb Baltimore, MD More articles by this author , Cheng LiCheng Li Chicago, IL More articles by this author , Kimberly A. Delli-ZottiKimberly A. Delli-Zotti St. Louis, MO More articles by this author , Brian T. HelfandBrian T. Helfand Chicago, IL More articles by this author , and William J. CatalonaWilliam J. Catalona Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1682AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Among prostate cancer patients, both higher preoperative prostate-specific antigen (PSA) levels and Gleason scores have been reported to be associated with a poorer prognosis after radical prostatectomy. However, very poorly differentiated tumors often secrete less PSA per cell than moderately- or well-differentiated tumors. In patients with Gleason 8–10 PCa, we assessed the outcomes after radical prostatectomy in relation to their preoperative PSA levels. METHODS From 1983 and 2003, 3,478 patients in our study group underwent radical prostatectomy. Of these, 230 had Gleason score of 8–10 in the prostatectomy specimen. We stratified patients according to preoperative PSA into groups: <2.5 ng/ml (N=22); 2.6–4 ng/ml (N=14); 4.1– 10 ng/ml (N=111), and >10 ng/ml (n=83) and assessed the outcomes of biochemical progression-free survival, metastasis-free survival, and cancer- specific survival. RESULTS The median age was 63 years and median follow-up was 77 months. The table shows that patients with PSA levels < 2.5 ng/ml had a proportionately higher recurrence rate (7 year progression free survival 35%) than those with PSA 2.6–4.0 and 4.1–10 (49% and 44%, respectively), but not than those with PSA >10 (31%). The 7-year metastasis free survival also was lower in patients with PSA <2.5 ng/ml (75% vs. 86%, 88%, and 87%, respectively). The cancer specific survival also was lowest among men with PSA < 2.5 ng/ml (79% vs. 100%, 92%, and 90%, respectively). PSA ng/ml 7-year PFS (%) 7-year MFS (%) 7-year CSS (%) PSA <2.5 35 75 79 PSA 2.6–4 49 86 100 PSA 4.1–10 44 88 92 PSA >10 31 87 90 p-value⁎ 0.07 0.61 0.36 7 year outcomes for men with high grade PCa stratified according to PSA. PFS = Biochemical Progression Free Survival, MFS = Metastasis Free Survival, CSS = Cancer Specific Survival. ⁎ log rank. CONCLUSIONS Patients with Gleason score 8–10 PCa with a preoperative PSA < 2.5ng/ml generally have proportionately worse outcomes after radical prostatectomy than those with intermediate PSA values. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e287 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Barry B. McGuire Chicago, IL More articles by this author Daniel C. O'Brien Chicago, IL More articles by this author Stacy Loeb Baltimore, MD More articles by this author Cheng Li Chicago, IL More articles by this author Kimberly A. Delli-Zotti St. Louis, MO More articles by this author Brian T. Helfand Chicago, IL More articles by this author William J. Catalona Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...