Correlation between the Total Initial PSA , PSA Density, and Prostate Cancer Aggressiveness: A Retrospective Study In Two Urology Centers In Cameroon

Abstract

Objectives: Our study aimed to determine the relationship between the initial total prostate-specific antigen (PSA), PSA density, and aggressiveness of prostate cancer (PCa) based on the new Gleason grade group in the two specialized urology centers in Cameroon. Method: A seven-year retrospective study was conducted from January 2012 to December 2019. The study concerned all men diagnosed with PCa graded using the novel Gleason grade group. Data were analyzed descriptively and analytically using Statistical Package for Social Sciences (SPSS) version 20.0. Bivariate analysis was done to identify independent associations. Results: A total of 253 files were reviewed; fulfilling the inclusion criteria. The mean age of our study population was 66.62±8.288 years with the most affected age being those aged between 59-69 years. The commonest finding on DRE was a hard-craggy prostate (46.0%). The mean initial total PSA was 98.78 ng/dL ± 300.17 ng/mL, while the mean PSA density was 1.73 ± 5.94ng/mL². Gleason grade group 2 was the commonest grade (30.6%). There was a positive correlation between initial total PSA and Gleason grade group (r = 0.314 (p-value 0.000)), and between PSA density and Gleason grade group (r = 0.919 (p-value 0.000)). Initial total PSA and the Gleason grade groups were independently associated with the radiological tumour stage (p-value 0.000 and p-value 0.03 respectively). Conclusion: There is a positive correlation between initial total PSA, PSA density, and novel Gleason grade group. We, therefore, recommend that more attention should be placed on PSA density in pre-biopsy decision making. This study enhances the stratification of therapeutic protocols for the management of PCa in Cameroon as well as across African Union member states.