MP05-11 PATHOLOGICAL AND ONCOLOGICAL OUTCOMES IN PATIENTS WITH PSA≥10 NG/ML LOW RISK PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I1 Apr 2018MP05-11 PATHOLOGICAL AND ONCOLOGICAL OUTCOMES IN PATIENTS WITH PSA≥10 NG/ML LOW RISK PROSTATE CANCER Cristina Negrean, Mila Mansour, Félix Couture, Kevin C. Zorn, Marc Zanaty, Pierre Karakiewicz, Côme Tholomier, Naeem Bhojani, and Azizi Mounsif Cristina NegreanCristina Negrean More articles by this author , Mila MansourMila Mansour More articles by this author , Félix CoutureFélix Couture More articles by this author , Kevin C. ZornKevin C. Zorn More articles by this author , Marc ZanatyMarc Zanaty More articles by this author , Pierre KarakiewiczPierre Karakiewicz More articles by this author , Côme TholomierCôme Tholomier More articles by this author , Naeem BhojaniNaeem Bhojani More articles by this author , and Azizi MounsifAzizi Mounsif More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.182AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Low risk prostate cancers (PCa) represent a particular challenge for physicians. Which patients should be on active surveillance (AS) and which should receive a more aggressive treatment including radical prostatectomy (RP)? Up to date, very few data is available on the differences in prognosis between PSA<10 ng/mL and PSA≥10 ng/mL in men with low risk prostate cancer after RP. Herein, we sought to compare onco-pathological outcomes in men with PSA<10 ng/mL vs PSA≥10 ng/mL after robotic assisted radical prostatectomy (RARP). We hypothesised that biochemical recurrence (BCR) rate would be lower in PSA<10 ng/mL. As a secondary endpoint, we tried to assess outcomes in men with PSA≥10 ng/mL on AS versus those who were upfront not on AS to assess any oncological differences between groups. METHODS We conducted a retrospective study on the prospectively maintained database. 309 patients with low risk Gleason 6 prostate cancer who had RARP at university hospital (CHUM) between 2007 and 2017 were included in this study. They were divided in 2 groups based on serum PSA; group 1 with PSA<10 ng/mL (n=279) and group 2 with PSA≥10 ng/mL (n=30). Using Kaplan-Meier curves BCR-free period was compared between the two groups. Furthermore, we examined at oncological outcomes in PSA≥10 ng/mL group between men on AS and those not on AS using t-test. RESULTS With regards to Gleason upgrading after RARP, no significant difference was observed between the 2 groups (57.3%, 66.7%, p=0.370). However, with a median follow up of 36 months, BCR was significantly higher in PSA≥10 ng/mL, 16.7% compared to 1.8% in PSA<10 ng/mL (p<0.001). The mean BCR-freedom was 70.7 ± 0.6 months in the last group. This was statistically longer than for PSA≥10 ng/mL group (61.0 ± 4.5 months, p<0.001). The BCR inside the PSA≥10 ng/mL group was similar between AS and non-AS subgroups (0% versus 23.8% respectively, p value = 0.109). CONCLUSIONS Our results advocate that patients with Gleason 6 low risk PCa and PSA≥10 ng/mL have greater BCR rate as opposed to PSA<10 ng/mL. The BCR-freedom is statistically shorter for patients with PSA higher than 10 ng/mL. This supports that PSA value is an independent indicator for BCR after radical prostatectomy in men with low risk cancer. Moreover, among men with PSA≥10 ng/mL, oncological outcomes appear to be similar regardless of the management approach, AS or not. This might suggest that low risk PCa with PSA≥10 can be managed by AS after RP without increasing their risk of BCR. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e46-e47 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Cristina Negrean More articles by this author Mila Mansour More articles by this author Félix Couture More articles by this author Kevin C. Zorn More articles by this author Marc Zanaty More articles by this author Pierre Karakiewicz More articles by this author Côme Tholomier More articles by this author Naeem Bhojani More articles by this author Azizi Mounsif More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...