PD03-08 PATHOLOGICAL OUTCOME FOLLOWING RADICAL PROSTATECTOMY IN MEN WITH PSA GREATER THAN 10 AND HISTOLOGICALLY FAVORABLE-RISK PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance I1 Apr 2016PD03-08 PATHOLOGICAL OUTCOME FOLLOWING RADICAL PROSTATECTOMY IN MEN WITH PSA GREATER THAN 10 AND HISTOLOGICALLY FAVORABLE-RISK PROSTATE CANCER Young Suk Kwon, Jiwoong Yu, Sinae Kim, Christopher Han, Nicholas Farber, Jongmyung Kim, Seok Soo Byun, Wun-Jae Kim, Seong Soo Jeon, and Isaac Kim Young Suk KwonYoung Suk Kwon More articles by this author , Jiwoong YuJiwoong Yu More articles by this author , Sinae KimSinae Kim More articles by this author , Christopher HanChristopher Han More articles by this author , Nicholas FarberNicholas Farber More articles by this author , Jongmyung KimJongmyung Kim More articles by this author , Seok Soo ByunSeok Soo Byun More articles by this author , Wun-Jae KimWun-Jae Kim More articles by this author , Seong Soo JeonSeong Soo Jeon More articles by this author , and Isaac KimIsaac Kim More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2096AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Active surveillance (AS) is now the preferred treatment of choice in men with a low-risk prostate cancer. Although there is no consensus on patients who are eligible for AS, PSA above 10 ng/mL is generally excluded. In an attempt to determine the validity of using PSA cutoff of 10 in counseling men considering AS, we have analyzed a multi-institution database to determine the pathologic outcome in men with PSA greater than 10 but have a histologically favorable-risk prostate cancer. METHODS Prospectively maintained database on men with histologically favorable risk prostate cancer but underwent radical prostatectomy between 2003 and 2015 were queried from three institutions. The cohort was categorized into three groups based on PSA levels: Low PSA (LP) (<10), Intermediate PSA (IP) (≥10 and <20), and high PSA (HP) (≥20). The associations between PSA group and adverse pathologic and oncologic outcomes were analyzed. A PSAD threshold of 0.15 ng/mL/g was employed for further risk stratification. RESULTS Of 2125 patients, 1327 patients were categorized as having a histologically favorable risk disease. In multivariate analyses, however, the rates of upstaging and upgrading were similar between the IP and LP group. In contrast, the HP group had higher incidences of both upstaging (p=0.02) and upgrading to ≥4+3 (p=0.046) compared to the IP group (table 1). BCR-free survival rates revealed no pair-wise inter-group differences, except between LP and HP. Unlike in the LP group where 38.4% patients had PSAD ≥0.15, more than 90% of the patients in the IP and HP groups had PSAD ≥0.15 cut-off (table 2). CONCLUSIONS Patients with elevation of preoperative PSA levels between 10 and 20 who otherwise had histologically favorable-risk PCa were not at higher risk for having adverse pathologic outcomes when compared to men with PSA < 10. PSAD has little or minimal discriminatory power in men with PSA greater than 10. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e59 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Young Suk Kwon More articles by this author Jiwoong Yu More articles by this author Sinae Kim More articles by this author Christopher Han More articles by this author Nicholas Farber More articles by this author Jongmyung Kim More articles by this author Seok Soo Byun More articles by this author Wun-Jae Kim More articles by this author Seong Soo Jeon More articles by this author Isaac Kim More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...