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Incidence of upgrading and upstaging in patients with low-volume Gleason score 3+4 prostate cancers at biopsy: Finding a new group eligible for active surveillance

Title
Incidence of upgrading and upstaging in patients with low-volume Gleason score 3+4 prostate cancers at biopsy: Finding a new group eligible for active surveillance
Authors
Park H.J.Ha Y.-S.Park S.Y.Kim Y.T.Lee T.Y.Kim J.H.Lee D.-H.Kim W.-J.Kim I.Y.
Ewha Authors
이동현
SCOPUS Author ID
이동현scopus
Issue Date
2013
Journal Title
Urologia Internationalis
ISSN
0042-1138JCR Link
Citation
vol. 90, no. 3, pp. 301 - 305
Indexed
SCIE; SCOPUS WOS scopus
Abstract
Introduction: The aim of this study was to identify patients with low-volume Gleason score 3+4 (GS3+4) prostate cancer (PCa) who may be candidates for active surveillance (AS) by analyzing the incidence of upgrading and upstaging following radical prostatectomy (RP). Patients and Methods: Of 907 patients who underwent RP at our institute over the last 5 years, 66 men diagnosed with low-volume GS3+4 PCa at needle biopsy were identified. The incidence of upstaging and upgrading was assessed. Results: The overall rate of upgrading and upstaging was 31.8 and 25.6%, respectively. Preoperative PSA levels were significantly higher in patients who were upgraded (p = 0.015). The optimal preoperative PSA cutoff level for the prediction of upgrading was 4.73 ng/ml (sensitivity 85.7%, specificity 57.8%). Patients with <15% of maximum cores positive had significantly lower upstaging rate than those with >15% of maximum cores positive (p = 0.035). Clinical stage and number of positive cores had marginal association with upgrading and upstaging statistically (p = 0.061 and 0.081, respectively). Conclusions: In patients with low-volume GS3+4 PCa at biopsy, underestimation may be effectively avoided when we select patients with PSA <4.73 and % maximum cancer involvement on positive cores <15%. Copyright © 2013 S. Karger AG, Basel.
DOI
10.1159/000345292
Appears in Collections:
의과대학 > 의학과 > Journal papers
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