The importance of PSA-Density in active surveillance for prostate cancer
Objective: In this study, we aimed to determine the predictive factor for additional treatment requirement in active surveillance (AS) for patients with low or very low-risk prostate cancer (PCa) and we investigated the effect of tumor burden by total core involvement rate in biopsy to predict of n...
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2020-06-01
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doaj-25c08822f0c84dacb8130315bc79caba2020-11-25T01:25:10ZengPAGEPress PublicationsArchivio Italiano di Urologia e Andrologia1124-35622282-41972020-06-0192210.4081/aiua.2020.2.136The importance of PSA-Density in active surveillance for prostate cancerCaner Ediz0Serkan Akan1Muhammed Cihan Temel2Omer Yilmaz3Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, IstanbulDepartment of Urology, Sultan Abdulhamid Han Education and Research Hospital, IstanbulDepartment of Urology, Sultan Abdulhamid Han Education and Research Hospital, IstanbulDepartment of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul Objective: In this study, we aimed to determine the predictive factor for additional treatment requirement in active surveillance (AS) for patients with low or very low-risk prostate cancer (PCa) and we investigated the effect of tumor burden by total core involvement rate in biopsy to predict of need for additional treatment. Material and methods: 107 patients with PCa in AS between 2005 and 2018 have been evaluated retrospectively. Groups were divided into two groups according to the need for additional treatment. Group 1 received additional treatment, group 2 did not receive additional treatments and active surveillance was continued. Patient’s total prostate-specific antigen (tPSA), prostate-specific antigen density (PSA-D), total core involvement count, quantity and rate at biopsy pathology results and follow-up period were recorded and compared in the two groups. Results: The current cohort includes 107 patients. Mean age at diagnosis was 63.01years. Mean tPSA values at diagnosis were 6.09 ng/mL and 5.2 ng/mL in the group 1 and group 2, respectively. Mean follow-up period was 38.1 months (range, 12 to 134 months). Only PSA-D measurement significantly predicted need for additional treatment (p = 0.017). ROC analysis showed that the optimal threshold was 0.13 ng/mL/cc (sensitivity: 70.8%; specificity: 57.1%). Additional treatment requirement was not detected in patients with PSA-D cut-off level less than 0.07 ng/mL/cc. Conclusions: Total tumor burden of less than 5% is safe for patients with low or very low-risk PCa in AS. A 0.13 ng/mL/cc cut-off level of PSA-D can predict to need for additional treatment in patients managed by AS. https://www.pagepressjournals.org/index.php/aiua/article/view/8756Prostate cancer, Active surveillance, PSA Density, Definitive treatment |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Caner Ediz Serkan Akan Muhammed Cihan Temel Omer Yilmaz |
spellingShingle |
Caner Ediz Serkan Akan Muhammed Cihan Temel Omer Yilmaz The importance of PSA-Density in active surveillance for prostate cancer Archivio Italiano di Urologia e Andrologia Prostate cancer, Active surveillance, PSA Density, Definitive treatment |
author_facet |
Caner Ediz Serkan Akan Muhammed Cihan Temel Omer Yilmaz |
author_sort |
Caner Ediz |
title |
The importance of PSA-Density in active surveillance for prostate cancer |
title_short |
The importance of PSA-Density in active surveillance for prostate cancer |
title_full |
The importance of PSA-Density in active surveillance for prostate cancer |
title_fullStr |
The importance of PSA-Density in active surveillance for prostate cancer |
title_full_unstemmed |
The importance of PSA-Density in active surveillance for prostate cancer |
title_sort |
importance of psa-density in active surveillance for prostate cancer |
publisher |
PAGEPress Publications |
series |
Archivio Italiano di Urologia e Andrologia |
issn |
1124-3562 2282-4197 |
publishDate |
2020-06-01 |
description |
Objective: In this study, we aimed to determine the predictive factor for additional treatment requirement in active surveillance (AS) for patients with low or very low-risk prostate cancer (PCa) and we investigated the effect of tumor burden by total core involvement rate in biopsy to predict of need for additional treatment.
Material and methods: 107 patients with PCa in AS between 2005 and 2018 have been evaluated retrospectively. Groups were divided into two groups according to the need for additional treatment. Group 1 received additional treatment, group 2 did not receive additional treatments and active surveillance was continued. Patient’s total prostate-specific antigen (tPSA), prostate-specific antigen density (PSA-D), total core involvement count, quantity and rate at biopsy pathology results and follow-up period were recorded and compared in the two groups.
Results: The current cohort includes 107 patients. Mean age at diagnosis was 63.01years. Mean tPSA values at diagnosis were 6.09 ng/mL and 5.2 ng/mL in the group 1 and group 2, respectively. Mean follow-up period was 38.1 months (range, 12 to 134 months). Only PSA-D measurement significantly predicted need for additional treatment (p = 0.017). ROC analysis showed that the optimal threshold was 0.13 ng/mL/cc (sensitivity: 70.8%; specificity: 57.1%). Additional treatment requirement was not detected in patients with PSA-D cut-off level less than 0.07 ng/mL/cc.
Conclusions: Total tumor burden of less than 5% is safe for patients with low or very low-risk PCa in AS. A 0.13 ng/mL/cc cut-off level of PSA-D can predict to need for additional treatment in patients managed by AS.
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topic |
Prostate cancer, Active surveillance, PSA Density, Definitive treatment |
url |
https://www.pagepressjournals.org/index.php/aiua/article/view/8756 |
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