Prediction of extraprostatic cancer by prostate specific antigen density, endorectal MRI, and biopsy Gleason score in clinically localized prostate cancer
Backgrounds The present study was designed to identify the preoperative parameters, including PSA‐based parameters, and endorectal MRI, predictive of pathological stage in males who underwent radical prostatectomy. Methods We studied 114 patients who underwent radical retropubic prostatectomy and pe...
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| Veröffentlicht in: | The Prostate 2003-06, Vol.56 (1), p.23-29 |
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| creator | Horiguchi, Akio Nakashima, Jun Horiguchi, Yutaka Nakagawa, Ken Oya, Mototsugu Ohigashi, Takashi Marumo, Ken Murai, Masaru |
| description | Backgrounds
The present study was designed to identify the preoperative parameters, including PSA‐based parameters, and endorectal MRI, predictive of pathological stage in males who underwent radical prostatectomy.
Methods
We studied 114 patients who underwent radical retropubic prostatectomy and pelvic lymphadenectomy for clinically localized prostate cancer. Clinical stage was assessed by DRE, pelvic CT scan, endorectal MRI, and bone scan. The correlation between the preoperative parameters, including PSA‐based parameters, clinical stage, and histological findings of biopsy specimens, and the pathological stage was analyzed. Logistic regression analysis was performed to identify a significant set of independent predictors for local extent of disease.
Results
Seventy‐six (66.6%) patients had organ confined cancer and 38 (33.4%) patients had extraprostatic cancer. Of the 38 patients with extraprostatic cancer, four had seminal vesicle involvement, while, none had pelvic lymph node involvement. Biopsy Gleason score, PSA, PSA‐α1‐antichymotrypsin (PSA‐ACT), PSA‐density (PSAD), PSA‐transition zone density, PSA‐ACT density, and PSA‐ACT transition zone (TZ) density were significantly higher and percent free PSA was lower in the patients with organ confined cancer than those with extraprostatic cancer (P |
| doi_str_mv | 10.1002/pros.10239 |
| format | Article |
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The present study was designed to identify the preoperative parameters, including PSA‐based parameters, and endorectal MRI, predictive of pathological stage in males who underwent radical prostatectomy.
Methods
We studied 114 patients who underwent radical retropubic prostatectomy and pelvic lymphadenectomy for clinically localized prostate cancer. Clinical stage was assessed by DRE, pelvic CT scan, endorectal MRI, and bone scan. The correlation between the preoperative parameters, including PSA‐based parameters, clinical stage, and histological findings of biopsy specimens, and the pathological stage was analyzed. Logistic regression analysis was performed to identify a significant set of independent predictors for local extent of disease.
Results
Seventy‐six (66.6%) patients had organ confined cancer and 38 (33.4%) patients had extraprostatic cancer. Of the 38 patients with extraprostatic cancer, four had seminal vesicle involvement, while, none had pelvic lymph node involvement. Biopsy Gleason score, PSA, PSA‐α1‐antichymotrypsin (PSA‐ACT), PSA‐density (PSAD), PSA‐transition zone density, PSA‐ACT density, and PSA‐ACT transition zone (TZ) density were significantly higher and percent free PSA was lower in the patients with organ confined cancer than those with extraprostatic cancer (P < 0.01). PSAD showed the largest area under the ROC curve (AUC) among those parameters (AUC = 0.732). Sixty‐eight (74.7%) of 91 patients with T2 on endorectal MRI had organ confined cancer, while 15 (65.2%) of 23 patients with T3 had extraprostatic cancer (P < 0.01). Multivariate logistic regression analysis indicated that Gleason score (≥7 vs. ≤6), endorectal MRI findings, and PSAD were significant predictors of extraprostatic cancer (P < 0.01).
Conclusions
The present study demonstrated that preoperative PSAD was the most valuable predictor among PSA‐based parameters for extraprostatic disease in patients with clinically localized prostate cancer. The combination of PSAD, endorectal MRI findings, and biopsy Gleason score can provide additional information for selecting appropriate candidates for radical prostatectomy. Prostate 56: 23–29, 2003. © 2003 Wiley‐Liss, Inc.</description><identifier>ISSN: 0270-4137</identifier><identifier>EISSN: 1097-0045</identifier><identifier>DOI: 10.1002/pros.10239</identifier><identifier>PMID: 12746843</identifier><identifier>CODEN: PRSTDS</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Aged ; Biological and medical sciences ; Biopsy ; Humans ; Logistic Models ; Magnetic Resonance Imaging - methods ; Male ; Medical sciences ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Nephrology. Urinary tract diseases ; pathological stage ; Predictive Value of Tests ; Preoperative Care ; Prostate-Specific Antigen - analysis ; Prostatectomy ; Prostatic Neoplasms - chemistry ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - surgery ; PSA-based parameters ; radical prostatectomy ; Rectum ; Tumors of the urinary system ; Urinary tract. Prostate gland</subject><ispartof>The Prostate, 2003-06, Vol.56 (1), p.23-29</ispartof><rights>Copyright © 2003 Wiley‐Liss, Inc.</rights><rights>2003 INIST-CNRS</rights><rights>Copyright 2003 Wiley-Liss, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4959-b12a24d571dd5fffa7a5dc7d87d08c3f1b88ca5dbb925bf5b1f059a460b9a4f63</citedby><cites>FETCH-LOGICAL-c4959-b12a24d571dd5fffa7a5dc7d87d08c3f1b88ca5dbb925bf5b1f059a460b9a4f63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpros.10239$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpros.10239$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14793140$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12746843$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Horiguchi, Akio</creatorcontrib><creatorcontrib>Nakashima, Jun</creatorcontrib><creatorcontrib>Horiguchi, Yutaka</creatorcontrib><creatorcontrib>Nakagawa, Ken</creatorcontrib><creatorcontrib>Oya, Mototsugu</creatorcontrib><creatorcontrib>Ohigashi, Takashi</creatorcontrib><creatorcontrib>Marumo, Ken</creatorcontrib><creatorcontrib>Murai, Masaru</creatorcontrib><title>Prediction of extraprostatic cancer by prostate specific antigen density, endorectal MRI, and biopsy Gleason score in clinically localized prostate cancer</title><title>The Prostate</title><addtitle>Prostate</addtitle><description>Backgrounds
The present study was designed to identify the preoperative parameters, including PSA‐based parameters, and endorectal MRI, predictive of pathological stage in males who underwent radical prostatectomy.
Methods
We studied 114 patients who underwent radical retropubic prostatectomy and pelvic lymphadenectomy for clinically localized prostate cancer. Clinical stage was assessed by DRE, pelvic CT scan, endorectal MRI, and bone scan. The correlation between the preoperative parameters, including PSA‐based parameters, clinical stage, and histological findings of biopsy specimens, and the pathological stage was analyzed. Logistic regression analysis was performed to identify a significant set of independent predictors for local extent of disease.
Results
Seventy‐six (66.6%) patients had organ confined cancer and 38 (33.4%) patients had extraprostatic cancer. Of the 38 patients with extraprostatic cancer, four had seminal vesicle involvement, while, none had pelvic lymph node involvement. Biopsy Gleason score, PSA, PSA‐α1‐antichymotrypsin (PSA‐ACT), PSA‐density (PSAD), PSA‐transition zone density, PSA‐ACT density, and PSA‐ACT transition zone (TZ) density were significantly higher and percent free PSA was lower in the patients with organ confined cancer than those with extraprostatic cancer (P < 0.01). PSAD showed the largest area under the ROC curve (AUC) among those parameters (AUC = 0.732). Sixty‐eight (74.7%) of 91 patients with T2 on endorectal MRI had organ confined cancer, while 15 (65.2%) of 23 patients with T3 had extraprostatic cancer (P < 0.01). Multivariate logistic regression analysis indicated that Gleason score (≥7 vs. ≤6), endorectal MRI findings, and PSAD were significant predictors of extraprostatic cancer (P < 0.01).
Conclusions
The present study demonstrated that preoperative PSAD was the most valuable predictor among PSA‐based parameters for extraprostatic disease in patients with clinically localized prostate cancer. The combination of PSAD, endorectal MRI findings, and biopsy Gleason score can provide additional information for selecting appropriate candidates for radical prostatectomy. Prostate 56: 23–29, 2003. © 2003 Wiley‐Liss, Inc.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Staging</subject><subject>Nephrology. Urinary tract diseases</subject><subject>pathological stage</subject><subject>Predictive Value of Tests</subject><subject>Preoperative Care</subject><subject>Prostate-Specific Antigen - analysis</subject><subject>Prostatectomy</subject><subject>Prostatic Neoplasms - chemistry</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - surgery</subject><subject>PSA-based parameters</subject><subject>radical prostatectomy</subject><subject>Rectum</subject><subject>Tumors of the urinary system</subject><subject>Urinary tract. Prostate gland</subject><issn>0270-4137</issn><issn>1097-0045</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9u1DAQxi0EotvChQdAvsChasB24jg5ohUslZa22hbBzfKfMTJ4k8XOioZH4WnxksDeuHis8W--zzOD0DNKXlFC2Otd7FO-sbJ9gBaUtKIgpOIP0YIwQYqKluIEnab0lZCME_YYnVAmqrqpygX6dRPBejP4vsO9w3A_RHXQG9TgDTaqMxCxHvGcA5x2YLzLb6ob_BfosIUu-WG8wNDZPoIZVMAfNpcXGbBY-36XRrwKoFJ2SCYT2HfYBN95o0IYcehz9D_BHj0m2yfokVMhwdM5nqGP797eLd8X6-vV5fLNujBVy9tCU6ZYZbmg1nLnnBKKWyNsIyxpTOmobhqTU1q3jGvHNXWEt6qqic6nq8sz9HLSzf7f95AGufXJQAiqg36fpCgZr4VoM3g-gSZ_NEVwchf9VsVRUiIPm5CHDuSfTWT4-ay611uwR3QefQZezIBKeQIu5qZ9OnJVdqQVyRyduB8-wPgfS3mzub79a15MNT4NcP-vRsVvshal4PLT1UquN7dXd5-XG8nK3wZwtJE</recordid><startdate>20030615</startdate><enddate>20030615</enddate><creator>Horiguchi, Akio</creator><creator>Nakashima, Jun</creator><creator>Horiguchi, Yutaka</creator><creator>Nakagawa, Ken</creator><creator>Oya, Mototsugu</creator><creator>Ohigashi, Takashi</creator><creator>Marumo, Ken</creator><creator>Murai, Masaru</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Liss</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20030615</creationdate><title>Prediction of extraprostatic cancer by prostate specific antigen density, endorectal MRI, and biopsy Gleason score in clinically localized prostate cancer</title><author>Horiguchi, Akio ; Nakashima, Jun ; Horiguchi, Yutaka ; Nakagawa, Ken ; Oya, Mototsugu ; Ohigashi, Takashi ; Marumo, Ken ; Murai, Masaru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4959-b12a24d571dd5fffa7a5dc7d87d08c3f1b88ca5dbb925bf5b1f059a460b9a4f63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neoplasm Staging</topic><topic>Nephrology. Urinary tract diseases</topic><topic>pathological stage</topic><topic>Predictive Value of Tests</topic><topic>Preoperative Care</topic><topic>Prostate-Specific Antigen - analysis</topic><topic>Prostatectomy</topic><topic>Prostatic Neoplasms - chemistry</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - surgery</topic><topic>PSA-based parameters</topic><topic>radical prostatectomy</topic><topic>Rectum</topic><topic>Tumors of the urinary system</topic><topic>Urinary tract. Prostate gland</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Horiguchi, Akio</creatorcontrib><creatorcontrib>Nakashima, Jun</creatorcontrib><creatorcontrib>Horiguchi, Yutaka</creatorcontrib><creatorcontrib>Nakagawa, Ken</creatorcontrib><creatorcontrib>Oya, Mototsugu</creatorcontrib><creatorcontrib>Ohigashi, Takashi</creatorcontrib><creatorcontrib>Marumo, Ken</creatorcontrib><creatorcontrib>Murai, Masaru</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Prostate</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Horiguchi, Akio</au><au>Nakashima, Jun</au><au>Horiguchi, Yutaka</au><au>Nakagawa, Ken</au><au>Oya, Mototsugu</au><au>Ohigashi, Takashi</au><au>Marumo, Ken</au><au>Murai, Masaru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prediction of extraprostatic cancer by prostate specific antigen density, endorectal MRI, and biopsy Gleason score in clinically localized prostate cancer</atitle><jtitle>The Prostate</jtitle><addtitle>Prostate</addtitle><date>2003-06-15</date><risdate>2003</risdate><volume>56</volume><issue>1</issue><spage>23</spage><epage>29</epage><pages>23-29</pages><issn>0270-4137</issn><eissn>1097-0045</eissn><coden>PRSTDS</coden><abstract>Backgrounds
The present study was designed to identify the preoperative parameters, including PSA‐based parameters, and endorectal MRI, predictive of pathological stage in males who underwent radical prostatectomy.
Methods
We studied 114 patients who underwent radical retropubic prostatectomy and pelvic lymphadenectomy for clinically localized prostate cancer. Clinical stage was assessed by DRE, pelvic CT scan, endorectal MRI, and bone scan. The correlation between the preoperative parameters, including PSA‐based parameters, clinical stage, and histological findings of biopsy specimens, and the pathological stage was analyzed. Logistic regression analysis was performed to identify a significant set of independent predictors for local extent of disease.
Results
Seventy‐six (66.6%) patients had organ confined cancer and 38 (33.4%) patients had extraprostatic cancer. Of the 38 patients with extraprostatic cancer, four had seminal vesicle involvement, while, none had pelvic lymph node involvement. Biopsy Gleason score, PSA, PSA‐α1‐antichymotrypsin (PSA‐ACT), PSA‐density (PSAD), PSA‐transition zone density, PSA‐ACT density, and PSA‐ACT transition zone (TZ) density were significantly higher and percent free PSA was lower in the patients with organ confined cancer than those with extraprostatic cancer (P < 0.01). PSAD showed the largest area under the ROC curve (AUC) among those parameters (AUC = 0.732). Sixty‐eight (74.7%) of 91 patients with T2 on endorectal MRI had organ confined cancer, while 15 (65.2%) of 23 patients with T3 had extraprostatic cancer (P < 0.01). Multivariate logistic regression analysis indicated that Gleason score (≥7 vs. ≤6), endorectal MRI findings, and PSAD were significant predictors of extraprostatic cancer (P < 0.01).
Conclusions
The present study demonstrated that preoperative PSAD was the most valuable predictor among PSA‐based parameters for extraprostatic disease in patients with clinically localized prostate cancer. The combination of PSAD, endorectal MRI findings, and biopsy Gleason score can provide additional information for selecting appropriate candidates for radical prostatectomy. Prostate 56: 23–29, 2003. © 2003 Wiley‐Liss, Inc.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>12746843</pmid><doi>10.1002/pros.10239</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Biological and medical sciences Biopsy Humans Logistic Models Magnetic Resonance Imaging - methods Male Medical sciences Middle Aged Multivariate Analysis Neoplasm Staging Nephrology. Urinary tract diseases pathological stage Predictive Value of Tests Preoperative Care Prostate-Specific Antigen - analysis Prostatectomy Prostatic Neoplasms - chemistry Prostatic Neoplasms - pathology Prostatic Neoplasms - surgery PSA-based parameters radical prostatectomy Rectum Tumors of the urinary system Urinary tract. Prostate gland |
| title | Prediction of extraprostatic cancer by prostate specific antigen density, endorectal MRI, and biopsy Gleason score in clinically localized prostate cancer |
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