Alteration of Antithrombin III and D-dimer Levels in Clinically Localized Prostate Cancer

PURPOSE: We performed a comparative analysis of the plasma levels of antithrombin (AT) III, plasminogen, fibrinogen, and D-dimer among patients with and without clinically localized prostate cancer to investigate the clinical significance of the coagulation profile in prostate cancer. MATERIALS AND METHODS: A prospective study was performed in which plasma levels of AT III, plasminogen, fibrinogen, and D-dimer were assessed in patients before they underwent prostate biopsy. According to the results of the biopsy, the patients were categorized into the cancer group or the control group. Levels of the four coagulation factors were then compared between the cancer and control groups. Also, levels of the four coagulation factors were correlated with tumor stage and grade in the cancer group. RESULTS: The cancer group had significantly lower levels of AT III activity and higher plasma D-dimer levels than did the control group (p=0.007 and p=0.018, respectively). Within the cancer group, no significant differences were observed in the levels of AT III, plasminogen, fibrinogen, or D-dimer between those with a pathological Gleason score of > or =7 and otherwise. Regarding pathologic stage of prostate cancer, the subjects with organ-confined disease and those with extraprostatic extension of a tumor demonstrated no significant differences in the preoperative levels of the four coagulation factors analyzed. CONCLUSIONS: Our results suggest that plasma levels of AT III and D-dimer are altered in patients with prostate cancer. Further study is needed to elucidate the underlying mechanism and clinical significances of such a phenomenon among patients with clinically localized prostate cancer.

Initial Experiences with a New 120 W Greenlight(TM) High-Power System for Photoselective Vaporization of the Prostate for the Treatment of Benign Prostatic Hyperplasia in Korea

PURPOSE: After successful launches of a 120 W high-power system for photoselective vaporization of the prostate (HPS-PVP), several studies in the United States and Europe have reported good short-term data. Here we report the initial efficacy and side effects of the 120 W HPS-PVP in Korea. MATERIALS AND METHODS: Between January 2008 and January 2009, we performed a retrospective clinical analysis of 133 patients treated by HPS-PVP. RESULTS: The mean age at surgery was 68.4+/-8.0 years. The mean prostate size was 44.2+/-22.6 ml. The mean operation time was 58.9+/-33.5 minutes, and the mean total applied energy was 103,108+/-74,362 J. The mean duration of catheterization was 21.5+/-10.8 hours. The blood loss was minimal, and there were no transfusions. The baseline mean peak urinary flow rate (Qmax) was 10.4+/-5.0 ml/s, mean postvoid residual volume (PVR) was 77+/-91.3 ml, the mean International Prostate Symptom Score (IPSS) was 20.7+/-9.0, and the mean quality of life (QoL) score was 4.2+/-1.3. At 6 months, Qmax was 17.5+/-9.9 ml/sec, PVR was 49.0+/-56.0 ml, the IPSS was 8.0+/-9.0, and the QoL score was 1.6+/-1.5. During the first postoperative month, irritative urinary symptoms were reported in 18 cases, urge incontinence in 7, mild hematuria in 5, urinary tract infection in 2, and temporary recatheterization in 13. CONCLUSIONS: The new 120 W HPS-PVP showed good short-term safety and efficacy for the treatment of Korean patients with benign prostatic hyperplasia.