Histopathological findings in extended prostate biopsy with PSA ≤ 4 ng/mL
Int. braz. j. urol
;
34(3): 283-292, May-June 2008. tab
Article
in English
| LILACS
| ID: lil-489587
ABSTRACT
OBJECTIVE:
Cancer detection has been reported in up to 27 percent of patients when lowering the PSA cutoff to 2.5 ng/mL. Although this practice could increase the number of biopsies performed, it also could lead to more frequent detection of significant prostate cancers at an organ-confined stage and/or a less aggressive state. This study describes the incidence of malignancy and tumor characteristics in extended prostate biopsies with PSA ≤ 4 ng/mL. MATERIALS ANDMETHODS:
Prostate biopsies from 1081 patients where examined, 275 (25.4 percent) patients had PSA level ≤ 4 ng/mL.RESULTS:
Cancer was diagnosed in 32.0 percent and 35.7 percent of patients with PSA ≤ 4 ng/mL and > 4 ng/mL, respectively (p = 0.906). The median Gleason score was 7 independent of PSA > or ≤ 4 ng/mL (p = 0.078). The median number of cores positive for tumor was 4 and 3, respectively, for PSA > 4 ng/mL and PSA ≤ 4 ng/mL (p = 0.627). There was a difference in the total percent of tumors involving all cores, 11 percent and 7 percent for PSA > or ≤ 4 ng/mL (p = 0.042). Fifty-six patients underwent radical prostatectomy, 12 had PSA ¡Ü 4 ng/mL. In both groups, a diagnosis of cancer was accurate with no differences in Gleason score, tumor volume or staging for both groups.CONCLUSION:
When PSA is below 4 ng/mL, cancer is detected in a proportion equal to the proportion diagnosed with a PSA > 4 ng/mL, and tumor characteristics are similar between the two groups. Only clinically significant tumors were diagnosed following radical prostatectomy.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Prostate
/
Prostatectomy
/
Prostatic Neoplasms
/
Adenocarcinoma
/
Prostate-Specific Antigen
Type of study:
Diagnostic study
/
Prognostic study
/
Screening study
Limits:
Adult
/
Aged
/
Aged80
/
Humans
/
Male
Language:
English
Journal:
Int. braz. j. urol
Journal subject:
Urology
Year:
2008
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
USP/BR
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