Korean J Urol.  2009 Apr;50(4):320-326.

Analysis of the Clinicopathologic Characteristics of Men with Prostate Cancer Undergoing Radical Prostatectomy in the Prostate-Specific Antigen Range of Less than 4 ng/ml

• Kwon T
• Jeong IG
• Hong JH
• Ahn H
• Kim CS

Abstract

PURPOSE
We analyzed the clinicopathologic characteristics of men undergoing radical prostatectomy in the prostate-specific antigen (PSA) range of less than 4 ng/ml and compared this with the results for men who had a PSA range of 4 to 9.9 ng/ml. MATERIALS AND METHODS: The study population consisted of 447 men treated for prostate cancer with radical prostatectomy between 1990 and 2006 at our institute who had a prebiopsy PSA of less than 10 ng/ml. The average follow-up period was 37 months. Clinicopathologic characteristics were compared between men with a PSA value of less than 4 ng/ml (low-PSA group) and men with a value in the range of 4 to 9.9 ng/ml (intermediate-PSA group). Survival analysis was performed by the Kaplan-Meier method and Cox proportional hazard regression analysis. RESULTS: Of these 447 patients, 60 (13.4%) and 387 (86.6%) had a low or an intermediate prebiopsy PSA level, respectively. The pathologic findings of the prostatectomy specimens showed no significant differences between the 2 groups, including Gleason score and pathologic stage. The 5-year biochemical recurrence-free survival in the low- and intermediate-PSA groups was 82.8% and 79.3%, respectively, and there was no significant difference between the 2 groups (p=0.946). Multivariate analysis showed that, in the entire cohort, pathologic Gleason score and lymph node involvement were independent predictors of biochemical recurrence. CONCLUSIONS: No statistically significant differences were found in clinicopathologic characteristics or clinical outcome between the low- and intermediate-PSA groups. These results suggest that a lower PSA cutoff should be considered as an indication for prostate biopsy in the Korean population.

Keyword

Prostate-specific antigen; Prostatic neoplasms; Prostatectomy

MeSH Terms

Biopsy
Cohort Studies
Follow-Up Studies
Humans
Lymph Nodes
Male
Multivariate Analysis
Neoplasm Grading
Prostate
Prostate-Specific Antigen
Prostatectomy
Prostatic Neoplasms
Recurrence
Prostate-Specific Antigen

Figure

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  Fig. 1 Five-year biochemical recurrence-free survival after radical prostatectomy by preoperative prostate-specific antigen (PSA) level in the entire cohort of patients with a PSA value of less than 10 ng/ml (n=447, p=0.946).

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  Fig. 2 Five-year biochemical recurrence-free survival by preoperative prostate-specific antigen (PSA) level in men without an abnormal digital rectal examination (n=266, p=0.076).

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