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Is prostate-specific antigen (PSA) density better than the preoperative PSA level in predicting early biochemical recurrence of prostate cancer after radical prostatectomy?
BJU Int. 2006 Mar; 97(3):480-4.BI

Abstract

OBJECTIVE

To investigate the relationship of preoperative prostate-specific antigen (PSA) level and PSA density with several clinical and pathological variables, including biochemical recurrence after radical prostatectomy (RP), and to compare the preoperative PSA level and PSA density as prognostic factors in prostate cancer.

PATIENTS AND METHODS

The study included 348 patients who had a RP at one institution, with whole-mount specimens of the prostate examined by one pathologist. Univariate and multivariate analyses were used to assess the relationship of the preoperative PSA level and PSA density with clinical and pathological variables, and by receiver operating characteristic (ROC) analysis to evaluate the relative usefulness of the two factors as predictors for biochemical recurrence.

RESULTS

The PSA level before RP was significantly correlated (Spearman's rank correlation) with patient age (P = 0.003), prostate weight (P < 0.001), cancer volume (P < 0.001) and Gleason score (P = 0.033), and with surgical margin status and pathological stage (both P < 0.001) in the RP specimen. In the multivariate analysis controlling for tumour stage, surgical margin status, and Gleason score, both PSA level and PSA density were significant predictors of PSA recurrence (P = 0.027 and 0.01, respectively). ROC analysis showed no statistical difference between the PSA level and PSA density in predicting PSA recurrence after RP (P = 0.40).

CONCLUSIONS

These results show a significant correlation of the preoperative PSA level with other established prognostic factors for prostate cancer. In the multivariate analysis, both PSA level and PSA density were independent predictors of PSA recurrence. Because the PSA level is as effective as PSA density in predicting PSA recurrence, the extra effort required to calculate PSA density may not be warranted. We recommend that the PSA level before RP be considered in stratifying patients into different prognostic groups, and in determining the optimum management.

Authors+Show Affiliations

Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

16469012

Citation

Jones, Timothy D., et al. "Is Prostate-specific Antigen (PSA) Density Better Than the Preoperative PSA Level in Predicting Early Biochemical Recurrence of Prostate Cancer After Radical Prostatectomy?" BJU International, vol. 97, no. 3, 2006, pp. 480-4.
Jones TD, Koch MO, Bunde PJ, et al. Is prostate-specific antigen (PSA) density better than the preoperative PSA level in predicting early biochemical recurrence of prostate cancer after radical prostatectomy? BJU Int. 2006;97(3):480-4.
Jones, T. D., Koch, M. O., Bunde, P. J., & Cheng, L. (2006). Is prostate-specific antigen (PSA) density better than the preoperative PSA level in predicting early biochemical recurrence of prostate cancer after radical prostatectomy? BJU International, 97(3), 480-4.
Jones TD, et al. Is Prostate-specific Antigen (PSA) Density Better Than the Preoperative PSA Level in Predicting Early Biochemical Recurrence of Prostate Cancer After Radical Prostatectomy. BJU Int. 2006;97(3):480-4. PubMed PMID: 16469012.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is prostate-specific antigen (PSA) density better than the preoperative PSA level in predicting early biochemical recurrence of prostate cancer after radical prostatectomy? AU - Jones,Timothy D, AU - Koch,Michael O, AU - Bunde,Paula J, AU - Cheng,Liang, PY - 2006/2/14/pubmed PY - 2006/4/4/medline PY - 2006/2/14/entrez SP - 480 EP - 4 JF - BJU international JO - BJU Int VL - 97 IS - 3 N2 - OBJECTIVE: To investigate the relationship of preoperative prostate-specific antigen (PSA) level and PSA density with several clinical and pathological variables, including biochemical recurrence after radical prostatectomy (RP), and to compare the preoperative PSA level and PSA density as prognostic factors in prostate cancer. PATIENTS AND METHODS: The study included 348 patients who had a RP at one institution, with whole-mount specimens of the prostate examined by one pathologist. Univariate and multivariate analyses were used to assess the relationship of the preoperative PSA level and PSA density with clinical and pathological variables, and by receiver operating characteristic (ROC) analysis to evaluate the relative usefulness of the two factors as predictors for biochemical recurrence. RESULTS: The PSA level before RP was significantly correlated (Spearman's rank correlation) with patient age (P = 0.003), prostate weight (P < 0.001), cancer volume (P < 0.001) and Gleason score (P = 0.033), and with surgical margin status and pathological stage (both P < 0.001) in the RP specimen. In the multivariate analysis controlling for tumour stage, surgical margin status, and Gleason score, both PSA level and PSA density were significant predictors of PSA recurrence (P = 0.027 and 0.01, respectively). ROC analysis showed no statistical difference between the PSA level and PSA density in predicting PSA recurrence after RP (P = 0.40). CONCLUSIONS: These results show a significant correlation of the preoperative PSA level with other established prognostic factors for prostate cancer. In the multivariate analysis, both PSA level and PSA density were independent predictors of PSA recurrence. Because the PSA level is as effective as PSA density in predicting PSA recurrence, the extra effort required to calculate PSA density may not be warranted. We recommend that the PSA level before RP be considered in stratifying patients into different prognostic groups, and in determining the optimum management. SN - 1464-4096 UR - https://www.unboundmedicine.com/medline/citation/16469012/Is_prostate_specific_antigen__PSA__density_better_than_the_preoperative_PSA_level_in_predicting_early_biochemical_recurrence_of_prostate_cancer_after_radical_prostatectomy L2 - https://doi.org/10.1111/j.1464-410X.2006.06022.x DB - PRIME DP - Unbound Medicine ER -