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Importance of tumor location in patients with high preoperative prostate specific antigen levels (greater than 20 ng/ml) treated with radical prostatectomy.
J Urol. 2007 Oct; 178(4 Pt 1):1311-5.JU

Abstract

PURPOSE

We investigated the effect of tumor location (anterior vs posterior) on pathological characteristics and biochemical-free survival in patients with a preoperative prostate specific antigen level of greater than 20 ng/ml undergoing radical prostatectomy since transition zone tumors are known to present with higher prostate specific antigen levels.

MATERIALS AND METHODS

We retrospectively studied the records of 265 patients treated with radical prostatectomy between 1984 and 2005 who had preoperative prostate specific antigen levels greater than 20 ng/ml. Review of pathology reports was performed and tumor location (anterior vs posterior) was defined. Differences in clinicopathological characteristics and prostate specific antigen recurrence rates were examined.

RESULTS

Of 265 patients with a preoperative prostate specific antigen level of greater than 20 ng/ml who underwent radical prostatectomy 50 (19%) had anterior tumors and 215 (81%) had posterior tumors. Patients with anterior tumors had lower clinical stage and less seminal vesicle involvement than patients with posterior tumors (p = 0.006 and <0.001, respectively). Although Kaplan-Meier analysis demonstrated significantly higher rates of 5-year biochemical recurrence-free survival for patients with anterior vs posterior tumors (63% vs 40%, p = 0.020), anterior tumor location was not an independent predictor of biochemical recurrence.

CONCLUSIONS

Radical prostatectomy is a feasible treatment option in patients with a preoperative prostate specific antigen level of greater than 20 ng/ml. The 5-year biochemical-free survival rate was 47%. Although anterior tumor location was associated with favorable pathological features and improved biochemical-free survival, it was not an independent predictor of biochemical recurrence. Further studies are warranted to identify patients with high preoperative prostate specific antigen levels most likely to have recurrence.

Authors+Show Affiliations

Department of Urology, The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17698095

Citation

Magheli, Ahmed, et al. "Importance of Tumor Location in Patients With High Preoperative Prostate Specific Antigen Levels (greater Than 20 Ng/ml) Treated With Radical Prostatectomy." The Journal of Urology, vol. 178, no. 4 Pt 1, 2007, pp. 1311-5.
Magheli A, Rais-Bahrami S, Peck HJ, et al. Importance of tumor location in patients with high preoperative prostate specific antigen levels (greater than 20 ng/ml) treated with radical prostatectomy. J Urol. 2007;178(4 Pt 1):1311-5.
Magheli, A., Rais-Bahrami, S., Peck, H. J., Walsh, P. C., Epstein, J. I., Trock, B. J., & Gonzalgo, M. L. (2007). Importance of tumor location in patients with high preoperative prostate specific antigen levels (greater than 20 ng/ml) treated with radical prostatectomy. The Journal of Urology, 178(4 Pt 1), 1311-5.
Magheli A, et al. Importance of Tumor Location in Patients With High Preoperative Prostate Specific Antigen Levels (greater Than 20 Ng/ml) Treated With Radical Prostatectomy. J Urol. 2007;178(4 Pt 1):1311-5. PubMed PMID: 17698095.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Importance of tumor location in patients with high preoperative prostate specific antigen levels (greater than 20 ng/ml) treated with radical prostatectomy. AU - Magheli,Ahmed, AU - Rais-Bahrami,Soroush, AU - Peck,Hugh J, AU - Walsh,Patrick C, AU - Epstein,Jonathan I, AU - Trock,Bruce J, AU - Gonzalgo,Mark L, Y1 - 2007/08/16/ PY - 2007/02/05/received PY - 2007/8/19/pubmed PY - 2007/10/20/medline PY - 2007/8/19/entrez SP - 1311 EP - 5 JF - The Journal of urology JO - J. Urol. VL - 178 IS - 4 Pt 1 N2 - PURPOSE: We investigated the effect of tumor location (anterior vs posterior) on pathological characteristics and biochemical-free survival in patients with a preoperative prostate specific antigen level of greater than 20 ng/ml undergoing radical prostatectomy since transition zone tumors are known to present with higher prostate specific antigen levels. MATERIALS AND METHODS: We retrospectively studied the records of 265 patients treated with radical prostatectomy between 1984 and 2005 who had preoperative prostate specific antigen levels greater than 20 ng/ml. Review of pathology reports was performed and tumor location (anterior vs posterior) was defined. Differences in clinicopathological characteristics and prostate specific antigen recurrence rates were examined. RESULTS: Of 265 patients with a preoperative prostate specific antigen level of greater than 20 ng/ml who underwent radical prostatectomy 50 (19%) had anterior tumors and 215 (81%) had posterior tumors. Patients with anterior tumors had lower clinical stage and less seminal vesicle involvement than patients with posterior tumors (p = 0.006 and <0.001, respectively). Although Kaplan-Meier analysis demonstrated significantly higher rates of 5-year biochemical recurrence-free survival for patients with anterior vs posterior tumors (63% vs 40%, p = 0.020), anterior tumor location was not an independent predictor of biochemical recurrence. CONCLUSIONS: Radical prostatectomy is a feasible treatment option in patients with a preoperative prostate specific antigen level of greater than 20 ng/ml. The 5-year biochemical-free survival rate was 47%. Although anterior tumor location was associated with favorable pathological features and improved biochemical-free survival, it was not an independent predictor of biochemical recurrence. Further studies are warranted to identify patients with high preoperative prostate specific antigen levels most likely to have recurrence. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/17698095/Importance_of_tumor_location_in_patients_with_high_preoperative_prostate_specific_antigen_levels__greater_than_20_ng/ml__treated_with_radical_prostatectomy_ L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2007.05.143?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -