PSA Density Predicts Worse Prostate Cancer Pathology

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PSA density (PSAD) predicts pathologic upstaging following radical prostatectomy (RP) for prostate cancer, a study found.

The finding suggests that PSAD may be an additional parameter that clinicians can use to counsel patients about heir post-operative outcomes, researchers concluded.

Michael R. Abern, MD, a urology resident at Rush University Medical Center in Chicago, and colleagues studied 203 patients, of whom 42 (21%) underwent perineal RP, 124 (61%) had retropubic RP, and 37 (18%) had robotic RP. PSAD was below 0.15 in 43% of subjects, 0.15-0.35 in 43%, and more than 35 in 14%.

Compared with men whose PSAD was below 0.15, those with a PSAD above 0.35 were 3.1 times more likely to have extracapsular extension, 2.8 times more likely to have positive lymph nodes, and 40% more likely to have positive margins, Dr. Abern reported.

As a result of study findings, urologists at Rush now use a PSAD above 0.35 as an additional criterion to decide which patients should undergo pelvic lymph node dissections, Dr. Abern told Renal & Urology News.
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