Predictors of Adverse Pathology After Prostate Cancer Surgery ID'd

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High PSA levels and larger number of positive biopsy cores are associated with positive surgical margins and extracapsular extension/seminal vesicle invasion after radical prostatectomy.
High PSA levels and larger number of positive biopsy cores are associated with positive surgical margins and extracapsular extension/seminal vesicle invasion after radical prostatectomy.

Higher PSA levels and a larger number of positive prostate biopsy cores are associated with adverse pathologic features following radical prostatectomy (RP) for low-risk prostate cancer (PCa), according to investigators.

In a study of 546 patients who underwent RP for low-risk PCa, investigators concluded that a PSA level greater than 4.5 ng/mL and the presence of more than 2 positive biopsy cores are the optimal values for predicting adverse pathologic features (APFs)—positive surgical margins (PSMs) and extracapsular extension (ECE)/seminal vesicle invasion (SVI)—following RP.

“Physicians should be aware of these parameters, which can predict APFs, and should avoid under-treatment of these patients,” Jae Won Park, MD, and colleagues at Yonsei University College of Medicine in Seoul, South Korea, concluded in a paper published in BMC Cancer (2018;18:545).

The men in the study had a median age of 64 years, median body mass index of 24.1 kg/m2, median prostate volume of 31 mL, and median PSA level of 5.6 ng/mL. Of the 546 patients, PSMs, ECE, and SVI were present in 179 (32.8%), 199 (36.4%), and 8 (1.5%), respectively.

Reference

Park JW, Koh DH, Jang WS, et al. Predictors of adverse pathologic features after radical prostatectomy in low-risk prostate cancer. BMC Cancer. 2018;18:545.

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