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Preoperative predictors of pathologic stage T2a and pathologic Gleason score ≤ 6 in men with clinical low-risk prostate cancer treated with radical prostatectomy: reference for active surveillance

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Abstract

To assess preoperative parameters that may be predictive of pathologic stage T2a (pT2a) and pathologic Gleason score (pGS) ≤ 6 disease in low-risk prostate cancer patients considering active surveillance. A cohort of 1,495 men with low-risk prostate cancer between 1993 and 2009 was utilized. Preoperative assessment focused on patient age, race, diagnostic PSA level, clinical stage, diagnostic biopsy Gleason score, and prostate cancer laterality. Kaplan–Meier curves and a Cox regression model were used for analysis of PSA recurrence. Preoperative parameters were analyzed by univariate and multivariate logistic regression methods. Of 1,495 patients, 187 (12.5 %) were identified with pT2a and pGS ≤ 6 disease. Of the 187 men with pT2a and pGS ≤ 6 disease, only 6 (3.2 %) cases had PSA recurrence. Kaplan–Meier PSA recurrence-free survival curves identified a difference between prostate cancers with pT2a and pGS ≤ 6 and prostate cancers with >pT2a or pGS ≥ 7 disease (p = 0.002). Only biopsy tumor unilaterality (OR, 10.452; p ≤ 0.001) and low diagnostic PSA levels (OR, 0.887; p = 0.003) were independent predictors of prostate cancers with pT2a and pGS ≤ 6 disease on univariate and multivariate logistic regression. Biopsy tumor unilaterality and low diagnostic PSA levels are the independent predictors of pT2a and pGS ≤ 6 disease in low-risk prostate cancer patients. Unilateral cancer by prostate biopsy and low diagnostic PSA level may be the reference to improving the selection of appropriate candidates for active surveillance within a low-risk prostate cancer cohort.

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The authors declare no conflict of interest.

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Authors and Affiliations

  1. Division of Urology, Department of Surgery, Duke Prostate Center, Duke University Medical Center (DUMC), Box 2804, Durham, NC, 27710, USA

    Qiang Fu, Judd W. Moul, Lionel Bañez, Leon Sun, Vladimir Mouraviev, Donghua Xie & Thomas J. Polascik

  2. Department of Urology, Provincial Hospital Affiliated To Shandong University, Jinan, 250021, China

    Qiang Fu

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  1. Qiang Fu
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  2. Judd W. Moul
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  3. Lionel Bañez
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  4. Leon Sun
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  5. Vladimir Mouraviev
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  6. Donghua Xie
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  7. Thomas J. Polascik
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Correspondence to Thomas J. Polascik.

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Fu, Q., Moul, J.W., Bañez, L. et al. Preoperative predictors of pathologic stage T2a and pathologic Gleason score ≤ 6 in men with clinical low-risk prostate cancer treated with radical prostatectomy: reference for active surveillance. Med Oncol 30, 326 (2013). https://doi.org/10.1007/s12032-012-0326-5

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  • DOI: https://doi.org/10.1007/s12032-012-0326-5

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