International Journal of Clinical Oncology

, Volume 20, Issue 1, pp 176–181 | Cite as

Prostate-specific antigen density predicts extracapsular extension and increased risk of biochemical recurrence in patients with high-risk prostate cancer who underwent radical prostatectomy

  • Takuya Koie
  • Koji Mitsuzuka
  • Takahiro Yoneyama
  • Shintaro Narita
  • Sadafumi Kawamura
  • Yasuhiro Kaiho
  • Norihiko Tsuchiya
  • Tatsuo Tochigi
  • Tomonori Habuchi
  • Yoichi Arai
  • Chikara Ohyama
  • Tohru Yoneyama
  • Yuki Tobisawa
Original Article

Abstract

Background

Patients with advanced local-stage, high-grade prostate cancer (Pca) and high pretreatment prostate-specific antigen (PSA) levels have inferior outcomes compared to their counterparts with more favorable clinical characteristics. However, some patients exhibit favorable pathological features or experience long-term PSA-free survival after radical prostatectomy (RP). We retrospectively examined the ability of preoperative characteristics to predict pathological and oncological outcomes in high-risk Pca patients who underwent RP.

Methods

We examined data of 1,268 consecutive Pca patients treated with RP alone at 4 hospitals from the Michinoku Urological Cancer Study Group database. Preoperative predictors included age, PSA level, biopsy Gleason score, clinical T stage, and PSA density (PSAD). The outcome measures pathological T stage and PSA-free survival were evaluated by multivariate analysis.

Results

We identified 380 high-risk Pca patients, of which 44 % patients had extracapsular extension. Logistic regression analysis indicated that PSAD was an independent predictor of adverse pathologic stage. The 5-year PSA-free survival rates were 82.9 % for patients with PSAD ≤0.468 ng mL−1 cm−2 and 50.7 % for those with PSAD >0.468 ng mL−1 cm−2 (P < 0.0001). Multivariate analyses revealed that PSAD, cT, and the number of preoperative high-risk Pca criteria were independent predictors of PSA-free survival.

Conclusions

PSAD may be an independent predictor of advanced pathological features and biochemical recurrence in high-risk Pca patients treated with RP alone. PSAD may be used for further risk stratification of high-risk Pca patients.

Keywords

Prostate cancer High-risk Prostate-specific antigen density Advanced prostate cancer Biochemical recurrence-free survival 

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Copyright information

© Japan Society of Clinical Oncology 2014

Authors and Affiliations

  • Takuya Koie
    • 1
  • Koji Mitsuzuka
    • 2
  • Takahiro Yoneyama
    • 1
  • Shintaro Narita
    • 3
  • Sadafumi Kawamura
    • 4
  • Yasuhiro Kaiho
    • 2
  • Norihiko Tsuchiya
    • 3
  • Tatsuo Tochigi
    • 4
  • Tomonori Habuchi
    • 3
  • Yoichi Arai
    • 2
  • Chikara Ohyama
    • 1
  • Tohru Yoneyama
    • 1
  • Yuki Tobisawa
    • 1
  1. 1.Department of UrologyHirosaki University Graduate School of MedicineHirosakiJapan
  2. 2.Department of UrologyTohoku University Graduate School of MedicineSendaiJapan
  3. 3.Department of UrologyAkita University Graduate School of MedicineAkitaJapan
  4. 4.Department of UrologyMiyagi Cancer CenterNatoriJapan

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