Predictive Factors of Unfavorable Prostate Cancer in Patients Who Underwent Prostatectomy but Eligible for Active Surveillance

Overview

Journal Prostate Int

Date 2014 Jul 18

PMID 25032192

Citations 4

Authors

Seol Ho Choo

Hwang Gyun Jeon

Byong Chang Jeong

Seong Il Seo

Seong Soo Jeon

Han Yong Choi

Hyun Moo Lee

Affiliations

Soon will be listed here.

Abstract

Purpose: To investigate the predictive factors of unfavorable prostate cancer in Korean men who underwent radical prostatectomy but eligible for active surveillance according to Epstein criteria.

Methods: We retrospectively reviewed the medical records of 2,036 patients who underwent radical prostatectomy for prostate cancer between 1994 and 2011. Among these, 233 patients were eligible for active surveillance based on Epstein criteria. Unfavorable prostate cancer was defined as pathologic Gleason sum ≥7 or non-organ-confined disease. We investigated pathologic outcomes and predictive factors for unfavorable prostate cancer.

Results: Of 233 cases, 91 patients (39.1%) were pathologic Gleason sum ≥7, 11 (4.7%) had extracapsular extension, and three (1.3%) had seminal vesicle invasion. Ninety-eight patients (42.1%) had unfavorable prostate cancer. When comparing clinically insignificant and significant prostate cancer, there were significant differences in mean age (P=0.007), prostate volume (P=0.021), prostate-specific antigen (PSA) density (P=0.03), maximum tumor volume in biopsy core (P<0.001), and rate of two positive cores (P=0.001). On multivariate analysis, age (P=0.015), PSA density (P=0.017) and two positive cores (P=0.001) were independent predictive factors for unfavorable prostate cancer.

Conclusions: A significant proportion of patients who were candidates for active surveillance had unfavorable prostate cancer. Age, PSA density, and two positive cores were independent significant predictive factors for unfavorable prostate cancer. These factors should be considered when performing active surveillance.

Citing Articles

Diagnostic Accuracy of Contemporary Selection Criteria in Prostate Cancer Patients Eligible for Active Surveillance: A Bayesian Network Meta-Analysis.

Fan Y, Mulati Y, Zhai L, Chen Y, Wang Y, Feng J Front Oncol. 2022; 11:810736.

PMID: 35083157 PMC: 8785217. DOI: 10.3389/fonc.2021.810736.

Comparative rates of upstaging and upgrading in Caucasian and Korean prostate cancer patients eligible for active surveillance.

Jeon H, Yoo J, Jeong B, Seo S, Jeon S, Choi H PLoS One. 2017; 12(11):e0186026.

PMID: 29136019 PMC: 5685613. DOI: 10.1371/journal.pone.0186026.

Selection Criteria for Active Surveillance of Patients with Prostate Cancer in Korea: A Multicenter Analysis of Pathology after Radical Prostatectomy.

Jeong C, Hong S, Byun S, Jeon S, Seo S, Lee H Cancer Res Treat. 2017; 50(1):265-274.

PMID: 28421726 PMC: 5784641. DOI: 10.4143/crt.2016.477.

Current status of active surveillance in prostate cancer.

Chung M, Lee S Investig Clin Urol. 2016; 57(1):14-20.

PMID: 26966722 PMC: 4778755. DOI: 10.4111/icu.2016.57.1.14.

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