ISSN 2149-3235 | E-ISSN 2149-3057
Original Article
Does extent of prostate-specific antigen fluctuation can predict Gleason score upgrading in low-risk prostate cancer patients?
1 Department of Urology, Atatürk Training and Research Hospital, Ankara, Turkey  
2 Department of Urology, Ankara Yıldırım Beyazıt University School of Medicine, Ankara, Turkey  
Turk J Urol ; : -
DOI: 10.5152/tud.2018.41017
Key Words: Biochemical recurrence, fluctuation, Gleason score upgrading, prostate cancer, prostate-specific antigen
Abstract

 

Objective: To evaluate the effect of prostate-specific antigen (PSA) fluctuation on Gleason score (GS) upgrading, disease upstaging, oncological outcomes in low-risk prostate cancer (PCa) patients who underwent robot-assisted laparoscopic radical prostatectomy (RARP) and met the inclusion criteria for active surveillance (AS).

 

Material and methods: Data of 354 low-risk PCa patients who underwent RARP were retrospectively evaluated. Patients were divided into two groups: PSA fluctuation rate<9.5%/month (Group 1, n=192) and >9.5%/month (Group 2, n=162). Mainly compared parameters were GS upgrading, disease upstaging, biochemical recurrence (BCR) and surgical margin positivity (SMP) rates.

 

Results: GS upgrading, disease upstaging and SMP were detected in 128 (36.2%), 56 (15.8%) and 42 (11.9%) patients, respectively. After a median follow-up of 46 months, BCR was observed in 40 (11.3%) patients. GS upgrading (41.1% vs. 30.2%, p=0.033), disease upstaging (19.8% vs. 11.1%, p=0.028), SMP (15.1% vs. 8%, p=0.035) and BCR development (15.6% vs. 6.2%, p=0.005) rates were statistically significantly higher in Group 1 than Group 2. In multivariate analysis, digital rectal examination positivity, the presence of two positive cores and low PSA fluctuation rate were found to be significant predictors of GS upgrading.

 

Conclusion: Low PSA fluctuation rate is associated with higher GS upgrading.

 

Cite this article as: Hamidi N, Atmaca AF, Canda AE, Keske M, Ardıçoğlu A. Does extent of prostate-specific antigen fluctuation can predict Gleason score upgrading in low-risk prostate cancer patients? Turk J Urol 2018. DOI: 10.5152/tud.2018.41017.

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AVES | Copyright © 2018 Turkish Association of Urology | Latest Update: 08.10.2018