کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4000040 1259365 2013 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Long-term oncological outcomes of men undergoing radical prostatectomy with preoperative prostate-specific antigen <2.5 ng/ml and 2.5–4 ng/ml
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی تومور شناسی
پیش نمایش صفحه اول مقاله
Long-term oncological outcomes of men undergoing radical prostatectomy with preoperative prostate-specific antigen <2.5 ng/ml and 2.5–4 ng/ml
چکیده انگلیسی

ObjectivesProstate-specific antigen (PSA) screening has increased the detection of small, organ-confined tumors, and studies suggest that these patients may have favorable outcomes following radical prostatectomy (RP). To date, there are limited data available on the outcomes of patients diagnosed with low PSA (≤4 ng/ml) who underwent RP. This study aimed to evaluate long-term oncological outcomes of patients undergoing RP with preoperative PSA <2.5 and 2.5–4 ng/ml compared with PSA 4.1–10 ng/ml.Materials and methodsData were analyzed from 3,621 men who underwent RP between 1988 and 2010 at our institution. Patients were stratified into 3 PSA groups: <2.5 ng/ml (n = 280), 2.5–4 ng/ml (n = 563), and 4.1–10 ng/ml (n = 2,778). Patient and disease characteristics were compared. Overall, biochemical disease-free (bDFS), and PCa-specific survivals were analyzed and compared between the groups. Multivariable analyses were conducted using proportional hazards model.ResultsCompared with the 4.1–10 ng/ml PSA group, Gleason score >7, extracapsular extension, and non-organ-confined disease were less common in patients with PSA ≤4 ng/ml (all P < 0.001). The incidence of organ-confined disease was similar between the PSA < 2.5 and 2.5–4 ng/ml groups while perineural invasion (P = 0.050) and Gleason score ≥7 (P = 0.026) were more common in the 2.5–4 ng/ml PSA group. Estimated 10-year overall and PCa-specific survivals were comparable across all PSA groups, whereas bDFS was significantly lower in PSA 4.1–10 group (P < 0.001). bDFS was not statistically different between PSA <2.5 and 2.5–4 groups (P = 0.300). 10-year bDFS were 59.0%, 70.1%, and 76.4% in PSA 4.1–10, 2.5–4, and <2.5, respectively. For the PSA ≤ 4 ng/ml groups, age, race, margin status, pathologic stage, but not PSA were independent predictors of bDFS, whereas age, pathologic Gleason, and biochemical recurrence were associated with overall survival.ConclusionsLong-term oncological outcomes (overall, bDFS, PCa-specific survivals) of patients presenting with low PSA (≤4 ng/ml) were excellent in this study. Compared with PSA 4.1–10 ng/ml, patients presenting with PSA ≤4 ng/ml had better bDFS outcomes. However, there was no difference in long-term outcomes between PSA <2.5 and 2.5–4 ng/ml.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Urologic Oncology: Seminars and Original Investigations - Volume 31, Issue 8, November 2013, Pages 1527–1532
نویسندگان
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