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• W2316247344 abstract "You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy III1 Apr 2016MP57-08 PROSTATE-SPECIFIC ANTIGEN DENSITY IS THE MOST APPROPRIATE FACTOR FOR DETECTING UNFAVORABLE PATHOLOGY AFTER RADICAL PROSTATECTOMY IN MEN ELIGIBLE FOR ACTIVE SURVEILLANCE FROM MUTLI-INSTITUTIONAL STUDY Takahiro Inoue, Kei Mizuno, Hidefumi Kinoshita, Toshifumi Yano, Hiroaki Kawanishi, Hideki Kanda, Naoki Terada, Tomomi Kamba, Kazuhiro Okumura, Mutsushi Kawakita, Keiji Ogura, Yoshiki Sugimura, Tadashi Matsuda, and Osamu Ogawa Takahiro InoueTakahiro Inoue More articles by this author , Kei MizunoKei Mizuno More articles by this author , Hidefumi KinoshitaHidefumi Kinoshita More articles by this author , Toshifumi YanoToshifumi Yano More articles by this author , Hiroaki KawanishiHiroaki Kawanishi More articles by this author , Hideki KandaHideki Kanda More articles by this author , Naoki TeradaNaoki Terada More articles by this author , Tomomi KambaTomomi Kamba More articles by this author , Kazuhiro OkumuraKazuhiro Okumura More articles by this author , Mutsushi KawakitaMutsushi Kawakita More articles by this author , Keiji OguraKeiji Ogura More articles by this author , Yoshiki SugimuraYoshiki Sugimura More articles by this author , Tadashi MatsudaTadashi Matsuda More articles by this author , and Osamu OgawaOsamu Ogawa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.662AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Most of low risk prostate cancer would not become life-threatening during lifetime. Active surveillance (AS) has emerged as an alternative to immediate treatment for those men, but the consensus in defining appropriate candidates is still lacking. We analyzed preoperative factors that predict upstaging (≥ pT3) or upgrading (radical prostatectomy (RP) Gleason score ≥ 7), defined as ′reclassification′, and also factors that detect pathological stage ≥ pT3 or RP Gleason score ≥ 4+3, defined as ′adverse pathology′ in AS candidates by examining the pathological findings of RP specimens. METHODS The retrospective study consisted of 1753 men who underwent RP at six independent high volume centers from 2005 to 2011. Of these patients, 306 met the AS criteria that included clinical stage T1c/T2 disease, serum PSA ≤ 10 ng/ml, Gleason score ≤ 6, and ≤ 2 positive cores. The clinic-pathological features were compared between patients with and without ′reclassification′ and ′adverse pathology′ after RP. RESULTS Among them, 167 (54.6%) required disease reclassification, and 42 (13.7%) had adverse pathology. Preoperative parameters evaluated included age, PSA, PSA density (PSAD), and number and percentage of positive cores. On multivariate analysis, age, PSAD and percentage of positive cores (PPCs) were independently associated with disease reclassification (P = 0.0033, 0.0006 and 0.0001, respectively), and PSAD and PPCs were with adverse pathology (P = 0.0030 and 0.047, respectively). The rate of reclassification and adverse pathology was significantly higher among patients with less than 10-core biopsy than the others (63.2% vs. 46.6%, P = 0.004 and 27.8% vs. 14.9%, P = 0.007, respectively). Multivariate analysis of the cases with 10 or more biopsy cores revealed PSAD and PPCs were significant factors of disease reclassification (P = 0.016 and 0.0084, respectively), and, PSAD was that of adverse pathology (P = 0.034). CONCLUSIONS Because the rate of reclassification and adverse pathology was significantly higher among patients with less than 10-core biopsy than the others, appropriate number of biopsy cores are needed when selecting candidates for AS. Furthermore, preoperative PSAD was still the most important factor associated with unfavorable pathological feature of RP specimens even under different methods of examination of prostate volume among the institutions. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e755-e756 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Takahiro Inoue More articles by this author Kei Mizuno More articles by this author Hidefumi Kinoshita More articles by this author Toshifumi Yano More articles by this author Hiroaki Kawanishi More articles by this author Hideki Kanda More articles by this author Naoki Terada More articles by this author Tomomi Kamba More articles by this author Kazuhiro Okumura More articles by this author Mutsushi Kawakita More articles by this author Keiji Ogura More articles by this author Yoshiki Sugimura More articles by this author Tadashi Matsuda More articles by this author Osamu Ogawa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2316247344 title "MP57-08 PROSTATE-SPECIFIC ANTIGEN DENSITY IS THE MOST APPROPRIATE FACTOR FOR DETECTING UNFAVORABLE PATHOLOGY AFTER RADICAL PROSTATECTOMY IN MEN ELIGIBLE FOR ACTIVE SURVEILLANCE FROM MUTLI-INSTITUTIONAL STUDY" @default.
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