Pathological outcome following radical prostatectomy in men with prostate specific antigen greater than 10 ng/ml and histologically favorable risk prostate cancer

Jiwoong Yu, Young Suk Kwon, Sinae Kim, Christopher Sejong Han, Nicholas Farber, Jongmyung Kim, Seok Soo Byun, Wun Jae Kim, Seong Soo Jeon, Isaac Yi Kim

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose Active surveillance is now the treatment of choice in men with low risk prostate cancer. Although there is no consensus on which patients are eligible for active surveillance, prostate specific antigen above 10 ng/ml is generally excluded. In an attempt to determine the validity of using a prostate specific antigen cutoff of 10 ng/ml to counsel men considering active surveillance we analyzed a multi-institution database to determine the pathological outcome in men with prostate specific antigen greater than 10 ng/ml but histologically favorable risk prostate cancer. Materials and Methods We queried a prospectively maintained database of men with histologically favorable risk prostate cancer who underwent radical prostatectomy between 2003 and 2015. The cohort was categorized into 3 groups based on prostate specific antigen level, including low - less than 10 ng/ml, intermediate - 10 or greater to less than 20 and high - 20 or greater. Associations of prostate specific antigen group with adverse pathological and oncologic outcomes were analyzed. Results Of 2,125 patients 1,327 were categorized with histologically favorable risk disease. However on multivariate analyses the rates of up staging and upgrading were similar between the intermediate and low prostate specific antigen groups. In contrast compared to the intermediate prostate specific antigen group the high group had higher incidences of up staging (p = 0.02) and upgrading to 4 + 3 or greater disease (p = 0.046). Biochemical recurrence-free survival rates revealed no pairwise intergroup differences except between the low and high groups. Conclusions Patients with preoperatively elevated prostate specific antigen between 10 and less than 20 ng/ml who otherwise had histologically favorable risk prostate cancer were not at higher risk for adverse pathological outcomes than men with prostate specific antigen less than 10 ng/ml.

Original languageEnglish
Pages (from-to)1464-1470
Number of pages7
JournalJournal of Urology
Volume195
Issue number5
DOIs
StatePublished - 1 May 2016

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Prostate-Specific Antigen
Prostatectomy
Prostatic Neoplasms
Databases
Multivariate Analysis
Survival Rate
Recurrence
Incidence

Keywords

  • outcome assessment (health care)
  • prostate-specific antigen
  • prostatic neoplasms
  • risk
  • watchful waiting

Cite this

Yu, Jiwoong ; Kwon, Young Suk ; Kim, Sinae ; Han, Christopher Sejong ; Farber, Nicholas ; Kim, Jongmyung ; Byun, Seok Soo ; Kim, Wun Jae ; Jeon, Seong Soo ; Kim, Isaac Yi. / Pathological outcome following radical prostatectomy in men with prostate specific antigen greater than 10 ng/ml and histologically favorable risk prostate cancer. In: Journal of Urology. 2016 ; Vol. 195, No. 5. pp. 1464-1470.
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abstract = "Purpose Active surveillance is now the treatment of choice in men with low risk prostate cancer. Although there is no consensus on which patients are eligible for active surveillance, prostate specific antigen above 10 ng/ml is generally excluded. In an attempt to determine the validity of using a prostate specific antigen cutoff of 10 ng/ml to counsel men considering active surveillance we analyzed a multi-institution database to determine the pathological outcome in men with prostate specific antigen greater than 10 ng/ml but histologically favorable risk prostate cancer. Materials and Methods We queried a prospectively maintained database of men with histologically favorable risk prostate cancer who underwent radical prostatectomy between 2003 and 2015. The cohort was categorized into 3 groups based on prostate specific antigen level, including low - less than 10 ng/ml, intermediate - 10 or greater to less than 20 and high - 20 or greater. Associations of prostate specific antigen group with adverse pathological and oncologic outcomes were analyzed. Results Of 2,125 patients 1,327 were categorized with histologically favorable risk disease. However on multivariate analyses the rates of up staging and upgrading were similar between the intermediate and low prostate specific antigen groups. In contrast compared to the intermediate prostate specific antigen group the high group had higher incidences of up staging (p = 0.02) and upgrading to 4 + 3 or greater disease (p = 0.046). Biochemical recurrence-free survival rates revealed no pairwise intergroup differences except between the low and high groups. Conclusions Patients with preoperatively elevated prostate specific antigen between 10 and less than 20 ng/ml who otherwise had histologically favorable risk prostate cancer were not at higher risk for adverse pathological outcomes than men with prostate specific antigen less than 10 ng/ml.",
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author = "Jiwoong Yu and Kwon, {Young Suk} and Sinae Kim and Han, {Christopher Sejong} and Nicholas Farber and Jongmyung Kim and Byun, {Seok Soo} and Kim, {Wun Jae} and Jeon, {Seong Soo} and Kim, {Isaac Yi}",
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Pathological outcome following radical prostatectomy in men with prostate specific antigen greater than 10 ng/ml and histologically favorable risk prostate cancer. / Yu, Jiwoong; Kwon, Young Suk; Kim, Sinae; Han, Christopher Sejong; Farber, Nicholas; Kim, Jongmyung; Byun, Seok Soo; Kim, Wun Jae; Jeon, Seong Soo; Kim, Isaac Yi.

In: Journal of Urology, Vol. 195, No. 5, 01.05.2016, p. 1464-1470.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Pathological outcome following radical prostatectomy in men with prostate specific antigen greater than 10 ng/ml and histologically favorable risk prostate cancer

AU - Yu, Jiwoong

AU - Kwon, Young Suk

AU - Kim, Sinae

AU - Han, Christopher Sejong

AU - Farber, Nicholas

AU - Kim, Jongmyung

AU - Byun, Seok Soo

AU - Kim, Wun Jae

AU - Jeon, Seong Soo

AU - Kim, Isaac Yi

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N2 - Purpose Active surveillance is now the treatment of choice in men with low risk prostate cancer. Although there is no consensus on which patients are eligible for active surveillance, prostate specific antigen above 10 ng/ml is generally excluded. In an attempt to determine the validity of using a prostate specific antigen cutoff of 10 ng/ml to counsel men considering active surveillance we analyzed a multi-institution database to determine the pathological outcome in men with prostate specific antigen greater than 10 ng/ml but histologically favorable risk prostate cancer. Materials and Methods We queried a prospectively maintained database of men with histologically favorable risk prostate cancer who underwent radical prostatectomy between 2003 and 2015. The cohort was categorized into 3 groups based on prostate specific antigen level, including low - less than 10 ng/ml, intermediate - 10 or greater to less than 20 and high - 20 or greater. Associations of prostate specific antigen group with adverse pathological and oncologic outcomes were analyzed. Results Of 2,125 patients 1,327 were categorized with histologically favorable risk disease. However on multivariate analyses the rates of up staging and upgrading were similar between the intermediate and low prostate specific antigen groups. In contrast compared to the intermediate prostate specific antigen group the high group had higher incidences of up staging (p = 0.02) and upgrading to 4 + 3 or greater disease (p = 0.046). Biochemical recurrence-free survival rates revealed no pairwise intergroup differences except between the low and high groups. Conclusions Patients with preoperatively elevated prostate specific antigen between 10 and less than 20 ng/ml who otherwise had histologically favorable risk prostate cancer were not at higher risk for adverse pathological outcomes than men with prostate specific antigen less than 10 ng/ml.

AB - Purpose Active surveillance is now the treatment of choice in men with low risk prostate cancer. Although there is no consensus on which patients are eligible for active surveillance, prostate specific antigen above 10 ng/ml is generally excluded. In an attempt to determine the validity of using a prostate specific antigen cutoff of 10 ng/ml to counsel men considering active surveillance we analyzed a multi-institution database to determine the pathological outcome in men with prostate specific antigen greater than 10 ng/ml but histologically favorable risk prostate cancer. Materials and Methods We queried a prospectively maintained database of men with histologically favorable risk prostate cancer who underwent radical prostatectomy between 2003 and 2015. The cohort was categorized into 3 groups based on prostate specific antigen level, including low - less than 10 ng/ml, intermediate - 10 or greater to less than 20 and high - 20 or greater. Associations of prostate specific antigen group with adverse pathological and oncologic outcomes were analyzed. Results Of 2,125 patients 1,327 were categorized with histologically favorable risk disease. However on multivariate analyses the rates of up staging and upgrading were similar between the intermediate and low prostate specific antigen groups. In contrast compared to the intermediate prostate specific antigen group the high group had higher incidences of up staging (p = 0.02) and upgrading to 4 + 3 or greater disease (p = 0.046). Biochemical recurrence-free survival rates revealed no pairwise intergroup differences except between the low and high groups. Conclusions Patients with preoperatively elevated prostate specific antigen between 10 and less than 20 ng/ml who otherwise had histologically favorable risk prostate cancer were not at higher risk for adverse pathological outcomes than men with prostate specific antigen less than 10 ng/ml.

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