Evaluating the Impact of PSA as a Selection Criteria for Nerve Sparing Radical Prostatectomy in a Screened Cohort.

IF 2.3 Q3 ONCOLOGY
Prostate Cancer Pub Date : 2014-01-01 Epub Date: 2014-04-16 DOI:10.1155/2014/395078
Shyam K Tanguturi, Ming-Hui Chen, Marian Loffredo, Jerome P Richie, Anthony V D'Amico
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引用次数: 5

Abstract

Purpose. We investigated whether NS-RP increased risk of PSA failure and whether PSA should be included as a selection criterion for NS. Methods. We evaluated 357 consecutive men with screen-detected PC who underwent open RP without adjuvant radiotherapy between 9/11/2001 and 12/30/2008. Criteria for NS included Gleason score ≤3 + 4, percentage of positive biopsies (PPB) ≤50%, percentage of core involvement ≤50%, nonapical location, no perineural invasion, and no palpable disease on pre- or intraoperative exam but did not include a PSA threshold. Cox multivariable regression assessed whether increasing PSA or unilateral- or bilateral-NS versus non-NS-RP was associated with PSA failure adjusting for prognostic factors. Results. After a median follow-up of 3.96 years, 34 men sustained PSA failure (9.5%). Increasing PSA was significantly associated with increased risk of PSA failure in the interaction model (adjusted hazard ratio (AHR): 1.09 [95% CI: 1.03-1.16]; P = 0.005), whereas unilateral (AHR: 1.24 [95% CI: 0.36-4.34]; P = 0.73) or bilateral NS (AHR: 0.41 [95% CI: 0.06-2.59]; P = 0.34) versus non-NS RP was not. Conclusion. NS-RP in a screened cohort did not increase risk of PSA failure using NS criteria not including PSA.

Abstract Image

评估PSA作为保留神经的根治性前列腺切除术的选择标准的影响。
目的。我们调查了NS- rp是否会增加PSA失败的风险,以及PSA是否应该作为NS的选择标准。方法。在2001年11月9日至2008年12月30日期间,我们评估了357名连续接受开放RP而不辅助放疗的筛查检测到PC的男性。NS的标准包括Gleason评分≤3 + 4,活检阳性百分比(PPB)≤50%,核心受累百分比≤50%,非根尖位置,无神经周围侵犯,术前或术中检查无可触及的疾病,但未包括PSA阈值。Cox多变量回归评估了PSA升高、单侧或双侧ns - rp与非ns - rp是否与PSA失败相关。结果。中位随访3.96年后,34名男性PSA失败(9.5%)。在相互作用模型中,PSA升高与PSA失效风险增加显著相关(校正风险比(AHR): 1.09 [95% CI: 1.03-1.16];P = 0.005),而单侧(AHR: 1.24 [95% CI: 0.36-4.34];P = 0.73)或双侧NS (AHR: 0.41 [95% CI: 0.06-2.59];P = 0.34),而非ns RP则没有。结论。在筛选的队列中,使用不包括PSA的NS标准,NS- rp不会增加PSA失败的风险。
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来源期刊
Prostate Cancer
Prostate Cancer ONCOLOGY-
CiteScore
2.70
自引率
0.00%
发文量
9
审稿时长
13 weeks
期刊介绍: Prostate Cancer is a peer-reviewed, Open Access journal that provides a multidisciplinary platform for scientists, surgeons, oncologists and clinicians working on prostate cancer. The journal publishes original research articles, review articles, and clinical studies related to the diagnosis, surgery, radiotherapy, drug discovery and medical management of the disease.
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