R. Ugalde-Resano, J.O. Herrera-Cáceres, C.I. Villeda-Sandoval, A. Cayetano-Alcaraz, B.E. Montaño-Roca, F. Rodríguez-Covarrubias, M. Sotomayor de Zavaleta
{"title":"改善Gleason评分升级的预测:前列腺特异性抗原密度的作用","authors":"R. Ugalde-Resano, J.O. Herrera-Cáceres, C.I. Villeda-Sandoval, A. Cayetano-Alcaraz, B.E. Montaño-Roca, F. Rodríguez-Covarrubias, M. Sotomayor de Zavaleta","doi":"10.1016/j.uromx.2016.07.002","DOIUrl":null,"url":null,"abstract":"<div><p>Conservative therapies, such as active surveillance, can be appropriate treatment for low-risk prostate cancer. The aim of this study was to analyze the frequency of Gleason score (GS) upgrading in patients with a low-grade GS. We reviewed our prospectively maintained database of patients with prostate cancer that underwent radical prostatectomy within the time frame of 2004–2015. Potential predictors of upgrading in patients with GS 3<!--> <!-->+<!--> <!-->3 were studied. Of the 342 patients in our database, 125 had GS 3<!--> <!-->+<!--> <!-->3. Biopsy GS and surgical GS were identical in 71 (56.8%) patients with GS 3<!--> <!-->+<!--> <!-->3, whereas 54 (43.2%) patients had an upgrade. The GS was upgraded to 7 in 70% of those patients and to ≥8 in 30%. We found a statistically significant correlation between postoperative upgrade and the preoperative prostate-specific antigen density (PSAD) value (<em>p</em> <!--><<!--> <!-->0.001), prostate volume (<em>p</em> <!-->=<!--> <!-->0.004), and patient age ≥70 years (<em>p</em> <!-->=<!--> <!-->0.011). We estimated an optimal PSAD cutoff point of 0.17<!--> <!-->ng/ml<sup>2</sup> through ROC analysis, with an AUC of 0.675 (<em>p</em> <!-->=<!--> <!-->0.001). It is our opinion that every hospital center offering active surveillance should carry out a continuous review of upgrading and related risk factors.</p></div>","PeriodicalId":34909,"journal":{"name":"Revista mexicana de urologia","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.uromx.2016.07.002","citationCount":"0","resultStr":"{\"title\":\"Improving the prediction of Gleason score upgrading: The role of prostate-specific antigen density\",\"authors\":\"R. Ugalde-Resano, J.O. Herrera-Cáceres, C.I. Villeda-Sandoval, A. Cayetano-Alcaraz, B.E. Montaño-Roca, F. Rodríguez-Covarrubias, M. Sotomayor de Zavaleta\",\"doi\":\"10.1016/j.uromx.2016.07.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Conservative therapies, such as active surveillance, can be appropriate treatment for low-risk prostate cancer. The aim of this study was to analyze the frequency of Gleason score (GS) upgrading in patients with a low-grade GS. We reviewed our prospectively maintained database of patients with prostate cancer that underwent radical prostatectomy within the time frame of 2004–2015. Potential predictors of upgrading in patients with GS 3<!--> <!-->+<!--> <!-->3 were studied. Of the 342 patients in our database, 125 had GS 3<!--> <!-->+<!--> <!-->3. Biopsy GS and surgical GS were identical in 71 (56.8%) patients with GS 3<!--> <!-->+<!--> <!-->3, whereas 54 (43.2%) patients had an upgrade. The GS was upgraded to 7 in 70% of those patients and to ≥8 in 30%. We found a statistically significant correlation between postoperative upgrade and the preoperative prostate-specific antigen density (PSAD) value (<em>p</em> <!--><<!--> <!-->0.001), prostate volume (<em>p</em> <!-->=<!--> <!-->0.004), and patient age ≥70 years (<em>p</em> <!-->=<!--> <!-->0.011). We estimated an optimal PSAD cutoff point of 0.17<!--> <!-->ng/ml<sup>2</sup> through ROC analysis, with an AUC of 0.675 (<em>p</em> <!-->=<!--> <!-->0.001). It is our opinion that every hospital center offering active surveillance should carry out a continuous review of upgrading and related risk factors.</p></div>\",\"PeriodicalId\":34909,\"journal\":{\"name\":\"Revista mexicana de urologia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2016-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.uromx.2016.07.002\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista mexicana de urologia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2007408516300465\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista mexicana de urologia","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2007408516300465","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Improving the prediction of Gleason score upgrading: The role of prostate-specific antigen density
Conservative therapies, such as active surveillance, can be appropriate treatment for low-risk prostate cancer. The aim of this study was to analyze the frequency of Gleason score (GS) upgrading in patients with a low-grade GS. We reviewed our prospectively maintained database of patients with prostate cancer that underwent radical prostatectomy within the time frame of 2004–2015. Potential predictors of upgrading in patients with GS 3 + 3 were studied. Of the 342 patients in our database, 125 had GS 3 + 3. Biopsy GS and surgical GS were identical in 71 (56.8%) patients with GS 3 + 3, whereas 54 (43.2%) patients had an upgrade. The GS was upgraded to 7 in 70% of those patients and to ≥8 in 30%. We found a statistically significant correlation between postoperative upgrade and the preoperative prostate-specific antigen density (PSAD) value (p < 0.001), prostate volume (p = 0.004), and patient age ≥70 years (p = 0.011). We estimated an optimal PSAD cutoff point of 0.17 ng/ml2 through ROC analysis, with an AUC of 0.675 (p = 0.001). It is our opinion that every hospital center offering active surveillance should carry out a continuous review of upgrading and related risk factors.
期刊介绍:
Revista Mexicana de Urología (RMU) [Mexican Journal of Urology] (ISSN: 0185-4542 / ISSN electronic: 2007-4085) is bimonthly publication that disseminates research by academicians and professionals of the international medical community interested in urological subjects, in the format of original articles, clinical cases, review articles brief communications and letters to the editor. Owing to its nature, it is publication with international scope that disseminates contributions in Spanish and English that are rigorously reviewed by peers under the double blind modality. Neither journalistic documents nor those that lack rigorous medical or scientific support are suitable for publication.