title: Radical prostatectomy for prostate cancer patients with prostate-specific antigen >20 ng/ml.
abstract: OBJECTIVE
  Prostate cancer patients with prostate-specific antigen (PSA) >20 ng/ml are at high risk of progression after radical prostatectomy. Comparison has seldom been made between the outcomes of patients with PSA 20.1-50 ng/ml and those with PSA >50 ng/ml after radical prostatectomy. We retrospectively analyzed the outcomes of these two groups.
  
  
  METHODS
  From 1993 to 2002, 60 prostate cancer patients receiving radical prostatectomy were enrolled in this study. Thirty-seven patients with PSA 20.1-50 ng/ml were assigned to Group I. Twenty-three patients with PSA >50 ng/ml were assigned to Group II. Preoperatively, Group II had greater PSA and PSA density than Group I (P < 0.0001). Group II had higher biopsy Gleason score and clinical stage than Group I (P < 0.05). Pathological categories and outcomes of both groups were compared.
  
  
  RESULTS
  Group II had higher Gleason score and tumor volume than Group I (P < 0.05). The incidence of organ-confined diseases was 29.7% in Group I and 0% in Group II (P < 0.05). Group II had higher incidence of extracapsular tumor extension, positive surgical margin and lymph node involvement than Group I (P < 0.05). The incidence of postoperative PSA >0.01 ng/ml and PSA failure were higher in Group II than Group I (P < 0.05). Need for adjuvant treatment and death from prostate cancer was similar in both groups.
  
  
  CONCLUSIONS
  Patients with PSA >50 ng/ml had a poorer prognosis than patients with PSA 20.1-50 ng/ml. Those with PSA >50 ng/ml had shorter freedom from PSA failure survivals than those with PSA 20.1-50 ng/ml (P = 0.004). Classification of high-risk prostate patients into two sub-groups with PSA 20.1-50 ng/ml and PSA >50 ng/ml should be considered.
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, National Yang-Ming University School of Medicine, Taichung, Taiwan. ycou@vghtc.vghtc.gov.tw
authors.forename: Yen-Chuan
authors.initials: YC
authors.lastname: Ou
authors.forename: Jung-Ta
authors.initials: JT
authors.lastname: Chen
authors.forename: Chen-Li
authors.initials: CL
authors.lastname: Cheng
authors.forename: Hao-Chung
authors.initials: HC
authors.lastname: Ho
authors.forename: Chi-Rei
authors.initials: CR
authors.lastname: Yang
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen