Predictive values for extracapsular extension in prostate cancer patients with PSA values below 10 ng/mL.
OBJECTIVE
We aimed to determine predictive values of extracapsular extension (ECE) in patients who had undergone radical retropubic prostatectomy (RRP) with prostate-specific antigen (PSA) values below 10 ng/mL.


METHODS
We retrospectively scanned data of 167 patients with PSA values below 10 ng/mL who had undergone radical retropubic prostatectomy (RRP) between April 2004 and August 2011 in our clinic. Age, PSA, PSA ratio, PSA density, digital rectal examination (DRE) findings, biopsy total Gleason score, perineural invasion (PNI), and lymphovascular invasion (LVI) were analyzed. Parameters of the groups with or without extracapsular extension in RRP pathology specimens were compared.


RESULTS
The mean age of patients was 66.4±12.3 years. According to histopathological analysis of the specimens of RRP of 167 patients, 45 (26.9%) had extracapsular extension (pT3-4) (Group 1); 122 (73.1%) were confined to the prostate (pT2) (Group 2). The mean PSA level was high in Group 1 (p= 0.114), PSA ratio was higher in Group 2 (p=0.09). PSA density was 0.17 in Group 1 and 0.24 in Group 2 (p=0.03). DRE positivity was 53.3% and 57.1%, respectively (p=0.71). Biopsy total Gleason score was higher in Group 1 than Group 2 with a statistically significant difference (p=0.04). A statistically significant difference was found between the rates of PNI and LVI (28.9% and 1.63%, respectively) (p=0.002). There was no statistically significant difference between both groups as for surgical margin positivity (p=0.18).


CONCLUSIONS
In PCa patients with PSA values below 10 ng/mL, PSA density, lymphovascular invasion and biopsy Gleason total score were statistically significant in predicting extracapsular invasion. Therefore, these results must be considered in preoperative evaluation.
Clinic of Urology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey.
Zülfü
Z
Sertkaya
Clinic of Urology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey.
Metin İshak
Mİ
Öztürk
Clinic of Urology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey.
Orhan
O
Koca
Clinic of Urology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey.
Mustafa
M
Güneş
Clinic of Urology, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey.
Muhammet İhsan
Mİ
Karaman
Extracapsular invasion; Gleason score; PSA density; prostate cancer