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pT3 Predictive Factors in Patients with a Gleason Score of 6 in Prostate Biopsies

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±è¼ºÁø, ¹Úâ¸é, ¼º±âÅÃ, ±è¼¼¿µ, Kim Han-Kwon, ¹ÚÁ¾¿¬,
¼Ò¼Ó »ó¼¼Á¤º¸
±è¼ºÁø ( Kim Sung-Jin ) 
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Urology

¹Úâ¸é ( Park Chang-Myon ) 
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Urology
¼º±âÅà( Seong Ki-Taek ) 
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Urology
±è¼¼¿µ ( Kim Sea-Young ) 
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Urology
 ( Kim Han-Kwon ) 
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Urology
¹ÚÁ¾¿¬ ( Park Jong-Yeon ) 
University of Ulsan College of Medicine Gangneung Asan Hospital Department of Urology

Abstract


Purpose: Often, a diagnosis of pT3 is made on the basis of radical retropubic prostatectomy specimens, despite a Gleason score of 6 on the preoperative prostate biopsy. Thus, we investigated the preoperative variables in patients displaying these characteristics.

Materials and Methods : Study subjects comprised patients at our institute from 1996 to July 2010 who had exhibited a Gleason score of 6 on their prostate biopsies and had undergone a radical retropubic prostatectomy. Through univariate and multivariate analysis, we investigated pT3 predictive factors including age, preoperative prostate-specific antigen (PSA) levels, transrectal ultrasonography (TRUS)-weighted prostate volume, digital rectal examination findings, bilaterality via prostate biopsy, prostatic cancer in prostate base cores via prostate biopsy, maximum length and percent of prostatic cancer, and number of cores detected in prostatic cancer via prostate biopsy.

Results: In the univariate logistic regression mode, a PSA value of 7.4 ng/ml or higher, TRUS-weighted PSA density of 0.2 ng/ml/cc or higher, prostate cancer detected in the basal core, and prostate cancer detected in 2 or more cores out of 12 were predictive factors for extraprostatic extension. Independent predictive factors for stage pT3 were a PSA of 7.4 ng/ml or higher and prostate cancer detected in 2 or more cores out of 12.

Conclusions: In the case of patients with the foregoing risk factors, it is advisable not to perform nerve-sparing surgery but to prepare for the possibility of a pT3 stage.

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Prostatectomy;Prostate-specific antigen;Prostatic neoplasms

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