Prostate-specific antigen density as a powerful predictor of extracapsular extension and positive surgical margin in radical prostatectomy patients with prostate-specific antigen levels of less than 10ng/ml

Jin Seok Chang, Hoon Choi, Young Seop Chang, Jin Bum Kim, Mi-Mi Oh, Du Geon Moon, Jae Hyun Bae, Jun Cheon

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose: To assess the ability of preoperative variables to predict extracapsular extension (ECE) and positive surgical margin (PSM) in radical prostatectomy patients with prostate-specific antigen (PSA) levels of less than 10 ng/ml. Materials and Methods: From January 2008 to December 2009, 121 patients with prostate cancer with PSA levels lower than 10 ng/ml who underwent radical prostatectomy were enrolled in the study. The differences in clinical factors (age, PSA, PSA density [PSAD], digital rectal examination [DRE] positivity, positive magnetic resonance imaging [MRI], Gleason sum, positive core number, and positive biopsy core percentage) with ECE and the presence of positive margins were determined and their independent predictive significances were analyzed. Results: The ECE-positive patients had higher PSA, PSAD, and MRI-positive percentages, and PSM patients had higher PSA, PSAD, MRI-positive percentages, Gleason sum, and positive biopsy core percentages for prostate cancer. In the multivariate analysis, PSAD and MRI positivity were the best independent predictors for ECE, and PSA and PSAD were the best independent predictors of PSM. By receiver operating characteristic curve analysis, PSAD had better discriminative area under the curve value than did PSA for ECE (0.765 vs 0.661) and PSM (0.780 vs 0.624). The best predictive PSAD value was 0.29 ng/ml/cc for ECE and 0.27 ng/ml/cc for PSM. Conclusions: PSAD has relevance to ECE (plus MRI findings) and PSM (plus PSA). PSAD might be a powerful predictor of ECE and PSM preoperatively in patients undergoing a radical prostatectomy with PSA levels of less than 10 ng/ml.

Original languageEnglish
Pages (from-to)809-814
Number of pages6
JournalKorean Journal of Urology
Volume52
Issue number12
DOIs
Publication statusPublished - 2011 Dec 1

Fingerprint

Prostate-Specific Antigen
Prostatectomy
Magnetic Resonance Imaging
Prostatic Neoplasms
Margins of Excision
Biopsy
Digital Rectal Examination
Age Factors
ROC Curve
Area Under Curve
Multivariate Analysis

Keywords

  • Extracapsular extension
  • Positive surgical margin
  • Prostatectomy
  • PSAD

ASJC Scopus subject areas

  • Urology

Cite this

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title = "Prostate-specific antigen density as a powerful predictor of extracapsular extension and positive surgical margin in radical prostatectomy patients with prostate-specific antigen levels of less than 10ng/ml",
abstract = "Purpose: To assess the ability of preoperative variables to predict extracapsular extension (ECE) and positive surgical margin (PSM) in radical prostatectomy patients with prostate-specific antigen (PSA) levels of less than 10 ng/ml. Materials and Methods: From January 2008 to December 2009, 121 patients with prostate cancer with PSA levels lower than 10 ng/ml who underwent radical prostatectomy were enrolled in the study. The differences in clinical factors (age, PSA, PSA density [PSAD], digital rectal examination [DRE] positivity, positive magnetic resonance imaging [MRI], Gleason sum, positive core number, and positive biopsy core percentage) with ECE and the presence of positive margins were determined and their independent predictive significances were analyzed. Results: The ECE-positive patients had higher PSA, PSAD, and MRI-positive percentages, and PSM patients had higher PSA, PSAD, MRI-positive percentages, Gleason sum, and positive biopsy core percentages for prostate cancer. In the multivariate analysis, PSAD and MRI positivity were the best independent predictors for ECE, and PSA and PSAD were the best independent predictors of PSM. By receiver operating characteristic curve analysis, PSAD had better discriminative area under the curve value than did PSA for ECE (0.765 vs 0.661) and PSM (0.780 vs 0.624). The best predictive PSAD value was 0.29 ng/ml/cc for ECE and 0.27 ng/ml/cc for PSM. Conclusions: PSAD has relevance to ECE (plus MRI findings) and PSM (plus PSA). PSAD might be a powerful predictor of ECE and PSM preoperatively in patients undergoing a radical prostatectomy with PSA levels of less than 10 ng/ml.",
keywords = "Extracapsular extension, Positive surgical margin, Prostatectomy, PSAD",
author = "Chang, {Jin Seok} and Hoon Choi and Chang, {Young Seop} and Kim, {Jin Bum} and Mi-Mi Oh and Moon, {Du Geon} and Bae, {Jae Hyun} and Jun Cheon",
year = "2011",
month = "12",
day = "1",
doi = "10.4111/kju.2011.52.12.809",
language = "English",
volume = "52",
pages = "809--814",
journal = "Korean Journal of Urology",
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TY - JOUR

T1 - Prostate-specific antigen density as a powerful predictor of extracapsular extension and positive surgical margin in radical prostatectomy patients with prostate-specific antigen levels of less than 10ng/ml

AU - Chang, Jin Seok

AU - Choi, Hoon

AU - Chang, Young Seop

AU - Kim, Jin Bum

AU - Oh, Mi-Mi

AU - Moon, Du Geon

AU - Bae, Jae Hyun

AU - Cheon, Jun

PY - 2011/12/1

Y1 - 2011/12/1

N2 - Purpose: To assess the ability of preoperative variables to predict extracapsular extension (ECE) and positive surgical margin (PSM) in radical prostatectomy patients with prostate-specific antigen (PSA) levels of less than 10 ng/ml. Materials and Methods: From January 2008 to December 2009, 121 patients with prostate cancer with PSA levels lower than 10 ng/ml who underwent radical prostatectomy were enrolled in the study. The differences in clinical factors (age, PSA, PSA density [PSAD], digital rectal examination [DRE] positivity, positive magnetic resonance imaging [MRI], Gleason sum, positive core number, and positive biopsy core percentage) with ECE and the presence of positive margins were determined and their independent predictive significances were analyzed. Results: The ECE-positive patients had higher PSA, PSAD, and MRI-positive percentages, and PSM patients had higher PSA, PSAD, MRI-positive percentages, Gleason sum, and positive biopsy core percentages for prostate cancer. In the multivariate analysis, PSAD and MRI positivity were the best independent predictors for ECE, and PSA and PSAD were the best independent predictors of PSM. By receiver operating characteristic curve analysis, PSAD had better discriminative area under the curve value than did PSA for ECE (0.765 vs 0.661) and PSM (0.780 vs 0.624). The best predictive PSAD value was 0.29 ng/ml/cc for ECE and 0.27 ng/ml/cc for PSM. Conclusions: PSAD has relevance to ECE (plus MRI findings) and PSM (plus PSA). PSAD might be a powerful predictor of ECE and PSM preoperatively in patients undergoing a radical prostatectomy with PSA levels of less than 10 ng/ml.

AB - Purpose: To assess the ability of preoperative variables to predict extracapsular extension (ECE) and positive surgical margin (PSM) in radical prostatectomy patients with prostate-specific antigen (PSA) levels of less than 10 ng/ml. Materials and Methods: From January 2008 to December 2009, 121 patients with prostate cancer with PSA levels lower than 10 ng/ml who underwent radical prostatectomy were enrolled in the study. The differences in clinical factors (age, PSA, PSA density [PSAD], digital rectal examination [DRE] positivity, positive magnetic resonance imaging [MRI], Gleason sum, positive core number, and positive biopsy core percentage) with ECE and the presence of positive margins were determined and their independent predictive significances were analyzed. Results: The ECE-positive patients had higher PSA, PSAD, and MRI-positive percentages, and PSM patients had higher PSA, PSAD, MRI-positive percentages, Gleason sum, and positive biopsy core percentages for prostate cancer. In the multivariate analysis, PSAD and MRI positivity were the best independent predictors for ECE, and PSA and PSAD were the best independent predictors of PSM. By receiver operating characteristic curve analysis, PSAD had better discriminative area under the curve value than did PSA for ECE (0.765 vs 0.661) and PSM (0.780 vs 0.624). The best predictive PSAD value was 0.29 ng/ml/cc for ECE and 0.27 ng/ml/cc for PSM. Conclusions: PSAD has relevance to ECE (plus MRI findings) and PSM (plus PSA). PSAD might be a powerful predictor of ECE and PSM preoperatively in patients undergoing a radical prostatectomy with PSA levels of less than 10 ng/ml.

KW - Extracapsular extension

KW - Positive surgical margin

KW - Prostatectomy

KW - PSAD

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U2 - 10.4111/kju.2011.52.12.809

DO - 10.4111/kju.2011.52.12.809

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JO - Korean Journal of Urology

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