Portal de Periódicos da CAPES

PROSTATE SPECIFIC ANTIGEN DENSITY OF THE TRANSITION ZONE FOR PREDICTING PATHOLOGICAL STAGE OF LOCALIZED PROSTATE CANCER IN PATIENTS WITH SERUM PROSTATE SPECIFIC ANTIGEN LESS THAN 10 NG./ML.

1998; Lippincott Williams & Wilkins; Volume: 160; Issue: 6 Part 1 Linguagem: Inglês

10.1016/s0022-5347(01)62250-x

1527-3792

Alexandre R. Zlotta, Bob Djavan, Michel Pétein, Martin Susani, Michael Marberger, Claude C. Schulman,

Molecular Biology Techniques and Applications

No AccessJournal of UrologyClinical Urology: Original Articles1 Dec 1998PROSTATE SPECIFIC ANTIGEN DENSITY OF THE TRANSITION ZONE FOR PREDICTING PATHOLOGICAL STAGE OF LOCALIZED PROSTATE CANCER IN PATIENTS WITH SERUM PROSTATE SPECIFIC ANTIGEN LESS THAN 10 NG./ML. A.R. ZLOTTA, B. DJAVAN, M. PETEIN, M. SUSANI, M. MARBERGER, and C.C. SCHULMAN A.R. ZLOTTAA.R. ZLOTTA More articles by this author , B. DJAVANB. DJAVAN More articles by this author , M. PETEINM. PETEIN More articles by this author , M. SUSANIM. SUSANI More articles by this author , M. MARBERGERM. MARBERGER More articles by this author , and C.C. SCHULMANC.C. SCHULMAN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62250-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Prostate specific antigen (PSA) density of the transition zone, which is the density of serum PSA related to the volume of the transition zone, has been recently demonstrated to enhance prostate cancer prediction in patients with intermediate PSA levels. We further investigated the usefulness of PSA-transition zone for predicting extraprostatic extension in clinically localized prostate cancer. Materials and Methods: Measuring the transition zone of the prostate by ultrasound using the prolate ellipsoid method, PSA-transition zone values were calculated prospectively in 198 patients with clinically localized prostate cancers and serum PSA less than 10.0 ng./ml. who underwent radical retropubic prostatectomy. The ability of PSA-transition zone to predict extracapsular disease in the surgical specimen was compared to Gleason score, serum PSA, PSA density of the total prostate and percent free PSA using univariate or multivariate analysis as well as receiver operating characteristics curves. Results: A total of 104 patients (52.5%) had pathologically organ confined prostate cancer while 94 of 198 (47.5) had extracapsular disease. PSA-transition zone levels were significantly higher in extracapsular disease than organ confined cancers (0.84 versus 0.42 ng./ml./cc, p <0.00001). Using multivariate analyses PSA-transition zone and Gleason score were the most significant predictors of extracapsular disease. The area under the curve was larger for PSA-transition zone (0.825) than any other parameter (p <0.004 versus PSA density and p <0.001 versus PSA, percent free PSA or Gleason score). A cutoff of 1.00 ng./ml./cc for PSA-transition zone provided 95.1% specificity and 28.8% sensitivity for predicting extracapsular disease. Probability plots using the best combination of independent variables for predicting extraprostatic extension were developed. Conclusions: These data demonstrate that the use of the PSA-transition zone may be of additional value for indicating which patients with clinically localized prostate cancer and PSA less than 10.0 ng./ml. are at high risk for extracapsular disease. References 1 : Correlation of pathological findings with progression following radical retropubic prostatectomy. Cancer1993; 71: 3582. Google Scholar 2 : Prostate-specific antigen after anatomic radical retropubic prostatectomy. Patterns of recurrence and cancer control. Urol. Clin. N. Amer.1997; 24: 395. Google Scholar 3 : The clinical usefulness of prostate specific antigen: update 1994. J. Urol.1994; 152: 1358. Link, Google Scholar 4 : Detection of organ confined prostate cancer is increased through prostate-specific antigen-based screening. J.A.M.A.1993; 270: 948. Google Scholar 5 : Combination of prostate-specific antigen, clinical stage and Gleason score to predict pathological stage of localized prostate cancer. A multi-institutional update. J.A.M.A.1997; 277: 1445. Google Scholar 6 : Prostate specific antigen density of the transition zone: a new effective parameter for prostate cancer prediction. J. Urol.1997; 157: 1315. Link, Google Scholar 7 : Prostate specific antigen (density of the transition zone, for early detection of prostate cancer. J. Urol.1998; 160: 411. Link, Google Scholar 8 : The free-to-total serum prostate specific antigen ratio for staging prostate carcinoma. J. Urol.1997; 157: 544. Link, Google Scholar 9 : The TNM classification of prostate cancer. Prostate1992; 4: 129. Google Scholar 10 : Transrectal ultrasound versus digital rectal examination for the staging of carcinoma of the prostate: results of a prospective, multi-institutional trial. J. Urol.1997; 157: 902. Link, Google Scholar 11 : Role of prostate-specific antigen velocity in prediction of final pathological stage in men with localized prostate cancer. Urology1997; 49: 716. Google Scholar 12 : Comparison of prostate specific antigen with prostate specific antigen density for 3 clinical applications. J. Urol.1994; 152: 120. Link, Google Scholar 13 : The use of percent free prostate specific antigen for staging clinically localized prostate cancer. J. Urol.1998; 159: 1238. Link, Google Scholar 14 : Measurement of free PSA in the diagnosis and staging of prostate cancer. Int. J. Cancer1997; 71: 756. Google Scholar 15 : Patterns of progression in prostate cancer. Lancet1986; 1: 60. Google Scholar 16 : Calculated prostate cancer volume: the optimal predictor of actual cancer volume and pathologic stage. Urology1997; 49: 385. Google Scholar 17 : Prediction of capsular perforation and seminal vesicle invasion in prostate cancer. J. Urol.1996; 155: 1361. Link, Google Scholar 18 : Optimized microvessel density analysis improves prediction of cancer stage from prostate needle biopsies. Urology1996; 48: 47. Google Scholar 19 : Correlation between serum prostate specific antigen levels and the volume of the individual glandular zones of the human prostate. J. Urol.1995; 153: 111. Link, Google Scholar 20 : Correlation of prostate specific antigen serum levels with prostatic glandular zone volumes. J. Urol.1997; 157: 116. abstract 453. Google Scholar 21 : Prostate specific antigen adjusted for the transition zone volume as an indicator of prostate cancer. J. Urol.1997; 158: 2193. Link, Google Scholar 22 : Prostate carcinoma screening in the county of Tyrol, Austria: experience and results. Cancer1997; 80: 1818. Google Scholar 23 : Transition zone volume-adjusted prostate-specific antigen value predicts extracapsular carcinoma of the prostate in patients with intermediate prostate-specific antigen levels. Eur. Urol.1998; 33: 32. Google Scholar 24 : Gleason scores from prostate biopsies obtained with 18-gauge biopsy needles poorly predict Gleason scores of radical prostatectomy specimens. Eur. Urol.1998; 33: 261. Google Scholar 25 : The clinical importance of the prostate transition zone (TZ): TZ measurement by transrectal ultrasound (TRUS) is reliable as demonstrated by an anatomo-radiological study. J. Urol.1998; 159: 317. abstract 1215. Google Scholar From the Departments of Urology and Pathology, Erasme Hospital, University Clinics of Brussels, Belgium, and Departments of Urology and Pathology, University Hospital of Vienna, Vienna, Austria© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byZLOTTA A, REMZI M, SNOW P, SCHULMAN C, MARBERGER M and DJAVAN B (2018) An Artificial Neural Network for Prostate Cancer Staging when Serum Prostate Specific Antigen is 10 NG./ML. or LessJournal of Urology, VOL. 169, NO. 5, (1724-1728), Online publication date: 1-May-2003.BALTACI S, YAGCI C, AKSOY H, ELHAN A and GÖĞÜS O (2018) DETERMINATION OF TRANSITION ZONE VOLUME BY TRANSRECTAL ULTRASOUND IN PATIENTS WITH CLINICALLY BENIGN PROSTATIC HYPERPLASIA: AGREEMENT WITH ENUCLEATED PROSTATE ADENOMA WEIGHTJournal of Urology, VOL. 164, NO. 1, (72-75), Online publication date: 1-Jul-2000. Volume 160Issue 6 Part 1December 1998Page: 2089-2095 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information A.R. ZLOTTA More articles by this author B. DJAVAN More articles by this author M. PETEIN More articles by this author M. SUSANI More articles by this author M. MARBERGER More articles by this author C.C. SCHULMAN More articles by this author Expand All Advertisement PDF downloadLoading ...