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PROSPECTIVE DETECTION OF CLINICALLY RELEVANT PROSTATE CANCER IN THE PROSTATE SPECIFIC ANTIGEN RANGE 1 TO 3 NG./ML. COMBINED WITH FREE-TO-TOTAL RATIO 20% OR LESS: THE AARAU EXPERIENCE

2001; Lippincott Williams & Wilkins; Volume: 166; Issue: 3 Linguagem: Inglês

10.1016/s0022-5347(05)65850-8

1527-3792

Franz Recker, Maciej Kwiatkowski, Andreas Huber, Bernhard Stamm, Kurt Lehmann, R Tscholl,

Hepatitis B Virus Studies

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Sep 2001PROSPECTIVE DETECTION OF CLINICALLY RELEVANT PROSTATE CANCER IN THE PROSTATE SPECIFIC ANTIGEN RANGE 1 TO 3 NG./ML. COMBINED WITH FREE-TO-TOTAL RATIO 20% OR LESS: THE AARAU EXPERIENCE FRANZ RECKER, MACIEJ K. KWIATKOWSKI, ANDREAS HUBER, BERNHARD STAMM, KURT LEHMANN, and RETO TSCHOLL FRANZ RECKERFRANZ RECKER , MACIEJ K. KWIATKOWSKIMACIEJ K. KWIATKOWSKI , ANDREAS HUBERANDREAS HUBER , BERNHARD STAMMBERNHARD STAMM , KURT LEHMANNKURT LEHMANN , and RETO TSCHOLLRETO TSCHOLL View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65850-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Little is known about the incidence rate and clinical relevance of prostate cancer in a low prostate specific antigen (PSA) level. In a prospective PSA based screening study we investigated the incidence and clinicopathological features of prostate cancer that occurred within PSA range 1 to 3 ng./ml. when the free-to-total ratio was 0.20 or less. Materials and Methods: Men participating in the Aarau, Switzerland, section of the European Randomized Study of Screening for Prostate Cancer between October 1998 and July 2000 were included in the study. As a side study, all men with PSA between 1 and 3 ng./ml. and free-to-total ratio 0.20 or less were invited to undergo further evaluation with ultrasound guided sextant prostate biopsy. Results: Overall, 168 (7.8%) participants fulfilled inclusion criteria. A total of 158 (94%) patients underwent prostate biopsy, and prostate cancer was detected in 17 (10.8%). There were no statistically significant differences between prostate cancer and benign prostatic hyperplasia in regard to patient age (60.7 versus 59.8 years), prostate volume (23.9 versus 23.0 cc), PSA (1.98 versus 1.86 ng./ml.), free-to-total ratio (0.161 versus 0.160), PSA density (0.089 versus 0.076 ng./ml.) or PSA transition zone density (0.33 versus 0.24 ng./ml., respectively). Median Gleason score was 5 on prostate biopsy versus 6 on retropubic prostatectomy specimen. Of the 14 patients who underwent surgery there were positive lymph nodes in 1, stage pT3b Gleason 7 disease in 1, and pathologically organ confined Gleason 5 in 2, Gleason 6 in 5 and Gleason 7 in 5. Mean tumor volume was 1.01 cc (range 0.02 to 5.17). There were 2 (14.3%) insignificant (less than 0.2 cc, Gleason grade 3 or less), 1 (7.1%) minimal (less than 0.5cc, Gleason grade 3 or less) and 11 (78.6%) clinically relevant and potentially harmful cancers. Conclusions: There is a significant number of prostate cancer cases diagnosed at PSA as low as 1 to 3 ng./ml. A majority of these tumors are clinically significant. This free-to-total ratio range may be helpful for identifying prostate cancer. The "window of opportunity" for detection of curable cancer may change in populations with higher life expectancy towards lower PSA. Lack of specificity and characterization of tumor aggressiveness remains an unsolved issue for PSA. References 1 : Prostate specific antigen: a decade of discovery—what we have learned and where we are going. J Urol1999; 162: 293. Link, Google Scholar 2 : Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: results of a multicenter clinical trial of 6,630 men. J Urol1994; 151: 1283. Abstract, Google Scholar 3 : Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease. JAMA1992; 267: 2215. 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Google Scholar From the Clinic of Urology, Department of Laboratory Medicine and Institute of Pathology, Kantonsspital Aarau, Aarau, and Clinic of Urology, Kantonsspital Baden, Baden, Switzerland© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byREMZI M, FONG Y, DOBROVITS M, ANAGNOSTOU T, SEITZ C, WALDERT M, HARIK M, MARIHART S, MARBERGER M and DJAVAN B (2018) THE VIENNA NOMOGRAM: VALIDATION OF A NOVEL BIOPSY STRATEGY DEFINING THE OPTIMAL NUMBER OF CORES BASED ON PATIENT AGE AND TOTAL PROSTATE VOLUMEJournal of Urology, VOL. 174, NO. 4 Part 1, (1256-1261), Online publication date: 1-Oct-2005.Haese A, Dworschack R and Partin A (2018) Percent Free Prostate Specific Antigen in the Total Prostate Specific Antigen 2 to 4 ng./ml. Range Does Not Substantially Increase the Number of Biopsies Needed to Detect Clinically Significant Prostate Cancer Compared to the 4 to 10 ng./ml. RangeJournal of Urology, VOL. 168, NO. 2, (504-508), Online publication date: 1-Aug-2002. Volume 166Issue 3September 2001Page: 851-855 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordsprostate-specific antigenprostatic hyperplasiaprostateprostatic neoplasmsMetricsAuthor Information FRANZ RECKER More articles by this author MACIEJ K. KWIATKOWSKI More articles by this author ANDREAS HUBER More articles by this author BERNHARD STAMM More articles by this author KURT LEHMANN More articles by this author RETO TSCHOLL More articles by this author Expand All Advertisement PDF downloadLoading ...