Predictive values for extracapsular extension in prostate cancer patients with PSA values below 10 ng/mL

Abstract

Objective: We aimed to determine predictive values of extracapsular extension (ECE) in patients who had un - dergone radical retropubic prostatectomy (RRP) with prostate-specifc antigen (PSA) values below 10 ng/mL. Material and 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) fndings, biopsy total Glea - son 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 spec - imens of RRP of 167 patients, 45 (26.9%) had extracapsular extension (pT3-4) (Group 1); 122 (73.1%) were confned 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 signifcant difference (p=0.04). A statistically signifcant difference was found between the rates of PNI and LVI (28.9% and 1.63%, respectively) (p=0.002). There was no statistically signifcant difference between both groups as for surgical margin positivity (p=0.18). Conclusion: In PCa patients with PSA values below 10 ng/mL, PSA density, lymphovascular invasion and biopsy Gleason total score were statistically signifcant in predicting extracapsular invasion. Therefore, these results must be considered in preoperative evaluation.