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A paucity of data exists on actual pathology of the contemporary patients strictly categorized as having low-risk prostate cancer. We tried to identify useful preoperative predictors of Gleason score upgrading in patients who underwent radical retropubic prostatectomy (RRP) for low-risk prostate cancer diagnosed via multi-core prostate biopsy. A total of 203 patients who underwent radical RRP for low-risk prostate cancer, as defined by D’Amico et al.'s classification (clinical stage ≤T2a, biopsy Gleason sum ≤6, and PSA ≤10 ng/ml), detected via multi (≥12)-core prostate biopsy were enrolled. We reviewed patients preoperative and pathological data. Among all subjects, 81 (39.9%) were upgraded to Gleason score ≥7 after RRP, whereas no downgrading was observed. In multivariate analysis, only preoperative PSA level ( P = 0.024) and number of positive cores ( P = 0.027) were observed to be independent predictors of Gleason score upgrading following RRP. Also, Gleason core upgrading was observed to be significantly associated with extraprostatic extension of tumor ( P < 0.001) and positive surgical margin ( P = 0.002). A significant proportion of patients with low-risk prostate cancer as defined by D’Amico et al.’s classification diagnosed via multi-core prostate biopsy in contemporary period may have Gleason score upgrading following RRP. For patients with low-risk prostate cancer, preoperative PSA level and number of positive cores may be useful predictors of Gleason score upgrading, which was observed to significantly associated with other adverse pathologic features. [ABSTRACT FROM AUTHOR]

OBJECTIVE To evaluate the subclassifications of pT2 diseases in tumour-nodes-metastases (TNM) staging system for prostate cancer. PATIENTS AND METHODS We retrospectively analysed the data of 372 patients who underwent radical retropubic prostatectomy (RRP) for pathologically organ-confined prostate cancer at our institution. Pathological staging of all subjects were re-evaluated using the 1997 and the 2002 TNM staging system for prostate cancer. Various clinicopathological features along with biochemical recurrence-free survival (BRFS) of pT2 subgroups were assessed. RESULTS Using the 2002 TNM staging criteria, 87 of the tumours (23.4%) were pT2a, and 284 (76.3%) were pT2c. Of all subjects, there was only one (0.3%) pathological 2002 T2b tumour identified. When subjects were classified according to the 1997 versions of the T2 subclassification (pT2a vs pT2b), the 1997 pT2a and pT2b cases showed no significant difference regarding BRFS (log-rank P = 0.645) among those who were followed-up for >2 years after RRP. Also, pathological stage (1997 pT2a vs pT2b) was not a significant predictor of BRFS in either uni- or multivariate analysis ( P = 0.289 and P = 0.241, respectively). Only preoperative serum PSA level and pathological Gleason score along with positive surgical margin were significant predictors of PSA outcome after RRP on multivariate analysis. CONCLUSION Our results suggest that two- or three-tiered subclassification of pT2 organ-confined prostate cancer via methods used in the previous or current TNM staging system may not be appropriate. Efforts should be made to upgrade the current TNM staging system for prostate cancer. [ABSTRACT FROM AUTHOR]

Aim: To investigate the relationships of serum testosterone, insulin-like growth factor (IGF)-1 and IGF-binding protein (IGFBP)-3 levels with prostate cancer risk and also with known prognostic parameters of prostate cancer in Korean men who received radical retropubic prostatectomy (RRP) for clinically-localized prostate cancer. Methods: Serum levels of total testosterone, free testosterone, IGF-1 and IGFBP-3 were determined in 592 patients who subsequently received prostate biopsy. Results were compared between patients who eventually received RRP for prostate cancer ( n= 159) and those who were not diagnosed with prostate cancer from biopsy (control group, n= 433). Among the prostate cancer only patients, serum hormonal levels obtained were analyzed in relation to serum prostate specific antigen (PSA), pathological T stage and pathological Gleason score. Results: Prostate cancer patients and the control group demonstrated no significant differences regarding serum levels of total testosterone, free testosterone, IGF-1 and IGFBP-3 across the different age groups. Among the cancer only patients, no significant associations were observed for serum levels of total testosterone, free testosterone, IGF-1 and IGFBP-3 levels with pathological T stage, pathological Gleason score and preoperative PSA. Conclusion: Our data indicate that simple quantifications of serum testosterone and IGF-1 along with IGFBP-3 levels might not provide useful clinical information in the diagnosis of clinically localized prostate cancer in Korean men. Also, our results suggest that serum levels of testosterone, IGF-1 and IGFBP-3 might not be significantly associated with known prognostic factors of clinically localized prostate cancer in Korean men. [ABSTRACT FROM AUTHOR]

OBJECTIVE To investigate the prognostic significance of common preoperative laboratory variables evaluated before surgery for clear cell renal cell carcinoma (RCC). PATIENTS AND METHODS We retrospectively analysed the records of 355 patients who had surgery for clear cell RCC, assessing: clinical factors, including preoperative laboratory measurements, i.e. haemoglobin level, leukocyte count, platelet count, erythrocyte sedimentation rate (ESR), serum calcium, alkaline phosphatase (ALP), albumin, bilirubin, alanine aminotransferase, aspartate aminotransferase, and red blood cells in urine; and pathological factors, with the survival rates after surgery. RESULTS The presence of metastasis, tumour stage and tumour size, with the ESR and ALP before surgery, were identified as significant prognostic factors for progression-free survival in a multivariate analysis. The same factors were significant independent factors for disease-specific survival, except for ESR and ALP, which were nearly statistically significant. When limited to non-metastatic tumours only, the multivariate analysis showed that ESR and ALP, with tumour stage, grade, size and necrosis, were independent prognostic factors for disease-specific survival. CONCLUSIONS Along with traditionally accepted prognostic factors, these results suggest that common laboratory variables assessed before surgery, e.g. ESR and ALP, might also be useful in assessing the prognosis for patients with non-metastatic clear cell RCC. Including various laboratory variables in prognostic algorithms for RCC should be considered after further validation in RCCs of various histological subtypes and stages. [ABSTRACT FROM AUTHOR]