Search

Objective: We aimed to investigate the long-term surveillance outcomes (biochemical recurrance, survival) and adequacy of active surveillance criteria to detect low-risk prostate cancer patients who were eligible for active surveillance but underwent radical prostatectomy. Materials and Methods: Data of patients who underwent radical prostatectomy for prostate cancer between January 2005 and January 2019 were retrospectively evaluated. Upstaging, upgrading, surveillance periods, and survival status of patients with clinical stage T1c and T2a, serum prostate-specific antigen below 10 ng/mL, International Society of Urological Pathology grade 1, number of tumor-positive cores in biopsy 2 and below, tumor percentage in tumor-positive cores 50 and below were inclusion criteria for active surveillance. Results: The study included 606 patients. Of these patients, 184 (30.4%) met the inclusion criteria for active surveillance. Upgrading was detected in 77 (41.8%) patients and upstaging in 29 (15.8%) patients who met the criteria for active surveillance. The prostate-specific antigen (PSA) and PSA density values of the patients who met the active surveillance criteria were significantly lower than those of the other patients (p<0.05). The mean surveillance period was 127.6±49.6 (8-227) months, and 123 patients died during this period. Among them, 18 (3%) patients died because of related causes of prostate cancer. None of the patients who met the criteria for active surveillance died because of prostate cancer (p=0.018). Conclusion: No cancer-related deaths were observed in patients who is eligible for active surveillance but underwent radical prostatectomy. This may suggest that active surveillance criteria are suitable for detecting low-risk prostate cancer patients. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to investigate the relevance of the Epstein criteria for the 12-core transrectal prostate biopsy (TRUS-Bx) scheme with the evaluation of clinicopathologic data recorded in the Urologic Cancer Database - Prostate (UroCaD-P), Urooncology Association, Turkey (UOAT). Materials and Methods: Patients with detailed pathological 12-core TRUS-Bx data for each biopsy core and who underwent RP due to PCa were included in this study. A total of 1167 patients from seven different centres were analysed. TRUS-Bx pathological findings were separately evaluated in the areas matching the sextant biopsy (6-core paramedian-lateral) scheme and in all 12-core biopsy areas (12-core biopsy scheme). Overall detection rates of PCa and ratios of clinically significant (sPCa) and insignificant PCa (insPCa) after RP were defined and compared between the biopsy schemes. Biopsy findings, according to the Epstein criteria, were also compared between the two schemes. A model for each biopsy scheme was created, including the Epstein criteria and additional biopsy findings using logistic regression analysis to predict clinically sPCa after RP. Results: There was a high correlation for the prediction of clinically insPCa between the two biopsy schemes in the same population. However, 7.3% of PCa could not be diagnosed in the 6-core TRUS-Bx scheme. Also, 69.4% of these had clinically sPCa according to the Epstein criteria in 12-core TRUS-Bx scheme and 51.8% of these were clinically sPCa after RP. The presence of perineural invasion (PNI) in 12-core biopsy was also significant regarding predicting sPCa (p<0.001). Conclusion: The Epstein criteria in 12-core prostate biopsy provide a better prediction of clinically sPCa than the 6-core biopsy scheme. Biopsy PNI findings appeared to improve the effectiveness of 12-core prostate biopsy, in addition to the Epstein criteria. [ABSTRACT FROM AUTHOR]

Objective: In this study we evaluated the hormone data before prostate needle biopsy (PNB) in patients who underwent retropubic radical prostatectomy (RRP) due to prostate adenocarcinoma (PCa). Correlations between the patients' RRP pathology results, recurrence-free survival (RFS), and hormone data were investigated. Materials and Methods: Patients were evaluated in two groups according to RRP pathologic T stage: T2 (group 1) and T3 (group 2). Then patients were assessed in two groups based on total testosterone (TTE) values: >300 ng/dL and <300 ng/dL. The preoperative data, hormone data, RRP pathologic data, and biochemical recurrence and RFS results were compared between these groups. Results: A total of 81 patients were evaluated. The mean follow-up time was 37.7 months. Mean recurrence free survival (RFS) among all patients was 94.2±7 months. In multivariate analysis of the preoperative data, TTE/prostate volume (p=0.015) and PNB tumor percentage (p=0.004) were significantly higher in group 2 (n=32) compared to group 1 (n=49). In the postoperative data, RRP pathology Gleason score (GS) (p=0.015) and tumor volume (p=0.02) were significantly higher in group 2. RFS was 99.2±5.8 months in group 1 and 77±12.1 months in group 2 (p=0.02). When patients were assessed according to TTE levels, of the pre- and postoperative data only RRP pathology T stage, GS, and lymph node positivity were significantly higher in the TTE <300 ng/dL group (n=30) compared to the TTE >300 ng/dL group (n=51). The biochemical recurrence rates and RFS times (87.7±13.8 months and 91.3±6.4 months, respectively) were similar between the groups (p=0.571). Conclusion: We demonstrated a correlation between locally invasive PCa and low TTE measured before PNB and low TTE density. In particular, TTE values <300 ng/dL were associated with high pathologic T stage, GS, and lymph node positivity. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Pathology is the property of Turkish Journal of Pathology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)