Pathologic Characteristics of Prostate Cancers Missed by Application of the Age-specific Prostate-specific Antigen Reference in Men over Sixties.
10.4111/kju.2007.48.8.809
- Author:
Seong Jin JEONG
1
;
June Hyun HAN
;
In Ho CHANG
;
Ji Hyung YU
;
Byung Kyu HAN
;
Sung Kyu HONG
;
Seok Soo BYUN
;
Sang Eun LEE
Author Information
1. Department of Urology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. selee@snubh.org
- Publication Type:Original Article
- Keywords:
Prostate cancer;
Prostate-specific antigen;
Age
- MeSH:
Biopsy;
Humans;
Male;
Prostate*;
Prostate-Specific Antigen*;
Prostatectomy;
Prostatic Neoplasms*;
Retrospective Studies
- From:Korean Journal of Urology
2007;48(8):809-814
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To examine the pathologic characteristics of prostate cancers missed by application of the age-specific prostate-specific antigen(PSA) reference in Korean men over sixties in clinical practice based on PSA cutoff 3.0ng/ml. MATERIALS AND METHODS: We made retrospective analysis of 1,063 patients aged between 60-79 who had had transrectal ultrasonography(TRUS)- guided biopsy due to the rise of PSA over 3.0ng/ml or abnormal findings in digital rectal examination(DRE) or TRUS. Age-specific PSA reference was set at 3.9ng/ml for 60s and 5.4ng/ml for 70s. RESULTS: Prostate cancer was detected in 34.3%(365/1,063) as a whole, and 31.5% in 60s, and 39.5% in 70s according to the age. When age-specific reference 3.9ng/ml was applied to 60s, 20(9.6%) cancers were missed compared with clinical cutoff value(3.0ng/ml). When age-specific reference 5.4ng/ml was applied to 70s, 23(16.0%) cancers were missed. On the average, 43(12.2%) of cancers were missed in 60s and 70s. Of 43 missed cancers, 39(90.7%) were with normal DRE and TRUS. Of these cancers, 16(41.0%) were clinically insignificant on biopsy, but only 7(22.6%) were insignificant in the pathologic examination of 31 radical prostatectomy specimens. CONCLUSIONS: In our clinical practice based on PSA cutoff 3.0ng/ml, most cancers missed by application of age-specific reference are clinically significant. But, considering the positive effect of age-specific reference on avoidance of unnecessary biopsies, large prospective study is needed to evaluate the efficacy of age-specific reference in Korean men over sixties.
