Abstract

Background

The aim of this study was to evaluate the efficiency of prostate-specific antigen (PSA) density (PSAD) calculated through prostate volume (PV) obtained via transrectal ultrasound (TRUS) and magnetic resonance imaging (MRI) and actual prostate weight (PW) methods obtained via pathological evaluation on the prediction of biochemical recurrence (BCR) in the follow-ups of patients who had undergone radical prostatectomy (RP).

Methods

A total of 335 clinically localized prostate cancer (PCa) patients who had received open RP between January 2015 and December 2018 were enrolled in the study. Pre and postoperative demographic data, clinical and pathological findings and BCR conditions were recorded. The PSAD was calculated using information obtained through preoperative TRUS examinations, MRI, and collected pathological specimens after RP by dividing the maximum preoperative PSA value and PV/PW.

Results

In a mean follow-up duration of 20.2 ± 8.5 months, recurrence was observed in 52 patients (24.4%) and progression was observed in 8 (3.8%) patients. The TRUS-PSAD, MRI-PSAD, and PW-PSAD values were statistically significantly higher in BCR patients compared to non-BCR patients. The International Society of Urologic Pathologists (ISUP) grade 5 and pT3b as a pathological stage were detected as independent variables in the prediction of BCR formation. Actual PW had a high prediction value compared to other PSAD measurements at <40 g prostate weights, but it had a low prediction value in prostates with an actual PW >60 g.

Conclusions

In this study, it was stated that PSAD acquired through different imaging methods does not affect the usability of PSAD in BCR prediction in clinical practice. The ISUP grade 5 and pT3b stage PCa were detected as independent markers in BCR prediction after RP.

中文翻译：

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使用三种不同方法测量前列腺特异性抗原密度预测生化复发的效率

摘要

背景

本研究的目的是评估通过经直肠超声 (TRUS) 和磁共振成像 (MRI) 获得的前列腺体积 (PV) 和实际前列腺重量 (PW) 计算的前列腺特异性抗原 (PSA) 密度 (PSAD)的效率通过对接受根治性前列腺切除术 (RP) 患者随访中生化复发 (BCR) 预测的病理评估获得的方法。

方法

共有 335 名在 2015 年 1 月至 2018 年 12 月期间接受开放式 RP 的临床局限性前列腺癌 (PCa) 患者参加了该研究。记录术前和术后的人口统计学数据、临床和病理结果以及 BCR 情况。使用通过术前 TRUS 检查、MRI 和 RP 后收集的病理标本获得的信息通过除以最大术前 PSA 值和 PV/PW 来计算 PSAD。

结果

在 20.2 ± 8.5 个月的平均随访时间内，52 名患者（24.4%）出现复发，8 名（3.8%）患者出现进展。与非 BCR 患者相比，BCR 患者的 TRUS-PSAD、MRI-PSAD 和 PW-PSAD 值在统计学上显着升高。国际泌尿病理学家协会 (ISUP) 5 级和作为病理阶段的 pT3b 被检测为预测 BCR 形成的独立变量。与其他 PSAD 测量值相比，实际 PW 在 <40 g 前列腺重量时具有较高的预测值，但在实际 PW >60 g 的前列腺中预测值较低。

结论

在这项研究中，指出通过不同成像方法获得的 PSAD 不会影响 PSAD 在临床实践中 BCR 预测的可用性。ISUP 5 级和 pT3b 期 PCa 被检测为 RP 后 BCR 预测中的独立标志物。