Affiliation:
1. University of Kragujevac , Faculty of Medical Sciences , Serbia
2. Department of Urology, Clinic of Urology and Nephrology, Clinical Centre “Kragujevac” , Kragujevac , Serbia
Abstract
Abstract
Screening has dramatically changed the distribution of the mean age, stage and grade of prostate cancer (PCa) at diagnosis. However, regional-level data that characterize contemporary PCa patients are limited. The aim of the study was to ascertain main clinical and pathological characteristics of PCa at the present time in the circumstances of opportunistic testing.
High-grade PCa according to age, serum prostate specific antigen (PSA), volume prostate, PSA density (PSAD), digital rectal examination (DRE) number of positive cores biopsies and the average percentage of cancer in biopsy at diagnosis has been retrospectively evaluated in 100 men with biopsyproven PCa, at Clinical Centre Kragujevac, from September 2016 until September 2017. PCa were stratified according to Gleason score (GS) into low/intermediate-grade (GS ≤ 7) and high-grade (GS ≥ 8). To identify the determinants associated with high-grade PCa, we performed univariate and multivariate logistic regression.
The most prevalent PCa were the low/intermediate-grade (65%), followed by high-grade (35%). The mean age of the patients was 71.5 (range: 56–88) years and median PSA was 14.6 (range: 1.4–935) ng/ml. There were significant differences in age, PSA, PSAD, DRE, number of positive biopsy and average percentage of cancer in biopsy between patients with or without high-grade GS. Logistic analysis demonstrated the PSAD and age have strong prognostic value of high-grade PCa.
In conclusion, our study has shown the worrying frequency of high-grade PCa in the circumstances of opportunistic testing. Older men and higher level of PSAD had a much higher probability of high-grade PCa.
Reference26 articles.
1. 1. Arnold M, Karim-Kos HE, Coebergh JW, Byrnes G, Antilla A, Ferlay J, et al. (2015). Recent trends in incidence of five common cancers in 26 European countries since 1988: analysis of the European Cancer Observatory. Eur J Cancer 51(9):1164-87. doi: 10.1016/j.ejca.2013.09.002.
2. 2. Hoffman RM, Meisner AL, Arap W, Barry M, Shah SK, Zeliadt SB, et al. (2016). Trends in United States Prostate Cancer Incidence Rates by Age and Stage, 1995-2012. Cancer Epidemiol Biomarkers Prev. 25(2):259-63. doi: 10.1158/1055-9965.EPI-15-0723.
3. 3. Shao YH, Demissie K, Shih W, Mehta AR, Stein MN, Roberts CB, et al. (2009). Contemporary risk profile of prostate cancer in the United States. J Natl Cancer Inst. 101(18):1280-3. doi: 10.1093/jnci/djp262.
4. 4. van Poppel H (2014). Locally advanced and high risk prostate cancer: The best indication for initial radical prostatectomy? Asian J Urol. 1(1):40-45. doi: 10.1016/j.ajur.2014.09.009.
5. 5. Noone AM, Howlader N, Krapcho M, Miller D, Brest A, Yu M, et al. (eds) (2018). SEER Cancer Statistics Review, 1975-2015, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2015/. Accessed April 30, 2018.