Changes in serum PSA after endoscopic enucleation of the prostate are predictive for the future diagnosis of prostate cancer

Lambert, E. Warren; Goossens, M.; Palagonia, Erika; Vollemaere, Jonathan; Mazzone, Elio; Dell’Oglio, Paolo; Pauwels, Evelyn; Groote, Ruben De; D’Hondt, Frederiek; Mottrie, Alexandre; Naeyer, Geert De; Schatteman, Peter

doi:10.1007/s00345-020-03444-0

Cited by 11 publications

(7 citation statements)

References 18 publications

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“…This issue rises several implications such as development of early PCa and limitations in cancer detection using updated technologies (1,2). The knowledge is useful for patient and physician information before any further invasive diagnostic procedure such as biopsy or before any therapy of concurrent benign prostatic hyperplasie (BPH) (3). The believes of most men is that every cancer is detected if we use magnetic resonance given that prostatic specific antigen (PSA) and digital rectal examination (DRE) may miss sometimes early cancer, therefore prostate mpMR (magnetic resonance) imaging is extremely required even if is not clinically indicated.…”

Section: Introductionmentioning

confidence: 99%

Detection limits of significant prostate cancer using multiparametric MR and digital rectal examination in men with low serum PSA: Up-date of the Italian Society of Integrated Diagnostic in Urology

Galosi

Palagonia

Scarcella

et al. 2021

Arch Ital Urol Androl

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Reasons why significant prostate cancer is still missed in early stage were investigated at the 22nd National SIEUN (Italian Society of integrated diagnostic in Urology, Andrology, Nephrology) congress took place from 30th November to 1st December 2020, in virtual modality. Even if multiparametric magnetic resonance (MR) has been introduced in the clinical practice several, limitations are emerging in patient with regular digital rectal examination (DRE) and serum prostate specific antigen (PSA) levels approaching the normal limits. The present paper summarizes highlights observed in those cases where significant prostate cancer may be missed by PSA or imaging and DRE. The issue of multidisciplinary interest had been subdivided and deepened under four main topics: biochemical, clinical, pathological and radiological point of view with a focus on PI-RADS 3 lesions.

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Section: Introductionmentioning

confidence: 99%

Detection limits of significant prostate cancer using multiparametric MR and digital rectal examination in men with low serum PSA: Up-date of the Italian Society of Integrated Diagnostic in Urology

Galosi

Palagonia

Scarcella

et al. 2021

Arch Ital Urol Androl

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“…Second, there had been no definitive protocols for both preoperative and postoperative screening during the observation period. Third, our study consisted of a small number of 9 PCa-Post patients compared to other studies, 16,17 and that may weaken a statistical power. Lacking definitive protocols for both preoperative and postoperative screenings during the observation period, uncertain number of potential candidates were efficiently excluded in preoperative screenings, or there could be overlooked PCa among non-PCa who were lost to follow-up.…”

Section: Discussionmentioning

confidence: 94%

“…Therefore, postoperative screening should be seriously considered in terms of HoLEP‐related cancer problems and poor outcomes in PCa‐Post. Recently, Lambert 16 and Abedali 17 reported usefulness of pPSA monitoring against patients undergoing HoLEP. As for adequate pPSA monitoring, Lambert 16 insisted that patients with PSA > 1.73 ng/mL within the first year after HoLEP should be rigorously followed‐up regarding PCa‐Post from 773 patients data.…”

Section: Discussionmentioning

confidence: 99%

“…15 Recently, two informative observations were published regarding HoLEP and PCa. Lambert 16 and Abedali 17 reported efficacy of pPSA monitoring against patients undergoing HoLEP respectively; however, there is no screening protocols after BPH surgeries. We investigate who needs careful preoperative PCa screening and intensive postoperative follow-up after HoLEP.…”

Section: Introductionmentioning

confidence: 99%

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Prostate‐specific antigen follow‐up and management for patients undergoing holmium laser enucleation of the prostate

Kimura,

Katayama,

Ohara

et al. 2023

Int J of Urology

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ObjectivesTo investigate who needs a careful postoperative monitoring for prostate cancer (PCa) after holmium laser enucleation of the prostate (HoLEP). We examined characteristics and oncological outcomes of HoLEP‐related PCa.MethodsPatients who underwent HoLEP during 2002–2017 in a Japanese tertiary center were retrospectively analyzed. Patients were divided into non‐PCa, PCa with HoLEP specimen (PCa‐Ope), and PCa diagnosed during follow‐up (PCa‐Post). Outcomes of all HoLEP‐related PCa were monitored.ResultsOf the total 758, 60 (7.9%) were diagnosed with PCa from resected specimen of HoLEP and 9 (1.2%) were diagnosed postoperatively. Preoperative prostate‐specific antigen (iPSA), postoperative PSA (pPSA), and PSA density were significantly higher in both PCa groups than those in non‐PCa group. While iPSA significantly correlated to prostate volume (PV), pPSA was not associated with PV. A receiver‐operating‐characteristics curve demonstrated that pPSA 1.2 ng/mL achieved the optimal cut‐off (AUC 0.95) for the incidence of PCa‐Post. In addition to the incidence of PCa and iPSA, lower enucleation efficiency (enucleated volume /PV) was significantly associated with pPSA >1.2 ng/mL. Among PCa‐Ope, 51 were Grade Group (GG) ≤2 and 42 were followed‐up with active surveillance, whereas 8 of 9 PCa‐Post were GG ≥3 and 2 progressed to death.ConclusionsPatients undergoing HoLEP are associated with some risk of potential PCa. While oncological outcomes were favorable among PCa‐Ope, postoperative PSA should be carefully monitored even if not diagnosed with PCa with HoLEP specimen. Enucleation efficiency should be also considered not to misread pPSA value.

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“…1 In other recent reports, Lambert et al demonstrated that 24 (4.2%) out of 773 patients developed postoperative PCa after HoLEP and argued that the pPSA after HoLEP is an independent predictor for future diagnosis of PCa. 2 Closer follow-up and diagnostic investigations to detect postoperative PCa are indicated when pPSA is >1.73 ng/mL (ROC AUC 0.903), specifically within the first year after HoLEP. Klein et al reported that the rate of iPCa was 10.7% (n = 134/1247) in patients who underwent HoLEP, and pPSA >2 ng/mL was the independent risk factor for iPCa progression after HoLEP.…”

Section: Editorial Commentmentioning

confidence: 99%

Editorial comment on Prostate‐specific antigen follow‐up and management for patients undergoing holmium laser enucleation of the prostate

Sekito,

Sadahira

2023

Int J of Urology

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Changes in serum PSA after endoscopic enucleation of the prostate are predictive for the future diagnosis of prostate cancer

Cited by 11 publications

References 18 publications

Detection limits of significant prostate cancer using multiparametric MR and digital rectal examination in men with low serum PSA: Up-date of the Italian Society of Integrated Diagnostic in Urology

Detection limits of significant prostate cancer using multiparametric MR and digital rectal examination in men with low serum PSA: Up-date of the Italian Society of Integrated Diagnostic in Urology

Prostate‐specific antigen follow‐up and management for patients undergoing holmium laser enucleation of the prostate

Editorial comment on Prostate‐specific antigen follow‐up and management for patients undergoing holmium laser enucleation of the prostate

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