Prostate-specific antigen levels and proportion of biopsy positive cores are independent predictors of upgrading patterns in low-risk prostate cancer

Porcaro, Antonio Benito; Inverardi, Davide; Corsi, Paolo; Sebben, Marco; Cacciamani, Giovanni; Tafuri, Alessandro; Processali, Tania; Pirozzi, Marco; Mattevi, Daniele; Marchi, Davide De; Amigoni, Nelia; Rizzetto, Riccardo; Cerruto, Maria Angela; Brunelli, Matteo; Siracusano, Salvatore; Artibani, Walter

doi:10.23736/s0393-2249.18.03172-7

Cited by 23 publications

(19 citation statements)

References 28 publications

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“…In the present study, we found that high BPC was associated with a lower probability of having PCI but a higher probability of having a more aggressive PCa. These results are concordant with our previous experience, demonstrating that more positive cores were associated with more aggressive disease [20,21].…”

Section: Pci and Pcasupporting

confidence: 93%

Prostatic chronic inflammation and prostate cancer risk at baseline random biopsy: Analysis of predictors

Tafuri

Sebben

Novella

et al. 2020

Arab Journal of Urology

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Objective: To evaluate predictors of prostatic chronic inflammation (PCI) and prostate cancer (PCa) in patients undergoing transperineal baseline random prostatic needle biopsies (BNB). Patient and methods: According to BNB outcomes, patients were divided into four groups: cases without PCI or PCa (Control group), cases with PCI only (PCI group), cases with PCa and PCI (PCa+PCI group) and cases with PCa only (PCa group). A multinomial logistic regression model was used to evaluate the association of clinical factors with BNB outcomes. Additionally, clinical factors associated with the risk of PCa in the overall population were investigated using a multivariable logistic regression model (univariate and multivariate analysis). Results: Overall, 945 patients were evaluated and grouped as follows: Control group, 308 patients (32.6%); PCI group, 160 (16.9%); PCa+PCI group, 45 (4.8%); and PCa group, 432 (45.7%). Amongst these, PCa was independently predicted by age (odds ratio [OR] 1.081), prostate specific-antigen level (PSA; OR 1.159), transition zone volume (TZV; OR 0.916), and abnormal digital rectal examination (DRE; OR 1.962). PCa and PCI (4.8%) were independently predicted by age (OR 1.081), PSA level (OR 1.122) and TZV (OR 0.954). In the group without PCa, the PSA level was the only factor associated with the risk of PCI when compared to the control group (OR 1.051, P = 0.042). Among patients with PCa, independent factors associated with the risk of only PCa compared to cases with PCA+PCI were TZV (OR 0.972) and number of positive cores (OR 1.149). In the overall population, PCI was the strongest predictor of a decreased risk of PCa (multivariate model, OR 0.212; P < 0.001) Conclusions: At BNB, PCI was associated with both a decreased risk of PCa and less aggressive tumour biology amongst patients with PCa. The presence of PCI on biopsy cores should be reported because of its implications in clinical practice.

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Section: Pci and Pcasupporting

confidence: 93%

Prostatic chronic inflammation and prostate cancer risk at baseline random biopsy: Analysis of predictors

Tafuri

Sebben

Novella

et al. 2020

Arab Journal of Urology

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“…All these findings are more important considering that in our previous experience we demonstrated that the NPC is strongly associated with more aggressive PCA resulting in tumor upgrading and upstaging, unilateral or bilateral lymph node metastasis and seminal vesical invasion ( 30 - 34 ).…”

Section: Discussionmentioning

confidence: 79%

Elevated prostate volume index and prostatic chronic inflammation reduce the number of positive cores at first prostate biopsy set: results in 945 consecutive patients

et al. 2020

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Objective To assess the association between prostate volume index (PVI), and prostatic chronic inflammation (PCI) as predictors of prostate cancer (PCA). PVI is the ratio between the central transition zone volume (CTZV) and the peripheral zone volume (PZV). Materials and methods Parameters evaluated included age, prostate specific antigen (PSA), total prostate volume (TPV), PSA density (PSAD), digital rectal exam (DRE), PVI, PCI and number of positive cores (NPC). All patients underwent baseline 14-core, trans-perineal random biopsies. Associations of parameters with the NPC were investigated by univariate and multivariate linear regression analysis. Results Between September 2010 to September 2017, 945 patients were evaluated. PCA was detected in 477 cases (50.7%), PCI in 205 cases (21.7%). PCA patients, compared to negative cases, were older (68.3 vs. 64.4 years) with smaller TPV (36 vs. 48.3mL) and CTZV (19.2 vs. 25.4), higher PSAD (0.24 vs. 0.15ng/mL/mL), further PVI values were lower (0.9 vs. 1.18) and biopsy cores less frequently involved by PCI (9.4% vs. 34.2%).High PVI and the presence of PCI were independent negative predictors of NPC in model I considering PSA and TVP (PVI, regression coefficient, RC -0,6; p=0.002) and PCI (RC -1,4; p <0.0001); and in model II considering PSAD (PVI:RC -0,7; p <0,0001; and PCI: RC -1,5; p <0.0001). Conclusions High PVI and the presence of PCI lowered the mean rate of NPC and is associated with less aggressive tumor biology expressed by low tumor burden. PVI can give prognostic information before planning baseline random biopsies. Confirmatory studies are required.

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“…The decision to perform an ePLND was mainly based on preoperative nomograms showing a risk of LNI greater than 5% [12]. In low-risk patients, the decision to perform an ePLND was based on clinical factors indicating an increased risk of tumor upgrading in the surgical specimen according to our previous experience [13-15].…”

Section: Methodsmentioning

confidence: 99%

Association between Basal Total Testosterone Levels and Prostate Cancer D’Amico Risk Classes

et al. 2020

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Objective: To test the hypothesis that basal total testosterone (TT) serum levels are associated with the D'Amico risk classification at diagnosis of prostate cancer (PCA). Materials and Methods: From November 2014 to March 2018, preoperative basal levels of TT and prostate-specific antigen (PSA) were measured in 601 consecutive PCA patients who were not under androgen deprivation therapy or undergoing prior prostate surgery. Patients were classified into low (reference group), intermediate, and high risk classes according to biopsy findings. The association of TT and other clinical factors with risk classes was evaluated using a multivariate multinomial logistic regression model. Results: According to the D'Amico classification, 124 patients (24%) were low risk, 316 (52.6%) were intermediate risk, and 141 (23.4%) were high risk. Median basal TT circulating levels were significantly increased along clinical risk classes. TT along with PSA, percentage of biopsy positive cores, and tumor clinical stage were independently associated with a high risk (OR = 1.002; p = 0.022) but not with an intermediate risk of PCA when compared to the low risk class. In the intermediate-risk group, endogenous TT together with PSA were independently associated with tumor grade groups 2 (OR = 1.003; p = 0.022) and 3 (OR = 1.003; p = 0.043) compared to grade group 1 cancers. Conclusions: Basal TT levels are positively associated with the D'Amico risk classification, but the association is significant for the high-risk group compared to the low-risk group.

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Prostate-specific antigen levels and proportion of biopsy positive cores are independent predictors of upgrading patterns in low-risk prostate cancer

Cited by 23 publications

References 28 publications

Prostatic chronic inflammation and prostate cancer risk at baseline random biopsy: Analysis of predictors

Prostatic chronic inflammation and prostate cancer risk at baseline random biopsy: Analysis of predictors

Elevated prostate volume index and prostatic chronic inflammation reduce the number of positive cores at first prostate biopsy set: results in 945 consecutive patients

Association between Basal Total Testosterone Levels and Prostate Cancer D’Amico Risk Classes

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