Prostate-Specific Antigen Density and Gleason Score Predict Adverse Pathologic Features in Patients with Clinically Localized Prostate Cancer

Abstract

Background: According to recent studies, prostate cancer is the second most common cancer among Iranian men. Radical prostatectomy has been considered the gold standard treatment in patients with clinically localized prostate cancer. Gleason score, PSA density, and PSA velocity are some of the parameters used to predict adverse pathologic features.

Objectives: The aim of this study was to evaluate the prognostic value of PSA density and Gleason score in predicting adverse pathologic features in patients with localized prostate cancer who undergo radical prostatectomy.

Methods: We conducted a cross-sectional study of 105 patients with localized prostate cancer who underwent radical prostatectomy between 2006 and 2013. We recorded Gleason scores and PSA levels, in addition to the results of pathological evaluations after radical prostatectomy, including prostate volume, stage, LNI (lymph node involvement), SVI (seminal vesicle invasion), and extraprostatic extension (EPE). Data were analyzed using SPSS version 21.

Results: Mean PSA density was 0.27 (0.17 SD). The frequencies of EPE, SVI, and LNI were 21.9, 16.2, and 2.9, respectively. The Mann-Whitney U-test demonstrated a significant correlation between PSA density and adverse pathologic features (EPE, SVI, and LNI).

Conclusions: PSA, PSA density, and Gleason score should be considered together in order to more accurately predict the adverse pathologic features of prostate cancer.

Keywords: Adverse Pathologic Feature; PSA Density; Prostate Neoplasm.

Figure 1.. Correlation between PSA density (A-C) or Gleason score (D-F) and adverse pathologic features, including extraprostatic extension (A, D), seminal vesicle invasion (B, E), and lymph node involvement (C, F).