The Impact of PSA on Pathologic Characteristics in the Radical Prostatectomy with PSA Level of 4-10ng/ml

Park, Hyoung Keun; Kwak, Cheol; Byeon, Seok Soo; Lee, Eunsik; Lee, Sang Eun

Abstract

PURPOSE: We evaluated the effect of the serum prostate specific antigen (PSA) levels in the range 4.1 to 10.0ng/ml on the pathologic characteristics after a radical prostatectomy.
MATERIALS AND METHODS
Between July 1997 and June 2004, 117 men (64 years: 44-75) with an intermittent PSA level underwent radical retropubic prostatectomy. The patients were divided into 6 groups according to the PSA level (4.1-5.0, 5.0-6.1, 6.1-7.0. 7.1-8.0, 8.1-9.0 and 9.1-10.0ng/ml), and compared the age, prostate volume, Gleason score of biopsy specimen and pathologic stage, grade and margin status of prostatectomy specimen between the 6 groups.
RESULTS
The mean age, prostate volume and Gleason score of the biopsy were not significantly different between the 6 groups. The pathologic stage and margin status also were not significantly different between the 6 groups. The mean Gleason score was higher in the high PSA group, but this was not statistically significant. When divided into two groups (group with PSA 4.1-7.0 and 7.1-10.0ng/ml), the pathologic stage and margin status were no different. However, the mean Gleason score and the rate of high grade (Gleason score 8-10) prostate cancer were higher in the high PSA group. The mean high grade prostate cancer rates were 22 and 7% in the PSA 7.1-10.0 and 4.1-7.0ng/ml groups, respectively (p=0.019).
CONCLUSIONS
A PSA level above 7.0ng/ml in the intermediate group influenced the pathologic grade of the radical prostatectomy. This result suggests that prostate cancer with a PSA level higher than 7.0ng/ml may have a more aggressive feature.