Viveros EJM, Rojas BL, Solares SME, Lamm WL, Morales MJG, Pacheco GC, Calderón FF

Language: Spanish
References: 22
Page: 116-121
PDF size: 223.28 Kb.

ABSTRACT

Background. Total prostatic-specific antigen (t-PSA), Gleason score and digital rectal exam (DRE) are the main predictors of extracapsular extension. However, up to 1/3 of the clinically localized tumors can be sub-staged. Low percent free PSA (f-PSA) has been associated to aggressive tumors. We evaluated the use of f-PSA to predict the pathological stage in patients with clinically localized prostate cancer.
Materials and Methods. One hundred and thirty seven patients with clinically localized prostate cancer underwent radical prostatectomy from April 1991 to July 2005. In 34 patients we evaluated age, DRE, t-PSA, f-PSA and Gleason score preoperatively, and extracapsular extension, seminal vesicles or lymph node involvement, Gleason score and neural invasion postoperatively.
Results. Organ confined disease was observed in 59%, extracapsular extension in 32%, seminal vesicles invasion in 9% and lymph node invasion in 3%. Mean f-PSA values for organ confined and locally advanced cancer were 16% and 12%, with f-PSA ≤ 15% in 50% and 86%, respectively. The risk of non-organ confined disease was 3 times higher with f-PSA ≤ 15%, compared to f-PSA › 15 percent.
Conclusions. Our results with 34 patients correlate to those reported in world literature. A worse pathological outcome is associated to f-PSA ≤ 15%. A strong association was found without reaching significance. We suggest the use of f-PSA in conjunction with t-PSA, DRE and Gleason score to predict the pathological outcome.

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