Detection Rates of Nonpalpable Prostate Cancer in Korean Men With Prostate-specific Antigen Levels Between 2.5 and 4.0 ng/mL

• Published in: Urology (Ridgewood, N.J.) Vol. 76; no. 4; pp. 919 - 922
• Main Authors: Kim, Hong Seok, Jeon, Seong Soo, Choi, Jae Duck, Kim, Wansuk, Han, Deok Hyun, Jeong, Byong Chang, Seo, Seong Il, Lee, Kyu Sung, Lee, Sung Won, Lee, Hyun Moo, Choi, Han Yong
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2010; Elsevier
• Subjects: Adenocarcinoma - blood; Adenocarcinoma - diagnosis; Adenocarcinoma - diagnostic imaging; Adenocarcinoma - epidemiology; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Aged; Biological and medical sciences; Biopsy, Needle; Ethnic Groups - statistics & numerical data; Gynecology. Andrology. Obstetrics; Humans; Korea - epidemiology; Male; Male genital diseases; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Organ Size; Palpation; Predictive Value of Tests; Prostate - diagnostic imaging; Prostate - pathology; Prostate-Specific Antigen - blood; Prostatectomy; Prostatic Neoplasms - blood; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - epidemiology; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Retrospective Studies; Tumors; Tumors of the urinary system; Ultrasonography, Interventional; Urinary tract. Prostate gland; Urology; Asia; Korea; Human; Nephrology; Urinary system disease; Prostate disease; Rate; Korean; Male; Tumoral marker; Malignant tumor; Urology; Prostate specific antigen; Adult; Diagnosis; Male genital diseases; Prostate cancer; Cancer
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2009.12.036

Objective To evaluate the detection rate and pathology of cancer in Korean men with low levels of prostate-specific antigen (PSA), 2.5-4.0 ng/mL. Methods We examined 1097 patients with PSA level of 2.5-10.0 ng/mL, who underwent transrectal ultrasonography-guided prostate needle biopsies between January 2008 and March 2009. Of the 1097 biopsy patients, 815 met our criteria of benign findings by digital rectal examination and the absence of cancerous lesions by TRUS. Clinical characteristics and detection rates of prostate cancer, as well as the pathology of specimens obtained by needle biopsies and prostatectomies, were evaluated in these patients. Results Of the 815 patients, 349 had group 1 (PSA level, 2.5-4.0 ng/mL) and 466 had group 2 (PSA level, 4.0-10.0 ng/mL). The percentage of patients diagnosed with prostate cancer was not statistically different between the 2 groups (21.8% in group 1, and 20.2% in group 2). In group 1, 70.7% of patients had a pathologic Gleason score of 7 or higher and 91.4% had organ-confined tumors (pT2). The pathologic characteristics, including Gleason score, pathologic stage, and percentage of insignificant cancer were similar in prostatectomy specimens between group 1 and group 2. Conclusions Detection rates of nonpalpable prostate cancer in Korean men were 21.8% in group 1 and 20.2% in group 2 without statistically significant difference. Pathologic characteristics of prostatectomy specimens also were similar between group 1 and group 2. These results suggest that a lower PSA level might be considered as an indication for prostate biopsy.