Active surveillance or radical prostatectomy? Which treatment is best?

Abstract

OBJECTIVE: We evaluated the patients who are candidates for active surveillance and treated with radical prostatectomy. These patients were compared with other patients who had not met the criteria of active surveillance. METHODS: In total, 135 patients were included in the study. The patients were divided into two groups. The patients in Group 1 had less than three positive cores, Gleason 6 (3 + 3) and PSA level equal to or less than 10 ng/ml. Patients in Group 2 had three or more positive cores, Gleason 6 (3 + 3) and PSA level equal to or higher than 10 ng/ml. Pathological results of each groups were compared. RESULTS: The patients' ages were between 52 and 76, and 50 and 77 in groups 1 and 2, retrospectively. There were 69 and 66 patients in groups 1 and 2, retrospectively. The mean age of patients, PSA levels, PSA density, and prostate volumes were 63.89 ± 5.89 years, 5.82 ± 1.84 ng/ml, 0.14 ± 0.07 and 51.21 ± 31.75 cc (Group 1) and 65.77 ± 6.36 years, 13.65 ± 17.11 ng/ml, 0.63 ± 1.03 and 45.44 ± 26.77 cc (Group 2). T2a, T2c, T3a and T3b were reported in 28 patients, 36 patients, 3 patients and 2 patients after pathological evaluation in Group 1, respectively. T2a, T2c, T3a and T3b were reported in 13 patients, 47 patients, 5 patients and 1 patient in the other group, respectively. CONCLUSION: The fi nal pathology showed that there is no difference in the positive surgical margin, proportion of insignifi cant prostate cancer and Gleason upgrading between groups. The clinicians must be aware of the fact that active surveillance can be misdiagnosed in some patients (Tab. 2, Ref. 20). Text in PDF www.elis.sk. KEY WORDS: prostate cancer, cancer-specifi c death, prostate specifi c antigen, PSA testing retropubic prostatectomy.

The Positive Immunostaining of TMPRSS2-ERG is Not Associated With Unfavourable Outcomes and Biochemical Recurrence After Radical Prostatectomy in Turkish Patients

“…Prostate cancer (PCa) is one of the most common cancers and one of the leading causes of death amongst men in developed countries [ 1 ]. Digital rectal examination and prostate-specific antigen (PSA) testing are the screening methods that lead to prostate biopsy for the diagnosis of prostate cancer [ 2 ].…”

“…Transrectal ultrasound guided prostate biopsy is the gold standard method for histopathological diagnosis. Radical prostatectomy (RP) is a curative treatment for patients with localized PCa [ 1 ]. The Gleason score (GS), pathological T staging and serum PSA levels are well established prognostic factors for the prognosis of PCa [ 3 ].…”