Association between Hormonal Evaluation Before Prostate Needle Biopsy and Locally Advanced Prostate Cancer

Çelik, Serdar; Bozkurt, Ozan; Yıldız, Hüseyin Alperen; Demir, Ömer; Tuna, Burçin; Yörükoğlu, Kutsal; Aslan, Güven

doi:10.4274/uob.638

Cited by 4 publications

(6 citation statements)

References 19 publications

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“…However, our previous EST analysis in a locally advanced PCa (T3a and T3b) group revealed significant correlation between EST and T3b disease (9). It has been shown that LH level is not a significant factor in the prognosis of PCa (9). In the present study, we found that hormonal parameters other than TTE, especially FSH and EST levels, were not associated with pathological T stage.…”

Section: Discussioncontrasting

confidence: 71%

“…A study assessing EST level reported no significant correlation between EST and locally advanced PCa (25). However, our previous EST analysis in a locally advanced PCa (T3a and T3b) group revealed significant correlation between EST and T3b disease (9). It has been shown that LH level is not a significant factor in the prognosis of PCa (9).…”

Section: Discussionmentioning

confidence: 76%

“…Of the other parameters studied, findings of perineural invasion (PNI), number of positive biopsy cores, and tumor percentage in PNB are also important (4,5). Numerous studies have investigated the association between locally advanced disease and pre-treatment levels of free testosterone (fTE), estradiol (EST), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and especially total testosterone (TTE) (4,6,7,8,9,10). Therefore, in this study we evaluated patients who underwent retropubic radical prostatectomy (RRP) in our clinic due to PCa and had pre-PNB hormone data.…”

Section: Introductionmentioning

confidence: 99%

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Predictive Value of Hormonal Evaluation Before Prostate Needle Biopsy on Prostate Cancer T Stage and Prognosis

Çelik¹,

Yörükoğlu²,

Bozkurt³

et al. 2018

uob

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In this study we evaluated the hormone data before prostate needle biopsy (PNB) in patients who underwent retropubic radical prostatectomy (RRP) due to prostate adenocarcinoma (PCa). Correlations between the patients' RRP pathology results, recurrence-free survival (RFS), and hormone data were investigated. Materials and Methods: Patients were evaluated in two groups according to RRP pathologic T stage: T2 (group 1) and T3 (group 2). Then patients were assessed in two groups based on total testosterone (TTE) values: >300 ng/dL and <300 ng/dL. The preoperative data, hormone data, RRP pathologic data, and biochemical recurrence and RFS results were compared between these groups. Results: A total of 81 patients were evaluated. The mean follow-up time was 37.7 months. Mean recurrence free survival (RFS) among all patients was 94.2±7 months. In multivariate analysis of the preoperative data, TTE/prostate volume (p=0.015) and PNB tumor percentage (p=0.004) were significantly higher in group 2 (n=32) compared to group 1 (n=49). In the postoperative data, RRP pathology Gleason score (GS) (p=0.015) and tumor volume (p=0.02) were significantly higher in group 2. RFS was 99.2±5.8 months in group 1 and 77±12.1 months in group 2 (p=0.02). When patients were assessed according to TTE levels, of the pre-and postoperative data only RRP pathology T stage, GS, and lymph node positivity were significantly higher in the TTE <300 ng/dL group (n=30) compared to the TTE >300 ng/dL group (n=51). The biochemical recurrence rates and RFS times (87.7±13.8 months and 91.3±6.4 months, respectively) were similar between the groups (p=0.571). Conclusion: We demonstrated a correlation between locally invasive PCa and low TTE measured before PNB and low TTE density. In particular, TTE values <300 ng/dL were associated with high pathologic T stage, GS, and lymph node positivity.

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Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

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Predictive Value of Hormonal Evaluation Before Prostate Needle Biopsy on Prostate Cancer T Stage and Prognosis

Çelik¹,

Yörükoğlu²,

Bozkurt³

et al. 2018

uob

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“…Mortalite oranlarını düşürmek ve biyokimyasal rekürrensi (BR) önlemek adına son yıllarda özellikle prostat spesifik antijen (PSA) ve prostat iğne biyopsisi (PİB) verilerini içeren ve lokal hastalığı öngören risk grupları (özellikle D'Amico ve NCCN risk sınıflamaları) ve nomogramlar oluşturulmuştur (1,2,3,4,5). Bunların dışında PİB perinöral invazyon (PNİ) pozitifliği, tedavi öncesi serum testosteron ve estradiol düzeyleri de ayrıca araştırılan verilerdir (6,7,8). Tüm preoperatif veriler ile prostat kanseri patolojik parametrelerinin temelini oluşturan Stanford tekniğine göre tanımlanan postoperatif parametreler, BR öngörmek adına önemli bilgiler vermektedir (9).…”

Section: Introductionunclassified

Relationship Between Tumor Density in Radical Prostatectomy Material, Preoperative Predictive Factors and Biochemical Recurrence

Çelik¹,

Bozkurt²,

Aslan³

et al. 2017

uob

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Objective: In this study, we assessed the relationship between tumor density (tumor volume prostate volume ratio), preoperative predictive factors and biochemical recurrence (BR) in patients who underwent radical retropubic prostatectomy (RRP) for prostate cancer in our clinic. Materials and Methods: For the patients undergoing RRP between 2005-2015 preoperative predictive factors, postoperative prognostic factors and BR status were evaluated. Preoperative and postoperative factors were compared between the patient groups whose BR was detected as positive and negative. Subsequently, the cut-off value effecting BR of tumor density was determined and the preoperative predictive values, postoperative prognostic factors and BR rates were investigated in patients whose tumor density found low and high. Results: BR was detected in 63 of 338 patients who underwent RRP, but not in 275 patients. In BR positive patients of multivariate analysis, the prostate needle biopsy (PNB) Gleason score of preoperative predictive factors, number of focus and perineural invasion presence and only surgical margin positivity were detected to be significantly higher from the postoperative prognostic factors (p<0.001). The cut-off value of tumor density affecting BR positivity was detected as 4.34 cc/cc (AUC: 0.711, p<0.001). BR was 4.65 times higher in patients with tumor density >4.34 cc/cc compared to patients with tumor density ≤4.34 cc/cc (p<0.001, odds ratio: 4.65). Sensitivity and specifity of the tumor density of 4.34 cc/cc value for BR were detected as 68.3% and 68.4%, separately. Moreover, it was observed in multivariate analysis that prostate specific antigen (PSA) density of preoperative data, PNB tumor percentage and number of focus were solely associated with high tumor density (>4.34 cc/cc). Conclusion: In conclusion, it was found that the most important prognostic factors affecting BR were surgical margin positivity and high tumor density; PSA density, PNB tumor percentage and number of focus were alone associated with high tumor density among the preoperative predictive factors and all predictive factors were positively correlated with tumor density. Keywords: Prostate cancer, radical retropubic prostatectomy, tumor volume, tumor density, biochemical recurrence Amaç: Bu yazıda kliniğimizde prostat adenokarsinomu nedenli radikal retropubik prostatektomi (RRP) yapılan hastaların prostatektomi materyalindeki tümör dansitesinin (tümör hacminin prostat volümüne oranı) preoperatif prediktif faktörler ve biyokimyasal rekürrens (BR) ile ilişkisi araştırıldı. Gereç ve Yöntem: 2005-2015 tarihleri arasında RRP yapılan hastaların preoperatif prediktif faktörleri, postoperatif prognostik faktörleri ve BR durumları değerlendirildi. BR pozitif ve negatif saptanan hasta gruplarında preoperatif ve postoperatif faktörler karşılaştırıldı. Sonrasında tümör dansitesinin BR üzerine etkili cut-off değeri saptanarak tümör dansitesi düşük ve yüksek saptanan hastalar arasındaki preoperatif prediktif veriler, postoperatif prognostik faktörler ve BR...

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“…Radikal retropubik prostatektomi (RRP) patolojisine göre tanımlanmış olan parametreler RRP Gleason skoru (GS), tümör hacmi, ekstraprostatik yayılım varlığı ve düzeyi, seminal vezikül invazyonu varlığı, cerrahi sınır pozitifliği ve T evresidir (6). Aynı amaçla öngörü oluşturabilmek adına başta PİB perinöral invazyon (PNİ) pozitifliği, tedavi öncesi serum testosteron ve estradiol düzeyleri olmak üzere nomogram dışı da birçok faktör araştırılmıştır (7,8,9). D'Amico risk sınıflamasını değerlendirdiğimizde özellikle yüksek risk grubu hasta dışında kalan düşük-risk ve orta-risk grubundaki hastalarda kür sağlamak amacıyla RRP sonrası T evresinde ve GS'de yükselmeyi öngören preoperatif parametreleri tanımlamak önem kazanmaktadır.…”

Section: Introductionunclassified

Preoperative Factors Related to Stage and Grade Increase in D’Amico Low-Risk and Intermediate-Risk Group Patients

Çelik¹,

Bozkurt²,

Demir³

et al. 2016

uob

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Objective: In this study we searched preoperative factors that may cause upstaging and upgrading at D'Amico low-risk and intermediate-risk group patients who underwent radical prostatectomy (RRP) due to prostate adenocarcinoma. Materials and Methods: Among patients undergoing RRP retrospective evaluation, those who have PSA<10ng/mL, prostate needle biopsy (PNB) Gleason score (GS) ≤6 and clinical T1c-T2a were placed in the low-risk group. Patients with PSA 10-20 ng/mL and/or PNB GS=7 and/or clinical T2b were placed in the intermediate-risk group. In accordance with PNB GS and clinical stage, patients whose RRP GS and T stage increased or not with PNB GS 3+4=7 (7a) and RRP GS 4+3=7 (7b) were assessed as upgrade. The PSA data, PNB and RRP pathological data and biochemical recurrence rates of patients were investigated. Current data were used to separately assess and compare low-risk and intermediate-risk groups according to upstaging and upgrading. Results: Among the 151 patients in the low-risk group, it was identified that 21 had upstage and 63 had upgrade, while in the 187 patients in the intermediaterisk group 84 had upstage and 39 had upgrade. In the low-risk group, the PNB tumor percentage was identified to be high in the upgrade group (p<0.001). In the intermediate-risk group, PSA, PSA density, PNB perineural invasion (PNI) positivity, tumor percentage and positive core numbers were high in the upstage group. However, in the intermediate-risk group PSA, fPSA, PSA density, PNB GS and tumor percentage were high in the upgrade group (p<0.05). When postoperative factors were examined, tumor volume and surgical margin positivity were observed to be correlated with upstaging and upgrading. Conclusion: In conclusion, in the low-risk group PNB tumor percentage was related to upgrading, in the intermediate-risk group, PSA, PSA density and PNB tumor percentage were correlated with both upstaging and upgrading, while PNB PNI positivity and positive core numbers were observed to be correlated with T stage increase only. Keywords: D'Amico risk classification, low-risk and intermediate-risk prostate cancer, prostate needle biopsy, upgrading, upstaging Amaç: Bu yazıda kliniğimizde prostat adenokarsinomu nedenli radikal retropubik prostatektomi (RRP) yapılan D'Amico düşük-risk ve orta-risk grubundaki hastalarda evre ve derece yükselmesine neden olabilecek preoperatif faktörler araştırıldı. Gereç ve Yöntem: RRP yapılan hastalardan prostat spesifik antijen (PSA) <10 ng/mL ve prostat iğne biyopsisi (PİB) Gleason skoru (GS) ≤6 ve klinik T1c-T2a olan hastalar D'Amico düşük-risk grubunda; PSA 10-20 ng/mL ve/veya PİB GS=7 ve/veya klinik T2b olan hastalar D'Amico orta-risk grubunda değerlendirildi. PİB GS ve klinik evresine göre RRP GS ve T evresinde yükselme olan ve olmayan hastalarda, PİB GS ve klinik evresine göre RRP GS ve T evresinde yükselme olan ve olmayan hastalar araştırıldı, bununla birlikte PİB GS 3+4=7 (7a) olup da RRP GS 4+3=7 (7b) olanlar da derecede yükselme olarak değerlendirildi. Hastaların PSA verileri, PİB ve RRP...

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Association between Hormonal Evaluation Before Prostate Needle Biopsy and Locally Advanced Prostate Cancer

Cited by 4 publications

References 19 publications

Predictive Value of Hormonal Evaluation Before Prostate Needle Biopsy on Prostate Cancer T Stage and Prognosis

Predictive Value of Hormonal Evaluation Before Prostate Needle Biopsy on Prostate Cancer T Stage and Prognosis

Relationship Between Tumor Density in Radical Prostatectomy Material, Preoperative Predictive Factors and Biochemical Recurrence

Preoperative Factors Related to Stage and Grade Increase in D’Amico Low-Risk and Intermediate-Risk Group Patients

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