Significance of the correlation between the serum prostate-specific antigen and the percentage of prostate cancer volume in postoperative biochemical progression

Abstract

Introduction/Objective Radical prostatectomy (RP) is the best form of treatment of patients with locally confined prostate cancer (PC). Biochemical progression (BP) of the disease occurs in 27–53% of patients after RP. The aim of our analysis was to assess the significance of the correlation of preoperative prostate-specific antigen (PSA) values and the percentage volume of PC in biochemical progression in patients with RP and the biopsy Gleason score of 6 and 7.

Methods The analysis included the results of treatment of 228 patients with the committed radical retropubic prostatectomy for localized PC in the 2007–2011 period. According to the Gleason grade system values, three groups were identified – 6 (3 + 3), 7 (3 + 4) and 7 (4 + 3). According to the preoperative PSA values the following three groups were determined and monitored: ≤ 4 ng/ml, 4.1–10 ng/ml, and ≥ 10.1 ng/ml. Biochemical progression was defined as two consecutive increases of PSA values ≥ 0.2 ng/ml after RP. The percentage of tumor volume (PTV) is determined by a visual assessment of the percentage of PC in each microscopic sample. Four PTV groups were determined: 0–5%, 6–25%, 26–50%, and 51–100%.

Results Biochemical progression was registered in 19 patients. Most frequent PTV in the group of patients with BP and from biopsy and RP was 6–50%, an average of 30%.

Conclusion Our study showed predictive significant connections between preoperative PSA values and the values of PTV after operational treatment and that these are independent parameters in the assessment of treatment results.

Keywords: prostate cancer; radical prostatectomy; prostate-specific antigen; tumor volume; biochemical recurrence