Objectives: To compare the pathologic outcomes and prostate-specific antigen (PSA) progression rates of patients who underwent radical prostatectomy because of prostate cancers and whose cancer was detected at a PSA level of 2.6 to 4.0 ng/mL versus those with cancer detected after the PSA level rose to greater than 4.0 ng/mL. Some studies have suggested that clinically significant prostate cancer is detected more frequently in an organ-confined stage with a PSA level between 2.6 and 4.0 ng/mL than with a PSA level greater than 4 ng/mL. However, it is uncertain whether this will affect clinical outcomes.
Methods: From 1991 to 2001, 20,788 men enrolled in a prostate cancer screening study had an initial PSA level of less than 2.6 ng/mL. Of these patients, 523 had a PSA level that rose to greater than 2.5 ng/mL and had prostate cancer detected. Of the 297 patients who subsequently underwent radical prostatectomy, 223 had a preoperative PSA level of 2.6 to 4.0 ng/mL and 74 had a preoperative PSA level greater than 4.0 ng/mL. The median follow-up was 4 years. The pathologic stage, mean tumor volume, Gleason score, possibly insignificant cancer rate, possibly rapidly progressive cancer rate, and PSA progression rate were compared between the two groups.
Results: The patients with a preoperative PSA level between 2.6 and 4.0 ng/mL had more favorable pathologic outcomes in terms of cancer volume, pathologic stage, and possibly rapidly progressive cancer rate. The possibly insignificant cancer rates were not different between the groups. A trend was noted for patients with a preoperative PSA level between 2.6 and 4.0 ng/mL to have a lower PSA progression rate.
Conclusions: Biopsy in men with PSA levels between 2.6 and 4.0 ng/mL may detect clinically significant prostate cancer more frequently at an organ-confined stage, with a lower PSA progression rate. Additional study in a larger population with longer follow-up is needed to confirm this trend.
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http://dx.doi.org/10.1016/j.urology.2005.03.093 | DOI Listing |
Immun Inflamm Dis
January 2025
Department of Rheumatology, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Objective: To assess CXC chemokine receptor 5 (CXCR5) circulating DNA methylation differences in autoimmune rheumatic diseases and their relation with clinical features.
Methods: Targeted methylation sequencing was performed using peripheral blood from 164 rheumatoid arthritis (RA), 30 systemic lupus erythematosus (SLE), 30 ankylosing spondylitis (AS), 30 psoriatic arthritis (PsA), 24 Sjögren's syndrome (SS) patients, and 30 healthy controls (HC).
Results: Significant differences in CXCR5 cg19599951 methylation were found between RA and HC, as well as AS and SLE.
Cancer Rep (Hoboken)
January 2025
Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Background: Current approach to clinically suspicious biopsy-naïve men consists performing prostate MRI, followed by combined systematic (TRUS-Bx) and MRI-Ultrasound fusion biopsy (MRI-TBx) in those with PIRADS score ≥ 3. Researchers have attempted to determine who benefits from each biopsy method, but the results do not support the safe use of one method alone. This study aims to determine the optimal approach in biopsy-naïve men, according to their PSA levels.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Urology, The Second Hospital of Tianjin Medical University, No. 23 Pingjiang Road, Hexi Destrict, Tianjin, 300211, China.
To develop and validate biopsy-free nomograms to more accurately predict clinically significant prostate cancer (csPCa) in biopsy-naïve men with prostate imaging reporting and data system (PI-RADS) ≥ 4 lesions. A cohort of 931 patients with PI-RADS ≥ 4 lesions, undergoing prostate biopsies or radical prostatectomy from January 2020 to August 2023, was analyzed. Various clinical variables, including age, prostate-specific antigen (PSA) levels, prostate volume (PV), PSA density (PSAD), prostate health index (PHI), and maximum standardized uptake values (SUVmax) from PSMA PET-CT imaging, were assessed for predicting csPCa.
View Article and Find Full Text PDFCureus
December 2024
Oncology, Oxford University Hospitals National Health Services (NHS) Foundation Trust, Oxford, GBR.
Prostate cancer is one of the most frequently diagnosed cancers and poses a significant health burden. New androgen-targeted therapies are now standard treatments for various stages of prostate cancer, including hormone-sensitive, metastatic, and non-metastatic castration-resistant types. These therapies are generally well tolerated and often have fewer side effects compared to traditional chemotherapy.
View Article and Find Full Text PDFRev Esp Med Nucl Imagen Mol (Engl Ed)
January 2025
ASCIRES-Departamento de Medicina Nuclear del Hospital General Universitario de Valencia.
Objective: To assess the clinical value of [F]F-PSMA negative PET/CT, in patients diagnosed with prostate cancer treated with prostatectomy with elevated PSA less than 1 ng/mL, on the outcome of salvage radiotherapy.
Method: We prospectively included 98 patients diagnosed with prostate cancer treated with prostatectomy with biochemical recurrence [mean PSA 0.51 ng/mL (range 0.
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