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Are Clinically Insignificant Prostate Cancers Really Insignificant among Korean Men?

PURPOSE: We aimed to determine whether 12 core-extended biopsies of the prostate could predict insignificant prostate cancer (IPCa) in Koreans reliably enough to recommend active surveillance. MATERIALS AND METHODS: Two hundred and ninety-seven patients who underwent radical prostatectomy after 12 c...

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Autores principales: Yeom, Chan Dong, Lee, Seung Hwan, Park, Kyung Kgi, Park, Sang Un, Chung, Byung Ha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Yonsei University College of Medicine 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282960/
https://www.ncbi.nlm.nih.gov/pubmed/22318824
http://dx.doi.org/10.3349/ymj.2012.53.2.358
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author Yeom, Chan Dong
Lee, Seung Hwan
Park, Kyung Kgi
Park, Sang Un
Chung, Byung Ha
author_facet Yeom, Chan Dong
Lee, Seung Hwan
Park, Kyung Kgi
Park, Sang Un
Chung, Byung Ha
author_sort Yeom, Chan Dong
collection PubMed
description PURPOSE: We aimed to determine whether 12 core-extended biopsies of the prostate could predict insignificant prostate cancer (IPCa) in Koreans reliably enough to recommend active surveillance. MATERIALS AND METHODS: Two hundred and ninety-seven patients who underwent radical prostatectomy after 12 core-extended prostate biopsies were retrospectively reviewed. 38 cases (12.8%) were shown to be IPCa. RESULTS: The average age was 65.2 years, serum PSA was 5.49 ng/dL, and the PSA density was 0.11. The Gleason scores (GS) were 6 (3+3) in 31, 5 (3+2) in 4, and 4 (2+2) in 3. After radical prostatectomy, higher GS was given in 16 (42.1%), whereas lower GS was given in 1 case (2.6%), as compared with the GS obtained from biopsy. 11 (28.9%) had GS of 7 (3+4) and 5 (13.2%) had GS of 7 (4+3). 6 in GS 7 (4+3) and 1 in GS 7 (3+4) showed prostate capsule invasion and 1 in GS 7 (4+3) had seminal vesicle invasion. Prostate capsule invasion was observed in 1 with GS 6 (3+3). The rate of inaccuracy of the contemporary Epstein criteria was 42.1%. Only PSA density was a reliable indicator of clinically IPCa (odds ratio=1.384, 95% CI, 1.103 to 2.091). CONCLUSION: Diagnosis of IPCa from a prostate biopsy underestimated the true nature of prostate cancer in as many as 42.1% of Koreans.
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spelling pubmed-32829602012-03-01 Are Clinically Insignificant Prostate Cancers Really Insignificant among Korean Men? Yeom, Chan Dong Lee, Seung Hwan Park, Kyung Kgi Park, Sang Un Chung, Byung Ha Yonsei Med J Original Article PURPOSE: We aimed to determine whether 12 core-extended biopsies of the prostate could predict insignificant prostate cancer (IPCa) in Koreans reliably enough to recommend active surveillance. MATERIALS AND METHODS: Two hundred and ninety-seven patients who underwent radical prostatectomy after 12 core-extended prostate biopsies were retrospectively reviewed. 38 cases (12.8%) were shown to be IPCa. RESULTS: The average age was 65.2 years, serum PSA was 5.49 ng/dL, and the PSA density was 0.11. The Gleason scores (GS) were 6 (3+3) in 31, 5 (3+2) in 4, and 4 (2+2) in 3. After radical prostatectomy, higher GS was given in 16 (42.1%), whereas lower GS was given in 1 case (2.6%), as compared with the GS obtained from biopsy. 11 (28.9%) had GS of 7 (3+4) and 5 (13.2%) had GS of 7 (4+3). 6 in GS 7 (4+3) and 1 in GS 7 (3+4) showed prostate capsule invasion and 1 in GS 7 (4+3) had seminal vesicle invasion. Prostate capsule invasion was observed in 1 with GS 6 (3+3). The rate of inaccuracy of the contemporary Epstein criteria was 42.1%. Only PSA density was a reliable indicator of clinically IPCa (odds ratio=1.384, 95% CI, 1.103 to 2.091). CONCLUSION: Diagnosis of IPCa from a prostate biopsy underestimated the true nature of prostate cancer in as many as 42.1% of Koreans. Yonsei University College of Medicine 2012-03-01 2012-01-30 /pmc/articles/PMC3282960/ /pubmed/22318824 http://dx.doi.org/10.3349/ymj.2012.53.2.358 Text en © Copyright: Yonsei University College of Medicine 2012 http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Yeom, Chan Dong
Lee, Seung Hwan
Park, Kyung Kgi
Park, Sang Un
Chung, Byung Ha
Are Clinically Insignificant Prostate Cancers Really Insignificant among Korean Men?
title Are Clinically Insignificant Prostate Cancers Really Insignificant among Korean Men?
title_full Are Clinically Insignificant Prostate Cancers Really Insignificant among Korean Men?
title_fullStr Are Clinically Insignificant Prostate Cancers Really Insignificant among Korean Men?
title_full_unstemmed Are Clinically Insignificant Prostate Cancers Really Insignificant among Korean Men?
title_short Are Clinically Insignificant Prostate Cancers Really Insignificant among Korean Men?
title_sort are clinically insignificant prostate cancers really insignificant among korean men?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282960/
https://www.ncbi.nlm.nih.gov/pubmed/22318824
http://dx.doi.org/10.3349/ymj.2012.53.2.358
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