Are Clinically Insignificant Prostate Cancers Really Insignificant Among Korean Men?

Chan Dong Yeom, Seung Hwan Lee, Kyung Kgi Park, Sang Un Park, Byungha Chung

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)358-362
Number of pages5
JournalYonsei medical journal
Volume53
Issue number2
DOIs
Publication statusPublished - 2012 Mar 1

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Neoplasm Grading
Prostatic Neoplasms
Prostate
Biopsy
Prostatectomy
Capsules
Seminal Vesicles
Odds Ratio

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Yeom, Chan Dong ; Lee, Seung Hwan ; Park, Kyung Kgi ; Park, Sang Un ; Chung, Byungha. / Are Clinically Insignificant Prostate Cancers Really Insignificant Among Korean Men?. In: Yonsei medical journal. 2012 ; Vol. 53, No. 2. pp. 358-362.
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abstract = "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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Are Clinically Insignificant Prostate Cancers Really Insignificant Among Korean Men? / Yeom, Chan Dong; Lee, Seung Hwan; Park, Kyung Kgi; Park, Sang Un; Chung, Byungha.

In: Yonsei medical journal, Vol. 53, No. 2, 01.03.2012, p. 358-362.

Research output: Contribution to journalReview article

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AU - Yeom, Chan Dong

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AU - Park, Sang Un

AU - Chung, Byungha

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N2 - 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.

AB - 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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