Role of Holmium laser enucleation of the prostate to increase cancer detection rate in patients with gray-zone PSA level.

Autor:	Kim KH; Department of Urology, Soonchunhyang University College of Medicine, Cheonan, Chungcheongnam-do, South Korea., Kim SW; Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea., Son HS; Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea., Kim DK; Department of Urology, CHA Gangnam Medical Center, CHA University, Seoul, South Korea., Jung DC; Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea., Kim HW; Department of Urology, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea., Kim JC; Department of Urology, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, South Korea., Hong SJ; Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea., Kim JH; Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea - JKIM@yuhs.ac.
Jazyk:	angličtina
Zdroj:	Minerva urologica e nefrologica = The Italian journal of urology and nephrology [Minerva Urol Nefrol] 2019 Feb; Vol. 71 (1), pp. 72-78. Date of Electronic Publication: 2018 Jul 23.
DOI:	10.23736/S0393-2249.18.03186-7
Abstrakt:	Background: Even though the safety of the treatment for prostate cancer diagnosed by HoLEP has been reported, the diagnostic value of HoLEP for prostate cancer detection has not been confirmed. Therefore, we investigated the diagnostic potential of HoLEP for detecting prostate cancer. Methods: Between December 2009 and October 2015, 359 patients (median age, 70.9 years; range, 66.2-74.8) were treated simultaneously with HoLEP and transrectal prostate needle biopsy (TPNB). Of these, 199 patients with a normal digital rectal examination and serum PSA concentration between 3.5 and 10.0 ng/mL were included in the study. Univariate and multivariate logistic regression analyses were performed to identify the predictive factor for prostate cancer detected by HoLEP. Results: Median PSA, prostate volume and PSA density were 4.97 ng/mL (range, 4.20-6.70), 57.40 gm (range, 43.67-77.80) and 0.09 ng/mL2 (range, 0.07-0.12), respectively. Prostate cancer (Gleason score ≥6) was detected in 46 cases (23.1%). Of these, 26 (56.5%) were detected by HoLEP pathology, 11 (23.9%) by TPNB pathology, and 9 (19.6%) by both. Univariate and multivariate logistic regression analyses were performed in 179 patients, including benign prostatic hyperplasia patients (N=153, 76.9%) and patients with cancer detected by HoLEP pathology. PSA density was identified as an independent predictor of prostate cancer detected by HoLEP in gray-zone PSA. Conclusions: HoLEP is a viable modality for detecting prostate cancer in selected cases. PSA density was an independent predictor of prostate cancer detected by HoLEP in gray-zone PSA.
Databáze:	MEDLINE
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