[Value of PSA and (pre- postoperative) Gleason in predicting the potential lymphatic involvement in patients with prostatic cancer].

Autor:	Gómez Veiga F; Servicio de Urología y Anatomía Patológica, Hospital Juan Canalejo, La Coruña, España., Díaz Bermúdez J, Alvarez Castelo L, Lorenzo Patiño MJ, Rodríguez Rivera J, Chantada Abal V, Vázquez Martul E, González Martín M
Jazyk:	Spanish; Castilian
Zdroj:	Archivos espanoles de urologia [Arch Esp Urol] 1997 Jan-Feb; Vol. 50 (1), pp. 33-9.
Abstrakt:	Objective: To determine the possibility of selecting patients at risk for lymph node involvement prior to radical prostatectomy utilizing PSA concentration and/or the Gleason score. Methods: We reviewed the records of 52 patients with tumor stage T1 to T3, who had undergone lymphadenectomy; of these, 50 patients underwent radical prostatectomy. The predictive values for PSA and the Gleason score and their utility in predicting risk of lymph node involvement were analyzed. Results: Of the 52 patients, 10 (19%) had lymph node involvement. Nine of 26 patients (35%) with PSA > 20 and 9 of 21 patients (42%) with a Gleason score > 7 had lymph node involvement. No patient with PSA < 15 or Gleason score < 5 and none of the 24 patients (57%) with PSA < 20 and Gleason score < 7 had lymph node involvement. The preoperative biopsy was understaged in 21 patients (41%); of these, 16% had a Gleason score of 5-6. Two of these patients with PSA > 20 micrograms/ml had lymph node involvement. Conclusion: PSA concentration and the Gleason score are useful in predicting the risk of lymph node involvement. Patients with PSA < 20 and a Gleason score of < 7 can be considered to be at no risk and staging lymphadenectomy could be unnecessary. Although the preoperative Gleason score appears to have a predictive value, the possibility of understaging should be taken into account. In this regard PSA can be useful in identifying those patients at risk.
Databáze:	MEDLINE
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