The Use Of Prostate-specific Antigen Capsular Penetration In Prostate Cancer

Objective:To evaluate predictive value of Prostate-specific antigen density(PSAD) for pathologic feature with established capsular penetration (ECP) after radical prostatectomy.Methods:Data from 667 patients (March 2007 to January 2014) who had been underwent radical prostatectomy were retrospectively analyzed.222 patients with complete medical records were both preoperatively classified as clinical stages T1-2c and postoperatively classified as pathological stages ≤pT3a, Receiver operating characteristic(ROC) analysis and multivariate logistic regression analysis were performed to assess accuracy of PSAD in prediction of ECP compared with total serum prostate-specific antigen (tPSA), f/tPSA and biopsy Gleason score.Results:110 patients were postoperatively classified as pathological stages pT3a(ECP) and 112 patients were postoperatively classified as pathological stages pT2(organ-confined disease).The area under the curve (AUC) by ROC analysis in prediction of ECP forthe different parameters including PSAD, tPSA, f/t and biopsy Gleason score were 0.708,0.653,0.338 and 0.623.The optimal cutoff of PSAD. was 0.27ng/ml/cm3,while corresponding sensitivity, specificity was 83.6,48.2,respectively.Furthermore, PSAD was more significant predictor in multivariate analyses(P=0.018).Conclusion:PSAD is an accurate predictor for ECP in Chinese patients undergoing radical prostatectomy.