Objective: The aim of our study is to demon- strate that differentiating patients receiving a palli- ative approach to prostate cancer from candidates for definitive treatment using age and PSA value at initial presentation.
Material and Methods: The records of pa- tients diagnosed with prostate cancer in our clinic and external centers and presenting to our clinic for treatment between 2007 and 2012 were exam- ined retrospectively. Information was collected concerning patients’ ages at presentation, presen- tation PSA values, rectal examination findings at time of presentation, prostate volumes, transrectal ultrasonography (TRUS)-guided prostate biopsy results, imaging findings performed for staging purposes in patients with prostate cancer, and pathological specimens in operated patients.
Results: Mean age of patients was 70.85±8.40. Mean ages, PSA levels, percentage quadrant rates, and Gleason scores differed significantly depend- ing on presence of metastasis (p<0.01). In terms of the presence of prostate cancer in a patient, at a cut-off value of age 75, specificity was 77.17%, sensitivity 68.18%, positive predictive value (PPV) 48.28%, negative predictive value (NPV) 88.58%, and accuracy 70.68%; a PSA cut-off point of 20 ex- hibited sensitivity of 92.13%, specificity of 91.52%, PPV of 80.69%, NPV of 96.79%, and accuracy of 91.68%; and also sensitivity at a percentage of quad- rant cut-off value of 0.41, specificity was 75.59%, PPV 52.17%, NPV 88.64%, and accuracy 73.96%.
Conclusion: Decision in management should
be made by evaluating age and PSA value whether to apply palliative care or curative treatments in the geriatric age group without performing a biopsy.
Keywords: Prostate cancer, palliative care, metastasis, aging male
Abstract
Objective: The aim of our study is to demon- strate that differentiating patients receiving a palli- ative approach to prostate cancer from candidates for definitive treatment using age and PSA value at initial presentation.
Material and Methods: The records of pa- tients diagnosed with prostate cancer in our clinic and external centers and presenting to our clinic for treatment between 2007 and 2012 were exam- ined retrospectively. Information was collected concerning patients’ ages at presentation, presen- tation PSA values, rectal examination findings at time of presentation, prostate volumes, transrectal ultrasonography (TRUS)-guided prostate biopsy results, imaging findings performed for staging purposes in patients with prostate cancer, and pathological specimens in operated patients.
Results: Mean age of patients was 70.85±8.40. Mean ages, PSA levels, percentage quadrant rates, and Gleason scores differed significantly depend- ing on presence of metastasis (p<0.01). In terms of the presence of prostate cancer in a patient, at a cut-off value of age 75, specificity was 77.17%, sensitivity 68.18%, positive predictive value (PPV) 48.28%, negative predictive value (NPV) 88.58%, and accuracy 70.68%; a PSA cut-off point of 20 ex- hibited sensitivity of 92.13%, specificity of 91.52%, PPV of 80.69%, NPV of 96.79%, and accuracy of 91.68%; and also sensitivity at a percentage of quad- rant cut-off value of 0.41, specificity was 75.59%, PPV 52.17%, NPV 88.64%, and accuracy 73.96%.
Conclusion: Decision in management should
be made by evaluating age and PSA value whether to apply palliative care or curative treatments in the geriatric age group without performing a biopsy.
Keywords: Prostate cancer, palliative care, metastasis, aging male