Impact of Prostate Specific Antigen Level on Oncological Outcomes after Open Radical Prostatectomy

Objective: To compare the impact of prostate specific antigen (PSA) on oncological outcomes in the patients with 4-10 and 10.01-20 ng/ml PSA level. Study Design: Retrospective comparative study. Place and Duration of Study: Hitit University, corum Erol Olcok Training and Research Hospital, corum, Turkey, between February 2010 and January 2018. Methodology: Patients who underwent open radical prostatectomy in our department were reviewed retrospectively. The patients were divided into two groups according to the PSA level at diagnosis between 4 and 20 ng/ml. The patients with PSA level of 4-10 ng/ml was in group 1 and 10.01-20 ng/ml was in group 2. Preoperative data including age, biopsy Gleason score (GS), PSA level, postoperative pathological reports, T stage, GS, positive surgical margin, upgrading and downgrading, were compared between groups. Results: There were 109 (71.24%) and 44 patients (28.75%) in group 1 and group 2, respectively. The median age and PSA level of the patients was 67 and 64.5 years; 6.12 and 12.45 ng/ml in both groups, respectively. There was no significant difference for age, GS, number of positive biopsy cores except the PSA level (p<0.001). The difference did not reach statistical significance for stage, upgrading, downgrading, positive surgical margin, and prostatectomy GS between groups. Conclusion: Serum high PSA level at the time of the diagnosis was unrelated to final pathology. The proportion of local advanced disease and positive surgical margin was higher in patients with low PSA values than high levels without statistically significance.