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Clinical understaging in patients with prostate adenocarcinoma submitted to radical prostatectomy: Predictive value of serum chromogranin A
Author(s) -
Sciarra Alessandro,
Voria Giuseppe,
Monti Salvatore,
Mazzone Luigi,
Mariotti Gianna,
Pozza Mariangela,
D'Eramo Giuseppe,
Silverio Franco Di
Publication year - 2003
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.10347
Subject(s) - medicine , prostatectomy , prostate cancer , urology , biopsy , prostate , chromogranin a , prostate specific antigen , adenocarcinoma , pathological , gastroenterology , cancer , immunohistochemistry
PURPOSE To evaluate whether the pretreatment determination of serum chromogranin A (CgA) can provide information beyond that obtained with serum prostate specific antigen (PSA) and Gleason score at biopsy as a predictive factor of clinical understaging (T2‐pT3) of prostate adenocarcinoma. MATERIALS In this prospective study, we analyzed 83 consecutive patients with clinical T2N0M0 prostate adenocarcinoma submitted to radical prostatectomy (RRP). On the same day of RRP, before surgery, a blood sample for the determination of serum total PSA and CgA levels (RIA) was obtained. RESULTS After RRP, 27 of the 83 cases (32.5%) showed extracapsular disease extension (pT3) at the final pathological examination and were considered clinically understaged. A significant association between serum CgA and pathological stage (r = 0.3830; P = 0.0004) was found. At the multivariate analysis, serum CgA and PSA, but not biopsy Gleason score, were found to be significant pretreatment independent predictors of pT3 at RRP ( P = 0.00004 and P = 0.0018, respectively). The relative risk of clinical understaging significantly varied according to serum CgA levels. Using a CgA cut‐off value of 60 ng/ml, PPV and NPV for clinical understaging were 0.5161 and 0.7885, respectively ( P = 0.0072). CONCLUSIONS Serum CgA could be incorporated into risk assessment models of newly diagnosed prostate cancer. © 2003 Wiley‐Liss, Inc.