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Role of Holmium laser enucleation of the prostate to increase cancer detection rate in patients with gray-zone PSA level

 Ki H Kim  ;  Sang W Kim  ;  Hee S Son  ;  Dae K Kim  ;  Dae C Jung  ;  Hyun W Kim  ;  Joon C Kim  ;  Sung J Hong  ;  Jang H Kim 
 MINERVA UROLOGICA E NEFROLOGICA, Vol.71(1) : 72-78, 2019-02 
Journal Title
Issue Date
Aged ; Biopsy, Needle ; Humans ; Lasers, Solid-State* ; Male ; Neoplasm Grading ; Prostate-Specific Antigen / analysis* ; Prostatic Hyperplasia / diagnostic imaging ; Prostatic Neoplasms / diagnostic imaging*
Lasers, solid-state ; Prostate-specific antigen ; Prostatic neoplasms
BACKGROUND: Even though the safety of the treatment for prostate cancer diagnosed by HoLEP has been reported, the diagnostic value of HoLEP for prostate cancer detection has not been confirmed. Therefore, we investigated the diagnostic potential of HoLEP for detecting prostate cancer. METHODS: Between December 2009 and October 2015, 359 patients (median age, 70.9 years; range, 66.2-74.8) were treated simultaneously with HoLEP and transrectal prostate needle biopsy (TPNB). Of these, 199 patients with a normal digital rectal examination and serum PSA concentration between 3.5 and 10.0 ng/mL were included in the study. Univariate and multivariate logistic regression analyses were performed to identify the predictive factor for prostate cancer detected by HoLEP. RESULTS: Median PSA, prostate volume and PSA density were 4.97 ng/mL (range, 4.20-6.70), 57.40 gin (range, 43.67-77.80) and 0.09 ng/mL(2) (range, 0.07-0.12), respectively. Prostate cancer (Gleason score >= 6) was detected in 46 cases (23.1%). Of these, 26 (56.5%) were detected by HoLEP pathology, 11 (23.9%) by TPNB pathology, and 9 (19.6%) by both. Univariate and multivariate logistic regression analyses were performed in 179 patients, including benign prostatic hyperplasia patients (N=153, 76.9%) and patients with cancer detected by HoLEP pathology. PSA density was identified as an independent predictor of prostate cancer detected by HoLEP in gray-zone PSA. CONCLUSIONS: HoLEP is a viable modality for detecting prostate cancer in selected cases. PSA density was an independent predictor of prostate cancer detected by HoLEP in gray-zone PSA.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sang Woon(김상운) ORCID logo https://orcid.org/0000-0002-5790-1948
Kim, Jang Hwan(김장환) ORCID logo https://orcid.org/0000-0002-9056-7072
Son, Hee Seo(손희서) ORCID logo https://orcid.org/0000-0001-7198-7816
Jung, Dae Chul(정대철) ORCID logo https://orcid.org/0000-0001-5769-5083
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
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