A total of 516 men with a serum total prostate-specific antigen (PSA) ≥ 2.5–10 ng/mL

were scheduled for initial prostate biopsy and urine was selleck inhibitor collected after digital rectal examination. PCA3 scores were determined and compared with biopsy outcomes. A total of 207 men (40%) had a positive biopsy and showed significantly higher PCA3 scores than men with a negative biopsy (69.6 ± 73.9 vs 31.0 ± 46.9; P < .0001; median values 50 and 18, respectively). With 35 as cut-off, the PCA3 score Inhibitors,research,lifescience,medical had a sensitivity of 64% and specificity of 76%. The probability of having a positive biopsy was 2.7-fold higher in men with a PCA3 score ≥ 35 (64%) than in men with a score < 35 (24%; P < .0001). A significantly higher PCA3 Inhibitors,research,lifescience,medical score was seen in men with biopsy GS ≥ 7 versus < 7, in patients with positive cores > 33% versus ≤ 33%, and “significant” versus “indolent” PCa according to Epstein criteria. A newly developed nomogram

was presented by Choi and colleagues20 to predict the probability of ECE in localized PCa. In their retrospective study, 446 of 1471 patients with clinically localized PCa Inhibitors,research,lifescience,medical had ECE (30%). Age, PSA, biopsy GS, positive core ratio, and maximum percentage of biopsy tumor were shown to be independent predictors of the presence of ECE (P < .05) by multivariate logistic regression models. The nomogram was internally validated, showed good predictive probability, and may be useful for preoperative identification Inhibitors,research,lifescience,medical of patients with ECE and selection of patients in which nerve sparing radical prostatectomy is oncologically safe and feasible. Loch and associates21 prospectively evaluated PCa in patients with multiple negative systematic random biopsies (SRB). A total of 132 patients with a history of at least 1 series Inhibitors,research,lifescience,medical of negative SRB were assigned to a computerized transrectal ultrasound examination. Cancer-suspicious areas were detected by the system via comparison with known and surgically removed carcinomas of the prostate. Targeted biopsies of areas of similarities with cancer patterns were

performed and GS was assessed. PCa could be detected in 66 of the 132 patients (50%), with 5 having a GS of 5, 25 of 6, 22 of 7, 8 of 8, and 7 of 9. The results of this prospective study show that significant cancer can be found in patients with multiple negative SRBs, as that 71.2% of the 66 men with a positive biopsy had a GS 6 or 7 PCa and 22% had a GS of ≥ 8. Essentially, multiple negative Fossariinae SRBs do not exclude high-grade PCa. The Surgical Approach In a multi-institutional study, Beauval and colleagues22 evaluated the pathologic characteristics of prostate specimen after radical prostatectomy (RP) was performed in low-risk patients eligible for active surveillance (AS). A total of 605 men fulfilled the AS criteria (T1c, PSA < 10 ng/ml, 1 positive core with < 3 mm involved, and GS < 7) and were analyzed with regard to pathologic features and oncological outcome.