The percentage of free prostate-specific antigen does not predict extracapsular disease in patients with clinically localized prostate cancer before radical prostatectomy

Objective To determine whether the percentage of free/total prostate-specif ic antigen (f/tPSA) can predict the pathological features in patients with clinically localized prostate cancer before radical prostatectomy. Patients and methods Univariate and multivariate logistic regression was us ed to analyse data from 171 untreated patients who underwent radical prosta tectomy. Variables included the total PSA (tPSA), fPSA, f/tPSA, biopsy Glea son score, clinical stage and patient age. Results In 115 patients with pathologically organ-confined tumours (pT2N0) the mean (SD) tPSA value was 6.9 (5.6) ng/mL: in 56 patients with extracaps ular disease (pT3pN0/N+) it was 10.2 (7.6) ng/mL; the respective f/tPSA val ues were 14.9 (8.1)% and 14.2 (12.9)%. In the univariate and multivariate a nalysis, tPSA and biopsy Gleason score were highly significant in predictin g extracapsular disease (P<0.001 and 0.002) but the f/tPSA was not (P=0.18) . There was no significant difference between the mean f/tPSA and final Gle ason scores. Conclusion The f/tPSA does not predict extracapsular disease in patients wi th clinically localized prostate cancer before radical prostatectomy. Knowi ng the f/tPSA provides no significant additional information in predicting extracapsular disease when the biopsy Gleason score and tPSA are known.