Chan Dong Yeom, et al. Table 1. Preoperative Clinical Tumor Characteristics of Prostate Cancer Patients Variables Insignificant prostate cancer (n=38) Significant prostate cancer (n=259) Mean age (yrs) 65.2 (43-71) 66.4 (48-74) Prostate volume (cc) 35.5 (16-76) 34.4 (14-123) Preoperative PSA (nL/mL)* 5.49 (2.51-11.8) 9.91 (3.08-19.73) PSA density (ng/mL)* 0.11 (0.07-0.34) 0.42 (0.10-0.73) Bx Gleason sum (mean)*† 5.7 6.9 <6 7 2 6 31 97 >6 0 158 % of positive cores (means)* 20.0 66.3 No of positive cores (means)*† 2.2 3.3 1 13 27 2 11 74 3 8 77 4 6 31 5 or more 0 48 PSA, prostate specific antigen. The parenthesis for age, prostate volume, preoperative PSA, PSA density are range. *p<0.05 by Student’s t-test. †p<0.05 by chi square test. p value 0.411 0.285 0.012 0.027 0.043 0.002 0.016 Table 2. Pathological Findings from Analyses of Prostatec- tomy Specimens which Fulfilled the Epstein Clinically Insig- nificant Prostate Cancer Criteria Pathologic findings (n) SM+ 5 (13.2%) Organ confined disease 34 Non organ confined disease ECE 3 SVI 1 LNI 0 Pathologic Gleason sum <6 4 6 18 7 (3+4) 11 7 (4+3) 5 Gleason sum upgrading 16 (42.11%) Tumor volume (cc) 0.27 >0.5 5 (17.2%) <0.5 33 (86.8%) SM, surgical margin; ECE, extracapsular extension; SVI, seminal vesicle invasion; LNI, lymph node invasion. ria was 42.1%. The incidence of IPCa after prostate biopsy showed a pat- tern of increase over time, especially in group 3. The propor- tion of IPCa was 8/81 cases (10.1%) in group 1, 10/94 cas- es in group 2 (10.6%), and 20/122 cases in group 3 (16.4%) (Fig. 1). However, there was no change of incidence with time to upgrade from IPCa to significant PCa after radical prostatectomy [3/8 cases (37.5%) in group 1, 5/10 cases (50%) in group 2, and 8/20 cases (40%) in group 3, respec- Table 3. The Results of the Multiple Logistic Regression Analysis to Test the Predictable Indicator for Clinically Insig- nificant Prostate Cancer Variable Odds ratio (95% CI) p value Age (yrs) 1.034 (0.843-3.117) 0.581 BMI (kg/m2) 1.058 (0.722-1.138) 0.517 PSA 1.293 (0.932-1.354) 0.067 PSA density 1.384 (1.103-2.091) 0.041 Biopsy Gleason sum Gleason scores ≤6 Reference Gladeason socres >6 0.948 (0.467-1.319) 0.815 %bioofppsyositive cores in a 0.782 (0.501-1.021) 0.355 No of positive cores 0.791 (0.091-2.312) 0.518 Prostate volume 1.141 (0.735-1.559) 0.329 Clinical T stage ≤T2 Reference T3≤ 0.931 (0.482-1.712) 0.381 BMI, body mass index; PSA, prostate specific antigen. tively]. In the logistic regression analysis, only PSA density was found to be a predictable indicator for clinically IPCa (odds ratio=1.384, 95% CI, 1.103 to 2.091) (Table 3). DISCUSSION The contemporary Epstein criteria are the most widely used tool for predicting clinically IPCa.4,11 One study reported that the accuracy of the Epstein criteria in the USA was 84%, 360 Yonsei Med J http://www.eymj.org Volume 53 Number 2 March 2012