Combination of the preoperative PSA level, biopsy Gleason score, percentage of positive biopsies, and MRI T-stage to predict early PSA failure in men with clinically localized prostate cancer

D’Amico, Anthony V.; Whittington, Richard; Malkowicz, S. Bruce; Wu, Yue; Chen, Ming‐Hui; Art, Meagan; Tomaszewski, John E.; Wein, Alan J.

doi:10.1016/s0090-4295(99)00479-3

Cited by 108 publications

(71 citation statements)

References 14 publications

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“…Subsequently, various additional clinical factors have been incorporated into statistical models aiming to improve prediction accuracy. 22,23 These parameters include prostate biopsy features (percentage of positive biopsies, percentage of biopsy tissue with cancer), MRI T-stage, PSA adjusted for prostate volume (PSA density) and plasma levels of transforming growth factor b 1 and soluble interleukin-6 receptor. However, to date only 2 studies have attempted to measure the incremental benefit gained by additional predictors.…”

Section: Discussionmentioning

confidence: 99%

Risk assessment for biochemical recurrence prior to radical prostatectomy: Significant enhancement contributed by human glandular kallikrein 2 (hK2) and free prostate specific antigen (PSA) in men with moderate PSA‐elevation in serum

Steuber

Vickers

Haese

et al. 2005

Intl Journal of Cancer

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Most models to predict biochemical recurrence (BCR) of prostate cancer use pretreatment serum prostate‐specific antigen (PSA), clinical stage and prostate biopsy Gleason grade. We investigated whether human glandular kallikrein 2 (hK2) and free prostate‐specific antigen (fPSA) measured in pretreatment serum enhance prediction. We retrospectively measured total PSA (tPSA), fPSA and hK2 in preoperative serum samples from 461 men with localized prostate cancer treated with radical prostatectomy between 1999 and 2001. We developed a regression model to predict BCR using preoperative tPSA, clinical stage and biopsy Gleason grade. We then compared the predictive accuracy of this “base” model with a model with fPSA and hK2 as additional predictors. BCR was observed in 90 patients (20%), including 48 patients with a pretreatment tPSA ≤ 14 ng/ml (13%), and 28 patients (10%) with a pretreatment tPSA ≤ 10 ng/ml. Overall, the predictive accuracy of the base model (bootstrap‐corrected concordance index of 0.813) was not improved after the addition of fPSA or hK2 (0.818). However, for men with moderate tPSA‐elevation (tPSA ≤ 10 ng/ml), addition of fPSA and hK2 data increased predictive accuracy (from a base model concordance index of 0.756–0.815, p = 0.005). The improvement in accuracy was not sensitive to the threshold for “moderately elevated” PSA. For patients with a moderate tPSA‐elevation (tPSA ≤ 10 ng/ml), which closely corresponds to concurrent disease demographics, BCR‐prediction was enhanced when fPSA and hK2 were added to the conventional model. Measurements of fPSA and hK2 improve on our ability to counsel patients prior to treatment as to their risk of BCR. © 2005 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

Risk assessment for biochemical recurrence prior to radical prostatectomy: Significant enhancement contributed by human glandular kallikrein 2 (hK2) and free prostate specific antigen (PSA) in men with moderate PSA‐elevation in serum

Steuber

Vickers

Haese

et al. 2005

Intl Journal of Cancer

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“…Standard prognostic markers in prostate cancer include serum PSA (13)(14)(15)(16)(17), Gleason score (2, 18 -24), and pathologic stage (25)(26)(27)(28). DNA ploidy is generally accepted by many as an independent prognostic marker, particularly if the cancer is extraprostatic at the time of RRP (1-3, 5, 9, 29).…”

Section: Discussionmentioning

confidence: 99%

Factors That Influence the Measurement of Prostate Cancer DNA Ploidy and Proliferation in Paraffin Embedded Tissue Evaluated by Flow Cytometry

Cheville

Katzmann

et al. 2001

Modern Pathology

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DNA ploidy (1-6) and proliferation (7,8) have been shown to provide prognostic information for prostate cancer. Studies examining the relationship between ploidy and proliferation and patient outcome are often based upon flow cytometry (FCM) data using formalin-fixed, paraffin-embedded tissue from radical retropubic prostatectomy (RRP) specimens. However, FCM cannot readily distinguish among benign epithelial, stromal, and inflammatory cells, high grade prostatic intraepithelial neoplasia (HGPIN), and cancer cells. Furthermore, studies that do not show DNA ploidy and proliferation as independent prognostic markers emphasize the strong correlation of cancer Gleason score with DNA ploidy and proliferation (9 -11).To the best of our knowledge, there are no published reports directly assessing the degree to which non-invasive tumor components in paraffinembedded tissue blocks are associated with prostate cancer ploidy and proliferation results determined by FCM. In this study, we evaluated hematoxylin and eosin (H&E) histologic features from 322 RRP formalin-fixed, paraffin-embedded tissue specimens used for determining DNA ploidy,

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“…Bu yüzden RRP öncesi T evresini, GS'yi, biyokimyasal nüks riskini öngörebilmek için PİB bulgularını da içeren risk grupları ve nomogramlar kullanılmaktadır (3,10,11,12,13,14 (20,21,22). Zaten yapılan çalışmalarda da PİB GS ile RRP GS uyumsuzluğunun yüksek oranda saptanması ve hastaların %50'sinde GS'de yükselme olduğunun gösterilmiş olması da bu araştırmalara olan gereksinimi destekler nitelikte görülmektedir (23,24).…”

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Preoperative Factors Related to Stage and Grade Increase in D’Amico Low-Risk and Intermediate-Risk Group Patients

Çelik¹,

Bozkurt²,

Demir³

et al. 2016

uob

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Objective: In this study we searched preoperative factors that may cause upstaging and upgrading at D'Amico low-risk and intermediate-risk group patients who underwent radical prostatectomy (RRP) due to prostate adenocarcinoma. Materials and Methods: Among patients undergoing RRP retrospective evaluation, those who have PSA<10ng/mL, prostate needle biopsy (PNB) Gleason score (GS) ≤6 and clinical T1c-T2a were placed in the low-risk group. Patients with PSA 10-20 ng/mL and/or PNB GS=7 and/or clinical T2b were placed in the intermediate-risk group. In accordance with PNB GS and clinical stage, patients whose RRP GS and T stage increased or not with PNB GS 3+4=7 (7a) and RRP GS 4+3=7 (7b) were assessed as upgrade. The PSA data, PNB and RRP pathological data and biochemical recurrence rates of patients were investigated. Current data were used to separately assess and compare low-risk and intermediate-risk groups according to upstaging and upgrading. Results: Among the 151 patients in the low-risk group, it was identified that 21 had upstage and 63 had upgrade, while in the 187 patients in the intermediaterisk group 84 had upstage and 39 had upgrade. In the low-risk group, the PNB tumor percentage was identified to be high in the upgrade group (p<0.001). In the intermediate-risk group, PSA, PSA density, PNB perineural invasion (PNI) positivity, tumor percentage and positive core numbers were high in the upstage group. However, in the intermediate-risk group PSA, fPSA, PSA density, PNB GS and tumor percentage were high in the upgrade group (p<0.05). When postoperative factors were examined, tumor volume and surgical margin positivity were observed to be correlated with upstaging and upgrading. Conclusion: In conclusion, in the low-risk group PNB tumor percentage was related to upgrading, in the intermediate-risk group, PSA, PSA density and PNB tumor percentage were correlated with both upstaging and upgrading, while PNB PNI positivity and positive core numbers were observed to be correlated with T stage increase only. Keywords: D'Amico risk classification, low-risk and intermediate-risk prostate cancer, prostate needle biopsy, upgrading, upstaging Amaç: Bu yazıda kliniğimizde prostat adenokarsinomu nedenli radikal retropubik prostatektomi (RRP) yapılan D'Amico düşük-risk ve orta-risk grubundaki hastalarda evre ve derece yükselmesine neden olabilecek preoperatif faktörler araştırıldı. Gereç ve Yöntem: RRP yapılan hastalardan prostat spesifik antijen (PSA) <10 ng/mL ve prostat iğne biyopsisi (PİB) Gleason skoru (GS) ≤6 ve klinik T1c-T2a olan hastalar D'Amico düşük-risk grubunda; PSA 10-20 ng/mL ve/veya PİB GS=7 ve/veya klinik T2b olan hastalar D'Amico orta-risk grubunda değerlendirildi. PİB GS ve klinik evresine göre RRP GS ve T evresinde yükselme olan ve olmayan hastalarda, PİB GS ve klinik evresine göre RRP GS ve T evresinde yükselme olan ve olmayan hastalar araştırıldı, bununla birlikte PİB GS 3+4=7 (7a) olup da RRP GS 4+3=7 (7b) olanlar da derecede yükselme olarak değerlendirildi. Hastaların PSA verileri, PİB ve RRP...

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Combination of the preoperative PSA level, biopsy Gleason score, percentage of positive biopsies, and MRI T-stage to predict early PSA failure in men with clinically localized prostate cancer

Cited by 108 publications

References 14 publications

Risk assessment for biochemical recurrence prior to radical prostatectomy: Significant enhancement contributed by human glandular kallikrein 2 (hK2) and free prostate specific antigen (PSA) in men with moderate PSA‐elevation in serum

Risk assessment for biochemical recurrence prior to radical prostatectomy: Significant enhancement contributed by human glandular kallikrein 2 (hK2) and free prostate specific antigen (PSA) in men with moderate PSA‐elevation in serum

Factors That Influence the Measurement of Prostate Cancer DNA Ploidy and Proliferation in Paraffin Embedded Tissue Evaluated by Flow Cytometry

Preoperative Factors Related to Stage and Grade Increase in D’Amico Low-Risk and Intermediate-Risk Group Patients

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