Longitudinal modeling of ultrasensitive and traditional prostate-specific antigen and prediction of biochemical recurrence after radical prostatectomy

Abstract

Ultrasensitive prostate-specific antigen (u-PSA) remains controversial for follow-up after radical prostatectomy (RP). The aim of this study was to model PSA doubling times (PSADT) for predicting biochemical recurrence (BCR) and to capture possible discrepancies between u-PSA and traditional PSA (t-PSA) by utilizing advanced statistical modeling. 555 RP patients without neoadjuvant/adjuvant androgen deprivation from the Turku University Hospital were included in the study. BCR was defined as two consecutive PSA values >0.2 ng/mL and the PSA measurements were log2-transformed. One third of the data was reserved for independent validation. Models were first fitted to the post-surgery PSA measurements using cross-validation. Major trends were then captured using linear mixed-effect models and a predictive generalized linear model effectively identified early trends connected to BCR. The model generalized for BCR prediction to the validation set with ROC-AUC of 83.6% and 95.1% for the 1 and 3 year follow-up censoring, respectively. A web-based tool was developed to facilitate its use. Longitudinal trends of u-PSA did not display major discrepancies from those of t-PSA. The results support that u-PSA provides useful information for predicting BCR after RP. This can be beneficial to avoid unnecessary adjuvant treatments or to start them earlier for selected patients.

Efficacy and Safety of Brazilian Green Propolis in Biochemically Recurrent Prostate Cancer after Radical Prostatectomy: A Single-Arm Phase II Study

“…Although we did not assign placebo-control groups and the low PSA levels in our study sample may preclude us from calculating reliable PSA-DT [33], we included PSA values before and after 6 months of propolis administration, and the PSA levels in most patients increased steadily compared with before baseline. Therefore, the PSA-DT and PSA slopes calculated in our study could reliably reflect the disease status [34], and this supplement may have a mild impact on PCa. Our results corroborate those of Endo et al, who reported that artepillin C, a cinnamic acid derivative in Brazilian green propolis, induced apoptosis in PCa CWR22Rv1 cells [35].…”

Quantitation of Femtomolar‐Level Protein Biomarkers Using a Simple Microbubbling Digital Assay and Bright‐Field Smartphone Imaging

“…Ultrasensitive PSA assessment in the post‐prostatectomy surveillance of prostate cancer patients has utility as a means of risk stratification and counselling of patients on prognosis and treatment decisions . Early detection of recurrence offers the possibility of early salvage therapy given at a lower cancer burden and a wider time window for cure .…”

Quantitation of Femtomolar‐Level Protein Biomarkers Using a Simple Microbubbling Digital Assay and Bright‐Field Smartphone Imaging

“…[19][20][21] Early detection of recurrence offers the possibility of early salvage therapy given at alower cancer burden and aw ider time window for cure. [19][20][21] Early detection of recurrence offers the possibility of early salvage therapy given at alower cancer burden and aw ider time window for cure.…”