Prostate Cancer Detection in the Prostate Specific Antigen Range of 2.0 to 3.9 Ng/Ml: Value of Percent Free Prostate Specific Antigen on Tumor Detection and Tumor Aggressiveness

Raaijmakers, René; Blijenberg, B. G.; Finlay, Jessica; Rittenhouse, Harry G.; Wildhagen, Mark F.; Roobol, Monique J.; Schröder, Fritz H.

doi:10.1097/01.ju.0000127731.56103.50

Cited by 60 publications

(33 citation statements)

References 18 publications

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“…The strength of our study relative to the previous studies relates to the consideration of very low tPSA values (2.5 ng/mL), as others were restricted to tPSA values higher than 2.0 ng/mL. [5][6][7]9,23,24 Therefore, our findings can be viewed as an extension of the previous reports, which extends the proof of %free PSA usefulness across virtually the entire range of tPSA values.…”

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confidence: 47%

“…18 The AUC in these reports ranged from 0.59 to 0.72. 5,9 Others could show that the combination of tPSA with %free PSA, free PSA, and human kallikrein 2 significantly improved the predictions of biopsy outcome, especially in older patients. 19 Our data also corroborate several previous analyses that examined the performance of %free PSA at initial biopsy, repeat biopsy, and saturation biopsy.…”

Section: Figure 2 (A)mentioning

confidence: 99%

“…The challenge stems from the knowledge that up to 1 in 5 men with tPSA 2.5 ng/mL may have prostate cancer at prostate biopsy, and that tPSA provides only limited ability to stratify the risk of prostate cancer in these men. 4,5 To address this challenge, we explored the ability of %free PSA to improve the prostate cancer risk stratification in patients with tPSA 2.5 ng/mL. Moreover, we tested the individual and combined abilities of tPSA, %free PSA, and digital rectal examination findings to predict prostate cancer at initial biopsy.…”

Section: Figure 2 (A)mentioning

confidence: 99%

“…Moreover, tPSA in the 2.5 ng/mL range has very limited ability to discriminate between prostate cancer and benign findings at prostate biopsy. 5 In consequence, accurate identification of men at risk of prostate cancer in the tPSA 2.5 ng/mL range represents a challenge, and novel biomarkers are needed for this subgroup.…”

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confidence: 99%

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Percent free prostate‐specific antigen (PSA) is an accurate predictor of prostate cancer risk in men with serum PSA 2.5 ng/mL and lower

Walz

Haese

Scattoni

et al. 2008

Cancer

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BACKGROUND.Up to 17% of men with a prostate‐specific antigen (PSA) level below the accepted prostate biopsy cutoff of 2.5 ng/mL may have prostate cancer. Because identification of these patients represents a difficult task, we assessed the ability of percent free PSA to discriminate between benign and malignant prostate biopsy outcomes in men with PSA ≤2.5 ng/mL.METHODS.Between 1999 and 2006, 543 men with a PSA ≤2.5 ng/mL were referred for initial prostate biopsy. Age, total PSA, percent free PSA, and digital rectal examination findings represented predictors of prostate cancer at biopsy in logistic regression models. The area under the receiver operating characteristics curve (AUC) quantified the discriminative ability of the predictors. The pathological characteristics of the detected cancers were assessed in individuals treated with radical prostatectomy.RESULTS.Of all, 23% had prostate cancer on biopsy, 16.5% of patients treated with radical prostatectomy had pT3 stage, and 35.6% had a pathological Gleason score of 3 + 4 or higher. The most accurate predictor of prostate cancer on biopsy was percent free PSA (0.68) versus age (0.50), total PSA (0.57), or rectal examination findings (0.58). Of patients with percent free PSA below 14%, 59% had prostate cancer. In multivariate models, percent free PSA (P < .001) and rectal examination findings (P = .001) were the only independent predictors of prostate cancer. The combined AUC of all predictors (0.69) was not significantly (P = .7) higher than that of percentage of free PSA alone (0.68).CONCLUSIONS.The risk of prostate cancer is clearly non‐negligible in patients with PSA ≤2.5 ng/mL. The percent free PSA can accurately predict the prevalence of prostate cancer at prostate biopsy in these individuals. Cancer 2008. © 2008 American Cancer Society.

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confidence: 47%

Section: Figure 2 (A)mentioning

confidence: 99%

Section: Figure 2 (A)mentioning

confidence: 99%

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confidence: 99%

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Percent free prostate‐specific antigen (PSA) is an accurate predictor of prostate cancer risk in men with serum PSA 2.5 ng/mL and lower

Walz

Haese

Scattoni

et al. 2008

Cancer

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“…A low %fPSA has been found to be a strong independent risk factor for stage pT3 disease 19 and high-grade tumours. 20,21 Thus, the use of %fPSA as the main criterion to decide whether biopsy is indicated will favour finding of tumours that threaten the health and life of the patient.…”

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confidence: 99%

The Value of Free PSA in Addition to Total PSA in the Early Detection of Prostate Cancer

Stenman¹

2005

European Oncology &Amp; Haematology

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Screening for prostate cancer

Ilić¹,

O’Connor²,

Green³

et al. 2006

Cochrane Database of Systematic Reviews

115

113

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Given that only two randomised controlled trials were included, and the high risk of bias of both trials, there is insufficient evidence to either support or refute the routine use of mass, selective or opportunistic screening compared to no screening for reducing prostate cancer mortality. Currently, no robust evidence from randomised controlled trials is available regarding the impact of screening on quality of life, harms of screening, or its economic value. Results from two ongoing large scale multicentre randomised controlled trials that will be available in the next several years are required to make evidence-based decisions regarding prostate cancer screening.

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Prostate Cancer Detection in the Prostate Specific Antigen Range of 2.0 to 3.9 Ng/Ml: Value of Percent Free Prostate Specific Antigen on Tumor Detection and Tumor Aggressiveness

Cited by 60 publications

References 18 publications

Percent free prostate‐specific antigen (PSA) is an accurate predictor of prostate cancer risk in men with serum PSA 2.5 ng/mL and lower

Percent free prostate‐specific antigen (PSA) is an accurate predictor of prostate cancer risk in men with serum PSA 2.5 ng/mL and lower

The Value of Free PSA in Addition to Total PSA in the Early Detection of Prostate Cancer

Screening for prostate cancer

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