Prostate Cancer Gene 3 (PCA3): Development and Internal Validation of a Novel Biopsy Nomogram

Chun, Felix K.-H.; Taille, Alexandre de la; Poppel, Hendrik Van; Marberger, Michael; Stenzl, Arnulf; Mulders, Peter F.A.; Huland, Hartwig; Abbou, C.C.; Stillebroer, Alexander B.; Gils, Martijn P.M.Q. van; Schalken, Jack A.; Fradet, Yves; Marks, Leonard S.; Ellis, William; Partin, Alan W.; Haese, Alexander

doi:10.1016/j.eururo.2009.03.029

Cited by 160 publications

(95 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A strong NPV is important when deciding who no longer needs repeat biopsy. Chun et al 10 found in their study an optimal cutoff value of 17. In fact, in our analysis, PCA3 was predictive as a continuous variable, with risk of cancer increasing steadily with increasing PCA3 score.…”

Section: Discussionmentioning

confidence: 86%

“…We performed internal validation of our nomogram using our same full cohort of patients. For comparison, we also performed external validation of the nomogram created by Chun et al 10 using our data set. ROC curve analysis was performed for both of these nomograms.…”

Section: Methodsmentioning

confidence: 99%

“…ROC curve analysis was performed for both of these nomograms. Next, using our nomogram and that provided by Chun et al, 10 we performed decision curve analysis. 11 This method determines the net benefit, calculated as follows:…”

Section: Methodsmentioning

confidence: 99%

“…Conversely, a higher PSA was associated with a lower risk of prostate cancer. Validation of the nomogram created in this study and one created by Chun et al 10 was undertaken using our data ( Figure 3). Both curves show generally good calibration to the ideal curve across the range of risk levels.…”

Section: Pca3 In Repeat Biopsy Patients Ak Wu Et Almentioning

confidence: 99%

“…7 In men undergoing repeat biopsy, studies have suggested that PCA3 may be superior to both PSA 8 and free PSA 9 in predicting the presence of prostate cancer. Furthermore, inclusion of PCA3 improved predictive accuracy of a multivariable model that evaluated probability of having prostate cancer in men with elevated PSA, with or without prior biopsy in a recent study by Chun et al 10 Based on these findings, PCA3 was included in a multivariable nomogram designed to predict the presence of prostate cancer.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Utility of PCA3 in patients undergoing repeat biopsy for prostate cancer

Reese

Cooperberg

et al. 2011

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

BACKGROUND: Men with persistently elevated and/or rising PSA levels after negative prostate biopsy often undergo multiple repeat biopsies. Prostate cancer antigen 3 (PCA3) has emerged as a predictor of prostate cancer. METHODS:We sought to define the utility of PCA3 in combination with other clinical data in predicting the risk of prostate cancer on repeat biopsy. We retrospectively obtained PCA3, PSA, PSA density (PSAD), digital rectal examination (DRE) and transrectal ultrasound (TRUS) findings from 103 patients at a single institution who had at least one prior negative prostate biopsy. The sensitivity and specificity of PCA3 in detecting prostate cancer was determined. Receiver operating characteristics curves were produced for each variable individually and in multivariable analysis, controlling for PCA3, PSAD, TRUS, PSA and DRE. A nomogram was created, internally validated and compared to another recently published nomogram. RESULTS:Of the 103 patients, 37 (31%) had prostate cancer on repeat biopsy. The sensitivity and specificity of PCA3 (using a cut point of 25) was 0.67 and 0.64, respectively. In multivariable analyses, PCA3 was independently associated with prostate cancer (odds ratio: 1.02, 95% confidence interval: 1.01-1.04), with area under the curve (AUC) of 0.64. A multivariable model containing PCA3, PSAD, PSA, DRE and TRUS findings showed the most diagnostic accuracy (AUC: 0.82). CONCLUSIONS:In the setting of prior negative biopsies, PCA3 was independently associated with prostate cancer in a multivariable model. In combination with other clinical data, PCA3 is a valuable tool in assessing the risk of prostate cancer on repeat biopsy.

show abstract

Section: Discussionmentioning

confidence: 86%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Pca3 In Repeat Biopsy Patients Ak Wu Et Almentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Utility of PCA3 in patients undergoing repeat biopsy for prostate cancer

Reese

Cooperberg

et al. 2011

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

show abstract

Epithelial cell adhesion molecule is an independent prognostic marker in clear cell renal carcinoma

Eichelberg

Chun

Bedke

et al. 2012

Intl Journal of Cancer

Self Cite

View full text Add to dashboard Cite

Epithelial cell adhesion molecule (EPCAM) has recently attained a renewed interest as a candidate protein in diagnosis, prognostication and therapy of various tumor entities. The molecular epidemiology and prognostic relevance of EPCAM in renal cell carcinoma (RCC) and amongst the histological subtypes of RCC are unclear. We analyzed the prevalence and prognostic significance of EPCAM in a tumor tissue microarray composed of 1,088 independent RCCs samples by immunohistochemistry (IHC). We found significant variations of EPCAM IHC staining intensities in between the RCC subtypes: in papillary and chromophobe RCC, the majority of tumors (89-93%) showed an at least weak EPCAM protein expression. In the largest subgroup, the clear cell (cc)RCC (n 5 767), a negative EPCAM IHC was found in 1/3 of the patients and was associated with high-grade disease and nodal metastases. Kaplan-Meier analyses demonstrated a significant association between positive EPCAM IHC and prolonged overall survival, even in a subset of low-risk ccRCC. In multivariable analyses, EPCAM represented an independent risk factor of survival throughout all subgroups. For localized, low-grade ccRCC, information of EPCAM IHC raised predictive accuracy of a multivariate model by~5%, compared to T-stage and grade alone. Our findings indicate that EPCAM is an independent prognostic molecular marker in ccRCC and, especially in localized ccRCC, might be able to provide auxiliary information for a better prognostication.Today, the majority of diagnosed and treated renal cell carcinomas (RCC) represent early-stage tumors, assuming a high cure probability after localized therapy. Counterintuitively, the cancer-specific mortality rates have been rising over the last decades displaying RCC's rather unpredictable nature of disease.

show abstract

Personalized strategies in population screening for prostate cancer

Remmers

Roobol

2020

Intl Journal of Cancer

View full text Add to dashboard Cite

This review discusses evidence for population-based screening with contemporary screening tools. In Europe, prostate-specific antigen (PSA)-based screening led to a relative reduction of prostate cancer (PCa) mortality, but also to a substantial amount of overdiagnosis and unnecessarily biopsies. Risk stratification based on a single variable (a clinical variable or based on the presence of a lesion on prostate imaging) or based on multivariable approaches can aid in reducing unnecessary prostate biopsies and overdiagnosis by selecting men who can benefit from further clinical assessment. Multivariable approaches include clinical variables, and biomarkers, often combined in risk calculators or nomograms. These risk calculators can also incorporate the result of MRI imaging. In general, as compared to a purely PSA based approach, the combination of relevant prebiopsy information results in superior selection of men at higher risk of harboring clinically significant prostate cancer. Currently, it is not possible to draw any conclusions on the superiority of these multivariable risk-based approaches since head-to-head comparisons are virtually lacking. Recently initiated large population-based screening studies in Finland, Germany and Sweden, incorporating various multivariable risk stratification approaches will hopefully give more insight in whether the harm-benefit ratio can be improved, that is, maintain (or improving) the ability to reduce metastatic disease and prostate cancer mortality while reducing harm caused by unnecessary testing and overdiagnosis including related overtreatment.

show abstract

Prostate Cancer Gene 3 (PCA3): Development and Internal Validation of a Novel Biopsy Nomogram

Cited by 160 publications

References 24 publications

Utility of PCA3 in patients undergoing repeat biopsy for prostate cancer

Utility of PCA3 in patients undergoing repeat biopsy for prostate cancer

Epithelial cell adhesion molecule is an independent prognostic marker in clear cell renal carcinoma

Personalized strategies in population screening for prostate cancer

Contact Info

Product

Resources

About