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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, T; Vickers, AJ; Haese, A; Becker, Charlotte LU ; Pettersson, K; Chun, FKH; Kattan, MW; Eastham, JA; Scardino, PT and Huland, H, et al. (2006) In International Journal of Cancer 118(5). p.1234-1240
Abstract
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... (More)
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. (c) 2005 Wiley-Liss, Inc. (Less)
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publication status
published
subject
keywords
free PSA, hK2, PSA, prostate cancer, biochemical recurrence, radical, prostatectomy
in
International Journal of Cancer
volume
118
issue
5
pages
1234 - 1240
publisher
John Wiley & Sons
external identifiers
  • wos:000235056100020
  • pmid:16152616
  • scopus:31844437949
ISSN
0020-7136
DOI
10.1002/ijc.21474
language
English
LU publication?
yes
id
47e10755-9919-4fc9-8d3a-5785527b9443 (old id 418192)
date added to LUP
2007-10-19 13:42:35
date last changed
2019-03-05 01:57:30
@article{47e10755-9919-4fc9-8d3a-5785527b9443,
  abstract     = {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 &lt;= 14 ng/ml (13%), and 28 patients (10%) With a pretreatment tPSA &lt;= 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 &lt;= 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 &lt;= 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. (c) 2005 Wiley-Liss, Inc.},
  author       = {Steuber, T and Vickers, AJ and Haese, A and Becker, Charlotte and Pettersson, K and Chun, FKH and Kattan, MW and Eastham, JA and Scardino, PT and Huland, H and Lilja, Hans},
  issn         = {0020-7136},
  keyword      = {free PSA,hK2,PSA,prostate cancer,biochemical recurrence,radical,prostatectomy},
  language     = {eng},
  number       = {5},
  pages        = {1234--1240},
  publisher    = {John Wiley & Sons},
  series       = {International Journal of Cancer},
  title        = {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},
  url          = {http://dx.doi.org/10.1002/ijc.21474},
  volume       = {118},
  year         = {2006},
}