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Independent validation of a pre-specified four-kallikrein marker model for prediction of adverse pathology and biochemical recurrence

Rasmussen, Martin ; Fredsøe, Jacob ; Tin, Amy L. ; Vickers, Andrew J. ; Ulhøi, Benedicte ; Borre, Michael ; Eastham, James ; Ehdaie, Behfar ; Guillonneau, Bertrand and Laudone, Vincent , et al. (2022) In British Journal of Cancer 126(7). p.1004-1009
Abstract

Background: Accurate markers for prostate cancer (PC) risk stratification could aid decision-making for initial management strategies. The 4Kscore has an undefined role in predicting outcomes after radical prostatectomy (RP). Methods: We included 1476 patients with 4Kscore measured prior to RP at two institutions. The 4Kscore was assessed for prediction of adverse pathology at RP and biochemical recurrence (BCR) relative to a clinical model. We pre-specified that all analyses would be assessed in biopsy Grade Group 1 (GG1) or 2 (GG2) PC patients, separately. Results: The 4Kscore increased discrimination for adverse pathology in all patients (delta area under the receiver operative curve (AUC) 0.009, 95% confidence interval (CI) 0.002,... (More)

Background: Accurate markers for prostate cancer (PC) risk stratification could aid decision-making for initial management strategies. The 4Kscore has an undefined role in predicting outcomes after radical prostatectomy (RP). Methods: We included 1476 patients with 4Kscore measured prior to RP at two institutions. The 4Kscore was assessed for prediction of adverse pathology at RP and biochemical recurrence (BCR) relative to a clinical model. We pre-specified that all analyses would be assessed in biopsy Grade Group 1 (GG1) or 2 (GG2) PC patients, separately. Results: The 4Kscore increased discrimination for adverse pathology in all patients (delta area under the receiver operative curve (AUC) 0.009, 95% confidence interval (CI) 0.002, 0.016; clinical model AUC 0.767), driven by GG1 (delta AUC 0.040, 95% CI 0.006, 0.073) rather than GG2 patients (delta AUC 0.005, 95% CI −0.012, 0.021). Adding 4Kscore improved prediction of BCR in all patients (delta C-index 0.014, 95% CI 0.007, 0.021; preop-BCR nomogram C-index 0.738), again with larger changes in GG1 than in GG2. Conclusions: This study validates prior investigations on the use of 4Kscore in men with biopsy-confirmed PC. Men with GG1 PC and a high 4Kscore may benefit from additional testing to guide treatment selection. Further research is warranted regarding the value of the 4Kscore in men with biopsy GG2 PC.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
British Journal of Cancer
volume
126
issue
7
pages
1004 - 1009
publisher
Nature Publishing Group
external identifiers
  • pmid:34903844
  • scopus:85121104641
ISSN
0007-0920
DOI
10.1038/s41416-021-01661-x
language
English
LU publication?
yes
id
7630a940-d5b7-4ae9-aabc-61e77474b9b2
date added to LUP
2022-02-01 16:45:15
date last changed
2024-04-06 17:42:29
@article{7630a940-d5b7-4ae9-aabc-61e77474b9b2,
  abstract     = {{<p>Background: Accurate markers for prostate cancer (PC) risk stratification could aid decision-making for initial management strategies. The 4Kscore has an undefined role in predicting outcomes after radical prostatectomy (RP). Methods: We included 1476 patients with 4Kscore measured prior to RP at two institutions. The 4Kscore was assessed for prediction of adverse pathology at RP and biochemical recurrence (BCR) relative to a clinical model. We pre-specified that all analyses would be assessed in biopsy Grade Group 1 (GG1) or 2 (GG2) PC patients, separately. Results: The 4Kscore increased discrimination for adverse pathology in all patients (delta area under the receiver operative curve (AUC) 0.009, 95% confidence interval (CI) 0.002, 0.016; clinical model AUC 0.767), driven by GG1 (delta AUC 0.040, 95% CI 0.006, 0.073) rather than GG2 patients (delta AUC 0.005, 95% CI −0.012, 0.021). Adding 4Kscore improved prediction of BCR in all patients (delta C-index 0.014, 95% CI 0.007, 0.021; preop-BCR nomogram C-index 0.738), again with larger changes in GG1 than in GG2. Conclusions: This study validates prior investigations on the use of 4Kscore in men with biopsy-confirmed PC. Men with GG1 PC and a high 4Kscore may benefit from additional testing to guide treatment selection. Further research is warranted regarding the value of the 4Kscore in men with biopsy GG2 PC.</p>}},
  author       = {{Rasmussen, Martin and Fredsøe, Jacob and Tin, Amy L. and Vickers, Andrew J. and Ulhøi, Benedicte and Borre, Michael and Eastham, James and Ehdaie, Behfar and Guillonneau, Bertrand and Laudone, Vincent and Scardino, Peter T. and Touijer, Karim and Sørensen, Karina D. and Lilja, Hans}},
  issn         = {{0007-0920}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{1004--1009}},
  publisher    = {{Nature Publishing Group}},
  series       = {{British Journal of Cancer}},
  title        = {{Independent validation of a pre-specified four-kallikrein marker model for prediction of adverse pathology and biochemical recurrence}},
  url          = {{http://dx.doi.org/10.1038/s41416-021-01661-x}},
  doi          = {{10.1038/s41416-021-01661-x}},
  volume       = {{126}},
  year         = {{2022}},
}