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NADiA prosvue prostate-specific antigen slope is an independent prognostic marker for identifying men at reduced risk of clinical recurrence of prostate cancer after radical prostatectomy

Moul, Judd W. ; Lilja, Hans LU orcid ; Semmes, O. John ; Lance, Raymond S. ; Vessella, Robert L. ; Fleisher, Martin ; Mazzola, Clarisse ; Sarno, Mark J. ; Stevens, Barbara and Klem, Robert E. , et al. (2012) In Urology 80(6). p.1319-1327
Abstract

Objective: To validate the hypothesis that men displaying serum prostate-specific antigen (PSA) slopes ≤2.0 pg/mL/mo after prostatectomy, measured using a new immuno-polymerase chain reaction diagnostic test (NADiA ProsVue), have a reduced risk of clinical recurrence as determined by positive biopsy, imaging findings, or death from prostate cancer. Materials and Methods: From 4 clinical sites, we selected a cohort of 304 men who had been followed up for 17.6 years after prostatectomy for clinical recurrence. We assessed the prognostic value of a PSA slope cutpoint of 2.0 pg/mL/mo against established risk factors to identify men at low risk of clinical recurrence using uni- and multivariate Cox proportional hazards regression and... (More)

Objective: To validate the hypothesis that men displaying serum prostate-specific antigen (PSA) slopes ≤2.0 pg/mL/mo after prostatectomy, measured using a new immuno-polymerase chain reaction diagnostic test (NADiA ProsVue), have a reduced risk of clinical recurrence as determined by positive biopsy, imaging findings, or death from prostate cancer. Materials and Methods: From 4 clinical sites, we selected a cohort of 304 men who had been followed up for 17.6 years after prostatectomy for clinical recurrence. We assessed the prognostic value of a PSA slope cutpoint of 2.0 pg/mL/mo against established risk factors to identify men at low risk of clinical recurrence using uni- and multivariate Cox proportional hazards regression and Kaplan-Meier analyses. Results: The univariate hazard ratio of a PSA slope >2.0 pg/mL/mo was 18.3 (95% confidence interval 10.6-31.8) compared with a slope ≤2.0 pg/mL/mo (P <.0001). The median disease-free survival interval was 4.8 years vs >10 years in the 2 groups (P <.0001). The multivariate hazard ratio for PSA slope with the covariates of preprostatectomy PSA, pathologic stage, and Gleason score was 9.8 (95% confidence interval 5.4-17.8), an 89.8% risk reduction for men with PSA slopes ≤2.0 pg/mL/mo (P <.0001). The Gleason score (<7 vs ≥7) was the only other significant predictor (hazard ratio 5.4, 95% confidence interval 2.1-13.8, P =.0004). Conclusion: Clinical recurrence after radical prostatectomy is difficult to predict using established risk factors. We have demonstrated that a NADiA ProsVue PSA slope of ≤2.0 pg/mL/mo after prostatectomy is prognostic for a reduced risk of prostate cancer recurrence and adds predictive power to the established risk factors.

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publishing date
type
Contribution to journal
publication status
published
in
Urology
volume
80
issue
6
pages
1319 - 1327
publisher
Elsevier
external identifiers
  • scopus:84870711829
  • pmid:23107099
ISSN
0090-4295
DOI
10.1016/j.urology.2012.06.080
language
English
LU publication?
no
id
82d7ff68-5cc5-46fd-8542-95c20274151e
date added to LUP
2022-12-06 17:16:07
date last changed
2024-01-03 19:36:35
@article{82d7ff68-5cc5-46fd-8542-95c20274151e,
  abstract     = {{<p>Objective: To validate the hypothesis that men displaying serum prostate-specific antigen (PSA) slopes ≤2.0 pg/mL/mo after prostatectomy, measured using a new immuno-polymerase chain reaction diagnostic test (NADiA ProsVue), have a reduced risk of clinical recurrence as determined by positive biopsy, imaging findings, or death from prostate cancer. Materials and Methods: From 4 clinical sites, we selected a cohort of 304 men who had been followed up for 17.6 years after prostatectomy for clinical recurrence. We assessed the prognostic value of a PSA slope cutpoint of 2.0 pg/mL/mo against established risk factors to identify men at low risk of clinical recurrence using uni- and multivariate Cox proportional hazards regression and Kaplan-Meier analyses. Results: The univariate hazard ratio of a PSA slope &gt;2.0 pg/mL/mo was 18.3 (95% confidence interval 10.6-31.8) compared with a slope ≤2.0 pg/mL/mo (P &lt;.0001). The median disease-free survival interval was 4.8 years vs &gt;10 years in the 2 groups (P &lt;.0001). The multivariate hazard ratio for PSA slope with the covariates of preprostatectomy PSA, pathologic stage, and Gleason score was 9.8 (95% confidence interval 5.4-17.8), an 89.8% risk reduction for men with PSA slopes ≤2.0 pg/mL/mo (P &lt;.0001). The Gleason score (&lt;7 vs ≥7) was the only other significant predictor (hazard ratio 5.4, 95% confidence interval 2.1-13.8, P =.0004). Conclusion: Clinical recurrence after radical prostatectomy is difficult to predict using established risk factors. We have demonstrated that a NADiA ProsVue PSA slope of ≤2.0 pg/mL/mo after prostatectomy is prognostic for a reduced risk of prostate cancer recurrence and adds predictive power to the established risk factors.</p>}},
  author       = {{Moul, Judd W. and Lilja, Hans and Semmes, O. John and Lance, Raymond S. and Vessella, Robert L. and Fleisher, Martin and Mazzola, Clarisse and Sarno, Mark J. and Stevens, Barbara and Klem, Robert E. and McDermed, Jonathan E. and Triebell, Melissa T. and Adams, Thomas H.}},
  issn         = {{0090-4295}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{1319--1327}},
  publisher    = {{Elsevier}},
  series       = {{Urology}},
  title        = {{NADiA prosvue prostate-specific antigen slope is an independent prognostic marker for identifying men at reduced risk of clinical recurrence of prostate cancer after radical prostatectomy}},
  url          = {{http://dx.doi.org/10.1016/j.urology.2012.06.080}},
  doi          = {{10.1016/j.urology.2012.06.080}},
  volume       = {{80}},
  year         = {{2012}},
}