TY - JOUR
T1 - Complexed prostate-specific antigen as a staging tool for prostate cancer
T2 - A prospective study in 420 men
AU - Sokoll, Lori J.
AU - Mangold, Leslie A.
AU - Partin, Alan W.
AU - Epstein, Jonathan I.
AU - Bruzek, Debra J.
AU - Dunn, Willard
AU - Mohr, Phaedre
AU - Wallerson, Gail
AU - Chan, Daniel W.
N1 - Funding Information:
This study was supported by Department of Defense Grant No. DAMD17-98-1-8468 and National Cancer Institute Early Detection Research Network Grant No. CA8623-02.
Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2002/10/1
Y1 - 2002/10/1
N2 - Over time, the parameters commonly used to predict pathological stage in men with localized prostate cancer have changed, and there is now little stratification in pretreatment prostate-specific antigen (PSA) concentrations, clinical stages, and biopsy Gleason scores. This prospective study evaluated the utility of complexed PSA (cPSA ) for predicting organ-confined disease in a contemporary series of subjects. The age range of the 420 men was 39 to 72 years (58.2 ± 6 years). Specimens were collected before radical prostatectomy, and total and free PSA (Hybritech Tandem assays, Beckman Access; Beckman Coulter, Inc., Brea, CA) and total and cPSA (Bayer Immuno 1; Bayer Corporation, Tarrytown, NY) were measured. Pathologic stage was determined from the prostatectomy specimen. Of the 420 men, 316 (75%) had organ-confined disease, and 104 (25%) had non-organ-confined disease (20.7% had extraprostatic extension, 2.6% had seminal vesicle involvement, and 1.4% had positive lymph nodes). Prebiopsy Gleason score distribution was as follows: organ-confined organ-confined, 6 (87%) and 7 (10%); non-organ-confined, 6 (66%) and 7 (30%). Of patients with organ-confined disease, 75% had clinical stage T1c disease compared with 56% for non-organ-confined disease. Using univariate logistic regression, the following variables predicted organ-confined disease: biopsy Gleason score, clinical stage, total PSA, percent free PSA, cPSA, percent cPSA (P <0.05). A multivariate model with biopsy Gleason score, clinical stage, and cPSA had a receiver operator characteristic area under the curve of 0.69. Replacing cPSA with total PSA in this model provided similar information. cPSA and total PSA were highly correlated (r = 0.985). In summary, cPSA was equivalent to total PSA in predicting organ-confined disease. Present and future models and nomograms using PSA as an indicator of pathological stage could consider use of cPSA.
AB - Over time, the parameters commonly used to predict pathological stage in men with localized prostate cancer have changed, and there is now little stratification in pretreatment prostate-specific antigen (PSA) concentrations, clinical stages, and biopsy Gleason scores. This prospective study evaluated the utility of complexed PSA (cPSA ) for predicting organ-confined disease in a contemporary series of subjects. The age range of the 420 men was 39 to 72 years (58.2 ± 6 years). Specimens were collected before radical prostatectomy, and total and free PSA (Hybritech Tandem assays, Beckman Access; Beckman Coulter, Inc., Brea, CA) and total and cPSA (Bayer Immuno 1; Bayer Corporation, Tarrytown, NY) were measured. Pathologic stage was determined from the prostatectomy specimen. Of the 420 men, 316 (75%) had organ-confined disease, and 104 (25%) had non-organ-confined disease (20.7% had extraprostatic extension, 2.6% had seminal vesicle involvement, and 1.4% had positive lymph nodes). Prebiopsy Gleason score distribution was as follows: organ-confined organ-confined, 6 (87%) and 7 (10%); non-organ-confined, 6 (66%) and 7 (30%). Of patients with organ-confined disease, 75% had clinical stage T1c disease compared with 56% for non-organ-confined disease. Using univariate logistic regression, the following variables predicted organ-confined disease: biopsy Gleason score, clinical stage, total PSA, percent free PSA, cPSA, percent cPSA (P <0.05). A multivariate model with biopsy Gleason score, clinical stage, and cPSA had a receiver operator characteristic area under the curve of 0.69. Replacing cPSA with total PSA in this model provided similar information. cPSA and total PSA were highly correlated (r = 0.985). In summary, cPSA was equivalent to total PSA in predicting organ-confined disease. Present and future models and nomograms using PSA as an indicator of pathological stage could consider use of cPSA.
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U2 - 10.1016/S0090-4295(02)01692-8
DO - 10.1016/S0090-4295(02)01692-8
M3 - Article
C2 - 12384158
AN - SCOPUS:0036789923
SN - 0090-4295
VL - 60
SP - 18
EP - 23
JO - Urology
JF - Urology
IS - 4 SUPPL.
ER -