Joshua S Jue1, Marcelo Panizzutti Barboza1, Nachiketh S Prakash1, Vivek Venkatramani1, Varsha R Sinha1, Nicola Pavan2, Bruno Nahar1, Pratik Kanabur1, Michael Ahdoot1, Yan Dong3, Ramgopal Satyanarayana1, Dipen J Parekh1, Sanoj Punnen4. 1. Department of Urology, University of Miami Leonard M. Miller School of Medicine and Sylvester Cancer Center, Miami, FL. 2. Department of Urology, University of Miami Leonard M. Miller School of Medicine and Sylvester Cancer Center, Miami, FL; Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy. 3. OPKO Diagnostics, LLC, Miami, FL. 4. Department of Urology, University of Miami Leonard M. Miller School of Medicine and Sylvester Cancer Center, Miami, FL. Electronic address: s.punnen@miami.edu.
Abstract
OBJECTIVE: To compare the predictive accuracy of prostate-specific antigen (PSA) density vs PSA across different PSA ranges and by prior biopsy status in a prospective cohort undergoing prostate biopsy. MATERIALS AND METHODS: Men from a prospective trial underwent an extended template biopsy to evaluate for prostate cancer at 26 sites throughout the United States. The area under the receiver operating curve assessed the predictive accuracy of PSA density vs PSA across 3 PSA ranges (<4 ng/mL, 4-10 ng/mL, >10 ng/mL). We also investigated the effect of varying the PSA density cutoffs on the detection of cancer and assessed the performance of PSA density vs PSA in men with or without a prior negative biopsy. RESULTS: Among 1290 patients, 585 (45%) and 284 (22%) men had prostate cancer and significant prostate cancer, respectively. PSA density performed better than PSA in detecting any prostate cancer within a PSA of 4-10 ng/mL (area under the receiver operating characteristic curve [AUC]: 0.70 vs 0.53, P < .0001) and within a PSA >10 mg/mL (AUC: 0.84 vs 0.65, P < .0001). PSA density was significantly more predictive than PSA in detecting any prostate cancer in men without (AUC: 0.73 vs 0.67, P < .0001) and with (AUC: 0.69 vs 0.55, P < .0001) a previous biopsy; however, the incremental difference in AUC was higher among men with a previous negative biopsy. Similar inferences were seen for significant cancer across all analyses. CONCLUSION: As PSA increases, PSA density becomes a better marker for predicting prostate cancer compared with PSA alone. Additionally, PSA density performed better than PSA in men with a prior negative biopsy.
OBJECTIVE: To compare the predictive accuracy of prostate-specific antigen (PSA) density vs PSA across different PSA ranges and by prior biopsy status in a prospective cohort undergoing prostate biopsy. MATERIALS AND METHODS:Men from a prospective trial underwent an extended template biopsy to evaluate for prostate cancer at 26 sites throughout the United States. The area under the receiver operating curve assessed the predictive accuracy of PSA density vs PSA across 3 PSA ranges (<4 ng/mL, 4-10 ng/mL, >10 ng/mL). We also investigated the effect of varying the PSA density cutoffs on the detection of cancer and assessed the performance of PSA density vs PSA in men with or without a prior negative biopsy. RESULTS: Among 1290 patients, 585 (45%) and 284 (22%) men had prostate cancer and significant prostate cancer, respectively. PSA density performed better than PSA in detecting any prostate cancer within a PSA of 4-10 ng/mL (area under the receiver operating characteristic curve [AUC]: 0.70 vs 0.53, P < .0001) and within a PSA >10 mg/mL (AUC: 0.84 vs 0.65, P < .0001). PSA density was significantly more predictive than PSA in detecting any prostate cancer in men without (AUC: 0.73 vs 0.67, P < .0001) and with (AUC: 0.69 vs 0.55, P < .0001) a previous biopsy; however, the incremental difference in AUC was higher among men with a previous negative biopsy. Similar inferences were seen for significant cancer across all analyses. CONCLUSION: As PSA increases, PSA density becomes a better marker for predicting prostate cancer compared with PSA alone. Additionally, PSA density performed better than PSA in men with a prior negative biopsy.
Authors: Juan Morote; Angel Borque-Fernando; Marina Triquell; Anna Celma; Lucas Regis; Richard Mast; Inés M de Torres; María E Semidey; José M Abascal; Pol Servian; Anna Santamaría; Jacques Planas; Luis M Esteban; Enrique Trilla Journal: Cancers (Basel) Date: 2022-05-11 Impact factor: 6.575
Authors: Salvatore M Bruno; Ugo G Falagario; Nicola d'Altilia; Marco Recchia; Vito Mancini; Oscar Selvaggio; Francesca Sanguedolce; Francesco Del Giudice; Martina Maggi; Matteo Ferro; Angelo Porreca; Alessandro Sciarra; Ettore De Berardinis; Carlo Bettocchi; Gian Maria Busetto; Luigi Cormio; Giuseppe Carrieri Journal: Front Oncol Date: 2021-05-20 Impact factor: 6.244
Authors: Boshen Jiao; Roman Gulati; Nathaniel Hendrix; John L Gore; Soroush Rais-Bahrami; Todd M Morgan; Ruth Etzioni Journal: Value Health Date: 2021-04-22 Impact factor: 5.101