A Multi-institutional Prospective Trial in the USA Confirms that the 4Kscore Accurately Identifies Men with High-grade Prostate Cancer

Diagnostic accuracy of prostate health index to identify aggressive prostate cancer. An Institutional validation study

“…Aggressive tumors were identified as those having any Gleason 4 or 5 patterns in the prostatic biopsy, using the 2005 consensus Gleason definition. 7,8 Quantitative variables were expressed as median and range, and qualitative variables as rates. The efficacy of %fPSA, PSAd and PHI was compared through ROC curves analysis and thresholds to detect 90%, 95% of all tumors and 95% and 100% of aggressive tumors were generated.…”

Canadian Urological Association recommendations on prostate cancer screening and early diagnosis

“…The test has been validated in several subsequent studies evaluating previously screened men, unscreened men, and men with a prior negative biopsy 67,68,[70][71][72][73] (area under the curve [AUC] of 0.71-0.82). The 4Kscore was also validated in a large, prospective study of 1012 men from 26 different centres in the U.S. 74 The 4Kscore demonstrated a better discrimination in predicting Gleason ≥7 cancer compared to the modified Prostate Cancer Prevention Trial Risk Calculator 2.0 model (AUC 0.82 vs. 0.74; p<0.0001).…”

Emerging biomarkers in the detection and prognosis of prostate cancer

“…Also, the authors underline that the detection of high-grade tumors was delayed in only 0.63%-0.70% of patients compared with biopsying all patients with PSA ≥ 3 μg/L, using, respectively, the four-kallikrein panel or the fourkallikrein panel+DRE. More recently, a multicenter and prospective evaluation of the four-kallikrein panel in the detection of high-grade PCa has been published [71]. The study included 1012 men scheduled for prostate biopsy, obtaining an AUC of 0.82.…”