A pilot study evaluating serum pro-prostate-specific antigen in patients with rising PSA following radical prostatectomy

Sottile, Antonino; Ortega, Cinzia; Berruti, Alfredo; Mangioni, Monica; Saponaro, Sara; Polo, Alessandra; Prati, Veronica; Muto, Giovanni; Aglietta, Massimo; Montemurro, Filippo

doi:10.3892/ol.2012.570

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…Sottile investigated the role of [−2]proPSA in the identification of patients with metastatic progression after RP [ 32 ]. In this study, 76 patients with BCR were retrospectively studied; the imaging performed at BCR time confirmed metastatic disease in 31 out of them.…”

Section: Discussionmentioning

confidence: 99%

“…Median PSA, free PSA (fPSA), %fPSA, [−2]proPSA and PHI were compared between metastatic and non-metastatic patients; [−2]proPSA was a statistically significant predictor of imaging-proven metastatic PCa. However, [−2]proPSA was assessed only at BCR time, so no information may be derived on its potential role, in predicting subsequent clinical progression, when measured at BCR time [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

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[−2]proPSA versus ultrasensitive PSA fluctuations over time in the first year from radical prostatectomy, in an high-risk prostate cancer population: A first report

et al. 2016

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Background[−2]proPSA and its derivatives have an higher diagnostic accuracy than PSA in predicting prostate cancer (PCa). In alternative to PSA, ultrasensitive PSA (uPSA) and [−2]proPSA could be potentially useful in recurrent disease detection. This research focused on [−2]proPSA and uPSA fluctuations over time and their possible clinical and pathological determinants, in the first year after RP.MethodsA cohort of 106 consecutive patients, undergoing RP for high-risk prostate cancer (pT3/pT4 and/or positive margins), was enrolled. No patient received either preoperative/postoperative androgen deprivation therapy or immediate adjuvant RT, this latter for patient choice. [−2]proPSA and uPSA were measured at 1, 3, 6, 9, 12 months after RP; their trends over time were estimated by the mixed-effects linear model. The uPSA relapse was defined either as 3 rising uPSA values after nadir or 2 consecutive uPSA >0.2 ng/ml after RP.ResultsThe biochemical recurrence (BCR) rate at 1 year after RP was either 38.6 % (in case of 3 rising uPSA values) or 34.9 % (in case of PSA >0.2 ng/ml after nadir), respectively. The main risk factors for uPSA fluctuations over time were PSA at diagnosis >8 ng/ml (p = 0.014), pT (p = 0.038) and pN staging (p = 0.001). In turn, PSA at diagnosis >8 ng/ml (p = 0.012) and pN (p < 0.001) were the main determinants for [−2]proPSA trend over time. In a 39 patients subgroup, uPSA decreased from month 1 to 3, while [−2]proPSA increased in 90 % of them; subsequently, both uPSA and [−2]proPSA increased in almost all cases. The [−2]proPSA trend over time was independent from BCR status either in the whole cohort as well in the 39 men subgroup.ConclusionsBoth uPSA and [−2]proPSA had independent significant fluctuations over time. PSA at diagnosis >8 ng/ml and pathological staging significantly modified both these trends over time. Since BCR was not confirmed as determinant of [−2]proPSA fluctuations, its use as marker of early biochemical relapse may not be actually recommended, in an high-risk prostate cancer patients population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

[−2]proPSA versus ultrasensitive PSA fluctuations over time in the first year from radical prostatectomy, in an high-risk prostate cancer population: A first report

et al. 2016

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“…Tosoian et al [ 10 ] found an association between baseline and longitudinal PHI, but not PCA3 [ 11 ] values and reclassification during active surveillance. Sottile et al [ 12 ] demonstrated significantly higher p2PSA and PHI levels in men with metastatic disease as compared to those without clinical metastasis. Collectively, PHI and/or PCA3 improve the selection of eligible patients for AS and decision curve analysis demonstrated that PHI outperforms PCA3 [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Epigenetic Signature: A New Player as Predictor of Clinically Significant Prostate Cancer (PCa) in Patients on Active Surveillance (AS)

Ferro

Ungaro

Cimmino

et al. 2017

IJMS

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Widespread prostate-specific antigen (PSA) testing notably increased the number of prostate cancer (PCa) diagnoses. However, about 30% of these patients have low-risk tumors that are not lethal and remain asymptomatic during their lifetime. Overtreatment of such patients may reduce quality of life and increase healthcare costs. Active surveillance (AS) has become an accepted alternative to immediate treatment in selected men with low-risk PCa. Despite much progress in recent years toward identifying the best candidates for AS in recent years, the greatest risk remains the possibility of misclassification of the cancer or missing a high-risk cancer. This is particularly worrisome in men with a life expectancy of greater than 10–15 years. The Prostate Cancer Research International Active Surveillance (PRIAS) study showed that, in addition to age and PSA at diagnosis, both PSA density (PSA-D) and the number of positive cores at diagnosis (two compared with one) are the strongest predictors for reclassification biopsy or switching to deferred treatment. However, there is still no consensus upon guidelines for placing patients on AS. Each institution has its own protocol for AS that is based on PRIAS criteria. Many different variables have been proposed as tools to enrol patients in AS: PSA-D, the percentage of freePSA, and the extent of cancer on biopsy (number of positive cores or percentage of core involvement). More recently, the Prostate Health Index (PHI), the 4 Kallikrein (4K) score, and other patient factors, such as age, race, and family history, have been investigated as tools able to predict clinically significant PCa. Recently, some reports suggested that epigenetic mapping differs significantly between cancer patients and healthy subjects. These findings indicated as future prospect the use of epigenetic markers to identify PCa patients with low-grade disease, who are likely candidates for AS. This review explores literature data about the potential of epigenetic markers as predictors of clinically significant disease.

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Surgical Procedures for Core Urology Trainees

Goonewardene¹,

Persad²

2018

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A pilot study evaluating serum pro-prostate-specific antigen in patients with rising PSA following radical prostatectomy

Cited by 4 publications

References 27 publications

[−2]proPSA versus ultrasensitive PSA fluctuations over time in the first year from radical prostatectomy, in an high-risk prostate cancer population: A first report

[−2]proPSA versus ultrasensitive PSA fluctuations over time in the first year from radical prostatectomy, in an high-risk prostate cancer population: A first report

Epigenetic Signature: A New Player as Predictor of Clinically Significant Prostate Cancer (PCa) in Patients on Active Surveillance (AS)

Surgical Procedures for Core Urology Trainees

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