Ability of preoperative serum prostatespecific antigen value to predict pathologic stage and DNA ploidy Influence of clinical stage and tumor grade

Kleer, Eduardo; Larson-Keller, Jeffrey J.; Zincke, Horst; Öesterling, Joseph E.

doi:10.1016/0090-4295(93)90558-r

Cited by 122 publications

(46 citation statements)

References 28 publications

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“…8,10 There is evidence, however, that combining clinical stage based on findings of a digital rectal examination and the Gleason score from examination of the biopsy specimen with the preoperative PSA level can improve preoperative staging accuracy. 8,9,11,12 Because recent studies have shown that a lower proportion of free PSA exists in the serum of men with prostate cancer compared with the serum of men with benign conditions, 15,16,[18][19][20][21][22] we postulated that a lower percent-free PSA value might predict rumor extension beyond the prostate in men with known prostate cancer. The results of our study indicate that percent-free PSA cannot be used to predict pathologic stage or extracapsular extension of prostatic adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Serum Percent–Free PSA Does Not Predict Extraprostatic Spread of Prostate Cancer

et al. 1998

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Percent-free prostate-specific antigen (proportion of free prostate-specific antigen [PSA] to total PSA) has been shown recently in studies on frozen serum samples to be more useful than total PSA alone in distinguishing prostate cancer from benign conditions of the prostate gland. The primary purpose of our study was to determine whether percent-free PSA could predict extraprostatic spread of prostate cancer. We also sought to evaluate the freeze-thaw stability of free PSA. Percent-free PSA values in fresh serum samples were compared with those in aliquots subjected to one to five freeze-thaw cycles. Percent-free PSA values in frozen serum samples from 130 men undergoing Prostate-specific antigen (PSA) is a 33-kd serine protease secreted almost exclusively by prostatic columnar epithelial cells.1 Serum PSA is the best and most widely used tumor marker for the early diagnosis and m a n a g e m e n t of prostate cancer.2 -5 Another major use of PSA is monitoring for recurrence in patients after radical prostatectomy; a detectable serum PSA value is a most sensitive indicator of residual or recurrent disease. 6 ' 7 PSA has proven to be less useful in preoperative staging of clinically localized prostatic adenocarcinoma,

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Section: Discussionmentioning

confidence: 99%

Serum Percent–Free PSA Does Not Predict Extraprostatic Spread of Prostate Cancer

et al. 1998

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“…These findings were in concordance with a previous British Journal of Cancer (1997) 75(5), [634][635][636][637][638] bone micrometastasis study using RT-PCR (Wood et al, 1994a). Recently, the negative predictive value (99.7%) of a low serum PSA concentration for bone scan findings has been demonstrated (Chybowski et al, 1991), but an elevated serum PSA concentration has not been predictive of bone metastases in individual cases (Osterling 1991;Kleer et al, 1993). However, this study has demonstrated that patients with a serum PSA concentration of 25 ng ml-' or greater had a significantly higher probability of bone involvement and that the sensitivity and negative predictive value for a serum PSA concentration of 25 ng ml-' or greater in predicting metastatic bone diseases were higher than those of bone scan and bone marrow aspiration.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, Chybowski et al (1991) have reported that patients with a low serum PSA concentration rarely have skeletal metastases. However, a high serum PSA concentration does not predict bone metastases because a substantial portion of patients with a high serum PSA concentration do not have bone metastases detectable by bone scan imaging (Osterling, 1991;Kleer et al, 1993). Failure to predict bone metastasis using the pretreatment serum PSA concentration might be attributed to the inability of conventional radiological scans to detect early bone metastases.…”

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confidence: 99%

Detection of micrometastatic prostate cancer cells in the bone marrow of patients with prostate cancer

Deguchi

Yang²,

Ehara³

et al. 1997

Br J Cancer

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Summary Thirty-five patients with prostate cancer were examined for micrometastases to the bone marrow using reverse transcription-polymerase chain reaction (RT-PCR) with primers specific for the prostate-specific antigen (PSA) gene. Of nine patients with bone metastases detectable by bone scan imaging, five patients had PSA mRNA expression in the bone marrow detectable by RT-PCR. Of 26 patients with negative bone scan findings, seven patients had PSA mRNA expression detectable in the bone marrow. RT-PCR could detect micrometastatic prostate cancer cells in the bone marrow that were not detectable by bone scan imaging. Of 16 patients with a serum PSA concentration of 25 ng ml-1 or greater, only nine (56.3%) had bone metastases detected by bone scans. Of the remaining seven patients, five had micrometastases to the bone marrow detected by RT-PCR. Overall, 14 of 16 patients (87.5%) with a serum PSA concentration of 25 ng ml-' or greater had metastatic bone diseases including bone marrow micrometastases. Of 19 patients with a serum PSA concentration of less than 25 ng ml-', two (10.5%) had only micrometastatic disease detected by RT-PCR. A significant correlation was observed between the incidence of bone involvement and the serum PSA concentration. This study suggests that RT-PCR will potentially develop into a relevant tool to assess bone involvement including bone marrow micrometastases and establish a precise correlation between serum PSA concentration and metastatic bone disease in patients with prostate cancer.

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“…Using a cut-off of 10 ng/ml, Oesterling et al [27] found a false-positive rate of 65%. Preoperative serum PSA has been found unreliable for predicting final pathologic stage, but the predictive power was significantly enhanced by combination with grade and clinical stage [28]. It is likely that the most effective use of pre-treatment serum PSA will be in combination with other prognostic factors [5].…”

Section: Psamentioning

confidence: 99%

Clinical staging of prostate cancer: Reproducibility and clarification of issues

Campbell

Blasko

Crawford

et al. 2001

Intl Journal of Cancer

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SUMMARY The American Joint Committee on Cancer (AJCC) staging system for prostate cancer adopted in 1992 is based on tumor-node-metastasis (TNM) designations. It has been widely accepted for use in local and advanced disease. The purpose of this study was to assess reproducibility of staging among observers and to help clarify staging issues. Twelve prostate cancer cases were sent to 20 physicians with special expertise in prostate cancer including eight urologists, eight radiation oncologists, and four medical oncologists. Physicians were asked to assign a stage based on the 1992 AJCC clinical staging. The most frequently reported stage assigned to each case was taken to be the consensus.

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Ability of preoperative serum prostatespecific antigen value to predict pathologic stage and DNA ploidy Influence of clinical stage and tumor grade

Cited by 122 publications

References 28 publications

Serum Percent–Free PSA Does Not Predict Extraprostatic Spread of Prostate Cancer

Serum Percent–Free PSA Does Not Predict Extraprostatic Spread of Prostate Cancer

Detection of micrometastatic prostate cancer cells in the bone marrow of patients with prostate cancer

Clinical staging of prostate cancer: Reproducibility and clarification of issues

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