Diagnostic Properties of Total and Free Prostate-Specific Antigen to Predict Overall and Clinically Significant Prostate Cancer Among Men With Low Testosterone and Prior Negative Biopsy

Schwarzman, Logan; Pagani, Rodrigo; Ohlander, Samuel; Mima, Mahmoud; Abern, Michael R.; Andriole, Gerald L.; Freedland, Stephen J.; Moreira, Daniel M.

doi:10.1016/j.urology.2019.11.004

Cited by 4 publications

(3 citation statements)

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“…The free-to-total PSA ratio and PSA density showed higher AUCs than the other PSA parameters for the prediction of PCa in men with low testosterone levels. Recently, Schwarzman et al reported that serum total PSA, free-to-total PSA ratio, and PSA density have comparable diagnostic values in screening for PCa in both men with low testosterone levels and men with normal testosterone levels and serum PSA levels of 2.5-10 ng/mL (16). The AUCs of total PSA, free-to-total PSA ratio, and PSA density for predicting overall PCa and csPCa in the low testosterone group were similar to those in the normal testosterone group.…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, the association between serum testosterone levels and PCa has been inconsistently reported in the literature (8)(9)(10)(11)(12)(13)(14). Furthermore, few types of research have been conducted on PSA as a screening tool for PCa or on the best cutoff value of PSA in men with low testosterone levels (15,16). To our knowledge, only limited studies are available about the performance of various PSA parameters in predicting PCa according to serum testosterone levels in Asian men with gray-zone PSA levels.…”

Section: Introductionmentioning

confidence: 99%

“…All rights reserved. https://dx.doi.org/10.21037/tau-21-1051 Supplementary † , the cutoff values of free-to-total PSA ratio and PSA density for Pca are 16.25 and 0.197 ng/mL 2 , respectively, and those for csPca are16.38 and 0.195 ng/mL 2 , respectively. Pca, prostate cancer; csPca, clinically significant prostate cancer, PSA, prostate-specific antigen.…”

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confidence: 96%

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Do prostate-specific antigen parameters have a similar role in predicting prostate cancer regardless of serum testosterone levels in men with gray-zone prostate-specific antigen levels?

Chung

Kim

et al. 2022

Transl Androl Urol

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Background: To evaluate whether various prostate-specific antigen (PSA) parameters have a similar diagnostic value in predicting prostate cancer (PCa) in men with gray-zone PSA levels (4.0-10.0 ng/mL) depending on different serum testosterone levels. Methods:We retrospectively reviewed the data of 635 men with gray-zone PSA levels who underwent prostate biopsy between January 2015 and December 2019. The study cohort was divided into two groups according to serum testosterone levels: normal (≥300 ng/dL) and low (<300 ng/dL) testosterone. Using the area under the receiver-operating characteristic curve (AUC), we analyzed the diagnostic accuracy of PSA parameters (total PSA, free PSA, free-to-total PSA ratio, testosterone-to-PSA ratio, and PSA density) in predicting PCa and compared the results between the two groups.Results: The median age was 68 (range, 40-88) years, and 76.1% (483 of 635) of the men had low testosterone levels. The PCa incidence was higher in the low testosterone group than in the normal testosterone group (45.5% vs. 35.5%, P=0.030). The AUC of free-to-total PSA ratio for predicting PCa showed no difference between the normal and low testosterone groups (AUC 0.616 vs. 0.684, P=0.257).Moreover, total PSA, testosterone-to-PSA ratio, and PSA density showed similar performance in predicting PCa between the two groups. Conclusions:The analyzed PSA parameters showed a similar diagnostic value in predicting PCa regardless of testosterone levels in men with gray-zone PSA levels.

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Section: Discussionmentioning

confidence: 99%