PHI and PCA3 improve the prognostic performance of PRIAS and Epstein criteria in predicting insignificant prostate cancer in men eligible for active surveillance

Abstract

In a same cohort of patients eligible for AS, the addition of PHI and PCA3 to Epstein or PRIAS models improved their prognostic performance. PHI resulted in greater net benefit in predicting IPCa compared to PCA3.

Laboratory clinical staging index is a new multiparameter indicator for prostate cancer

“…Распространенность опухолевого процесса в предста-тельной железе рТ и степень ее дифференцировки (индекс Глисона) были использованы для разделения больных по агрессивности опухолевого процесса [10][11][12] Примечание. * -критерий значимости р между группами больных РПЖ при стадиях pT2a-b и pT2c; ** -критерий значимости р между группами боль-ных РПЖ при стадиях pT2c и pT3a; *** -критерий значимости р между группами больных РПЖ при стадиях pT3a и pT3b.…”

Tissue-based biomarkers in prostate cancer

“…[18] PHI is also available for those contemplating active surveillance (AS) as it correlates with those with Gleason 7 or greater. [19] 4K score has been shown in a large multi-institutional prospective trial to demonstrate its ability to predict Gleason 7 or greater prostate cancer prior to biopsy. [20] Urine-based tests include PCA3 which has been shown to have similar increased sensitivity in cancer detection of prostate cancer and predict those with Gleason 7 or greater prostate cancer in AS.…”

“…[20] Urine-based tests include PCA3 which has been shown to have similar increased sensitivity in cancer detection of prostate cancer and predict those with Gleason 7 or greater prostate cancer in AS. [18] [19] [21] These are just a few examples of urine and serum-based tests that are commercially available and certainly have a role in the detection and determination of active surveillance versus treatment aspects of prostate cancer management.…”

What Can Be Expected from Prostate Cancer Biomarkers A Clinical Perspective

“…Although in a double-blind PCA3 vs. PHI study, PCA3 seems to outperform PHI in cancer prediction accuracy, PHI remains the most accurate predictor when screening exclusively for significant PCa; thus, in population screening, authors recommend the use of PHI rather than PCA3 [49]. In a repeated biopsies environment, multiparametric MRI grading combined with PCA3 score are associated with better PCa detection rates [50,51] and in men eligible for AS, PCA3 can improve the prognostic performance of PRIAS and Epstein criteria for insignificant PCa [52]. Hansen et al [53] proved that the use of PCA3 within nomogram might improve the accuracy of the clinical model by 4.5-7.1% when predicting the risk of harboring PCa at initial biopsy.…”

“…The fact that SelectMDx becomes predictively valuable only after combining with other parameters, might be considered a limitation in itself. Although the algorithm outperforms PCA3 analyzed exclusively, one should notice that the construction of nomogram based on PCA3 and clinical data has also been undertaken in some already-mentioned studies [52,55]. Comparison between these tools and SelectMDx is yet to be performed.…”