Predictors of prostate cancer on repeat prostatic biopsy in men with serum total prostate‐specific antigen between 4.1 and 10 ng/mL

Okegawa, Takatsugu; Kinjo, Manami; Ohta, Masaya; Miura, Ichiro; Horie, Shigeo; Nutahara, Kikuo; Higashihara, Eiji

doi:10.1046/j.0919-8172.2003.00605.x

Cited by 11 publications

(4 citation statements)

References 27 publications

(73 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Another fact to be considered, which is still unedited, is the proposal for using the method presented here in the routine for performance of transrectal biopsies in patients with indication who, in case of a benign diagnosis even in the presence of suggestive changes (PSA and/or digital recital examination) could benefit from another parameter for increasing the specificity of PSA when altered values are maintained. When considering the possibility in the near future that these patients undergo a new invasive procedure that is not exempt from risks, we must remember the recent studies published by Okegawa et al (20) and Singh et al (21), showing that PSADTZ, as well as advanced age and presence of high grade PIN, is one of the strongest predictors for PCa in subsequent biopsies following the initial biopsy.…”

Section: Commentsmentioning

confidence: 99%

Assessment of serum level of prostate-specific antigen adjusted for the transition zone volume in early detection of prostate cancer

Ferreira

Koff

2005

Int. braz j urol.

View full text Add to dashboard Cite

Objective: To determine the clinical usefulness of prostate-specific antigen (PSA) density in the transition zone (PSADTZ) for increasing the specificity in early detection of prostate cancer (PCa) and reducing unnecessary biopsies in males with PSA between 4.0 and 10 ng/mL. Materials and Methods: This cross-sectional study obtained PSADTZ measurements in 68 patients with PSA between 4.0 and 10 ng/mL. All patients underwent transrectal ultrasonography (TRUS) with biopsies. PSADTZ was estimated by dividing the PSA value by the volume of the transition zone (TZ) obtained. We compared performance measurements for these parameters with those from the PSA itself, PSA density (PSAD) and free PSA/total PSA ratio (F/T PSA). The ability of the method in increasing PSA specificity was demonstrated and compared in univariate and multivariate analyses, and by Receiver Operating Characteristic Curves (ROC).Results: Of the 68 patients under study, 17 (25%) were diagnosed with PCa. The TZ volume (p = 0.001) and PSADTZ (p = 0.001) variables presented means that exhibited statistically significant differences. When compared with the area under the curve (AUC), ROC curves obtained by this method revealed that PSADTZ was the strongest predictor for PCa when considering the cut-off point provided by the curve; that is, 0.35 ng/mL/cc. When PSADTZ was employed, the detection failure would be close to 20%, and less than 45% of cases would undergo unnecessary biopsies. On the other hand, when F/T PSA was used, the loss would reach almost 40%; however less than 30% would undergo unnecessary biopsies. Nevertheless, PSADTZ had the only AUC presenting p < 0.05 in significance when compared with 50%, and was consequently discriminative.Conclusions: PSADTZ increased PSA specificity in early detection of PCa in males with PSA between 4.0 and 10 ng/mL. However, it was shown to have lower predictive value and lower accuracy than the percentage of free PSA since it presents a higher negative predictive value than all other parameters assessed, and it can be considered clinically useful for reducing unnecessary indications for biopsy.

show abstract

Section: Commentsmentioning

confidence: 99%

Assessment of serum level of prostate-specific antigen adjusted for the transition zone volume in early detection of prostate cancer

Ferreira

Koff

2005

Int. braz j urol.

View full text Add to dashboard Cite

show abstract

“…Повторная биопсия предстательной железы позволяет выявить рак простаты у 20% мужчин при отсутствии данных о наличии опухоли при первичном гистологическом исследовании [8,9]. Таким образом, 80% пациентов с повышенным сывороточным ПСА подвергаются излишним биопсиям.…”

Section: Discussionunclassified

The Combined Role of Herbal Therapy in the Prevention of Urinary Tract Infections During Prostate Biopsy

Г. В. Ільяш,

В. П. Глухов,

Н. Е. Авадієва

et al. 2019

View full text Add to dashboard Cite

Prostate biopsy is a routine method for diagnosing prostate cancer. However, there are a number of serious complications associated with this procedure, and especially development of infection.The objective. Evaluation of the effectiveness of complex herbal therapy in the prevention of infectious complications in patients exposed to prostate biopsy.Materials and methods. The study included 40 patients aged 48 to 69 years who underwent prostate biopsy. Patients with chronic prostatitis (category 4 NIH) were divided into two groups. Patients in the comparison group limited to standard antibiotic therapy, and the patients of the main group additionally received Canephron® N. The efficacy of the therapy was evaluated at 1, 2 and 6 months after the start of treatment by the dynamics of leukocyte count in prostate secretion and bacterial contamination, prostate– specific atigen (PSA) level, questionnaire data, ultrasound and urodynamic survey methods.Results. The level of PSA compared to baseline data, decreased by 56.9 % in the comparison group and by 67.6 % in the main group (p<0.05). A clinically significant bacterial titer and an increase in the number of leukocytes more than10 in sight, were registered in the comparison group in two times more often, than in patients of the main group.Conclusion. The results of the study make it possible to recommend for patients with chronic prostatitis of category 4 NIH the prescription of Canephron N.

show abstract

“…Finally, its pharmacodynamic and pharmacokinetic properties (9, 10) justified a once-a-week administration with 50 to 100 mg in an attempt to retain activity while substantially reducing toxicity. Subject selection was based on the notion that men with elevated circulating PSA and negative, noncancer biopsy findings constitute a suitable and relatively large population at higher risk of developing prostate cancer, for whom no intervention is currently available (11,12).…”

Section: Discussionmentioning

confidence: 99%

“…Men with elevated serum prostate-specific antigen (PSA) and negative prostate biopsies have a 20% to 25% risk of being diagnosed with cancer at subsequent biopsies (11,12). Because no standard treatment is available, chemoprevention represents a promising approach for these high-risk individuals (1,13,14).…”

mentioning

confidence: 99%

Phase I-II Trial of Weekly Bicalutamide in Men with Elevated Prostate-Specific Antigen and Negative Prostate Biopsies

Zanardi

Puntoni

Maffezzini

et al. 2009

Cancer Prevention Research

View full text Add to dashboard Cite

Background: Men with elevated prostate-specific antigen (PSA) and negative prostate biopsies are at risk for prostate cancer. The antiandrogen bicalutamide has a prolonged half-life, thus potentially allowing an intermittent administration to retain activity while reducing toxicity. We conducted a phase I-II trial of weekly bicalutamide in men with PSA >4 ng/mL and negative biopsies.Methods: Eighty subjects were nonrandomly assigned to a three-arm trial to either bicalutamide 50 mg/wk (n = 26) or 100 mg/wk (n = 28) or no treatment (n = 26) for 6 months. Blood samples were obtained at 0, 3, and 6 months, and prostate biopsies were repeated after 6 months. The outcome measures were 6-month changes of tissue Ki-67 (primary end point), high-grade prostatic intraepithelial neoplasia (HG-PIN), proliferative inflammatory atrophy, circulating PSA, and sex hormones.Results: Ki-67 expression was higher in HG-PIN than in normal tissue (10% versus 3%; P < 0.01) but was not modulated by bicalutamide in normal luminal cells. A trend toward an improvement of HG-PIN status was found in treated subjects (26% improved, 60% had no change, 15% worsened) as compared with the no-treatment arm (4% improved, 83% had no change, 13% worsened; P = 0.07). Proliferative inflammatory atrophy prevalence was not reduced by bicalutamide. Bicalutamide reduced PSA by 50% in both arms and raised testosterone and estradiol levels. Asymptomatic breast swelling was noted in 40% of the treated cases.Conclusions: A weekly administration of bicalutamide seems to be reasonably safe and shows an encouraging signal of activity on HG-PIN prevalence, supporting further studies of this schedule in men at high risk despite the negative primary end-point findings on Ki-67.

show abstract

Predictors of prostate cancer on repeat prostatic biopsy in men with serum total prostate‐specific antigen between 4.1 and 10 ng/mL

Cited by 11 publications

References 27 publications

Assessment of serum level of prostate-specific antigen adjusted for the transition zone volume in early detection of prostate cancer

Assessment of serum level of prostate-specific antigen adjusted for the transition zone volume in early detection of prostate cancer

The Combined Role of Herbal Therapy in the Prevention of Urinary Tract Infections During Prostate Biopsy

Phase I-II Trial of Weekly Bicalutamide in Men with Elevated Prostate-Specific Antigen and Negative Prostate Biopsies

Contact Info

Product

Resources

About